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Home My WebLink About3194DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 72.19 -1 -3 BOX 26 03194 ff t T Rev. 3186 PUTNAM COUNTY DEPARTMENT OF'HEALTH Division of Environmental Health Servicex, Carmel, N.Y. 10512 '4 Engineer Must provide P C:H D: Permit N — —J .. tT L�R u _... . .r - c._w.• - Y .. - ..wi . ^'ti '• /`. .` LSl . 1�114i1ii1.. V.J 1 l y a.V1YlYLlliai�+ll V'r, .r .�cV ✓rli6v��:. .. �,: 'a: �- ... ... -. .. _.. Town Or:. Village'.. ... Located at Sprout Brook Road Ta= MaP � 14 : '.- -, • �r 56 & 57 Owner /applicant Name Al. Bruno Formerly Subdivision Name _ . Sabdy. Lot N P. 0. Box 423," YorktOWn Hat s 10598 Mailing Address - � Date Permit leaded Separate Sewerage System bulit by Address abOVe "'. Consisting of 1000 Gallon Septic Tank and 225 LF of 24 wide absorbtion 'trench Water Supply:' PubHc.Sdpply 'From Address or: XX Private Supply DrMW by Anderson 'Address Barger St.,' Pdtnam Valley Building type 2 Story frame Has Erosion Control Been Completed? Yes . Number of Bedrooms tWO. Has Garbage Grinder. Been Installed? Other Requirements ? YO i certify that the system(s) as'listed serving the above premises were construct y '1391 - n`t ''plans of the completed work ( copies of which are attached); and in accordance with the standards, rules and regul no, o c wi e f ad plan, and the permit issued by the Putnam'County Department Of Health. .� 3 -6 -2 P.E. R.A. Address P. 0. BOx 3 Oxk e7 "`hts :x 1 59 License No. 64431 Any person 'occupying premises served by the above system(s) shall promptly take su �rl.�. a *anax b^e.eq conditions resulting from such usoge. Approva.I. of the separate sewerage syste h. a Ky�GO n d available and the approval. of the private water supply shall become null and w an k: p� subject to modif)cation /or change when, in the Judgment of the Commis o )Neill c ci1i�f Date /v` /z"� By ;ure the correction of any unsanitary as a pubt': sanitary. sewer becomes nes available. Such approvals are ition or change Is hecefaary. Title &A �' CMG P T ri, - ►� �rp� WELL COMPLETION RE OR DEPARTMENT OF HEALTH rt _onm� -.. �.1 Hea]�'R Services PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use Only fz WELL LOCATION gtC1&AUUhtSS', WNIVIL TAX CRIO NUMBER: �. d � 14- r;;& 4, 5"1 WELL OWNER NA DRESS: pgiVATE PUBLIC USE OF WELL 1- primary 2 - secondary ® RESIDENTIAL ❑ PUBLIC SUPPLY O AIR /COND. /HEAT PUMP ❑ ABANDONED ❑ BUSINESS ❑ FARM ❑ TEST /OBSERVATION ❑ OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT 6 gpm. /NO. PEOPLE SERVED 7' / EST. OF DAILY USAGE gal. REASON FOR DRILLING A NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST /OBSERVATION ❑ REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH eZ � ft. I STATIC WATER LEVEL A ft. DATE MEASURED DRILLING EQUIPMENT OTARY ❑ COMPRESSED AIR PERCUSSION ❑ DUG ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ❑ SCREENED ❑ OPEN END CASING. OPEN HOLE IN BEDROCK ❑ OTHER CASING DETAILS TOTAL LENGTH. ft. MATERIALS: %,STEEL ❑ PLASTIC ❑ OTHER LENGTH.BELOW GRADE ;'0 tt. JOINTS: ❑ WELDED RTHREADED ❑ OTHER DIAMETER ° in. SEAL: ❑ CEMENT GROUT ❑ BENTONITE -OTHER WEIGHT PER FOOT /1 I b.l ft I DRIVE SHOE,KYES ❑ NO . UNER: ❑ YES )00 SCREEN f T - I , �. S K DIAMETER (in) SLOT SIZE LENGTH (It) DEPTH TO SCREEN (it) DEVELOPED? FIRST O YES ONO HOURS _ SECOND _ _ . � _._ _--; - ---- -- - - - .. � _ - GRAVEL PACK O YES O NO GRAVEL ::too SIZE IAMETER F PACK in. TOP BOTTOM DEPTH ft. DEPTH It. WELL YIELD TEST t If detailed pumping M H00: O PUMPED 1 tests were done is in- I COMPRESSED AIR r formation attached? O ILED ❑OTHER ❑YES ❑ NO it more detailed formation descriptions or sieve analyses WELL LOG are available, please attach. DEPTH FROM SURFACE Water Bear- ing Well Oia- In FORMATION DESCRIPTION G70E, it. WELL DEPTH It. DURATION hr. min. DRAWDOWN ft. YIELD gpm. Land �z s WATER O CLEAR TEMP. QUALITY O CLOUDY HARDNESS O COLORED ANALYZED? O YES ❑ NO ANALYSIS ATTACHED? O YES D NO STORAGE TANK: TYPE—. CAPACITY G WELL 0 L NAME �,�, -v►� OAT ADORE PUMP WFORMATION TYPE APACITY MAKER DEPTH MODEL OLTAGE HP IrA PUTNAM COLMY DEPARTMENT OF REALM DIVISION OF ENVIRONMENMAL HEALTH SERVICES . 'r x�.+ c.yr... t. .. r =_ ca � 7 ... �.a' .. � _.: :rrr �e �...w.. �•fa . wa•. m �a.�.•a w. ...a.� �- �.c+ -. ��. � r.� .mr .. '1n. � ..c .. ..• ...... i.�_.. ...._ .. e. . . �T�a`�.ri Al Bruno 14 - -- 56 & 57 Owner or Purchaser of Building Owner . Building Constructed by Sprout Brook Road Location - Street Putnam Valley Road Municipality 2 -story frame Building Type Section Block Lot Continental Village Subdivision Name 56 & 57 Subdivision Lot # GUARANM OF SUBSURFACE SEWAGE DISPOSAL SYSTEM I represent that I am wholly and completely responsible for the location, workmanship, material,. construction and drainage of the sewage disposal system serving the above described property, and that it has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed,. by me which fails to operate for a period of two years immediately following the date of approval _of the "Certificate of Construction Compliance" for the sewage disposal system, or any r i ;js.Az ad la,v:fir� -- E'U.'_�- S`1ate- ��+.-`Cs:.ep �v ;-e tang- - .l r � _n ,..i _... .tee- ��, �e .;..;g�� .� r .pc s y-it- caused.by the willful or negligent act of the occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Director of the Division of Environinental Health Services of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated this j 0 day of A" 19 Signature Title Owner General.Contractor (Owner).- Signature Corporation Name (if Corp.) Address rev. 9/85 mk Corporation Name (if Corp.) ess ! -} YML Environmental LAB NUMBER X20 001.3 9117 Services DATE /TIME TAKEN 3/4/92 8:45 a.m. .. >. _ 321 Kear Street, Yorktown Heights, NY 10598. ELAP #10323 -� 4• �y�� 2��- Z8�Ut� ~; .a DATE REPORTED Bath"r.00m sink tap SAMPLING 247 Sprout Brook Rd, SITE Putnam Valley, NY Site Design Consultants P.O. Box 423 For Lab Use Only 2070 Saw Mill. River Rd. <4C Potable _ HNO3 _ pH LT 2 _ Yorktown Heights, NP 10598 _ Nonpotable _ NaOH _ pH GT 9 <20 >4C _ HCl _ Na2SO3 _ >20C COLD BY I Alphrio Bruno I _ STAT! H2SO4 ZnOAc NOTES a sM # F MPN P/A X RESULTS OF ANALYTE RESULT UNITS pH ALKALINITY S.U. mg/L PHOSPHOROUS AMMONIA mg/L mg/L: SILVER CALCIUM mg/L mg/L SODIUM CHLORIDE mg/L mg/L SULFATE COLOR mg /L Units SULFIDE CONDUCTIVITY rrg/L umhos /cm SULFITE COPPER mg/L mg/L TURBIDITY CORROSIVITY NTU LSI g FLUORIDE mg/L HARDNESS mg/L IRON mg/L LEAD mg/L SPC MANGANESE per 1.0 