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BOX 19
02133
s,
"'`ENGINEER ,'MUST`
F PROV`I`DE
b Town o► VNlage 1
y r h
�LOeated !at ���T�r f'Ik�d �� <�' "�lC(�Ta c_u n ' ,� � � �y T�y �p � n S K C k .• -. --
1 »:<
Owner V T'�'���A / Formeily Y rTax3Map Lot . 1 ✓�1�� 9ubd Lot Y s
S �..1 A 4 1 .+ ?t 1 ?•.
Separate Sewerage SY!, built by ] /a;nitl�(�il/1/�
Y
4S0' l.1-
Consisting of ' i�JQ. Oal Septic Tank Band Y
c r l i
Other requirements
Public Su I From
VYater SUPPIY nr PP Y r a }
` ;Private ?SUPPIY, 'Drilled BY
.r p. 'AddreSS -` 9�+ c aa
Bding 7YDg'`""' No 3or
uil `Bedrooms Date Permit Iawed' �'
Has Erosion Control Been Completed? Has garbage grinder been 3nstalled?
. y... .:9 ..,.• . °.Po �. }w,�,.k ,. � ,,.�.: x.t s, ...,., ,y s Plans oP;..tlia completed' work (copies
-I cartif that the syetem(s) as,liated aervin the above. remiaes'were constructed eseentiall as_ahown on the
of which'are atEached) ''and in,accordance with, the Btandardsz rules and'raqulatione intaccordance with the file an, and ?theYpermit.asaued by the
Putnam County Deper�aitt 'Of Hedltih , r - 4
3 Sl } s
'Dates r Certified by 'm a r
Addrass ^C "�V tr�tt �� LICenNNO
M9_ 4u..1: °-Ve , °G, a� �^;r, ..,� .! ✓4�. �.... x <�! u .�yl. 1 :..
r-
;Any person occupying premises served by the above syttem(s) {shall= prompttytake,wch aetiori as maybe neasary3to s�eure,the cor►edlon; of any .unsanitary
u
;conditions resulting irom!�such ,usage °?ADprovsloi the separate °sewerag'e"system shall "becoina4nulliand vo'id,�a soon_.isr a;public +ynftary pvwi•;bscomef
availdtile` anQ dlte,ap roGbl of !the private_% a -'' suDP1Y�ahall become null and void' when }e �pubik water suDp�Y MCOmes avallabN ;Such approvals are
P _.. y- 4 1 n nr es,r x 1
subject Ao nrodirfcatlon or ch'arige when,nan the;ludgment of the.Commisslonpr of Nealth,, wch revoeitbn; modili$stion or "change la necesarY.
IN
qy .
r
Data
Y TRIG ��
k
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Owner or Purchaser of.Building Section Block Lot
�lGtiTy'Za �c�.�
Building Constructed by
AMP" W
Location - Street
Municipality
dTf�r�
Building Type
r005-1 (PARK
Subdivision Name
Subdivision Lot #
GUARANTEE OF SUBSURFACE SEWAGE DISPOSAL 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 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
operate for a period of two years immediately following the date of approval of the
,AlCertificate-••of Construction Compliance " - for _ the sewage disposal system, or any
repairs made by we to 'such system, except where tlie' 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 Environinental Health Services of the Putnam County
Department of Health as to whether or not 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 3 day of mp,2, 19_!�a Signature
Title
General Contractor (Owner) - Signature
Corporation Name (if Corp.)
Address
rev. 9/85
mk
Corporation Name (if Corp.)
Address
z.
t _ — COU14TY OFFICC DUILOIUG. i'C'AR r
,� 3 ps teooR is to be completed by well driller and submitted to County - Health Department together with *Iaborato► in o
xL� ttiatlr•t of water sample indicating water r, cl sati;faetory baCtcnal qu�ltty uclorc eeruheric o1 eon;truetiotreompgantt�y
FEEf''a�f3.r a1 US i [:E '-5UMAITTED VOTHltV'30 &A1Y - OF Vy LL�CO:.IPLETIO:. "�t1
.._ gy�pp,,
�'t R
' �f
DOMINICK VENTURELLA
A:1DlEll
3 Adam Lane', Carmel, NY 10512 'z°
tOM :
fNO. s st...q
(Iowa)
µu:
Waterfalls Lane
Putnam Valley, New York
'
® DOMESTIC
ESTACLISHMENI
❑
a6l POSED
FARA
MY WELL
r
t+t1611C
D s u rnT
D InIDUS1rlA1
AIR
cowornoKlNC'
OTHi!
