Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
3280
DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73. -2 -3 BOX 26 03280 / I ,. M � � Vi 1[� �� V r ;.Rev ';86',; Divte L'nglneeY MFtlOVifle r h <' PCHD P pk �7 CERTM -CATE OF CONSTRiJCTIOPi COMPLIANCE FORS WAGE DHSPOSAL S7tSTEM E t a { f uwa Z T Blockr��e Lott 3 .Located at Ta: Sa1011 lon Nam v Lot ll'° .Owner /appllcanttilValae Formerly M s' �: �' Zipt 1 �9 Date Permit Dsened 0� �TI' 1 v aWag Addres ' r Separate Sewerage System bout by N Address r�r �' r K Septl -Con of alidn' Galion ¢ Tsnk and: VDU ' l ..FT- ` � Water Supply: Palillc Supply mom ' Address '� or 1/` Piivate Supply Di0ta by Adtlreae Gov Building 7j pe �i L� {- Has Eeoslon Control Been Completed? s, 1�iamber of Bedrooms Has Gaibage Grinder Been InstalledY b1 I T nl� i `'( -" Other Regaliements ` I certify that the syeiemfs) Fes fisted serving the atave=premiaes xeze constructed essentially ae shown he plans of the' completed �rork (copies of which are attdched) ;find 71. rules and regulations cor ce wi fir d plan and the pe mit,iss, by .the Putnam `County apartment 0f Nealth rt t sus } � Oats \ s Certified by P E R A �' ddress a X license Pro ah a. t s Any person occupying Oremises served by 4'he above •system(.) shall promptly take ;uch:actiop as may beynoeosa•r' 4o,eseurs the correction of amy_unsanitsiy' :. �condit {ons resulting from ,usrGge ttApproJal of the separate iseworago .system shill bacome null and void ae soon is a pubC saNtsry"aw*vbocc"*s ' avNUbls',andthe''approval "of the' privatsw�tersupplyshall 'becomenullandrooW when a publle'watee: wpply;LHCOmms awllatfN. 8 la'are- wb)ect ,to modifiCOltlon'oI Change' When in the ju`,dgmeM Oi the COmmiBS)Oner Of Fleelth such revOeatbn, Mcdificotlon or things It MCeefla /y.' 1 Gate _ Title ' n IM '.6 •; fe z:,. $s "fit - --�-- - --"- -- Use Oily a ;:�Ll'ARTi,Ii.N'I Division "Of Ell. OF iYi)>rii��nt rl= Fig e'1 1 4.1ry -a. PUTNAM COUNTY DEPARTMENT OF HEALTH STREET ADDRESS: TDWNIVILLACT1711Y TAX GRIO NUMBER: WELL kOCATION . TINS.:.BIDf ____..___.PiITNAM,�iALLF�Y NAME: LOT 5 ,lot 5 AOORESS: 1:1, PRIVATE In WELL DWNEA PUBLIC 'USE ELL. M RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIRICONO. /HEAT PUMP ❑ ABANDONED �a1, primary: O BUSINESS ❑ FARM ❑ TESTIOBSERVATION ❑ OTHER (specify) 2a "secondary ❑ INDUSTRIAL p INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT gpm. /N0. PEOPLE SERVED -% / EST. OF DAILY USAGE ' gal. ° TREASON 3R.,> ® NEW SUPPLY O PROVIDE ADDITIONAL SUPPLY O TEST /OBSERVATION F � DRILLING ? O:-,REPLACE EXISTING. SUPPLY 0 DEEPEN EXISTING WELL' 7H WELL DEPTH 340' ft. STATIC WATER LEVEL' ft. DATE ME,�5URED. - -- =. r z +'DRILLING 0 ROTARY ❑DUG EQUIPMENT " O WELL POINT O CABLE PERCUSSION :: ❑ OTHER (specify): ESL TYPE ? 'SCREENED -.0,,OPEN END CASING. ijp OPEN HOLE IN BEDROCK ❑ OTHER ' TOTAL LENGTH : 9h' _.. tL MATERIALS: 0 STEEL" ❑ PLASTIC ' O,OTHER CASING LENGTH.BfLOW GRADE:" fit. JOINTS: 0 WELDED ® THREADED OTHER' 'DETAILS * ` '`DIAMETER _fi" in. SEAL: ❑ CEMENT GROUT ❑ BENTONITE .l2'OTHER WEIGHT PER FOOT Ib.Ift: DRIVE -SHOE O YES "]ONO LINER: OYES : tpb a DIAMETER (In) SLOT SIZE LENGTH (ft) DEPTH TO.SCREtN (1t), DEVELOPED? o YES ❑'NO SECOND ';GRAVEL PACK AYES ` GRAVEL: DIAMETER • TOP Bottom t.'. _ ,:.,- . .' ,::,- O NO SIZE . OF PACK .... i n. DEPTH i1 DEPTH it. 1 AL -YIELD :TEST If detailed urh in ' D P 9 A/ WELL LOG. II more detailed formation descriptions or. sieve analyses ,.._ , . , fAETHOO: O PUMPED tests'were done is in- are available, please attach.,.,, DEPTH FROM .water SURFACE sear- Well .4(a-. FoR(,tanoN DESCRIPTION raOE " 1' 'COMPRESSED A1R formation attached? tt. (L '..O BAILEO O OTHER i O YES O NO. 'ng meter WELL DEPTH DURATION DRAWOOWN, YIELD Lurlaco 86 6 19 - overburden ft.' hr. min. It.. 9Pm- RA i&n " 1 i mPSt•ot1� i 340 ' 64-hr ,WATER' ❑ CLEAR,_' TEMP. QUALITY O CLOUDY HARDNESS - ~ -- - -~ O COLORED ANALYZED? .OYES O No ANALYSIS ATTACHED? O YES ONO STORAGE TANK: TYPE 251 WellXtrol CAPACITY_ __ _ _ __ _ `GAL: ,PUMP INFORMATION ",. TYPE SUbmer. CAPACITY WELL DRILLER NAME �_ v DATE norman.anderson int. /,20/8( MAKER ADDRESS : SIGNAIiJRE uaoEi : VOLTAGE 3�4 HP� Putnam valley ,,ny. /&Vxu6_ /,z � LAB j/ - - -- Yorktown Medical Laboratory, Inc. 321 Kear Street Date, Taken: _ .. imme e �= L L PYork t own He a$ hcs.N Y 1OS9 M8 40.E (914) 245 -3203 Date Reported: Director: Albert H. Padovani M. T. (ASCP) Collected By: N. ANDERSON T- Referred By: Sample Location: BATHROOM.TA HUNTING RIDGE, PUTNAM VALLEY, WEINERMAN, HOWARD — --- DEVON.DEV. Phone,# 528 -8698 Phone # — I Sample Type: L J Repeat Test? (check one) LABORATORY REPORT ON THE QUALITY OF WATER INORGANIC NON- METALS (mg /L) Acidity _ Alkalinity Chloride _ Detergents, MBAS' .__ Hardness, Total. Nitrogen, Ammonia Nitrogen-, Nitrat-e Phosphate, Total _ Sulfate _ Sulfide Sulfite METALS (mg /L) Copper _ Iron Lead Manganese Mercury Sodium Zinc MISCELLANEOUS PH (units) _ Color (units) _ Odor (TON) Turbidity (NTU) MICROBIOLOGICAL (CFU /100mL) GENERAL BACTERIA _ Standard Plate Count (CFU /1.OmL) MEMBRANE FILTRATION TECHNIQUE. v Total Coliform Fecal Coliform —.Fecal Streptococcus MOST PROBABLE NUMBER TECHNIQUE Total-Coliform Index Fecal Coliform Index KEY FOR TERMINOLOGY N/A Not Applicable LT Less Than (<) GT = Greater Than (>) TNTC= Too Numerous To .Count CON.= Confluent ( =TNTC) NR = Non- reactive REMARKS /COMMENTS (For Lab Use) ✓ Potable Non- potable _ STP INF _ STP EFF Other: Sample Status: (check each) Outgoing HNO3 _ HC1 H2SO4 _ NaOH ZnOAc Na2S203 Other: Incoming LE 4 °C _ /GT k °C — pH LE 2 PH GE 9 _ pH GE 12 Other: THESE RESULTS'INDICATE THAT THE WATER.S.AMPLE (WAS) (WASN.'T) (N /A) OF A SATISFACTORY SANITARY QUALITY ACCORDING TO.T YORK STATE DRINKING WATER STANDARDS, FOR. THE PARAMETERS TESTED, AT THE TIME OF.COLLECTION. THESE RESULTS INDICATE.THAT THE WATER. SAMPLE (DID) (DIDN'T) .(N /A) MEET THE SATISFACTORY CHEMICAL QUALITY STANDARDS OF, THE NEW. YORK STATE DRINKING WATER CODES, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. Lx/ � '� { / ALL 'C -l}� l" 2 /86(Rvsd7 /87)RWE Albert H. Padovani M.T. (ASCP). Dirj:ctor Tt TPTUTNA�M COUNTY DEPARTMENT O�F(�HEA�LsTH}•�'/��t� .'A,: .-:l ..,�. r,,: sr+ s- i{ � 's'«iuv- �'^a.:�:..- ?'r ?...�� --1 _. 'D1i1 �►7�1�',iV vii'L11�iV'3:Ca�� ^ L' 7. 3'. el 4ai .J1-H��.C.Ct- V= �.