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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 51. -1 -50.1 BOX 21 rU � Tti cl ti r, ♦� : J. - PUTNAt +UNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT W Et~ tia»s..WV, Strdet'Addres "s: - ,,...., / 1l%. C3�7S` tl'lag 1 Map Block f Lot(&) Well Owner: Na e: Address: Use of Well: 1- rima 2- secondary Res dential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment Rotary Cable percussion Compressed air percussion Other (specify) Well Type Screened Open end casing` Open hole in bedrock _ Other Casing Details Total length _ Zi_ft. Length below grade V o ft. Diameter min. Weight per foot -_Q_lb /ft. Materials-:--- Steel _ Plastic _ Other Joints: _ Welded_ Threaded _ Other Sea1:1 Cement grout _ Bentonite Other Drive shoe Yes No Liner: Yes _ No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First _ Yes—No Hours Second Well Yield Test _ Bailed _ Pumped Compressed Air Hours Yield gpm Depth Data Measure from land surface- static (specify ft) A3 During yield test(ft) 4500 Depth of completed well in feet S'6-5" Well Log If more detailed information descriptions or si_e.v.� e . analyses' .. _ . - -- are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface . & q go' 3/ .e4ol O .sus ",V r" v, n , . ... < ; If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Inform n vi Pump Type $ Capacity ,5 Depth S! Voltage a$D HP Ih Tank Type VAUJWMbLVolume Date Well Com leted Putnam County Certification No. Date of Report Well rill (signature) NLP I E: t;xact location of well with distances to at least two permanent landmarks to be provided on a separate sheet/plan. Well Driller' e �42.L�Si� OILS Address: N A4 Signature: Date: White copy: HD File; Yellow copy Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 M m m c� i- r� f I�- ,d9; �, 9. t � e ,,�.o�.' � -� � � ♦�� ICI ♦iI 11� ,� ��.� WO CE70rrg1l' lICAA'E OF CONSTIBUCTI ®N COMPLIANCE ]rum OM WAAU ' l{i;EATMENT a 15 i r.iaa PCHD CONSTRUCTION PERMIT # Located at �"e�1 f� I'1 tv is Gi Town Village rl/� Owner /Applicant Name T/ Pf 8" t-1i At 6,0§71-4r- Tax Map 8 Block / Lot V. % Formerly J , a I? I c Subdivision Name '� /o" P 9Af L i,./A /'J'T Subd. Lot # Mailing Address C/a,/S-/ ®l/Y fdc,fb �', Zip Date Construction Permit Issued by PCHD G Separate Sewerage %Lstem built by C- 4 RU4 -r- Address fu� 'tf "4 Consisting of d- JV Gallon Septic Tank and Other Requirements: Al n �P— Water Su�Ilv,: Public Supply From Address Private Supply Drilled by J % �/ C�S� Address�s�y,� Building Type J/ ti G F_ / L y Has erosion control been completed? ? $ Number of Bedrooms �f Has garbage grinder been installed? Alel y I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved plans and the standards, rules and regulations the PutnawpCo ty Department of Health. Date: ` Certified by P.E. R.A. (Desi�nAAProfe ional) Address �� �� /� -e-W r� a� � �[ �r y License # Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Public Health Director, such revocation, modification or change is necessary. CTitle: Date: I opy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PUTNAT- AUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT lf I:ocation PW�ell S/ tr /cAe 1 x t. A adil dress: '_ _� : �-<„ _� .:° La\ie Cs -"s TownNilla ge: rAt VAj Tax Grid 'f3; ...• ' � Map & #° Block 'L° o-:: - � Owner: Address: %Sr^ r K��iN iN Use of Well: 1- rima 2- secondary Res dential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment Rotary Cable percussion Compressed air percussion Other (specify) Well Type Screened Open end casings Open hole in bedrock _ Other Casing Details Total length eft. Length below grade o ft. Diameter in. Weight per foot -L-7—lb /ft. Materials:-- Steel _ Plastic _ Other Joints: _ Welded Threaded _ Other Seal:-"-, Cement grout _ Bentonite Other Drive shoe'----.,Yes _ No Liner: Yes No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First _ Yes—No Hours Second Well Yield Test Bailed Pumped Compressed Air Hours Yield gpm Depth Data Measure from land surface- static (specify ft) o� 3 During yield test(ft) Depth of completed well in feet Well Log If more detailed information descriptions or sieve..analyses are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface 69 L A d. &q go ' 34 p. :, -- � �, -K NIT - If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type Capacity - Depth 4 40' Model Voltage a30 HP 11l., Tank Type W fUa^i%b'LVolume Date Well Com leted Putnam County Certification No. 1411-51 Date of Report dur Well nl (signature) - NOTE: Exact location of well with distances to at least two permanent landmarks to be provided on a separate sheet/plan. Well Driller' Address: AgmoivE N. Signature: Date: Q5- White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services . Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845)278-6558 WIC (845) 278.6678 Fax(845)278-6085 Early intervention /Preschool (845) 278.6014 Fax (845) 278 - 6648 E911 ADDRESS VERIFICATION (FORM OWNERS NAME:. ICI AQr lw e TAX MAP NUMBER: � � � JC 0. I E911 ADDRESS: I lmbtr Coua:r TOWN: Po) r\j � M VA AUTHORIZED TOWN OFFICIAL: DATE: l The Putnam County Department of Health will not issue a Certificate of construction Compliance unless the above form is completed., i.e., a legal E911 address is assigned by an authorized town official. This form is to be submitted with the application for a Certificatc of Construction Compliance. (E9I 1 verfrm) PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION -OF ENVWONTVWTAL MALTH..SERVI.CES, GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM T H 6R,- I/ kv Ass o �-(t4e s Owner or Purchaser of Building L4, S Building Constructed by 5 '- tHb_o 1tv e c©ute - Location - Street S n) q I Teti I �we_ / f0 Buildi g Type Si 1 _50,/ Tax Map Block Lot TownNillage 7"r, 6.e✓ i1" Subdivision Name Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is 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 treatment 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 Public Health Director 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: • nth ay 19 Year f ��5' Signat Title: ral Contrac or (_Owner i LEA- - 2ONE FX C,4v9-40A) j:,-J(, Corporatiioon Name (if corporation) V?V((,Pq Address:l. � q P State uu) vop-L Zip Corporation Name (if corporation) Address: State Zip Form GS -97 a CONSULTING TING ENGRNEE RS _ ...�... e.:..- n_ Y. i..,.-- v.. �. JY: J' iw ....:.i�..xw�.o..+OF:: >.c -:.a3 fir.: wr.r.::-'.:vti:•. r.� f.i..,,�wt�._:_ ...� _,. .... rn. � t. r. a._ue »...�J... .. .. . ., . . .. ... .. 120 Breckenridge Road Mahopac, N.Y. 10541 June 15, 2005 845- 628 -7576 Putnam County Department of Health Geneva Road Brewster N.Y. 1 0509 Att: Mr. Joseph Pavarotti RE: As Built Plans Timberline Estates Lot #1 Timberline Ct. Putnam Valley Enclosed please find: 1. Certification -of Construction Compliance 2. Well Log and Bacti Results 3. Guarantee and two, copies 4. Three copies o boil plan 5. Filing fee o 200.00 3 , 6. E911 Verifi 'on etter Your prompt attention would be appreciated. Sincerely Site o Sanitary 0 Environmental LORETTA MOLINARI Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 November 24, 2004 Dan Donahue, PE 120 Breckenridge Road Mahopac, New York 10541 ROBERT J. BONDI County Executive Re: Field Inspection — Timberline Associates Timberline Court, (T) Putnam Valley TM# 51. -1 -50.1 ~5 (° S Dear Mr. Donahue: A site inspection was made for the above referenced project on November 23, 2004. The following comments must be corrected in the field. 