N�
CON.rRESSED
D CAISLE
Q OTHER
I'
J1dU1
R
t0 TA 1,
AIR PERCUSSION
PERCUSSION
(fli�il ►1,
�k p AI13
( 20h
DlAm[IEitmcnsl! WOW"I ►EI tool
6 19
-
I a THREADED ❑ WELDED
W:IV 5Mpj^ V
1 yES, �„_INO1
�w,,� IS• K�
UTES
0
O
quo
f
aAIUD
PUMPED Lam' COMPRESSED
AIR
4
3O
1 trtr
a
S 1 ''afI.SYRE.
1119" "No
SYR /ACE- SIAIIC(SptGlr ltittJ DURING TI[LD TESL [lost)
I
Depth of CowplH.d Wet1 �-'Ty
Ix
30
325
foot belo.. Lund
Idrfoto
zy YS.„
aA�E
L.Sol h ipl.bi i i f.
h h ftlE[k
i 4ETAILf
si.W i:.
Dlgw[fLi poem +l
I IF GRAVEL
D:on.eu. of . rll 7nd�dieg
r ^,y�
GIAVEI S:Z[ finenssl IR U..IJ
ft
Aar�',S#.!`I-..
I PACKED:
, A.onl pack (in:nttril:
} =+�, •.
S.. r.
:a
If 5�i�
{
{5 Ir� iL�Mi
3
BREWSTER LA160RATORIES
t ? +.
Box. 224 ;=- BREWSTER;.,td.•Y.
a �t
-2072
(914) 225
WATER ' REPORT
A4NALYSIS
r
SAMPLE NO.
5771
'4Y
SOURCE:
Dominic Venturella Well
Water Fall Lane.
;! >;
"
Putnam Valley, NY
COLLECTED:
April 26, 1185
BY:
Mill Drilling, Inc.
'
BACTERIOLOGICAL EXAMINATION
P "
'
Colifotm Count,.MF Method O
per 100
� kf .
3
>
This result indicates the source of the sample. was
�
of ,satisfactory sanitary quality when the sample was collected.
y
May 1,
1985
Roy iclavit P.E.
i
r(iw'��'y»-{ SY?'1 �'' .
'.. .... 14 -.,
..�,�..- .-- .. 'p -°^.. -, � .. .. w. _ r.<r'i..
• >Y: T "_" .. _ <• .. ,.. -.. .. '
'J
i
m
WA F ro
4�-
IKON nq,?
IV,o CAL, MAONKY
444 W (� '74"
Z' KO.6 FILIL
-
0 OP
A
I
r t4s
EA (0.415 ALrz�S
I
Imo rAL, WeM Kf
I ..
IR6TA"P
is--,o apAt, m*oNCy -,Wnc. TA41:
450 I F P IA" Tre;WC, H
2, 12,0,6. rILL-
GOCATION6
Aj
TANK._-
AN K
d-
L(IT-F,X*'j '75 UO-0
AGE DiSPO'S"i" -"'S-'-r.tA WAS
iiAT -Ur
T ';IS IS 'i-')
C() S INDICA'Jij? C)"'! IMS NAN -1-11A '1 '11 1,
:ovhPI:D T OVE
A:IIC:F VITI'l I 'XI 1.
NOW
HOUSE f PKIIJ61•Ay t,00,ATI0t,15 AS
FAR suRVeY >31 5UiZ&je5e-- f t3e+t r-
Butnam County Department fpf Health
7
L
Otwision oY Environmental HeE Lith Servic--
approved as noted for 60nfc-16noe with
Applicable Hules and RogulatJ9'ne of the
Putnam County Health DepartmAht.