�SL•�i.•.'w'e «��.p�. -_� � .- � r—.. K _.. .: .::_., _. Owner or Purchaser of Building Section-_ Block Lot Building Constructed by [Jr Aj Location - Street Subdivision Name Municipality Subdivision Lot # Building Type GUARANTEE OF SUBSURFACE SEWAGE DISPOSAL SYSTR4 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 opprova�- ..of_.the :. . ---- - -..._ --i- .— Certificate o£ Construction Com lahce" fore "sewa��" dl1=i; nr °gin "` P g' y .._....,. repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Director of the Division of Environmental Health Services of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated thi day of 199 Signature .77 Title a C� ti eral Contractor (Owner) - Signature 7�'ysj Corporation Name (if Corp.) Corporation Name (if Corp.) V©? Address Address rev. 9/85 mk PUTNAM COUN'T'Y DEPARTMERr OF HEALTH - - - - _.. _ - -. R .yMF- .��rAL F,F.,AT.+Tki SF�t .. Owner or Purchaser of Building Building Constructed by A U , -- V_" -tZO �' �' Location - Street } l —p V Municipality Building Type Cry 2 i iaa - Block Lot' i VVI Subdivision Name k Subdivision Lott — 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 "�ertifi•cat - of Cop: -st -ru sti-t--:n -- Compliance° for the sewage disposal system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Director of the Division of Environmental Health Services of the Putnam County Department of Health as to whether or not the failure of the caused by.the willful or negligent act of the occupant of the the system. Dated this _ _ day of 1990 Signature Title - Signature o Name jif Corp.) riaaress Yoiultv� << rev. 9/85 mk system to operate was building utilizing Corporation Name (if Corp.) Address >3 .�" "' y_'"'A''"r�. -r^ •a.^-v�- ,4�*�q.r"' k '.". }`wry". M' v_.- nA Y,yio k h X f� ix t4 to 'fix 8z oti �u z a •.t � ,`f z `Z 1 }.- y .# �f .4 c z {' .i �c � � 'r�r �. >'z- - � r:� y $ },•�, v t t C #, zl Q� t/ ' a PUTNAM COUNTY DEPARTMENT OF HEALTH > r ``` � �' '' : 'Divieloaof Environmental Health�Servicoa Carmel N 'Y 1051? s E6gfneer tD Provide=Permit N ` � �� I , i. \ .,t. r 4 q ti • y z �, ' ,, x r rO r on CERTIFICATE OF COMP ' ..•j Permit N r _ i CONS CTION PERMIT FOR SEWAGE,DISPOSAL SYSTEM 2 v Q Al ,, LOCa /•; , O� * F .x a ' �tn. Town Or� V •`4 a S• r-. e;+...g ic""'"us ....,g �...,, a - it a s r .�7•' - ..•..- •-s ^.�.' � - SandivWon Name %? Sabd Lot N Lo . Ta: MapBloclt :T t=c 'Renewal_❑ Revision p i � Owner /Applicant Name D ' A/7 Date of Prevlone A� jproval' MaWng Addreee'1 /GKJt r 4 BaildinQ Typo Lot Area ;T FW Sectlan Only Depth k Volume Nambeir of Bedrooms Design Flow'G P D 0� PCHD NotJflcatlou Ilk k.gafred When fl ie completed Sepaente Sewerage System to eOn8let of Gabon Septic Tanit To be conatracted by, � L7 � _ - Address r Water $aPPI! y Pttbllc Supply From Address _ j 1� ° _Addreae on Privste Supply DrWed by , other. Reaairemente + 1 represent that 1 am wdolly antl completely responsible for tits design and location of�,tlie- proposatl systems) 1) that the ,separate. „sewage disposal - system t above;descnbed,wJl be, constructed as shown on the approvedamendmsint there, to and m: accordance with the stantlards rulesan regu,a ions o e • Putnam County` Department of'M`Hsalth,.':antl that °On completion thereof a Certificate of Construction Compliance; satisfactory to'tho Comrrm�ssioner of HealtAwill be wbmdto `to the Departmen t,” and, a written guarantee will bye furnished Elie owner, his wccessors tieiri or assigns by "the builder, that said bwld'er;,i4ill place in good operating condition any part of said sewage 'disposal system.duury the penotl,of two (2) year metl)ately followiity thetlate of the issu jf .. �`• . . 4 a. -Y ?,. ^%A'^ .,dw -.5:. . SYSs.:r. t* Y C.�. s ''� anca: of rthe approval of`ahe .Certificate •oi, ConstrucUOn Compliance ;ofthe original system or any repaint th , et ' 2j thatahe,tlrilled:well descnbed above u witl beaocated'as shown on the appr "Quad plan and that said wellwill tie Installed inaci �'bce tti the nd` rds iules nd'',regu a ions a of the Putnam , County. DO rrient Of Health A nx� �' h Date '27 � L z � ` � � SigneC a �•� ,� p E R A a Adtlress License No IVY •,, APPROVED FOR CONSTRUCTION This'approvalezpir two years from the pate issustl unlessconst ction of'.the building has,been untler,taken and revocable` /or cause or may De amended ortnotlifietlwhen considered necessary Eby the Commissioher of Health Any change or alteration of 'construction requires a new'`ermit c Approvetl for disposal of domesticksandary sewage and r pFrte water supply only �r " `E Rev.' 1/87 Date r a.... .�... .. .. . -. r+� - e- ..r•. -.•... -�. Y....- ��o•��A..•c+� .w..... .. ... - z.. .-.... .. - ..._.. _ _. ...r_ .. _. .. ..� r� - �- r- .- .n +..���s�.. -. a.. .. y..r+•.._...V..r .. ..... - • v....- .....� _._ FINAL SITE, INSP�ION Dates. Inspa•t: by SP= LOCATION '►--- . OR SuMDIVISION W1 J r'R •� IV. V. VI. ri Im. SL,Y?GE DISPOSAL AREA a. SDS area located as per a=roved plans b_ Fill section - Date of placement 2:1 barrier_ LGTH W= AVG•DPTH '00CW c. Natural soil not striDred d. Stone, brush, etc., greater than 15` from SDS area. e. 100 ft. from water course /wetlands. . SENTI ✓. DISPOSAL SYSTR4 a. Septic tank size - 1,000 1,25 9,-.I eon b. Septic tank installed level c. 10' minix= fran foundation �j ! d. No 90° be_ -nds, cleanout within 10 ft- of 45° be-rid I I e. DISTRIBUTION BOX 1. All outlets at same elevation - water tested I j I 2. Protected belcw frest I'I 3. Minim= 2 ft. original soil between box and trenches I oT I f. JUNCTION BOX - rroperly set I - 1. Length regu -red . - �� ®�% Length ins t ed -H 2. Distance to wct°7'course neasuxed I Imo, I I 3. Installed according to clan i 4. Distance ce_*it--- to ce_nte_r 5. Slone of trench acceptable 1/16 - 1/32 "/foot. 6. 10 feet from pron-_-ty line - 20 feet - foundaticrs I �' 7. Dent_h of trench < 30 inc*ies free surface 8. Roan allax-ei for eY-Larsion, 50% ° .Size of travel 3/4 - 1iT" diameter � O 10. DeDth of [!ravel in tr e_-m±i 12 ° m i n i mtnn I 111. Pire ends capped h --1- ��z'e•'oi`'DL'IttD ��,�r.. _,. -. - ..a� -_..., a _v ...� .. ___ : �.,.._ .� ,....... _. _ ... R_ _.. -.. 