mL mg/L TOTAL COLIFORM MERCURY pt -lot mg/L FECAL COLIFORM NITRATE y nyA E. COLI NITRITE sit ffier 100- mg/L FECAL STREP. ODOR er 1 rp ITON X RESULTS OF ANALYTE RESULT UNITS pH S.U. PHOSPHOROUS mg/L SILVER mg/L SODIUM mg/L SULFATE mg /L SULFIDE rrg/L SULFITE mg/L TURBIDITY NTU g SPC per 1.0 mL TOTAL COLIFORM pt -lot FECAL COLIFORM y E. COLI sit ffier 100- FECAL STREP. er 1 rp — Gr) C I't'7 These results indicate that the water sample tram S] [WAS NOT] [NA] of a satisfactory sanitary qualht a(c�r *pb the New York State Sanitary Code, for the ers tested, at the time of sample collection. C-) --< v) These results indicate that th ater sample [WAS] [WAS NOT] [N of a satisfactory chemical quality according to the New York State Sanitar Co fort a parameters tested, at e ti e of sample collection. NA = Not Applicable N = Not Present (Negative) SUBMITTED BY. P = Present (Positive) SA = See Attachment(s) ' = Also done because Total Coliform was present Albert H. Pao i, M.T. (ASCP) TNTC = Too Numerous To Count Director > = GT = Greater Than < = LT = Less Than I * A COT. WELL UUMrLL_11UlN t',LrUml DEPARTMENT OF HEALTH _k # _Division Of -Environmental Health Services PUTNAM COUNTY-DEPARTMENT OF HEALTH Office Use Only WELL LOCATION REET AOURESS.- I WNIVILLACA y TAX GRIO NUMBER: LcIr 1:1-61 =W4. 14- 1� WELL OWNER , 0RESS., PSIVATE PUBLIC USE OF WELL 1 - primary 2 - secondary 9 RESIDENTIAL 0 PUBLIC SUPPLY ❑ AIRICONO./HEAT PUMP ❑ ABANDONED ❑ BUSINESS ❑ FARM ❑ TEST/OBSERVATION ❑ OTHER (specify) 0 INDUSTRIAL ❑ INSTITUTIONAL. 0 STAND-BY ❑ AMOUNT OF USE YIELD SOUGHT gpm.INO. PEOPLE SERVED EST. OF DAILY USAGE gal. REASON FOR DRILLING NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST/OBSERVATION ❑ REPLACE EXISTING SUPPLY 0 DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH !// r ft.j STATIC WATER LEVEL _a`S/� ft. j DATE MEASURED DRILLING EQUIPMENT )9;-ROTARY 0 COMPRESSED AIR PERCUSSION ❑ DUG ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ❑ SCREENED ❑ OPEN END CASING. )R[,OPEN HOLE IN BEDROCK ❑ OTHER CASING TOTAL LENGTH k MATERIALS: 0,STEEL ❑ PLASTIC 0 OTHER LENGTH.BELOW GRADE ' k JOINTS: .0 WELDED RTHREADED 0 OTIHEIR DETAILS AIL6 DIAMETER in. SEAL: .0 CEMENT GROUT OBENTONITE7,10THER WEIGHT PER FOOT /J" Ib./ft. DRIVE SHOE. )KYES ONO LINER: 0 YES ,NO SCREEN DETAILS GRAVEL PACK DIAMETER (in) "SLOT SIZE LENGTH (11) DEPTH'TO SCREEN (ftj- nimuopsoj FIRST 0 YES ONO SECOND _ 11 YES 0 NO GRAVEL SIZE: DIAMETER TOP OF PACK in. OEM fL BOTTOM OEM It. WELL YIELD TEST I If detailed pumping MfTHOO: 0 PUMPED 1 tests were done is I >kCOMPRESSED AIR formation attached? 0 hILb 0 OTHER ❑ YES ❑ NO e detailed formation descriptions or sieve analyses WELL LOG 'a' more detailed please attach. DEPTH FROM SURFACE Water pear- ing Well Dia- meter I M FORMATION DESCFDESCRIPTION COOE WELL OEM DURATION hr, min. DRAWDOWN ft. YIELD 9pm. d Surface z/ .24) WATER 0 CLEAR TEMP. QUALITY 0 CLOUDY HARDNESS 0 COLORED ANALYZEDT OYES, ONO ANALYSIS ATTACHED? 0 YES ONO STORAGE TANKi TYPE CAPACITY GhL. WELLDFOL NAME I DATL L 37. Sl NA ME PUMP INFORMATION TYPE APACITY MAKER DEPTH MODEL OLTAGE — HP _Z MA_ FINAL SITE INSPECTIO Dat: OWNER In P'-: .71 JCv TM. # OR SUBDIVISION LOT 4 v --;pl---�:7-----Izi;�;�-:�-�-----2q,--, Owner or Purchaser of Building Section �Wjli� g,zy l:d�*ig _C��nst,zatc�d ,hv Block �y�...4 h. ^�• � .9. T_. l...f .._ 2a•. .... .