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HomeMy WebLinkAbout2165DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 30.18 -1 -1 BOX 19 Is me ml irl6 16M 1 . kP 02165 rs` PUTNAM COUNTY DEPARTMENT OF HEALTH f DiVisrorf of 'Entiiionfhen6l H691th Services Carme% N Y 10512 CERTIFICATE OF, -ONSTRUCT•IQN COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM `T'o w rJ o� 'DTI" San YA _Tawri "or "Vili3yd. R Located at i.' i TT.R �-rE -bF. WE. Beef _ .: - _ y z � Block °Owner— sAVSe1b -�!Lox A �`,I 3 A 2Y> $vS W E Address s "5 El:, 1"'i A ea Separate Sewerage System built by p Consisting •of, `aa Gal. Septic: Tank °_3 Z O lineal Feet (X width trench Other requirements',�'o.g C— R/4VEl.. �i(_1._ lU P`'p, GS'° 1tJ�^ •S D. ='A x z G Q po�>.i c "oM.'�LET As ry f .,Water`SuPpIYi Public Supply :;F Tom. _ 'b Private Supply Drilled By Address •'Building Type 'o�E `i�AhiL�f . 1� r C1�E �C No of Bedrooms` 4 :.Date Permit Issued Has ,Eros�o,n Control' Been Completed Z (,certify that the system(sj, as listed serving the atioVe pr'em'ises were constructed a ;fpritiaa Za3 shown eM� plans o4'.0 ompleted work (copies of which are attached) and in accordance with the standards,. rules and regulations plans file$�a he, t she y thnam Co y apartment of Health. • , ., P E. R.A. . [ Date '1v14y •Z�. }j4 Certified 4y' .. •, - l�iE M c�PAC -ra 1, Address P O� �O?� wog : •'�� 10°5$1 License No. Z$ ,- l 'Any person occupying premisescserved by.the above systems) shale promptily, take_ sQclY 4i ,gsygieq°betrleLessaryto secure. the correction of any unsanitary l fj conditions, resuliini from such. 6sage:. .Approval of .the separate, sewerage system'•sT* *�!6(d i '��R�e�B void assoon as a -public, sanitary,,sewei ,becomes �'availatile and the approval "of the private water supply'shall become null and void when"Aa;pYVljA4 0aier "supply becomes available. Such approvals are' subject,to .modification :or change when, in the u' dgment of the. Commissioner.of Ith such revocation modification or change is; necessary. . Title I M � i ... <�. .� a ..� ,. u all WO Vi z V) V) m CL w in kZ. 11 0 U. NJ k k kj K r Ix o Ln �lj z K \, 1�1 C % h 'A l41 it BEr R MS' 2 S. GALLON SEPTIC TANK LF X .96-ABS. TRENCH O 0 SI % P� PMNt JUN 10 7Y /0 AS CONSTRUCTED SEPARATE SEWAGE DISPOSAL SYSTEfA' TOWN OF COUNTY. N DATE .T -27 -7/ 1 SCALEq, rJOB NO. SULLIVAN - THIEDE CONSULTING ENGINEERS CLARK PLACE YORK � - -.-.r -5,- I u. H 0 6'p F LNG Ho [iSE ��" ��` -_ ',� j: v' ���� /�` '400 /j / q4- q'r 4 tr yb •/ k .J� /,200 GALLON SEPTIC TANK ABS. TRENCH u. H 0 6'p F LNG Ho [iSE AS CONSTRUCTED SEPARATE SEWAGE DISPOSAL SYSTEM M. 7- TOWN OF COUNTY.NEW.YORK 3 DATE -7o SCALE JOB NO. SULLIVAN THIEDE CONSULTING ENGINEERS CLARK PLACE ��" ��` -_ ',� j: v' ���� /�` '400 /j / q4- yb •/ AS CONSTRUCTED SEPARATE SEWAGE DISPOSAL SYSTEM M. 7- TOWN OF COUNTY.NEW.YORK 3 DATE -7o SCALE JOB NO. SULLIVAN THIEDE CONSULTING ENGINEERS CLARK PLACE %j /; \� Iihs;l Oda b � \�\ •i �.1 Its t� � j R �r ,ta r �i—'% � �� Tyis .9.CC�.v rr G?E Fi•L tiE'� \01 V''V to •� �� 0 X I I I 0 ��,GO T /d.L .9�✓ ,,` `` ``` n� i• ONE I \ / / 53°.0'_ O i \ \•\ \ `� I / )/ 1 p —zs.a / 0 / { 1 1 ! i 2010 GALLON SEPTIC TANK 9210 LF X -96-ABS. TRENCH AS CONSTRUCTED:` SEPARATE SEWAGE DISPOSAL SYSTEM SA ✓E.E /O M.�+G WEST ,POFJp - o.q,C� /pGE O,P�YE .C/ T T.2ElJ G-E p'E'YYE I ,�iFT.i' M.