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02130
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CONSTR
Subdivision
owner /Address !–>
PUTNAM COUNTY DEPARTMENT OF HEALTH ENGINEER TO PROVIDE PERMIT #
ON CERT FICA E OF CO LIA E.
Division of Environmental Health Services, Carmel, N. Y. 10512 PERMIT if
N PERMIT FOR SEWAGE DISPOSAL SYSTEM / td 0` /r? el
�•C✓� ,l�t.`_'.�:.::':. ".' . �°.: �'. ..,.;�::.;';.- ;E:.:.:.. >:�,.,.. _.._._:.,. �. ":Ta;d:;ML]::a;.�_ --��- _- _alock
Town or Villajr
1?�_L.;"Ls,]i ...'� � •::�'.�:.... �,.,
f1
y Subd. Lot p Renewal Revision
/ f< � r,,
Building Type Lot Area
Number of Bedrooms — Design Flow G /P /,, U
Separate Sewerage System to consist of J Gal. Septic Tank
To be constructed by .�
Water Supply: Public Supply From
— Private Supply to be drilled by
Address /
Other Requirements z� �6' o� r 'r4 Mz
Date Of Previous Approval
Fill Section Only ❑—
P.C. H. D. Notification Required
andG'G'
Address
1 represent that I am wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate sewage disposal system
above described will be constructed as shown on the approved amendment there to and in accordance with the.standards, rules and regulations o e u ham
County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner 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 ppSiod of two (2) years immediately following the date of the issu-
ance of the approval of the Certificate of Construction Compliance of the origirdafl'sylstem or` -arm repairs thereto; 2) that the drilled well described above
will be located as shown on the approved plan and that said well will be Installed inofaccorbance viith the standards, rules and regu a ions of the Putnam
County Departm nt of Health.
Date /d � Signed °;� , ��'`a P.E.- R.A.
Address �` License No."�
� i'Y 1, _.�.. Y�:: °� h tl
APPROVED FOR CONSTRUCTION: Th approval expires one year from then ate issued unle const- uction of the building has been undertaken and is
revocable for cause or may be amended r modified when considered necessaGy, ;by „, thefCommiis {oner ,p(lHEalth. Any change or alteration of construction
require a new permit. Approved f r disposal of domestic sanitary sewage` and /prl0bte water U” I" only.
Date —cJ 17 By���N r _ra'�'� tle
y `r
Rev. 6/85 .pru..: �•.`.__.,:_.,...
e.
DEPARTMENT OF HEALTH
r Division of Environmental Health Services
TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914).225 -3641
CONvT12�JCT�- ptVAT ER "= IfEs -•,: :�:-
PCHD PERMIT #
WELL LOCATION
Street_ },A�ddress f Town Village it Tax Grid Number
iC,5r*W�2 O2 C'
WELL OWNER
,Name
Yr i
- _-_ r6!a
Address rivate
USE OF WELL
1 - primary
2 - secondary
ZRESIDENTIAL
® BUSINESS
® INDUSTRIAL
❑PUBLIC SUPPLY ❑AIR /COND /HEAT PUMP
❑ FARM ❑ TEST /OBSERVATION
O INSTITUTIONAL ❑ STAND -BY
OABANDONED
❑ OTHER (specify
AMOUNT OF USE
YIELD SOUGHT
gpm /#
PEOPLE SERVED /EST. OF DAILY USAGE Fed gal
REASON FOR
DRILLING
EW SUPPLY
❑REPLACE EXISTING SUPPLY
❑PROVIDE ADDITIONAL SUPPLY
ODEEPEN EXISTING WELL
®TEST /OBSERVATION
DETAILED
REASON FOR
DRILLING
WELL TYPE
nDRILLED
®DRIVEN
®DUG ®GRAVEL
®
OTHER
IS WELL SITE SUBJECT TO FLOODING? YES P" NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:
Lot No.,.
WATER WELL CONTRACTOR: Name / Kf47,110' �7'.3�e'� Address:
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES _/'NO
NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY
"DISTANCE- TO- °PROPERT`i-- FROM-NEAREST - 7,JATER--MAY'� y - - -
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED
®ON REAR OF THIS APPLICATION 260N SEPARATE SHEET
(date) .a.s �Ggn e) a
PERMIT
TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above is granted under the
provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and
provided that within thirty (30) days of the completion of water well construction,
the applicant.shall:
1. Pump the well until the water is clear.
2. Disinfect the well in accordance with the requirements of the Putnam
County Health Department attached to this permit.
