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HomeMy WebLinkAbout2903DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 62.15 -1 -21 BOX 24 i� r 02903 SITE ,R4.: Mil 6-tAa lc�&f V5-mf FrN 105,17 PHCNE �QJQ -!532- - `7 7 9 To 6A +s —It •- a I MAILING ADDRESS ?VJLJ*j1 W-Lt4tj' i IOf-. LO n f PERSON MnWIEWED MM CmVlaint # Name & Relationship (i.e, owner,tenant, etc.) DATE 1-i �' TYPE FACILITY PROPOSED INSTALLER *t�SV & � iPu� C) c,Iz 0138' PHA 6-a —as9S- Proposal (include sketch locating all adjacent wells): NOTE: Repair must be in same location and of same type as original sewage disposal system. Different location may require submittal of proposal from licensed professional engineer or registered architect. Proposal Disapproved Inspect6r's Signature & Title 'roposal approved with the following conditions: 1. Procurement of any Town permit, if applicable. 2. Submission of as built repair sketch in duplicate showing: a. Owner's name. b. Site Street Name, Town and Tax Map number. c. Location of installed components tied to two fixed points d. System description (e.g., 1250 gal. concrete septic tank, drywells surrounded by one foot + gravel). e. Installer's name and number. 4111-o (e.g.,house corners). three precast 6' diem. x 6' deep 3. System repair to be performed in accordance with the above proposal and conditions. I, as owner or reported gent of owner agree to the above conditions. SIGNATURE TITLE 14(p DATE 0MS: V be MV; YeUjw atm ED; Pink (AaUcgnt) DIVISION OF ENVIRONMENTAL HEALTH SERVICES John M. Sinanons, M.D. pp Deputy Camni.ssioner of Health - FIELD ACTIVITY .REPORT - Sheet l of INSPECTION NAME ��� �l- . p L�4 �L — Orig. Routine Orig. Ccanplain ADDRESS �,� f'yi tip Orig. Request No. Street Town TK No. _ Ccanpliance MAILING ADDRESS t �$ty }-► 0 A 04 Final Paint Carp P.O. OfJE Zip Code Group Illness -� — Construction TELEPHONE Reinspection PERSON IN CHARGE Field, Sampling Only OR INTERVIEWED Field.Conference Name and Title DATE 49 - 1 C) - � TYPE FACILITY Other TIME ARRIVED 1, 3D TIME LEFT 2_e)--O Explain FINDINGS: 5 5 i7 to 'g yLr c O F- 03 F A C-i4 i PERSON IN CHARGE OR INTERVIEinTED: I acknowledge this Field Activity Report. SIGNATURE: PETER C. ALEXANDERSON County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 September 22, 1987 Mr. Walter Frehm 178 Hanson Lane New Rochelle, New York 10804 Dear Mr. Frehm: JOHN SIMVONS, M.D. Deputy Commissioner JOHN KARELL, Jr., P.E. Director Proposed Well Re: Frehm- Variance Request Mill Road Lake Oscawana (T) Putnam Valley You are hereby advised that your request for a variance from provision of the required 100 foot separation distance between your proposed well and the existing sewage disposal system on your property has been considered by the Board of Health on .September, 21, 1987. and de ied. V y truly you , Ray and Jone Pr ident RJ:pt Bo rd of Health cc: Building Inspector (T) Putnam Valley JK File PETER C. ALEXANDERSON County Executive September 2, 1987 Mr. Walter Frehm 178 Hanson Lane New Rochelle, New Dear Mr. Frehm: DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 York 10804 Re: Frehm Mill Road Lake Pev l t?5C' Vja_WG+' (T) Putnam Valley W JOHN SIMMONS, M.D. Deputy Commissioner JOHN KARELL, Jr., P.E. Director Review of an application to construct a well for potable water supply purposes-to serve the above - captioned property has been completed. Such review indicates as follows: * -O-- 1. The lot is presently supplied by the Lake P r,� }ti+1 Water Works with summer water. 