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HomeMy WebLinkAbout2220DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 41.05 -1 -12 BOX 19 _ � Z .r ` { '-i L !� 02220 7, n, jY'S"f`' ' 'w'-r•�i ;..t' , "!4' -�"- `..__ 'r'- '.�j .'^'.."'"C'"'— '._.i. ±...^'..: J• ... ..y,.... ] PL'TNAM COUNTY: EPARTMENT OF HEALTH ' V. 3186 Division of Environmental Health Servicex, Ci*mel, N Y 10512 Esiglneer Must ProvldtP V 36.- 8.6 . P.C. D Permit p : — ' � � - Putnam Valley CERTIFICATE OF CONSTRUMON.COMPLIANCE FOR SEWAGE�DISPOSAL SYSTEM F: r _..: ._ { Town or; Vil!}sge Lecated,imt Oakri:dge .Drive',, putnam. Valley Tom' p g Bleeh 1. TLo�, l r Mar Ka Powers' fth Map: of Roaring Owner /eppllcant Name '' y y Formerly sib' ion Nam Snbdv Lot q _ Matlitig Aa&eaa 5 3 C ar ey - .Street zip_ 10.5;41 Date. Permit aaiea 11;/ 10 / 8 7 Mahopac.;.New .York Separate Sewerage System buQf by Ted MdGlas son Address Carmel , NY . 10 512 1000 Conslstlui of Gsllou Septic Tank and, 334 LF,' "QF:. 1'8 X. 24 ' t'reriC-leS Water Supply. %blic Supply From Address or: Pilvate Supply DA1ed•byNOrman :•AndersoT AddeeesBarger Stk. , Putnam •Valley,NY Bull frame Hss'Eroslon.Control Been Completed? N �A Nmiber of Bedrooms' 3 Has Garbage Grinder'Been InetslledY Other Regilrements T certify that the.syetem(a) as listed serving the above premises. were con 'ruct I essentially as o Mo f n he lane o completed work ( copies ,. of'which are attached), and in accordance with' the standards rules and,•re ulat a iri acco ance t ed Wd *the• permit issued by the Putnam County Department Of'Heilth:•;{ f oats Auetust 18 ; . 198&. certined by Address 380 Main Street, Ridgefield, ,CT , , 0687Z�conse No. .059113 Any person .occupying premiai served by .the above, systems) sha11 promptly. take such action as may be necessary to iecure tM correction of any unsanitary conditions resulting from'. such usage y.'Approval -of the' separate;sawe ge systam ihilI become nu11 and' . as soon as a pub!;: unitary awer becomes available and the approval of the private water Supply shall-become. and void when `,a u Ili water supply becomes available. Such approvals are subject . to difiation or ange when in the judgment of the Is or of ch'revftfiNon. % fiction or change I n y. Date ✓ ey Title Yorktown Medical Laboratory, Inc 321 Kear Street Yorktown Heights, A!. Y. 10598 _ (914) 245 -3203 Director: Albert H. Padovani M. T. (ASCP) 'i 32.O14700 LAB a t Date Taken: Time Date .Rc'.d: -_3_- Time: Date Reported: MAY 2 5 09 Collected By: 4F, A10le Referred By: T_ _ 1 Sample Location: 7,T1br* 710100 1V6 le 7/1AO6 P/ �b y 1-3 6 X 3) 7 Phone N Phone 11 L J Repeat Test? _ L13CRATORY REPORT Ot THE QUALITY OF WATER NEON - METALS (mg /L') MICROBIOLOGICAL.. (CFU /100ctL) — Acidity GENERAL BACT =?IA Alkalinity / 3 Chloride s� Standard Plate Count _r Detergents, MBAS (CFU /1.OmL) hardness, Total _ Nitrogen, Ammonia MEMBRANE FILTRATION TECHNIQUE _ Nitrogen, Nitrate Phosphate, Total / Coliform !