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HomeMy WebLinkAbout3524DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 74. -1 -6 BOX 28 03524 a \, f . PUTNAM COUNTY DEPARTMENT OF HEALTH 4 EN CERTIFICATE OF CONSTRUCTION COMPLIANCE SEWA, TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # /may ;Z7 -0l Located atO,ylr����� Town or Village Owner /Applicant Name 17%C17 �/ C�. ace/4 Tax Map _ 74 Block / Lot Formerly Subdivision Name Subd. Lott # Mailing Address 27-33 ZL50re XV Zip /off i Date Construction Permit Issued by PCHD /a/ -,/ / Separate Sewerage System built by 67�16W `vim Cv��' Address Aoi3 -I-r Alva Consisting of %o a y Gallon Septic Tank and �d ,�� 2 ,4 41 e, fr Other Requirements: % / C Water Supply: Public Supply From Address or: % Private Supply Drilled by1,�rr �,� /�a/j Address / c� - Number of Bedrooms Has garbage grinder been installed? .lel I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved plans and the standards, rules and regulations of the Putn Department of Health. OF N Date: &.-I ell & .7-, Certified by � P, i y P.E. k*" R.A. ,LIJ Address 2— ,:7,, Any pe n occupying premises se a by the above * I License # �'- y �1� --s✓ take such action as may be necessary to secure the correction of any unsanitary conditions resuliuch usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Public Health Director, such revocatio , modification r change is necessary. By: Title: r Date: {' White copy -.HD I, Ye o copy - Building Inspector; Pink copy wn , range copy - Design Professional Form CC -97 PUTNAM (COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL IE1<IEAILTIH[ SERVICES WJELL_COM ><, 0 ! - Well Location Str t Address: �67-7:? lla e• " Tax Grid # Map, Block Lot(s) Well Owner: e: I Address: v� N 4&L Use off Well: fl- primary 2= secondlary esidential Public Supply Air cond /heat pump Irrig tion Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment ?t Rotary Cable percussion Compressed air percussion Other (specify) Well Type Screened Open end casing X Open hole in bedrock _ Other Casing Details Total length / 3 S ft. Length below grade 43k. J Diameter in. Weight per foot alb /ft. Materials: Steel _ Plastic _ Other Joints: _ Welded X Threaded _ Other Seal: jam. Cement grout _ Bentonite Other Drive shoe: -'21-, Yes No Liner:_ <No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First _ Yes—No Hours Second Well Yield Test _ Bailed _Pumped Compressed Air Hours% v Yield O p Depth Data Measure from land surface- static (specify ft) During yield test(ft) _ Depth of completed well in feet gg � Jed Well Log If more detailed information descriptions or ev "atiaiyses are available, please attach. Depth Fr Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type Capacity Depth A 22i Mode` Voltage O HPY 'Tank" 0 Y Vol me -2 _ /"7 Date Well Completed 9/6 71 Putnam County Certification No. 11 Date of Report Zo — . Well Driller (signature) i;NUX E�Exact location of well witn instances to at Least two permanent iramarxs to or pruviucu uu a bupata« aiI" F all. i, Well Driller's Name ,g"ZrAe-j— �� ' Address */• / Signature: _ �,�, -- a -- Date: White copy: HD File; Yellow copy - Building. Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 I � YML ENVIRONMENTAL SERVICES 321 Kear Street Yor k ' -- Albert H. Padovani, Director � LAB #: 32.202564 CLIENT #: 55375 NON STAT PROC PAGE 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~-�~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ � MCCORMACK, RICH ' 74~�-- �� � DATE/TIME TAKEN: 04/08,02 11:30A 23 STEPHAN SMITH DR DATE/TIME REC'D: 04/08/02 1200P PUTNAM VALLEY, NY 10579 REPORT DATE: 04/16/02 PHONE: (845)-528-1491 SAMPLING SITE: 273 BARGER ST,PUT VALLEY,NY SAMPLE TYPE..: POTABLE : TANK , PRESERVATIVES: NONE COL'D BY: SARAH ANDERSON TEMPERATURE..: NOTES...: COLIFORM METH: N/A ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE PUTNAM CNTY PROFILE 04/08/02 MF T. COLIFORM 04/08/02 LEAD (IMS) 04/08/02 NITRATE NITROG 04/08/02 NITRITE NITROG 04/08/02 IRON (Fe) 04/08/02 MANGANESE (Mn) 04/06/02 SODIUM (Na) 04/08/02 pH 04/08/02 HARDNESS,TOTAL 04/08/02 ALKALINITY (AS ~ � 04/08/02 . '.TURBIDITY ITUR, RESULT NORMAL - RANGE ABSENT /100 ML 10.5 ppb <0.2 MG/L <0.01 MG/L <0.060 MG/L 0.010 MG/L 3.75 MG/L 6.4 UNITS 48.0 MG/L 48.0 MG/L '- <1^NTU ABSENT 0-15 ppb 0 - 10 N/A 0-0.3 mg/l O-0.3 mg/l N/A 6.5-8.5 N/A N/A 0-5 NTU` COMMENTS: BACT THESE RESULTS INDICATE THAT THE WAT WAS NOT) OF A SATISFACTORY bHNl|AKY QUALITY ACCORD E NEW YORK STATE AND EPA FEDERAL DRINKING WATER STAND OR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. Pb/Cu LEAD limits for p EPA Lead & Copper than 10% of their than 15 ppb and a treatment must be potential. ublic schools are set at 15 ppb. Rule for Public Systems requires that no more distribution points have a LEAD value of more COPPER value of 1.3 mg/L, else water undertaken to reduce the waters corrosive Fe/Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg/L. Na No limits for Sodium ale proscribed. Suggested guidelines state that for people on a sodium restricted diet,the water should contain no more than 20 mg/L of Sodium. 