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41.14 -1 -19
BOX 20
' ,'L IN L r I• I.
ti, `
02352
-
Rev .m-3/86,,, o PUTNAM COUNTY DEPARTMENT OF HEALTH ,
D sion of Environmental Health Services, Carmel, N.if.10512
Engineer Mnet Provide,
P.CcH D PenIDItN
__...CERT>FICATE OF CONSTRUCTION COMPUANCE FOR SEWAGE DISPOSAL. SYSTEM
�..,.... _ - .: Town or village - - -.
Located at Lake Shore Road : West Tax Map 12 Block 1 Lot 9
Lee'Skolnick Roaring 461
Owner /applicant Name Formerly Subdiv6lon Name Subdv..Lot N
jK uing aaare.a 116 University-Place- �p 10003 - Date" PermitIssuea 9 25 =.84
New York; NY
Separate' Sewerage System built by Ra .,..:Fior:entino -
Consistlpg of 10.00 Gallon Septic Tank
t Val, N
Trenchs
Water Supply: Public Supply:From Address
ore XX' Private Supply Drilled by N. Anderson . Address Put. Val,., NY . 10579
Building Type 1 F am o Res' ' Has; Erosion Control Been Completed? YE
Number of Bedrooms. 3 Has Garbage .Grinder Been Installed?
Other Requirements
I certify that the system(s) as listed seri.ing the abode premises we co ated assent all as shown on the plans of the completed work ( copies
of which are attached), and, in accordance with the standards, rules' d regul tions, in a ith the e,•`plai d the permit issued by the
Putnam County De' rtment.;of- .Health.
P
.Date 'e f .1.9/8,.7 Certified by
E C a XX
MUSCoot Nort , F #2, X488, K =tops 11056
Address ifshall No
1
Any 'person. occupying. premises served by. the above syitem(s)- shall.p mptly t e w coon as may be necessary to , re the correction of any unsanitary
conditions resulting from such usage. Approval of :the separate ,' rage „tsm'shall become null and void As soon'ss- a pubc': sanitary lower becomes
available and the approval.of the privste'Witer'supply shall become nu void .when public water supply becomes available Such approvals are
subject to' modification or, change when, in the judgment of t_he 6MMIssioner of Health,` —such revocation, modification or change Is necessary,
Date
®� 0 "y� ,C �, By s Tt
�� a
►�
W Y
WL'LL trV11rL1;11VIN AzrVAl
DEPARTMENT OF HEALTH
Division Of Environmental Iieal.t b - Services
PUTNAM COUNTY DEPARTMENT OF HEALTH
Office Use Only
116 0.-7—
-0
- Y
WELL LOCATION
STREET ADDRESS: W'GRIO NUMBER
�' dR� �% ,
WELL OWNER
NAM ' - o x �,�°' ADO s•
pBIVATE
❑ PUBLIC
USE OF WELL
1 - primary
2 -secondary
JR RESIDENTIAL ❑ PUBLIC SUPPLY O AIR/COND./HEAT PUMP O ABANDONED
❑ BUSINESS ❑ FARM O TEST/ OBSERVATION ❑ OTHER'(specify)
❑ INDUSTRIAL 0. INSTITUTIONAL ❑ STAND -BY ❑.
MOUNT OF USE
YIELD SOUGHT gpm. /N0. PEOPLE SERVED �—' / EST. OF DAILY USAGE ° 0 gal.
REASON FOR
DRILLING
NEW SUPPLY O PROVIDE ADDITIONAL SUPPLY O TEST / OBSERVATION
❑ REPLACE EXISTING SUPPLY O DEEPEN EXISTING WELL
DEPTH DATA
WELL DEPTH ��r ft.
STATIC WATER LEVEL 0?0 f ft.
r9ATE MEASURED s r
DRILLING
EQUIPMENT
'� ROTARY ❑ COMPRESSED AIR PERCUSSION ❑ DUG
❑ WELL POINT ❑ CABLE PERCUSSION O OTHER (specify):
WELL TYPE
❑ SCREENED ❑ OPEN END CASING. IL OPEN HOLE IN BEDROCK O OTHER
CASING
DETAILS
TOTAL LENGTH ft.
