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MEN
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01812
SITE LOCATION
PUTNAM COUNTY HEALTH DEPARTMENT.
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
PROPOSAL FOR SEWAGE TREATMENT SYSTEM REPAIR��
Repair Permit issued in last 5 years ❑ Not in Watershed
Repair within Boyd's Corners, W. Branch or Croton Falls Res. ❑ Delegated
Repair within 200 ft. of 'a watercourse or DEC - mapped wetland 2f�-doint Review
OWNER'S NAME
MAILING ADDRESS
Z /'Z'Z TOWN G G TM # 35 " 5 —34—
b LOAe-S (,l, QA1 PHONE# q /�f & 43a21
APPLICANT
Name & Relationship (i.e., owner, tenant, contractor)
DATE _ FACILITYTIYPE �h,,,,��.z�r. j PCHD COMPLAINT # 36o "/%
PROPOSED I TALLER !' „c�r,1 ��� G�- ��. -�� PHONE #
ADDRESS
pil 7 ►►+� "� �: %w /�. �•� REGISTRATION /LICENSE #
Proposal (include a separate sketch locating the house, property lines, all adjacent wells within 200
feet of repair and the location of existing and proposed system)
NOTE: The Department may require submittal of proposal from licensed professional depending on the
nature and
of the rep ir.
6�, P
I, as owner,agree to 711is a conditions stated form .
SIGNATURE ` E DATE O p
(owner)
I, the septic installer, agree to comply with the conditions of this permit for the septic system repair
SIGNATURE /L ... :.... TITLE ..� •..,.... DATE /4
(installer) ffi
Pro osaI a rove ith the foflowin conditions:
1. Procurement of any Town Permit, if applicable.
2. Submission of as built repair sketch by the septic system installer within 30 days of the repair, in duplicate showing:
a. Owner's name, Site Street Name, Town and Tax Map number
b. Location of installed components tied to two fixed points
c. System description (e.g., 1250 gal. Concrete septic tank, etc.)
d. Installers' name and phone number
3. System repair to be performed in accordance with the above proposal and conditions
4. The proposed SSTS repair is considered a best fit design and there is no guarantee to the duration at which the
completed SSTS repair will function.
5. No completed work is to be backfilled until authorization to do so has been obtained from the Department.
INTERNAL USE ONLY
Pro sal Approved Proposal Denied ❑
In ector's Signature & Title Date Expiration Date
Repair proposal is in compliance with applicable codes Yes 0 No
COPIES: PCHD; Owner; Installer
PC -RP 99ML Rev. 2/07
FRANK O FOWLER III, PE, LS
ENGINEERS.SURVEYORS.PLANNERS
72 South Rd
HOLMES, NEW YORK 12531
TO P-7
119ITT1212 @IF V ° ° H@59044La.
DATE JOB NO.
RE:
WE ARE SENDING YOU OA ached ❑ Under separate cover via the following items:
❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications
❑ Copy of letter ❑ Change order ❑
'THESE ARE TRANSMITTED as checked below:
�OF rapproval
o r your use
• As requested
• For review and comment
❑ FORBIDS DUE
REMARKS
❑ Approved as submitted ❑ Resubmit
❑ Approved as noted ❑ Submit _
❑ Returned for corrections ❑ Return —
—copies for approval
_ copies for distribution
corrected prints
❑ PRINTS RETURNED AFTER LOAN TO US
COPY TO
FRANK G FOWLER 111, PE, LS
ENGINEERS.SURVEYORS.PLANN ERS
72 South Rd
HOLMES, NEW YORK 12531
TO
WE ARE SENDING YOU ttached ❑ Under separate cover via the following items:
❑ Shop draw gs ❑ Prints ❑ Plans ❑ Samples ❑ Specifications
❑ Copy of letter ❑ Change order ❑
COPIES
PATEI
NO.
DESCRIPTION
/
THESE ARE TRANSMITTED as checked - below:
❑ For approval
,Por your use
�❑ As requested
❑ For review and comment
❑ FOR BIDS DUE
REMARKS
COPY TO
• Approved as submitted
• Approved as noted
❑ Returned for corrections
❑ Resubmit copies for approval
❑ Submit copies for distribution
❑ Return corrected prints
❑ PRINTS RETURNED AFTER LOAN TO US
SIGNED:
/f enclosures are not as noted, kindly notify us at
PUTNAM COUNTY DEPARTMENT OF HEALTH
FIELD ACTIVITY REPORT
;/ aJ R
Street Town State Zip
PERSON IN CHARGE 4 (1B_IlITFR VRWF7I: [
l
PUMP TEST 0. DOSE TEST
REQUIRED GALLONS
�f
1)4 51.x'
EL. START
i EL. STOP
I acknowledge receipt of this report: SIGNATURE:
02/96 Title:
PUT'I"A1I COUNTY DEPARTMENT OF HEALTH DIVISION OF
RONMENT��-HEALTH SER aC ES` --
All information must be fully completed prior to any
For: Fill 0,;VN
Trenches
Inspections being made.
