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631- 589 -8100
62.18 -1 -9
BOX 25
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03013
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SITE LOCATION
OWNER'S NAME
PUTNAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
TR. QWENT_ YS7F.M- RE.PAi1R -�'`:.
internal Use Only PERMIT # T1\~-
Repair Permit issued in last 5 years
Repair within Boyd's Corners, W. Branch or Croton Falls Res.
Repair within 200 fl. of a watercourse or DEC - mapped wetland
9 CoLvm4145 AW TOWN Pure" ✓�/ur�
A /VW 140Fpw, -w
LJ Not in Watershed
❑ Delegated
❑ Joint Review
TM #_ 62.If' _/_ g
PHONE # 914- 6'29- 6651'
MAILING ADDRESS Po,Sdx 331 /nAHc,0,9r Ntj /c Sy1
APPLICANT Am v 9v;r",w _
Name & Relationship (i.e., owner, tenant; contractor)
DATE 1 d FACILITY TYPE E -01-1) Pu 644vdo PCHD COMPLAINT #
PROPOSED INSTALLER PHONE #
ADDRESS race. r--c_% Svc,,,? REGISTRATION /LICENSE #
/v -)
Proposal (include a separate sketch locating the house, property lines, all adjacent wells within 200
feet of repair and the location of existing and proposed system)
NOTE: The Department may require submittal of proposal from licensed professional depending on the
I, as owner,agree to the conditions stated on this form
•
SIGNATURE..._ ....................._ p..�Ne/Z DATE S �...
(owner) _.. _..... .
I; the se "pticinstal - � ag'r'eto'comp y with -the eonditioris of this.permit or the septic system repair
SIGNATJ DATE ZIO'—_
(installer) .
Proposal approved with the following conditions: **_NS7A1- c -CIZ
1. Procurement of any Town Permit, if applicable.
2. Submission of as built repair sketch by the septic system installer within 30 days of the repair, in duplicate showing:
a. Owner's name, Site Street Name, Town and Tax Map number
b. Location of installed components tied to two fixed points
c. System description (e.g., 1250 gal. Concrete septic tank, etc.)
d. Installers' name and phone number
3. System repair to be performed in accordance with the above proposal and conditions
4. The proposed SSTS repair is considered a best fit design and there is no guarantee to the duration at which the
completed SSTS repair will function.
5. No completed work is to be backfilled until authorization to do so has been obtained from the Department.
INTERNAL USE ONLY
Proposal Approved
Inspector's Signature &
Repair proposal is in compliance with t
COPIES: PCHD; Owner; Installer
PC -RP 99ML
Proposal Denied ❑
Da e –/ E piratio Date
pplicable codes Yes C� No ❑
Rev. 2/07
SITE LOCATION `� Lolv,+.dus AW TOWN Pa7w,-, , ✓hut TM # • r _
OWNER'S NAME PHONE # g�4 -b29- 66st
MAILING ADDRESS Pc 6o x 3.71 1nA14 c iAt Ny /c s4l
APPLICANT Avey
Name & Relationship (i.e., owner, tenant, contractor)
DATE (i FACILITY TYPE L31V P) 644ado PCHD COMPLAINT #
PROPOSED INSTALLER \ PHONE # ^
ADDRESS snce_ rRck U Ceorq REGISTRATION /LICENSE # An
*7q
Proposal (include a separate sketch locating the house, property lines, all adjacent wells within 200
feet of repair and the location of existing and proposed system)
NOTE: The Department may require submittal of proposal from licensed professional depending on the
nature and extent of the repair,
I, as owner,agree to the conditions stated on this form
�S10NaTU �G.0� DATE RE
owned ..
Q r' -- _ t
I, Cii�'Si;N�ic InSta i`; El�i•6c;`�0 COmplj�•JVI.I'I the Ems, ^, i�iu „ Cf- �.�,,,.pef•I?4�tf t he C€pJC S }`5t °^l r?paIr... •:.• ...• --. ._ ._ _ _. __. ._ � .. _
SIGNATb TITLE DATE
(installer)
Proposal approved with the following conditions:
1. Procurement of any Town Permit, if applicable.
2. Submission of as built repair sketch by the septic system installer within 30 days of the repair, in duplicate showing:
a. Owner's name, Site Street Name, Town and Tax Map number
b. Location of installed components tied to two fixed points
c. System description (e.g., 1250 gal. Concrete septic tank, etc.)
d. Installers' name and phone number
3. System repair to be performed in accordance with the above proposal and conditions
4. The proposed SSTS repair is considered a best fit design and there is no guarantee to the duration at which the
completed SSTS repair will function.