04%A The fill for grading appears to be excessive, especially in the expansion area. The approved plans called for about 2 feet of fill and a final slope of about 15 %. The pad is almost flat. Please verify depth of fill and if it is greater than 2 feet, please provide perc data for the fill pad. l,;i The clay barrier for the expansion area is too steep. The side`"slopes need to be at 3 foot horizontal to 1 foot vertical. The 2 foot solid pipe before the trenches begin has not been installed. 'r The well casing needs to be raised to 18" above grade. Bedroom count needs to be done once the house is complete. IS 'Ye g' If you have any further questions, please contact me at (845) 278 -6130 ext. 2157. ilk a5 Sincerely, I� Joseph S. Paravati, Jr. Assistant Public Health Engineer JSP:cj _ ....l. .. ... ..... u . 1 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE INSPECTION Date: Inspected b f Street Location `7; va�� {rye Cowr _..._ .. � . -. Owwger. - ._::1;:�- ��f�r� _• �:Sl�.":�'fcs`-�GC::�. , Permit TM #— l - .t Sb . Subdivision Lot # i iwn4"i e- esf 1. Sewage Svstem Area a. STS area located as per approved plans .......... .. ................ b.. Fill section - date of placement 3:1 barrier Lgth. Width . Avg.Dpth c. Natural soil not stripped .................................................. d. Stone, brush, etc., greater than 15' from STS area......:... e. 100' from water course / wetlands ..... .............::................ 11. Sewage System :a. Septic tank size - 1,000 .......... 1, 250 ..... .... other ............:... b. 'Septic*tank installed level ............... .........: c. 10' minimum from foundation. d. distribution Box 1. All outlets at elevation -water tested ....... :......... 2. Prot elow frost .................. ............................... um 2 ft.Original soil between box & trenches e. Junction Bog - properly set .......... ............................... 6. 'trenches � 1. Length required _ ggLl Length installed 41-. q 2: Distance to watercourse measured Ft. 3. Installed according to plan .................................... 4. Slope of trench acceptable 1/16 - 1/32" /foot ............. 5. 10 ft. from property line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface .................. T: Room allowed for expansion, 100 % ......................:.. 8. Size of gravel 3/4 -11/2" diameter clean ...................: 9. Depth of gravel in trench 12" minimum ........ :........... 10. Pipe ends ca yed .:................... .........:....::....::. ...... . .:: - g�.1Puip or Y)oszstems -~ _ .._._M_.. ...:...... . �_._. 1. Size of pump chamber .. .......... .....:.. ...................... 2. Overflow tank .... ............... 3. Alarm, visu udio..................................................... 4. Pum ily accessible, manhole to grade ................. 5. , st box baffled................................ .......................... 6. C�yycle witnessed by H.D.estimated flow /cycle........... . Ho use /Duddirig a. douse located per approved plans..... .__ .......:.. . b. Number of bedrooms .....................:..40 f ...cam. . 1V. Well Well located as per approved plans . ......:........................ b. Distance from STS area measured o d ft........... c. :Casing. 18" above grade ............... . .............:................. d.:. Surface drainage around well acceptable ....................... V. Overall Workmanship . a. Boxes properly grouted ................... ............................... b. All pipes partially backfilled .. ............................... c: All pipes flush with inside of box ... ............................... d. Backfill material contains stones <4" diameter .............. . e. Curtain drain & standpipes installed according to plan...}�) f. Curtain drain outfall protected & dir.to exist watercouls g. Footing drains discharge away from STS area ............... h. Surface water protection adequate ........ :............................ i. Erosion control provided ................. ............................... Rev. 12/02 5� n' ■ 4 VA a � PUTNAM COUNTY DEPARTMENT 'OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ATTENTION AN JOSEPH ❑ GENE REQUEST FOR FINAL INSPECTION All Wormition must be My completed prior to any inspect ions being made. PCHD Construction Permit# For: Fill Trenches A' re Located: &jag AmidiAeLTM Block Z Lot 1, Owner/Applicant Name: J` ;0, / Formerly: Subdivision Name: T�NI irdeAjff Subdivision Lo*f # Is system fin completed? Date: Is system-complete? Date: Is system C.0nptructed as;M plans?.. Is well drilled,? led,? Date: Is well located as per plans? Are erosioa,eontrol mews in place?. FCA I certify that q system(s, as listed, labove,"P*iemls6s his, en constructed and I haveinspcoted , and verified their completion in acc6tdafice- with' the issued PCHD Construction Permit and approved plans and the Standards, . 'R'u*les and Regulations of the Putnam County Department of Health. Date: */0 'Certified by: PE _L-�RA Design Professional Form FIA-97 NOV-22-2004 �'MOR.1'11:07 "TILL:845-278-7921 NAME:PUTNAM COUNTY DEPARTMENT OF P NI r PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES . '\y. . CONSTRUCTION PE RT FOR SE rAc� T ATM ENT SYSTEM PEI8NUT # Located at�t�� °���` 67— "r' /a°i dt�e add Subdivision name '7 Subd. Lot # Date Subdivision Approved ft Owner /Applicant Name141 To Tillage 4 on Lam Tax Map Block LotJV� Renewal V Revision Date of Previous Approval XIV-4 Mailing Address QL c _aZ 49 /94610 n111VJ? Gt4 S7' d°d,R"r edor1w Alley, Zipi-;�' Amount of Fee Enclosed 4 :fe e) Building Type A 4ryl� Lot Area No. of Bedrooms Design Flow GPD Fill Section Only Depth Volume PCHID NOT'IFICAT'ION IS RE UIRE D WHEN FILL IS COMPLETED Separate Sewerage f s� teen to consist of /c'LJ'D gallon septic tank and 444- �, /'* 13 f a 4 Vne,- -fr ¢Aev -� - Other Requirements: aD.0 Pr V 19 x14.4 r &1� 491<- -f 10111009 To be constructed by Address �Yater SaannIlv: Public Supply From Address or:— Private Supply Drilled by V /��% Address F - I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatments sum described above will be constructed as shown on the 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" satisfactory to the Public Health Director 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 treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: P.E. R.A. Date ®` Address OA&�dlc. A License # -A ?y/ APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new =roved for discharge of domestic sanitary sewage only. By: u Title: A-P14-6 Date: 61 - Q Whi copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL /� please Hn or type- ° . -. PCHD Permit#/ Well Location: Street Address: illage Tax Gri j �w1,0PA z -"ovo eT �t�J`N �� �J Ma Block Lot(s) Well Owner: Name 7/ `'r4P4-40-1.4 l Address: %-xJ 49,C4z-& %-x C7- Af'r o 'J� /_ <_ �R G �fi3 AA1, Use of Well: Y Residential Public Supply Air /Cond/Heat Pump Irrigation rimary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought gpm le Served Est. of Daily Usage % gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling )/New Supply (new dwelling) Deepen Existing Well Detailed Reason Swilq. 