PCHD Construction or Repair Permit #
Located: 2/ Z Z Z'Z (T) (V) �a
Owner /Applicant Name: D0101165° k cl In P%" TM Block 5; Lot 54-
Formerly: IVW Subdivision Name M1
Subdivision Lot # IVW
Is system fill completed? IV)kq Date: 12 zM &0-
Is system complete? Date:
Is system constructed as per plans?
Is well drilled? Ex/5-11170
Is well located as per plans?
Are erosion control measures in place?
Date: IVA
I certify that the system(s), as listed, at the above premises has been constructed and I have inspected
and verified their completion in accordance with the issued PCHD Construction Permit and
approved plans and the Standards, Rules yRe ations of t nam County Department of
Health. Date: / f Certified by: � W��� PEA / RA
Design Professional
Address:
/V
1Z ;3% Lic. # 59
t
Comments: F,JI� I�
(((�
"' i �.
S' �s:iC �Z -(..C. G3 ✓L-C :�i' �i(!.. --1
Z_
Form FIR-99
nviroW neritaI }
Protection
Caswell F. Holloway
Commissioner
— - _. _ .. _......_.._.. November 4, 2010
Mr. Joseph Paravati, Jr., P.E.
Putnam County Health Department
1 Geneva Road
Brewster, New York 10509
Paul V. Rush, P.E.
Re: Dolores Wunner SSTS Remediation
Deputy Commissioner
(T) Patterson, Putnam County
Bureau of Water Supply
prush @dep.nyc.gov
Bo Brook Reservoir Drainage Basin
g g
DEP Log #2010 -BB- 0976 -CR.1 (Joint Review)
465 Columbus Avenue
Valhalla, NY 10595 -1336
T:(845)340 -7800
F: (845) 334 -7175
r
co-
1
a
0
C
N
Dear Mr. Paravati:
This letter is to inform you that the New York City Department of
Environmental Protection (DEP) has no objection to the above - referenced
activity, subject to the following conditions:
1. The owner must maintain an effective septic tank pump -out schedule
until the subject repair is completed.
2. The subject repair cannot be used as a system to provide sewage
treatment for new construction or expansions on this site.
This determination is based on the review of submitted documents including
the drawings titled "Repair Site Plan for Sewage Disposal System for Dolores
Wunner," 2122 Route 22, Patterson, New York", dated October 20, 2010
If you have any questions, I maybe reached at (914)742 -2055.
c: Roger Sokol, NYSDOH
Sincerely,
Danny Shedlo, P.E.
Civil Engineer III
Wastewater Design Review EOH
NYC
Environmental , .. - -
Protection
Caswell F. Holloway
Commissioner
Mr. Joseph Paravati, Jr., P.E.
Putnam County Health Department
1 Geneva Road
Brewster, New York 10509
November 4, 2010
Paul V. Rush, P.E.
Re: Dolores Wunner SSTS Remediation
Deputy Commissioner
(T) Patterson, Putnam County
Bureau of Water Supply
Bo Brook Reservoir Drainage Basin
g g
prush @dep.nyc.gov
DEP Log #2010 -BB- 0976 -CR.1 (Joint Review)
465 Columbus Avenue
Valhalla, NY 10595 -1336
Dear Mr. Paravati:
T: (845) 340 -7800
F: (845) 334 -7175
0
CV
This letter is to inform you that the New York City Department of
Environmental Protection (DEP) has no objection to the above - referenced
activity, subject to the following conditions:
1. The owner must maintain an effective septic tank pump -out schedule
until the subject repair is completed.
2. The subject repair cannot be used as a system to provide sewage
treatment for new construction or expansions on this site.
This determination is based on the review of submitted documents including
the drawings titled "Repair Site Plan for Sewage Disposal System for Dolores
Wunner," 2122 Route 22, Patterson, New York ", dated October 20, 2010
- If youhave any questions, I may be reached•at• (914)742 -2055: - - -
c: Roger Sokol, NYSDOH
Sincerely,
Danny Shedlo, P.E.
Civil Engineer III
Wastewater Design Review EOH
FRANK G FOWLER 9019 PE, LS
ENGI NEERS.SU RVEYORS. PLAN N ERS
72 South Rd
HOLMES, NEW YORK 12531
TO
D
DATE
JOB NO.
ATTENTl�� - -�•— ...' .
RE:
NO.
DESCRIPTION
WE ARE SENDING YOU Attached ❑ Under separate cover via the following items:
❑ Shop dra Ings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications
❑ Copy of letter ❑ Change order ❑
COPIES
DATE
NO.
DESCRIPTION
THESE ARE TRANSMITTED as checked below:
or approval ❑ Approved as submitted
❑ For your use ❑ Approved as noted
❑ As requested ❑ Returned for corrections
❑ For review and comment ❑
❑ FORBIDS DUE
REMARKS
❑ Resubmit copies for approval
❑ Submit copies for distribution
❑ Return corrected prints
❑ PRINTS RETURNED AFTER LOAN TO US
N
COPY TO
SIGNED: -✓��'�
H enclosures are not as noted, kindly nodly us a nce.