MATERIALS: .STEEL O PLASTIC O OTHER
LENGTH.BELOW GRADE Ao,ft.
JOINTS: ❑ WELDED ®.THREADED O OTHER
DIAMETER in.
SEAL: ❑ CEMENT GROUT O BENTONITE�WTHER
WEIGHT
PER FOOT � Ib. /ft.
DRIVE SHOMYES ONO
UNER: OYES,gNO
SCREEN
DETAILS
_x
DIAMETER (in)
SLOT SIZE
LENGTH
(it)
DEPTH TO SCREEN (ft)
DEVELOPED?
FIRST
O YES ONO
flOURS-
SECOND
, .... _ _ .._._..
_ __
_ _ , ...R
� �
GRAVEL PACK
11 YES
O NO
GRAVEL
SIZE:
DIAMETER
OF PACK in.
TOP
DEPTH tt.
BOTTOM
DEPTH It.
WELL YIELD TEST If detailed pumpingIELL
METHOD: O PUMPED I tests were done is in-
XCOMPRESSED AIR it formation attached?
O BAILED O OTHER ; ❑ YES O NO
LOG It more detailed formation descriptions or sieve analyses
are available, please attach. .
DEPTH FROM
SURFACE
Water
Bear-
ing
Well
Dia-
meter
FORMATION DESCRIPTION
ft.
ft.
WELL DEPTH
It.
DURATION
hr. min.
ORAWOOWN
ft.
YIELD
9Pm_
Land
SuAace
`
/
-®
WATER O CLEAR ' TEMP.
QUALITY O CLIkOY HARONE
O COLD D ANALY D? O YES ONO
ANALYSIS A CHED O YES O NO
STORAGE TANK: TYPE . .
CAPACITY GAL.
WELL DRILLEBJI
/(9M E Vie/ 16, 1 OAT
ADDRESS ��'✓ /J�y' �/"'_
PUMP INFORMATION
TYPE CAPACITY
MAKER DEPTH
MODEL VOLTAG HP
p
p
LAB�0�
Yorktown Medical •Laboratory, Inc.
Collection Station Used:
321 KeaiStreet
Carmel
Yorktoivn Heaghes,I�:�: I�59� -. � - -- - .—
-- ...�P.ee.kv.ki11:_.,�...._..
`Mt..Kisco Nev City
_
(914) 245 -3203
Director: Albert H. Podovoni M. T. (ASCP)
_
Date Taken: 2
3a;AeV ;
Date Received.,;-,2b ,,/Z-''J
r RON FIOREN.TIO
Date _Reported:
Collected. By: a,e
d
RD1,
Referred By:
Sample. Source:
. PUTNAM VALLEY, - NY 10579
L —j
528 -2373.
vG 60&S7 mGc 7iy.�i Y y
LABORATORY REPORT ON BACTERIOLOGICAL
QUALITY OF WATER
GENERAL BACTERIA
lzstandard Plate Count per...1.0 ml
(Agar plate @ 35 °C)
MEMBRANE FILTRATION TECHNIQUE (MFT)
IZZT otal Coliform per -100 ml
O
_ Fecal Coliforlm ner 100 ml
Fecal Streptococcus per 100-m1
MOST PROBABLE NUMBER TECHNIQUE (MPN)
_. Total .Col,iform: _._MPN_Inde.x_ ner
100 .ml
Fecal Coliform: MPN Index Der
100 ml
0THER ANALYSES
TH SE RESULTS INDICATE THAT THE WATER SAMPLE (D(WAS) (WAS NO T) (NOT APPLICABLE) OF A SATISFACTORY SANITARY QUALITY ACCORDING NEW YORK STATE DRINKING
WATER STANDARDS, FOR THE PARAMETERS TESTED, AT IME OF COLLECTION.
Albert;H. Pa ovani, M.T. (ASCP), Director
LEGEND
ADS = Recommend Disinfect -
ing Water Source
< _ .less, than
TNTC = Too Numerous Too
Count
b.
PUTNAM COUNTY DEPARMW OF HEALTH
DIVISION OF ENVIRONMUAL HEALTH SERVICES.