4 for Drilling Well Type rilled Driven ' Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes � No Name of subdivisiont7- /"SM Z44-& F. T, Lot No. Water Well Contractor: —r;R1) Address: Is Public Water Supply available to site? .................................. ............................... Yes No Name of Public Water Supply: /% 14 TownNillage Distance to property from nearest water main: A14& Proposed well location & sources of contamination to b provided o separate sheet/plan. Date: Applicant Signature: PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED. FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well driller certified by Putnam County. Date of Issue X0 y. Permit Issuing Official: �-�- Date of Expiration Title: A& 5-b� jL kc �JA— Permit is Non - Transf White copy - HD file; Yellow copy -Building Inspector; Pink copy - Owner; Orange copy -Well driller Form WP -97 LORETTA MOLINARI Public Health Director April 26, 2004 ..,... ROBERT J. BONDI County Executive DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 )Environmental Health (845) 278.6130 Fax(845)278-7921 Nursing Services (945)278-6558 WIC (845)278-6678 Fax(845)278-6085 Early Intervendon/Presdool (845) 278.6014 Fax(845)278-6648 Dan Donahue, PE 120 Breckenridge Road Mahopac, New York 10541 Re: Proposed SSTS Renewal — Timberline Associates LLC Timberline Court, (T) Putnam Valley TM# 51 -1 -50.1 Dear Mr. Donahue: This office, as received and reviewed the most recent set of plans for the above mentioned project. We would like to offer the. following comments for your review and consideration. 1. Deep hole testing is greater than 10 years old. A minimum of 100 `feet should be maintained between a cemetery and a well and SSTS. ' Please provide 100 feet and provide minimum dimension labels. Please provide north arrow for.30 -scale site plan. • ' Please show -fill for grading in plan view and - profile and label proposed contours -- r: Please show roof leader /footing drain route and discharge location. Please provide a note stating that the SSTS and well are to be staked by a licensed land surveyor before the start of any construction. Floor plans presented for review contain five (5) bedrooms. P. Tax map number provided is incorrect. This office will continue its review upon consideration of the above - mentioned comments. Please feel free to contact me at ext. 2157 if any questions arise. Ve truly yours, oseph S. Paravati, Jr. Assistant Public Health Engineer JSP:cj -PUTNAAI C WPAJD- Or "IV VtR 'Exi .4 , EALT-n AS �E DESIGN DATA OWW - SET - s�URI?ACE s EWAGE . • ; VICES C r2 s TUATMENT SYSTEM Located agstmt I 'Add o /sew �Gndicatteo nearest cross street) Tax Map_ Block / MunicipaUtyy �t,�N',y Lot --L_ doo Watershed c0ty iPkp ' r Date of SOIL PERCOLATION TEST DATA Z Date of Percolation Test , P, Pt sal 9iQ.t 2. percolation test hole. (i.e. s.1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for review. Depth measurements to be made from top of hole. i +l f f . r.. :.. .•. v, <. v: �z ..i:KN},.: ".':1... .. .Y .. t....'t '�. • };T�tt <� ; ++xvi'.'y. ', a te ate'. �% Grp 'n' :Hole Nq, ; • ,; u> .4,� + +t'•'`y •): i1Y. /�+a• v?•''�...:... F �.,.r$.�.r...in. �.s< < .{:,•. :•':, :.H\ /m �.►Stal't 2 D }_ 1 J&- -- ,y * 5 2 U 11 JU, 3 /d 3 �s i►r zr 3 ; �o 4 3 4 5, NOTES: 1. Tests to be repeated at same depth until Mroximately equal uercolation rates are obtained at each 2. percolation test hole. (i.e. s.1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for review. Depth measurements to be made from top of hole. i +l f f DEPTH G.L. 0.5' 2.0' 3.0' 3,5' ' 4.0' 4.5' 5.0` 5.5' 6.0' 5.5' 7.5'. $ At a , TEST Pff DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE N®. HOLE N®. 11.5' 9.0' 9.5' _ 10.0' Indicate level at which groundwater is encountered 0 HOLE NO. Indicate level at which mottling is observed =. ... . Indicate level to which water level rises after being encountered Deep hole observations made by; : p&R erg D ,V Date "� 7 Design Professional Nmne:'R,Aii L 51, pg .°r �I tes Address: Aa aff,0A. a &of oe "t Signature:- Design Proffisional's Seal Oar- ' f'- Nq . e¢ �, J. opt, X0:48 &� y0 a e s c Nm IT. MEN ry —FNGIN E -_. .:...._....__._...(Li�V'V'LEQ�3 �tF"Q'D�G�1�S�Q�Q`U'°TPGa�Q. 200 breckwuldge Road Mmovec, N.Y. I W I •r a�io« 914.6163.7376. TO WE ARE. SENOINO YOU C Apache! Cl undo soperots cover vim —the 1eHowft !lams: O Shop dnwfnp, O Prints O Puns O Samples ❑ Spaemcdo ns O Copy of wet O Choose order D l.._�. �._ TPiESE"AR61 "'TRAi�i86iAiiiE ® "'as CheckeA- 6Se4�a:• ::_. , . .:....._ .._..,.__ .._._ o .. _ ...... _..._: - .. © for appreva1 J Approved as submitted O ,11soubmi4,..,.._,00p6ma for approval 7 for your use J for rwW& end wnunent 0 Approved as nosed O S6rbrnit...... won for. d►strib tloo O Retu►r" LW corrections O RMur+n **"O*ad prlrmts C1 p I" SIDS DUE 19 —a PRINTS RUURNEO AFTER LOAN TO US REMARKS --- «. BttiNEO: . ..• ._ ••... s...w ..seAr ro .o eww. LORETTA MOLINARI Public Health Director April 26, 2004 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 . Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 Dan Donahue, PE 120 Breckenridge Road Mahopac, New York 10541 Dear Mr. Donahue: ROBERT J. BONDI County Executive Re: Proposed SSTS Renewal — Timberline Associates LLC Timberline Court, (T) Putnam Valley TM# 51 -1 -50.1 This office has received and reviewed the most recent set of plans for the above mentioned project. We would like to offer the following comments for your review and consideration. Deep hole testing is greater than 10 years old. A minimum of 100 feet should be maintained between a cemetery and a well and SSTS. �v.._..:._.:._....:. .. -: ;.Please.prmidw.100.feet and- provide- mihimiirri dim. m ension-labels:- 3. Please provide north arrow for 30 -scale site plan. 4. Please show fill for grading in plan view and profile and label proposed contours. 5. Please show roof leader /footing drain route and discharge location. 6. Please provide a note stating that the SSTS and well are to be staked by a licensed land 7. 8. surveyor before the start of any construction. Floor plans presented for review contain five (5) bedrooms. Tax map number provided is incorrect. This office will continue its review upon consideration of the above - mentioned comments. Please feel free to contact me at ext. 2157 if any questions arise. Very truly yours, oseph S. Paravati, Jr. Assistant Public Health Engineer JSP:cj 4 LORETPA MOUNARI ?, ROBERT J. BONDI Pablla HmW D4sob. • , . .. 0-0 Cnnatw .. DEPARTMENT OF HEALTH ,. 1 Gmcva Rwd, ' Brewua, Ncw York 10509 � Faitr®,maotal Raab 184P 478 -dPQ FU MS) 278.7921: ' Nmt1a8, Bwlm (543) 278. 6.558. 