J
I
kCj�
GAU -o,Js
Sp,�Jf05 �uS4'in�
f ii f ,c 1130
4370
11c) o6 ,51 0
. to S,4,)
1... .10 -165o1- 6c
-7 66
to
to &�a
/Y 16 1 A3 O
FRANK G FOWLER III, PE, LS
EN GI N EERS.SU RVEYO RS. PLAN N ERS
72 South Rd
HOLMES, NEVI/ YORK 12531
W--
WE ARE SENDING YOU ached ❑ Under separate cover via _
❑ Shop drawing ❑ Prints ❑ Plans
❑ Copy of letter ❑ Change order ❑
[AUU G3 OCF 4 ° e MMOVULad
' ''A
'
•
min
❑ Samples
the following items:
❑ Specifications
THESE ARE TRANSMiTTED'as checked below:
or approval
❑ For your use
❑ As requested
❑ For review and comment
❑ FORBIDS DUE
REMARKS
• Approved as submitted
• Approved as noted
❑ Returned for corrections
❑ Resubmit copies for approval
❑ Submit copies for distribution
❑ Return corrected prints
❑ PRINTS RETURNED AFTER LOAN TO US
COPY TO
SIGNED:
If enclosures are not as noted, kindly notify us at
SHERLITA AMLER, MD, MS, FAAP
Commissioner of Health
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
DEPARTMENT OF HEALTH
I Geneva Road, Brewster, New York 1 0509
ROBERT J. BONDI
County Executive
ROBERT MORRIS, PE
Director of Environmental Health
TO: DEPAI"ENT OF ENGINEERING AND DESIGN REVIEW
7
DELEGATION S'T'ATUS
FOR
SUBSURFACE SEWAGE TREATMENT SYSTEM PROGRAM
JOINT ICE VIE W
A J C9/1_v
PROJECT: (/�' U %'1 v)�! ` J
TOWN: f��a %�` s� SUB'D APP DATE—. ify`
NOTICE OF COMPLETE APPLICATION: DATE: l A�
❑ Within the drainage basins of West Branch, Boyds Corner Reservoirs or Croton Falls.
❑ Within 500 feet of a reservoir, reservoir stem or control lake.
❑ Within 200 feet of a watercourse or a DEC wetland and appearing on a subdivision
map approved after December 31, 1992.
❑. Design-1to_w greater than 1000 gallons /day.
Commerci Sal STS\ v
jtreviewrepair
Environmental Health (845) 278 -6130 Fax (845) 278 -7921
Water Supply Section (843) 225 -5186 Fax (845) 235 -5418
Nursing Services (845) 278 -6558 Fax (8=45) 278 -6026 WIC (845) 278 -6678
Nursing Home Care Fax (845) 278 -6085
Early Intervention /Preschool (8=45) 278 -6014 Fax (845) 278 -6648
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SY$TEM
Owner Qci 6/1e5
Address /V 5/ 1054�
Located at (Street) 2120 Tax Map Block Lot34—
Municipality (indicate nearest cross street) Waters . hed 6 CC/ 49101^0C)e"
SOIL PERCOLATION TEST DATA
Date of Pre-soaking .9' /70 //0 Date of Percolation Test -9/.--t, / /10
Form DD-97
.... ..
.............. ......... .....
W
D pffito'l-at'
Gr'o'0**
er
;::�`U.v Y
e
erc 4r
Hole No
..... . .. . .. ....
'R "n:No`;"'
....... 7.
.. ...
Start S to
osp. Ti me
II,
Surface Ofi nc'* h. e s
Start to
JDropp
. ... ..
M ne
ION
Z-
19
Z,
2
19
ZZ
3%!5,b
-7
3
z
4
'ea v7
9,
/9
S-4
5
5
%l�
19
22-,
'3
Z&
2
5
?2
3
56P147
�
-Z -3
ZLO
3
4
5
2
3
4
5
NOTES: 1.
Tests to be repeated at same
depth until approximately equal percolation rates are obtained at each
percolation test hole. (i.e.
min for 1-30 min/inch, s 2 min for 31-60 min/inch)
All data to be
submitted
for review.
2.
Depth measurements to be made from top of hole.
Form DD-97
DEPTH
G.L.
0.5'
1.0'
1.5'
2.0'
2.5'
3.0'
3.5'
4.0'
4.5'
5.0'
5.5'
6.0'
6.5'
7.0'
7.5'
8.0'
8.5'
9.0'
9.5'
10.0'
TEST PIT DATA
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
HOLE NO, ® �
5 91d,
t7�e
HOLE NO.