.:.ua. �. ....,.n �s i. �, _. as -...n •v-_✓.<.r1 :.�. �, :: '•. .. .,: �..,, e.:a .s. _• _. � .. :'1�...,r ..w.z�. <.rs .._. ., ... .. ..r. ..
LEE SKOLNICK
Owner or Purchaser of Building..
Building Constructed by
LAKE SHORE WEST
Location. - Street
PUTNAM VALLEY
Municipality
12 1 9
Section Block Lot
ROARING BROOK LAKE
Subdivision Name
461
Subdivision Lot #
ONE FAMILY RESIDENCE
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 propertyl, and that it.has been constructed as sham 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 fora period of two years immediately following the date of approval of. the
"Certificate. ,of.- Construction., Compliance ", for. the sewage. disposal- system;:--or• any,
repairs made by me to such system,.except where the failure to operate properly is
caused by the willful or negligent act of the occupant of the building utilizing
the system.
The undersigned further agrees to accept:as conclusive the determination of
the Director of the Division.of Environmental Health Services of the Putnam County
Department of Health as to whether or not the failure of the system to operate was
caused by the willful or negligent act of the occupant of t e building utilizing
the system.
Dated this 2 o day of Cry' . 19LS� Signature GR'
Title G. Contractor Sewage 'System
on rae or
General Contractor (Owner) - Signature
Corporation Name (if Corp.)
Corporation Name (if Corp.) L Shore Rd. Putnam Va ley, NY
Address
Address
rev. 9/85
mk
�.,.. -,.gt-^. z rr . � "- •' _. �,
TUTNAM COUNTY DEPARTMENT OF HEALTH " °� Perm E r TV,,
48
\ \�I piwsion of Environmenial Health vices,Careno I /V. Y 10512
COItISTRION PERMIT .FOR SEWAGE': DISPOSAL SYSTEMS ��o = Putnam Valle
Twn�or village
Located at T 'Road W _:St Tax Map" .L2 Block " toc O
.Subdivision Roar :M g Bro
ok Lake subs - Lot a 461` Renewal
Revygion _��11 L, _ _ r
`
Owner /Addresz • Skolnick, 11 i Uzi verSity .Place f Previous Appioval 8./30/83
One Family House' ' 28 0.0.0 SF ��
Building Type Lot Area r Fill Section Only E)" ,`
Number of BedfOOmf. Design. -Floe G /P /D �h�� P.C. R. D. Notification Requited
-1000... ...:420: LF of. F.ield's
Separate: sewerage, System to consist of Gal. Septic Tank and
TO be constructed by Kastuk & Sons ad dress .P.utri am Val -levy 14Y :,'I 0579 :.
7.
water. SuPPIy: Public Supply From
XX PriMq Supply to, be, drilled by N. Aridersbn
... Putnam Val 10579
Address
Other Requirements
I reprewnt that vam wholly and completely responsible for the design and location Of the' proposed syst"(s);,I) that` the separate sewage dis oral - system
.above described will be Construcfed as sfiown•on the approved amendment there Wand in accordance with.the standards,_rules•an . regu a,�ons o , tne : Putnam
County Department of ` Health;, and that on `completion thereoi'a "Certdicate .of Construction Compliance ":satisfactory to, the Commissioner of Healthwill
be submitted' to t(►e Department, and 'a written guarantee will De furnished the owner, - his.successors,, heirs or auigns 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 issu
once of the approval d the Certificate of ' .Construction Compliance of `the original system or` ny iepaiis fierot' 2) that the driliad'weil described above
will be located'as shown on the " approved plan and ttiat said well will be inst in. accordance h the standards' les,and regu a i�'ons'. f the 'Putnam
County Department of Health,
pate ' 8/15/83 9ned pre R.A. X
Addre F BX 88' a C 105. ,.erase lyo: `l'1056
APPROVEQ'FOR CONSTRUCTION This approval expires one year f t..,, date is ed' -unle truction of, the. -b ilding has been untle ► taken and is
revocable for cause or may be amended or.modified when ' nsi er nec ry by, t Coen sinner f Health.,- Any c rage or ai Lion of construction .
