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03702
PUTNAM COUNTY DEPARTMENT OF HEALTH
D". 10N:.OFENVIRONMENTAL HEALTH - SERVICES =_ ..
CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM
PCHD CONSTRUCTION PERMIT #
Located at �1 t->C--J%QZ LA.tA EF Town or Village TK-) yt-- - y
Owner /Applicant Name T _ eC ISioj-4 Tax Map -7+, I-1 Block I Lot 3
Formerly Subdivision Namel2Lrr� A` 44il1 e 5 ° C E5
Subd. Lot #
Mailing Address �� �°��1,� C�1�.. tit° Zip
Date Construction Permit Issued by PCHD L42 -11! e b —1
Separate Sewerage System built by . V- , X :A 1 f Address I-E�'
CAS' ea— r-AL
Consisting of I'2JEff:U) Gallon Septic Tank and � L_Ir,
Other ,
Water Super: Public Supply From Address
or: Private Supply Drilled by Address PIMPAVA
- ' Builain ` g. ...�' 3�p T Has erosion control been'p6hip end? :.
Number of Bedrooms Has garbage grinder been installed?
I certify that the system(s), as listed, serving the
built plans (copies of which are attached), in ace
plans and the standards, rules and regulations 6
Date: 1t~7 Certified by
Address
constructed essentially as shown on the as-
0 PCHEh Construction Permit and approved
lbatnt of Health.
License #
R.A.
Any person occupying premises served by thelabw7lbaEr mptly take such action as may be necessary
to secure the correction of.any unsanitary con±�tic s such 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
revoca 'on, modificatio or change is necessary.
By: Title: Date: 7
2- 1-/ q8
White copy - HD Fil Yell py - Building Inspector; Pink copy - er; Or a copy - Design,Professional
Form CC -97
PU NAM COUNTY DEPARTMENT-OF HEALIH
DIVISION OF ENVIRONMENTAL EVALTH SERVICES
Owner or Purchaser f Building S'e'ction Block Lot
�r Y, a.
Building Constructed by
VD�MFA 1.
Location - Street
Municipality
022_5w rl
Building Type
2uT� S C.
Subdivision Name
g�Subdivision #
/ GUARAI=.OF SUBSURFACE SEWAGE DISPOSAL SYSTEM
-Z 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 - & - -period of _-two years' immediately:. fo1_lawing the. date. sof _approval
"C'ertificate of Construction 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 Environinental Health Services of the Putnam County
Department of Health as to whether or not the failure of the system to operate was
caused by the willful or negligent act of the occupant of the building utilizing
the system.
Dated this day of_ 19 Signature
Title
Gen a Co tracto er) - Signature
_e�P. V P Ct
Corporation Name (if Corp.)
rev. 9/85
mk
Corporation Name (if Corp.)
Address
YML ENVIRONMEN
321 F:.. ea
Y ' ���/
[
Akbert H.,Padpvani, Director'
' '
LAB ^ �
76 ^ PRnC ' PAGE
MAHOPAC, NY 10541 REPORT DA TE. 0'7/07/?8
SAMPLING SITE: 18PARTRIDGE N . SAMPLE TYPE.`-: :POTABLE
,DATE FLAB PROCEDURE- RESULT NORMAL RANGE METHOD
c -y 9139
0"1/03/98 MANGANESE (Mn 0.016 MG/L 0-0.3 mg/l 20311
07/'03196 ' JT Y .� .. N���.
COMMENTS:
BACT THESE' RESULTS INDIr4T| A
SATISFACTORY.SANI Y QUALITY ACC '
'
NEW YORK STATE
AND EPA FEDERAL DRINKING WATER STANDARDS, FORTHE PARAMETERS `
TESTED, AT THE TIME OF COLLECTION.,
Pb /Cu LFAD limits schools-.� Are set -at 15 .pb. '
EPA Lead '& Copper Rule for Public- Sys'tems requires that no more
than 10%,-i . f.'the,"r distribution point' have a LEAD value of more
than 15 oob and aCOPPER* value of 1.3 mg/L, else water `
' treatment must be undertaken to reduce the waters corrosive
potential. ' '
Fe/Mn If both i ro o� and mang 'an ese are present, their total Value
combined shall not exceed 0.5, mg/L,
'
Na No limits for Sodium are proscribed.. Suggested guidelinesi state
that for people on sodium restric'ted diet,the water should
con ain no more than 20 mg/L of Sodil/m. Forth' e on �a'
moderately restricted diet,-a maximum of 270 mg /L of Sodium-
is suggested. . '
'
PUTNAM COUNTY DEPARTMENT OF HEALTH
H
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
WELL COMPLETION REPORT
Well Location
Street Address:
`" _,-Al
T " /Villa :
Tax Grid #
Map Block Lot(s)
Well Owner:
lNap)vAddress:
Use of,Well:.