2. Overflow tank 3. Alaan, visual /audio 4. Pi= easily accessible manhole to cede I I 5. First box baffled I N. I 6. Cycle witnes=sed by Health De=-une_*it I 1 estmated flow per cycle I I I a. rouse looted r�T arrrove3 clans. b. Nuat er of bedroacs Wr ,h a. Well located as per a =roved plans L b. Distance fran SDS area measured JAT tv IPOV I I C. Casing 18" above grade_ d. Surface d_* -mace around well accep4bNole`? 04' --iLUI , WORKI�ASnIP a. Boxes Droper-ly trcuted I J I b. _Ll pioes Partially back =i?led 0r,��Q c. d. ALl pives flus=h with inside of box Backfill mate..T-ial contains stones < 4" in diameter Cartain drain installed according to plan tolov I f. _J Cartain drain outfall protected & dir. to axis t_watercoursd 1 g. Footinq drains discharte away from SDS area AO I h. Surface water rotecti.on ademmte i. Er osion ccntro Drov -d_ d cn slopes treater than 15 %. . Im. DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 .. � ,- APP�IZAfi 'UT�f"�.PO'I;UNST�UCT'�, WA'TEE WELT, PCHD PERMIT # WELL LOCATION Rr et Ad essT L°f' Village 9 ty Tax Grid Number WELL OWNER Name G 6n Mailing Address / arrivate O Public USE OF WELL 1 - primary 2- secondary SIDENTIAL 0 BUSINESS 0 INDUSTRIAL O PUBLIC SUPPLY Q AIR /COND /HEAT PUMP O FARM 0 TEST /OBSERVATION O INSTITUTIONAL O STAND -BY 0 ABANDONED ❑ OTHER (specify O AMOUNT OF USE Y ELD.SOUGHT S gpm /# PEOPLE SERVED /EST. OF DAILY USAGE Cow gal REASON FOR DRILLING WIM SUPPLY O PROVIDE ADDITIONAL SUPPLY ❑REPLACE EXISTING SUPPLY ❑DEEPEN EXISTING WELL. O TEST /OBSERVATION DETAILED REASON FOR DRILLING WELL TYPE [ DRILLED DRIVEN ®DUG []GRAVEL ® OTHER IS WELL SITE SUBJECT TO FLOODING? YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:_ Lot No. WATER WELL CONTRACTOR: Name -o i3 .-D Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES r/ NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE- TO-PROPERTY''FROM NEAREST WATER MAIN,: ' LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED []ON REAR OF THIS APPLICATION Q09_SEPARAjEiA (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: G% / 19 Date of Expiration: / 19 li ermit Issuing fici Permit is Non - Transferrable White copy: H.D. File Yellow Copy: Bulluluy Inspector 2/87 Pink Copy: Owner fh -anrrc mrnr• raoll rw -411or Nt A -A..; PUTNAM COUNTY DEPARTMENT OF HEALTH Iona— nVir AFFIDAVIT — CORPORATE OWNER APPLICATION FOR PER24IT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT TO: Commissioner of Health In the matter of application for: represent that I am an officer or employee of the corporation and am authorized to act for 1,k)771b 6= ;k"11 6,6- 0oxA (Name of Corporation) A having offices at 0 /e: C a /V S N Whose officers are: President: (Name and Address) Vice — President: (Name'a'nd Addressr-1 Secretary: (Name and Address)' Treasurer: -f�VVA k 57 )v 'ter v`v1 s, JV V 1,04Y 7- A) (Name and Address) and that I am and will be individually responsible for any and all acts of the corporation with respect to the approval requested and all subsequent acts relating. thereto. Sworn to before me this day Signed: of Title: 1Z Notary Public MAP.1' L. Wo* Public, State of New York N0.9820275 Qualified In Vfttchester County Commission Explre:i Nov. 30, 1988 8184 LorporaEe beaL • sN'a e. eN E TAL HEALTH SERVICES, DESIGN DATA SHEET- SUBSUFACE- SEWAGE DISPOSAL SYSTEM VII E..ND._ - -- __ .aTr «.•C•-u ..2> c ... . }: �i- C• {.�.�' . _ � � � t.. :Y V- e'K.y.� o�" <.�n�•T.....M��. �c�+b +i.s'ti -.:r. `.. � _ /.. .s•P.�_�Y. _.__. _ .. ... r. -.: .T t .... ... � -M�+4 _.i _ Z r ✓ %7 BLDG' en ;r` Ac3ddreSS Owner Located at (Street) ' M/ % /e;'' �D ��'c . Block �� Lot (indicate nearest cross. street) —fM- Municipality (T�iL/ Watershed SOIL PERCOLATION TEST DATA REQUIFtED TO, BE SUBMITTED WITH APPLICATIONS Date of Pre- Soaking �� /9` Date of Percolation Test 4. 5 HOLE 1 NUMBER CLOCK TIME 2 PERCOLATION PERCOLATION Run Elapse Depth to Water From Water Level No. Time Ground Surface In- Inches Soil Rate Start -Stop Min. Start Stop Drop In Min/In Drop Inches Inches Inches 1 ,0. 2 . 2 3 15' 30 �/� 31d P / 3 3ja --350 -�o 6). 5 21 x :37 W, , �O a23/v . �) 3 7 3 X3-'/`7 -,3`117 30 3/,i L � . 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal soil rates 'are obtained at each percolation:.test hole. All data to'be submitted for review. 2. Depth measurements to be made fran top of hole. rev. 9/85 4. 5 1 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal soil rates 'are obtained at each percolation:.test hole. All data to'be submitted for review. 2. Depth measurements to be made fran top of hole. rev. 9/85 r+ TEST PIT DATA REQUIRED TO BE SUBMITTED..WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. HOLE NO. HOLE NO. G.L. nOCSA.I1 a1�7S ��, �ir • n `.J j��YhG� r�1 a, U ,� 2' ,F 31- 4' 5'/ `( 51 7' to' 81 9' 10° 11' 12° 13' 14' INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING DEEP HOLE OBSERVATIONS MADE BY: �jaL DATE: DESIGN Soil Rate Used / / -/ Min /1" Drop: S.D. Usable Area Provided No. of Bedrooms 41 Septic Tank Capacity /LSD gals. Type 1' � Absorption Area Provided By ADO L.F. x 24 width trench Other %/ (: J, Name —r Address/ 1 0�en zrzc� /✓ ,Z, 5 FOR USE BY HEALTH Signature SEAL = "r Arc CSSIV Soil Rate Approved sq.ft /gal. Checked by �`�'"� Date f� z•9Ku& Pumm COUNT -v DEPmmmTr OF HEALTH - DIVISICN OF ETWIRCME= HEALTH SERVICES INDIV` DUAL WATER SUPPLY & SUBSURFA_GP SE -aGE DISPCSAL SYSTEMS REVIEW SriE"T - CONSTRUQION PERMIT (Ni ame of Cwner'") Street Lecaticn) OPTS YES NO I' i i i I I - I I L= trench. provided' reaui= = Ii5l 60 ft: ma:". �- - Parel.lel to contours I I I 1 a°T I j &" F= SYSTEM .�---- clav ier "- 10 f ., fi notes serer. depth gauges 100 vr. flood elev. 200 ft. reservoir, etc. 150 ft. trigall /gal<l. DATE R,LVL= .vr"D: %® 4 BY . DCCUMOITS Pen, Ut Application Corporate Resolution Plans - Three sats Engineers A.uthorizaticn Design Data She--t (DDS) Deep Hole Lo Consistent Perc Res-,f Perc Hole Depth ef s, s SUBDIVISICN Parc (3) Fill c3 �e House Plans - Two sets Well ?vs Variance R -=uest GJ.:,LYil.1 -L Leal Subdivision Subdivision. Approval Cherk--.c Ex -a_ aroval SSDS Ad . Lots Che^.': -d Wetland (Tcw-n/DEC Permit R & D) Data Cn DDS Plans & Psrmi t Sa Ls REQUIRED DETAILS : CN PT -?