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HomeMy WebLinkAbout2171DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. vAmscanyourdocs.com 631- 589 -8100 30.18 -1 -10 BOX 19 1 ru 1 r r 'I ' 0 or i .. ,. i +,- � � T 02171 � f h f ' PUTNAM COUNTY DEPARTII�NT OF HEALTH , Re 3/ Division of Edvtronmental Hee1W Sevlpea, Carmel, N -Y 10512 r Engineer Must Provide Q OF GONST1tL)GlIQN ,CCOMPLIANCE FOR SEWAGE DISPOSAL SYSTEM Towp'or VWage ! Iacated'tlt , . Ta:ap Bloc)t_ ib& Lot ormerly Snbdivieion Nam Oinner /app8cant Name , MaWng Address AJ/ Zip Date'Permit:lssned _Separate Sewerage System bnilt,tiy : . A Address Consisting of 77 12:5 Gallon Septic1Tank and _ Pabllc Supply From Address Water,SapPly or: Prlyate Sapply Drilled' by Address Eroeloti Control Heed Completed? Bntlding Type Has Garbage:Gsinder Been InstsRedY Number of Bedrooms 7Y7. Otber:gegnlrements S. certify shut the system(s) aid listed ,serving tile'. �vdaPr,.1 lee construCtS ationa $sentialo =d aeesvhown- oft., t ape of erhied tomple itW ssuedcb�iea of which pro ",attached), and in accordance with the assn the petnam Co t" paztme t Of' eiilth P EA I! Certlf{ed by ! Data: l - :Qidl llcena NO. Address i _ shall rom ti take inch action as slay , nsesaary to un thif cogesd on of any' unYnitiry Any,,perwn oeeuDY�rW;premises•served by the above sYnem(s) P Pw Y n from su"!'usage APP ►oval, of the ;separate sawerags systam shall become null and fold as soon as a Pub( sanitary a pill becomes conditlOns,rasult {nq Y C'' thtIn Drotral of •the private wafer supply shall beeoine nuts and vokl, when a public water suP01Y bscOn►a avillabN. Such , approvNa ,are avallibls and P n -. -subject to modlflut {oo or change when in the judgment of the Comm {;sione�of Heal eyoeatbn;•modificatlon or_ehanga�b 60c, eaaar Oates :Pill _ �7—_.. r PUTNAM COUNTY, DEPARTMENT QOF HEALTH ° Diy►s►on "of Environments/ Health Serdices, Carmel, Y 20512 f CONSTRUCTION PERMIT '.FOR SEWAGE DISPOSAL SYSTEM; CIrll� , ` xah Town o illage 1p Located at i1 e� 1 QrFI �1i�,l "SecEion O Block Subdrvisfon Lot Job Owner ' r _ Address = ��ke ��td i t -I it C, 4 a �, r t # BUitding 1TYPe� `yjl of Area frP .�- ('j Number of Bedrooms > Square Feet <4 Q p Total Habitable Space Separate Sewerage System, to consist, of ! j fj s — Gal Septic Tank w ,r � p 4 lineal feet X •� width trench 4 �To be constructed by �''ypr Addreess 4 y,. Wat �FQrS)y it?it? Public'SupplY =From t r , aye P0ivite.SupplY fobe drills -d by> xf y . � �^. '^*"`°t�'r"i•. r ` 'Address •�Qt !1 ' -` r �' } � }. ;L ' - er •`bq'uirgmonts F A M A Op 1 prase f, that 1 am >Jvholly an co Tpletely'respo' bls�fo nand so tion of :the proposed systems) l) that the separate sewage disposal system t!e °d ? �viFWi3•c nst� ted.as shown on t app Ved aYrte tlri)e�tt them to and in accordance with the star►dards, rules an regu a one o e n iZ cg ty Dope ment, o j h,•and that,on co e n her�fta h , . u am &� Certiflcate� of Construction Compliance satisfactory to. the Commissioner of Healthwil) % br ent, and a writ n "g aiont�g8? w(ll tie Aurnished t ie owner; ,his successor's heirs or ass�gn3';by site builder, that said builder will ndition any ;part f sa settR &ge disposal,sysi m daring,;the period of two (2) years imrriediately`:foilow•ing She date of the,issu- an Of?