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HomeMy WebLinkAbout1956DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 36.30 -1 -14 BOX 18 ,,T„ . WO 01956 a „- c3154-31 ng, N 564 Oats WELL COMPLETION REPORT PUTNAM COUNTY. DEPARTMENT OF HEALTH 3/71 Division of Environmental .Health Services COUNTY OFFICE. BUILDING - CARMEL, NEW YORK This report is to be.completed by Well driller and submitted to County Health Department: together with laboratory report of analysisof-.watar sa- m..pleindicating :water- .is..o €s ,satisfartory baitierial.,quality before g cificate..of caonstruction.comoliance is Issued - REPORT MUST BE SUBMITTED WITHIN' 30 DAYS OF WELL COMPLETION. _z NAME ADDRESS OWNER James Carlucci. 16 Veterans Road, Patterson., NY LOCATION 2 (No.. & Street) (Town) (Lot Number) OF WELL Mallne Drive, Brewster, NY PROPOSED BUSINESS a DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ TEST.. WELL USE OF WELL 11 SUPP Y ❑ INDUSTRIAL ❑ CONDITIONING ❑ (speEfy) DRILLIN EQUIPMENT COMPRESSED R PERCUSSION ❑ CABLE ❑ .OPH Efy) ❑X ROTARY A PERCUSSION CA SING DETAILS LENGTH (lest) 3O t DIAMETER(lnchos) 6 n IWEIGHT PER FOOT 19. ® THREADED ❑ WELDED .•. YES NO WA; CASING TJUTED? YE5 NO ELD.. �...___ ._ ... TEST _._.. ,:_.:_....� .. -.... _..._ ._.,. ____' _... ��:_: �._ .. _.... -, _- �..- .= :��HOURS'""-,�'.'G.P.M. ❑.BAILED L PUMPED ❑ COMPRESSED AIR -�` -- -•- 6 71 YtEID "(Q.P:IN:J -" .�- . __.. - 71 WATER LEVEL MEASURE FROM LAND SURFACE — STATIC (Specify feet) 201 DURING YIELD TEST l lget) 2201 Depth of Completed Well in feet below Land surface: 2401 MAKE LENGTH OPEN TO AQUIFER (feet) SCREEN DETAILS. SLOT SIZE DIAMETER (lnchea) IF GRAVEL- Diameter of well including GRAVEL SIZE (Inches) FROM (lest) TO (feet) t. PACKED: gravel pack (lncheal: DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with dlatencea; to at least two permanent IanQmarks. FEET to FEET Drilling in overburden 0 .10 dirt, cla. and boulders Hit bedrock 1 10 30 Drilling in bedrock casing set and --routed _�,3. rock-granite.. //:r1 !,iAy 1 1986 D pT 4M cOVNT Y , OF Hl��LT� Af If yield was tested at different depths-during drilling, list below FEET GALLONS ' PER MINUTE DATE WELL COMPLETED DATE OF REPORT WELL DRILLER (Signature) l _z . - ..4� ELLIS A. TARLTON LABO:RAT1ORY DIVISION OF ELLIS A. TARLTON, ENGINEERS, INC. CHEMICAL' 34 PLEASANT STREET D ' NBURY, CONN. 06813 -2328 WATER - WASTEWATER PHYSICAL METHODOLOGY BIOLOGICAL P.O. BOX 2328 iO3-748-7903 APH�C EPA - ASTM __�.r.- <,....� _...- .a�EPCiI�T�OF`B�►C'T€i iOLOG(C�L "hND °C IE Ii ►L E AMINA%ION OF WATER NAME AND ADDRESS OF PERSON TO RECEIVE REPORT I Mr. James Carlucci 16 Veterans Road I Patterson, N.Y. 12563 tDATA SOURCE OF SAMPLE Water Supply, 12 Malone Drive Patterson, ,N.Y. DATE OF COLLECTION March 26, 19 8 6 COLLECTED BY J. Carlucci Hydrogen Ion COLOR TURBIDITY ODOR CORROSION INDEX DISSOLVED SOLIDS Concentration LANGELIER (PH) 6.3 3 .70 NTU none RYZNAR 2.80.0 . M04. Alkalinity as CaCO3 Fluoride IF) Nitrite .010 Mg /L Bicarbonate 34.0 Mg /L .60 Mg/ NITROGEN Alkalinity as C00O3 Chlorine Residual CONSTITUENTS Nitrate 5.60 Mg /L Carbonate 0 • Mg /L .00 MO/ AS NITROGEN (N) Total Hardness as caCO3 174.0 Conductivity 522.0 onia .000 Mg /L Mp /L Micromohos/cr Albuminoid -- Mg /L Iron as Fe • OO Mg /L Sodium 4 8.. O Mg/ Chlorides as CL 109.0 Mg /L Manganese as Mn • 00 Mg /L Mg/ Detergent as MBAS 0 • Mg /L Sulfate ae 604 .2 4 . 8 Mg /L Mg/ The arithmetic mean of all standard samples examined per month using the membrane filter (echnique shall not exceed one colony per 100mt. Coliform colonies-• per standard sample shall _not - exceed 3/50m1, 4 /100m1. 7/200m1, or 13/500ml in: la) Two consecutive aamplee;- (.).