'For those on a moderately restricted diet a maximum of 270 /L of Sodium METHOD 1008 9101 9139 2037 2037 9043 YML ENVIRONMENTAL SERVICES 321 Kear Street (914) 245-2800 � Albert H. Padovani, Director LAB #: 32.202564 CLIENT #: 55375 NON STAT PROC PAGE 2 MCCORMACK, RICH DATE/TIME TAKEN: 04/08/02 11:30A 23 STEPHAN SMITH DR DATE/TIME REC'D: 04/08/02 12:10P PUTNAM VALLEY, NY 10579 REPORT DATE: 04/16/02 PHONE: (845)-528-1491 SAMPLING SITE: 273 BARGER ST,PUT VALLEY,NY SAMPLE TYPE..: POTABLE : TANK PRESERVATIVES: NONE COL'D BY: SARAH ANDERSON TEMPERATURE..: NOTES...: COLIFORM METH: N/A ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD is suggested. .pH pH SCALE IN WATER RANGES FROM 1-14. MEASUREMENT OF pH IS ONE OF THE IMPORTANT AND FREQUENTLY USED TESTS IN WATER CHEMISTRY. WATER WITH A LOW pH MIGHT BE CORROSIVE TO METAL PIPES AND FIXTURES. THE NORMAL RANGE OF pH IS 6.5 TO 8.5. Hd TOTAL HARDNESS IS DEFINED AS THE SUM OF THE CALCIUM & MAGNESIUM CONCENTRATION, BOTH EXPRESSED AS CALCIUM CARBONATE, IN MG/L. THE HARDNESS MAY RANGE FROM O TO HUNDREDS OF MG/L, DEPENDS ON THE SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED. �R��Fk��I�W MODERATELY HARD WATER: 70-140 MG/L MG/L = MILLIGRAM PER LITER | HARD WATER: 140-300 MG/L (1 grain/gallon = 17.2 MG/L) | SUBMITTED BY: - Albert 44~Padovanfl M.T.(ASCP) Director ELAP# 10323 P UTNAM CO UNTY DEPARTMENT OF HEALTH DIVISION OF ENVIROr�MENTAL HEALTH SERVICES..... _ .:S .. GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM Owner or Purchaser of Building, Tax Map Block Lot Building Constructed by Location - Street Building Type TownNillage / sd��l�s q-,R,d /���sSE� Subdivision Name Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above- described property, and that is 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 treatment 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 The undersigned further agrees to accept as conclusive the determination of the Public Health Director 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: Month 5_Day_Z,5 Year ) - Signature Corporation corn on Name if co oran a tio} /8 Address: _ va, " e �'( State ���, Zip /D Si g nature• �4n^'./ Title: Dwr? e.-i^ Corporation Name (if corporation Address: f ` State Zip Form GS -91 Public Hecith, Director . 4 Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH I Geneva' Road Brewster, New York. 10509 Environmental Health (914) 278.6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 WIC (914) 278 - 6678 . Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Preschool (914) 278.6082 Fax (914) 278 ! 6648 E911 ADDRESS VERIFICATION FORM TAX NIAP'NUMBER: E911 ADDRESS: A . RIZ W 110ED TON OFFICLAL UT (Signature) .. . . . ......... The Putnam County Department of Health will not issue A-0e r0da-t-6--b-f Compliance unless the above form is completed, 1.9.9 glegal E91-1-... assigned by an authorized town official. This form As-to--bd.subm.itted---- Ni-itb the application for a Cirfific'ate of Co ns tructio ­ n C om a c&'. n 'Z! U'd V. :4 -- �-­ '­`� _ ." 6 -1 , �n, � , 1. --now, ­77 Q -AM MET e7- "MOM YL 777 _­77 - V Wild's WWQ 107 KM Any—, r Al Minim, V, INV ­W7,4 "A" 44k "7 Moss- A, on. t's W A0 FW AM Q4*1 oat 4w �4��J"dr P.IPPY AIM , 117 q4- �ny my x BRIT, J� ktlll -4 ­A, Now �-Y, too 05, EnvAiO�:4;"`_H 4�k N- U.. vow. A T�fhv les Aw �keguis SCA I V Y w4n. sy%M" f__ CP' OK A n0h Min 1111012 azo Of jg_ 2, woo -Woo . . . . . . . . . . . . . . t PUTNAM COUNTY DEPARTMENT OF 1IEALT11 :.�.. :..- .xDIViCiON_ .F� k:NVT.RONMENTAL, 4 FIELD ACTIVITY REPORT A'nn'RRCC:_ 13,#1ZC957Z 52: . IL9LL 6y AXY, Street Town State Zip PERSON IN CHARGE 1 a OF PUMP TEST [j DOSE TEST nI- /fl I. 03 O m O O \ I I � J . 