�J i_. �.v �.♦ -_a YEN " -��. ... ®ti..� _�-. 1. r.U.. �.r .+ -.. � .u. ... 9n._4 yr /�_a..... ..♦ • r.. .Location I Street Lot /eet \,� V A Lv L Munici ality Subdivision Namej Building 5frype Subdv. Lot # GUARANTEE OF SEPARATE SEWAGE SYSTEM I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage disposal system serving the above described property, and that it has been constructed as shown on the approved plan or approved amendment_ thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his success- ors, heirs or asIsigns, 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 initial use of the sewage disposal system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occu- pant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determin- ation of the Director of the Division of Environmental Health Services Health n n- � th F q 1- ._as t_ wh• kte.r o.r. nc�. •.: e:.�U . ure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated this_ day of 198 Signature Title Corporation Name if corp.) Add ess - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION WILL BE ISSUED. GUARANTOR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Division of Environmental Health Services, Putnam County Department of Health PUTNAM COUNTY.,DEPARTMENT Ok' HEALTH.' Permit o.�„jd VX - r D!wsion of._Environmental'Healih Services t,ermel N. Y 10512 ;a ,t ,CONSTRUCT PERMIT FOR SEWAGE DISPOSAL SYSTEM p(� Val l ev Town of vITlage "t T roc8ateo at _��li ur2� r p r i 14 'of C'erta pPrital Vi 11 agPSu qtr n 56 'R 57 +� y pE g r �, `s � ti+ 3• 7 Subdivision =Nan Renewal �.' Revision M` } Mr- Alit �.� Date O4 Previous Approval ^Owner /Address - Building' -Type .2 strY blk. dot Area 47 437 sf Fi11 Section only ❑ , A Number of Bedrooms 2 Llesign Plow G/P /D `f00 P C N. D Notification; Required 74 Separate so- werage System - to consist of 750 Gal Septic Tank and 2�� ` T; F of 24" W1C�thtreTlch ' To be constructed by S A F :septics ti Address 'Ibdd '- LeW1SbOr0 * H z.` tis Water Supply Public SuPD1Y From i �, " �_;'Pnvate:Supply'_to De : drilled by Anderson Well Dr111'er w Y > Brewster.• N Y 6 Other Requirements n 1 ba ,represent -t hat am wholly aniJ, completely`responsibte for•SF a design and location of th osed• sys;em(s) lj that the +sepaiate ?;sawsge,fdispossl system; above; dezcribed.w'ill ba constructed,as shown on tfie;approved'amendment - there�toa eRl iU; the standards rules an =regu - Onf O '�' • lJ -rlam , ;County :Department of Health, =and that.on completion.theieoi a :GertifiEate o iance•' satisfactory -to the_Gommiufoner -.of Healtftwhl tie submitted to,the Departmentf,':'and a written guarantee will ' be' - furnished, r P� s hensor' assigns =by the builder'tbat said builds; will ,:;place �n good operating :condition any •pa t oi4 �sotd sewage; "disposal sy,, am u )year mmedistely tollowirlg`thedate of the issus 1 ante of:,4he approval of -the Certificate 'of_ Coestrucfion Compliance-of. th Qr irf't 0 2) tAat the: drilled well despibed above will.be =lot5ated as shown on the approved `plan and.tnat said well will be:;Install. a t sts ar ruler,and rspu a ons .of ether. Putnam County _Department of