�P of ,2opejN6 � BAG o oK ,G A,CE" coTS ✓o. 53a s3/ TOWN OF f��TN9M CdUNTY. NEW.YORK 03 . DATE /,2- ,2,2_7o SCALE,ps .verEO r 98 NO. 70 -s.S SULLIVAN - THIE rE CONSULTING ENGINEERS CLARK PLACE 7MAMPAC- NEW YORK 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 we(1 driller alid'submit`ted to County Health" Ddpaartml�flt`together'With i'86oia�ory report 'of analysis of water sample indicating water is of satisfactory bacterial quality before certificate' of construction compliance is issued. REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION OWNER 5 NAME i ' ADDRESS r �. t 5' vt�i1 /O J E l G!� L (No. 8 Street) ( (Town) ( L t LOCATION ( OF WELL BUSINESS TEST WELL PROPOSED E DOMESTIC ESTABLISHMENT F FARM T USE OF WELL O OTHER S SUPPLY INDUSTRIAL C CONDITIONING ( ) DRILLING C COMPRESSED C CABLE O OTHER CASING L LENG /T�eel) D DIAME TER(Inchas) W WEIGHT PER FOOT E ❑WELDED Y E S O ( ( C D DETAILS / 6 J J 9 T THREADED ❑ HOURS G G.P.M. Y YIELD (G.P.M.) YIELD H BAILED El PUMPED ® COMPRESSED A AIR 7 75- WATER M MEASURE FROM LAND SURFACE —STATIC (Spa clty teetJ D DURING YIELD TEST (feet) D Depth of Completed Well LEVEL i in feet below Land surface: d MAKE L LENGTH OPEN TO AQUIFER (feet) SCREEN DETAILS S SLOT SIZE DIAMETER pnc�i§ S S ca�c,. R RAY l f P(I ches)�EROM�(fee �TC(LI et) � �, d f f e zs? P a it � DEPTH FROM LAND SURFACE S Sketch exact location of well with distances, to at least FORMATION t, f two permanent landmarks. ; ; f t G17 j j 3 L Lz4 .F r T J+ 4:• 90 If y yield vas t , Owner or Purchaser of Building Municipality Building Constructed by "IT A" A41% Location Street Block Building Vlks& of GUAtANTY OF:.; SEPARATE • SEWAGE SYSTEM I represent that I am wholly and completely responsible._for;the location, .workmanship, material;_ construeti.o* and drainage of the sewage . disposal syste ,,serving., the above d scr bed.,prop ®rty, .arid,::that .it has ".been constructed as :,shown on the approved plan,or app roved- amendment.:thereto, f , and in accordance Stith the; standards, rules and regulations Putnam County Department''of;Health,, and ''herEby guaranty..to.. -the,. owner,, his succes- sors, heirs,.or., assigns, to;place in good,: operating condition any part of said system constructed by,.me wh ch..,fails .to,.operate.,for. a,- ,period „of two . years immediately.folio'wsng:`the date1-of initial use of the sewage disposal system, or ariy repairs made by I me,to.such system, except where the failure to operate,;properly s...,cause.d;,by. the. willful. or,,negligent act. of the occu- pant. of the building .utiliz,ing,,the...syst.em: undersz�meri farther agreed to, accept as ! c.onc,lusive -,.the de- termination. o .f the ;D.irector of the ,:Divisi,on,.of. ,Environmental .Health Ser- vices 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 51 day of 6 19 '"i1 Signature e Title N ,M . (If corporation,. —give name and address) THREE (3) COPIES.-ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION WILL BE ISSUED. GUARANTOR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM. Division of Environmental Health Services, Putnam County Department of Health PUTNAM COUNTY DEPARTEM T OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES } Date J try 1, %q-to Re: _ Property of SAVEe%o Located at wG-z-c KA P q Block ( Loth Z E -I F►F'ct� 1.�p�p oP RoAR��C -� g,Q2.oe>t� b.AKE'• Gentlemen: %c g _I 4.o'T� moo, s3a 531 This letter is to authorize a duly licensed professional engineer / ..or registered architect (Indicate) to apply for a Construction Permit for a separate sewerage-system; to serve the above noted property in accordance with the standards, rules or regulations as promulgated 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 system or systems in conformity with the provisions of Article 145 or "+ 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. OFf 7NElL���� Countersigne4t��P,.