�1S Swinge System Plan - ( north Sewage System iivdraul i c Prof ile - Gravity F1cw Fill Profile & Dimensions - Vbj-, .s D o ;Trenca /C-al1 ery; Pwp pit-- de moils Septic Tank Size, Detail Well Detail, Service Line if over .ca„s4n;:ctier_,L`:oss :(ender' Design Data: perc and deep resu is Two -Foot Contours Existing & P_ccosed Drive'aay & Slopes Cut Footin /Gutter,Curtain Drains (discharge OK) Perc & Denp Holes Located Representative of primary and expansion Expansion Area; shown; gravity flcw,suff. size .roped Pit & D Box Shcw-n & Detailed House - No. of Bedrooms Wells & SSDS's Win 200 ft. of Proposed Systan. Property motes & Bounds House Setback Necessary (Tight lot) House Suer - 1 /4 " /ft. 4 "0; Zy_ ce pipe No Bends; Max. Bends 45° w /cle=nout SEPIWMON DISTA K''ES SPECIFIED CN PLAN Fields 10' to P.L., Drive-Nay, large Treees,Too of fi. 20' to Foundation Walls 100'.to Well; 200' in D.L.O.D, 150' pits 100' to Streari, Watercourse, lake (inc. erg: 15' to Drains- Curtain, leader, Footing 35'to catch basin,storindrain,pici watercour. 10' to Water Line (pits -201) 50' intermittent drainage course Septic Tanks 10' fran Foundation; 50' to well NAM` DIVISION OF ENVIRONMENTAL HEALTH SERVICES John M. Simons, M.D. Deputy Camnissioner of Health FIELD ACTIVITY REPORT - Sheet of INSPECTION NAME Orig. Routine . .... Orig. Cmplain ADDRESS Orig. Request No. Street Town IM No. Cmpliance Complaint: Camp MAILING, ADDRESS Final P.O. Box Post Office Zip Code Group Illness Construction 0404A *573,15 Reinspection PERSON IN CHARGE Field, Sampling Only OR INTERVIEWED Field Conference, Nam and Title Other DATE_,� TYPE FACILITY TIME ARRIVED 42 t2!f2-- TIME LEFT Explain FINDINGS: INSPECTOR: Signature and 11 PERSON IN CHARGE OR IN1'ERVI3VW'i' I acknowledge this Field Activity Report. SIGNATURE: r /OC rPT'Pr.P - 1° .J U L— 1 6— g 1 T U E 16:42 R O A D W A Yr C O N T R A C T I N G DEPARTMENT Of HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225-0310 T. Michael Daly, P.E. Box 243 Shenorock, New York 10587 January 30, 1991 Re: Failing Sewage Disposal, System Bannor, Lot #5 Hunting Ridge 10 Miller (toad (T) Put:iarn Valley TM# 62 -11 -24 P JOHN KARELL Jr . P.E.. M S Publle M001th DlrOetor Dean�:Mr. Daly: Receipt of plans dated January 29, 1991 for the repair of the above taentioned sewage disposal system is hereby ackncwled;;ed. Review of such plans and Departmental inspection reports indicates that the south Bide of the original sewage disposal system continues to fail, even though -the trench pipes on this side of the area have been blocked. The plans indicate that s. portion of each trench will be excavated on the south side of the original �. ... •. _•_ ' -. -... ... ._ _...... �... .... ..- .- .._„_;z.. -Y _.. _. �.— :+.- ..- .._�.. .... ... ,.. ...... .. � _ .. .. Cam.- n ... —..-.. ... junction boxes (5) and this area filled with a compacted clay sufficient to prevent flow." If the assumption that effluent is flowing around the original junction boxes is correct, the proposed clay barrier in each trench appears to be a reasonable solution. This should allow the original 200 lineal feet of absorption trench on the north side of these junction boxes as well as the new 500 lineal feet of absorption area, to function as designed. You are hereby advised that the Department feels that the proposed work represents a reasonable approach to correct the problems experienced with this system and therefore has no objection to the proposed repair with the following conditions. 1. All proposed repairs be completed within five (5) days of receipt of this letter. 1. Considerable care be taken in placing the clay to insure that all flog to the trenches on the south side be prevented. 3. Th cavated or otherwise disturbed areas will be seeded, raked and mulched. o soil. If th s cannot be complete a time, an extension will be granted until April 15, 1991. 9 1 :q v �' - .. ,. ;_ � r. : p..> .,.r, «n: ..�mv- � .. •: �. .. . _ .- r ; - r .. it r....; ...: . �: ,..:� 'v . .:.� _':... . :.}.'� .... ..«..: -.-av { � „gin F �-�i- '�:� -2_ 4. That the property owner be advised of the construction schedule. 5. That a representative from your office ire present during the construction period. b. That the Department be advised of the date of the proposed work if you have any questions concerning this mutter, please contact me at your earliest convenience. V ry tru y yours, n 'ar L JK:WE ublic health Director cc:Robert Bannon, w /anc. BI (T) Putnam Valley w /enc. Howard & Mark Winerman w /enc. 1 1 j 1 � J I, 1 .T UL— 1 E—'9 1 TUE 116 1--41 ROADWAI ROBERT W. BANNON �_.. h. -. A`1 "JP69NICY'AT I..AW 10 MIT3.1ru Ro %11 PUTNAM VAT.I.L"Y. A.Y. 10579 *141 52wo17v July 16, 1991 Putnam County Health Department Division of Environmental Health Services 110 Old Route Six Center Carmel, N.Y. 10512 Att: William Hedges RE: 10 Miller Road Putnam Valley (TM #62-11 -24) Dear Mr. Hedges: This will confirm our telephone conversation of July 15, 1991 regarding the restoration of the lawn area above the leaching; fields of the above referenced premises. As I advised you, Devon had two laborers, who did not speak any English, throwing seed on the &Aturbed areas. This is not satisfactory and will not result in the restoratic> F ": my ont lawn nor provide the necessary ground cover for an operable leaching field system. Additionally, it does not comply with the requirements set forth in Mr. Karell'r: January 30, 1991 letter concerning the necessary repairs to the system. In this letter, Mr. Karell states that "all excavated or otherwise disturbed areas will be seeded, raked and mulched, and provided with top soil." It..is _:ny :understanding., that your _Department haa...s -written agreement - from- -Devon -Development that they will restore It he area in accordance with your Department's prior written directives. I expect your Department to use whatever administrative remedies available, including the levy of fines, to enforce this agreement. If necessary, I will retain a licensed landscape architect to formulate plans for the proper restoration of the area. I think this is unnecessary since it is standard practice to place top soil prior to seeding. Please advise me concerning your Department's plan to enforce your agreement with Devon. RWB /dd cc: J. Karell Public Health Director w /Attach. Ve my y u ^, UA ROBERT W. BANNON In , TMM J U L- --- I t:& I —; 1-1 E 3. en, s- Z 'S F, 0 A D W e2) Y C C-1 N T R ACT I t4 G F' - 0 2 14, NAM V I a VY "MO W1 0 514 on 7. • ULO W, 199.1.. Fotnaw —mi; wealch Deparcizeat UvWo" v: SoWnpental Health Services 110 ON IWO Nix center Carme), 4 1, 14512 ALL: W111fin 4edges or: 1 MIler UK Vu ram Valley (TM 062-11-20 On,r vt j,p4- MY vi - i c"Wrm our telephone convarsitioN a Au t: 15, 1991 regarding :0 restarif i m of the lawn area above the Leavhl"z fields "f the above refer envuo pramisr- !A , advWd you, Deven had cw, W -rurs, who did not sneak av-v Engllhv. thr,wing seed on the disturbed nruay. VhN is not ✓atisfakory and wit) Rot fvm= to Lhe restorMtlan of My Froac Owu or provide the necesemn groomi cover 1 , io leaching field system. 