3. Submit a Well Completion,Report on a form provided by the Putnam County
Health Department.
Date of Issue: D°,cp w � 19�
Date of Expiration :6RgALjL, ?19- �--- -- ermi t ssui ng ffi ci
Permit is Non - Transferrable
0
8/86
13
DAVID 'G.' BRUEN'-
County Executive
DEPARTMENT. OF HEALTH
Division Of Environmental Health Services.
November 26, 1986
Mr. Joseph F. Sullivan
2972 Ferncrest Drive
Yorktown Heights, New York 10598
RE: Proposed SSDS,
Groank
Dicktown Road
(T) Putnam. Valley
Tax Map# 4-1-15.2
Dear Mr. Sullivan:
Deputy Commissioner
Review of plans and other supporting documents submitted at this
time relative to the above captioned ptoject1has:been completed..
Comments are offered as follows:
In the future, Tax Map # should be included,on all documents,
/where indicated
.4 bedroom design should have a 1250 gallon septic tank, not,a
1200.gallon tan - plans accordiAg.ly
Keve.—..
property metes and bounds are lacking
plans' should indicate exact location of SSDS and well on
01-1' djacent lot, tax map number 4-1-15.3
Upon receipt of a submission-, revised to reflect the above comments,
this application will be'conside'red further.
Very rul eyours,
Anne Bittner
AB:pt
cc:AB
JK
File
Asst. Public Health Engineer
TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225-3641
County Executive
DEPARTMENT .OF HEALTH
Division Of Environmental Health Services
November 26, 1986
Mr. Joseph F. Sullivan
2972 Ferncrest Drive
Yorktown Heights, New York 10598
RE: Proposed SSDS
Groank
Dicktown Road
(T) Putnam Valley
Tax Map# 4 -1 -15.2
Dear Mr. Sullivan:
Ir
JOHN SIMMONS. M.D. I
Deputy Commissioner
Review of plans and.-o:their.supporting documents submitted at this
time relative.to the above captioned project has.been completed.
Comments are offered as follows:
In the future, Tax Map # should be included on all documents
where indicated-
..4 bedroom design .should have a 1250 gallon 'septic `tank,`- not .a
1200- _gallon.. tank revisA ,play., accordingly;
property metes and bounds are lacking
plans should indicate exact location of SSDS and.well on
adjacent lot, tax.map number 4 -1 -15.3.
Upon receipt of a submission; revised to reflect the.above comments,
this application will be considered further.
AB:pt
cc: AB
JK
File
Very rul yours,
o _
"Anne Bittner
Asst. Public Health Engineer
TWO COUNTY CENTER. - CARMEL, N.Y. 10512 (914) 225 -3641
PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMEUM HEALTH SERVICES
INDIVIDUAL WATER SUPPLY & SUBSURFACE SEDGE DISPOSAL SYSTEMS
p REVIEW SHEET - CONSTRUCTION PERMIT
,:!fie -:of -Owner i ( S
COMMENTS I YES
LF trench provided
required _
60 ft. max.