Signature 46 Itle
A5 E$UILT Sg fMO, 6Y'5TINA
VWKI� POMINUX VMTA-6"
LOT Ni to Or FOMT WK, FM;" (5140
I
TM 0 -q - I
wAFeKr-ALt, L/44
TOWN OF tiUMAM vA OV
rUNAAA CO. , NI
T; M 1A4) r,
Pil a
PUTN`AM COUNTY DE
s �Dfvfsfon of j Enwronmental;+zHeal
'CONSTRUCTION _P,ERMIT F_Ok' SEWAGE RISPOSAL SYSTEM
Ma .
r''Located at
r
�, '.Subdivision
SubdQ Loup
Owner /Address
Building`'TYpe.�y+ IT��� Lot Area
t
c, umber of Bedrooms _ Design Flow
s e I
.Separate
. sewerage., ystem- to consist of d Gal 5!
r To be constructed by
i
�yWater Supply Public Supply From ; T
c r
✓
Pnvate Supply to_ be tlnlled by
1
Address
Othei Reguvements o' ��' �� +,
— 4
(;represent that I am wholly and completely responsib to
:above ' describetl -will be constructed as shown on the approyed;amentlment th4
County Oepartinent of ,Health, and that on complefiori thereof a Certifiu
be submitted to -the Department ;antl a written guarant" will be furnish
.,place iW ?gootl operating ";condRion, any pail of said sewage disposal: systI
ante ,of, dhe approval of. the Certificate of Construction ,Complia'nce of -t
will betlocated aishown on "the approved plan and that said.weil will betnstall
i County Department of Health
oate is I
:Slgned`G
L
Address
APPROVED FOR ;CONSTRUCTION This'approval,expires. one year;irom 1
revocable;for, cause or may :be amended or modified when considered net Ss
rtequlres,a new permilt. A WP" ove for disposal of domestic` i ry` wal
4 Date
�V gel y Ley _
C._..`.... i..a.. .��.... _......_._,.�. ...._ .�..... Y -... _.. ..... _._�__...... �.___........ _.�_ , —.emu.
4
-
ARTME,NT
r. Services �Carine/ W FY 105.12
own o► alage ..
aEiock
I`" Renewal � Revisions Q., � ..i
J � �
e �-
/` Date Of Previou's Approval '.'}
Bection:�Only
• P C N" D Notficat \ion'!Required` =
tie Tank and 4447
Address u� �
1 i wri m"h l
s
ition of life proposed systems) 1) that the separate sewage disposal system'.; <'
s,eto and .in accordance with the staridar4 rules'an regu a ons of e PutnaF.
9. of Construction Compliance satisfactory :to:the Commissloner "of,Healthwill
Itthe owner aiis' successor ;'heirs;orassigns'by, the builder,'thpt said :builder will;
"•during: the period of two;(2) years immediately following thedate of the issu-
i "original system or any -,repairs thereto 2 .t at the dkilled well•described above i
I m accordance w rth stands i ru s nd regu a ons of the Putnam'
k 7. �j P.E:/ •R.A
L tense No
a i
e; °date issued unless construction of he building has been `undertaken and''Is
the. tCommi ioriei oi; Health: , Any 'change or •alterat_ion of construction
antl /or priva water s y.
Title !
ti E7 �J L 1 li 2Y V 11/ 11 } V l'.
CONSTRUCTION PE
Nor. r
Located':aty�=
Subdwision Fore s t
:Dominic; ;.