-More then one etin0ard sa'm'ple wAen' less than 76— 'ire' exitninet per °montA; —oi (c) More than five per cent of the samples when 20 or more are examined per month. MEMBRANE FILTER TEST Collform Colonies /1100MI. E AT THE TIME THE SAMPLE WAS SUBMITTED: ,. Tl:: rr..,Al[ c` the anWy::is o! !ilis iample were satisfactory and met requirements for a potable water. ® 2. The results of the analysis of this sample were satisfactory for a potable water but certain of the chemical or physical constituents were high. These 9gas follows: pH below 6.4 El3. This sample was not satisfactory since.itdid not meet the bacterial requirements for potable water. The presence of organisms of the Coliform group in a as I pf�t�lble water Is undereireble and, while not necessarily. Indicating the presence of any diseiwproducing organisms, does indicate that such contamination migIOurvive to tht�me extent. The presence of organisme.of the Coliform group.may also indicate.that thedreatment-was not adequate at the-time the sample was collect* r 4. This sample was unsatisfactory as a potable water because certain chemical or physical constituents were above acceptable limits.1 ese g Tel to V r O COMMENTS y�•q ���} Hard water, with above average mineralization and acid reaction. Physical,:appearance is good. No iron or manganese are present to cause brown metallic staining. Sanitary chemical history is good, showing no organic contamination by disposal system leachate. Chlorides are above the area isoahlor of 8.0 mg /1 and may be due to road salt or softener backwash. Sodium in excess of 20. mg /l is above the limit At which people on low salt diets should be warned. The rate of corrosion towards iron and copper is above average due to the chloride content. Certified .��� •,� A -1 Owner or Purchaser or Building MUMIcipality Building Cbns.tructE y Section : Malone,'Road 4. Location Street Bloc. : One Family Residence 3 Bui i.ng Typ e_ Lot. ' GUARANTY OF SEPARATE SEWAGE SYSTEM I represent that I,"am wholly and :completely responsible for the location, workmanship, material, construction and drainage of the sewage disposal system serving the above described property, and that it has been. constructed as shown on the 'approved 'plan or approved amendment thereto, " and in accordance with the standards; rules and regulations of the. Putnam County Department of Health, and :hereby guaranty to the owner,' his succ.es- sors, heirs or assigns, to place- in..good operating condition any`part.of Aid system constructed by me which fails to operate for a period. `of" "two years immediately following the. date of initial use of the sewage disposal system, or any repairs made.by me to such system, except where the failure to operate properly' is caused by the willful or. negligent act of the occu- pant of the building utilizing' the system:' The undersigned further . agrees to accept. as conclusive the de- termination o.f the Director -of:the Division. of Environmental Health Ser vic.as of:. -_ the"_ Pu .tnara..,.County- :D.epartrrient •of` Health. as 'to. whether failure of'the system'to operate'was caused by the willful or negligent act of the occupant.of the building utilizing the system. Dated this �O day of 19 Sgnature Title I corporation, glve.name and address) - - - - - - - - - - - - - -,; - - - - - - - - - - - - - - - - - - - THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS :BEFORE CERTIFICATE OF COMPISETION WILL BE ISSUED. GUARANTOR IS REQUIRED TO FILE NOTICE.OF TE OF FIRST USE OF SYSTEM. Division of Environmental Health Servic� !I��utna my Department of Health D pr�11,4 v, 19(96 �r� .,...,. ,.,. -.» .,. ;� ;,:,�•� �.^,n.� ++mow - ?g,,.',..^+,� «�r:r -•�aa a •c,. ¢ >., ...� �.,..mc.: s .,u n.r.