DATE REVIEW:c�
nation)
DOCUMENTS
Permit Application
Corporate Resolution
Plans - Three sets
Engineers Authorization
Design Data Sheet (DDS)
Deep Hole Log
Consistent Perc Results
30" Perc Hole
Other
s/s
SUBDIVISION
Perc
(3), Fill
cd
House Plans - Two sets
If PWS - Letter if wellipermit
Variance Request
REQUIRED DETAILS ON PLANS
Sewage System Plan
Sewage System Hydraulic Profile - Gravity Flow
Fill Profile & Dimensions - Volume
D or J Box;Trench /Gallery; Pump pit details
Septic Tank - Size, Detail
Well Detail, Service Line if over
Construction Notes
Design Data
Two-Foot Contours Existing & Proposed
Driveway & Slopes Cut
Footing /Gutter Curtain Drains
Perc & Deep Holes Located
Representative'of Sewage & Expansion Area
Expansion Area;shown;gravity flow,suff. size
If Pumped Pit I&! Box Shawn & Detailed
�Hc?iis =No -of Bedrooms
Wells & SSDS's w /in 200 ft. of Property Located
Property Metes & Bounds
House Setback Necessary (Tight lot)
House Sewer - 1 /4" /ft. 4 "0; Type pipe
No Bends; Max. Bends 45° w /cleanout
SEPARATION DISTANCE'JS SPECIFIED ON PLAN
Fields
10' to P.L., Driveway, Large Trees
20' to Foundation Walls
100' to Well; 200' in D.L.O.D,.150' pits
100' to Stream, Watercourse, Lake (inc. expan)
15' to Drains - Curtain, Leader, Footing
35'to catch basin,stormdrain,piped watercourse
10' to Water Line (pits -201)
50' intermittent drainage course
Septic Tanks
ran Foundation; 50' to well
15' Well to PL
GENERAL .
.Legal Subdivision
Subdivision Approval Checked
Ex- approval SSDS Adj. Lots Checked
Wetland (Town /DEC Permit R & D)
Data On DDS Plans & Permit Same
wO"._ ��
Re:
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Property of
Located at_
(T)�� 6
Subdivision of
Date
Block Lot %
Subdvo Lot # Filed Map # Date
Gentlemen:
This letter is to authorize
a duly licensed professional .engineer // .or registered architect
(Indicate
to apply for a Construction Permit for a, separate sewage system, to
serve the above noted property in accordance with the standards, rules
or regulations as promulagated-by the Commissioner of the Putnam County
Department of Health, and to sign all necessary papers on.my behalf in
connection with this matter and to supervise the-construction of said
s t erm- o-r: -s s-t em s -- n: - C onf ormi- -y �-wr th triz °irbwi "sio%s ' of �Axticle --- 1V5 "or_:.._.._.:. _
147, Education Law, the Public.Health Law, and the Putnam County Sani-
tary Code.
Very truly yours,
p/<�G Signed'
�3spt Dw,ner of "Propert`y'm-
Countersign,e�d�:>
P e E ` Vii ,\ l
c:.:..
e,w Address
Address -o - F Town
Telephone
Tele hone
DESIGN DATA SHEET SUBSUFACE SWAGE DISPOSAL SYSTEM FILE NO.
Ownerr C✓ Q �a r°�S' address I� /Ya J'' /•6'T ,_:.%j - '/Ui%i�%
Located at (Street) �� Gi/ 1`c ►yam . /7�' rL Sec. .. Block % Lot %3- 2
(indicate nearest cross street)
Municipality t, �i
! . o 15r,
Watershed'.
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS
Date of Pre- Soaking Diate of Percolation Test
HOLE
KEM. CLOCK TIME .
PERCOLATION
PIIRCbLATIC}N
Run Elapse
Depth to Water Fran
Water Level
No. Time
Ground Surface
In Inches
Soil Rate
Start -Stop Min.
Start Stop
Drop In
Min /In Drop
Inches. Inches
Inches
2,�FYZ C! S y % y
Z ,yam
4.
�) 5
3
4
5
1
2
3
4
5
NOTES' 1. Tests to be repeated'
are cbtaine3.at each
for review.
2. Depth measurements to
rev. 9/85
at same depth until approximatel y
percolation test.hole. All data:
be made from top of hole.
equal soil rates
to' be sukmitted
TEST PIT DATA REQUIRED.TO --BE'SUBMITTED WITH APPLICXTION
DESCRIPTION OF SOILS ENCOUNTE M IN TEST HOLES
DEPTH HOLE NO. HOLE Mo Z HOLE NO.
r. ~ : - .._ - _ _ .. - -• - -- r _. . cam-.._ ti= < . .: -� _ .. _...> r s .. _ ..� _..__•_ _
G.L.
2 9 a` r . —r✓dss
4°
5°
6°
7°
8°
g°
10°
11°
12'
13'
14'
_ -• _ - -_.._ - INDICATE I�VEL AT 6dIiIC�i GROON�WATER IS ENC�OU[�EEtF�D _ ._.__ _. r.__C�s� �- ...__.�. ...... t ... � ._ __ . .