Owner'
Numtier'of. Bedrooms ::
To be its' t Gontra— c . fr not, et. ",on
-
.Constructed bY -
Address
Water Supply Public Supply From t 1�
rivate -- ,Supply .to be drilletl by " C�1eStQZ' P11Ckey
Putnam al'ley9:No Yo
Fill required-�Ad isOti q, 9 ,t Wink A Other Requirements tQI -propc "ti, ons 121 area 6� R 3 R't average dept o USti
settle at, .least. b:0 da =s. ,- then `re tested and lan . compleaed prior; to 'construe ori�
f1 Q ppn�1vV jja�ii n� y 9 P
Q$epP@88mi tA"df S�rwholly and ;completely responsible "for the design and locati9n of the ropoaed systems) L) that he aepazate sewage disposal
P
system above described will be constructed as shown on the approved attachments kiereto and in acc'ordanoe with the atanda'rde, rujes and regulations; '
of the• "PUtham County ,Department,0;f Health" arid_tfiat on "completion °thereof a " Certificate -of Construdtion Compliance eatisfactoiy,to the• Commssion-
jq., -
er of Health will be.subm#t:?d to the Department and a.written':guarantee will _bei'fu;niafied the `owner,, +his successors, heirs,or,;asaigne'by,the °build t
er, that said builder will place -'in good;,operatinq condition any part of aid sewage disposal system during the period 'of two (2).yea;sediately ,,
following the "date of the issuance g the, approval of the Certificate of :Construction: Compliance of the :original syeteai or any' :repairs ttieretoji2) ,.
that the3dri17ed well described 'above will be located as- :shown on`the approved,pl4fi aj ,.tha,t said well,will be netalled`,in.acco;dance' with the stare '.�
- ---* -- w
Bards; rules and.'regulationa of the Putnam County Department Of Health
Date November<.209 h1978: x
ed',. q P:E R A
urge s ehr9 $�"
D °mxorse oared Roa �, Caravel �No Y 98GS
Address 4 o License No
;APPROVED FOR /'CONSTRUCTION *hW approval expires one r:from the date ,issued aril s` c hstruction of the buaipogg has been undertaken. and is
revocable fo► cause or may be amended or;modifled When cohsi eyed, ec sa`ry b Commi io r,:of Health Arty ch$rlge or terat:iorr of construction
requires a new permit Approved for s osal of Aomestic mtar
w...�. �. ,..
• p �� wage; d/ rev ate s p
BY
Gate Title
i
Application to a.n
Division of Environmenia! ,f
CONSTRUCTION .PERMIT' FOR SEWAGE" DISPOSAL :SYST
TT.ortherly,4 side'' Dicktpwri Rd': a=
Located at
R v e bedrooms - File' IIQ7 -61)
�.
vices �Carmel .`ll! Y 10512
°` Futnam Valley
rs e Ci t l On - `Town or,'•V it loge p ,
.l Tax Map # Block. 1 r
Subdivision Taz+Map Lot'#
Dominick R. a aerie en. are a 16 Fieldstone Dr Apt 3
Owner Address
Buud�n` 'T 2 .sty dwellln'g ,6.25 a6 re ar s a e.` • r,:
g" ype Lot Area F
8 10 minute's
Number. of BedroghnS _ Design Flow Total Habitable Space Square Feet
1200 .,
Separate "Sewerage System to. consist of Gal Septic Tank and, Oft 2��trench /„ ( ) '( X )leaching pits
To be 'construcfed by NAt Wet deClded f l
'Water SuPPIy- Public° SuPPIy From K
<:
x Chester. Puckey
Pnvate Supply to be drilled by
• •
Address
Ftihl�lg required insti% goo qua i y - ,
g aQ :� v�ntst^,Y`a•�Z, -p 3.1Qt'
ettle at least •60 days, :then: k,-. e tested sand plan comple''ted prior to coristructon
I represent that I`am wholly and,coinpletaly responsible for the design, ^and location of ;the propoaed,syetem(s)•�.1) that.ahe'aeparate sewage disposal %
system above .de scribed will be bonstructed as,ahown'on' the appio'ved attachments: heretoµ and in accordarige wiEh'the standards,'. rules and regulations .
of the'putnam County;Departmegt Of Health and •that onrcompleton thereof a Certificate'of Construction Compliance 'satisfiictory to'•;the Commission -.,.