/.Total Sulfate _`. Sulfide Fecal Coliform _ _ Sulfite Fecal Streptococcus METALS (mg /L) _ _ 140ST PROBABLE NUMBER TECHNIQUE _ CoDner IIron -7 Lead Manganese Mercury Sodium Zinc MISCELLANEOUS pH (units) Color (units) _ Odor (TON) Turbidity (NTU) Total Coliform Index Fecal Coliform Index ti KEY FOR TER:dINOLOGY N/A = Not Applicable' LT = Less Than ( <) GT = Greater Than (>) TNTC= Too Numerous To Count CON = Confluent ( =TNTC) NR = Non- reactive REMARKS /COMMENTS (For Lab Use) Sample Type: (check one) ZPotable _ Non - potable _ ST? INF _ ST? EFF Other: Sample Status: (check each) OutaoinK _ H:103 HC1 H2SO4 NaOH Zr.OAc Na2S203 Other.: Incoming -le'-L, r 4 0 C _ GT 4 °C _ nii LE 2 pH GE 9 _ DH GE 12 Other: THESE RESULTS INDICATE THAT THE -WATER SAMPLE (WAS) (WASN'T) (N /A) OF A SATISFACTORY SANITARY QUALITY ACCORDING TO T N YORK STATE DRINKING WATER. STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. THESE RESULTS INDICATE THAT THE WATER SAMPLE (DID) (DIDN'T) (N /A) MEET THE SATISFACTORY CHEMICAL QUALITY STANDARDS OF THE NEW YORK STA D KING WATER CODES, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. p ✓ ZX/ Albert Ho Padod ni, M.T. ASCP), Director 2 /86(Rvsd7 /87)RWE i e f U 7z? l C��O�%. TTl'TT T /1 /�LrtTT TTT ALT i]L�T)AIiT WL' LaL l,VP1tLLS11Vly L�Gr VAi y .a DEPARTMENT OF HEALTH i ._Division Of Environmental Health Services PUTNAM COUNTY DEPARTMENT OF HEALTH Office 'Use Only. Y1 WELL LOCATION STREET A DRESS: W I Y �: j TAX GRID NUMBER: WELL OWNER NAM ADDRESS. PRIVATE a 3/ o �� PUBLIC S jk 8ESI TIAL 0,661111 IC SUPPLY O AIR /COND. /HEAT PUMP 6 ABANDONED ❑ BUSINESS ❑ FARM ❑ TEST /OBSERVATION ❑ OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ USE OF WELL 1- primary 2 - secondary MOUNT OF USE YIELD SOUGHT gpm. /N0. PEOPLE SERVED / EST.-OF DAILY USAGE gal. REASON FOR DRILLING gNEW SUPPLY , ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST /OBSERVATION O REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH ft. STATIC WATER LEVEL °2' ft. DATE MEASURED DRILLING EQUIPMENT ROTARY ❑ COMPRESSED AIR PERCUSSION ❑ DUG ❑ WELL POINT 0. CABLE PERCUSSION' ❑ OTHER (specify): WELL TYPE 0 SCREENED O OPEN END CASING. JR OPEN HOLE IN BEDROCK ❑ OTHER CASING DETAILS TOTAL LENGTH .2 ft MATERIALS: 34 STEEL ❑ PLASTIC ❑ OTHER LENGTH.BELOW GRADE 11 &1_ ft JOINTS: ❑ WELDED 19-THREADED ❑ OTHER DIAMETER in. SEAL: ❑ CEMENT GROUT ❑ BENTONITE 270THER WEIGHT PER FOOT lb. /ft. DRIVE SHOE:I;�-YES. O NO LIN ER: 0YES RN SCREEN DETAILS _ . DIAMETER (in) SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (ft) DEVELOPED? FIRST OYES ❑ NO HOURS SECOND . __ _ _ . _ - __�._ .. GRAVEL PACK O YES O NO GRAVEL DIAMETER SIZE OF PACK in. TOP DEPTH ft. BOTTOM DEPTH h, WELL YIELD TEST It detailed pumping M 00: O PUMPED I tests were done is in- COMPRESSED AIR , formation attached? O AILED ❑ OTHER :OYES ONO !! WELL LOG 11 more detailed formation descriptions or sieve analyses are available, please attach. DEPTH FROM SURFACE water Bear. ing We11 Dia- Ineter FORMATION DESCRIPTION CooE. It tt WELL DEPTH ft. DURATION hr. min. ORAWOOWN ft, YIELD gpm. Surface � 300' � . D WATER O'CLEAR TEMP. QUALITY O CLOUDY HARDNESS O COLORED ANALYZED? O YES O NO ANALYSIS ATTACHED? O YES ❑ NO STORAGE TANK: TYPE — CAPACITY `�U GAL. PUMP INFORMATION / TYPE CAPACITY 4 MA DEPTH ° MODEL -QP' / — � VOLTAGES WELL DRILLER N ME - DAi L- 44 [y AOOR /may k���`fiSIGtTURE �� �f .y PU NAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENrAL HEALTH SERVICES +.. t'....r ...