requir, p rmit pp ov` or disposal Of domestic nits[ s age d/ rival water
._ _. .. - SY . .. - Title -
Rev. 9-81 - -
M
r Supplye
s yr rr,i Ira °� PUTN*M:�®13N .T� � �NT ®� sH]�'A�.T)� Permit B U'
s�� {t Division of Environmental Health Servi es, :Carmel 11/ Y 0512
!N ,PERAIIIY��FOR�.SEWAGE' DISPOSAL;=SYSTEflA �%�� �6 ✓P:u'triam
V
down or lage
�k'e ,Shore..'Ro;ad ;West- 12 Block _.Lw _ �rQt
Tax Map — L
�a�,�lq- �•DOQk� �G�e Sobd. I�ot N....61,' Renewal _� .Revision
dew S�orkr ' f�y M. I' j. APPro
Date Of Pie -ioes val
)ne Fain House 28 OA0 5F`
Lot Area r Fill Section Only' b
Ims' 3 `Design Fiow c /p /o i 6.00 t
il P.0 H .D. Notification Required
System .to- consiit' of 66 0"
Gal; Septic Tank and
420 LF of. Fields
A. Kastuk & Sons Putnam; j7alley NY 10579
f by Address i
public Supply From '
XX private Supply to be tlriued by N Anderson ;
Aea ►ess Putnam .Valley NY 10579
�- ,
f
m:wholly and completely responsible for thedasignand '.location of the:proposad system(s); :1) that the separate ;sewsge.disposal4ystem
Ill: be, constructed as shown on'.the appioved.ameiidment there to and In''accordance ;with,t6e standards rules an regu a ohs O + e .0 nam _
nt i -of Health and that on.completion thereof a Certificate of' Constructlon.COmplianea'� sitisfictory to, the Commissioner. of AieIthwill
he +0epartment and a written guarantee wlll''be furnished the owner, his successors .Heirs or assigns by:tne build ®► that sak! buildair will.
Brat ng condition any part `of said sewage disposal system during the pe►iod oi, two ;(2) years immediately following 4hedate o4 th'e ;isw-
>val,':of the rCertificate of Construction Compliance iof the original system or.any.repairs thereto,; 2) that `th'e,driiled.welLdeseribed• above .
A— hown on tlie' approved plah,and that said well will be Installed in `accordance ,with the,,.sta' artls; {ules Bn regu a, ons o4 - `'.the' 'Putnam
tt of Health A
5f, 83 U COOt`N St eed E
O f p RA
Address ai'o ac i0 11,0
'ens Nto, 5 6
CONSTRUCTION :Thu approvil expires one year from the dat i ued, unless construction •of the build as been undertaken and Is
s or ;may be`amOnded or modi(ietl when consid necessary ;by?`t a Com stoner of. Health. Any Change qr alteration of Construction tt
rmit Approved for, disposal of dorrf a sari y eubage id /or pr sejtar supply' only.'
� d
�e ♦ � L s� __ _�- Pig.
V .
�
| ��� IF lE��
������ �� .������_ ,���^�^BIERG
_
.wusceov NOIRTH, lR0i) IBN0X 4"
NEW VORKN034N
'
-
AUGUST 20, 1986 �
'
MR. J0HNKARELL JR., P.E.
ENVIRONMENTAL HEALTH SERVICES
C�8
m*
PUTNAM COUNTY DEPARTMENT 0F HEALTH
-
TWO COUNTY CENTER
CARMEL, NEW YORK 10512
=.,
RE: SK0LNICK SDS
��^~c
s'-'n
LAKE SHORE ROAD
,o
i
PUTNAM VALLEY, NEW YORK
TM 12-1-9
ROARING BROOK LAKE 4461
' '
DEAR MR. KARELL,
1 AM IN RECEIPT OF YOUR LETTER DATED AUGUST 19, 1986.
AS l TOLD YOU OVER THE PHONE TODAY, MY FILES INDICATE
'rHAT N0 HE0UE5T-.F0R- A FINAL' INSPECTION-WAS'MADE'BY� MY
0FFICE. HOWEVER, WE ARE AWARE OF YOUR REQUIREMENTS
AND THOSE OF THE BUILDING DEPARTMENT AND WE WILL FOLLOW
THROUGH WHEN I RECEIVE ALL THE NECESSARY INFORMATION
FROM THE VARIOUS PEOPLE INVOLVED IN THIS PROJECT.