'Adiflonally, It does not Cow- WIth toe ;vq"1vhmcnts set forth in Mr. `ere ll'v lanuary 30, 1991 lector to"Verning the nervuNney repairs to the systwm. In ChN intrar. Mr. Moil states thnt "ill excav"WO or Aherwise disturbed a will be .ceded, raked and mulched, anti providwo wit" top moil." A is my as urstanding that your Depeirtme"i bon a wriccon agreement prior wrl!ry ilrectives, I expect •our Boyartmenr to use whacevai remedius nalkKka, including the levy of One-, to enArce chic ag from Nam reemenf. if WeS-n;V, I will remain a licensed landscaps ArLhUmcc cc formulate pi n, fai chp proper eeaccration of the area. 1 rhi"k this !A unnecessary sinev H is ata"dn-w privctce cc place top soil prior t, seeding, Nease Wst me concerning your Departmunt', PlAs to enforce your agreeinwri Wich IV,,.! ly RONIT W. WNCE RWO do cc; 1. f4rt�vk Public With Director Witney'' U L- — I 6— 9 I T U E 1 6 : 3r_4 - ROAD W Ay T. Kiclhai, I I Bu,x 24,1-- Ne- York t 0 t4 a Deaf K-_ : Daly. CON TR PI 07 1 NG R . 03 OEPAPTiMENT Oi HE-AI TH ear, 19141, 2211103:0 janmary .30, JE,�491 Re: Failing S8.4p-&4 Di$pwal Sy6i-e-j B-- -MQV, LO: {Id- - 'Rumttn3 Rifdge 10 Ioad (T) Pj-, -im V4'Upy TiI# 'UPik 'kAq- J P"til- qJ181:h azu 5 %*Af a c ed nu a ry 1 of Lhu above mez-, 4Q, dt4posai gyqt.em I.s- h .ereby Revltv Of Such ulans ar'd Depattwan- 1 side of che oz-�t rOPO"3 tbQr the South to f-Rilt eve en tho-t:gh-the pipps VJis SIde of ey e e e r,.- -b I Cr)��S Vu 11, an 4 e, or 6V t Q boxes 8 Ild th j 1 ed 1 11 a i; oopa c, t e d aY ♦u c it r, t to L ZQ" ra ow, SC Se. vf?1I ins zbj,npti,n a:"ea, to 3 5 deqiyncd< the or chi� JS f ""ed that C'tle �eYiarctlent f;:eI.53 L" IC the proposed �,Yor� 8 rea$-nn-0tF 1e appn>ach to with thts '-a,; 110 objecti".)n toc� ti -'al'i-41"I the, follow wich.11,7 flva (,S' race-jpt of ch4.,q L 17are be '8� e,-j Jr P16ci,g tay Z!, 1.3 Sure thac r:. 3 c P-P-che S 0a the Isouch side be prevt�ateS, TAX14 r., the -V 3; 'r!AZ-.PL1J-4-X—c�Vated Or othenwl Se 8 'be t -i-RP S I-. I ; , :iii exten.j!,on v1_11, be 3 rancc U L I T U Ez" 1 6 0 P4 D WA 9-3 4 4, Tewt the propeTry ow-er bit advised -�A tEe construction softedljjLe. Oroc. yovr oluce bo pzeaent dijriag the coostructIOD 6# That the Depar,mevt be advised of the Bette of the proposed work this marter, please cow-act to at your It yov have any qvtastioav c=tzrnint, earliest conveaienee, J4; MH i FuAsra Valley V/tnc. i %ark Winemari 'r-I nc; ry tru y )ours, .ubllc' Heldh Dfractor TELEPHONE Re'inspection PERSON IN CHARGE Field, Sampling Only OR INTERVIEWED Field Conference Name and Title Other DATE Z2 TYPE FACILITY .'�OE z°S TIME ARRIVED ��r 2 TIME LEFT % f �� Explain FINDINGS: NEVISOR - - �s' INSPECTOR• / Signature and Title PERSON IN CHARGE OR INTERVIEWED: I acknowledge receipt of a copy of this Field Activity Report .................. LEPHONE : I -i SIGNATURE: TTTT,F Al PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES John M. Simmons, M.D. Deputy Commissioner of Health - FIELD.ACTIVITY REPORT - Sheet of NAME r INSPECTION Orig.. Routine ADDRESS �c� -- j g7� %rc �T o/ Orig: Complain, Orig. Request No. Street unicipa itl y (T)(V)(C) Compliance Complaint Comp MAILING ADDRESS Final P.O. Box Post Office Zip Code Group Illness Construction TELEPHONE Re'inspection PERSON IN CHARGE Field, Sampling Only OR INTERVIEWED Field Conference Name and Title Other DATE Z2 TYPE FACILITY .'�OE z°S TIME ARRIVED ��r 2 TIME LEFT % f �� Explain FINDINGS: NEVISOR - - �s' INSPECTOR• / Signature and Title PERSON IN CHARGE OR INTERVIEWED: I acknowledge receipt of a copy of this Field Activity Report .................. LEPHONE : I -i SIGNATURE: TTTT,F Al P.O. Box 71, Yorktown Heights, N.Y. 10598 (914) 737 -6200 fax: (914) 736-6581 Mr. William Hedges Sr. Public Sanitarian Putnam County Board of Health 110 Old Route 6 Center Carmel, New y0rk 10512 April 10, 1991 Re: Sewage Disposal.System Lot 5 Bannon Hunting Ridge FM 2276 TM 62 -11 -24 PV -34 -88 Dear Bill, On your suggestion i am writing to request an extension of the 4/15/91 deadline set by your office as completion date on the above referenced matter. We request a 30 day extension as per your discussions with Tom Daly to allow time for the new system to function and to.determine if it functions properly. Pleas e.coiifirm the extension, when you plan to inspect the system, etc., so we will know when to seed the area. Your consideration is greatly appreciated. Sincerely Howard Weinerman HW:sm cc: T. Michael Daly Robert Bannon 1 h= DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old, Route Six Center, Carmel, New York 10512 (914) 225 -0310 April 15, 1991 Devon Development Co. PO Box 71 Yorktown Heights, NY 10598 Re: Sewage Disposal System Lot 5 Bakery Hunting Ridge FM 22 -6 TM #62 -11 -24 PV34 88 Dear Sirs: bilk JOHN KARELL Jr., P.E., M.S. Public Health Director I have received and reviewed your request for a 30 day extension (from April 15, 1991 to May 15, 1991) to complete the seeding /mulching on the above mentioned parcel. My last field inspection, on April 11, 1991, revealed an.' area near the end of the 5th original trench, on the south side of the system, that may require additional work. This portion of the system should be removed and filled with original soil, as was done at the end of trench #3. Please be sure that this area is repaired within the next ten days (by April 25th, 1991) so that the area can be monitored for a reasonable period of time prior to grading and seeding. Therefore, a 30 day extension will be granted by this Department 'with' the 'following- - conditions: a) the area of trench #5 is repaired by April 25, 1991. b) all grading and seeding must be completed by May 15, 1991 The hearing, scheduled for May 1991, is hereby rescheduled for June 4th, 1991 at 10 a.m. If you have any questions, please contact me at your convenience. Very truly yours, William Hedges Sr. Public Sanitarian WH /jp cc: T. Daly, P. E. Robert Bannon, 10 Miller Road, Putnam Valley Bruce Foley, Enforcement Office, PCHD BI (T) PV I .PUTNAM; 00UNT;Y Imo' TH DIVISION OF ENVIRONMENTAL HEALTH SERVICES John M. Simmons, M.D. Deputy Cam issioner of Health - FIELD ACTIVITY REPORT - Sheet of INSPECTION NAME �� f%1j Orig. Routine / Orig. Complain ADDRESS % � / � /� Orig. Request No. treet Town No. _ Canpliance . Camplaint Comp MAILING ADDRESS. �G �� �' "C "� Final P.O. Box' Post Office Zip Code Group Illness Construction oYoi U.