•••••., -DOSE Pl1 FRAG1�4"��uNL����it�'.�".E P.E., _'.� Qc s < <;• ��eal) Address ; C* • p�� • 4`��. 2489`P.Z� L Oac MAHOPA�;' Telephone Very truly yours, Signed Owner of Property 3,r05 AV EvzuE 1-5 0,--, ;;-bCn.C— EvZ YO 11-1 Address 30 $ 9%4 - ME -6 -845 Telephone r, . PUTNAM. COUNTY: DEPARTMENT OF. HEALTH Separate Sewerage System T�w� or- 1?'uT➢JR�AA vAa���y Municipality CONSTRUCTION PERMIT wEz AA KA T T c�oA� P Located at Block LOTS 53o�531 r -tF-r% ,MAP or- Subdivision ge>ARtN& Bpoote j-hy Lots 2 Z Job_ A -me 'Owner tsa%% gr2 Address Area Building Type Rg-�, evesvos No. of Bedrooms --I Total Habitable Space 1Asao -t sq.ft. Separate Sewerage.System to consist of qQo Gal. Septic Tank z4 o lineal feet width trench 3cfl" woe St'i To be constructed by F=pwA4k® ft)skL_C)j Address ceLt,p&b -o Na - ttQ%5 %ate, m V6 Water Supply Private.Supply to Address Public Supply from be drilled by �s1E�AGs� �F '3` -0" R• ©.Z,-GtAveL- Aft eA C-3t-- Other Requirements S�wP►�,. c��SPo-SAt_ �tEt_c�s re -present. that -1 -am responsible.- f.c-r- he -de- sign - _ - - -- _..�...,._ and location of the proposed system(s): 1) that the separate sewage dis- �osa�l.s stem above described will be constructed as shown on'the approved pp7an or approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satis- factory to the Commissioner of Health will 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 immediately following the date of the insurance of the approval of the Certificate of Construction Compliance of the original system or any 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 in accordance with the standards, rules and regulations of the Putnam County Department of Health. A pseV'%A F 2w� cis $�S�.tv Ate, P057 Date -1 Signed APPROVED-FOR CONSTRUCTION: This approval expires one year from the date issued unless construction of the building has been undertaken and is re- vocable for caus.e.:.or.: may- be..amended:.Qr..modified whe.n.considered necessary by the Commissioner of Health. Any change or alteration of construction requires a new permit. Approved for disposal of domestic sanitary sewage. Date 0 z: a.. . PUTNAM. COUNTY: DEPARTMENT OF. HEALTH Separate Sewerage System T�w� or- 1?'uT➢JR�AA vAa���y Municipality CONSTRUCTION PERMIT wEz AA KA T T c�oA� P Located at Block LOTS 53o�531 r -tF-r% ,MAP or- Subdivision ge>ARtN& Bpoote j-hy Lots 2 Z Job_ A -me 'Owner tsa%% gr2 Address Area Building Type Rg-�, evesvos No. of Bedrooms --I Total Habitable Space 1Asao -t sq.ft. Separate Sewerage.System to consist of qQo Gal. Septic Tank z4 o lineal feet width trench 3cfl" woe St'i To be constructed by F=pwA4k® ft)skL_C)j Address ceLt,p&b -o Na - ttQ%5 %ate, m V6 Water Supply Private.Supply to Address Public Supply from be drilled by �s1E�AGs� �F '3` -0" R• ©.Z,-GtAveL- Aft eA C-3t-- Other Requirements S�wP►�,. c��SPo-SAt_ �tEt_c�s re -present. that -1 -am responsible.- f.c-r- he -de- sign - _ - - -- _..