94C (MS) 278 � 6618 FU(B43)278-608S garly. IaterftMdsa!Frarhaol (545) 278.601♦ Pax (845) 778.6668 April 26, 2004 - Dan Donohoe, PE 120 Breclamridge Read MAhopu, New York 10541 Re: Proposed SSTS Renewal — Timberline Associates LLC • Turberliae Cowl, (7) Putnam Valley TMN 51.1.50.1 Dear Mr. Donahue: . This office has received and reviewed the most recent act of plans for the above mentioned project. We would Ww to offer the following comments for your review and consideration. I. Deep hole tcadng is greater than 10 yeas old. 2. A minimum of.100 feet ahould,bo maintainad between a cdmetery ' and a well and SSTS. Plcasa provide 100 feet'and provide minimum dimension labels. 3. Please provide . north arrow for 30 -scale site plm.' , ' 4. Please Show fill for )paling in plan view and profile and label proposed contours. S. Please show roof leader /faoting drain route and discharge location. 6. Please provide a note stating that the SSTS and well am to be slaked by a licensed land surveyor before the atmi of any construction, . 7. Floor plane presented for revitiw contain five (5) bedrooms. 8. Tax map elunbeprovided is incorrect - This office will continue iia ruvimv upon wneldeRdOn of theabovc- mentioned aotrmmnts. Please feel fieo to contact me at met. 2157 if any quoedous atlas. V truly ",, oeOlt S. Pamvati. Jr. Assistant Public Health Eagiaeer JSP:Qj XO : SIMSM WO<3 : WON AE,00 : SWIS COMM V0:9T 9Z -UC1V : SKII MIS T/T : Szovd 9L5L8Z96 : SNOHd TZ6L- 8LZ -5V8 rMl HIUHH dO ZNSJdZ21UM AIN[100 WKNInd : MN 90:9T NOW 1V00Z- 9Z -UdK : 511VG NOIZMN00 DNIMIIS `F Hf'A1`ilEEL I DONAlClilUE, P. E., C®NLSUMNG ENGINEERS - .r� .� - ......� z, ...... ... .. ..._. 120 Breckenridge Road:_. Mahopac, N.Y. 10541 845 -628 -7576 April 6, 2004 Putnam County Department of Health Geneva Road Brewster N.Y. 10509 Att: Mr. Joseph Pavarotti RE: SSTS Permit & Well Permit Timberline Estates Lot #1 Timberline Ct. Putnam Valley Dear Mr. Pavarotti: Enclosed herewith please find: 1. Application for permit to construct an SSTS 2. Application for a permit to construct a well. _...._..._� _ _3..Letter.ofauthorazatioh- ... ___ ._... ___ .. ...� .__.� ..,� _...._...._�........ .._. __.. ___._ ,._.. _ .._ ... 4. Three copies of construction drawings Comments: Application is for a renewal and name change fee filed under separate cover. Your prompt consideration would be greatly appreciated. Sincere I/ Donahue, P.E. Site o Sanitary o Environmental PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES AFFIDAVIT - CORPORATE OWNER. APPLICATION FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT To: Public Health Director In the matter of application for: A.I. 11eAf7Ji► FK r rrr r yc-4-c- GdTS '� /— 8 i Iw L, I.� represent that I am an officer or employee of the , corporation and am authorized to act for: Name of Corporation: � &a�I� AFep ' u-'( Having offices at: ,Z�i' Whose Officers Are: President- Name: � �L�Le-- _T(N'CA4-25.�� Vice President - Name: "�N LOU, Address: 5D ��� Secretary -Name: Treasurer - Name: Address: and that I am and will be individually responsible for any and all acts to the approval requested and all subsequent acts relating thereta.=�\ Sworn to before me this 13 day of _(month) 2_00 ' _ (year) Notary P is ''— racey A. Box t"` �i_IC, State of Newya fvo. 01805081711 Lialified in Westchester County - Cornmission Expires July 07, Form CA -97 Signed: Title: iv►0�'� - Corporate Seal ion with respect LLk- LETTER OF AUTHORIZATION ON RE: Property of I...,.. . .. _. Located at ()TV P yT jq4,m if *P0 ax 'Map # 2>4 Block r�_ Lot Subdivision of 7 / .M OR k J 4 a rAvy-g-s Subdivision Lot # Gentlemen: Filed Map # 2-(Aa A • Date Filed 12-1 ICJ °I6 This letter is to authorize DAW J �, �. D4 a duly licensed Professional Engineer V or Registered Architect to apply for the required wastewater treatment and/or water supply permits) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on.my behalf in connection with this matter and to supervise the construction of said wastewater tretment and/or water supply systems in conformity with the provisions of Article 145 and/or 147 of the Education Law, the Public Health Law, and the Putnam Cou ty_Sanitary Code. Very truly you , Countersigned: / Signed: P.E., R.A., # ���( � (owner of Property) p) (ds�� P,L TWSPSPoV Aailin Address Mailm g Adres: c o2P 2_ZZ 69A(x 04uWWO s State Atli Zip ® Q 6 State Zip 105-6 Telephone: Telephone: °I4- 62$- 4�'5s - Form LA -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # V 40 _ O .Z Q;L Located at �%/�''L��14 !6" r Village 1f1_*A1Xt ,��� f' Subdivision name A � Subd. Lot # _/ Tax Map 7 _� c9` Block Lot Date Subdivision Approved A Renewal Revision Owner /Applicant Name C10,4 d rZZ- f Date of Previous Approval Mailing Address jD/ crg*, A a_L oP/ai 40I ,/&005 J A'r Zip Amount of Fee Enclosed f 36 d 'r/ H4 A-* Building Type p Lot Area No. of Bedrooms 11C Design Flow GPD4R5�4 , Fill Section Only . Depth I Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of gallon septic tank an d Other Requirements: _02.4ip L 24049) dpwx a 4_omlilr ea To be constructed by % t? D Address Water Sunnly: Public Supply From Address or:� ; - Pri-vate-Supply-Drilled-,oy.,_: _ r-- -� �: _ . Address - .._.._ _�.._.__ ...�.... - . I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatments sy tem described above will be constructed as shown 'on the 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" satisfactory to the Public Health Director 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 treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs ereto. Signed: P.E. `' R.A. Date �- Address f a vA We /j�I� License # APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified hen considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new p� t. A prove r discharge of domestic sanitary sewage only. By: � - Title: Date: �...- White copy - HD F' ; Y llo copy - Building Inspector; Pink copy - ner Or ge copy - Design Professional Form CP -97 . PUTNAM. COUNTY DEPARTMENT OF HEALTH BDIWSRON OF ENVIRONMENTAL TAL HEALT Hl SERVICES _ APPLICATION TO CONSTRUCT A WATER WIELD, ... _ ... _ please print of type PCHI) Permit 4 1�- Well Location: ---- - -- .. .. - — — -- w -" Street Address: JEO illage Tax Grid # -- -- -- ®d Pt '9-d "V day 9q- &EX . Map � � Block � Lot(s) � Well Owner: Name: Addrpess:: c� t j Use of Well: residential Public Supply Air /Cond/Heat Pump Irrigation 3Il- imargy Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Yield Sought S� _ gpm "Mfflne Est. of Daily Usage �e�gal. Amount of Use Reason for Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well ➢Detailed Reason for Drilling Well Type 9---Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes ,4-- No Name of subdivision !%G rl A,oAeG ,f Lot No. Q Water Well Contractor: P Address: Is- Public Water Supply available to site? .................................. ............................... Yes No�� Name of Public Water Supply: Town/Village Distance to property from nearest water main: Proposed well location & sources of contamination to be provided on separate sheet/plan. D ate. _ 2-- Applicant Signature:,_ - PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED. FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the County. � approved plan requires a new permit. Well to be constructed by a watewell driller certified by Putnam A Date of Issue Permit Issui O ici - Date of Expiration Title: Permit is Non- Transfferrab e White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 14.1&A (2t17)—Ta :t 12 , 617.29 SEOR PROJECT I.D. NUMBER Appendix C State Entrlronmental Duality getrlew_ ,. _ , .. . . SHORT ENVIRONMENTAL ASSESBNiEN1f 16AM For UNLISTED ACTIONS Only �P R OJECT INFORMATION (T0 be completed by Applicant or Project sponsor PART I— , 1. APPIIGANT ISRONSOR 2. P�+OJE NAME R 4mss %�' �f " ,f ��ii s•r 3. PROJECT LOCATION: Municipality to r TN�!'