"er of'Health'wiil be'submitted'to , the,;l)epartment' and a.written. guarantee will be furnished the ?;owner, °his,suc &easora, Heirs or.asaigns by the build -,
er, that said builder will place'in good operating condition any part of`said sewage disposal system during the; period of two,:(2) yeare; immediately
follo{v n`g•the :date.of; the issuance of. the approval. of'.tha Certificate`of Construction Compliance, of the origigal system.or any, repairs theretoi 2),
wm oh the approved 'plan and .',that said well will, be anatalled.ln';accordance with the•.etan -'i
that,the_.dFil ?ed welltdescribed above will be,- locatedLas sho
dards,'irules and,r6guXatidfis of. :ifib'putnam County: Department 0 Health'
November
Date S� ed P.iz X:
R A
ur s Behr ,.: u
9
Address -- NrnraAh Ci Q 12 License No:
;APPROVED -FOR •COfVSTRUCTION 'Thi's approval expires one ye' rorn',the date, issued unless constr id of'the building has been undertaken and is
a revocable for cause or may be amende. modified when consider d ne scary` by' the Cotmmiss�oner,: N th' Any'.chan :alteration of construction
`equves a' new p and Approved for tlisp of tlomestic sa it se e a d /or p ate at Y
By Title
1 -3
ors � .� �-:
RBEPOUNO ROAD
MO - 03063 '
1& -04522 CARMEL, N. Y.
1 9 . CARMEL 5 -3312 (MICA 914)
l; December 1, 1978:
iJf. i
Mr. Dominick Venturella`
16 Fieldstone Drive -Apt .358
1; Hartsdale, N. Y. 10530
Re: San Design Lot b
f
Forest Park -Town Put Valley
Dear Mr. Venturella:
?' We spoke with Mrs. Venturella yesterday regarding the
.above and were advised that in order to keep this design
to a three bedroom house, the wall between the "loft"
and the adjoining bedroom would be eliminated, making
this into ONE Master bedroom.
Mr. Behr advises that you proceed with installation of
i! flll._based. on the requirements for three bedrooms and
nave ..house plan= revised• --to- show -'your intentions. You
can X out the wall yourselves and sign your name right
on the plan as having done this and send us a copy along
.1 with a statement of hoer you will eliminate the possibility
of labeling the extra area "bedroom ", or of any other
indication that would convey the idea of use as a bedroom.
We cannot revise the Ilan again..It would require another
drafting, which would mean additional expense; however we
did keep two copies,of the three bedroom design in our
1 files, marking them REVISED. We are sending,you one of
these, so you can see quantity of fill required for the
three bedrooms, as well as; linear ft of tile field.
Future drawings submitted to the Health Deps:tment will
show three bedroom design and "as Built "system... A copy
of this letter together with a copy of the original three bedroom
design will also accompany it, so they will.be aware of this
decision.4s
Any -ques.: ons? Feel free to call.
Very tr ly ynura,
BL E S & BEHR J9 P. /C
r'
B rL.4 L
ob T1)ton.i,, P7. e-al. fih _Opt. .�'
97
1 r
197
4�UTNAM. COUNTY.
... .. ;,
_. .. ...u.o.r
f
I ,
Roy BUROE88
ALVIN H. BEHR
PROM8810NAL ENGINEER
LAND Sunv n
awfum
BURGESS & BEHR, P. C.
,.
N.Y.- 179824
N.J. - /1824
PROFEssIDNAL ENGINEERING & LANG SURVEYING
N.Y. - X27707
PA. � Ie454E
R O a. HO
CONN. - 03394
RBEPOUNO ROAD
MO - 03063 '
1& -04522 CARMEL, N. Y.
1 9 . CARMEL 5 -3312 (MICA 914)
l; December 1, 1978:
iJf. i
Mr. Dominick Venturella`
16 Fieldstone Drive -Apt .358
1; Hartsdale, N. Y. 10530
Re: San Design Lot b
f
Forest Park -Town Put Valley
Dear Mr. Venturella:
?' We spoke with Mrs. Venturella yesterday regarding the
.above and were advised that in order to keep this design
to a three bedroom house, the wall between the "loft"
and the adjoining bedroom would be eliminated, making
this into ONE Master bedroom.