5. No completed work is to be backfilled until authorization to do so has been obtained from the Department.
INTERNAL USE ONLY
Proposal Approved Proposal Denied ❑
Inspector's Signature '& Title Da e _ / E, iratio Date
Repair DroDosal is in compliance with applicable codes Yes C/ No 0
COPIES: PCHD; Owner; Installer
PC -RP 99ML Rev. 2/07
PUTNAM COUNTY DEPARTMENT OF HEALTH
01 =:OE EN T RONME
DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM
Owner 4 N ^J M"o 'rn 4,) Address. �" 6 yX '37- A^04C ,v y l o J'li
Located at (Street) `i9 G"—, %d ,S 4vc, Ai_,.sATax Map E 2 t b Block ( Lot i
(indicate nearest cross street)
Municipality mt(- !, Watershed
SOIL PERCOLATION TEST DATA
Date of Pre - soaking Date. of Percolation. Test Z/ /2 /;
rc,2c (_4rr".w 7zZjrs tv,& t- ('earJo-rr-t-';> F-,*K /9 0,veI "uf OQva AJ 0ejCi;(IC-� w /✓nq Dt't,'Mo�r ��.rgi,.slaws
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NOTES: 1. Tests to be repeated at same depth until approximately equal percolation
rates are obtained at each percolation test hole. (i.e. 5 1 min for 1 -30
min/inch, <_ 2 min for 31 760 min/inch). All data to be' submitted for review.
2. Depth measurements to be made from top of hole.
Form DD -97
Pg. 1 of 2
TEST PIT DATA
DESCRIPTION OF. SOILS El®1C.OlUN'�IER ED INVEST HOLES
DEPTH HOLE NO. I HOLE NO. Z HOLE NO.
G.L. a*
0.5'
1.0' ter Say,., S i 4-m
1.5'
2.0'
2.5'
3.0'
3.5'
4.0' 2vicet
4.5'
5.0'
5.5' ' GK
6.0'%
6.5'
7.0'
7.5'
8.0'
8.5'
9.0'
9.5'.
10.0' _ . ... __ .._ ._... _�._ ___....___..--- -'--_. ,__. _....._ ....._._ .....__ ........_..
Indicate level at which groundwater is encountered 4--A
Indicate level at which mottling is observed �' /*
Indicate level to which water level rises after being encountered
Deep hole observations made by: Qv P5cza- ///q, Date 2 /m
Design Professional Name: Address:
Li,,1-63nP-J f" /2Yc /
Signature:
Design Professional =s Seal
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PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
APPLICATION FOR APPROVAL OF PLANS FOR
A WASTEWATER TREATMENT SYSTEM
1. Name and address of applicant: Av,-j 14ocr,,n 1W
loe 3
M,9,qC> A9C
2. Name of Project: 4ppm,4y 5wru_ 3. Location(JN-
4. Design Professional: _606 vr .5. Address: St Z, It Ce(tfrta- 5 P, /Yk -3 i-&J /J) z
6. Drainage Basin:
7. Type of Project:
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)? .............. Yes/No
Type Status (check one) ..................................................................... Type I Exempt
Type II Unlisted
9. Is a Draft Environmental Impact Statement (DEIS) required? .................... Yes'/No
10. Has DEIS been completed and found acceptable by Lead Agency? ............. Yes/No
11. Name of Lead Agency
12. Is this project in an area under the control of l6c ail planning, zoning,'or other officials,
ordinances? ............................................................................................... -Yes/No X
If 96 have plans'bedffsubmiftE&fci'siicIYauthorities? ........................ N 0 ......
