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(FORMERLY) (NEW T.M. #)
RAY RAiNALLI 58 73,5
Owner or Purchaser of Building Section
I -z - -. -: RAY RANALLI - _ -� . 1,.."
Building Constructed by',' Blo`c'k
KNOLLS ROAD
Location - Street
TOWN OF PUTNAM VALLEY
Municipality
ONE FAMILY RESIDENCE
Building Type
9
Lot
Subdivision Name
Subdve. Lot '#
GUARANTEE OF SEPARATE SEWAGE SYSTEM.
12
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 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 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 th6,"wi :llful or negligent. act of the occu-
pant of the building utilizing the system.
The undersigned further agrees to accept as conclusive the determin-
-at- ion - -of- -the Director of_; the D"ivis"ion. of Environmental. Health Services _. ..... -._,,. 1. of the Putnam County Department, of Health_ a,s the or not f i1_=
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 g day of ,y 19,{ Signature
Title OWNER
Corporation Name if corpo)
Address
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
LAB #
Yorktown Medical Laboratory, Inc. Date Taken: 4 -26 -91 Time: 8:45AM
321 Street Date Rc' d : I- -2 - Time: : 4 AM
Yorktown Heights, N. Y. 10598 Date Reported. PR. 301991
(914) zas -zaoo Collected By ay Ranalli
DirP.GtBr> .r�LbFE' -dr i6laOVafilsAj'i: 7:'(`i1'CI�J�' : ; _.. FO%�f71Y�nt_.:..v. ? t.r_
Referred By:
Sampling Site: -Laun ry room tap
Ray Ranalli
47 Spruce Knolls
Putnam.Valley, NY 10579
L
J
REPORT ON THE QUALITY OF WATER
INORGANICS (mg /L)
Alkalinity
Chloride
_ Copper
_ Detergents,.MBAS
— Hardness, Calcium
— Hardness, Total
_ Iron
Lead
_ Manganese
— Mercury
— Nitrogen, Ammonia
_ Nitrogen, Nitrate.
_ Nitrogen, Nitrite
_ Phosphate, Total
_ Silver
_ Sodium
_ Sulfate
_- _Sulfide _._..__.
Sulfite- . ,...:....`;..:
_ Zinc
Phone ( )
MICROBIOLOGICAL
_ Standard Plate Count
.(CFU /1.0 mL)
Conform & Related Organisms
Circle Method: MF MPN P/A
Total . Coliformm _ !V
Fecal Coliform
_ Fecal Streptococcus
— E. Coli
For Lab Use)
SAMPLE TYPE:
(Check. -One ). -- --
zPotable
_ Non- potable
OUTGOING
(Check Each)
. HNO
_— HC13
._ HOSO4
NaOH
ZnOAc
Na2S203'
_ Other:
KEY FOR TERMINOLOGY INCOMING:
(Check Each)
LT = < = Less Than /
GT = > =.,.Gr_eat,er. Than_._ _.., _ _. ✓.LE 49C
_NA' __Vo-t'APplicable - . . - _ GT..4 /LE 2_OoC -_
SA = See Attachment(s) GT 200C
TNTC = Too Numerous To Count _ pH LE 2
PHYSICAL/MISCELLANEOUS P = Present (Positive), _ pH'GE 12
N = Not Present (Negative) _ Other:
PH (S.U.) * = Also done because To-
Color (Units) tal Coliform Positive
REMARKS COMMENTS Lab se
Conductance (uhms /c)
_ Odor (TON)
_ Turbidity (NTU)
NYS ELAP #10323
THESE RESULTS INDICATE THAT THE WATER SAMPLE (WAS) (WAS NOT) (NA) OF A
SATISFACTORY-SANITARY QUALITY ACCORDING TO T E YORK STATE PUBLIC DRINKING
WATER CODES, FOR THE PARAMETERS TESTED, AT TH ME OF SAMPLE COLLECTION.