INDICATE -LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED
DEEP HOLE, OBSERVATIONS MADE BY, � Bs� DATEa f/ �0
,> DESIGN -
Soil Rate Used ,!�? —_5 Min /1" Drop: S.D. Usable Area Provided _�S'ey
No. of Bedrooms � Septic Tank Capacity�'f1 gals..
Absorption Area Provided By GJ L.F. x 2411 width trench
Other
cmn>r.
� �o
9 A A:o'oA:A A �
Name 4g'� / �� Sig tint r
p
�[ y7 lam, s
Address Z�/� r, p
THIS MeZ FOR USE BY HEALTH DEP ONLY:
,:'Soil Rate Approved sgaft /gal. Checked=by Date
ENGINEER -MUST (�•—� !/
b PUTNAM COUNTY DEPARTMENT OF HEALTH PROVIDE
i` Division of Environmental Health Services, Carmel, N. , Y. 10512 — )v
PJERMIT #
CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM
Town or. village
Located at If ;Tax.MaP', - _.�__..... rBlock. ._... �.�...._...
OwnerCA -1 t$ /3V V r® / Formerly Tax Map Lot N 4r / 2 Subd. Lot q
Separate Sewerage System built by i7e::; -fV h was Address G6�s �� A'
Consisting of J>:S*Z' —Dal. Septic Tank and �b V 2- 0
Other requirements / /5! (/ 1-15
Water Supply: Public Supply From
Private Supply Drilled By
Address
Building Type� No, of Bedrooms Date Permit Issued
Has Erosion Control Been Completed? Has garbage grinder been installed? /V 9
�,�Q�6pou3u
I certify that the system(s) as listed serving the above premises were constructed ease %.1))ras[Ij�i�an the plans of the completed work ( copies
of which are attached), and in accordance with the standards, rules and regulations, a;tCrd§agL�. th iled plan, and the permit issued by the
Putnam County Department Of Health. .SA
�aa � � .Afro.
a
Date Certified by aA * P.E. R.A.
' r•� vs'g:i,. fit
Address.= -' ' • h License No.
Any person occupying premises served by above systems) shall promptly take such'ictfolwas may be
conditions resulting rom such usage. Approval of the separate sewerage r "' ,� `"
g 9 ge system shall beCO 1 null ah
available and the approval of the private water supply shall become null and void when a�pitb►ie =wate
subject to modification or change when, in the judgment of the Commissioner of Health, °'suthYAVOi
Da_ -�_b_
Rev. 6/85
:ure the correction of any unsanitary
as a public unitary sewer becomes
tes available. Such approvals are
ition or change Is necessary.
Y®rkt®wrn Medical Lab®rato .ry9 Inc.
321 Kear Street
Yorktown Heighes,.N: Y. 10595 -
(914) 245 -3203
Director: Albert H. Padovani M T. (ASCP)
Ali, /, :1 7
I/02771- Jl • ieoe'- Pfiie�
LAB d � E.7. 006171
Date Taken: '111- O Time: y
77
Date Reported: NOV. q 19g
Collected By: v1, /'r'e_ 0,0 -,e,�,
Referred By:
Sample Location: 2 444,,r.:4
Phone 9
Phone 0 Sample Type:,
Repeat Test? v (check one)
/ i
✓ Potable
_LABORATORY REPORT ON THE BACTERIOLOGICAL QUALITY OF WATER _ Non - potable;
GENERAL BACTERIA
_ Standard Plate Count (CFU /1.OmL)
(Agar* Plate. @ 35 °C)
MEMBRANE FILTRATION TECHNIQUE (MFT)
/Total,Coliform (CFU /100mL)
Fecal Coliform (CFU /100mL)'
— Fecal Streptococcus.(CFU /100mL)
MOST PROBABLE NUMBER TECHNIQUE .(MPN)
Total Coliform: MPN Index (per 100mL)
_ Fecal Coliform: MPN Index (per 100mL)�
OTHER ANALYSES
REMARKS (For Laboratory Use)
I()
_ STP -INF
_ STP EFF
Other-..
Sample Status:'
(check each)
Outgoing
® Na2S203 .