Mr. Behr advises that you proceed with installation of
i! flll._based. on the requirements for three bedrooms and
nave ..house plan= revised• --to- show -'your intentions. You
can X out the wall yourselves and sign your name right
on the plan as having done this and send us a copy along
.1 with a statement of hoer you will eliminate the possibility
of labeling the extra area "bedroom ", or of any other
indication that would convey the idea of use as a bedroom.
We cannot revise the Ilan again..It would require another
drafting, which would mean additional expense; however we
did keep two copies,of the three bedroom design in our
1 files, marking them REVISED. We are sending,you one of
these, so you can see quantity of fill required for the
three bedrooms, as well as; linear ft of tile field.
Future drawings submitted to the Health Deps:tment will
show three bedroom design and "as Built "system... A copy
of this letter together with a copy of the original three bedroom
design will also accompany it, so they will.be aware of this
decision.4s
Any -ques.: ons? Feel free to call.
Very tr ly ynura,
BL E S & BEHR J9 P. /C
r'
B rL.4 L
ob T1)ton.i,, P7. e-al. fih _Opt. .�'
97
1 r
197
4�UTNAM. COUNTY.
�.
-.
e
PUTNAM COUNTY DEPARTMENT OF NEALTiI i
• DIVISION OF ENVIRONMENTAL-HEALTH SERVICES
S,e pt'emb er 119' 19TS 1
Date
ominick c Va erle e.n ure a... `
Res Property o?-. f
�
L,oc teod at orther side ofDicktown Rd. at 'inter +ection
uI. rcpt wn an ,
Section 4 Blo`ek Lot
-Gentlemen: Lot 6 of Subdivision . of Forest Park -Filed M p: #1546
This letter is to authorize Roy .A o Burgess
a duly licensed professional engineer x . 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 `
I
connection with this matter ana to supervise the construction of said f
. system or systems in conformity with the provisions of Article 145 or f
. ... .. 147, Edu a ion La , ..the Publc. H e alth Law , and t he Ntn am County Ssni-.
tary Code..
j' Very truly y ours,
Signed
1 Owner o . operty
16 Fieldstone Drive -Apt 358
Countersigned: 9845
Aadress
P.E., R.A., ## 'Hartsdale., N. Yo. 10530 .
1
Burgess .Behr 9' PO C o Telephone
Address - w.
R D 8 Horse'pound : Road 1. � 'o F.
Carme 19 N a Y. 10512 ...,
L,~
' 'Tee eplaone
5-33
NO. gal
S'y'SR2uEYQ¢
I
FUTNAM COUNTY DEPARTNMT OF HEALTH
DIVI811014 " V ENVIRONMENTAL HEALTH SERVICES
COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512
-'"N' "'P'^ SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. 1107-614
Owi,ar. Dominick &Valerie VentureAddfress 16 Fieldstone D•r, Apt 358
,ocat -ed at
(Stree�Tndicate Dicktown Rd Sec. 4 Block 1 Lot 15.6
neares cross street ot. 6 Forest,Park
I*Inicipality Putnam Valley.
7
Watershed
New York
City
7 "
;OIL PERCOLATION TEST DATA
REQUIRED TO BE SUBMITTED WITH APPLICATIONS
24.
71"1 7_3
1
9 *f
9:00 -9:09
9
24
�5
1
9 ,r
—.52:10-9:19
9-
CLOCK
TIM'
PERCOLATION
18:42 -x:50
PERCOLATION
-:�
Elapse
DeptH
to water
Water Lavei
No•,
Time
From Ground Surface
in Inches
Soil Rate
-art -Stop
Min.
Start
Stop
Drop in
Min. /in drop
_.
Inches
Inches
Inches
-8:35 -8:41
6
24
25
1
6 Min
28;42 -8:49
7
24:
25 -
1
7 "
-8:50 -8:59
9
24.