�.: .'.q .. ..+K.:..+.� ...��.i �; ...-, �.- .�_...- .•..... ✓4�.. sr-.a.u.t:+_.ae, -c-a.. .. _ .a —... _ . -. a�... _.. .. -. ... ...._..i -. .. -� � ..._ -_..., �. ,.���.�.�.ri,. W....:.�:::.eaa.:��nOw .S� V^ 0 Owner or Pbrchaser of Build' g Section Block Lot -Building Constructed by "ale. A Rao, go a V, V &V C, FVo o k �a Location - Street J SubdivisiotY Name . Ve, Ile R A, 4POVeAL JAI% V 0 Municipality Subdivision Lot # 1de���.1 Building Type 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 "Certificate of Construction Compliance" for the sewage disposal system, or any re s: made by. .me- to -.such - sy.stsn,._except.where:the fai -lure -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 t building utilizing the system. Dated this day of 19 Signature Title General Contractor (Owner) - Signature Corporation Name (if Corp.) Address rev. 9/85 milt �Ovo K, FINAL SITE INSPECTION Date ? vlf Sn= T4cATI0N 04/ Z (2 ,w G U` A PERMIT # 1� TM # OR SUBDIVISION LOT II, IV. V. VI. Inspect by OWNER G"ti 10 `SEWAGE DISPOSAL - a. SDS area located as per approved plans b. Fill section - Date of placement 2:1 barrier_ LGTH WIDTH AVG.DPTH d c. Natural soil not stri d. Stone, brush, etc., greater than 15' from SDS area. e. 100 ft. from water course /wetlands. p( SEMGE DISPOSAL SYSTEM --f a. Septic tank size - if, 00 1,250 C ohpw b. Septic tank install evel C. 101 miniImIIn fran foundation 'X d. No 90° bends, cleanout within 10 ft. of 45° bend e. DISTRIBUTION BOX 1. All outlets at same elevation - water tested VrIj 0 2., Protected below frost 3. Minimum 2 ft. original soil between box and trenches ' f. JUNCTION BOX - properly.set g. TRENCHES 1. Length required - Length installed- 2. Distance to watercourse measured: ft. 3. Installed accordin2 to plan 4. Distance center to center 5. Slope of trench acceptable 1/16 - 1/32 " /foot. 6. 10 feet from property line - 20 feet - foundations 7. Depth of trench < 30 inches from surface 8. Roan allowed for expansion, 50% 9. Size of ravel 3/4 - 11" diameter 10. Depth of gravel in trench 12" minimum ll.-Pipe ends capped h. PUMP OR DOSE SYSTEMS 1. Size of pump chamber _ - - 2a-0verflow tank 3. Alarm, visual /audio 4. Pmp easily accessible manhole to grade '' 5. First box baffled 6. Cycle witnessed by Health De ent /v r estimated flow per cycle HOUSE a. House located a2pEoved plans. b. Number of bedrooms :ti_v .. -• 4 " "' a. Well located as per approved plans j ' b. Distance from SDS area measured b6 ft. 7 x/ ""75 c. Casin 18" above gEade. d. n Surface drainage around well acceptable. OVERALL WORKMASHIP a. Boxes Fr-operly grouted . b. All pipes partially backfilled c. All pipes flush with inside of box ..v,., d. Backfill material contains stones < 4" in diameter e. Curtain drain installed accordin q to plan f. Curtain drain outfall protected & dir.to exist.watercours g. Footing drains discharge away from SDS area h. Surface water protection adeauate i. Errosi.on control provided on slopes greater than 15 %. 