2. The proposed well on your lot (Lot 8) is located approximately 60 feet from the existing sewage disposal system located across High Street and 60 feet from the existing sewage disposal system on Lot #7. One hundred feet is required in both instances. Recognizing the above, your application for a permit to construct a well on this property is hereby denied. Reference is made to your letter dated July 27, 1987, which letter contains a variance request. Please be advised that your request for a variance from the minimum well to sewage system separation distance will be considered at the next meeting of the Board of Health on September 21, 1987 at 7:30 P.M. in the Conference Room of our offices at BOCES, Building #3, Old Route 6, Carmel, New York. You or your representative should be present to discuss your reasons and justification for the variance. If you have any questions, JK:pt cc : R. Jones, Pres. BOH JK File feel free o contact me at Ext. 304. Ve ul r , n arell, Jr., irector, Environmental Health Services i x' 0 0 PETER C. ALEXANOERSON County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 July 8, 1987 Estelle & Walter Frehm 178 Hanson Lane New Rochelle, New York 10804 RE: Proposed Well Dear Mr. & Mrs. Frehm: JOHN SIMMONS, M 0. Deputy Cpmm-ssloner JOHN KARELL, Jr, PE. O,rector Please find enclosed your application to construct a water well. This application must be submitted to Putnam Valley's Epee T. i[?*-v .n _ _. C1i%e; ? -: pricir:.t : the rev Ew _bv_ this Department. Only after Mr. Odell's written comments are received by this office can the approval process continue. Upon receipt of a submission revised to reflect the above comments, this application will be considered further. Ver ,m� yyo%u�rs�,/� Robert Morris Environmental Health Technician RM:pt Enc. cc:RM Filet,-' JK DEPARTMENT OF HEALTH Division of Environmental Health Services ":�•C TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 APPLICATION TO CONSTRUCT A WATER WELL _ Ly Y GX, _ PCHD PERMIT WELL LOCATION Str et Address Town /Vi lage /City Tax Grid Number t. 11 p; e sr. N L ti Town/Vi . 3 22d0 WELL OWNER Name Mailing Ad ress Private 175 A,V j; i-&; k�k)kXRCLL. QIRCq OPublic USE OF WELL .1 - primary 2 - secondary ;RESIDENTIAL ❑PUBLIC SUPPLY ❑AIR /COND /HEAT PUMP 0ABANDONED ❑ BUSINESS O FARM O TEST /OBSERVATION O OTHER (specify] a INDUSTRIAL O INSTITUTIONAL O STAND -BY ❑ AMOUNT OF USE YIELD SOUGHT�gpm /# PEOPLE SERVED_ /EST. OF DAILY USAGE .SZC gal REASON FOR DRILLING O NEW SUPPLY O PROVIDE ADDITIONAL SUPPLY O TEST /OBSERVATION JRIZEPLACE EXISTING SUPPLY O DEEPEN EXISTING WELL DETAILED REASON FOR DRILLING ( -rt c r 61-- (c`R z •r 44 44CFC cA t,',L z: 7'C3 " vC cE�Q 4:z Asti •'- - -n.4G r z WELL TYPE ®DRILLED M DRIVEN ®DUG OGRAVEL O OTHER IS WELL SITE SUBJECT TO FLOODING? YES �No IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION f�•2C'LtS Lot No. WATER WELL CONTRACTOR: Name/yOg 9Ai) AaE;'�,im) Address : Ry .� TAIC&Er (g 2-Y y IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: C, cM !:L YES NO NAME OF PUBLIC WATER SUPPLY:'? c.�(ti/�n.� V'rf� Lt 0l 7'7` TOWN /VIL /CITYV (0';1:� A DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: 7C r� LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ,! O ON REAR OF THIS APPLICATION LSYARATE SHEET _ 4+ /o (date) (signature) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions.of 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 s.hall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. Date of Issue: Date of Expiration: Permit is Non - Transferrable 2/87 19 19 Permit Issuing Official White copy: H. D. File Yellow copy: Building Inspector Pink Copy: Owner Orange copy: Well Driller i �l, Pubiie - Feaitk' 6iiectoi'' i' DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 BOARD OF HEALTH Procedure for Variance Request Pursuant to the provisions of Article III Section 2, (b) an application for the installation of an individual sewage disposal system that has been denied by the Director may be reviewed by the Putnam County Board of Health who may reverse the decision based upon proof of hardship and with concurrence of the Director that the proposed sewage disposal system will not create a health hazard by its use. Individuals wishing to make application to the Board of Health for a variance must submit a letter, to the Board President, Michael Schoolman, Putnam County Department of Health, 4 Geneva Road, Brewster, New York which application must include: 1. In a letter (14 copies) a) Formally request a variance .. - -'- -- •.__.,__ _. __....__._ ._.__ .