6-//6 /o-)- -/l/ REQUIRED GALLONS Signature and Title DEPORT RRC`.RTVF.T) RV. I acknowledge receipt of this report: SIGNATURE: 02/96 Rpm- Title: PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONIAENTAL HEALTH SERVICES . FINAL SITE D6PECTION S /G�o� �,4�1 Date: 3 //_ o� .sop e� (ebele�g Steef Location 5AK6� 5T2s_"c-- Owner Town _� iiMA& Permit 4 ?V- TM r 7 (2. Subdivision Lot 4 � I. Sewage Svstem Area YES � CO1� MENTS a. STS area located as per approved plans ...........................s Q b. Fill section = date of placement 3:1 barrier Lgth. Width Avg.Dpth 1,51 c `Natural soil not stripped ........................ ....:.................... . d. Stone; brush, etc., greater than 15' from STS area.......... C. 100' from N ater course- wetlandsy,, ......... - .— -- II:-_S ewicre Svstem � , @-- - g�y� nor per peptic tan�_si .. :: X1,400: -� 1;20. other. b. Septic tanki evel ................ ............................... c. 10' minimum from foundation�.................................. , � � , 3 • r .� s = -, .�" �io r .� - �.-..,�- � T1 'ATl out DeTiit,s ame elevton w ested :: 2. Protected below frost .................. ............................... 3. Minimum 2 ft.Original soil between box & trenches e. Junction Boxx - properly set ........... ............................... f. rent ches Length required 5 Length installed 5 2. Distance to watercourse measured-71- /00 Ft.......... ' 3. Installed according to plan ......... ............................... . ' 4. Slope of trench acceptable 1 /16 -1/32" /foot ............. 5. 10 ft. from property line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface ........ :......... 7. Room allowed for expansion, 100% ......................... 8. Size of gravel 3/4 -1 %2" diameter clean. - - _ _.- .�.E..�1i ttth grK. ends capped . _ :urn Dok&Sv 5�k e;g pump c aim er ' 2. Overflow tank .. .........................:.:.... .......... -,6- X _ate _.7a,i.. cor. 3. Alarm; visuaVaudio .................... ............................... 4. Pump easily accessible, manhole to grade ................. 5. First box baffled .......................... ..............::............... 6. Cycle witnessed by H.D.esfunated flow /cycle.......:... III. ouse/Buildin a house located per approved plans... b ?lumber of bedro ms ° a /� a3m,�Q- ° - -" a7-Well located as per approved plans ............................. b. Distance from STS area measured r/ oo ft .........:. c. Casing 18" above grade dam: S ce drat a aio4t� uid well acceptable:. =� kn TiY►�� Y . ' ' g // V. Overall "i�Vorkmansliin / �`;` °'�P;�r��t */� Jn °'o.'srea'`� a. Boxes properly grouted ................... ............................... b. All pipes partially backfilled ........... ............................... c. All pipes flush with inside of box ... ..:............................ d Backfill matenal contains"stones <4" diameter .- e K CUrtaui drains &_stant Ape`s'installed ac oidtng f u-'rtain drain outfall protected & dir.to exist waterco^ se g� Footing drams discharge away from STS area Er ce waterprotectionadequate h Surfs - ' r i onion co t l provided ......: fi 03/13/2002 12:38 9149624248 JOSEPH SULLIVAN .. . PAGE .. 01. --,- — PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ATTENTION 13 ADAM GENE REQ=j FOR FINAL INS 1JCTION For: Fill All information must be fully completed prior to any Trenches _JZ inspections being made. PCHD Construction Permit Located: if .4 e4f (1) (V) /�4—wa lov—klalle- Owner/Applicant Name: .r e~.& /< TM 710 • Block Lot Formerly: Subdivision Name:— ;2 Subdivision Lot # - -1 Is system fill completed? Y-4�4, Date: Is system complete? of o Date: Is system constructed as per plaa4f Vr—,o - Is Well"drilled? /( Date: Is well located as per Pima? Are erosion control• measures in place!' I certify that the system(s), as listed, at the above premises has been coakructed, and I have inspected and verified their completion in accordance with the issued PCHD Construction Permit and Me V1,11e -put im-&-Coud� -D� Health. Date: Certified b y: PE — BRA Design Professional Address: Comments: Form FIR-99 AO e 0c w M1 ML I^M 0 OV 74.09 74.13 ---- - - - - -- P/0 63-3 -51 AL JL 35 ..t—oo - - —� 4 AL 38.29 AC BRYANT PO/V,9 74.06 I � — 74.10 It 4.14 t q RYAN POND PON D 4 60 w 1 ;j A: Z? 1.5 AC Irma LT3 A -n CAL it 407.39 9 5 9 ; i CAL 4.78 C. C L q RYAN POND PON D 4 60 ;j A: Z? 1.5 AC Irma LT3 A -n CAL it 407.39 9 5 9 ; i CAL 4.78 C. C L All _.P ."•,a c ". �_;y".'.. .. i's�'sxi.�.c•�r•i'" R<i .%•.,�w:..�- _:rr :W:�.3 s•R �.r:`•�.:.m.r�. �. :r BRUCE R- FOLEY Public Health Director March 19, 2002 DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services Environmental Health (845)278-6130 Fax(845)278-7921 Nursing Services (845)278-6558 WIC (845)278-6678 Fax(845)278-6085 Early Intervention (845)278-6014 Fax(845)278-6648 . Preschool (845)228-5912 Fax(845)228-6113 Frank Sullivan, PE 2972 Femcrest Drive Yorktown Heights, New York 10598 Re: Field Inspection - McCormick Barger Street, (T) Putnam Valley Lot # 1, TM# 74 -1 -6 Dear Mr. Sullivan: The following comments must be corrected in the field. 