14. Has preliminary approval been granted by such authorities? Date granted:,
15. Type of sewage treatment system discharge ........................ surface water X groundwater
16. If surface water discharge, what is the stream class designation? ...........................
17. Waters index number (surface) .......... : ..................................................................
18. Is project located near a public water supply system? ................................ Yes& a -/VL
19. If yes, name of water supply Distance to water supply
20. Is project site near a public sewage collection or treatment system? .......... Yes&
21. Name of sewage system Distance to sewage system
22. Date : test holes observed 2 - //210 y .23. 1 Name of Health Inspector. JD3000
24. Project design flow (gallons per day) .....
25. Is State Pollutant Discharge Elimiriat'i6n'system (SPDES) Permit required? ....Yesg)
26. Has SPDES Application been . submitted to local DEC office? ......................... Yes/No
Rev. 11/02 Form PC-97
Pg. 1 of 2
Y
27. Is any portion of this project located within a designated Town or State wetland ?... Yes
28. Wetlands ID number .... ..........
29. Is Wetlands Permit required? ...................................... ............................... Yes
Has application been made to Town or Local DEC ........................... Yes&
30. Does project require a DEC Stream Disturbance Permit? ... .. .........:...............Yes
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? ........................................ ...........................Yes(9
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? ............................ ............................... .... Y'e No
DESCRIBE:
33. Is there a local master plan on file with the Town or Village? .........................Yes/No
34. Are community water and /or sewer facilities planned to be developed within
15 years in or adjacent to project site? .................................. .........................Yes/No
35. Are any sewage treatment areas in excess of 15% slope? .............................. Yese
36. Tax Map ID Number .............. ............................... Map 6 Z , I ? Block ( Lot 19
37. Approved plans are to be returned to ................ Applicant _> Design Professional
NOTE: All applications for review and approval of a new SSTS to be located within the NYC 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 for such activities from DEP and submit
those forms to DEP for review and approval.
If the application is signed by a person other than the applicant shown in Item 1, 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 this 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 the Penal Law.
SIGNATURES`& OFFICIAL TITLES.
Mailing Address: - Q- 0 ... 3>A-�<-..P `i
VA,kyo* c 1\l y
lowt
Form PC -97
SHERLITA AMLER, MD, MS, FAAP
_..Commissioner of Health
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
OWNER'S NAME:
DEPARTMENT': OF ::HEALTH
1 Geneva Road, Brewster, New York., 10509
E911 ADDRESS VERIFICATION FORM
TAX MAP NUMBER: �I a� • ,� D " — 1
E911 ADDRESS:
TOWN:
ROBERT J. BONDI
County Executive
ROBERT MORRIS; PE
Director of Environmental Health
AUTHORIZED TOWN OFFICIAL: /(X- r',Q"
(Signature) �.
--.—DATE,
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 Certificate
of Construction Compliance.
E911 addressverification
Environmental Health (845) 278 -6130 Fax (845) 278 -7921
Water Supply Section (845) 225 -5186 Fax (845) 225 -5418
Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678
Nursing Home Care Fax (845) 278 -6085
Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648
SHERLITA AMLER, MD, MS, FAAP
y Commissioner of Health
LORE TTA MOLINARI, RN, MSN
Associate Commissioner of Health
May 20, 2008
Hagopian Engineering
682 East Chester St.
Kingston, NY 12401
Dear Mr. Hagopian:
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
ROBERT J. BONDS
County Executive
ROBERT MORRIS, PE
Director of Environmental Health
Re: Proposed. SSTS Repair
49 Columbus Ave.
(T) Putnam Valley, TM # 62.18 -1 -9
Review of plans and other supporting documents submitted at this time relative to the above
regarded project has been completed. Comments are offered as follows:
1. Remove design note number one as the plan for this property is a repair. Please be
advised that the proposed repair does not meet this Departments current code and
therefore, is not considered a three bedroom septic system...
2. Please be advised that the ccirrect tax niap-nurnber for'this lot is 62.18 -1 =9: + "
3. Please provide the pump tank model number and this Department's pump note (see
attached).
The construction of this sewage disposal system may be subject to local wetlands regulations.
You should contact local wetlands officials in this regard.
Upon receipt of a submission, revised to reflect the above comments, this application will be
considered further.
GDR:kly
Respectfully,
4�-.
Gene D. Reed
Senior Environmental Health Engineering Aide
Environmental Health (845) 278 -6130 Fax (845) 278 -7921
Water Supply Section (845) 225 -.5186 Fax (845) 225 -5418
Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678
Nursing Home Care Fax (845) 278 -6085
Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648
�4 -i
. 12 i
. ." "._ ".°':�'i�i:���si�n° cisteria�ox�' �plaz�,: ta. inclu. de ,.nuixtl�r::of;bedroom�s,�sc�il excolat�on '
rate and deep test hole soil information, and sizes of SSTS components.
n. Construction notes pursuant to Appendix C.
o. Space for Putnam County Health Department Approval stamp (minimum
3" x 5 ") preferably at the lower right hand portion of the design plan.
p. Location map (minimum scale of I"= 2,000'.).
q. Erosion control measures for house, well and SSTS.
r. When a pump pit is proposed due to insufficient elevation for gravity flow
or for dosing purposes, the pump pit design /detail shall include, as a
minimum, the following:
• Make and model of pump to be used and operational
characteristics.