Flealth i Yrv2 t K ; i Date Nnv iO r 9�h ,Signed �� % Address 2070 r Rcl. ` L`ieense:NO 41 a: Knit r t ks Cw v 4 .i APPROVED FOR _CONST,RUCTIO•N , ,Thi; Approval': expires one -year from the da p r6ction of the building has been undertaken and is r revocable.lor•eause or,may be amended or modified ;when considered necessary, b .t ei 'of Health:_ Any change or`,alteratbn of Construction requires 4a permit prov or is oral of domestapy sews 7vate `ovate ' wp only { /9 /elf l '� Rev 9 61 ( / :� �'(l e err —� -r DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 -,',7a 17! C ..J��°' art Pr9n PRPMTT A WELL LOCATION Street Address Name Town/Village/City Tax Address Grid Number URPrivate O Public WELL OWNER USE OF WELL 1 - primary 2- secondary Q:RESIDENTIAL 0 BUSINESS 0 INDUSTRIAL ❑PUBLIC SUPPLY ❑AIR /COND /HEAT PUMP O FARM 0 TEST /OBSERVATION 0 INSTITUTIONAL 0 STAND -BY 0ABANDONED O OTHER (specify 0 AMOUNT OF USE YIELD SOUGHT gpm /# PEOPLE SERVED /EST. OF DAILY USAGE gal REASON FOR DRILLING NEW SUPPLY o REPLACE EXISTING SUPPLY ❑PROVIDE ADDITIONAL SUPPLY 0 DEEPEN EXISTING WELL ❑TEST /OBSERVATION DETAILED REASON FOR DRILLING WELL TYPE ®DRILLED DRIVEN ODUG GRAVEL ❑ OTHER IS WELL SITE SUBJECT TO FLOODING? YES ' )le, NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: tie�PlTIIJp��fpl� �t�.rti1/P� :1►�ld.F. l�- Lot No. rD (o E 51 WATER WELL CONTRACTOR: Name _fr.: if?I�i�d,� y%O05 Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES >C NO NAME OF PUBLIC WATER SUPPLY: / TOWN /VIL /CITY T11'ti'E'41��'n: T.1 �r?l1PRRTv ? yER MAInT� FIOiv _EST T.TA �a LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ® ON REAR OF THIS APPLICATION ® ON TE S (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. r Date of Issue: yC��'� % 19 90 Date of Expiration:,Pc Permit I suing -Official Permit is Non - Transferrable 5.4e> Design Consulbnrs.... Civil trig'ineerb ' ®' Land F9enners P.O. Box 174 • 2070 Sew Mill River Roed • Yorktown Heights. New York 10598 [914] 962 -4466 November 21, 1986 Mr. Bill Hedges Putnam County Health Dept. Environmental Health Re: Existing SSDS updated to today's standards, as required by the Putnam Valley building inspector. Dear Bill, I recently spoke with you on the phone concerning the referenced project. We have decided to follow the request of the building inspector. He insists that the system be updated to todays standards even though this is technically not required by the Health Department. The problem .I forsee is the plan being reviewed under the pretext that it is a new dwelling. Since it is not as tax records show, it should be reviewed as an addition to an existing system. This review would not require topography to be shown. I hope this letter helps to clarify the matter and give you a better understanding of the proposed project. Sincerly, Michael Doebbler 01: ° r PUTNAM COUN'T'Y DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENMkL HEALTH SERVICES DESIGN DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO. '- .s lJW1J.:er aiVTY %�� :.-. .a .. .. -„i'•- ••• ,--'r _ — ,..•i.. °a•^5�'i�'.ti:C.r. n L1'.