1. Expose comers of the septic tank and pump tank. 2. A pump test needs to be witnessed by this Department once the electrical inspection has n) i f16 tift a. � ecyl S "t)1�rr1.; �:d. ±- Ahl i;c 3. Stand pipes need to be installed as per the approved plan. 4. Silt fence needs to be installed downgrade from the well. 5. All silt fence must be properly installed in the ground, as per the approved plan. If you have any further questions, please contact me at. (845) 278 -6130 ext. 2261. GDR:cj Very truly yours, /- 0�2 Gene D. Reed Environmental Health Engineering Aide BRUCE" k. - 'r`Gi EY Public Health Director �LOI'c�'17A �MOLINA�" -kN' ., M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845)278-6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Fax (845) 278 - 6648 March 19, 2002 preschool (845) 228 - 5912 Fax (845) 228 - 6113 Frank Sullivan, PE 2972 Ferncrest Drive Yorktown Heights, New York 10598 Re: Field Inspection - McCormick Barger Street, (T) Putnam Valley Lot # 1, TM# 74 -1 -6 Dear Mr. Sullivan: The following items are in violation of Article III, Section 2C of the Putnam County Sanitary Code: 1. Silt fence has not been installed below the well. A trench was constructed allowing silt and tailings to enter the adjoining stream. Please note that all silt fence must be properly installed as per the approved plan prior to the start of any construction. A formal notice of hearing may be issued if the violation is not corrected within 5 days. It is truly hoped that the above violations are corrected without having to take legal action. GDR:cj cc: Norman Anderson Richard McCormick Very truly yours, RIP 5-11f Gene D. Reed Environmental Health Engineering Aide SMMG-CONRUM.-T, N DATE : MAR-20-2002 WED 00:09 NAME : PUTNAM COUNTY DEPARTMENT OF HEALTH TEL 845-278-7921 PHONE : 919149624248 PAGES : 2/2 START TIME : MAR-20 00:08 ELAPSED TIME : 00'55" MODE : ECM RESULTS : OK FIRST PAGE OF RECENT DOCUMENT TRANSMITTED... BRUCE R. F01" 1A)RMA MOLWAJU R.N. M.S.N. A—d.* ft&. h.." Dfts tar M.00, -f Pa w,# DEPARTMENT OF HEALTH I Ckmeva Road Brewator, Now yoft losog 11-ft(us)2111.600 F-MS)271-11111 Wj*; a. (145)27A-6Sn sec (WS)27a -6679 9.(645)2711-4W X" Tftrwa#-p W278.$014 Ra(1545)2701-601 n"dwd(WS)U8-"12 Fas(041)228-6113 March 19, 2002 2972 Famorest Drive Yorktown Heights, New York 10598 Re: Field Inspection - McCormick Berger Street, M Pumsm Valley Lot # 1, TX# 74-1-6 Dca Mr. Sullivan: The following comments must he corrected in the field, 1. Exposo oomers of the septic tank and pump tank. 2. A pomp test needslo be witnessed by this Depairtniont once the electrical inspection bas bam completed and notification of such has been submitted to this Department. 3. Stand pipes need to be installed as per the approved plan. 4. ce Silt fenneeds to be installed downgrade from the well. 5. All silt fence must be properly installed in the ground, as per the approved plan. if you have any fiather qucstiom please comw me at (845) 278-6130 ext. 2261. Very truly yours, A-1111, Deno D. Rood GDR:oj' Environmental Health Enginoming Aide 4 Ln E ru F+ --A m rI 91 i $10 R3 I.- z 3) :1 m z 3) :9 n 0 C: z 0 m u 3) m z --i 0 m A iii lz R T N E R C i R E , i t ft S q jq w A v U S U Pc 'A U 0P' E L E'C T 'R 7;: 1TY 40 Fli�-T*N Nt-M YORK,`4 OS C F, R I K.. 'fit ;IL wi de,,crfl-Te �telvw uO 4AVIppicwn.r naxilO 8a, flu . .. ..... . .. ........ ... ... ................. . . .. . ............ . .... . ........ i ..... . . ........ ....... ... .............. . ON! a . .......... .......... ................................. �.i .......................... ............................ . ....... .... ........ . . .... . --------- - - --- G3 of t:.W. A.W. �(:;W AW .... ... ...... ..... . . .................. ........... ..... .... ............... . .............. ........................... ............................ ........... .............. ... . ...... t ... . ...... ......... ....... ............... ................ . . .......... . ................... MS Wi �ILL D W41 F 2 s WkNkCt MOTORS I�tolys ................. ..... ...... . . ..... ---- - ------ -",vsm -- V--5 duT V- ..J, ? �4- Aut W 4-1 ..'it CUP AM M M m'.1 nr ar r ............... .. .................. ....................... ...... ............... ............... ... .......... . .... . ................. . ,: ....... ,. . ..... ... .. ............. ................ ........... . ... .... ................................................. .... .... Nf-T ....... .... .. W41E �pw? 0 Aw�' .......... ...... .... ........ . . . . . . . ... ..... ............... ............ ...... ... . .. . . ...... ....... . ............... ... . ..... . .......... . ......... ...... ................ . ............................... lkc T�ll �O)— -'c Ift t;ny :4 I P�,.e -- otvcn - -ilno 11 �n- -Cara-tft lmj"tft+m "Cy ,1 il I 9L w O From: RICHARD MCCORM,Fax: +1(645)526.7436 To: gone reid Fax: (845)2767921 Page 1 of 2 Monday, May 13,2002 10:32AM 0 q '., ._ ;c_:w. ti�:��.. _.�... .•e'C �-- °,_- -rc.3 �- ,""^Ue.c _i. � .. .. �'- r.�.cu...y� -ti" .....,. "1i� �l'�rtFv�s -:. ":"i`"s'-•, -. ...ar.� -... r�,R �0 o gene reid Phone F &u Phone (845)2787921 IDate: Monday, May 13, 2002 Pages including cover sheet: 2 From.- RICHARD MCCORMACK 23 STEPHEN SMITH DRIVE PUTNAM VALLEY NEW YORK 10579 Phone +1(845)528 -1940 Fax Phone +1(845)528 -7436 _77P_70�1 KIOMC - PI ITKiom rni 6.ITV I)CP0QTMrkIT fll= P 1 o� PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF M ENVIRONENTAL HEALTH SERVICES •.�::• - .e.:q.:.al�`7ri =: . _ .. - - _ .. oz air° � cj° ^.,_ ... ---!7m -7 ..�: .. :�.ae Z" -;4!^ F .. CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # loll-t9-1-0t d %G►Y 1 / �jL!"� �'%'� Town or Village X��� Located at $ g � ,Vw4y Subdivision name Subd. Lot # . % Tax Map Block % Lot Date Subdivision Approved 1fd57 Renewal Revision Owner /Applicant Name 9111c4e'j I%C� rr� l��i Date of Previous Approval Mailing Address ;23 y e,& Zip Amount of Fee Enclosed 23 C7 ey Building Type Lot Area 3 - ;2 &No. of Bedrooms 3 Design Flow GPD o o Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED sv tem to consist of Other Requirements: To be constructed by a gallon septic tank and .mod ��.� .2 ' rev /� �• %� Address Water Supply: Public Supply From Address or:--i7 .. - Private Supply Drilled by _ �? U i� ^` "--Addre'ss' `% -5 I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. �1 pF NEW yo Signed: ~P ANC /S `rG �� E. R.A. Date V13 Address ;2 f % 7— ��� W License # ;-2 'V "Y" �jf�i� 248 APPROVIA FOR ONSTRUCTIO ires two years from the date issued unless construction of the sewage treatment system has been complete by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new perroNt. Appro ed fo Wcge domestic sanitary sew only. By: Title: (ior, Date: 101 White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professio al Form CP -97 PU NAMI COUNTY DEPARTMENT 07 HEALTH DRWSRON OF IEN VERONMIIENTAL HEALTH H S ERVR CIES - APPLICATION TO CONSTRUCT A W. AT ER WELL please print or type MhIJ Pirifiii We11 ILocatnone Street Address: TownNillage Tax Grid # ,� el �a , Map ?* Block / Lot(s) Weal (Dwnein Nam : Address- Use off WeRI: Aesidential Public Supply Air /Cond/Heat Pump Irrigatio I- pirimairy Business Farm Test/Monitoring Other (specify) 2- semmdlan y Industrial Institutional Standby Annnma mt of Use Yield Sought �r gpm # People Served Est. of Daily Usage e, al . IBeasolm ffoa• Replace Existing Supply Test/Observation Additional Supply IlDn!uJiiig I,-New Supply (new dwelling) Deepen Existing Well DetsMedl Reason ffo>r Pniflkg WeB Type Drilled Driven Gravel Other Is will site subject to flooding? ................................................. ............................... Yes No A,-' Is W11 located in a realty subdivision? ...................................... ............................... Yes X.- No Nane of subdivision Lot No. p Warr Well Contractor: A 1--,Vel b Address: Is IPiblic Water Supply available to site? .................................. ............................... Yes No A,- Name of Public Water Supply: TownNillage Disgrace to property from nearest water main: IProesed well location & sources of contamination to be provided on separate sheet/plan. iialica At. Sigr4Vare PERMIT IT TO CONSTRUCT A WATER WELL Tb6permit to construct one water well as set forth above, is granted under provisions of Article 10 of the IEAarn County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided ithawithin thirty (30) days of the completion of water well construction, the applicant or their designated rersentative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the retirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form P "ded by the Putnam County Health Department. During all well drilling operations, the applicant and/or wr driller shall take appropriate action to assure that any and all water and waste products from such wj drilling operations be contained on this property and in such a manner as not to degrade or otherwise coaininate surface or groundwater. .