� `Z� County t. PRECISE LOCATION (Street address and road interjections, prone ind'nt••IindlnatR&,'etc.;'or prdvide map) S. IS PROPOSED ACTION: 0 Ne+r ❑ WC-131011 ❑ ModificatioNalleration 5. DESCRIBE PROJECT BRIEFLY: COr1 V G TO h+ Q1C /q hl SS / X 7. AMOUNT OF LAND AFFiCTED: Initially 0. acres Ultimately d r �� acres 8. W,IILLtL PAOPOSErrD'fACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? JSJ Yes u No It No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? WResidential G industrial ❑ Commercial D Agriculture PerWForestlOpen space ❑ Diner Describe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL STATE PR LOCAL)? Eyes ❑ No If yes, list agency(&) and permlVappmvals 11: DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VAUD PERMIT OR APPROVAL? ❑ Yes I g No It yes, list agency name and permitiapproval Q. AS A RESULT &OFF PROPOSED ACTION WILL EXISTING PERMITIAPPROVAL REQUIRE MODIFICATION? u Yes ri No 1 CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor .name: N/ fr L . V,' N�Q tJF' . Date: Signature: If the action iS 'in the Coastal Area, and you are a state agency, complete'the Coastal Assessment Form before proceeding with this.assessmotlt OVER i If the action iS 'in the Coastal Area, and you are a state agency, complete'the Coastal Assessment Form before proceeding with this.assessmotlt OVER i PART N-- ll:NVIRONMENTAL ASSESSMENT tTo be completed by Anesnnyl A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.427 it yes, coordinate the revfew process and use the FULL EAF, U Yes ZNo E. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED •. CTIONS IN 6 NYCRR, PART 617.6? If No, 6 negative declaration may be supereeded by another In"lved ageney. . U Yos * MA C. COULD ACTION, RESULT IN ANY ADVERSE EFFECTS, ASSOCIATED. WITH THE FOLLOWING: (Answers may be handwritten'. It legible) Cl. Existing sir quality. 6urface •or`®rounder�tei•quallty.or quantity, rnoise levels, existing traffic pattern$, solid waste production or di ;ppeat, potential tar erosion, diainage or flooding pr6blarnsf Explain Orlefiy: C2. Aesthetic, agricultural, archaeological, historic, or other natural Of cultural resources; of community or nelghborhDod character? Explain briefly: /V d N1 C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: a C4, A community's existing plans or goals as officially adopted, at a change In use or intensity of use of land or other natural resources? Explain briefly I Al a CS. Growth, subsequent development, or related activities likely to be induced 1;y the proposed action? Explain briefly. C6. Long term, short term, cumulative, or other effects not Identified In C1437 Explain briefly. C7. O:nsr im, ^acts (including changes in use of either quantity or typo of energy)? Explain briefly; Ne, tv '' D. IS THERE, OR IS THERE LIKELY TO EE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? FJ Yes Z No It Yes, explain briefly PART Ili — DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect Identified above, determine whether it is substantial, large, Important or otherwise significant. Each effect should be assessed in connection with its, (a) setting (Le. urban or, rural);. (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been Identified and adequately addressed. C3 Check .this box if you have Identified 'one or:more potentially large or signiflcant adverse knpacts which MAY occur. Then-proceed directly to the FULL EAF and/or prepare a' positive declaration. )'aheck this box If you have datetmined,.ba tad on the information snd'•analysi,;•apove. „s)<nd any supporting documentation, that the`proposi'd'actloit WILiy NAT result in any significant adverse eftvironmenta( Impacts AND provide on attachments as necessary, the reasons supporting this determination: r:. .. %2(-- v q6 a /mss'. ( or Tvve Name *I Aesponsible Olticer in Lea 4 ¢Lead Asencv - -� prature of reparer fit Zliffllfemt frQM t ponsi e o rcer} �--1 -0� ate SAM �G� CIO 'Sheet_ of 1 ` * PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRQNMENTAI .IIEATLI- H.SERVICES FIELD ACTIVIT=Y REPORT . NAME: 'Teh AnDRF.CN: Street Town State Zip PERSON -IN CHARGE ORWRY). Date, Name and Title TYPE OF FACILITY FINDINGS: PUTNAIVICOUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEMS _ .. _ ... REVIE-W-SHEET FOR CONSTRUCTION PERMIT r .- NAME OF OWNER: d STREET LOCATION: REVIEWED BY: RM, GR, AS, &ATE: C� d" TAX MAP #: (CONFIRMED) 3 Y DOCUMENTS PERMIT APPLICATION (f!j( )WELL PERMIT OR PWS LETTER (/jC__)PC -97 % Cf!!n(_)LETTER OF AUTHORIZATION L,-n(__)DESIGN DATA SHEET (DDS) (_)(_,JCORPORATE RESOLUTION ( /(__)SHORT EAF ( - OLJPLANS -THREE SETS (Q(JHOUSE PLANS - TWO SETS /jVARiANCEREQUESI SUBDIVISION i��JLEGAL SUBDIVISION UUSUBDIVISION AP V CHECKED LdL_)PERC RATE (�� (FILL REQUIRED 0 -42 y DEPTH UUCURTAIN DRAIN REQUIRED GENERAL L,( _)LOCATED IN NYC W D UUPLANS SUS TO DEP DUDE ED TO PCHD EP APPROVAL, IF REQ'D DEEP TEST HOLES OBSERVED (��PERCS TO BE WITNESSED ,Cf::::y(__)EX- APPROVAL SSDS ADJ, LOTS (_JL,::Ji'VETLANDS (TOWN/DEC PERMIT REQ'D ?) (_)DATA ON DDS PLANS & PERMIT SAME (_,)(PRE 1969 NEIGHBOR NOTIFICATION UTTER BUZBA = ` j p YR.- FLOOD ELEVATION W11-200' C_) SOIL TESTING LOTS >10 YEARS OLD REQUIRED DETAILS ON PLANS ( jSEWAGE SYSTEM PLAN - (NORTH ARROW) (_eJ-(^)SSDS HYDRAULIC PROFILE (::f5UGRAVITY FLOW (CONSTRUCTION NOTES 1 -15 CDESIGN DATA: PERC & DE SULTS _2' CONTOURS EXISTIN PROPOSED DRIVEWAY A SLOP , CUT (-,�J ' USDA SOIL. UPE BOUNDARIES (TITLE BLOCK, OWNERS NAME ADDRESS TM#, PE/RA; NAME, ADDRESS, PHONE# L %DATE OF DRAWING/REVISION (l } DATUM REFERENCE LOCATION OF WATERCOURSES, PONDS LAKES,WETLANDS WITHIN 200' OF P.L. PROPOSED FINISH FLOOR AND BASEMENT ELEVATIONS WELLS & SSDS'S WAN 200' OF SSTS (- )C PROPERTY METES & BOUNDS (EROSION CONTROL FOR HOUSE, WELL & SSTS, EROSION CONTROL NOTE COWMNTS: (REVSHEET)09 /01/00 0HOUSE (REQUIRED DETAILS ON PLANS CONT'D) SEWER - %11 FT. 4 "0'; TYPE PIPE CAST IRON CZL_)NO BENDS; MAX BENDS 45' W /CLEANOUT RENEWALS (—)(SIT E (NO CHANGE) FILL SYSTEMS (� HORIZONTAL; PAST TRENCH SLOPES 3:1 TO GRADE )FILL SPECS / FILL NOTES 1 -5 C�FILL PROFILE & DIMENSIONS FILL IN EXPANSION AREA FILL GREATER TR4N2 FEET (�(� CLA BARRIER UC--)] RTIFI TION N TE C—)(__)DEPTH ES vUVOL. ON P R.O.B., UNCLASSIFIED & IMPERVIOUS (�( )SEPARAT ON DISTANCE FROM TOE OF SLOPE TRENCH ( JC- LF TRENCH PROVIDED 60FT MAX.. C�C PARALLEL TO CONTOURS 0100% EXPANSION PROVIDED �DETAIL/DUST FREE CRUSHED STONE OR WASHED GRAVEL GEOTEXTIELE COVER SEPARATION DISTANCES ON PLAN - FROM SSTS 10' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL "20' TO FOUNDATION WALLS 100' TO WELL, 200' IN DLOD,150' TO PITS 100' TO STREAM, WATERCOURSE, LAKE (inc. expan). C_,.)r�50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER -• . 