� +i PERSON IN CHARGE OR INTERVIEWED Name and Title DATE �, �~ TYPE FACILITY 0 TIME G TIME LEFT Reinspection Field, Sampling Only Field Conference Other Explain FINDINGS: F /7,"77 - _ v INSPECTOR: TELEPHONE: Signature and Title PERSON IN CHARGE OR IN 'ER VIE WED_ : I acknowledge this Field Activity Report. SIGNATURE: 6/86 TITLE: John M. Simmons, M.D. PUTNAM COUNTY HEALTH DEPARDENT- DIVISION OF ENVIRONMENTAL HEALTH SERVICES Deputy Canmissioner of Health - FIELD ACTIVITY'REPORT - Sheet of INSPECTION NAME c d� <� c,,-, Orig. Routine Orig. C:canplain ADDRESS z�- 1-4 5 f' <�� -°-- i'f Orig. Request No. Street Town TM No. _ . Ccmpliance _ Complaint Carp MAILING ADDRESS ��� `� r Final P.O. Box Post Office Zi Code . Group'Illness Construction TELEPHONE PERSON IN CHARGE OR INTERVIEWED Name and Title DATE c TYPE, FACILITY TIME ARRIVED TIME, LEFT ' FINDINGS: Reinspection ' Field, Sampling Only .Field Conference Other Explain i INSPECTOR :. �49) cz- 'J Signature and Title PERSON- IN- CHARGE OR INTERVIEWED: . I acknowledge this Field Activity Report. SIGNATURE: 6/86 TITLE: TELEPHONE: A• `b 1 DEPARTMENT OF HEALTH Division Of. Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225-0310 T. Michael Daly, P.E. Box 243 Shenorock, New York 10587 January 30, 1991 Re: Failing Sewage Disposal'System Bannor, Lot #5 Hunting Ridge 10 Miller Road (T) Putnam Valley TM# 62 -11 -24 JOHN KARELL Jr., P.E., M.S. Public Health Director Dear.Mr. Daly: Receipt of plans dated January 29, 1991 for the repair of the above mentioned sewage disposal system is hereby acknowledged. Review of such plans and Departmental inspection reports side of the original sewage disposal system continues to trench pipes on this side of the area have been blocked. a portion of each trench will be excavated on the south. and thkg area _f_illed wffi i compacted prevent flow." indicates that the south fail, even though the The plans indicate that side of the original. _clap 'tsu- ff�cient _to ._- If the assumption that effluent is flowing around the original junction boxes is correct, the proposed clay barrier in each trench appears to be a reasonable solution. This should allow the original 200 lineal feet of absorption trench on the north side of these junction boxes as well as the new 500 lineal feet of absorption area, to function as designed. You are hereby advised that the.Department feels that the proposed work represents a reasonable approach to correct the problems experienced with this system and therefore has no objection to the proposed repair with the following conditions. 1. All proposed repairs be completed within five (5) days of receipt of this .letter. 2. Considerable care be taken in placing the clay to insure that all flow to the trenches on the south side be prevented. 3. That all excavated or otherwise disturbed areas will be seeded, raked and mulched, and provided with topsoil. If this cannot be completed at this time, an extension will be granted until April 15, 1991. O. _2_ 4. That the property owner be advised of the construction schedule. 5. That. a representative from your office be present during the construction period. 6. That the Department be advised of the date of the proposed work If you have any questions concerning this matter, please contact me at your earliest convenience. i JK:WH:p cc:Robert Bannon, w /enc. BI (T) Putnam Valley w /enc. Howard & Mask Winerman w /enc, V ry tru y yours, n ar 1, r. . . ublic Health Director ILI .9 pvt 4. WV �i' An'v e�z ZVI-, A17" I T ILI .9 pvt 4. WV �i' An'v e�z ZVI-, A17" I -:PUTNAM,,, CO(TNTY.-liFALTH..DE.P.ARr-MEN.T DIVISION OF ENVIRONMENTAL HEALTH SERVICES John M. Simmons, M.D. Deputy Commissioner of Health FIELD ACTIVITY REPORT - Sheet of INSPECTION NAME '0" Orig. Routine Orig. Cmplain ADDRESS Orig. Request No. Street Town TM Nd. Compliance Ccmplaint Carp MAILING ADDRESS Final P.O. Box Post Office Zip Code Group Illness Construction TELEPHONE Reinspection PERSON IN CHARGE Field, Sampling only OR INTERVIEWED Field Conference Name and Title DATE TYPE FACILITY TIME . ARRIVED TIME LEFT P Other Explain 010v goF OP 0-d-r INSPECTOR: PHONE: Signature and Title PERSON IN CHARGE OR INTERVIEWED. 4 I acknowledge this Field Activity.Report. SIGNATURE: 6/86 TITLE: #40 John M. Simmons, M.D. k.T , .:. .a.- �C;(: �3NTY-�HEAI "THl�.DEPAR'I�EN`�I' -� Li-vi-OWN yr ENVIRONMENTAL HEALTH SERVICES Deputy Cm- missioner of Health - FIELD ACTIVITY REPORT - Sheet of INSPECTION NAME Orig. Routine Orig. Canplain ADDRESS c/ (( Orig. Request No. Street Town IM No. Compliance Canplaint Cmip MAILING ADDRESS Final P.O. Box Post Office Zip Code Group Illness Construction TELEPHONE Reinspection PERSON.IN CHARGE Field, Sampling Only OR INTERVIEWED Field Conference Name and Title DATE TIME ARRIVED Other TYPE FACILITY TIME LEFT acplain INSPECTOR: Signature and Title PERSON IN CHARGE OR INTERVIEWED: I acknowledge this Field ActiVity:Report. SIGNATURE: 6/86 TITLE: TELEPHONE: �.�. •r � r ,.T 1 , .4_ • 't .. .. ..as,.r..a ..iia.�. ..� n+ii`: i •-- .tr:<.; �,y,� �.r. DIVISION OF ENVIRONMENTAL HEALTH SERVICES John M. Simmons, M.D. Deputy Commissioner of Health - FIELD ACTIVITY REPORT.- Sheet of NAME �� ey INSPECTION Orig. Routine ADDRESS �' �'^"`� _ Orig. Orig. Cmiplain Request MAILING ADDRESS P.O. Boat Post Office Zip Code Canpliance Complaint Ccmp _ Final Group Illness J4 Construction TELEPHONE Q' nspection PERSON IN CHARGE Field, Sampling Only OR INTERVIEWED Field Conference Name and Title ��� Other DATE TYPE FACILITY TIME ARRIVED .� �� TIME LEFT 1 ! Explain INSPECTOR: TELEPHONE: Signature and Title PERSON IN CHARGE OR INTE'RVIEWED:.