HAVE ANY 0UEPTJ0NS� HESITATE T0 JALL
ME.
VERY TRULY YOURS,
--�l t.,
-
iopi I Anpom
...��.,.�.=
JLG:AC
CC: LEE SK0LNICK
MARVIN 0`DELL, P.V. BUILDING INSPECTOR
TOWN PLANNER ~FUTNAW VALLEV, NEW VORK°
L
r
DAVID D. BFUEN
County Executive
DEPARTMENT OF HEALTH
Division Of Environmental. Health Services
August 19, 1986
Mr. Joel Greenburg, R.A.
RR #8
Muscott North & Baldwin Place Road
Mahopac, NY 10541
Dear Mr. Greenburg:
F
JOHN SIMMONS, M.D.
Deputy Commissioner
Re: Skolnick SDS
Lake Shore Road, PV, TM..12 -1 -9
Roaring Brook Lake #461
Reference is made to a letter from James S..Hodgens dated
April 16, 1986 to you, copy attached, relative to the above - captioned
property. Such letter is believed to be self explanatory.
Review" of our files indicates we have had no further corres-
pondence or action relative to this project to date except that
Mr. Kostuk has indicated that he did not install' the system.._.(The
construction permit states he will.)
You:are reminded that this house cannot be occupied until ,a,
certificate of construction compliance is approved by the Department,
issuance of which is contingent upon provision of additional
information and documentation as set forth in the above mentioned
letter.
If you have any questions, please.call me at extension 241.
ery tr ly yours,
qh"'Ka ell, Jr., P.E.
Director
Environmental Health Services
JK:amm
cc: Lee Skolnick
Marvin O'Dell, P.V. Building Inspector
/JK
File
Attachment
TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641
DAVID D. BHUEN
County Executive
DEPARTMENT OF HEALTH
Division Of Environmental Health Services -
April 16, 1986
Mr. Joel Greenburg, R.A.
RR # 8
Muscott North & Baldwin Place Rd.
Mahopac, New York '.10541
Re: Skolnick SDS Final Inspection
`Lake Shore Road, PV, TM 12 -1 -9
Roaring Brook Lake #461
Dear Mr. Greenberg:'
JOHN SIMMONS, M.D.
Deputy Commissioner
Based upon your April 1, 1986 notification for final inspection of the above
referenced system, a Departmental inspection on April 7, 1986 indicated the
system had been relocated from the permitted location and backfilled. Though
the boxes were excavated, the apparent system relocation coupled with the'inabil#y
to verify placement of three feet of bank run will necessitate Departmental
re- inspection.
In order to verify compliance with County and State regulations, it will be
necessary to excavate and expose the following system components to permit
on: septic tank :and junction= 6xi inlets" and- 6iitlets.;. and -
trench ends. Additionally adequate deep test holes in vicinity of relocated
Sewage Disposal System 'must be dug to a depth of at least seven feet. These
deep test holes can be dug during inspection of the balance of the system to
assure they are adequate.
Please call me when the above arrangements are made to establish a time
for our joint field inspection.
If there are any questions pertaining to the above please call me at
225 -3838 or 225-3833.
Very truly yours,
�Sames S. Hodgens
Assistant Public Health Enaineer
bh/ JP
cc: File
A. Kostuk & Sons, Installer
Lee Skolnick, 116 University P1ace,New York,NY 10003
TWO. COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641
PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONDERUAL HEALTH SERVICES
INDIVIDUAL WATER SUPPLY SUBSURFACE SEVU GE DISPOSAL SYSTEMS
FIELD INSPECTION REPORT
DATE:
INSP. BY:
INITIAL SITE INSPECTION I YES I NO I CONTENTS
Property lines or corners found ...................
Can estimate house location .......................
Willdriveway need cut ............................
Must trees be removed - note these................
Deep hole 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 Descr
0 ft.
3 ft.
6 ft.
9 ft.
12 ft.
D. H. 2 • Lot
Depth to G.W.
Depth to rock
0 ft.
3 ft.
6 ft.
9 ft.
12 ft.
boll Descr
r
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.