HOLE ^NO.
o;
2
Indicate level at which groundwater is encountered %!e,4 C_
Indicate level at which mottling is observed e4 it
Indicate level to which water level rises after being `ene untered Allf
Deep hole observations made by- �'nN�lowl� d6e 14MV0 75'� kf® Date
Design Professional Name:
Address: 72 57cei7,
Signature:
Design Professional's Seal
FO
9
a � a
Poor SW
FEATURES
1. Impeller
2. Casing
3. Mechanica
Seal
4. Shaft
5. Motor
6. Bearings -
Upper & Lc
7. Power cabl
8.O -Ring
1
a
MODELS
Series HP
Volts
Phase
Max.Amp. RPM Solids
Wt.
WE0311L
115
7.0
9.4
460
WE0312L '/3
_
230 _
WE1512H
4.7 1750
56
WE0311M
115
1
9.4 ,
9.2
WE0312M
23t
WE1534H
4.7
WE1512HH
WE0511H
115
15.0 80
13.0
208/230
WE0512H
230,
WE1534HH
6.5
3
WE0532H
208/230_
3
3.4
.3500
WE0534H
460
.3500
1.7
60
WE0511 HH
115
1
13.0
90
WE0512HH
_
230
60
6.5
WE0532HH w
208/230
65,
3.3
87
WE0534 HH
460
56
1.65
WE0712H
230
1
10.0
84
VVE-0-732FF 3/,
208/230
3
5.4 3500
WE0734H
460
,,45.
2.7
70
WE1012H
230
1
12.5
WE1032H
1 208/230_
3
7.0
WE1034H
460
WE0532H
3.5 _
WE1512H
230
1
15.0
WE1532H
208/230_
3
9.2
WE1534H
460
WE1534H
4.6
WE1512HH
,
1 /2 230
1
15.0 80
WE1532HH
208/230
1
9.2
WE1534HH
460
3
4.6
EFFLUENT EJECTOR SYSTEM
Effluent ejector system
offers ease of ordering
and installation. A single _
ordering number specifies
a complete system _
designed for most resi-
dential and commercial
sump and effluent pump
applications.
ISENECA FALLS. NEW YORK 13148
Package Includes:
Submersible Effluent Pump,
WE63,1L 12L or WE031 1 M,
12M, WE0511HH, 12HH
Mercury Level Control Switch
A2 -5 (115V), A2 -6 (230V)
Basin A7 -1801 S
Basin Cover A8 -1822
Check Valve A9 =20 `,
Order No.: SW E0311 C,
SWE0312L,
Goulds
_
q,u. S 4 , S .d f f ��.Y R •:� � R
ss
li '.. - s
x k q.�.J ± ` ,i
i
Y i m
gf� . r •
*f IS
PERFORMANCE RATINGS (Gallons Per Minute)
Series
WE0511H
WE0512H E0712
WE1012H
WE0511HH
WE151211 WE0512HH WE1512HH
N0.
WE0311L
WE0311M
WE0532H
WE0732H
WE1032H
WE1532H
WE053211H WE1532HH
WE0312L
WE0312M
WE0534H
WE0734H
WE1034H
WE1534H
WE0534HH WE1534HH
HP
''/3
%
'/2
%
1
1'/
'/2
1'/2
RPM
1750
1.750
3500
.3500
3500
3500.
.3500
3500 .
5
.100
.70
-.80 '
90
106
-
60
-
10
80
65,
76
87
102
112
56
84
15
60.:.
57
72
84
100
108
53
82
20.
.30 '.
,,45.
65.
79.
95
105..
._ 48
77 . .
25
25`1.;
59
'74
91
100
45
75
A
30
50
67
85
96 ,
-.40
.72:
3
35
.
40,:,?
.•:61
79
92..:
35
70
40
26
52
72
86
30
67
LL
45
10
64
80
25
64
d
50
30 J
54
73
18
60
=
55
17
42
65
12
58
0
60
6
30
54
3
54
�-
.65
70
5
26
47
75
14
43
80
4
40
90
33
100 24
110 15
120 5
DIMENSIONS.
(All dimensions in inches)
(Do not use for construction purposes.)
12Y2 ".'' x�
53/"-1
s
ROTATION >
2' NPT
3,/4"
-- KICK -BACK
SWE0311M, SWE0312M, D "'/3,'/2, %and 1 HP. 15 except for model.WE0712H &.WE1012H 113 "; .
SWE0511HH, SWE0512HH. 1Y2HP = 18
Available Certilicatlons:CO Canadian Standards Association '
Testing Laboratories
SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE. PRINTED IN U.S.A.
Performance
Curves
METERS FEET
h j�+
MODEL 3885
SIZE 3/4" Solids
GPM
L L
I
0 10 20 30 ml /h
CAPACITY
MGOULDS PUMPS, INC.
SeZCA FALLS NEW YDW 13148
METERS FEET
90
120
_.___11.0...
100
90
80
70
60
50
40
30
20
10
0
25
80
Q
70
w
v
2
20
J
H
660
0
H
50
15
40
10
30
20
5
10
0
0
h j�+
MODEL 3885
SIZE 3/4" Solids
GPM
L L
I
0 10 20 30 ml /h
CAPACITY
MGOULDS PUMPS, INC.