�^.i, �:i: %3.: wr.: "i�vT ,rj.: �e ., ;v:• .. _ ' i r. ,. - ,,, Er`iinn Located at (Street) Sprout Brook Rd Sec. 14 • Block Lot 56 & 57 (indicate nearest cross street) Municipality Putnam Valley Watershed Hudson River SOIL PERCOLATION TEST DATA RDQUIRED TO BE SUBMITTED WITH APPLICATIONS Date, of Pre - Soaking Nov. 3, 1986 Date of Percolation Test. Nov. 4 HOLE NUK3ER C[= TIME PERCOLATION PERCOLATION Run Elapse Depth to Water Fran Water Level No. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start stop Drop*In Min/In Drop Inches Inches. Inches 1 10:04 .! 10.34 10 20 23 3 10 2 10:37 : 11:04 30 20 23 3 10 111:10 : 11:40 30 20 23 3 10 0 5 10:10 10:37 27 20 23 3 9 1 '1 1 1 • 2 11:10: 11:37 27 20 23 3 9 4 10,13o 10.37 24 2(l 23 3 R 5 10:40 : 11:04 24 20 23 3 8 1 11:07 : 11:31 24 2 4 5 1 M C ddb ;•- , NCn'ES: 1. Tests to be repeater at same depth until approximately equal soil rates are obtained•at each percolation test hole. All data'to'be suhmitt�?d for review. 2. Depth measurements to be made fran top of hole: rev. 9/85. TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE'NO. HOLE NO. HOLE NO. �Sarici"`S1 tGl:,datfi 1' * Note: No test pits dug as of vet 2' soil determined by perc tests. 3' 5' 61. 7' 8' 9' 10, 12' 13' 14' _..._. -. INDIC TEJT,EEL ,AT WHICH (,ROUNI7WATER IS...EK)0U.NT. -. -. INDICATE LEVEL, TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY: DATE: DESIGN Soil Rate Used 10 Min /1" Drop: S.D. Usable Area Provided 5000+ sf. No. of Bedrooms 2 Septic Tank Capacity 750 gals. Type P/C concrete Absorption Area Provided By 222 L.F. x 24" width trench Other s�E °- Name Site Desicn Consultants Signature Address -'070 Sawmill RivPr Rd- SEAL 4181 Ynrktnain �Jts N,y, 10598 RO`FSSioNP�' THIS SPACE FOR USE BY 'HEALTH D:'"' "'NT ONLY: Soil Rate Approved ,£t /gal. Checked by Date r_ , _ r a - r ,r -'Q a. ' n ' r j } _ 31 � a —77 77 r r. .:. i- a �3 IV � � � K�'°T. � � �C' � 9 F h �.a..+]:�i. �va. ,' " "w?C � f � :L -- �r.-•v ..�,• =. �... a _ '" "' rYi-4 I.; } � fv...r � � r � '�:..'X: bS'r 2'e �'��..�r`i.a�,;.- 4..k*n,L ]� ,.5: _.Svn•...,;.i:..ES -"�-�— 'x.!::r +.._ _ ' ^Lh... 4-= S � n ._. —Y \/•��'i N ®i.. � - ._ LVLLL-iL'i WVLVi JL •.yLF. I.fJ_I�.I7.l �.LlI.tll.�.- DIVISION OF ENVIRO*WMAL HEALTH SERVICES John M. Simwns, M.D. Deputy Commissioner of Health - FIELD ACTIVITY REPORT - Sheet of ^-5) CT i/ iNSPDION NAME �'�/ �� Orig e Routine, Orig. Complain ADDRESS Orig. Request Street Town �[M No. Compliance • 4 Ccmpla. int Canp MAILING ADDRESS �""7 Final P.O. Hoar I fice Zip Code Group Illness Construction TELEPHONE Reinspection PERSON IN CHARGE Field, Sampling Only OR INTERVIEWED Field Conference Name and Title Other DATE ...® TYPE FACILITY TIME ARRIVED ds, e TIME LEFT �, Explain FINDINGS e ,,O TELEPHONE: E OR II�PPERVIDbaED: is Field Activity Report. SIGNATURE: TITLE: 6 -86. P 3 � Uu V TE , PHO[JE: mature and Title £ i Report:" SIGNATlA2E: L "d A TITLE: :_ RECORD OF TELEPHONE CONVERSATION PUTNAM COUNTY DEPARTMENT OF HEALTH Dj-ViSion-of-A—�.» Program: Facility: 13 eoe avf &de.- o,?,W Time: Date: 0",VZOI Zfej2phone�. jPeg"I'Vft Caller's Name: DISCUSSION:- �7 c2p vo, PUTNAM COUNTY HEALTH DEPARTMENT aaz .a L.UVLDLU14 OF ENVIRONMENTAL r4re.D.Ln arimViLCrJO John M. Simmons, M.D. Deputy Commissioner of Health FIELD ACTIVITY REPORT - Sheet of. INSPECTION NAME Orig. Routine Orig. Ccm p ain /"-<Pl -ZP ed Orig. Request ADDRESS �'q'u s t No. Street Town 24 No. Compliance; Canplain MAILING ADDRESS 4F Final. P.O. Box Post Office ip Code Group Illness', Constr66"tidfi-:-.'