• One -day's storage past the high -level alarm within the pump chamber.
• Check Valve.
• Gate Valve
• Unions
• Operating and alarm levels for pump.
• Means for pump removal for maintenance.
• All weather junction box with an outlet and screwed cover at or above
grade at the pump chamber to allow for a plug in connection for the
pump(s).
• Pump curve should be supplied with the engineering report.
tpump operain range should be indicated on the 'Dump curve.
'� • Pump dose volume to be equal to 75% of tfie volume avaiiabie In tiie
SSTS .pipe network.
• Minimum Velocity of 2 ft per second to be provided in force main
Baffled distribution box to be utilized for SSTS.
• Trench detail for force main, specify pipe type and rating, bedding and
Inver
• Note stating, "All electrical work and material for pump installation
shall comply with the National Electrical Code."
• Note stating, "An electrical Underwriter's Certificate for the pump
chamber must be provided to the Department prior to the Department
PIS conducting a final inspection on the pump chamber."
• Note Stating, "The pump control panel and alarms shall be
located inside the house."
s. De ation of United States eDartment of Agriculture Soil Conservation
. Service soil type boundaries.
t. Retaining walls greater than 4 feet in height for an SSTS design shall be
designed and certified by a NYS Licensed Professional Engineer.
SUBJECT RESIDENTIAL SITE INQUIRY DATE :.05/14/2008
372800 PUTNAM VALLEY 62.18 -1 -9 ROLL SEC TAXABLE
PARCEL PRCLS 210 1 FAMILY RES
KOFFMAN ANN L TOTAL RES SITES 1 LAND $44,000
49 COLUMBUS AVE TOTAL COM SITES 0 TOTAL $231,000
SALES= _________= RES_S.ITE R01 = =___= RESIDENCE-==== _______
YEAR BUI . T � 1947
EXTWALL MAT COMPOSITION STORIES 1.0
GRADE AVERAGE - - -AREAS -
PROPERTY CLASS 1 FAMILY RES HEAT TYPE HOT NTR /STM 1ST STORY: 856
ZONING R2 NO. OF FIREPLACES 1 2ND .STORY:
SEWER PRIVATE NO. OF BATHROOMS 1. 1/2 STORY:
WATER ..PRIVATE � NO. OF BEDROOMS l_J 3/4 STORY:
UTILITIES ELECTRIC I ATT. GAR. CAPACITY FIN BASMT:
NEIGHBORHOOD 28160 BAS. GAR. CAPACITY TOTAL SFLA: 856
== =TOTAL IMPROVEMENT ITEMS 4 TOTAL LAND ITEMS 1
TYPE SIZE1 SIZE2 QUANI TYPE FRNT DPTH ACRES SQR FT
1 PORCH,OPEN 1 1 PRIME SITE .30.
2 PORCH,OPEN
3 GAR,1.5 DET
4 GAR,1.5 DET
F1 =MORE ITEMS F6 =ASMNT INQUIRY F10 =GO TO MENU
75.20 03 -050 F4 =NEXT RES SITE ON FILE F9 =G0 TO XREF Fll =PREV ITEMS
PUTNAIYI' C OTJNTY DEPARTMENT OF HEALTH Y l
.. is -•
DIVISION OF ENVIRONMENTAL HEA.LI$
. µ - t�Dz Iu&AL vmtFFc`SL'i rLT & SiJBa'V1�PAC:LSY VAGE TREATMENT SYSTEMS'•
REVIEW SHEET FOR CONSTRUCTION PERMrr
N4Iv1E OF OWNER: yy &dc� .n - - STREET LOCATION: _1/� Ave-,
.BY: RM, � J.S T.A
P, SRDATE: r X MAP*: (CONFIIUv )
DOCUMENTS
�PPLICATION
R.MIT OR PWS LETTER
JF AUTHORIZATION
)ATA SHEET (DDS)
r OR
CORPATE RESOLUTION
SHORT EAF
PLANS -THREE SETS
HOUSE PLANS - TWO SETS
VARIANCE REQUEST
SUBDIVISION
hC.- ¢)LEGAL SUBDIVISION '
i i /l )SUBDIVISION APPROVAL CI+ CKED
PERC RATE
I FILL REQUIRED DEPTH
(--) PAIN DRAIN REQUIRED
GENERAL
OCATED .IN NYC WATERSHED
P S SUBIV =D TO DEP
ELEGATED TO PCHD
D P APPROVAL; IF REQ'D
EP TEST HOLES OBSERVED
PPRCS TO BE WITNESSED
APPROVAL SSDS ADJ, LOTS
WETLANDS (.TOWN/DEC PERMIT REQ'D ?)