�k 1) he,Cert if" icate' of .a oat ction� Compliance iof }ie oyiginai system: or any repairs (hereto !2j'`that •th'eidrilled well described .above will b on the approved plan a d t saidhWell WIn" be^lnatalled> in accordance .with she, sta dards, rules a' i :l%- egu a ons . of: the 'Putr(am'' ov County Oep a of Ffealth , r% 1 N Date 6 :x �'� •0 9 J P.E. R.A. Address A License APPROVED FOR CONSTRUCTION This.bpproval ex om the date °ISSUed,unl on uction "of the wilding has been undertaken 'and is t revocable for,Cause.or• may be amended or modified :when,considere ace ° r y y the' ommis o er of Health: Any., change or alteration of construction ` requires a anew permit Appro r disposal of domestic san(t y and vale iy ' flu }A _.� . •�' is / w`yRh -.1 _ i " 1a x ._.... _..- ....,__�,.BY.Y__..- �..a...� •-- �- '.�:�-7�a..:;C._: _0 n � f � -•,I Y y49 Town ors illage s .,Block 1.sr Job' N le Spece, ^ Square Feet,' - F RIFE e1,4 feetgx lath trench �f1 Rt717 i& 1 = Ji. N9. 6393. F� that: lh v ' ag@r 8is s51 i e in' good ng congitonany ao wso .y ,y e of the approval of :the Certificate of ;Construction Comphance,of the original System or any iepetrs (hereto, 2) that the drilled well described ebr 4. Jocated as slioenrn onahe approved plan and that said well will be Installed.'in. accordance with the stari ards, rules and regula�i� on of thej Putr mty De arjrneM of Health r RACE` e Signed , s Address/ � z' Cense DROVED FOR�'CONSTRUCTION: This ap ovaF expires one year from the date issue ss c nstructton of the building has'been ,undertak,' >Cablegfor cause or may be amended or modrfied when considered necessary _by the Commissioner FofvHeaI n Any change or`alteration of cc ZY sire's a new ermit Approved•: for disposal of domestic sanitar sewage, a /or pnv a watery supply only x t e CR, f c; V2 0 ox LD M 4J PS Form 3811, Jnfy 1983 447 -$45 OIIISTIC RETURN RECEIPT E _ GG1I % V �Y � � �F N Z � ri^I V�/ � u O /�� gyp{ r+.� 4 V � V � Q `Tf�' ► 0 �1"ry1 �y rf C O + C e e'er «��.a 3 0 � N �� LX101 Q. 0 «g�� (� p a�N�. � ¢tiro �w cn Q SL � � � ^ �- � 4 � " �I � CIClC7 a a a; x' x M 4J PS Form 3811, Jnfy 1983 447 -$45 OIIISTIC RETURN RECEIPT E _ GG1I % V �Y � � �F N Z � ri^I V�/ � u O /�� gyp{ r+.� 4 V � V � Q `Tf�' ► 0 �1"ry1 �y rf C O + C e e'er «��.a 3 0 � N �� LX101 Q. 0 «g�� (� p a�N�. � ¢tiro �w cn Q SL � � � ^ �- � 4 � " �I If yield was tested of different depths during drilling, list below FEET I GALLONS PER MINUTE DATE WELL COMPLETED DATE OF REPORT WELL DRILLER (Signature) e �� . 