- TELEPHONE fl"r a z P-W VW a V'R a o9wL3,9 spection:-,- PERSON IN CHARGE Field, Sampling OR INTIWI&CD 'O�A Field Co nf eteh.66_ Name and TitW Other ;^&P. DATEC TYPE FACILITY 'OV A TIME ARRIVED TIME LEFT 41:9 1, Vqv ,P &.20 a.- S\ .0 A' -&q 2wX;;n' .tea'93 A AS cny cgs c: I= INSPBCIOR: PERSON IN CHARGE OR I acknowledge this Field Activity Report. SIGNATURE: mm TITLE: DIVISION OF ENVIRONMENTAL HEALTH SERVICES John M. Simmons, M.D. Deputy Commissioner of Health - FIELD ACTIVITY REPORT - NAME ADDRESS N 10 WOW. WA Ll%j. MAILING ADDRESS P.O. Box Post Office Zip Code TELEPHONE 5�P Sheet,5R of Orig. Routine Orig. Complain Orig. Request Compliance Complaint Comp Final Group Illness Construction Reinspection PERSON IN CHARGE Field, Sampling Only OR INTERVIEWED Field Conference Name and Title Other DATE TYPE FACILITY TIME ARRIVED TIME LEFT c;� Explain FINDINGS:, d � � 1 �6 '-'- 9 C:0 4 () , , A:� cl INSPECTOR: � /F/ - Z:Z - TELEPHONE: Signature and d-Title PERSON IN CHARGE OR INTERVIEWED: I acknowledge this Field Activity Report. SIGNATURE: 6/86 TITLE: DAVID D. BRUEN County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services January 10, 1986 Mr. Marvin O'Dell, Building Inspector Putnam Valley Town Hall Oscawana Lake Road Putnam Valley, NY 10579 Dear Mr. O'Dell: JOHN sIMMONS.IkD. Deputy Commissioner Re Lubbe_rs S.DS - -• -. -. ro -iit Br- ookr_Rbad, "PV, 'TM 77 1= 21'� As a result of conversations with you and Mr. Bill Lubbers concerning the above referenced site, I am sending.this letter to confirm this Department's policy regarding a subsurface sewage disposal system (SSDS) which was permitted prior to this Department's inception. The permit to construct a SDS was reportedly issued by the Town about 1950; it therefore seems appropriate that the Town complete the permit,.review, inspection, and compliance process. If .— —. n r n i _t....._. -..• 1,. -. _. .,a^- ..7 —'� ] .. = _" L..� '1 -�1 L - l h L� ' ' •• � u i � ` ..try i . a _ _... .� . .. -.: _ l�ll'l-' A1J'J liGb a1Vt. YCI. lJCI -al ia. si. uil' f: uj' i� "'"vrvitiCa'ta.c'_:•ia"l..e" :�a.:.0 ^ ^::::... Y � _ � .•.. - _.._ the applicant to obtain a SSDS Construction Permit from this Department to assure conformance with current requirements. If there are any questions, you may call me at 225 -3838 or 225 -3833. Very trul yours, James S. Hodgens Assistant Public Health Engineer JSH : amm �. a cc: B. Lubbers, RD #4, Indian Lake Road East, P.V. 10579 II/File JSH j'. TWO. COUNTY CENTER - CARMEL, N.Y. 10512 (914) .225-3641 i . , - �.- -.... ..._ - +_ - .-.... ... �:.... -e:.:✓ ..., _ .� ..,.i.« < 'y�-s ,C a;.a _� _P. ._ �.�, � � � m .. ..� ._�:r� r... it... -.- .tC:t?s.. . - .. v r+... «. �J4H1 Z96 FitJ>7IREv aPAInIAG� �Xth(i�iU WEtL i I p ' 1 .A 0 0. a• hoc o ado pap �c,e FT oo' ' /ITH1rj 200 o0' 'S ;`fe DiPlsioa op cent of I o s�STEN} ipL loo' I�PgLore. 8h°irormea aDDrO tat $881th Berpla6 DEStGnI applicable Rule for QonPormaaoe with PeRu PAfV- ata.`Iil and �lationa of the APPLfcrA7iba RATE Co Health De Partin 2EGtJtREOAREALi R�QrJiR>;O Ae>W 5atur8 Pitle 2/ PROPosso sYS�M 11" JA a Date LOT AREA': 4'1143'1 �F 5� ArID "ri'I ti