10':.TO.WATER LINE -(pits -•20') _- 50' INTERMITTENT DRAINAGE COURSE 200' /500' RESERVOIR, ETC. _ 150' GALLEY SYSTEMS 10' MIN TO LEDGE OUTCROP SEPTIC TANK jI0' FROM FOUNDATION; 50' TO WELL WELL ((�DIMENSIONS TO PROPERTY LINES ( /f ( )LOCATION OF SERVICE CONNECTION (__)(MIN 15' TO PROPERTY LINE SLOPE �} SLOPE IN SSTS AREA (520 %) REGRADED TO 15 %, IF REQUIRED DOSE/PUMP SYSTEMS (_)UPUMP NOTES U(_JDOSE 75% OF P V /DOSE VOLUME NOTED U(�DETAIL FOR FOR , (PIPE TYPE, ETC.) ( —)L}PIT AND D -BOX S & DETAILED U(�1 DAY STORAGE ABOVE ALARM AIN DRAIN (_)(STANDPIPES, 5 B H ES, DETAIL (_)(_)15' MIN to CDS %, 2 -4%,151-3%,351-16/o, 100 % - <1% (�( )20' MIN to CD D GE /100' with 182 cons day discharge (_)(_)10' MIN to NON ERFORATED PIPE . -. .. -I IWI, DANIEL J. DONAHUE, P.E. CONSULTING ENGINEERS. ... . _ - 120 ..._ rec a e_._._oa - .Y•i...0 -.1 wOb.Ki'•.3•.:.r:-- .�- ^.salr m V` ..�. rw n .r. .Vr+wuV�.. a.. t.. .. V srV�•A.1 .... +u+u.�R••'.: ^` . Y..- A._:as �-a. e..m . C..._.. niM .•1rs- 1'u..ta..V-.V:.�s.v:r,.. ��.••iR"�iV m.MM`. •+.tom_.. a•r Mahopac, N.Y. 10541 845 -628 -7576 May 2, 2002 Putnam County Department of Health Geneva Road Brewster N.Y. 10509 Att: Mr. Shawn Rogan RE: SSTS Permit & Well Permit Property of Gizzi Timberline Estates R. S. Lot #I -Putnam Valley Dear Mr. wig: X06,4 v Enclosed herewith please find the following: 1. Form PC -1 2. SSTS application 3. Well permit application 4. Design data sheet 5. Letter of authorization 6. Fee in the amount of $300.00 7. Short EAF 8. Three copies .ofconstructionplans:__._.�_.:_ 9. Two sets of house plans By: Daniel J. Donahue, P.E. w �y �a Site - Sanitary - Environmental PUTNAM COUNTY DEPARTMENT OF HEALTH fiDIVISgON OF ENVIR0N1VIEN1'H'Ag. HIEAII.7i'H SERVICES LETTER OF AUTHORIZATION RE: Property of ` QWAA� 'e-6 ,0 Located at (9v 4 dl4k jfax Map # 3 4 Block % Lot � Subdivision of ee�Le Subdivision Lot # Filed Map # Date Filed Gentlemen: This letter is to authorize D4 'y-0 0.e. �� ® 4-1 a duly licensed Professional Engineer or Registered Architect to apply for the required wastewater treatment and /or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on my behalf.in, connection with this matter and to supervise the construction of said wastewater.tretment and/or water'supply systems. in conformity with the provisions of Article 145 and/or 147 of the Education Law, the Public Health Law,-'and the Putnam County Sanitary..Cade.._......, Very truly yours; Countersigned: Sign P.E., R.A., # (Ownp of Propc y) Mailing Addressk�•--Oot� ��� ®��°�°� Mailing Address: o20f cf�+u) /lei / /iC State Zip Telephone: State A)• r. Zip /© 70/ Telephone: (9/q) %3.3 v0V Form LA -97 PUTNAM COUNTY DEPARTMENT OF'HEALTH DIVISION OF ENV ONMENTAL HEALTH SERVIUS"" DESIGN DATA SHEET - SUBSURFACE SENVAGE TREATMENT §YS . TEM ONmr jo Addres Located at Tx Map3l- Block _WZ,16je re�r a Lot (indicate nearest cross street) Municipality P&74-V4-*y_ AL�Aqo y Watershed -C *,V O'Pgr AA", o SOIL PERCOLATION TEST DATA Date of Pre-soaking AX. b 2- Date of Percolation Test .4 �t-444�% -D "th't W e -A .2 'G "' - aDs.e Tj rom roull C -xl r pp I P t Tart 09, es: 1 /1/36 2 .32 al R--- 4.-r 4 5 __ ._ _.. _._l._ . _ - .�� ..fie �.. �3 � _ -- .._ _ � � �� �, 3 ,� 2 30 11 jLj- 3 3 4> ZI 4 5 —.7 2.- 3 4 5 NOTES: 1. Tests to be repeated at same clepin unul approximiticlY z4ual Vv1%,v1Q1jv11 &Q41.0 "4V W•.W441- -- -- percolation test hole. (i.e. i I min for 1.30 minfinch, s 2 min for 31-60 minlinch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. TEST PIT DATA 2 DESCRIPTION OF SOILS ENC0UNTERED IN TEST HOLES DEPTH 1 l J HOLE NO. �_ HOLE NO. HOLE N0. G.L. -= 0.5' Ps sAL 1.0' 1.5' 2.0' 2S', 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.01 ......... 10.01 Indicate level at which ot*ndwater is encountered Indicate level at which mottling is.observed a g M f. Indicate level to which vwater level rises after being encountered Deep hole observations made by: G,DC Date Design . o. Address: :. Design Professional's Seal 1 W 1'1 \� ' -•_.. `....- -%.. �. :. X11 y�.I_ �£ OF fV Pi1TNAM COUNTY DEPAla'1'MEN T OY HEA.L'1'll DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION FOR APPROVAL OF PLANS YOR - - -- A WASTEWATER TREATMENT SYSTEM _ _ 1. Name and address of applicant: Jd dAf GfZZ-i _ ;tot Xot,r01/4-e- R1 X&AW Y40 JP!!i ✓. AZ2. Name of project: SiN6s e j'Ryic, r r 3. Locatia�V: 4. Design Professional: JAAt 4. d7oNilHur-- 5. Address: /4oPEc`�'i.v,Q�p6t''o 6. Drainage Basin: ,C#,01 V,6& ' #Age�4 4r 0#04 y 7. Type of PEoject: Private/Residential Food Service Commercial Apartments Institutional Mobile Home'Park Office Building Realty Subdivision Other (specify) 8. Is this project subject to State Environmental Quality Review (SEQR)? Type Status (check one) ............... :........ ............................... Type I exempt Type II Unlisted 9. Is a Draft Environmental Impact Statement (DEIS) required? ......................... W/� 10. Has DEIS. been completed and found acceptable by Lead Agency? ............... A oe 11. Naha of Lead Agency j2.. `is�this project in an area under the control of local planning, zoning, or other officials, ordinances? .......... I.......................... plans-been submittW - 14. Has preliminary approval been granted by such authorities? Date granted: _&0�� . 15. Type of Sewage Treatment System Discharge ................. surface water Ygroundwater 16. If surface water discharge, what is the stream class designation? .................... 17. Waters index number (surface) ........... ............................... ...... . . —-,-- 18. Is pro'ect'located near public water supply system? ...... ............. ..................: /I!D 19. If yes, name of water supply Distance i6water supply. ` 20. Is project site near a public sewage. collection or treatment system? :............:...: /1/D 21. Name of sewage system :Distance ao sewage system 22. Date test holes observed 23. Name of Health.Inspector X ?ioA ZA 1 24. Project design flow (gallons per day) 25. Is State Pollutant Discharge Elimination .System (SPDES) Permit required ?... 26. Has SPDES Application been submitted to local DEC _office? ............ ............... Ill_ �- Form PC -97 .Z 27. Is any portion of this project located within a designated Town or State wetland? N' 28. Wetlands ID Number.............:............:::........:.:.....:.......:.: .............................:: _ 29. Is Wetlands Permit required? M ........ N e) Has application 'been made to Town or Local' *DEC office? _�. h. 30.,. Does project require a DEC Stream Disturbance, Permit? .................. � 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge application or industrial. activity? ............................ Y 32. Is project located within 1,000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge, disposal site or any other potentially known source of contamination? ............................... `des& DESCRIBE: 33, Is there a local. master plan on file with the Town or Village? ......................... r r 34. Are community water and/or sewer facilities planned to be developed within 15 years in,or adjacent to project site? ................................ ................. ............... _ Al a 35. Are any sewage treatment areas in excess of 15% slope? . ............................... &b 36. Tax Map ID Number ....................... .............. .. ............ Map Block Lot 37. Approved plans are to be returned to ..... Applicant „ Design Professional b16T`E:AI agpli�atlon� -for re- viewandappiovid-ofh new SSTS ter.be located;wit1a.the C Watershed shall . be sent to the Department, and need not be sent in duplicate to the DEP, although the project may require DEP approval of the SSTS prior to final approval by the Department. Projects within the watershed may also require DEP review and approval of other aspects of a project, such as stormwater plans or the creation of impervious surfaces, and the project applicant should obtain the appropriate forms l'or such activities from DEP and submit those fortes to DEP for review and approval. If the application is signed by a person other than the applicant shown in Item l .,the application must be accompanied by a Letter of Authorization (Form LA -97). Failure to comply with this provision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury, that information provided on 9his form is true to the best of my knowledge and belief. False statements, made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of ilia Penal Law. SIGNAT'U1 ES & ®FFICM TITLES.- S. Z)AN P (.. 4 c jo V^-..,. YML ENVIRONMENTAL SERVICES 321. Kear Street Yurktown Heights, N.Y. 10598 ' (9 14 245-2800 Albert H. Padovani, Director -AB #: 1.501947 CLIENT #: 114 ~~~~~~~~~~~~~~~~~�~~~~~~ [ORLISH & SONS 9OX 271, 45 MAPLE AVE. �TTENTION: DWAYNE TORLISH �RMONK, NY 10504 5AMPLING SITE: CHANGE BRIDGE CC) I.')[ LOT : PUTNAM VALLEY �OL'D BY: D. TORLISH | \10 TES...: KITCHEN TAP | BACT NON STAT PROC 'DATE/TIME TAKEN: DATE/TIME REC'D: REPORT DATE: PHONE: (914)-273 PAGE: 1 ~~~~~~~~~~~~~~~ 04/04/05 O9:30 04/04/05 10:30 04/12/05 -3448 1 SAMPLE TYPE..: POTABLE PRESERVATIVES: NONE TEMPERATURE..: < 4C COLIFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~... ... ... ... ... ~~~~~~ ... ... ... ... ~~~ DATE FLAG PROCEDURE RESULT PUTNAM CNTY PROFILE O - 10 9052 04/O4/05 MF T. COLIFORM ABSENT /100 ML 04/04/05 LEAD (IMS> <1 ppb 04/04/05 NITRATE NITROG 0.52 MG /L 04/04/O5 NITRITE NITROG <0.01 MG /L 04/04/05 IRON (Fe) 0.596 MG /L 04/04/05 MANGANESE (Mn) 0,010 MG/L 04/04/05 SODIUM (Na) 9.87 MG /I 04/04/05 pH 6.7 UNITS 04/04/05 HARDNESS, TOTAL 86.0 MG /I 04/04/05 ALKALINITY (AS 62.0 MG/L O4/04/05 TURBIDITY (TUR 11.0 NTU NORMAL - RANGE METHOD ABSENT 1008 0-15 pp 9003 O - 10 9052 N/A 9J.62 0-0.3 mg/1 9002. 0-O.3 mg/l 9002 N/A 9002 6.5-8.5 9043 N/A N/A 9001. 0-5 NTU . | COMMENTS: THESE RESULTS INDICATE THAT THE WAT AS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORDI -THE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. `b /CU LEAD limits for p EPA Lead & Copper than 10% of their than 15 ppb and a treatment must be potentiaI. -tblic schools are set at 15 ppb. Rule for Public Systems requires that no distribution points have a LEAD value of COPPER value of 1.3 mcj/L, else water undertaken to reduce the waters corrosive :7e/11n If both iron and manganese are present, their total value | combined shall not exceed 0.5 mg/L. more more 4a No limits for Sodium are proscribed. Suggested guidelines state that for people on a sodium restricted diet, the water should contain no more than 20 m- '/L of Sodium. For those on a | | moderately restricted diet, a maximum of 270 mg/L of Sodium YML ENVIRONMENTAL SERVICES 321 Kear Street 0598 (q14) 245-28O0 � Albert H. Padovani, Director LAB #: 1.501947 CLIENT #: 114 NON 5TAT PROC PAGE: 2 J TORLISH & SONS DATE/TIME TAKEN: 04/04/O5 09:3O BOX 271, 45 MAPLE AVE, ' DATE/TIME REC'D: 04/04/05 10:30 ATTENTION: DWAYNE TORLISH REPORT DATE: 04/12/05 ARMONK, NY 10504 PHONE: (914)-273-3448 SAMPLING SITE: CHANGE BRIDGE CONST LOT #1 SAMPLE TYPE..: POTABLE : PUTNAM VALLEY PRESERVATIVES: NONE COL'D BY: D. TORLISH TEMPERATURE..: < 4C NOTES...: KITCHEN TAP COLIFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ is suggested. pH pH SCALE IN WATER RANGES FROM 1-14. MEASUREHENT OF pH IS ONE OF THE IMPORTANT AND FREQUENTLY USED TESTS IN WATER CHEMISTRY. WATER WITH A LOW pH MIGHT BE CORROSIVE TO METAL PIPES AND FIXTURES. THE NORMAL RANGE OF pH IS 6.5 TO 8.5. Hd TOTAL HARDNESS IS DEFINED AS THE SUM OF THE CALCIUM & MAGNESIUM CONCENTRATION, BOTH EXPRESSED AS CALCIUM CARBONATE. IN MG/L. THE HARDNESS MAY RANGE FROM 0 TO HUNDREDS OF MG/L, DEPENDS ON THE SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED., S8FT'WAIER: 8 ^ - HARD _-_--_-_.-_- MODERATELY HARD WATER: 70-14O MG/L. MG/L = MILLIGRAM PER LITER | HARD WATER: 140-300 MG/L (1 g ain/gallon = 17.2 M(*.-3/L) | ` | C-) co CJ7 X� 6P YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 (914) 245 -2800 Albert'' H'. Padovani ;" b'irector LAB #: 1.504171 CLIENT #: 57698 NON STAT PROC PAGE: 1 MARFIONE, COSMO DATE /TIME TAKEN: 06/22/05 03:20 1129 MAIN STREET DATE /TIME RECD: 06/22/05 03:30 FISHKILL, NY 12524 REPORT DATE: 06/27/05 PHONE: (914)- 424 -0359 SAMPLING SITE: LOT 1 TIMBERLINE COURT, PUTNAM VALLEY SAMPLE TYPE..: POTABLE : BATHROOM FAUCET PRESERVATIVES: NONE COLD BY: COSMO MARFIONE TEMPERATURE..: NOTES...: COLIFORM METH: N/A DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD 06/23/05 IRON (Fe) 0.29 MG /L 0 -0.3 mg /1 9002 06/24/05 TURBIDITY (TUR 2.7 NTU 0 -5 NTU COMMENTS: FAX TO 845 - 896 -8713 COMMENTS: Fe /Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg /L. c SUBMITTED BY: ' a Albert H. Padovani, M.T.(ASCP) Director ELAP# 10323 __.a Y11L. E'NVlAONMENTAI. 91-.kV'ICES 3L21 Keox Street rorktown Pleights, N.V. 10598 (9L4) 245 -2800 Albert 4. Padovant. Director _AD 0. 1.501947 'CLIENT &: I14 NON STAT'PROC PAGE, 1 _ - - -- -- ,..,.. `---- �.�___.. ti..�.,....- ....... --- ......M_- ...- ____.. .. rORLISH $ SONS DATE /TIME: TAKEN: 04/04/05 09136 BOX 1271. 45 MAPLE: AVE. DATE /TIME RECD' 04/04/0.5 aTTENTI0111.1 DWAYNE TORLI!�FI REPORT DATE: 04112!0`, IRMONK, NY 10504 PHONE. (914)- 273 -344G ' SAMPLING 91'TL'i CHANGE'HRIDGE CONS'I Lill' kl SAMPLE TYPE..• POIAHLE r PUTNAM VALLEY PRESERVATIVES, NONE: '-'OL'D SYf D. TORLISH TEMPERATURE... d 4, . VOTES..,: I.ITCHF_N TAP COL!FORM METH: iF' DATE. FLAG PROCEOURE RESULT NORMAL - RANGE K IHUD PU1'NAM CNT'i PROF)l..E p4 /04 /05 MI= T. COL I G OFM ADSEN I , 1U0 ML ADSENT 10()G 04/n4/05 LrAD ( rmr1 <1 l,pb n•.1.5 ppb 903.3 04/04/0:3 NI1RATE NITRUQ 0.52 He /1.. 0 - 10 04/04/05 NITRITE N1 TR(10 •;4.01 MG /L. IJ /A 04/04/05 IRON (Fe) 0.396 MG /1- 0 -0. 