__._ -._�, .._.._._ b) Fully describe the variance requested and the properties affected by the Variance, i.e., a reduction in the required 100 foot separation distance to the Smith well is requested. The proposed separation is 80 ft. c) Discuss the hardship that will be experienced should the variance not be granted 2. Provide 14 sets of plans 3. Submit a letter from the local Town Building Department that the property in questions is a legal building lot. The Board of Health will not consider variance requests for property that is not a legal building lot from a Town Zoning standpoint. A4 John Karell, Jr., P.t. Public Health Director JK:pt 10/92 4 ` Mr. John Karell Director Environmental Health 110 Old Route 6 Center Building #3 C -rmel, N.Y. 10512 Dear Mr. Karellg t 'ELEPHONE 682 -5600 July 27, 1987 Our house at 25 Mill Road, Putnam Valley, N.Y.at present has only town water from April to November. In order to make it livable all year round we want to install a well. Enclosed is a copy of the application we sent in. Mr. Marvin Odell of Putnam Valley inspected the proposed site and informed us that we would need a variance. Therefore, please put me on the agenda for your next meeting of the Board of Health and send me the notice as to time and date at address below... Si er ly yo so ' L \ Walter Frehm 1'78 Hanson Lane New Rochelle, N.Y. 10804 914 235 4698 r -e✓ KING FEATURES SYNDICATE DEPARTMENT OF H Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 RmIO'1« kC'JNCrRJt- T- `9 "X PCHD PERMIT WELL LOCATION Street Address �-� ' G� �r. v _ Town/Village/City Tax . Grid Number . VA -L0 WELL OWNER 1.5 Name Mailing Esr6Li.E ft4AL;i t^2 F(2F6 175 IV Ad ress 1 n Private �,� Ij L-#1 Wek)kX016LLC I020Y 0Public USE OF WELL 1 - primary 2- secondary RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP O ABANDONED 0 BUSINESS O FARM 0 TEST /OBS.ERVATION O OTHER (specify) 0 INDUSTRIAL O INSTITUTIONAL O STAND -BY Q AMOUNT OF USE YIELD SOUGHT -q-7%>5-_gpm /# PEOPLE SERVED_1j_/EST. OF DAILY USAGE •500 gal REASON FOR DRILLING NEW SUPPLY JiMPLACE EXISTING SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST /OBSERVATION O DEEPEN EXISTING WELL DETAILED REASON FOR DRILLING r 'c -r Ld CP — 1.5 r6P, S✓ ^ f: c,u L-( -- o - Oi/; .T^, : L Y_ j Aa:1- o Mc r WELL TYPE 13DRILLED MDRIVEN EIDUG 13GRAVEL OTHER IS WELL SITE SUBJECT T.0 FLOODING? YES _ x NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. WATER WELL CONTRACTOR: Name, ES PUBLIC WATER SUPPLY AVAILABLE TO SITE: cl� Address = -! ; S�..`� YES NO JANE_ OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY�J ( /r� G ti L ^� 6efE E.y� �rb�b 4144 k YI I t'. .... .aT5TrA,SUCE..-T°.O . FRO. -- N- EAREST-= ATER'14i1N: ,OCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ON REAR OF THIS APPLICATION S ARATE SHEET (date (signature) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of 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 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 attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. Date of Issue: 19 D Permit Issuing fficial ate of Expiration: 19 Permit is Non- Transferrable White copy: H.D. File Yellow copy: Building Inspector 2/87 Pink Copy: Owner - (lranry m nnrn r.T l I MARVIN O'DELL PUTNAM VALLEY, N.Y. Bldg. Inspector E` (914) 526 2377 BETTE STOCKINGER JOHN MAHONEY TOWN O F P U T N A M VALLEY Bldg. Dept. Clerk Deputy Zoning Inspector BUILDING, ZONING, AND SANITARY DEPARTMENT 0 March 14, 1994 Putnam County Board of Env. Health 4 Geneva Road Brewster, N.Y. 10509 Att: Robert Morris Re: Proposed Water Well Mercedes Gonzales 25 Sawmill Rd.- TM#62.15 -1 -21 Dear Mr. Morris: Pursuant to request of February 3, 1994, I have reviewed the above premises regarding a proposed well. The location of the Sewage Disposal area was verified as being as shown on a site plan submitted with this application. c:.nia�i�Tg °'s+cpcl�. t' dn�i "�.vi[S�`Y.�1CiiGit °` \uiE "Cd.L 01'�:GT'ii:1CLt,c7 15 - `."