71-7.7 WELL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH 3/71 Division of Environmental Hoalth Sorvices COUNTY OFFICE BUILDING - CARMEL. NEW YORK Thic report is to be completed by well driller and su::'.:itted to County Health Depz)rtment together with laboratory report of - analysis -of -water sample indicating water is.of.. satisfactory bacterial_quIlity. before certificate of construction compliance is issued. REPORT MUST BE SUBMITTED WITHIN 30 MAYS OF WELL COMPLETION _ OWNER NAME /� ADDRESS f�/ �j % / O Y s+ —t! LOCATION (No. & Street) I (Town) (Lot Number) OF WELL r, C� PROPOSED DOMESTIC lJ ESTAE ISHMENT FARM TEST WELL USE OF WELL OTHER D CONDITIONING SUPPLY INDUSTRIAL (Specify) r� COMPRESSED D ROTARY AIR PERCUSSION CABLE Q El OTHER PERCUSS:Oi•� EQUIPMENT U 1J LL___.JJ (Specify) CASING LENGTH (feet) DIAMETER(inche$) WEIGHT PEP. FOOT X (jD)R-rjVE SHOE WAS CASiNG� D ❑ DYES � NO YES t_�J NO DETAILS � ; � r THREADED WELDED l__J ;: , YIELD ��j HOURS G.P.M. U YIELD TEST BAILED PUMPED U COMPRESSED AIR J _ i) i V) WATER MEASURE FROM LAND SUkFACE— STATIC(Specilyfeel) fleet) DURING YIELD TEST j Depth of Complelod Well LEVEL �` ;y't` �)C•i''#' in feet below land svrfacw, U - MAKE LENGTH OPEN TO AQUIFER (leet) SCREEN SLOT SIZE DIAMETER (Inches) IF GRAVEL Diameter of well GRAVEL SIZE (inches) FkOM (loot) TO (foot) DETAILS PACKED: encliding gravel pock (inches): DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEE T 1a -- -I CA -' - R 19�''� If yield was tested of different depths during drilling, list below FEET I GALLONS PER MINUTE DATE WELL COMPLETED DATE OF REPORT WELL DRILLER (Signature) e �� . 71-7.7 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Owner or PurchastAr of Building Builcli ng Constru ted by ki LocationmStreet Municipality Building Type Seeton Block Lot rm l 4 l G Subdivision NanA . 4005 Subdivision Lot # GUARAN= 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 _ "Cer- tificate 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 " m 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. )k�� Dated this 'Z ( day of 19_ Signature NWk n� Title General Contractor ( er) - Signature (:� �4F Q_L� Corporation Name (if Corp.) Addrdds rev. 9/85 mk Corporation Name (if Corp.) Address Yorktown Medical Laboratory, Inc. 321 Kear Street Yorktown Heights; N. Y. 10598 1 - (914} 245 -3203 Director: Albert H. Padovani,M. T. (ASCP) T_ -1 LAB — .0()4'572) Collection Station Used: Carmel _ Peekskill _ Mt. Kisco New City Date Taken Date Received: / Date Reported: All eH6A5/ �jCr/�� Collected By: 11 .r Referred By: v. �f /,� ,�U / Sample Source: /� ---✓k:'O,F'�'� /3,&e-" ,4/j x'117. 141 LAB.O-RATTO..RY REPORT ON BACTERIOLOGICAL QUALITY OF WATER GENERAL "BACTERIA Standard Plate Count. per 1.0 ml !y (Agar plate @ 35 °C) MEMBRANE FILTRATION TECHNIQUE (MFT) Total Coliform Der 100 ml_ Fecal Coliform per 100 ml Fecal Streptococcus per 100 ml MOST PROBABLE NUMBER TECHNIQUF.(MPN) Total Coliform: MPN Index Der 100 ml r._.....::..._ �_ Fec•al C�oli-Tor-m ._.._. M 'PN._:Imd-ex...pe.r,-- 10,0__ml .. _ :�..- OTHER ANALYSES THESE RESULTS INDICATE THAT THE WATER SAMPLE (WAS) (WAS NOT) (NOT APPLICABLE) OF A SATISFACTORY SANITARY QUALITY ACCORDING T10, T NEW YORK STATE DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. Albert H. Padovani, M.T. (ASCP), Director ' ELAP #10323 LEGEND RDS = Recommend Disinfect - ing Water Source TNTC = Too Numerous To Count CONF = Confluent < = Less Than > = Greater Than :i Yorktown Medical Laboratory, Inc. 321 Kear Street _ Yorktown Heights, N._Y, 105-98 _. . ... ° (914) 245 -3303 ......., _......