&JIROV EID.IFOR CONSTRUCTION: This approval expires two years from the date issued unless c4naction of the well has been completed and inspected by the PCHD and is revocable for cause or may be ceded or modified when considered necessary by the Public Health Director. Any revision or alteration <u-te approved plan requires a new permit. Well to be constructed by a water well driller certified by Putnam Y. �; of Issue (oil S °i Permit Issuin Official: a4 R jCy, of Expiration 1:71,0 Title: ]P-omil b Non- Traansfer>rabIl 106,e copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 PUTNAM COUNTY ]DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES LETTER OF AUTHORIZATION RE: Property of Located at Jf T/V _r =� -9 ; Tax Map # 7 Block �_ Lot 6 Subdivision of e'n Subdivision Lot # Filed Map # 2- 3 3,4 Date Filed 7 Gentlemen: This letter is to authorize dv-.s �hL! /�� a duly licensed Professional Engineer or Registered Architect to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said wastewater tretment and/or water supply systems in conformity with, the provisions of Article 145 and /or 147 of the Education I.�aw, the PubLic.Health. Countersigned: Mailing State 2.�- i 1e�✓'Z Telephone:- Very truly yours, Signed: (Owner of Property) Mailing Address: V/. State /., U Zip Telephone: � �� �'� �' / , e Form LA -97 Goulds Huhn r �y -.. , ' .. nA ,a.&..u.,a.+6owr......�Lrarww+a �lw, / i � • N{tfiGW pro eri k mum smovFujim, ors ;t :� ,��i�.r�tcE rontulutlEa� y= h. t_ 7� PrwV1!'!0 . i!i s I ter u! d l +. f, . `' 11 }1 +3Lr "iii3illy �a 4`ti<:t lilt rt %1i (l t}L p8tif'i I' 'si0,nr.dfc''thc ¢ 'Snai., threaded: 4�l +i tt1iitl4Vl[e.s, , i4 11 . d r�c7!lYoS�.Ipi)fv('.aflt� • r3;r SsUS1 mew, 0 , duty W1 17('itr111 � Btiiiings: ;N teal Ag` !ype �...;( 1 tifCiiJil��;1!C'Efi }` (rv,lEttU(1r`UCf, i >Wr courts f I )we! 21; r" ' t I J 1�9 f �44�St'iii�ls� a� .�i't3iiuty� � - . i;c tv�i1 . rdtari; i 1e(yywrtld ��J &tGr re6s(St 11, , s.Yt C47, Y Yl'tltbr °.2Rd , Ij ,- ?: fr �.. s_,7 ,�IY_:t',e.;Pt �,�.,y � t t � +r th,s �walla,,le,, y r t;t�;�OM E T SWON pMvide secondary moisture 11,du5ir, StOglp phone! .- f;,�l''iOW _+ rsiU fi^v5. .a�1r?ii3r'rl 1cw'0 Gf oSr lF1'*'k "i I $ r- i ' t 6 and rl HP i v.� ,,J -01 4. h 1.1: •: , , � 1t , r ( ' .•, E flu("' �. syst�.rns � n gel r:,:tt,. p. t:', alnag, and is preu ht "D wQM 117 V or 280 v Me �iri��, ,s t,'.ast0i� ere,, wicking; > �+Agep yrp��,11 1y�k�Migg��e� profl.g lUWg. t ey A V1 CR i.p,RSi'i1U+7941'478E�Y _ so! r[ 1 P —' U So) ':0111 Y1 � c�t�iili` ��i,'l l'r air. �1 .tiJr,?l.ii'l Yom:.. 1d'�iEE�� muls po—SR* i 9 F'UITit1 Lire leads. "1uirliE � ', UB? r 1116 Ir C SeallfYa.agaEt�5t L'tiRt�]friino is * ] %i�i!?u I'.PlEtill1 C2h atJl iui3t:: T tiros ,'3liiiSi : rL ' r i ,aw nui n thme and 9,i (etikt:Rr . 21% HP— 10 STC pme nu ds to aua(u 060mwe sit NPT. 40h bare lr;,,S On OSA agshm conpunerd dw;Vle AGENCY LIST9MQS •'t ir• M1J t I 1 . rrli?r p :•n� r. ..«+�+...,�.. s Capaciba; up to 1 �tt3 GPwi t•, d n10 eIG - 210 fna- r .;ct , i I t,s ..�,�ii..l , a !? Gan,, ^,t ?:aye Sta rlISardsAnar.ralttrtl Total heads: up W 123 feet drt J;i? a,! I'�,i?l and ST'y't'" a 1An4•Iir 4illd 'Lib 'l'vs �c iri Ji '•D#1, aw Wrllw -d. t`,gi) gf; d `ibine oil for f sHdl; -silicon ;rd ofi;tNl,Jl °iE f CJ:,Iruttm LiWratoff 0 t' i;arhi! +8'�t� tsr���t'Sili�gr; FEATUAt _ transiFr �; a•lllipl�.l1%'f_ {.,.YSI ?CUR 3E ?1111- � r`1G' :i�iit" fl,!5.�.�.siifI'Ee� ..... series s air0esis steel matai (. Operation; r t ';+? t rl ary n 1:7r1, 11Df1-C1�7g i'1✓iff? f)Ellli;!- '��! t t:a_iLlt, . �1at u, DUNG. -N elastoaiiur` - 41I.It Vanes , lfd I r?CCi10r;1 rn S$Kll WAN :; t max r1�i!'°lll�sower�s a Temperature: I pla ecton. Balanced for eI1Ue4 Vviking limits, 104cF (40 °C ) continuous 14WF (60°C) intermittent. METEA3 PUT E v rastarlers: 300 series coi `__ -.. -. _ _.; ......� NOW So , ' ., , t. vil�' - �!p abie of running diy =�' 30 r 1 I ". ts i _ I Whou1 darn age to 1 Single phase: i wrnrrr r `;�. ``.,, . I i ! I .. , RPM; � 1 1��1, I Hwy_ >ly 3�O ��J .�P, f �' , ^t ii HP- 1'i;:HP, 230 V, i) Built-in overload wlti I , �' --- �:....>e,..,s�"''"��...�;.,. '�.. � �.I � I..�'"'�;w, •�..;, i .,�_ autonlotrc r tiltlSv g lf151+iOUr ?. \ ( r I ; i , ~�''- "'7 �= 1 •ti.,, e "`h:t�e Phase" iLr ( ' ; �;.��..`,, ' ._.�,.'.,,,�.� 1 I r f r i 1 �Jry �{ i IA' HP —111 H11 20012 0! u` t .. {-., I 1.. 