�5
1
9 *f
9:00 -9:09
9
24
�5
1
9 ,r
—.52:10-9:19
9-
18:42 -x:50
8
24
25
1
8 "
2.8:50 -8:57 7 24 25 1 7 It
8 :59 -9:07 8 24 25, 1 8 It
),9:10-9:18 8 .24 25 1 8 It
5
1 :Note - these are new tests made November 15, 1978
2 Former tests made-'in old approved san area ran 9 and 10 minutes
3
4
5
Notes: 1)' Tests to be repeated at same depth until aroximatelyy equal soil
rates are obtained at each percolation test hole: All pp data to Ue submitted
for review.
2 Depth measurements to be made from top of hole.
D
11
�1
(I
:s
i_
_
•ytl
w ,
'IE51 "PIT llATA' REQUIRED 'T0 BE SUBMITTED WITH APPLICATION
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
DEPTH
HOLE NO. 1
,HOLE NO. 2
HOLE NO. 3
r,
„.
'Topso'il
Topsoil _ ..;
_ Topsoil
G.L.
4211' '
Tt
, r�
It
6n
"
Rock :.(bid bould;er._•.
12 ".. `
Sandy
Sandy gravelly
sandy. loam,
:..............
_.,gravelly..;-:,
moves. but _too .big.....
.
18"
loam
loam
n.
24"
I
t666me out. of
"
30f1
r,
„.
3611
4211' '
Tt
, r�
gravlly.loam
"
Rock :.(bid bould;er._•.
..small stones
4811
•.)
5444...,.....:......_
Rock '(solid)
moves. but _too .big.....
.
6011,
t666me out. of
Rock at "L T vOTr
:..,hole
66"
7211
8 411
INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED
INDICATE LEVEL TO WHICH.WATER LEVEL RISES AFTER BEING ENCOUNTERED
TESTS MADE BY Burgess e.. Be hr s P. C-0 Date ov. 159 1978
DESIGN
Soil Rate Used 8-10 Min/1'P Drop: S.D. .Usable. Area Provided69000 SF+
No. of Bedrooms 3 Septic Tank Capacity. 900 Gals. TyPe. precast cone
Absorption Area Provided By333 L. F<x241 tx 361P w'ddth tre h. Other Install
good _quality, r -o -b grayei6TX'351x 2.Tagph9 gra�e to proper
^-°- -
Name Signature
Address SEAL
PUTNAM COUNTY DEPARTMENT OF HEALTH
Soil Rate Approved Sq. ; Ft. /Gal, r ,. Checked; by, :: , • :.. Date
proportions. and allow to settle; at =..least b0 .days; prior .to• :.,dny
consturction- Fill MITST be tested priior..to - construction and plan:
completed
TEST�
DEPTH
G.L.-
11 Me
DATA, REQUIRED TO BE SUBMITTED WITH.
RIPTION Olr SOM, -ENCOUNTERED IN TEST HOLES
HOLE No. 4
Topsoil
M
HOLE NO..-
Topsoil
rr
Sheet 3
.... ..
HOLE NO. 6
Topsoil
tt
1211 Sandy Loam
Sandy Loam.
Sandy Loam
1811
2411 it
It
rr
3011 it
3611 it
it
It
421f Gravelly loam and
4811 It
It
it
5411 17
it
6011 If'
6611 It
it
It
7211 it
it
If
7811
Rock
'INDICATE LEVEL AT WHICH GROUND
WATER IS ENCOUNTERED
INDICATE LEVEL TO WHICH WATER LEVEL
RISES AFTER BEING ENCOUNTERED 15o 1978
P. C. Ov
TESTS MADE BY Burgess a Behr,
Date
Soil Rate Used 8-10 Min/1"Drop:
DESIGN S.D. Usable
Area Provided69000 SF+
No. of Bedrooms 3 Septic
Tank Capacity 900
Gals. Type Precast cone
.Absorption Area Provided ByI33
L.F.x24" X 36"
dth trench.
See requirements on Sheet 2
her
Name Roy A. Burgess!
Signature
Burgess & Behr, P. C.
Address
3 Lf.,,
A
D b-Horse ound Road
P
Car me
THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY:
0.
U RVE _'O'L
0 ,S
ESSION
Soil Rate Approved Sq.
Ft/Gal. Checked by Date