SeZCA FALLS NEW YDW 13148
METERS FEET
MODEL 3885
SIZE 3/4" Solids
0 10 20 30 40 50 60 70 80 90 100 110 120 GPM
L L I I
0 10 20 30 m' /h
CAPACITY
01985 Goulds Pumps, Inc. Effective July, 1985
35
_.
30
25
2 20
J
0
H
15
10
5
0
120
_.___11.0...
100
90
80
70
60
50
40
30
20
10
0
v
MODEL 3885
SIZE 3/4" Solids
0 10 20 30 40 50 60 70 80 90 100 110 120 GPM
L L I I
0 10 20 30 m' /h
CAPACITY
01985 Goulds Pumps, Inc. Effective July, 1985
:TABLE
n k
4
Friction Losses Through Plastic Fittings
in terms of Equivalent Lengths of Plastic Pipe
Type
Nominal Size Fitting & Pipe
of
1-1/411 1-1/211 211 2 -1/21'
311
411
Fitting
Equivalent Length of Pipe - Feet
900 STD. Elbow
7.0
8.0 9.0 10.0
12.0
14.0
45° Elbow
3.0
3.0 4.0 4.0
6.0
8.0
STD. Tee
(Diversion)
7.0
9.0 11.0 14.0
17.0
22.0
Check Valve
11.0
13.0 17.0 21.0
26.0
33.0
Coupling or
Quick Disconnect
1.0
1.0 2.0 3.0
4.0
5.0
Gate Valve
0.9
1.1 1.4 1.7
2.0
2.3
TABLE 5
FRICTION LOSS PER 100 FEET OF PLASTIC PIPE
FLOW
PIPE SIZE (IN.)
RATE
GPM
1 "
1 -1 /4"
1 -1 /2"
2"
2-1/211
3"
4"
2
0.3
3
0.6
4
1.0
0.3
5
1.5
0.4
0.2
6
2.1
0.6
0.3
7
2.9
0.8
0.4
8
3.6
1.0
0.5
9
4.6
1.2
0.6
10
5.5
1.5
0.7
0.2
12
2.1
1.1
0.3
14
2.7
1.3
0.4
16
3.5
1.7
0.5
0.2
18
4.4
2.1
0.6
0.3
20
5.2
2.5
0.9
0.3
2
3 0
3.8
5.2
1.
1.8
0.5
0.6
-; 35
24...._.
0:3
40
3.1
1.0
0.4
:45
3.8
1.3
0.6
50
4.7
1.6
0:7
60
2.2
0.9
0.2
70
2.9
1.2
0.3
80
3.7
1.5
0.4
90
4.6
1.9
0.5
100
2.3
0.6
9L�<<
'I'M
A
PUTNAM COUNTY. DEPARTI'VLENT OF HEALTH
DIVISIO-N, 017 ENVIRONIMENT-4&L HEALTH SERVICES
DESIGN DATA SHE —ET— SUBSURFACE _—)E__)k7AGE TREATMENITT SYSTEM
Address r,
Owner: v =0 YLe�_��
Located at (street, 3!( Block Lot
Municipality: 191, Watershed:
SOIL PERCOLATION TEST DATA
Witnessed by: Pair
Date of Pre-soaking: 1,3 0 //0 Date of Percolation Test:
I Note
-s:
1. Tests to be repeated at, same depth until armrox-i'mately acual ot-,colatiOr- Mies are
obtained a, each percolation esT hole. < 1 mir, fo-, 1-30 minimch, < mir for S.!'-,6(: rr. . in/incri i.
.6,11 data zo be submitted for revie•.
Depth m- asur- menis cc, be made from t
n of hole.
.1�
I i
i
. Depth to
Time
Elapse
water from
Water
i Percolation
Hole -No.
Run -No.
Start - -
-around
surfac-
'Me- _J
" - -,-- --r - -- I
Stop
(nnin.)
(inches)
in inches
mintline
Start - Stob
ZQ -1b.- 441
11�
-7
2
I to: Y i- s0
'07
3
I iav_ I
-7
L.
37
5
lr
1
1-7 -
2
-1 r- 'I L. 3 5'
03 -. a(,
4
1 3
li1:36- 1`:q�
i
1
-3
32
4
2
3
4
I Note
-s:
1. Tests to be repeated at, same depth until armrox-i'mately acual ot-,colatiOr- Mies are
obtained a, each percolation esT hole. < 1 mir, fo-, 1-30 minimch, < mir for S.!'-,6(: rr. . in/incri i.
.6,11 data zo be submitted for revie•.
Depth m- asur- menis cc, be made from t
n of hole.
.1�
03 Sln vie
5ok-W
A4.