_ a..�. . ,.. �..... -. Director: Albert H. PadovanM T (ASCP) "'D G LAB # 34.004572 Collection Station Used: Carmel _ Peekskill _ Mt Kisco ,New City -� Date Taken: Iv l 3v Date Received: Date Reported: =.Alz Collected By: ,- Refe rred By: Sample Source- ; V&1' v L �4JC..� � � ��Gj7 u7V1y P7 LABORATORY REPORT ON BACTERIOLOGICAL QUALITY OF WATER GENERAL BACTERIA Standard Plate Count per 1.0 ial y (Agar plate @ 35 °C) MEMBRANE FILTRATION TECHNIQUE (MFT) Total Coliform per 100 ml Fecal Coliform per 100 ml Fecal Streptococcus per 100 ml ...'POST PROBABLE NUMBER TECHNIQUE (MPN) Total.Coliform: MPN Index Der 100 ml Fecai Coliform b APN Index per 100 ml OTHER ANALYSES THESE RESULTS INDICATE THAT THE WATER SAMPLE (WAS) )(WAS NOT) (NOT APPLICABLE) OF A SATISFACTORY SANITARY QUALITY ACCORDING TqTWNEW YORK STATE .DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. Albert 'H. Padovani, M.T. (ASCP), Director ' E LA P #10323 LEGEND RDS = Recommend Disinfect- ing Water Source TNTC = Too Numerous To Count CONF .=-Confluent _< = Less Than > = Greater Than h i NY ;¢ t. C p TEST PIT DATA REP�t1I DESCRIPTION OF HOLE' NO. icy �o; i _ log X50; C CUi •e TO BE SLR?:; ITTED iiITH APPLICATTON SOIL") ENCOU ,,TERED IN TEST*HOLES HOLE NO. HOLE NO. -Too .So b 1. Sa, C 04m r- 84" INDICATE LEVEL AT WHICH GROUND HATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING- ENCOTj7TE yu, D - TESTS MADE BY R o b e p -r; D 0 SS Date 17 DESIGN Soil Rate Used_ 0:-" Pan/l!'-Drop: µ ^ S.D. Usable Area �r�v�d =Q:`3 No. of Bedrooms Septic Tank Capacity Gals. Type C nMCAe-f-,e Absorption Area Provided By I5L L. F. x24" 3 56'� 3 6 width trench:. Name c a e � {� ds S Signature Address s I a Lu N tv o 0 Q A 0 SEAL C U 1,4&10 q0 THIS 12" BY HEALTH DEPARTPENT 18" 1 24" Sq. Ft /Cal. 3011 3 36 if 42" 48" 5411 r 60" 66" . 72'... TEST PIT DATA REP�t1I DESCRIPTION OF HOLE' NO. icy �o; i _ log X50; C CUi •e TO BE SLR?:; ITTED iiITH APPLICATTON SOIL") ENCOU ,,TERED IN TEST*HOLES HOLE NO. HOLE NO. -Too .So b 1. Sa, C 04m r- 84" INDICATE LEVEL AT WHICH GROUND HATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING- ENCOTj7TE yu, D - TESTS MADE BY R o b e p -r; D 0 SS Date 17 DESIGN Soil Rate Used_ 0:-" Pan/l!'-Drop: µ ^ S.D. Usable Area �r�v�d =Q:`3 No. of Bedrooms Septic Tank Capacity Gals. Type C nMCAe-f-,e Absorption Area Provided By I5L L. F. x24" 3 56'� 3 6 width trench:. Name c a e � {� ds S Signature Address s I a Lu N tv o 0 Q A 0 SEAL C U 1,4&10 q0 THIS SPACE FOR USE BY HEALTH DEPARTPENT 014LY: Soil Rage Approved Sq. Ft /Cal. Checked by 0.'039%- ly�F rur7nxaRE.�E Notes: 1) Tests to be repeated at same depth until approximately equal'soil .rates are obtained at each percolation test hole. All data tolbbe submitted for review. 2) Depth measurements to be made from top of hole. PUTNAM COUNTY DEPARTMEi`IT OF :HEALTH DIVISION OF ENVIRONINOTTAL IMALTK SERVICES r: COUNTY OFFICE BUILDING, CARP -'L, N. Y. 10512, DESIGN DATA SHAT- SEPARATE SEWAGE DISPOSAL SYSTEM:,....