THESE RESULTS INDICATE n1AT THE WATER;:'SAMPLE (DID) (DID NOT) ) MEET THE
SATISFACTORY CHEMIC Q ALITY STANDARDS OF THE NEW YORK STAlipiCOILLECTION. DRINK-
ING WATER CODES, R PARAMETERS TESTED, AT THE TIME OF
x 7 /87(Rvsd1 /90)RWE
A bert H. a ovani, =A), Director
,.WELL' MPUTION REPORT PUTRIARA COUNTY DEPARTMENT OF r9t;AdV9
Division of Environmental Health Sorvicea
1 COUNTY OFFICE BUILDING - CARMEL. NEW YO�V.
s report is• to be completed by well Vriller -and submitted to County Health Department together with laboratory report of.
lysis_oi.water, sample indicating water is of satisfactory bacterial quality before certificate of construction compliance is issued.
- -:� --.gam. �:.�•.�y. _ - -.._.
REPORT MUST BE SUBMITTED WITHIN! 30 DAYS
E , ADDRESS
Ow
LOC id ••� + Street) ocrn) fLot Numbor)
'
OF.. LL
BUSINESS -
PRO ED 'DOMESTIC ESTABLISHMENT FARM TEST WELL
os�. F
�V PUBLIC ' . o AIR OTHER
❑ SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING ❑ (Spocif7)
DRI G W ROTARY ❑ AIR PERCUSSION ❑ PERCUSSION ❑ OTHER
. �t�Ul ENY
CA' S LENGTH (loaf) DIAMETER(1nches) WEIGHT. PER FOOT �jj t: Pd nUT! �
' ®Q l4
THREADED ❑WELDED YES Pd0 YES NO
j HOURS G.P.M, YIELD (G.P.M.)
? ❑ BAILED ❑ PUMPED �/. COMPRESSED AIR
MEASURE FROM LAND SURFACE— STATIC(Spoclly feel) DURING YIELD TEST (Not) tll( � � � Depth of Cemplatod Well
L in foot bolow land surfaces
MAttE LENGTH OPEN TO AQUIFER (loot
S EN
0 ILS SLCY SIZE DIAMETER (Inehes) IF GRAVEL I;P�� ityn woll including. GRAVEL SIZE (inch oa) ROM (tool) TO Ifooll
PACICEDs (Inehos):
DEPTH 4M LAND SURFACE Scotch ouocf locotlon of aoll with dlolancoo, to of /oast
FORMATION DESCRIPTION enrmrinonl landmnrko.
If yield was toalod at different dopths during drilling, list below
1 FEET GALLONS PER MINUTE
i •,
D DAT O REP T WELL DRI
i
i7'
Dture)
- N-A
PA
UTNAIA, CO *
UNT Y DE
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uvfalvon,�, ot,-�&nvlro in
6&WO41th services--- M
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CONSTRUCTION :-� PERMIT-,' FOR
SEWAGE DISPOSAL SYSTEM x Town of -
Putnam
t Town or Village
-P
8 374,2-
Siibdi4lSioh K-n
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n.rii,r
owner Rai an 'gdu.
6 J Area ti
white !"P.1 M
A
y Ml
7
Number 6f Flow r6�n a Tot 'tabie.-sp F�eet
Separate Wi
S
Sewerage 1s�t6m�z' L
:
be constructed 'n(
Matersijow Public From
� L�. Not selected .
r U6Y S b y
7
.Add,
r6
-,0 her,tA
equiremen s
7
M-
:1 'represent 'that FAM-Whbily and. cqMp let 9.y resp that heseparate:,sewage isposal� syst,
,qnsible or the-desig design nd,locat ion 'o A he" pro pg��, �systennj s),L, �-,iv -f -d am,
above described will be constru&6dIiCsrk shown -,"
County
'e- Health,
. .,, he,,ap
p rq
ypq-anen. d menV6er�tj ,- , -
---'
. .09, 0.