Incoming
_V'l LE k °C
_ GT k °C
_ Other:
KEY FOR TERMINOLOGY
RDS = Recommend Disinfec-
tion of Source
TNTC= Too Numerous To Count
CON = Confluent ( =TNTC)
LT = Less Than (<)
GT = Greater Than ( >)
N/A = Not Applicable
LV = T.Paa than nr eeual to
THESE RESULTS INDICATE THAT THE WATER SAMPLE, WAS)
(WASN'T) (N /A) OF A
SATISFACTORY SANITARY QUALITY ACCORDING TO THE YORK STATE DRINKING
WATER STANDARDS, FOR THE PARAMETERS. TESTED, AT'THE TIME OF COLLECTION.
X/
Alber H. Padovani, N.T. ASCP , Directors'
12 /85(RwsdT /8T)RWE
For Lab Use Only:
H/C to
LAB OFFICE HOURS (Main Lab):
9AN -5PM, Mono -Fria
9 AN -NOON q Sat.
O CO..
WELL UUE1rLh_11UN tcLrVMI
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
ETJTNAt�f 'COU'iJTY...DEPiARTMENT' OF.; HEALTH ::
Office Use Only
WELL LOCATION
ST "T �10U ESS: _. ��tL Y TAX GRID NUMBER:
r
WELL OWNER
NAME: ADORES
/ a�
p PUBLICS
USE OF WELL
1 - primary
2 - secondary
fWRESIDENTIAL O PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP O ABANDONED
❑ BUSINESS ❑ FARM O TEST /OBSERVATION ❑ OTHER (specify)
❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑
MOUNT OF USE
oo gal.
YIELD SOUGHT S gpm. /N0. PEOPLE SERVED / EST. OF DAILY USAGE
REASON FOR
DRILLING
® NEW SUPPLY ❑ .PROVIDE ADDITIONAL SUPPLY ❑ TEST / 08SERVATION
❑ REPLACE EXISTING SUPPLY O DEEPEN EXISTING WELL
DEPTH DATA
' WELL DEPTH SOO / ft.
STATIC WATER LEVEL � '� ft.
DATE MEASURED v � A
DRILLING
EQUIPMENT
-0-ROTARY ❑ COMPRESSED AIR PERCUSSION ❑ DUG
❑ WELL POINT ❑ CABLE PERCUSSION O OTHER (specify):
WELL TYPE
❑ SCREENED ❑ OPEN END CASING. %OPEN HOLE IN BEDROCK ❑ OTHER
CASING
DETAILS
TOTAL LENGTH tL
MATERIALS: 0 STEEL ❑ PLASTIC O OTHER
LENGTH.BELOW GRADE ft.
JOINTS: O WELDED ® THREADED O OTHER
DIAMETER 6' F' in.
SEAL: ❑ CEMENT GROUT O BENTONITE 3ROTHER
WEIGHT
PER FOOT JC' .Ib. /ft.
I DRIVE SHOE. AYES ONO
LINER: O YES ANO
SCREEN
DETAILS
DIAMETER (in)
SLOT SIZE
LENGTH
(ft)
DEPTH TO SCREEN (ft)
DEVELOPED?
FIRST
O YES ONO
HOURS. :.
SECOND
_... - .:.
GRAVEL PACK
❑ YES
❑ NO
GRAVEL
SIZE:
DIAMETER.
OF PACK in.
TOP
DEPTH ft.
BOTTOM
OEM It.
WELL YIELD TEST If detailed pumping
METHOD: O PUMPED 1 tests were done is in-
COMPRESSED AIR , formation attached?
O BAILED O OTHER i D YES D NO
WELL LOG It more detailed formation descriptions or sieve analyses
are available, please attach.
DEPTH FROM
SURFACE
Water
Bear-
ing
well
Dia-
meter
FORMATION DESCRIPTION
Ap
c00E,
ft.
ft.
WELL DEPTH
ft.
DURATION
hr. min.
DRAWDOWN
ft,
YIELD
gpm.
Suriace
A0
1
r
P�
f
WATER ❑ CLEAR TEMP.
QUALITY O CLOUDY HARDNESS._
O COLORED ALYZED OYES ONO
ANALYSIS ATTACHE ❑ ES CO NO
STORAGE TAN-K: TYPE—.
CAPACITY GAL.