10 -on CERTI]TICA _ _ SubdlvIsI6i'Na'm-e'n,aP­6i to' AO roval Fill Sicltfoiii� Only Address dress Or: PA ate Supply DM sent that 'I m w tioliy� and� coinpiefely reiponiiiblo�'for the aoiiin and . loca I tion of 'the propoS . ed. SySteim(s);L 1) that. t�e,�saparate-siwage'clisposal system County pepiirim'e�nli oi,'44eai6.. "r to r. maybe amen a or Date- /L he 6611dir t at said-builder will vfrom the -date issued unless, �onstruction of the building has been undertaken and is ;an supply only. Title , ~ ENGINEER TO PROVIDE PERMIT # do TM[ENT ®F HEALTH :: orl cERr: FICA o CO PuA E. Division of'. Environmentat Healih, Seivrces Carrr►el Hl..,: Y 9 PERMIT . .�, - CONSTRUCT) PER MIT FOR EWAGE DISPOSAL SYSTEM -.' Tpwn or i. age Tax •'IVlap Block / Lot �l'�'• ._. �, Located at Subdivision' O O' Subd. Lot N � Renewal _❑ Revision i1L� an A 7 L p 60 Z "� (; (��� � r t77 Qh o Date -of Previous A royal Owner /Address S t�1 � �- � FP Building Type P�1�'► Lot Area 0 "•4125 Re- Fill ,section.only ❑ Number of"BadroomS " v - " Design Flow G /P /D_ '' P.C. 'H.. D. Notification Requirk Separate' Sewerage'.5ystem to 'consist of. 1060 Gal Septic Tank" anti To be constructed by Address water Supplyc Public Supply From Private Supply to be drilled" by 'Address' Other Requirements 1 represent that I am wholly antl completely, responsible for the design ndocation of the proposed systems) 1) that the separate sewage disposal system above described will b'e constructeG as shown`on the'approveG amendment theie t0 antl; ?in accordance withVie standards,• rules an regu a ons o e Putnam County i0epart men t''of Health, aria that on completion thereof a Certificate :- ,of,Constf�ottionxCompliance satisfactory to the :Gomm�ssionerFof Health will be submitted to the .Department, and a written'guarar t9p 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 dlSposal. system' during the period of two,(2) yeas IrrimeGiately tollow�ry`th ®date of the isw- ance. of the, approval of the Certificate of; Construct,om •Compliance, of the;origmal system or any repens the►eto,.2j, that the drilled +well described above will be located as shoran on the approvad pian antl "that said :well willb`e installedFAn aceordance'with the.`' tanda' s, 'rules and'iequ a�OnS�of -'the Putnam County Department of Health.. Date /L� ''S�gn PE. R.A. T . - p� Address �U C O 1 v[ (�YF ��_t]/ /! -'J� °T f� / �L � License 'No APPROVED FOR CONSTRUCTION This 'approval expires one year -fr m t date. s ed unless constru on of the. building has been undertaken and is revocatli:, cau e, or M be amended or mods �, when considerod`n es Y'. by t _C miss n / 'Ith: Any change o► blteratbn of construction requires a 'new ermd.; roved for disposal of_iiomestic samtar ge =and/ a a r (f y only 2 Date Y. Title __j_ ev.,_ 6/85 �. __... -- - -- _ ._ _ ... - -- — ° - - -'- - - _.... __ ..: `_ PUTNAM COUNTY DEPARTMENT OF HEALTH ----." ..