` I acknowledge this Field Activity'Report. SIGNATURE: pul DIVISION OF ENVIRONMENTAL HEALTH SERVICES John M. Simmons, M.D., Deputy Canissioner of Health- FIELD ACTIVITY REPORT - Sheet of INSPECTION NAME � e—z-7 Orig. Routine ADDRESS No. 11-z I .1 1 MAILING ADDRESS P.O. Box Post Office Zip Code Orig. Ccmplain Orig. Request Canpliance Canplaint Comp Final Group Illness Construction TELEPHONE Reinspection PERSON IN CHARGE Field, Sampling Only ;-"OR Field Conference Name and Title Other TYPE FACILITY DATES TIME LEFT- 5cplain A TIME NGS: 5 Cy INSPECTOR: TELEPHONE: Signature and Title PERSON IN CHARGE OR --- I N TE, R-V,I-E- WED:- I acknowledge this Field Activity Report. SIGNATURE: 6/86 TITLE: I MICHAEL DALY, P. E. COtZiUft! , nQ En din - EVE (914) 628-0507 BOX 243 SHENOROCK, NEW YORK 10587 January 29, 1991 Memo: Putnam County Department of Health 110 Old Route 6 Center Carmel, New York Att.: Mr. William Hedges Ref. Hunting Ridge - Lot #5 Dear Bill: Pursuant to our conservation, I am enclosing a sketch of the proposed repair. The SDS fails on the south side of the old SDS, even with the boxes blocked. The north side of the old SDS is O.K. Therefore, block off the south side of the old system with a sufficient amount of.clay to prevent flow in this area. Very truly yours, ichael D P.E. TMD; pd ,.<�UTNANt ^V�IViYT`Y 1H AL1H %LL DIVISION OF ENVIRONMENTAL HEALTH SERVICES John M. Simmons, M.D. Deputy Commissioner of.Health - FIELD ACTIVITY REPORT - Sheet of -, INSPECTION NAME 107 _ Orig. Routine � �%�" _ Orig. Ccmnplain ADDRESS Orig. Request No. Street Town✓ TH No. Canpliance MAILING ADDRESS Q /'"�',e f'^� —_ Fina Comp P.O. Box Post Office Zip Code Group Illness TELEPHONE PERSON IN CHARGE OR INTERVIEWED _ Name and Title DATE TYPE FACILITY TIME ARRIVED ° , ,,%. `� TIME L ,'r�T FINDINGS: Construc. ion Reinspection Field, Sampling Only Field Conference. Other Explain ._._ mot....',• _ ,. _ -. _ • -'a ..`.:' ... _:.A.. -..... + - a TELEPHONE: Signature and Title IN CHARGE OR INTERVIEWED: Report. SIGNATURE: 6/86 TTTr.P e /Vo -fie lkA j Z;� dr- b Alm pt ra ®r 0- loco • - i�V j y rr•we POW- John M. Simmons, M.D. PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF' IROME;N1'AL °H ",kM SERVICES Deputy CaTmissioner of Health - FIELD ACTIVITY REPORT - Sheet of INSPECTION NAME Orig. Routine ADDRESS r� �� �� �/ ,f�C/ Orig. Complain Orig. Request No. Street Town TH No. Compliance MAILING ADDRESS 6 �c /� ar S� ` .� �� ,� .� � _ Complaint Comp Final P.O. Box Post Office Zip e Group Illness _ Construction PERSON IN CHARGE OR INTERVIEWED _ Name and Title DATE �/ ��/ �� TYPE FACILITY TIME ARRIVED " / e TIME LEFT 7/ Reinspection Field, Sampling. Only Field Conference Other Explain FINDINGS: /r_/ / / / I,- v '! � D d d/ Gi S / Q/ 5-0 ""'� .�'� d.e La C INSPECTOR: TELEPHONE: Signature and Title I „ PERSON IN CHARGE OR INTERVIEWED: I acknowledge this Field Activity.Report. SIGNATURE: 6/86 TITLE: ¢•� PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES Simmons, M. D. Commissioner of Health - FIELD ACTIVITY REPORT - Sheet �-- of INSPECTION NAME e'21 %1''a Orig. Routine -- _ Orig. Ccenplain ADDRESS Orig. Request No. Street Town �1 No. Compliance _ NO;�r, Camplaint Comp - cx�..xw — SNAILING ADDRESS Final P. O. Box Post Office Z ip Code _ Group .Illness Construction ��TELEPHONE x Reinspection V 610Z' APERSON IN CHARGE Field, Sampling Only ORI TE�tVIE�IED — Field Confereance �A Name and Title � a - Other DATE S TYPE FACILITY TIME TIME LEFT Ecplain `��F�INDINGS; ',S ✓ c G3 . 3, i / Q ah. � f, 10-117 e-0-2 %' �' G'.. ✓'� 'i - mss` -�-�, ais -'�7 V C !sue >•'1 .�t3s �fbo a ,a { INSPR TELEPHONE: Signature and Title ERSQNIN- CHARGE OR INTERVIEWED- e ss this Field Activity Report. SIGNATURE: ANIL ',S ✓ c G3 . 3, i / Q ah. � .�t3s �fbo { INSPR TELEPHONE: Signature and Title ERSQNIN- CHARGE OR INTERVIEWED- C, Owl R. this Field Activity Report. SIGNATURE: 'k6f 86 TITLE: 3 0 PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES .-M.''Sinux)ns, M.D. -DeDutV,Ccmnissioner of Health FIELD ACTIVITY REPORT - Sheet of - DATE TYPE FACILITY TIME TIME LEFT. -FINDINGS 9- 42e-7 e" 22 INSPECTION Orig. Routine ADDRESS - /6) RA Orig. Complain Orig. Request 0 Street Town T-K No. Compliance Cariplaint Comp �kAILJNG ADDRESS Final P.O. Box Post Office Zip Code Group Illness Construction TELEPHONE Reinspection � PERSON j cHARGE Field, Sampling Only 'OR INTERVIEWED Field Conference Name and Title Other - DATE TYPE FACILITY TIME TIME LEFT. -FINDINGS 9- rz Go R%4 ge OR s F 777 2" Signature and Title INTERVIEWED: v TITLE: WIVA -1 0 Explain C/ e"' RA rz Go R%4 ge OR s F 777 2" Signature and Title INTERVIEWED: v TITLE: WIVA -1 0 Explain C/ e"' _ .. awl' J �. — _ "' ef `l/ JF�k�n 2oa?_ r lnn i! PUTNAM COUNTY DEPARTMENT OF HEALTH NOo ®862 -90 -19 TOWN SFRIJTG— .J�E%LZ4T . RECORD _..... ,i Putnam Valley DATE 11 -14 -90 REFERRED TO TAKEN BY J. Hopper TELEPHONE CALL ::.: IN PERSON LETTER x fax CONFIDENTIAL REQUEST FROM Robert Bannon ADDRESS TELEPHONE ENVIRONMENTAL HEALTH: Home Sewage Rodents Refuse Public Water Food Service Migrant Camp Other COMPLAINT OR REQUEST Failing subsurface sewage disposal system Failure is in the same area of the fields. as the previous leak. See complaint #119 -90 -19 and attached letter. Directions- Peekskill Hollow Rd., to Miller Rd., lot #5 TM #62 -11 -24 ACTION TAKEN BY S d ► DATE�i FINDINGS O`G% fl �J J q✓.v FOLLOW UP INSPECTION ts) DATE FINDIN %GSS " / Y/� C=P( S DATE k-?'- f��� PROBLEM ABATED DATE PERSON NOTIFIED ESTTMATED TOTAT, MAN HOURS SPENT Rol mfi.T W BANNON 10 M11J,VN WOAD 1'+ ITNAbi Y. 10570 411C .°,-''14.111 7: December 17, 1990 Putnam County Depzrtment of Wealth ntt 1 Mr. Wi .I 1 tam Hodges RE, 10 Miller Road Puttlam Valley, N.Y. Dear Mr. Hedgeii- This wi 11 confirm my December 14, 1990 telephone conversation with John Hopper of your of'ficc. I explained to Mr. Hopper that I have talked with you on several occasiogsv, concerning the above ref`reaced septic system and that I advised you it w s failing. L regge:,rvd thst�.