._....... _.. unknown. The separation from the absorption area and the proposed well is as shown on the site plan. The proposed well would be at a surface elevation higher than the existing absorption area. MO'D:es cc: Marianne DeSantis Very truly yours, )d MARVIN 0 DELL Building & Zoning Inspector DEPARTMENT OF HEALTH j Division of Environmental Health Services r/ 4 Geneva Road, Brewster, New.York 10509 (914) 278 -6130 ... kY'lyt lt;li`1-im `1'O" k:OA- ST'WLyl Y °`''. "iry TiI' " Fi— 1; PCHD PERMIT #_L� <I WELL LOCATION S ree ess Town Village City Tax Grid Number 25 %aw '!i Al l Road (GTi I d Wood Knolls utnam Valley NY 372800 WELL OWNER Name Mai11 g AddrePlss (3Private Mercedes Gonzalez 40 Waterside aza NYC 10010 O Public USE OF WELL 1 - primary 2- secondary t§ RESIDENTIAL O PUBLIC SUPPLY 0 AIR /COND /HEAT PUMP 0 ABANDONED 0 BUSINESS O FARM O TEST /OBSERVATION O OTHER (specify, O INDUSTRIAL O INSTITUTIONAL O STAND -BY O AMOUNT OF USE YIELD SOUGHT 4 to 5 gpm /# PEOPLE SERVED 4 /EST. OF DAILY USAGE 500 gal MXREPL ACE EXISTING SUPPLY O TEST /OBSERVATION CI ADDITIONAL SUPPLY [3 NEW SUPPLY NEW DWELLING O DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING No wa ter between Nov and Apri ould like to eventuall make this m ear r7u—nT home.. lownwater supplied in bummer _ months not adequate even during tie bummer month. Town IwouTTlike to doaway with. summer water altogether WELL TYPE DRILLED ©DRIVEN E]DUG C]GRAVEL D OTHER IS WELL SITE SUBJECT TO FLOODING? YES XXX NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: WILDW00D KNOLLS Lot No. 8 WATER WELL CONTRACTOR: Name. Henry Boyd & Ass-oc. Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: Only Summer mogs NO NAME OF PUBLIC WATER SUPPLY: Putnam Valley TOWN /VIL /CITY Putnam Valley - DISTANCE TO.- PROFERTY _FROM NEARES`i._ WATER. MAIN:_ 7eF� LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED I Would be willing to double case the well (BON SEPARATE SHEET and put in a UV System and have priced the 0,4 `� cost see attached /% signature) PERMIT TO CONSTRUCT A WATER WELL ThisrQermit_-to construct one water well as set forth above is granted under the provisions L._ r of Subgart'5T2 of Part 5 of the New York State Sanitary Code, and provided that within thirjs:(:r*):;days of the completion of water well construction, the applicant shall: 1:_- c *. 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a.form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or of wise contaminate surface or groundwater. Date of Issue: 19 b M, K40 Date of Expiration I�p _19 q It Permit•.Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3189 Yellow copy: Bldg. Insp. Orange copy: Well Driller DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 April 6, 1994 TO: File FROM: Robert Morris SUBJECT: Well Approval - Mercedes Gonzalez Well permit was approved on the basis of: Public Health Director 1. The writers field inspection which indicated that no SSDS was within 100 feet of the proposed well location. 2. No negative comments from Marvin O'Dell, Building Inspector, Town of Putnam Valley. 3. Improvement in present site conditions. Boyd Artesian Wells TEL No. Jan.13,94 13:52 P.02 R. D, 85 RT. 52 CARMEL, NEW 10612 (914.) 2215­319b (914) 225--6420 FAX January 3, 1,994 40 Wt1•prvirh,4 Plaza Apt, 2K New York, New York 10010 R, 2S :Saw Mill Road PL.O.OeOYI VOMllf.�Y ()CiA P MCSVICVCAC-�!!, 0 5o low is the information that YOU reque.sted. When an existing well becomes pallkited, an effective rr.-nnx-c-1, the well by coment, in a Secondary .te -is to driuble case CaF.ing if*l place US-ing a pDcke•. This serves to well c?fi• the water supply while maintaining the original wi-11 and d'o,­eper pure aquifers. '11vis. method can also be used In the construction of new wells whe•re the vep-aration distances betwv4en the well and potential contamin.ation sources do nest, meet current, r4-qwirsments, In those cat3es an overlsizc--rd printary with a 10" diarfieter Is sn ale d at le-a-vt 10' int-0 a onnsolidated format ion uzing a drive shop and nant cemenr then a 0" diameter, hole is drilled within that 10" grOUt c, - ' nda I, tp allow for the installation of a 6" seco Y SN:.,.S>nrl ;�L mNin'Irrium tJ 20' Tui-t+er -into thv c6mprAe.1-11 k ) d r k fo r m a V I on This 6 casing i T also sea dvIve �.tiov and nest cement grout- The wall 11 1 s then f i n -15 hf...,d in the, u5i-6ual manner - by drilling a 6" open hole in tt-le. hed•ot.:k until a sufficient water supply is achievEld. IMs is an Idpa'I method of providing a gnfp w0ter', supply fur- harries that conformed to regulations when built, (iei NYIS.