--.-.-----..-DI.V.ISI.ON-.-OF-ENVIRONME-NTAL-1 M-LTH---.SERV.ICES,,.-,-. -- - - --- COUNTY OFFICE BUILDING, CARMEL, N. Y.; 10512 I)EBIGN DATA B1. IKET- SEPARATE. SEWAGE DISPOSAL SYSTEM FILE NO. -owl. ()w I it) I A (1A r bm"aLud at Umut L esoc. eb Mock i Lot �lndlca e nearest cross mUr1i0�.Pa1ity11R"r-q'1A-VV\ \/ro-t-teZ Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE'STJBMITTED WITH APPLICATIONS NUmbOr, CLOCK TIME PERCOLATION 'PERCOLATION 'iun . 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 , tq (4 1 z .1 Z"Z. I I -0 It A M10 to - .... r --:-, - - - - , - - -- --- -1 4 z,; 6-713.: Z4 za 5 tt 15', 151 -Ell 5P z,-1 50 t 3 34111 Lt'. go Z11 4 5 Not,wi: .1 ) TwIto r -I 11, (al I t t..() . oUaL h)), T.(,)V.1()W. to be ropeatc"(1 nt -,3111110 Until a rox 'loci tit uacV) pur-colatlun Lost hole. AYY da rribasuremorits to be mado from top of h 0. Gti it 'Ot OF NEW YO I 2111rl _ �, ,, , tq (4 1 z .1 Z"Z. I I -0 It A M10 to - .... r --:-, - - - - , - - -- --- -1 4 z,; 6-713.: Z4 za 5 tt 15', 151 -Ell 5P z,-1 50 t 3 34111 Lt'. go Z11 4 5 Not,wi: .1 ) TwIto r -I 11, (al I t t..() . oUaL h)), T.(,)V.1()W. to be ropeatc"(1 nt -,3111110 Until a rox 'loci tit uacV) pur-colatlun Lost hole. AYY da rribasuremorits to be mado from top of h 0. Gti it 'Ot OF NEW YO I PUTNAM COUNTY DEPART OF HEALTH - DIVISION OF 'HEALTH SERVICES INDIVIDUAL MATER SUPPLY & SUBSURFACE SERE DISPOSAL SYSTEMS REVIEW `(Name of Owner) COMMENTS 10A 10 :_ __- - -- .-- -_-� -- SHEET - CONSTRUCTION PERMIT- BY: DOCUMENTS Permit Application Corporate Resolution Plans - Three sets. Engineers Authorization Design Data Sheet (DDS) Deep Hole Log Consistent Perc Results (3) Perc Hole Other House Plans - Two sets If PWS - Letter 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 ✓6esign Data Two -Foot Contours Existing & Proposed Driveway & Slopes Cut Curtain Drains Perc & Deep Holes Located Representative of Sewage & Expansion Area Expan_sion Area; shown; gravity flow,suff. size If Pumped Pit & D Box Shown & Detailed House - No. of Bedrooms Wells & SSDS's w /in 200 ft. of Property Located Property Metes & Bounds ouse Setback Necessary (Tight lot) House Sewer - 1 /4 "/ft. 4 110; Type pipe No Bends; Max. Bends 45° w /cleanout SEPARATION DISTANCES SPECIFIED ON PLAN 10' to P.L., Driveway, Large Trees lotion Walls f100' to Well; 2001 in D.L.O.D, 150' pits 100' to Stream, Watercourse, Lake (inc. expan) 15' to Drains- Curtain,Storm,Leader,Footing 25' to Catch Basin 10' to Water Line (pits -201) Septic Tanks 10' from 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 (Street YES1 (tocation) NO ,�- ,/ f .� �/ y...., _,---,,Tooting/Gutter ✓ r/ — A)O 4 John M. Simmons, M.D. PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES Deputy Canmissioner of Health - FIELD ACTIVITY REPORT - Sheet of INSPECTION NAME �� r P rev v �' ra, Orig. Routine _ Orig. Complain ADDRESS %% , �- .