PUMP INFORMATION
TYPE
MAKER
MODEL
CA CITY
D H
VOLTAGE HP
WELL 0 DATE �.
ADORE 211 E
• y
0
_P[PllI M COUP F1 DETPi tZf%lL: ff OF_EMALTH
DLVIS i0N o Ei�4TIi:0�1I�ILDII'AL HEAL`iFi
,....._.. ....... u_ SERVICES-
r
Owner or Purchaser of
Building Constructed by
•
P, AYIYL a4,77
icipiality
.-
ka_. __ z
Section Block Lot
q- I P5 >X
.• -ivision Name
Subdivision Lot #
GUARANI`EE OF SUBSURFACE SEWAGE DISPOSAL SYSTEM
I represent that I am wholly and completely responsible for the location,
workmanship, rrkit:erial., construction and drainage of the sewage disposal system
serving the above described property, and tliat 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 guarantee to the owner, his successors, heirs or assigns, to place in good
operating condition any part of said system constructed by me which fails to
- ocnrate for a_peria3 of two years immediately following the .date of app,�ovai of the
"Cer£ificate of Construction Compliance" for 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 occupant of the building utilizing
the system.
The undersigned further agrees to accept as conclusive the determination of
the Director of the Division of Environmental Health Services of the Putnam County
Department of Health as to whether or riot the 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.�r day of U.W, 19
General Contractor (Owner) -
er poration Name (if Corp.)
rev. 9/85
mk
t, r
MEN
Corporation Name
APPENDIX C /
FINAL SITE INSPECTION Da e r '
spected by
,-,--LOCATION - OWNER
,�aT # . - ( TM # OR /SUBDIVI
SION . LOT
SIO � ...U,_. ,,.,.
- COMMENTS
SEWAGE DISPOSAL AREA
a. SDS area located as per approved plans 6
b. Fill section - Date of placement
2:1 barrier.. LGTH WIDTH AVG.DPTH
c. Natural soil not stripped
d. Stone, brush, etc., greater than 15' fran SDS area.
e. 100 ft. fran water course /wetlands.
II. SEWAGE DISPOSAL SYSTEM
a. Septic tank size - 1,000 1,250 I n d J r (1
b. Septic tank installed level
C. 10' minimum fran foundation
d. No 90" bends, cleanout within 10 ft. of 45° bend
e. DISTRIBUTION BOX
1. All outlets at same elevation - water tested
2. Protected below frost
3- .Minimum 2 ft. original soil between box and trenches
4 f. JUNCTION BOX - properly set
1. Length required - Length install
2. Distance to watercourse measured: ft.
3. Installed according to plan
4. Distance center to center J11
n 5. Slope of trench acceptable 1/16 - 1/32 " /foot.
0 feet from property line - 20 feet - foundations > Z
7. Depth o Inc es fran surface
8. Roan allowed for expansion, 50%
9. Size of gravel 3/4 - 1 diameter
1
M L,63
0. Depth of gravel in trench 12" minimun
11. Pipe ends capped
r �1
h. PUMP OR DOSE SYSTEMS - - -
1. Size of haniber'
2. Overflow tank
3. Alarm, visual /audio {
4. P=p easily accessible manhole to grade
5. First box baffled
_ 6. Cycle witnessed by Health Department
estimated flaw per cycle
I V LYY' -�j
IV. HOUSE
a. House located per approved plans.
r b. Number of bedroans � Ly
V. WELL
a. Well located as per approved plans
b. Distance from SDS area measured ft.
C. 'C;a�sing 18" above grade.
d. Surface drainage around well acceptable.
VI. OVERALL WORKMASHIP
a. Boxes properly grouted
b. All pipes partially backfilled
C. All pipes flush with inside of box
d. Backfill material contains stones < 4" in-diameter
e. Curtain drain installed according to plan
f. Curtain drain outfall protected & dir.to exist.watercours
9. Footing drains discharge away from SDS area
h- Surface water protection adequate
i. Errosi.on control rovlded onslopes greater than 15 %. ,n
10
S No.
WL
�. •�f, / ' � 1 7•f ` fit;
5 .,� •K >!
t
t
c
t. r
• !•� 7 — * r �r it { e + �' a\� *M
%X'y�.
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