-? I
03 Sln vie
12/17/2009 10:38
18452261108
INTERCOUNTY
RL!'1 NAM CCUN TY HEAL 1 H DERAFTkE
DIVISION OF ENVIRONMENTAL HEALrw SERVICES
THIS IS NOT A REPAIR PERM-IT
PROPOSAL FOR EXPLORATION OF SE-PTrC SYSTEM FAILURE
All information below must be UN compfeted priar to, any'schedufing
r1mur- 01.1 U1
SITE LOCATION 941 19a TOWN
OVAINER'S NAME a�•o ail rc'ari r��Nnl FHOI�IE 7/ - Q�t 1 �
MAUNG ADDRIESS _1&�R V1)C1';:JA -T&aAl 12 a1U JA4Q
f'RQPOScD CON i P.AC TO Fiji
P?-60N•G -0
A_� �
qaop E � S E Q rtE;1s- RA7laNIICi =vWir
Reason for_ exgforatiort:
❑ failure to surface 0 back -up in house V find limits of system for repair k other (explain baJow)
kly:excei:sectic.
') �, Ian
jt�
lie— 2�1
L,-j N.
(A
r
vt
0—
VI-I
41
LAC,
f-yo
041"
6u ve
cj, Lt- g `-, l - (", 5,vh---
IL
_ _ _ _ �_. �___ _ �._u .__..... w _v -k i _ ` y
UFO_-
I
MEMORY TRANSMISSION REPORT
JIME MAR709-2010., 04:00PM
TEL NUMBER 8�52787921*�
NAME ENVIRONMENTAL HEALTH
FILE NUMBER 493
DATE MAR-09 03:59PM
TO 819147730343
DOCUMENT PAGES 003
START TIME MAR-09 03:59PM
END TIME MAR-09 04:OOPM
SENT PAGES 003
STATUS OK
FILE NUMBER 493 SUCCESSFUL TX NOT ICE
SF- ,E:r-,Lr-t
2 3
--3
ofrzc!e ax :"3-+s 1:90. -r-
_! .•r: = /Y' 1liT� Y•G. -wS =_ :/ 'r
P.— a;-- 3-s z:::!-s i- tr,:y -.A
3"9 - %_;!
SHERLITA AMLER, MD, MS, FAAP
Commissioner ojHealth
LORETTA MOLINARI, RN, MSN ^ `~
Associate Commissioner of Health
ROBERT J. BONDI
County Executive
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
REQUEST FOR FIELD TESTING
All information below must be fully completed prior to any scheduling. DATE: ak(o
ENGINEERING FIRMI�5:- /b jam/ �L.1� PHONE
PERSON TO CONTACT: �,,�ruyilar
❑ NEW CONSTRUCTION XJtEPAIR PROGRAM ❑ ADDITION PROGRAM
REASON: DEEPSX PERCS X PUMP TEST: ❑
ROAD /STREET: 12!7-
TOWN: 'Zol // JJ ® r) TAX MAP #: 35o —5 —,q4-
SUBDIVISION: No e, . / LOT #: J�.l
OWNER: A0Q1ort! ' t1C/1I,Q e
NYCDEP CRITERIA FOR JOINT REVIEW AND WITNESSING OF SOIL TESTING
YES NO
❑
Proposed SSTS within the drainage basin of West Branch or Bo ds Corner &_. -..
Cro R
ton Balls eservoirs.
❑ Proposed SSTS within 500 feet of a reservoir, reservoir stem or control lake.
❑ Proposed SSTS within 200 feet of a watercourse or a DEC wetland.
❑ Proposed SSTS design flow greater than 1000 gallons /day or SPDES Permit required.
ox ❑ Proposed SSTS for a Commercial Project.
It is the responsibility of the design professional to provide the above information prior to soil testing.
The Department will determine the NYCDEP project status (Joint or Delegated) based on the response.
If you answered Les to any of the questions, NYCDEP must witness the soil tests. This Department will
coordinate a mutually suitable time for field testing with the Design Professional and NYDCEP.
If a project has been determined to be Delegated based on the above response and then subsequent
information indicates NYCDEP is required to witness the soil tests, it will be the sole responsibility of
the design professional to schedule re- witnessing of the soil testing with NYCDEP.