✓ , v 14 e", ew // _ Orig. Request No. Street Town TM No. _ Canpliance _ Canplaint Comp MAILING ADDRESS Final P.O. Box Post Office Zip Code _ Group Illness 74 - -ate✓ Construction TELEPHONE _ Reinspection PERSON IN CHARGE /f� Field, Sampling.Only OR INTERVIEWED Field Conference Name and Title Other DATE ��TYPE,FACILITY TIME _ TIME LEFT h'i's Explain FINDINGS: r wo 0 INSPECTOR: PERSON IN CHARGE OR INTERVI Acrivity I acknowledge this Field Report. SIGNATURE: 6/86 TITLE: e PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES - Date Re: Property of May il�, ppyl f-'2�-2 Located at C2111L 2 1n L a: (T) Section Block % Lot Subdivision of Subdve Lot Filed Map ,# eL 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 system.. - or .,_yem�s_n_csarif'sax'�r!i_ty__. wit. Yi :.t.e_.p.rca.�rasbors- o#�rtele 14� 1.47, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Very truly yours, Signed - ✓GLZ.e'.�° er of Property Countersigned: /' PoEa , R. A. , C # Jr� //� �3 � ti Address x`D , i - tiv��17 - OlJ Address o .�� Town 1`il n O ��p �1 J.1986 Telephone Telephone � ,. coy PUTNAM COUNTY DEPARTMENT ' OF "'HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES y, COUNTY OFFICE BUILDING, = "CARMEL; N: -,Y. '10512 : -- DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner �1 �,1� k Pp v� S Address S3 (C,AeC:� g • n4A_tk)VA Located at ( Street � U' a) i7 (o C-7 , Sec. 4�: Block�_Lot Indicate street) 1 neares cross Municipality' ; N' t /��Ey" Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION 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 8;( 3 r,. A3 3 ) if . 13 5 ..2�; 3flj2boll 1.1 am '2 u /& 3 1« 3 t d: L/ °N i ': LZ jai f A I,tl 4 iz:,-t, l ;Z: Notes: 1) Tests.to be repeated at same rates are obtained at each percolation for review. I . epth m 2) Depth to be mad, 3 P/ 10 M/j °3 / V/0 all A) . depth �ti�f iii --approximately ately equal soil tee �,o�e. A�,data, to be submitted frtftt' 6b le . h+�rr 1.1 am '2 u /& 3 1« 3 t d: L/ °N i ': LZ jai f A I,tl 4 iz:,-t, l ;Z: Notes: 1) Tests.to be repeated at same rates are obtained at each percolation for review. I . epth m 2) Depth to be mad, 3 P/ 10 M/j °3 / V/0 all A) . depth �ti�f iii --approximately ately equal soil tee �,o�e. A�,data, to be submitted frtftt' 6b le . h+�rr TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION �. a...:.. .�.�:�,nFSCRIPT ION. OF::SOIZ�.. !TVC(?UN9-TI'rD; IN_TEST,:N.OL&S,;:.,:..,...... .:.. �. _ ._ ... v. .. . DEPTH HOLE NO.—A_ HOLE NO. HOLE NO. G.L. 6" 12" 18" 2411 30" 36" 42" 4 811 54 ii 60" <61' 72" ,(811 84" 5'RA/DS� L�i4 wt �[ iZoc�T1 2..771-- Mt, CI"47ELV Cor,PACr ,QED ��vvc/A/ �i�tic SAWD✓ L..or4M ,3qjj LO6SCLt' COM *1+C -T S0►ND7 �/ f—"'lost. Vjf MEAiuM sroazs -ror�sdiL 1 I ova 32avJnf r, Vk 5gn1III) M wJRocYTS _ 1/Ee d.oN� 'B�o nJ a1 FiA f- a,;N '0� INDICATE IEVEL AT WHICH GROUND WATER. IS ENCOUNTERED:= INDTCATE' GE'VEL 50­ V`I�CH'WATER LEVEL - RISES AFfiER 'BEING COUNTERED TESTS MADE BY e G p y/ L L--)?_ :'Z' Date 4_-03, jo f / 9,6 !! DE IGN r. Soil, Rate Used /� Min�/1 �� Drop: S. D. Usable Area Provided 0e) ��– No. of Bedrooms .3 Septic Tank Capacity / ©O Gals. Type MA50to(? Absorption Area Provided By 33 L.F.x24" width trench. Other gna Address , - SEAL .r THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. A /Cal. Checked by h j Nd _J ' fY 1_'__.