: r
-
e g'u
at ions
".-h'e 'P .,
u. x
n:am
u R y Department Hoal th;,ind lhaf6h�� MWe 9P _o fConstructionc qmp anqe,�Mtis actory.jo,the66m m4i6ner'oikei Wi I Iw
'
,pomitted Department and a wri 1 �Ownerj is-suF�assors r ild' tWit14 6iidirwhl
-place,ingow opera ng conqfldh,any )art- d sewage'-,disposal ,sy em,dOng� year�-imM66iaiei;,i6floWir§the date o Assu
W of the Ihe Cortifigate-&., k tk plia n Aqp� 'ig i na I y em -or -ny,rjpairsi h` t e drill'ed:_well described above will be`ldcated as showWon fh an I r Zs qsaRq p6� 'Putnam
A County ,
'X7
Date
ddess License N j- -t
APPROVED ' FOR CONSTRUCTION.
This 46prbvalexpires ,one,
-YeA l a�. A
issued :u , t
k4p" and is
oCamaybe ed Wej,RpQaereo 0 by-,MCCor , r a I rat construction
n
, S" .pew k pern -
domifticc
Date `7
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�'i3'TTA=br I;Gti�� 1 DE PA€TNIEN7' 0
Gentlemen:
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Date May 9. 19 79
Re: Property. of RaV R i n;; 1 1 i
,Located at Knolls Road arid. :Coli ny Road
T.M.
ft Block Lot
This letter is to authorize Noel GreenhRrq
a duly licensed professional engineer or registered architect
(Indicate
to apply for a.Construction Permit for a separate sewerage system; to
serve the above noted property in accordartce with the standards, rules
or regulations as promilgatel. by the Commissioner of the Putnam County
iepar - anent of n7lealti1, and' to sign all nece55ary papers on my behalf in °
connection with this rrattef and to supervise the construction of said
system or
tary Cod
Counters';
R
Gj ,��gRNCI
i �":l.- af� T^I:T
F
•N
P.E., .A., #
ormity with the provisions of Article 145 or
n'
li c . Hearth. Law,.= .
RR #8 Muscoot North (Seal)
Address
914 - 629 -6613
Telephone
Very truly yours,
1
Signed
Ow erl_of Prope_ty
50 Dpyer Ave. White Plai N.Y.
A ress
10605
949 -4243
Telephone
PUTNAM COU'NT'Y DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
`COUNT OFFICE BUILDING, CARMEL, N. Y. 10512
16 19 3 6.3.3.. =21
Notes* ..l) Tp'�ts to,be' repeated at same depth until app roximately equal soil
.rates are obtained at each percolation test hole. A1y data to be submitted
for . reviev.e. i
2) Depth measurements. to be made from top of hole.
TEST PIT DATA REQUIRED TO -BE SUBMITTED WITH APPLICATION
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
DEPTH HOLE NO.- 1 HOLE NO. 2 HOLE, NO. 3
in. ; ^. .�-. 4 _ 4....c �� :. -�•.r- <i- ., y, ,. .n .w.ry :'•; :.� ,,._a 1!' =•✓ ..'- ±...m:.. .'*4���rc^c -��ti� ... i- _..ai.��.., s -�� .•- c..�.:.� .. .
G. L. Tnz Snit Top gnil Tnn RniI
Sand & _lay
n
n
78"
8411
INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED None Encountered.
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED N/A
TESTS MADE.-BY Joel Greenberg Date 4/25%-79
-- .C,a.. -,r- - _ - z . _-.. _ .. <- -. . _ . ,-; . o _ _... ._.. . ' -tea• - z .��. � ... . » DESIGN
Soil Rate Used 21= '3OMin/1''Drop: S. D. Usable Area Provided 5000.
No. of Bedrooms -° 3 Septic Tank Capacity_ _ 200 Gals : Type_Pr ` _ Gam,
Absorption Area Provided By�_L.F.x24 * ""js` width trench.
Other. .. .
KTame Joel 'Greeriberg Signature
Address RR #8''Musc6ot'North SEAL
_ Mahg,Dac- New York 10541
THIS SPACE FOR USE BY71EALTH DEPARTMENT ONLY:
Soil Rate Approved— , Sq. R /Cal.
Checked by
Date
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