460 V 60 H�, 3500 ApNI. 10 20 30 wo o din. ;.� Class irESUlatic�n......___� r _ _.._ ...���.___._.- _-- __.__.._.__._. __.._ _ - _.....w Io i e 20 CAPACITY 11905 MOUIs Pumps, Wc, F:f19DtIV,�.iV�B ��IIt�. •.... ...., - ' "_ ... ..-.'. ..:. ... .� .�r. -, ':.� -... it :,. .:, ,:'....'�_.. '.. -:.: ..., .:w. .. ::. . �r.r. ».:.::.'"• .,. wU .. '• �•.�„'�iyn.vr+cra:'iF.`a.��•"'� - . r c n PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES - "PLICArI ION F6' "AP'PiWVAi OE I'LANS7FOR -. A WASTEWATER TREATMENT SYSTEM 1. Name and address of applicant: 2. Name of project: 4. Design Professional:�5���� vp� 6. Drainage Basin: 130 7. Type of Project: Private/Residential Apartments Office Building 3. Location 5. Address: Food Service Institutional Realty Subdivision Commercial Mobile Home Park Other (specify) 8. Is this project subject to State Environmental Quality Review (SEQR)? Type Status (check one) ....................... .... ............................ Type I Exempt Type II Unlisted 9. Is a Draft Environmental Impact Statement (DEIS) required? ..........:.............. �Y'o 10. Has DEIS been completed and found acceptable by Lead Agency? ............... 11. Name of Lead Agency _...tisaajcl:in an. t.tic',er'�.:cc�ntro .o . oel a�aig,:�ni�g, _...._ :1:. f1 ail' officials, ordinances? ............. ............................... ......... ............................... 13. If so, have plans been submitted to such authorities. 14. Has preliminary approval been granted by such authorities? _ Date granted: 15. Type of Sewage Treatment System Discharge ................. surface water Y' 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? ....... ............................... -- 19. If yes, name of water supply Distance to water supply 20. Is project site near a public sewage collection or treatment system? ................ Ie 21. Name of sewage system Distance.to sew ge system 22. Date test holes observed" 1y10 23. Name of Health Inspector AM . 24. Project design flow (gallons per day) G °O 25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?.:. A/'a 26. Has SPDES Application been submitted to local DEC office? .. Form PC -97 F 27. Is any portion of this project located within a designated Town or State wetland? Ale) 28. Wetlands ID Number ..... ............................... _ .. �4. Is'Netlanus Yeririit required ......................... ............. � Has application been made to Town or Local DEC office? 30. Does project require a DEC Stream Disturbance Permit? A/'v 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/No 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? ............................... Yes/No w DESCRIBE: 33. Is there a local master plan on file with the Town or Tillage? ......................... Alel 34. Are community water and/or sewer facilities planned to be developed within •� 15 years in or adjacent to project site? ................................ .........:.................:... 35. Are any sewage treatment areas in excess of 15% slope? . ............................... Ive 36. Tax Map ID Number .......................... ............................... Map Block ) Lot Z 37. Approved plans are to be returned to ..... Applicant e,' Design Professional NOTE:,All applications for review.and approwal of a new S$T'1to b = 1ra�sc 'the-be aftftfeK neea 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 storrnwater 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. �-y SIGNATURES & OFFICIAL TITLES: Mailing Address: ........................... �� T� i PUTNAM, COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES 1AsT,61q!'D­ TA SHEET SUBSURFACE SEWAGE TREATMENT SYSTEM �'a Address Owner--/' leAn,,1,111 V. IV Located at (Street) l a, rq &e- 15f- Tax Map 7* Block Lot (indicate nearest cross street) Municipality b2c, �vvj le, q Watershed SOIL PERCOLATION TEST DATA Date of Pre-soaking 'T I I,, I C91 Date of Percolation Test — q1 1 -7 101 fy 3 4 5 9 0 I I I —2- -2 N 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at ea( percolation test hole. (i.e. s I min for 1-30 min/inch, s 2 min for 31-60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD-) ......... Depth to Water' ' V From Ground tevel ercd- I I a p t T'. e:.. .. ...... ..... . E I 1"Me _4ps� 1 Surface (Inches) 'Start Stop'...:,f'.. Q ypp 4Awhe S A 2e 21 2 pie 30 �U ;?