- 50' diotance rpoulrernen• between vw,�11 ai-id !LAept-1c). but are now not able tc) meet, newer, updated standard . SIncere'lY, Ilent"Y Boyd, Pres, J Boyd '� 5 No. i Rte t a e N Y1 10512 (914) 225 -3196 (203) 794 -0394 DATE -r -- /ell EStim.ate TO BE DRILLED FOR L flLf S - -&>N' HOME ADDRESS 4//11 1 —) ALL 602 Z) PHONE # '212 - ;L,q 2 '241 1'/ ° �2, /;7 WELL LOCATION SIGNATURE "Y DRILLING AT PER FOOT (n CASING AT —27"') PER FOOT DRIVE SHOE. , MOBILIZATION���i ?, �e HE) URL -Y CHAR6E t PERMITS ��CY✓( !i_- >t.a;�Oar L %ls, .5��.'.lC! __ �`3AlrtIrf '7.iU'�rOti 19 1 ,- "A a 0 . . Quality and quantity of water cannot be guaranteed. Owner assumes responsibility for site preparation and /or clean up. A Service Charge of 11/2 % per month will be added to all accounts over 30 days. hall DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 x; .a,F?LICAT.i9N ' .- CONSTRTJ.CT. A. WATER; WELT PCHD PERMIT_�,(� Y WELL LOCATION S reef - ,dress Town Village City Tax Grid Number 25 aw 1 Road (4!i'ld Wood Knolls utnam Valley NY 372800 WELL OWNER Name Mai 1� cr Address OPrivate Mercedes Gonzalez 40 Waterside PLaza NYC 10010 O Public USE OF WELL 1 - primary 2- secondary 6 RESIDENTIAL O PUBLIC SUPPLY O AIR /COND /HEAT PUMP O ABANDONED 0 BUSINESS O FARM O TEST /OBSERVATION O OTHER (specify 0 INDUSTRIAL 0 INSTITUTIONAL O STAND -BY O AMOUNT OF USE YIELD SOUGHT 4 to 5 gpm /# PEOPLE SERVED 4 /EST. OF DAILY USAGE 500 Jgal ISKREPLACE EXISTING SUPPLY O TEST /OBSERVATION GIADDITIONAL SUPPLY, O NEW SUPPLY NEW DWELLING 13 DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING o wa er between Nov and Apri I Woul e to eventuall make this m ear round home.. own water supplied in-summer months not adequate even durin t he Summe.r months Town would i. a to' do away with. summer water altogether WELL TYPE DRILLED ©.; DRIVEN ODUG (3GRAVEL D OTHER IS WELL SITE SUBJECT TO FLOODING? YES = XXX NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: WILDWOOD KNOLLS Lot No. 8 WATER WELL CONTRACTOR: Name Henry R.oyd & Assoc Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: Only Summer mogt�s NO NAME OF PUBLIC WATER SUPPLY: Putnam Valley TOWN /VIL /CITY Putnam Valley DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED I Would be.willing to double case the wel- GON SEPARATE SHEET and put in a UV System and have priced the 1/10 14 ��j cost see attached signature) t) _ L� -' PERMIT TO CONSTRUCT A WATER WELL This permit:_-to construct one water well as set forth above is of Subgart'5w-2 of Part 5 of the New York State Sanitary Code, thir 't 'y:C30�- days of the completion of water well construction 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements Department attached to this permit. V granted under the provisions and provided that within the applicant shall: of the Putnam County Health 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or 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: Date of Issue: Date of Expiration Permit is Non - Transferrable 3/89 19 19 Permit Issuing Official White copy: HD File Pink copy: Owner Yellow copy: Bldg. Insp. Orange copy: Well Driller DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 February 3, 1994 Mercedes Gonzales 40 Waterside Plaza Apt. 2K New York, NY 10010 Re: Proposed Well Dear M�. Gonzales: JOHN KARELL Jr., P.E., M.S. Please find enclosed your application to construct a water well. This application must be submitted to Putnam Valley's Building Inspector, Marvin O'Dell's written comments are received by this office can the approval process continue. Upon receipt of a submission revised to reflect the above comments, this application will be considered further. RM/i P enc. Very truly yours, Robert Morris Public Health Engineer