�...,._ and location of the proposed system(s): 1) that the separate sewage dis- �osa�l.s stem above described will be constructed as shown on'the approved pp7an or approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satis- factory to the Commissioner of Health will 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 immediately following the date of the insurance of the approval of the Certificate of Construction Compliance of the original system or any 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 in accordance with the standards, rules and regulations of the Putnam County Department of Health. A pseV'%A F 2w� cis $�S�.tv Ate, P057 Date -1 Signed APPROVED-FOR CONSTRUCTION: This approval expires one year from the date issued unless construction of the building has been undertaken and is re- vocable for caus.e.:.or.: may- be..amended:.Qr..modified whe.n.considered necessary by the Commissioner of Health. Any change or alteration of construction requires a new permit. Approved for disposal of domestic sanitary sewage. Date 0 Re: Property of Ayee:a Located at wee iz oAQ ©A�c'iZ�GC7c^�iZ,J.'c �c-A•a q Block ( Lo.t-S . Z e F' ►F i�{ 1-tAP es G. �� f�'r�A(�1�JC -t 2y2.GC:k. Z,%\iCE" Gentlemen: cea. 2, %CA49 h 14.ed .�� .,G g _� ka s . %o, :E : -- This, letter is. to . authorize ,�� -�5� �t7 P F, iF, a duly licensed . professional engineer �/ _ or registered architect (Indicate) to apply.for a Construction Permit for 'a separate sewerage system; to serve the above noted property in accordance with the standards, rules or regulations as- promulgated by the. Commissioner..of. the Putnam County. Department of.Health, and to sign all necessary papers on my behalf it connection *with this matter and to supervise the construction of said ays-tem-. or- systems .in' conformity with the. . provi .s.i,ons...of_Ar_V.ic1.e.. 45, ror 147, Education Law,. the Public Health Law, and the Putnam County Sani- tary Code. ,t�iiiirrrrr� ��•�Q(E OF N J Very truly yours, �j Signed Owner of Property 305 wc 'j ER AV C G k-A e \Q i O P Y, Address a Ad rm e s s 1) C R4 %248SP- z YIAH1PPt!4aT 15 4- k G l4 - r,Z S - `9 -IT -7 Telechone. Telephone PUTNAM COUNTY DEPARTMENT OF HEALTH .'-.. .._. ..... .0 .,.. .1.. ...•.m.a .s :.. .. n .. .rte:, :_... _.. Separate Sewerage System 'Town of ^�Pu-r1 —z v�.�4-Ey Municipa ity CONSTRUCTION. PERMIT - AK KA Located at o!�k;2 ►G .,� Pc,�ao S Block 1 40 TS a30.�Sli FIFTH `:qx . Subdivision Lots ' 2 Job SAvE;tb_ ".4 G-- z..DkiN 365 %.4ZZS4Z-=)-V'ER_ ANe Owner ' Address Ew �oGt1l.1.c- Lot Area Building Type No. of Bedrooms 3 Total .Habitable Space I, Soo -Y sq.ft Separate Sewerage System: to consist of.ctQc>Gal. Septic Tank z4olineal. feet width trench 3SG" —.e ;. S�Z AL$ pt 14 'y PUS. - . Mc. P%D To be constructed by E st�skjcE y Address e�� -ate -�►� ^ ti�C��C> -�, u,y, Water Supply / Public Supply from i/ Private Supply to be drilled by Address R, GeAVE E A vt Other Requirements SE w �►G �' t��SPc�-�AL ������ . -...I, represent that -1-am-wholly-and-completely responsible for the design. and location of ^the proposed system('s� ; - I) t °nat `the sepa'r'ate-- se-wa'ge "dis �ossall system above described will be constructed as shown on'the approved p -fin or approved amendment thereto and in accordance with the' standards; rules and regulations of the Putnam County Department of Health, and that. on completion thereof a. "Certificate of_Construction Compliance .".satis- factory to the Commissioner of Health will 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 immediately following the date of the assurance of the approval of the Certificate of Construction Compliance of the original_ system or any 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 in accordance with the standards, rules and regulations of the Putnam County Department of Health. Date .�).:..