- �6`.+�� W�"O•� •'% A. Fy ^R "A _..^�" •.. w C._.r' O� e p y I w._ - -_ - -__ �.'_._j�.� y \ � �,.?�y✓ � may"' . w� i O.FOv A,, f•y r _ __ 6..:_ --r -= _atF-'0- a-a•'.: --�- JR'd�._..___..�.— v_ ^'.t. '� �� �+r- �'e� -�._. —__- i • - v- 1 0 -- -- --- - ^- , 1 - - - ---� -_ - - -_ - - -- - -- - -� 2- I I A• I pG1G - la. PUTNAM COUNTY HEALTH.DEPAR7MENT }uh DIVISION OF ENVIRONMENTAL HEALTH SERVICES John M Simmons, M.D. DeputyCccrnnissioner of Health - FIELD ACTIVITY REPORT - :No. Street � - / Town TM No. MAILING ADDRESS P.O. Boat Post Office Zip Code r z;TELEPIONE PERSON IN. CHARGE ,OR INTERVIEWED�,A.� iCr / yJ V is Name and Title TYPE FACILITY TIME LEFT G d Orig. Routine Orig. Complain Orig.. Request Canpl iance Complaint Camp Final Group Illness Construction Reinspection Field, Sampling Only Field Conference Other. Explain TELEPHONE: SIGNATURE: TITLE: PUTNAM.COUNTY DEPAR`I TT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY SUBSURFACE SEWAGE DISPOSAL SYSTEMS FIELD INSPECTION. REPORT a DATE: INSP. BY: } (Name of Owner) (Street Location) INITIAL SITE INSPECTION TM q-1-11 co J 1 i -Iq I YES 1 NO I CHI'S Wetlands on /or proximate to property .............. Property lines or corners found ................... Can estimate house location ....................... Willdriveway need cut ............................ Must trees be removed - note these ................ Deep holes representative of entire SDS area...... Additional deep holes needed...... .. ..... .... Sufficient SDS area available considering driveway cut, house location, separation distances,etc... Adjacent. wells/ septics ............................ D. H. 1 Lot Depth to G. W. Depth to rock Soil Descri tii 0 ft. 6 ftT c r, 9 ft. 12 ft.i -, I I D. H. 2 Lot Depth to G. W. Depth to rock Soil Descri tion 0 ft. 3 ft. -16" ft. 9 ft. 12 ft. Q uma�. D. H. - Deep Hole G.W. -Groundwater D. H. 3 Lot Depth to G. W. Depth to rock 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. Soil Descri DATE: FINAL SITE INSPECTION INSP.BY: YES NO COMMENTS House SSDS located per approved plan ............. Length of trench measured Width of trench average Slope of tile line and trench acceptable......... Roan allowed for expansion trenches .............. 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 .............................. Distance well to SSDS (ft.) ...................... Number of bedrooms checks ........................ Stones, brush, stumps, rubble, etc., greater than 15 ft. from nearest trench ................ 15 ft. of peripheral soil horizontally from trench ..... ............................... Boxes 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 GMNG OF SITE ACCEPTABLE.. .... ... ..... it T M. .H. .,,.;u .. - iC' •� . .r� EtPublic Health.,Director..,, .._,. �9lLEXANDERSON. :SIMMONS; 4Cduhly`Execviive ? . <•, Q4` ::Deputy Commissioner -DEPAR €Iv1ENT <.OF 't °HE'L.TH �DHN;iKA1RELo;,., P E • t ' .