3 mg /1 9.:"Jp 04/04/05 MANGANESE (hp -}.OLO Moil.. 04104/OE SODIUM 1Ni) Y.017 MG /L N/A 9nur' 04/04/05 pH 6.? UNITS 6.5•0.5 9043 04104/03 HARONESS,TDTAL 66.0 MG /I_ N/A 04/04/05 ALKALINITY (AS 60.. E) MG /L. N/A 91 n'I 04/04/05 TURUIDITY (TUR 11.0 NTU 0-5 N'TU I COMMENTS: i ])ACT THESE RESULT'S INDTrATE THAT THE WA'TI <WAS) (WAS EW YORK 6 NOT) OF 'A SATISFACTORY SANITARY (sUAI.ITY ACCORD HE.N'rA'rE: AND EPA FEDERAL DRINKING WATER srANDHRDS, FOR THE PARAMETSnS TESTED, AT THE TIME OF COLLECTION. Pb /Cu LEAD Limits for public —huoln ere eat at 15 PPb• EPA Lead LI Copper Rule for Public. S"tem9 requires that: no more than 10% of their distribution points have A LEAD value of !more, than 15 ppb and a COPPER value of 1.3 mg /L,.el8s water . treatment mu %t bei undertaken to reduce the water$ corrugive potential. Pe /Mo If both :run and manganese are I)resent, their total value combined %hull not exceed 0.H mg /L.. Na No limn:? •fur Sodium are pl,OULc !bed. Suggested giiidw;.insu gi :ate that for people on a :odium r•e$tricted diet,the water Should i r_ontain no more than 231 m911.. OF Sodium. For those on a moderately rv$tricted u.Let' a maximum of A70 mg /L. of Sodium ••'aBJ.UKSNV'dl MEKnOW JM08U 30 BJKd ISHIa XO : ssznsau WOE : 8a0w JT JO : swis Q8sdvga Sfi:60 £T -Tor : MOIL suss £/£ SaDvd £TL89686 MOM TZ6L- 8LZ -SV8 "M HZTdZH dO ZNHKIH ddaa XINnOD WVNSnd HKVN 9V:60 a8M 900Z- £T -'IfIf : SMI NOIZD ONICKS YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 (914) 245 -2800 Albert H. Padovani; ° Director, ' LAB #: 1.504171 CLIENT. #: - 57698 NON STAT PROC. PAGE.: 1 MARFIONE; COSMO DATE /TIME TAKEN: 06/22/05 03:20 1129 MAIN STREET DATE /TIME RECD: 06/22/05 03:30 FISHKILL, NY 12524 REPORT DATE: 06/27/05 PHONE: (914)- 424 -0359 SAMPLING SITE: LOT 1 TIMBERLINE COURT, PUTNAM VALLEY SAMPLE TYPE..: POTABLE : BATHROOM FAUCET PRESERVATIVES: NONE COLD BY: COSMO MARFIONE TEMPERATURE..: NOTES...: ----- ------------------- -- - - COLIFORM METH: -- ---------------- ~~ --------------- N/A ���� DATE FLAG PROCEDURE RESULT NORMAL RANGE METHOD 06/23/05 IRON (Fe) 0.29 MG /L 0 -0.3 mg /1 9002 06,/24/05 TURBIDITY (TUR 2.7 NTU 0 -5 NTU COMMENTS: FAX TO 845 - 896 -8713 COMMENTS: Fe /Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg /L. SUBMITTED BY: Albert H. Padovani, M.T.(ASCP) Director ELAP# 10323 YMLENVlRONMENTAL SERVICES 321 Kear Street Yorktown Heig"tj,_N.Y, 1O598 `^ ~ ''^~014> 245-2800 ~ Albert H. Padovani, Director LAB #: 1.501947 CLIENT On 114 NON STAT PROC PAG& 2 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ TORLISH & SONS BOX 271, 45 MAPLE AVE. ATTFNTION: DWAYNE TORLISH ARMONK, NY 10504 DATE/TIME TAKEN: 04/04/05 09:30 DATE/TIME REC'D: 04/04/05 10:30 REPORT DATE: 04/12/05 PHONE: (914)-273-3448 SAMPLING SITE: CHANGE BRIDGE CONST LOT 01 SAMPLE TYPE..: POTABLE : PUTNAM VALLEY PRESERVATIVE& NONE COL'D BY: D. TORLISH TEMPERATURE..: < 4C NOTES...: KITCHEN TAP COLIFORM METH: MF DATE FLAB PROCEDURE RESULT , NORMAL - RANGE METHOD is suggested. pH pH SCALE IN WATER RANGES FROM 1-14. MEASUREMENT OF pH IS ONE OF THE IMPORTANT AND FREQUENTLY USED TESTS IN WATER CHEMISTRY. WATER WITH A LOW pH MIGHT BE CORROSIVE TO METAL PIPES AND FIXTURES. THE NORMAL RANGE OF pH IS 6.5 TO 8.5. Hd TOTAL HARDNESS IS DEFINED AS THE SUM OF THE CALCIUM & MAGNESIUM CONCENTRATION, BOTH EXPRESSED AS CALCIUM CARBONATE, IN MG/L. THE HARDNESS MAY RANGE FROM 0 TO HUNDREDS OF MG/L, DEPENDS ON THE SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED. SOFT WATER: (7/70 MG/L-' VERY HARD WATER: ABOVE 300 MG/L MODERATELY-HARD WATER: 70-140 MG/L` _NG/L = MILLIGRAM PER LITER HARD WATER: 140-300 MG/L (1 grain/gallon = 17.2 MG/L) SUBMITTED BY: Albert 1-1.7r-adovani, M.T. (ASCPT � Director ^ . 'I cz) Ln �..� cn '` �`'��f` 70 �''r :x; !y�-� � ELAP# ('Y0323 ^ ~" YML ENVIRONMENTAL SERVICES 32L Kear Street Yorktown Heights, N.Y. 10598 (914)`245�280O . - - Albert H. Padovani, Director LAB #: 1.501947 CLIENT #: 114 NON STAT PROC PAGE: 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ... ... TORLISH & SONS BOX 271, 45 MAPLE AVE. ATTENTION: DWAYNE TORLISH ARMONK, NY 10504 DATE/TIME TAKEN: 04/04/05 09:30 DATE/TIME REC'D: 04/04/05 10:30 REPORT DATE: 04/12/05 PHONE: (914)-273-3448 SAMPLING SITE: CHANGE BRIDGE CONST LOT #1 SAMPLE TYPE..: POTABLE : PUTNAM VALLEY PRESERVATIVES: NONE COL'D BY: D. TORLISH TEMPERATURE..: < 4C NOTES...: KITCHEN TAP ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ COLIFORM METH: Ml::' DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD PUTNAM CNTY PROFILE 04/04/05 MF T. COLIFORM ABSENT /100 ML ABSENT 1008 04/04/05 LEAD (INS) <1 ppb 0-15 ppb 9003 04/04/05 NITRATE NITROG 0.52 MG/L 0 - 10 9052 04/04/05 NITRITE NITROG <0.01 MG/L N/A 9162 04/04/05 IRON (Fe) 0.296 MG/L 0-0.3 mg/l 9002, 04/04/05 MANGANESE (Mn) 0.010 MG/L 0-0.3 mg/l 9002 04/04/05 SODIUM (Na) 9.87 MG/L N/A 9002 04/04/05 pH 6.7 UNITS 6.5-8.5 9043 04/04/05 HARDNESSJOTAL 86.0 MG/L N/A 04/04/05 ALKALINITY (AS 62.0 MG/L N/A 9001 04/04/05. . TURBIDITY (TUR 11.0 NTU NTU ' COMMENTS: BACT THESE RESULTS INDICATE THAT THE WAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORDWi-��lTHE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION., Pb/Cu LEAD limits for public schools are set at 15 ppb. EPA Lead & Copper Rule for Public Systems requires that no more than 10% of their distribution points have a LEAD value of more than 15 ppb and a COPPER value of 1.3 mg/L, else water treatment must be undertaken to reduce the waters corrosive p9tential. Fe/Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg/L. Na No limits for Sodium are proscribed. Suggested guidelines state that for people on a sodium restricted dietvthe water should contain no more than 20 mg/L of Sodium. For those on a moderately restricted diet, a maximum of 270 mg/L of Sodium • ��C? 22� o� 2s .. L =55 0 \, „ 4?� DRAINAGE \ �O , AND GENERAL UTILITY EASEMENT SIGHT CJ�/� MONUMENT `{ 0 \� FOUND N (` \ m S sS3o s�� SEMENT O 1 \ Q O o m � 0 Lot 1 AREA _ � 6 W _ A 1.9137 A ES v i r�NCE �tvl i �-- _ 50.0 N O m y'I i `�09'�L `SSpo F 50.0, o g ry�ti Garage I C Iler ' i' Enl ance 0 N 88 °30'34" W h b, q. E 60.4' Q ^' ei 13 E2 u'°� �I pN Z ah I. x o c al Q LOT "A' fA m 50.0' ' �D o c K x p C d 0� LINK I ` i N55°501OT Od FENCE 39.57 ETA L CONS I Y EA Si co x xJ g > C9 Op Pipes i :....... _.__ :..._ ._ -✓I WATER; .. N86''09,22 „W 314.471 - -- ....... "'ACCORDANCE WITH'THE EXISTING CODE. OF.-PRACTICE F( SURVEYS "'ADOPTED BY THE NEW;YORK STATE ASSOCIAT .PROFESSIONAL LANb SURVEYORS. -4HIS CERTIFICATION SF RUN ONLY TO THE PARTY FOR WHOM THIS SURVEY WAS PREPARED AND ON THEIR BEHALF TO THE TITLE COMPANY LENDING INSTITUTION LISTED' HEREON. THIS CERTIFICATIO NOT BE TRANSFERABLE. CERTIFIED TO: TIMBERLINE ASSOCIATES LLC SSTS TIE - INS (MEASURED BY TAPE) UNIT A B SEPTIC TANK 12 40 1 40 25'.' 2 50 35 . 3 57 42 4 65 50 5 72 57 6 80 66 7 86 72 8 72 91 9 66 90 10 60 84 . 11 56 83 12 48 79 13 42 76 14 40 75 . 15 62 30 PUTNAM COUNTY DEPAi DIVISIO{y OF E4VIRONMI APPROVED AS NOTED F( APPLICABLE RULES ANC PUTNAM -COUNTY HEALI • .�iws�A I ATURE TITLE, � LENGTH OF TRENCH 60 60 ,. - .... 60 60' 60 60 .60 22 ,z w ASBUILT PLAN SEWAGE TREATMENT SYSTEM Property of TIMBERLINE ESTATES LLC TIMBERLINE CT. TM# 50-1 -50.1 PUTNAM VALLEY (T) DANIEL J. DONAHUE, P.E. CONSULTING ENGINEERS 120 BRECKENRIDGE ROAD MAHOPAC, N.Y. 10541 628-757.6 MAHOPAC, N.Y. 10541 DATE: JUNE 7,2005' SCALE V =30' SURVEY BY: ROLAND LINK. O C CO c w U THIS IS TO CERTIFY THAT THE SEWAGE DISPOSAL SYSTEM WAS CONSTRUCTED AS INDICATED ON THE SYSTEM WAS INSPECTED BY ME BEFORE IT WAS COVERED OVER. THE SYSTEM WXS CONSTRU WITH ALL STANDARDS, RULES AND REGULATIONS of um PUTNAM cowry DEPARTMENT OF Hl YORK STATE DEPARTMENT OF MALTH