-, , FILE NO`. .; Owner . � Address _ . o u Located' at (Street iN es r L p jCe b See. Block Lot �t OS� . indicate neares cross s ree . Municipality Watershed. SOIL PERCOLATION TEST DATA RE�JUIR'D TO $E SUBMITTED WITH APPLICATIOPiS . .Hole Number CLOCK TIY_ EP PERCOLATION.' PERCOLATION, Run Elapse Doepta do Water . a er. nwel No. Titre From Ground. Surface in Inches Soil Rite Start -Stop Min. Start Stop Drop in' Min. /in drop Inches Inches Inches 1 �}•.00 B•.0� S ' a t� a. � 3 O— . o 2 q .►u �c . lit c, a z3 3 s 3 1:30 8.39 g a� ° 3 (;.Li 0 �sl a a3 3 0 4 c 5 Notes: 1) Tests to be repeated at same depth until approximately equal'soil .rates are obtained at each percolation test hole. All data tolbbe submitted for review. 2) Depth measurements to be made from top of hole. T,1� c�n�cK z Late / - Insp . by : SPIT e n �� .rt �t � � Comment .s 1 SN:f -TT11L SI 1 T ITIS EC IO! : Y - r � No Comment, ,Property linos or corners found Gan estir;ate house location . . . . . . o Will driveway need cut . • • • . . . . . . . . Must trees be removed- 3�.ote these . . Is deep hole represen latlive of entire SDS area Additional deep holes needed. . . . . . . . . . Sufficient SDS area available considering driveway cut, house location, separation . . distances, etc. . . . . . ' glij, i.JLLCS�SEPTC�.� DEEP HOLE DATA D_pth: "Water elevation:. - Rock elevation: Soils descr_i.;_)tion: Date: .� LD Z FINAL STTE Ti,TSP ECTIG�N Insp. by: House located where *shoi.,n on approved plan *- • • SDS located wlliere approved . . . . . . . � �-- :Len(rth of trench m asur'od Ca • ilidi,ii of trench ave_r-age Slope; of tile, line and trench. dccepta,ble Room allowed for expansion trenches . . . . . .- ° FINIAL GrMING or SITE ACCEPT11I1T. E t3E p -5 5,� ,. 1 PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES John M. Simmons, M.D. Deputy Commissioner of Health - FIELD ACTIVITY REPORT - Sheet of UY INSPECTION NAME A41VA n Orig. Routine �. Orig. Complain ADDRESS Orig..Request , No. Street Municipality (T)(V)(C) Compliance Complaint Comp MAILING ADDRESS _ Final P.O. Box Post Office Zip Code Group Illness Construction TELEPHONE _ Reinspection PERSON IN CHARGE Field, Sampling Only OR INTERVIEWED Field Conference Name and Title Other DATE TYPE FACILITY TIME ARRIVED. TIME LEFT Explain FINDINGS: a' INSPECTOR: TELEPHONE: 13ignature and Title PERSON IN CHARGE OR INTERVIEWED: I acknowledge receipt of a copy of this SIGNATURE: Field Activity Report .................. TITLE: cl s a 0 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES _...._._ ­ COUNTY OFFICE BUILDING; CARMEL;° N." Y; ':10.512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner Address L1or 1 -cxa2� S)Kn t R. QA Rock Q1 nC4!G5bA Z04 Located at ( Street�Indicate W eS ,r L p Ke Kb sec. Block Lot y 0 neares cross street) Municipality Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Run Elapse p o a er water Level No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches i �• ; � 2 .iu .1� 9 a(0 3 x:30 S 39 C1 Q a 3 0 -5 5 q:NO .x:51 j► a a 3 o d 0 1 2 3 Notes: 1) Td,�ts to be repeated at same depth until approximately equal soil rates are obtained at each percolation 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 ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. 