- Division •`Of ' EnvironmeritAl Health 'Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 July 12, 198 i Mr.-Frank Fowler, III, P.E: 386 Main Street Ridgefield, Conn. 06877 Re: Mary Powers Lot 500 7 Oakridge Road (T) PV 36 -86 Dear Mr. Fowler: As we have discussed, the sewage disposal system on the above mentioned lot was not constructed according to the approved plans. The following items must be corrected., 1. The tile fields not constructed in original soil must be removed. 2. The fill material, which is unsatisfactory, must be _removed- ..,f -rom the .$ewa.ge.... d.i s.posa_.1_ s r.ea. - _ 3.� The Ftrenchesi must be reconstructed in the original soil. Once this fill material is removed. It is my understanding that Ted McGlasson is the general contractor and therefore responsible for these corrections. Please contact. Mary Powers and her contractor, Mr. McGlasson to make arrangements for these corrections to be made within the next (14) days. If you have any questions concerning this matter, please contact me at this office. Very truly yours, William Hedges Public Health Sanitarian WH /JP cc: Mary Powers, 53 Carey Street, Mahopac, NY 10541 Greg Northrop, Box 317, Mt. View Rd, Peekskill,NY10566 Ted McGlasson, McGlasson Realty, Inc. Fair St & Hill & Dale Rd., Box 610, Carmel, NY 10512 JK, EC NoR'TH N Ila32'30'E DESIGN DATA 3 BEDROOM HOUSE N S0. FT OF EF ECTIYE LEACHNG AREA REQUIRED. e • ' F D.1 29 r +e.astYlTH < pp G SEPTIC TANK AS SPEClflED E pA (S�EC� ED. CD N ry ry y�3, h X932. RFS /p �C FNS s �Oc K 100, OO , N 0' Eiys ry SEPTIC SYSTEM AS , BUILT' 2 lFZ7 MARY K. POWERS 3 LF3p i THIS IS TO CERTIFY THAT THE SEWAGE OASLINDICATED PUTNAM VALLEY N,YDiviaion of �n °�rO�ontal C!'. tea, t ' 00 110's WAS CONSTRUCTED SCALE I"=201 n � f voted for , t o • a of � •a ON THIS BFu7e8 ara Dcga� 9 5 1P33 12 St DATE 8/18/88 �Dplic bl � C0�,ty ,lth t'cv Q BEFORE IT WAS COVERED OVER. Lp 34 13 �_ Iate IN ACCORDANCE WITH ALL P gigrat -- & T tle Y 6 �e 37 14 N° A B A/ \�i ' a I 15 60 '..: ,w' C m ? RANK G. FOWLER X.1N.Y. P.E.59113, cF 46 2 50 80 ^ y B 3 57 84 �^ lP4g /6 4 64 89 V 5 67 90 6 75 96 LF46 7 86 106 �e 8 92 109 rO 4,, , 19 33` 'cF 9 96 107 . ......... - _ 10 104 117 _1.2.. 47— 53 59.. 13 59 .62 14 66 66 15 71 70 ?0, 16 86 80 ®gKR�pOE 17 El 2 84 R�0 18 03 95 19 109 101 SEPTIC SYSTEM AS , BUILT' PREPAREO FOR MARY K. POWERS LOT BOO — OAKRIDGE ROq, °»ty +V.nt °� R ° °'th DeF� dealth Sc,r:tae THIS IS TO CERTIFY THAT THE SEWAGE OASLINDICATED PUTNAM VALLEY N,YDiviaion of �n °�rO�ontal C!'. tea, t ' 00 110's WAS CONSTRUCTED SCALE I"=201 n � f voted for , t o • a of � •a ON THIS BFu7e8 ara Dcga� PLAN AND THAT THE SYSTEM WAS INSPECTED BY ME St DATE 8/18/88 �Dplic bl � C0�,ty ,lth t'cv Q BEFORE IT WAS COVERED OVER. THE SYSTEM WAS CONSTRUCTED �_ Iate IN ACCORDANCE WITH ALL P gigrat -- & T tle Y STANDARD RULES AND REGULATIONS OF THE PUTNAM �R,roFFOWW�Oq ' T�T��� COUNTY DEPARTMENT OF HEALTH A/ \�i AND THE NEW YORK STATE ✓L✓" DEPARTMENT OF HEALTH." '..: ,w' C m ? RANK G. FOWLER X.1N.Y. P.E.59113, a`� j use 380 MAIN STREET RIDQEFIELO , CT. n.� _•_