-/ 3 ,& & 3a 4 5 fy 3 4 5 9 0 I I I —2- -2 N 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at ea( percolation test hole. (i.e. s I min for 1-30 min/inch, s 2 min for 31-60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD-) a TEST PIT DATA 2 DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE NO. � HOLE NO ~ R HOLE NO v G.L. 0.5' 1.0' _ 13 �arr �ov ate, �dr2 3.0' ti 1 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 10.0' Indicate level at which groundwater is encountered Indicate level at which mottling is observed 71 Indicate level to which water level rises after being encountered Sari Deep hole observations made by: %,/ Dater Design Professional Name: Address: >,r7,-'— Signature: Design Professional's Seal 1. 1 A 4 , A Kd 11. 1 tel't I !" 0 8 tine. t.j E u s s t-N- n s Pump lain maxi,-wim. Dis-hargri siz.e: 21" NPT. L -, .- 0 ipac ijp to 126C Total h•adG: up to 123 i06t a Overload proviW,, iv, ter w!iti threaded. 41,T staIr,!@s,,3 steoi, and lowor. Siagle, phe.-sq., and' HP - 1 -IV3 S, M - 2'0 V Three th 115 V oi wo.O.g plug. %i- *1 ' i HP - STO. 'v.dth bare leads- Three phasw i"11111i HP-1414 GTO -with bare On CSA !ts'ked modes -- 20 fooi SJ11N -md ST VV aria N P 7 - SILIC.ON Stai r, !a .;-'rIel r�!Aal, P;v Is, BU,".41A.`,1 r stainle::. -, Threaded Olase nlv,-A S to nard ar '11 1 Ca:1 uwailluously v4tijoul, a geatiaUs: Upo6r and lvnur he:!Rvy dully ball hehring mms"l-Uckion. a Plawortable! S�vq.m. %duty ratan, end water resistant. Fpoxy ,,,eaf on motor end provides secordarj moisture bar-vier ;;n cue of outer jkkel damagr. and 'L'v prevent Oil wi&ng, P. Assures positive seaiing against contaminants • ?,:-id oil leakhga. AGENCY LISTINQS. ri CAA; P , SIA n lards Asoctallun 'tine oil for -iutiro , . . . �� heet (UL) vi"ISPA(rit5riLOMWIV& 14! anid officler S801: silicon carbida-rotary seaVsHicon. FEATURES transfer C 31.W il.1,1--l�--11 e steel meta! a W Operatim Ptur,l) ratings, avo, ,,,pan, non -Oog with Pump- 1, 1 earls, BUINA-N elastormirs, within th� �%:jtor fra, U�Oclute:"S out vanes for mechanical seal Temperature: recon-,,:eoded working limits, Protection. Balarwed for 104 c,F 4011C) continuous 40 I ' (60°C) intermittent. L F mvcm rEFT Fastanerts: 300 series 20 J SEHO"! 38a.,-, r-"J . :steel. C;, i p a b i 6: runm;ng diy R.' M VA A 10 US '"N! EV I J1. W.MOU! dafn�lge to 7 WOO ,. 2',) Mato, A lip, 1-5 V., 200 V, 2so v 60 `0 -0 RPM HP, i, Hz, I '7,� 'Iz, 3,� 00 q Phil; > 115 V0 , 6 Hp- 1 .;.t -G, P 2 3 0 V, 10l- WIZEvirl. ..1....L.-4 .... ... ... 6 0 .4 7, 3.600 RVA Built-in ovprload w1fl. 4- - q 'r, ..e, �a lQ" p.�r +,,.,1 j ..., _ '_ .� �_`� -• —I ,....i!�,.,ti�,.ti � .� ,.�....l...y,� „,..., ...r_' : Gass B T A Th., et H r — V,,d� HP-4.00/2301; 7 • 460 V, N Hz, 3500 RPM. 0 0 M GO 7;j 80 'j0 1 QQ 1 0 120 'W'ORM • Olass B h!.,iulation. 10 20 30 n13/h CAPACITY 1 80r4 Gaul &. pumv&, hie, effeefiva May;A OdB.-:• -A=-tr . . . . . . . . . . . . 09/17/2001 13:27 9149624248 o ... JOSEPH SULLIVAN PAGE 01 A `?`:--°114 SAT C 19 Ail F11.1 -44 �T-f EM' 11q,k TH P A I h!'0. i514"N M ri BRUCE R. FOLLY � LOIM TA MOLINAM RX. 342-N, Public Heafrh Diroa or A610090 Mile M$011k Dir®ewr Mrwiof of Mimi Sarvtear DEPAR.`rMENT CAF HEALTH I Geneve Road Browmer, New York M04 0 My A'i R :N'i 10N*. A,tiX S'l''JEB ELAING 0 GM RPRD All Worrnation below must be 1& completed prior to any sekeduling. DAM I✓NGINCER OW FIRM: ado � _ _ � ml r #:. ' ° REASON: IDEEM. FERCS: n KIN1P TEST: o RO A,flb /URNET. SUBDIVISION. LOTO: OWNER- .. —� vN•..�— �r��. .nr - -mow .� — 0_.09� .�. _ _r� .,�,.,.. YES NO u Proposed SSTS within the dtainage basin of West Brach or Ji Oyd§ COMW MOSCrvoirs, wit'. i:t St►!a.trx }. Q11Q resxrvoic.,'tos®¢voir stcu or Control ltb�. Propoffied r9S'C w ttiiit'oQ It4t bf 6 Proposed SETS clesign slow greater than 1000 gallons /day or MRS Permit required- r Cl Proposed SS'T's for it Commericid Project. It is the responsibility of the design pro(essio,na1 to provide the. abovo information prior to sail testing. This 0epal-talient wiU o+terenine the NYCJRIw'P praiect status (Joint or Delegated) bitted on the redponse. If yqu b1L91 ered,k= to any of the questions, NYCDTP must wvilmss the Boilt46ting. T116 Department vtall coordin4te a inutually suitable tent for r1eld testing with the PCDOH, the Dedgn Professional slid NYCDEP, If a project has been deterrtdned to be delegated based on the above rciponse aad t'het, subaequttit informatioa joidicates WCDEP is required to witncss the soli testing, it w 1fi be the sole r+espocasibilit:y ofthr desiput p)•ofessional to schedule of the soil testing with NYCDEP. rUlt C()Vwy 7J51 ONLY oe Aa IvI.-o aGIG11 Mf1N 1 d� Sa TFI RdF- a7R -74 ?1 NAME: PI ITNAM rfll IFJTVDOOrrnckm n r r,