� � � � 7 0 Signed �:. APPROVED FOR CONSTRUCTION° This approval expires one year from the date issued unless construction of the building ha-s been undertaken and is re- vocable for cause or may be amended or modified when considered necessary by the Commissioner of Health. Any change or alteration of construction requires a new permit. Approved for disposal.of domestic sanitary sewage. Date By. tj b JOSEPH F. SULLIVAN B.C.E.. P.E. SULLIVAN - THIEDE -.--:,CIVIL ENGINEERS:: -- GANSTRUCTION „CONSULTANTS_, ' -. OLD STONE BUILDING, CLARK PLACE P.O. BOX 308 MAHOPAC, N.Y. 10541 MAHoPAz 8.8777 Deeember 220 1970 Putnam County Department of Health Division of Environmental Health Services Putnam County Offiee Building Carmel, New York# 10512 To The Attention Of: George Haughney, PaEOo Direetor Gentlemen: FRANCIS W. THIEDE M.C.M. P.E. Enclosed please find our As constructed drawing of the separate sewage disposal system loeated on the Property of Saverio Serio at West Roads Roaring Brook Subdivision, in the Town of Putnam Valleys We have inspected the system itself and find that it'does eonform to the rules and regulations of The Putnam County Department of Healtho Some graa.dingo ' filly and drainage work will* however, have to be alone when weather permitao The owner of the property has submitted a letter indicating that this work will be done anal we will su *ervise it and certify it upon eompletione 1% would greatly appreeiate a temporary Certificate of'Oecupaney as the owners must move in next week* Very truly yourss Sullivan - Thiede Consulting Engineers 4 C ;�Io4sepph FO Sullivan, P.E. DIVISION OF ENVIRONMENTAL HEALTH: SERVICES DESIG"N 'DATA SHEET SEPARATE .SEWAGE DISPOSAL SYSTEM. FILE NO SA14 EtZio RtA -re R.:- �- ,�.- �:�-��co _' .r.:..., , .�, > ..,�cidress '►� E c.�`% i�o c.�iE V T ES . • @a A� Tg x AP - , . Located at (Street) a q�CC�tp C E '���,� E .• . q Block 1 LotS Z �:`�,. .(Indicate nearest cross. street) 23 v �L LIEy Municipality o•� y c F p�Z A� Watershed QoAR 1 oc 2Q c,ic I.. A tz ;SOIL'PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATION ' FIFTN MAP of Z, oAk G• Pftcc;) L, A.Ke L.oT6'.�o. Sao 'S3j FES !Z, 1449 �. pit-EP Hole Number CLOCK TIME PERCOLATION PERCOLATION. Run ...Elapse. Depth to. Water Water Level No. Time."..' From Ground Surface in Inches Soil Rate Start Stop .Min. Start Stop .Drop.in Min/in.drop Inches Inches Inches 2 P o. 3 GTR ANjEL . F7 ��' c..�`cH -T ,�. w iA e%.3 A10 3 .� .ts .A.�t E .�E�, rL.Y ' SET i L_eT:) 5 3 4 5 Notes: 1) Tests to be repeated at same depth until approximately equal soil rates are ob= tained at each percolation test hole. :All data to be submitted for.'review.. 2) Depth measurements to be made from top of hole. 1211 36rc 42 rr: 7811 8 4rr, INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED. TESTS MADE BY cj ,,a i) ; v c -, -T r Date 5 Soil Rate Used ' Min/l" Drop: S.D. Usable Area Provided S o 6 -f ! ] No. of Bedrooms 3 Septic Tank Capacity 9 o o Gals. Type Absorption Area Provided By �4 o L. F.x24" 36"___y/ width trench. Other AEG oF. �'_c'` P,o.v• G(hvc -L Pk --L %� at--=N ��SQC�sAL V. ELaS Name ..Ic�g�p.a F�ayG,S ��%LL�V a� Si attire .t'�5 j-, Address SULLIVAN- TRIEDE ° g v CIARK PUCE Xi 9A q ° PUTNAM COUNTY DEPARTMENT OF HEALTH.do g5 . 248 ° °°°° ° If 10 Soil Rate Approved Sq.i Ft. /Gal. Checkecl,R,�€SS!Q�;��`�� Date PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF.ENVIRONMENTAL HEALTH.SERVICES J� j DESIGN,ADATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. SRvEIZta r-1, a Gc.vk %.A 36S7 R Avpt��>r Owner E Address�� ►aEw S lz. , o . v-DE8T "r'A x Located -at (Street) oAK.