� fi w , ;rn: w '.'�.. .r-,r r^^� ,..s:.,,'.k:^t s "r i ^..� ,.- '�SisTecr PUTNAM COUNTY .DEPARTMENT OF HEALTH Permit • ' I bivision of :Environmental Health, Services, Carmel,' -.N. Y. 1601 CONSTRUCTION ...PERMIT FOR SEWAGE DISPOSAL SYSTEM' Patterson Town or Village ' Ma'lone:. ^7 -� ._, „I_ocatad..at -= . _.Road: _ _ _ -- •Taz= .w,a� -.: � �• x>jlock � •a , �.bt� ,��.:,� - ....�.�.. Subdivision Map C, Put. LA-6 Subd. iota C Renewal p Revision i Owner /AddressJ.-Carlucci, 16 :Veteran RD .Patterson NY Date Of Previous Approval,• Building Type (1) F'am. R6s Lot Area l6, 000SF Fill Section only Number of Bedrooms 3 Design Flow G /P /D 600 P.C. H. D. Notification. Required 1000 420LF of 21 wide Leaching renche, Separate Sewerage System to consist of Gal. Septic Tank and g To be constructed by Bertrum Address Patterson, NY 12563 Water Supply: Public Supply From X_ Private Supply to be drilled by P.F. Beal Address Brews ter , agy Other Requirements 3ft. o.f . Bank Run Gravel Fill I represent that 1 am wholly and completely. responsible foi 'the design and location. of the proposed system(s). 1), that the separate sewage disposal system above described wiff lit constructed as shown on the approved amendment' there to and in accordance with the standards, rules and regulations o e u nam County Department of Health, and that on compietionthereof a' <'? Certificate of Construction Compliance" satisfactory to the. Commissloner.of Healthwill be submitted to the Department, and a written guarantee will be furnished the ,owner, his successors, heirs or assigns,by the builder, that said builder will place in good operating condition any part of said sewage 'disposal system during the period of two (2) years immedi ate ly.following the date of the Issu- ance of the approval of the Certificate of Construction Compliance of the original system "construction theret 2).thit the drilled well described above . will be located as shown on the approved plan and that said well will be Install accordance ards, ules and. regulations of the, Putnam County Department of Health. Date 12/3/84 Signed._ P.E. R.A. XX ;x ... Address MuS'cOOt North `RFD X 48 NY 5LAc�nse No. 1105E APPROVED FOR CONSTRUCTION. This ipproval'ezpires one year from date is d 'Issloner nn of th building has been undertaken and Is revocable for cause or may be amended.o►;modified when eM.' necessary. by the C lth. An change or alteration of construction requires a new "-""°�� permit. Approv for disposal ^of dourest Sawa d /or p water supply only. Date ` BY Title Rev. 9 -S . �x :�i.::''_JO =tom ,_.- - - -a+ - - �:..•,r.L iG+:tti5r� .. _ -.. x x... _�ar^� - -�7 .. " pUi'14AM COUNTY DEPARTMENT. OF. HEALTH.- DIVISION .0F'ENvmon4mTALEEAWH.SERVICES INDIVIDUAL WATER SUPPLY /SUBSURFACE SERE DISPOSAL . SYSTEMS FIQ� ......._._. .- INSPDGTh1 _ __. D.H. 1 Lot Depth to G.W. Depth to rock Soil Description 0 ``ft. 3 ft. 6 ft. 9 ft. D.H. 2. Lot Depth to G.W. Depth to rock 0 ft. 3 ft. 6 ft. 9 ft. 5011 Descr r D.H..- Deep Hole G.W.- Groundwater D.H. 3 Lot. Depth to G.W. Depth to rock Soil Description 0 ft. 3 ft. 6 ft. 9 ft. .12�..ft DATE: FINAL SITE INSPECTION INSP.BY: V, Y YES NO COATI'S House SSDS located per approved plan ............. Length of trench measured; Width.of trench average Slope of the line and trench acceptable......... Roam allowed for expansion trenches ............. DD 17iwA Over 100 ft. from watercourse., .................. Natural soil not stripped or SDS area unnecessarly graded ............................ 10 ft. maintained from property line and 20 ft. from house.