)(._J-BATA .ON DDS-.PLANS- & PERMIT SAME
X969- ErGBHbRN'OTllZCA
R- T1TI.T T, N" -
tirl \TT „T MTf 1
(� 00 YE; FLOOD ELEVATION W1I 200'
,bifzsOm-TMSTINGLOTS.>10 YEARS OLD
REQUIRED •DETAILS ON PLANS '
SEWAGE SYSTEM PLA X- (NORTH ARROW)
JL SDS HYDRAULIC PROFILE
GRAVITY FLOW Rvmp
CONSTRUCTION NOTES 1 -15
DESIGN DATA: PERC & -DEEP RESULTS
CONTOURS EXISTING & PROPOSED
RIVEWAY & SLOPES, CUT
FOOTING/GUTTER/CURTAIN DRAINS
USDA SOIL TYPE BOUNDARIES
E BLOCK; OWNERS NAME ADDRESS
TM#, PE/RA; NAME, ADDRESS, PHOE#
(- TE
OF DRAW.INGMEVISION
DATUM REFERENCE .
ULOCATION OF WATERCOURSES, PONDS A1111
LAKES,WETLANDS WITHIN200' OFP.L.
PROPOSED FE41SH FLOOR AND
BASEMENT ELEVATIONS
WELLS & SSDS'S W/IN 200' OF SSTS
f)UPROPERTY METES & BOUNDS
•- )L j ION CONTROL FOR: ,
(SSTS;EROSIONCONTROLN TE
A
ICS
Y IREOUIRED DETAILS ON PLANS CONT'D)•
��)HOUSE SEWER -1/1' FT. 41101; TYPE PIPE. CAST IRON
(�jL—)NO BENDS; MAXBENDS 45' W /CLEANOUT
RENEWALS
SITE NOTE (NO CHANGE)
FILL SYSTEMS
10' HORIZONTAL; PAST TRENCH SLOPES 3:1 TO GRADE
(U FILL SPECS / FML NOTES 1 -5
•' FILL PROFILE & DIMENSIONS
(� IN EXPANSION AREA
FILL GREATER THAN 2 FEET
CLAY BARRIER
FILL'CERI CATION NOTE
DEPTH GAUGES
VOL. ON PLAN FOR R.O.B., UNCLASSIFIED & IMPERVIOUS
EPARATION DISTANCE FROM 'TOE OF SLOPE
TRENC9'
21, LF TRENCH PROVIDED 8 f 60FT MAK
EL •TO CONTOURS
100% EXPANSION. PROVIDED
DETAdLdDUST FREE CRUSHED'STONE OR WASHED GRAVEL -�..,
UG OTEXTILE COVER
SEPARATION DISTANCES ON PLAN . FROM'SSTS
U' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL .
( ✓. • 0' TO FOUNDATION WALLS
100' TO WELL, 100' IN DLOD, 150 TQ MS'
�1100':TO. S:I'i?F.A -Y- RYA TERC(3T -TSE; LAIOL• (inc- eapiml .
�50' TO CATCH BASIN, 35'.STORMDRAIN, PIPED WATER
10' TO WATERLINE (pits - 20')
50 INTERMITTENT DRAINAGE COURSE,
200'1500' RESERVOIit, ETC- 150' GALLEY SYSTEMS
25(—)10' M N TO LEDGE OUTCROP
SEPTIC TANK
UU10' FROM FOUNDATION; 50' TO WELL
WELL
DIMENSIONS TO PROPERTY LINES
LOCATION OF• SERVICE CONNECTIONxi`5fsu�
*;MIN 15' TO PROPERTY LINE
'' 'SLOPE
{!('�� OPE IN SSTS AREA
vUpmGRADED TO 15 %, IF REQUIRED
DOSETLTMP SYSTEMS
(-_ L—)Fum:p NOTES .