%jr_�GE "V>w,�E '" W. Block 1 LotS� 3 (Indicate nearest cross street) Municipality -r o w v o F PST AM Watershed p_oAyt, Nz , %ftc., � E SOIL PERCOLATION TEST DATA REOUIRED TO BE SUBMITTED WITH APPLICATION �-` FtPT►1 M�iP o'F {�oRf�,,�G• (3tzoc�vC I..AKE I„o^r�. ,�c�, S�� �.53� F rc S 12 , 14 4 9 �= t 1.. sr P ►.� = 3c6 � Hole Number CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth to Water Water-Lev,el -No. Timer`. From Ground Surface in Inches Soil Rate Start Stop Min. Start Stop Drop in Min/in.drop Inches.. Inches Inches N o-iE T—' ` Pew Go �-A i �o ►� `°c ESTS 54,�.Irlr SE TRICE !J 2 �Z o. t3 , Gfe AVEI__ FI L.-.. IkT S%3cH -s- I ME .. w K rM VQ 3 4 S , 2 3 4 - f 3 � ,;a gal _ r c.lQ 5J ! .i.ICrG� . • `Yryp �.� ,tri:31 ;�c�•, d,- 4 t1_rK Qw e^J `(J h r`y Notes: 1) Tests to be repeated at same.depth until approximately equal soil rates are ob- tained at each pereolation.test hole. All data to be submitted for review. 2) Depth measurements to be made from top of hole. TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCWN!tkEb"*-'ik"TESi*'HOLES DEPTH HOLE ''N0: HOLE NO. 7HOLE '51 6'r 12 24tt' 301? 36" 42?t j4 48 CIL 5 4?1 6 Olt za 7211 7811 8411 INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL TO WHICH:. WATER LEVEL RISES AFTER BEING ENCOUNTERED n c- . Yw e- TESTS MADE BY f!)-, v of L,-A -T- Date TO Soil Rate Used Min/1't Drop': S.D., Usable, Area Provided SA 400 (D No. of Bedrooms S_Septic Tank Capacity goo Qals. Type Absorption Area Provided By.2.4o L.F.x2411 36"__/ width trench. Other 14 -Z 4% q S, N Name Address SULLIVA-THIEDE 4 0 CLARK PLACE ' P, o, a o)-e- -So% 0, 0 UP Nru► Vno►f i c> S4 P. 0 PUTNAM COUNTY DEPARTMENT OF HEALTH Soil Rate Approved Sq.•.Ft./Gal. Chee y0- 2489 0 Date PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH"SERVICES •r DESIGN, DATA SHEET. - .SEPARATE ` SEWAGE .DISPOSAL SYSTEM FILE .NO. . Owner .. Elio Address lo F_:w — v�EST -rA c AP .. . Located at (Street) o q�C(2ti1� GE '?�a,.tE 9 Block' LotSZ (Indicate nearest cross street) vAL LEy Municipality -r a xz 6 .:oF PyTUZ a� Watershed P_ j Apxg c- , 2coVc nAK G _ SOIL PERCOLATION TEST DATA REQUIRED `TO BE SUBMITTED WITH 'APPLICATION / � 1 F T ►� M A P o f ". , {_ o A k % )0 C, 1-ci 1.. A. Me Hole Number CLOCK TIME PERCOLATION PERCOLATION. Run Elapse Depth.to Water Water Level. No. '�'ime ` From Ground Surface in Inches Soil . •Rate Start Stop. Min: Start Stop Drop in Min/in.drop Inches Inches Inches �- C� E � G o � A � � c� � : E ST S S H Al,.t_: S C TAI ICE ,1.1 . • 1 `� 2 G —P AyE t. F� 3 �AkP E=t LL IS ice` Pc -�1�� S�:r F�� ����r �y 4. SETTI..Ep. 5 1• 3 4 S 5 .. Notes: 1) Tests to be repeated at same depth until approximately equal soil rates are ob= tained at each percolation test hole.. All data to be submitted for review. 2) Depth measurements to be made from top of hole. 4811 5 41► 60'1 661} 7211 7811 8411 _ ... . .. INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED i .�•,�� �� e-'x i ») �r• >•.� INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED r5 c rn C TESTS MADE BY. j ,z j) ; v 1-t ; c� Date - - 7 v DESIGN Soil Rate Used - � Min/l" Drop: S. D. Usable Area Provided S,000 No. of Bedrooms 3 Septic Tank Capacity__- !10r)-Gals. Type :�c0.Sa•�t� Absorption Area Provided By z4 o L. F.x2.411 361i_- width trench. Other A -je-, 24119 I ' / L � ;° Name ,� w �.e �S Address SULLIVAN-TRIED 6�0° ° °- ° Kpt CLARK PLACE _ > O WJ" 1 S4 ° PUTNAM COUNTY DEPARTMENT OF HEALTH e���°o d� o e°° 248 Soil Rate Approved Sq., Ft. /Gal. Checke &1Tr io a;,��' Date