FOR.COUNTY USE ONLY
DATE: lr p a
COMMENTS:
TIME: 57 : 3,,>,11t14
REQ. FOR FIELD TFSTING:KLY
Environmental Health (845) 278 -6130 Fax (845) 278 -7921
Water Supply Section (845) 225 -5186 Fax (845) 225 -5418
Nursing Services (845) 278 -6558 Fax (843) 278 -6026 WIC (845) 278 -6678
Nursing Home Care Fax (845) 278 -6085
Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648
JAN -1 -2002 12:00P FROM: _ _ _ TO:8458784031 P:1 /1
COUNTY OF PUTNAM & TOWN OF PATTERSON I Bill No. ON660
2009 COUNTY & TOWN TAXES Sequence No. 2992
For Fiscal Year 01/01/2009 to 12/31/2009 • Warrant Date 12292008 Page No. l of 1
[AXE CHECKS- >PAAB'LE•'I100:
u.� r AK i i i r SiUA, Y FAiui i i 971W R -6.3#
:CE1V£R OF TAXES ! ATTU SON TOWN HAI..t, Address: 2122 Rt 22
BOX 421 1142 ROLFM 311 Town of: Patterson
TAN, NY 12563 PATTERSOK NY 12-%1 School: Brewster Central
5478A300 X 18 MUN - FR1 9 AM TO 3 PM NYS Tax & ,Finance School District Code:
Wunner Ernest 4312 - cras alwiiwl T oh $eect. i
Wtmner Dolores Parcel Dimensions, 750.00 X 0.00
248,Foggingtown Rd Account No. 018860
Brewster, NY 10509 Vank Code
T X-F r-,nr Estimated State Aid: TOWN 30,000
tOPER; Y 1 Ant•nYER � ore.1. Gr l�lvrl'i'S
he assessor estimates the , Full Market Value of this property as of July 1, 2007 was: 518,200
im Tou-1 Asse=d :rafi= ofvhdspr •"•i is: 51800
heUniform Percentage of Valite used to establish assessments in your municipality was: 100,00
f you feel your assessment is too high, you have the right to seek a reduction in the future. For further information, please ask your
ssesso 'O t'- '{1 -kW, "I low tea File 1 COII! lainC 6II Yatrr ASSe95SiEIIt��. 1'1C3a'C DOi► t::at t:lE period for filing complaints '_�_ !1SC
bove assessment has passed. ' "' ' _ . _ . _._�__._._. _._.. _ . ? _ , g p
F:emption Wig Tax Putnosc Eall_Va1ue E8L-W Exemption Value Tsz Punwac Full Value Fstimats�
:O:: T ;' ;,`"S .- ._.�...._..._........�_.... „h Change l roo► CasaWeAaesed valrrc 6tsus 51000
*zinc Pure Toul Tut Lew prior Year or Units u r py tlait DR AM0001
riOWHOMESTEAD PARCE1-01
Iwn Tax 4,862,636 0.8
i4vy q io,oUV V.7
reel! 'IY t'A•1, 1 11A '111 j•�
rubagc Uist UNITS
JLL PAYMENT DUE BY JANUARY 31
Nh urU. FA YNILN 1 M)L JANurU: P i l
DLLGCTING SATURDAY JANUARY 24 AT PATTBRSON TOWN HAU. 10_-1
.%1.11.1.111 \lJ Jf \l VJW /11 JIU \L' %V:l J1 A•! 1'lJ I l..11./ I_.1..L 1 UL!10USL 10 -1
iB PAYMENTS DUE WITH I %.MAR<`H PAYMENTS DUE WTM 2% PLUS 52.00
? i 3�v "v.UV
1.Lz i yi 4
:,1 )9.5
518,200.00
3.209608
1.663.22
iii,200.00
1"3i
,43.4i
S 1 R 21X) 4N)
.77717$
402.73
1.00
375,385800
375.39
-opaty description(s): 06900000020320000000 007500000OOOOO0000296 69 -2 -32
Yee..tltwenterrst A1rMOtertr - -- ..1AW UUt $3,745.26
1't Ry. n nnnn 1 roc ter. 3 �yc 2F
Apply For Third Party Notification By: 11/1 52009
Taxes paid by CA C t-i
,ETURN THE ENTIRE BILL WITH PAYMENT AND PLACE A CHECK MARK IN Tf S, BOX YOU WANT A RECEIPT
r t'A li A41sly 1. 1 iiL ALC LIV'ER'S STU R MUS't* till Kx rusuvr;U era 1 ii 1 °AY IALN7.
2009 COUNTY & '1'OWN TAX- S H;ll N.._ 04460
Iwn of: Palw xoll RECEIVER'S STEUB 372400 35. -S -34
ch /wl: Drewstc: Ccntrll
•open' fWdreas: 111E IU "
'Bank Code
Pay By: Gif VA-00i 3,745.26 3,745.26
Wunncr Pmest
Wunder Dolores
•''iJ Cu�iu lUwt7 kV
13rewsrer,' 10509
TOTAL TAXES DI IF,
$3,74516
Aug 0510 09:10a Frank Fowler 8458784031 p.1
SHERLITA AMLER, MD,. MS, FAAP
Commissioner of Heaali
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
DEPARTMENT OF HEALTH
I Geneva Road, Brewster, New York 10509
REQUEST FOR FIELD TESTING
ROBERT J. BOND[
"CbuxTy Lrzecritve _.._.._:.
All information below roust be fully completed prior to any scheduling. DATE: .512 6
ENGINEERING FIRVI:,LlC ggnt J rE PHONE S ej% �.
PERSON TO CONTACT:l7,,�
❑ NEW CONSTRUCTION AIEPAIR PROGRAM ❑ ADDITION PROGRAM
REASON: DEEPS: PERCS: PUMP TEST: El
ROADISTREET: Z/z z- Z--
TOWN: 'A07 of) TAX MAP #: 35. -.5
SUBDIVISION: Mn e- LOT #: /�l9
OWNER: VQ %[�/'tC'
NYCDEP CRITERIA FOR JOINT REVIEW AND WITNESSING OF SOIL TESTING
YES - - -NO-
❑ Proposed SSTS within the drainage basin of West Branch or Boyds Corner &
Croton Falls Reservoirs.