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.........
Room allowed for expansion trenches ..............
Over 100 ft. bran swamp, watercourse .............
Natural soil not stripped or SDS area
unnecessarly graded............................
10 ft. maintained fran property linand
e
20 ft. fran house ..............................
Distance well to SSDS (ft.) ......................
Number of bedrooms checks ........................
Stones, brush, stumps, rubble, etc., greater
than 15 ft. fran nearest trench ................
15 ft. of peripheral soil horizontally
frcm trench ..... ...............................
Boxes properly set ...............................
�ould surface runoff fran driveway, roads,
ground surface, etc., channel near SDS area....
)oes lot drainage appear OK in area of SDS.......
yINAL GRADNG OF SITE ACCEPTABLE.. ..... ......
rev /9/85
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Date �29 CtLy
Re: Property of Lee_ GkOL N ICK
Located at LAkt- Gtkmg RZ � WF-
(T) Section Block Lot
Subdivision of P-06R. G EFLOoK LAKE
Subdv. Lot # Filed Map # Date
Gentlemen:
This letter is to authorize `j[� j, ( zr- -NSj�—R�
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
_ sst.em . ox_. s_ ysaerrx ::sri_°c.drif_..o:rrxiay._itb .the._ provisions- of - Art:c1:e5..:or_
147, Education
tary Code.
Countersigne
P.E., R.A.,
is Health Law, and the Putnam County Sani-
Very truly yours,
t
Signed �&-
Owner of Property
RFD "2, Box 488 I
Address ' nnahopoc, NY 10541 ,.
9j+ 3
Telephone
116 U t oy r—�P—s rrT R, ACS
Address
Nr-W
Town
2t2 X24
Telephone
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
COUN'Y OFFICE BUII;DING,.CAlL -;
DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM
FILE NO..
Owner Lee Skolnich Address 116 University Place, New York, NY 10003
Located at (Street Lake Shore West Sec. 12 Block 1 Lot 9
Indicate neares cross street)
Municipality Town of Putnam Valley .Watershed . Hudson River
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS
Hole
Number CLOCK TIME PERCOLATION PERCOLATION
Run apse Depth to Water a er Leve
No. Time From Ground Surface in Inches Soil Rate
Start -Stop. Min. Start,: Stop Drop in Min. /in drop
Inches Inches Inches
PTH #1 1 8.00 -8.33 33 16 19 3 33/3 =11
2 8.34 -9.07 33 16 19 3 33/3 =11
3 9:08 -9:41 33 16 19 3 33/3 =11
4 9:42 -10:15 33 16 19 3 33/3 =11
5
PTH #2 1,8:05-8:38
33
16
19
3
33/3
=11
16
3
9:13;9:46
33
16
19
3
.33/3=11
�F
5
1
2
3 ,
' C;,
5
Notes: 1) Tests to be repeated at same depth until approximatelyy 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 N0: ° - IIOLE. NO: DTH #:2-
DTH #1
G.L. Top Soil _ Top Soil
6" --sand, Small Stones, Sand, Small Stones,
12" & Some Clay _ & Some Clay _
18"
24"
361 „
5411
66"
7211
84"
INDICATE. LEVEL AT WHICH GROUND WATER IS ENCOUNTERED None
INDICATE LEVEL.-TO-WHICH-WATER LEVEL RISES AFTER BEING ENCOUNTERED_. None _.__ _
-
:TENS- MADE.•$Y Joel
DESIGN
Soil Rate Used 11-15 Ydn/l "Drop: S.D... Usable Area Provided 5j000 SF
No. of Bedrooms - 3 Septic Tank Capacity 1 000 Gals. Type Pre -cast conco
Absorption Area Provided By 420 L.F.x24" �3b" enc .
�ha
lvame Joel Greenberg bignature - -
Address Muscoot North, RFD #21 Bx 488 S L 0)
Mahopac, NY 10541 0,1
THIS
SPACE FOR -USE
BY HEALTH DEPARTMENT
ONLY:
Soil
Rate Approved
Sq. Ft /Gal.-
Checked by_
to
9
E7' 4,
7-
5EPpTI DISC:
.1CT '.. 7 .,� '.
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