1 HOLE NO. HOLE NO. 6'r 1211 Cb1d S e Sc. 1811 2411 3011 3 If 42 rr 48" 5411 j 60" 66rr 72" 78 r' 8411 "fop So , Coum Ste„. (o u r S- e- 50 "i s� c rave..\ INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTE D TESTS MADE BY a2 0 6 e 2 -r D ��SS Date U ! 7y Soil ~Rate Used y� Min/1"Drop: S.D. Usable Area Provided sQ�� No. of Bedrooms 3 Septic Tank Capacity Gals. Type Absorption Area Pro ded By IS L.F.x24" �j` '— 3 y dth Name ID S� © i na ure_ Address a WYN WOOD k o SEAL C 0,6 THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft /Gal. Checked by n'o. 039 %t �`��, al I tl, r 3 _ t f 1.., -y`T "iii + i' !''i r :. r r i, + _j -.i. ,jf 11 1 r, 1. �1 i. i-1 i -_ - i.j - r - 1-! Y'• 1 .I +_j i 14 I J� J l ; `l l: 1 - 1 - • �� ,�=_.�: t� y_,. L 1. Li _ ,;t - .� _ 1 $�., : ;. ' -- .I.I i.., i,f�l,i I l j �" i!j .lr = ' I ' I !k ! !; • ! Y _ t.; 1 1 { L 1_11 3 . j ti.� . 11'- .I r �1 t . -1_ i l ,. _. I 1 _, _ I,{l.� t ,'`'� !.tlj'C - S 1 -I .; j . , it f :'! 7 1 i J ;- ! t 1.1 LI AT 111 • - S. 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T ' t - : d - r , d ' -'-# — _j.{ 14 11 l -i-• f 1 i t j ,r's i_- -� 'f_ { -�I? iT-- •i -r- �. .; - ?. - I3I i., , r.... i{-I- .i_ -r r.l i Ij- !.1_''f 1 -1 '• "1?1!! .iI E, ' , ; }_,r 1 -;j f, - ..�1'� J -i I I - i -11 - -- I} -_ _ f 1f[ {1 -1 i- III( '` I }. _1'!I,'•�,�p -1`' 1�I ��u.'._m$.,.t. {• fi -t�f4 I1 - VISIT _ 1�_ 1J: "Ail - � {i_j;;� 'f t i H I ' j j •-it -I j ; -I I lot; , :. - .i: �, -- ' .I. I .� j s. oa 1 -r +_ � �� - i } . i _L: I i#I_I:- + i TOM ,_r err ,,1 -- {ij;� f ;.3!� • os! ! _ : ,.. . i f j • + .} I i t i V _I r t 1 4- _ # t �z .I �t. ! '' 1t }r :, I�.' '° -, IV oil i 44 j K� hi' 1 G� _. �:.! r. I 1�' ' __�� 1 ��� j + I t1 t , ! -,� l 1 {. ! i __ #_ V1 j r {{ i I i i I I -I _�.I { j , i i f I i I L, I ; , , Lit' j t 6 of - i 1 _. j :. , j f i' , i 1 r I _ i I i�r _. j } ' ' + f ! i 1 - kilt. I ! } hill! ' l 11 !I I i I .I . ._. . i O,06�5 / p(EVX tIV/A` - AVFL1 6u"wf DY j j. AAsR , l�oP.�- rft, WAS DAT�p �2dr.:.Z�, ►g:i�'1 - ` ���f O-q ✓ X pp,, T _ ?1Z.,_ 22 0. _a 4 \?"a vv .17t GOL`1 fRJ '11-J 415 IN) (:� v t F, t t 1," -- +.... ..__ $ }tirff WAS I1`iS' -rirD Ft, i" rS. 'i L t 4 AS WAS CONST'ROC Ilan 1,! AC.COi llA U, \i iTH P-U THk xU1IS AND U* Ur:A110.5 CAN ':!'i[1 ['(''i }Jint?t:C)tJ�`TY. Putnam C.oun �►C . �s?, �, ��rrAx rp�EN'r oF: i I I A F Jivielon ' tY Deyartmeat of $eg1:LD �HnvirCWntal Hea14� Bomaer . ' sPP ed a notedt fofor oonfo Orman HtD 1-2� (*I- a w_ aPP1loablg Hulee .and Regulations 0#-t Is %ice t�n� 5 G7i1Nk u?izal ttti+� fv'• }25a (h sC�rio Tr�v�L :Putnam county Health bGzjQrtmenty` u , L�Ad (4) ftVKOOM, FJO `; fil � BI ;.� • A 7y MS 4Y .....J' L�S'+V. .`. 1 ➢ A b_; l!; i" t -�. rf`3• 1. � •.. r .. .. ... ,- 4':.:... . ... .... a .. . _ .,r.... �. -•1 ... ...,•1'. ➢ _ .. -.i ..V" .�:..� 2t": �.. .:•. `.. u . :. ,�. . .l}; Y1 '�? ;'_ x!.y.Y )�1 :X i d l