`a formal enforcement actlnn be instituted immediately with all resp( iii4tble ;parties brought into the action. This includes the developer and the engineer „; „responsible for the deAlgn. T1 Fact Fact time some work is done, the system is to advis u you chat the system is failing. appropriate that the system be tested with not takv months to have any action taker:, �I”; �'� � 1 • th �. e�'- xxraiy�? eu1".:��1s�- eLn-'tra'�t"� ��":` not tested and it is left up to me In the future, I. think it would be all. panties present so that it does i Finally, alt our last hearing, Zaidk s ",indicated, Shat the area mu7t be g're'dt" "d and; ��eaed.,, ;- Alt_hou-gh .-the developer did do phis work, the wbfk`Ke dD �washed,-'out.f�n a f�t:orm several days later: t= =rxnec �tira.t" fl— d"- ompd- i-ance certj.f icatcs w I I %'be �issuetl un"titl Judge raiden.'s ruling is adhered Co. I e pgc7t- I .rII I he hearing fW-=6 9- �c1PconrerninF ;a fnrmni-h"eAr.ing,dat.�►_� the �- rea�fLlt Very truly yours) i ROBERT W. BANNON RWBfdd A•r•tORNKY AT LAW tU 141t.t,li;lr .,., ., .__ - :,,, -.a -- -- _..�_ . `- •- E'E TNAtiI t'Af.lXi, NN, 10.'i70 M14t :52H.0i V Putnam County Dep @rtmen;t of Health Division of l.nvironmantal Health Services 110 Old Route Six Center Carmel, New York 10512 Att: Mr. William Hedges Sr. Public Sanitarian Dear Mr. Nudges: November 13, 1990 RW; Case 119 -90-19 TMI #62 -11 -24 10 Miller Road Putnam, Valley, N.Y. 10379 Per your November 6, 1990 telephone message, you have advised that the County enforcement action relative to the /s�tptic system for the above reference,] prem�t as was. cpnvlud•eA sod I -"presume that you feel the system Be � ! 1. � . ti.. � 3/ i is it', complin'Mra. e ad Lsed'th .t there is a visible a d ubs .�rtlt2w leak �a fXu f4t? O exaC[ f,� ,t.. �rhatnet failu%evwas determined. Although this may not be eff :I.uent , it cues i dlcete the preseAc /�£ waarei in/the leaching £ialcis ,a +zd, as such, ; f dude trr - another failure= ' 7 18st- weuke�, due to •the heav +rains and d, m �e t.i €-ront y " &r� way we€ired` LL<dvin`g-'nutne cus -' anrEel`s` t`h� ou h tl:e tc�lssoil. Several of these channels are.. die,p, +rn >ugh:Ft.o..have ` rea,ehe.d 't-he- t rrl4llmrr u/ding t•h'e`'"ieaching fields. It should be noted that Devon elected to price seed with a hay covering on as steep slope instead of using a more weather proof application such as hydre- seeding. The type application used is prone to failure should a heavy rain occur prior to the seed taking hold. This is exactly what happened. Please bL advised that I do not consider the system to be in compliance +car the following reasons and hereby request another field inspection: 1. Trap sol l and seed washed cut thereby leaving the leaching fields exposed to further soil erosion. 2, The presence of substantial and Continuous water flow in the Area of the leaching fields in the exact location of the previous leak. Vil'I'am Redjzas- er 3, Fal lure, to restore areas disturbed by the test holes dug at your . direction. Should your irlspection substantiate the ahcva conditions, 1 request zhalc you withdraw your compliance certificate and schedula anothiar hearing in accordance with Judge Zaiden'sorder. Very truly yours, ewW RWBIdd John M. Simmons, M.D. PUTNAM_COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES Deputy Commissioner of Health - FIELD ACTIVITY REPORT - Sheet of INSPECTION NAME c '4V ory G'y7 Orig. Routine C � � �� / Orig. Complain ADDRESS // g Orig. Request No. Street Town ' TM No, Compliance _ Complaint Comp MAILING ADDRESS �� _� Final P.O. Box Post Office z! Zip Code Group Illness Construction WN-511RIT 17 PERSON IN CHARGE OR INTERVIEWED Name and'Title DATE TYPE FACILITY TIME ARRIVED % r j c;'/ TIME LEFT / T FINDINGS: l Reinspection Field, Sampling Only Field Conference Other INSPECTOR: TELEPHONE: Signature and Title. PERSON IN CHARGE OR INTERVIEWED: I acknowledge this Field Activity Report. SIGNATURE: Explain ' " qo c 4v iro OF TRUCTED AS INDICATED. ON, THIS PLAN AND THAT 1141i 413 T WAS COVERED OVER, SYSTEM WAS CONSTRUCTLEr IN ACCORDANCE.-W.111i ALL THE RULES AJ�M,'RP7lUL&TIONS -.Of- THE PUTNAlA couNTY, bOP CIA PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES r`1 . .4- :.ar.•• s,ai +.w` -. PROPOSAL :[:L:4'i:R3PA33{r: °:?rx. .1 ::+w :: ✓;n'�.ac:- .a...: :.Gw: Via... w. OWNER'S NAME R©bJa:Y'+ soo\ -Yeam PHONE I4� -S� Zg "6122 SITE LOCATION er y To % -3 o Z — 3 MAILING ADDIESS PERSON INTERVIEWED Rabe-r-+- '7Cc,A^ 1— ©lU he? n PCHD Complaint # Name & Relationship (i.e, cwner,tenant, etc.) DATE Ao r i 7 1 D Z TYPE FACILITY PROPOSED INS!TALLER Laois rdlI °4- SOh. &AVG "t- VC-JIO,K fW-.P TONE =,736-,�010 REGISTRATION # Pc— 5-60 " 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 fram licensed professional engineer or registered architect. N _ - Proposal approved Proposal Disapproved Inspector's Signature & Title : to Iroposal 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 (e.g.,house oorners). d. System description (e.g., 1250 gal. concrete septic tank, three precast 6' diem. x 6' deep drywells surrounded by one foot + gravel). e. Installer's name and number. 3. System repair to be performed in accordance with the above proposal and conditions. I, as owner, a agent of owner agree to the above conditions. °1 SIGNATURE TITLE DATE 1,4 PIS: Wiite (MV; Yellow MiAn ED; Pink (kTUaaV -) PC -RP 97 r' PyUTNAM COUNTY HEALTH DEPARTMENT SI - F* •wE - R�% ���ET.EMWI= (' . fr L"2.�:C.f•4: - - • ..e4t .C^ • 225 =0310 PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPAIR OWNER'S NAME Oeyeri _D4yrcoPw j ► PHONE _73'7-Woo SITE LOCATION o i de'1; W,0E'0- P0, Pv tJA11 V41_ y _ I U y . TO MAILING ADDRESS PQ. &,X YoPkiuwa H6jJK_ &J-h, PERSON INTERVIEWED 140W V41 WJ iN E2,N -fi Q PM Complaint # Dame & Relationship (i.e, owner,tenant, etc.) DATE TYPE FACILITY J�E�in9G PROPOSED INSTALLER 19U.-PRO. kn 0I)CR PHONE 73 7 - !?( k& 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. RE coos)7p oc ,f_ a t �a Tr on 3 Proposal approved Inspector's with the Proposal Disapproved conditions: t 0__ E5�1 to 1. Procurement of any 'lawn permit, it appiicarae. 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 (e.g.,house corners). d. System description (e.g., 1250 gal. concrete septic tank, three.precast 6' diam. x 6' deep drywel.ls surrounded by one foot + gravel). e. Installer's name and number. 3. System repair to be performed in accordance with the above proposal and conditions. I, as owner, o e agent of owner agree SIGNATURE OOPt�'SA TAbite (PCHD)4 YeUcw (fin HL): Pink 0ppliamt) to the above conditions. TITLE DATE