❑ Proposed SSTS within 500 feet of a reservoir, reservoir stem or control lake.
❑ Proposed SSTS within 200 feet of a watercourse or a DEC wetland.
❑ Proposed SSTS design flow greater than 1000 gallonslday or SPDES Permit required.
❑ Proposed SSTS for a Commercial Project.
It is the responsibility of the design professional to provide the above information prior to soil testing.
The Department will determine the NYCDEP project status (Joint or Delegated) based on the response.
If you answered des to any of the questions, NYCDEP must witness the soil tests. This Department will
coordinate a mutually suitable time for field testing with the Design Professional and YYDCEP.
If a project has been determined to be Delegated based on the above response and then subsequent
information indicates NYCDEP is required to witness the soil tests, it will be the sole responsibility of
the design professional to schedule re- witnessing of the soil testing with NYCDEP.
FOR COUNTY USE ONLY
DATE: TIME:
COMMENTS:
ACQ. FOR RE�.0:'U` WQXLY Environmental Health (845) 278 -6130 Fax (845) 278 -7921
Water Supply Section (845) 225 -5186 Fax (845) 225 -5418
Nursing Services (845) 278 -6558 Fax (843) 278 -6026 WIC (845) 278 -6678
Nursing Home Care Fax (845) 278 -6085
r.__i.. r ...- �....��:....ID.,.e..l.....1 M1r)')7R.Fflid Pav (QA5) �73Z-AFAR
j
1 g
I'}
a
• i
:
115. -- ----t- -- -- + - -- --- -'---- — - - -- - -- - - --!'-, � �-- f— - -t- -'- - -- --- ii L 2�� '
2'5Ch'40 P1C.
Folce Main I , i I F_ Z �" cc _
cor
I Castj /ron i 4' SOR 95 I j i p w
Ro i Cine 1X Mii -S /ope m C o
II
105 I i — - -I ' -- — _, a
CL
IN THE 'DESCRIPTION"
VALL SHOWN ALONG
'' --- — -- - -- -- - -- '-- j - - -
,. 100.7. --
� i
! 1 I I � i •I { I { I
j
Red Line represents I
Existing ; i , i I ! i of Eoster/y wo // referencing
of As Built dimension
i I i
90
40 80 120 160 200 240 280 320
210.43' S02 °20'15 11 W
Stone l40 // 216.80' . SO1 °54'20 "W -
B
Tofo ® 6B ' Eo.
J M Top
1, 000 Go% _ -- — _ C .
Sep. Tnk. 1000 Go% _ -' - _ OT ` -oM S1'd. Leo h Trench S i�he in
`- `5� - - •• /ev (9409
pump Ch - -- _
A7 e
— ..Foxe,
40 - - -- - _. —
Cost /ron _ -- -__ � � - ` �"� -�� •� \
�- _._-- - - ----
1 _. � = � __. - y-- -- - -- — __ ---��- - - -_ . \�� , �� �� , \ - -- - - -- Note.•
There are no wells within 200'
Septic System except os shown
1 Sty. S /ock • 1 2 `�., _ __\\ _ _ `_ _ \�
Goroge •''
I'll' Sty. Block
& Frome 1(lv p
osmg
3 Clev. 102.44
�FFFI IIFIJT TRFA
F
S. S. AS -BUIL T INFO.
NO.
A
Cor. Bldg.
B
Cor. Bldg.
C
SEE NO TE
BELOW
D
FA CE & END
SOUTH WALL
DESCRIPTION
1
24.5
21.0
TANK MANHOLE
2
17.5
52.2
PUMP CH. MANHOLE
3
10.6
95.9
DI S T. BOX
4
10.6
95.9
BEGIN TRENCH 1
5
21.5
91.9
BEGIN TRENCH 2
6
28.6
92.4
BEGIN TRENCH 3
7
17.8
28.8
END TRENCH 1
8
33.1
24.6
END TRENCH 2
9
44.2
25.5
END TRENCH 3
THE DISTANCES NOTED IN COLUMN C" ABOVE REPRESENT THE PERPENDICULAR DISTANCE TO THE POINT REFERENCED IN THE 'DESCRIPTION"
COLUMN FROM THE RED LINE SHOWN ON THE SITE PLAN AS BUILT THAT IS A LINE DRAWN PARALLEL TO THE STONE WALL SHOWN ALONG
ITS WESTERLY FACE.
PUMP CALCULATIONS: PRIMARY SEPTIC
DISTRIBUTION BOX INVERT .................. 132.0
BOTTOM PUMP CHAMBER .................. 94.0
STATIC HEAD .................. 38.0 (SH)
EQUIVALENT PIPE LENGTH (FOR 2" DIA. PIPE)
AMT. FITTINGS EACH TOTAL
2 45 ELBOW 4.0 8.0
1 CHFrK VA VF 17n 1 -7 n
2». e4 SOS