* ..... I ...... Distance well to SSDS (ft.). Number of bedrocros checks.......... .............. Stones, brush, stumps, rubble, etc., greater ei�fl�D / than 15 ft. from nearest trench...............: 8 /.,Quo CEO 15 ft. of peripheral soil horizontally from trench ..... ............................... Braes properly set ...........:................... Could surface runoff from driveway,.roads, ground surface, etc., channel near SDS area.... Does lot drainage appear OK in area of SDS....... FINAL GRADING OF SITE ACCEPTABLE .................. r r Plumber CLOCK ,TIME ..5 PERCOLATION PERCOLATION No. Start Stop apse Time .-.Mina Depth to - Water From - Ground Start .- Inches. Surface Stop Inches Water ve in Inches Drop in Inches oil Rate Min. /in drop PTH #1 .... l...g 2__10:.19. :,45 ... , . . _ :. I0 :15 10:49 .. 30 . 30 :15 .15 . -. 17. 75. 17.75 . 2.75. 2. 15 30/2. 75_11 30%2.75 =11 -.3 10.. :.53 _. 11 :23 30 -.15 17 75... 2 75. 30/2:`75 =11 ..l _9 s'50._ ... -_ _ 1*,0 ,.:.20., - 30 16 : -- ._:_.lg:.. 3 . ..30/3 -10 2 10 : 21 _ to -5i 3n iF. ig.. 3 - 3ni�_i�. 3 i n :• rl,) 11:22 30 1 '7 C� . �n '7q_i i Notes: 1) Tdsts to be repeated at same raes are obtained at each percolation for review. °2) Depth measurements to be made depth until ao roximately equal soil test hole. All data to be submitted from top of` hole. ..5 Notes: 1) Tdsts to be repeated at same raes are obtained at each percolation for review. °2) Depth measurements to be made depth until ao roximately equal soil test hole. All data to be submitted from top of` hole. i / Mahoipac,NY 10541- Iv T THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: U y�F of �VN 0 "0 Soil Rate Approved-, Sq. Ft /Cal. - Checked by te. .. ... _; ... ; •►•tip j�� .. U zrzm -G.=" W' 41 ISTS '-� ~w. to c -l1L+ c -Sltt c•31iD c- 31G•(t 31SY c•�1G-1 ''s154 c -S1S� e: s1s5 ftP•MNCMIAfceA . tr�sr .. STOP. sTQni ' jI •w� 104 Til11K PQ' - Pa" - .. .. .... j _ n64P!LS �`, 50 1: •�• /st T�'� GO "� 1101 .. - _......... SG .6S ' /76 H = N o. ao� E• . ..-•`- ... -zoo �.. ' ' MC.!_.or•�E pL�.G (PAPER 00A0) SSDS SCALE. 17_40'. t.. • V S or•.1•• Tslw sopy"4f�6NLT' '.':C"' • )° - . ':..:': _ , ' J•d ■ + .JOEL LAWRENCE GREENBERG ° "•' 4 -za-ee ARCHITECT - TOWN . PLANNER ■itli1i••+ 'n•u.1+.9! ooc o.•.. •n 9//9/86 • `MR:.JAME5 CgQLUCGI'- 1 ruleooT NOIITN Ni0 •!, !o! 4:8. �dr•A0a60 _'MALONE.'P(AGG 1 e.•st•. t+ rAMOfAC NEW YORK 10f1 • -ro rLAt• ... ,+V�1J.. -.� _ NIA f!f f•t! 3 - -. DESIGN CRITERIA • . , "--^-- °___�._ �.^,_-- ... —.. _�_; - - - _ d 1. 3 BEDROOM HOUSE, 1000GALLON PRE- CAST*CONCRETE SEPTIC TANK REQUIRED. 1000GALLON PRE -CAST CONCRETE SEPTIC TANK PROVIDED. ...... 9 dG '4? b 2. SOIL 11 -15' MIN. f IN.'. = 0.8 µ DAILY FLOW 200 GALLON PER BEDROOM: -200 .X 3 =, 600 GPD• .Z......' 600'GALS; +- 0-.8'= '750SQ:'FT: ' +-2. °.-'375'LF :`R'EQUIR'ED.- ,.__7........ -, -- .... .. 7 di. 5" . •375 LF. PROVIDED -'8 -- _.'101... 101; 1 THIS IS TO CERTIFY THAT THE SEWAGE DISPOSAL SYSTEM WAS CONSTRUCTED AS INDICATED ON THIS PLALN.AND THAT THE SYSTEM WAS INSPECTED•BY-ME _ BEFORE IT WAS CQVERED OVER. THE SYSTEM WAS CONSTRUCTED IN ACCORDANCE WITH ALL STANDARD RULES AND REGULATIONS, OF THE PUTNAM COUNTY 0 DEPARTMENT OF HEALTH AND THE NEW YORK STATE -.78 '. DEPARTMENT OF HEALTH. =74 .63 • - .....15 _4...-28.. 251e SMTUNIC r,.Mt 'Op loalth 'II Pam CoffitY "Ith Ses°Saee Divieio ad � _ �rcaa09 Ia tl,,,, Of the -WELL 28 35 g avD 2, - ?E& ;• y Z No GAP- 'SACAE ce(NDme- S '- Dat g�Nataee 3C � 4�FiED .4 .5 .aPENCE .: t.. • V S or•.1•• Tslw sopy"4f�6NLT' '.':C"' • )° - . ':..:': _ , ' J•d ■ + .JOEL LAWRENCE GREENBERG ° "•' 4 -za-ee ARCHITECT - TOWN . PLANNER ■itli1i••+ 'n•u.1+.9! ooc o.•.. •n 9//9/86 • `MR:.JAME5 CgQLUCGI'- 1 ruleooT NOIITN Ni0 •!, !o! 4:8. �dr•A0a60 _'MALONE.'P(AGG 1 e.•st•. t+ rAMOfAC NEW YORK 10f1 • -ro rLAt• ... ,+V�1J.. -.� _ NIA f!f f•t!