DOSE 75% OF PIPE VOLUMEMOSE VOLUME NOTED
ETAIL FORFORCKkA.W, (PIPE TYPE, ETC.)
PIT AND D -BOX SHOWN & DETAILED
�tL— 1 DAY STORAGE ABOVE ALARM
CURTAIN DRAIN
S TANDPIPES, 5' BOTH SIDES, DETAIL
to CD DISCHARGE1100' with 182 eons dap discharge
L�U10' MIN to NON - PERFORATED PIPE
vse e-0vj eG'f TNT,* �-- ! Z, l I - i - ,?.
MffNTS: �ls�vd� (�Jszs7�1.1 �1R��� � :�n� a ^a1w,11 %�..k P9JO-1.,..i ' i '. i.�i d a-
�i%i n — - --L_ !.
Sheet of
PUTNAM COUNTY DEPARTMENT OF HEALTH
:. _..� '�DI4'•I�>�I'a �•OF�EN':�IIZ�1ld:��l`I�T'Q:I, ��- •a�E���`�:l�I��E•���gCES . - _:,.�...:� _,,.;.�. -:: - ::..:. . _,:_.. - :.. .
FIELD ACTIVITY REPORT
Illy X4F. • /o FfMAAJ Tel.
ADDRESS: #? CoLUMBSUS Ads 1�v�iy n? 1l�it[
. Street Town State Zip
PERSON IN CHARGE c
OR INTERVIEWED.
WED I�o 3 W46.0 PIA►. �v>J T�atP: /o/z/ /off
Name and Title
TYPE OF FACILITY: 1Z e ?A. / Z
FINDINGS:
DU OQ eIAC4M44 Q P E L -� 4%- C0
r/
�9 „ 7a�-,
M
L
WQ,PF.CT0R, TFT a
Signature and Title
RFPnRT RF('FTVFT) BY-*
I acknowledge receipt of this report: SIGNATURE:
02/96 Title:
07/27/2009' 02:15 "19737646`404 ALLCOUNTY 'PAGE 01/03
EARTH CARE/ALL COUNTY DIVISION
INSTALLATION DIVISION
YERNON,NJ. 07462
Date July 27, 2009
Number of pages including cover sheet 3
To: From:
Attention: Karen Yates ED BOWER
EXTENS: 112
INSTAL�,ATIONIREPAIR
RE: As -built sketch COORDINATOR
For 235 Old Church Road e-mail: ebower @earthcare,us
Phone: 800428 -6166 Ex. 112
Phone 845- 278 -6130 Fax Phone; 973- 764 -640+4
Fax Phone 845 - 278.7921
CC:
�....Fdr your r€.�aeN -- -Q. • R�fi� yh��R � �.._. �'- 7'�;EasG s�ri�enfi — -'_ .
Karen, '
Please find our as -built for 235 Old Church Road for the Kliegel residence. We replaced the two
drop boxes on the opposite side of the driveway and the pipe between the two. In regards to 49
Columbus Ave. we have never done any further work there. We had coordinated .them with an
engineer to design a system and gave them a qoute to install the system as per design and
nothing further. If we still have a permit open and it is possible to close on your end we would
greatly appreciate it so no one else can use our name and open permit being it has been over a
year. Any questions, please call me.
Fd Bower
Installations /Repair Coordinator
EarthCare /All County Division
An RMS Company
.1- 800 - 428 -6166 @ Extension 112
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382 F.ALST CSESTER ST.
KINGBT,ON, NEW YORK 124 01.
(845) 331 -5290, E 1KAIEL BGEME®A031-COM
October 27, 2008
Mr. Gene D. Reed,
Putnam County Department of Health
1 Genevia Road
Brewester, New York 10509
Re: Sewage disposal system for Hoffman
Town of Putnam Valley
Dear Mr. Reed:
On October 21, 2008 I conducted a construction inspections for the above
referenced replacement sewage disposal system. The inspection revealed the
following:
A different chamber was used instead of the proposed cylindrical tank.
The tank installed was a 550 gallon pre -cast concrete pump chamber and the
cut sheet is attached.
The pump installed was a Goulds 1/3 hp. pump instead of the Myers 1 /3
The orientation of the septic tank and pump chamber was slightly
different than the approved plans shown.
Based on my inspection, and the above items completed, the construction
of the absorption system appeared to be otherwise in general conformance
with plans approved by the Putnam County Department of Health.
Furthermore, I required that the appropriate maintenance be conducted on
the system.
bert a Hagopian, P.E.