1- primary
2- secondary
ResiWendalf Public Supply Air cond/heat pump Irrigation
Business Farm Test/monitoring Other(specify)
Industrial Institutional Standby
Drilling Equipment
�. Rotary
Cable percussion Compressed air percussion Other (specify)
Well Type
Screened Open end casing >< Open hole in bedrock Other
Casing Details
Total length o
Length below grade
Diameter to in.
Weight per foot 140 lb /ft.
Materials: Steel _ Plastic _ Other
Joints: _ Welded _ hreaded _ Other
Seal: --_ Cement grout _ Bentonite Other
Drive shoe: x Yes No
Liner:_ Yes >CNo
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 2 Yield 1 d gpm
Depth Data
Measure from land surface-static (specify ft)
During yield test(ft)
Depth of completed well in feet
Well Log
If more detailed
information
descriptions orp�
sieve ahalyscs
are available,
please attach.
Depth From
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 SUS Capacity 5fiM
Depth Rsc� Model e"' 4LD
Voltage 2AQ HP 't.3 /A-
Tank Type Vk4 Volume t
RIK
Date Well CoM eted
Putnam County Certification No.
Date of Report
Driller (signature)
iwi z7 t:xact tocanon of wets wttn atstances to at teast two permanent lar►atnazxs to be provtaea on a separate sneeypl an. A
Well Drillees Name / �/ Address: y Q1..., ��
Signature: Date:
White copy: HD File; Yellow copy -Building Inspector; Pink copy - Owner; Orange copy -Well driller
Form WC -97
1
C
PUTNAM COUNTY DEPARTMENT OF HEALTH
v
A�11 IVISION OF ENVIRONMENTAL,IHEALTH -SERVICES
_. ..,. _.
..:.T. - APPLICA'TION FOR ��P�'ROVA�, =�2F PLAr1S l�'O� >..
A WASTEWATER TREATMENT SYSTEM,
1. e" and address of applicant: ! �o
Aely
im
Ft tM
2. Name of project: 3. Location T/V:u
4. Design Professional: jr, FZIT60► k (Lp 5. Address: I p `Z uc�)o v \f a--1 �-�-
6. Drainage Basin:
7. iyl2e of:Pro'ect:
_ Private/Residential Food Service Commercial
Apartments Institutional Mobile Home Park
Office Building Realty Subdivision Other (specify)
8. Is this project subject to State Environmental Quality Review (SEQR)?
Type Status (check one )........ ........... Type I .
.i� Type II
9. Is a Draft"Environmental Impact Statement (DEIS) required? .........................
`Y
10. Has;bbS been completed and found acceptable by Lead Agency? ................
11. `Naive of Lead Agency
4
12 Is this � ro'ect in an area under the control f 1 1 1 th
Exempt
Unlisted
C7 -
P . o...:. 9ca, p annmg, zoning, or o . ex
- offc�als; °brdiiiarices ?_ :.:: _ .... _ ......................... - .
13. If so, have "plans been submitted to such authorities?............ .............................. `G
. S
14. Has: preliminary. approval been granted by such authorities? Date granted:: f10 b�
15. Type of Sewage Treatment System Discharge ::..............`. surface water 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? ................
r.
21. Name of sewage system �. /°�, Distance to sewage system
22. Date test holes'observed a� , , 23.E Name of Health Inspector
24. Project design flow (gallons per:day) .. .... ...:.. .......... ...............................
25. Is State Pollutant Discharge Elimination System (SPDES) Permit required ?... _b
26. Has SPDES Application . been submitted to local DEC office? .........................
Form PC -97
20
i
27. Is; any portion, of this project..located within a. designated Town or State wetland? t-ILD
28. Wetlands ID Number..
29. Is Wetlands Permit required? ............................. --4c)
Has application been made -.�q Town or Local DEC office? ......... ......... d
30. Does project require a DEC Stream Disturbance Permit? .. ............................:.. `
31. Is or was project site,used for agricultural - activity involving application of
pesticides to orchards 'or other crops, solid or hazardous waste dis'po`sal; r
landf cling, :sludge application or industrial activity? ......:.:
... .........::. ' Yes/No b
r
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, '
DESCRIBE:
33. Is there, a local master plan on file with the Town or Village? ..... ....... ..,...........
34. Are community water and/or sewer facilities planned to be developed within
15 years in or adjacent to,project site? :.............................. ............................... _ f�
I
35. Are'any sewage treatment areas in excess of 15% slope? ...................... ..... � b .
36. Tax Map ID Number :......................:.. ................ ................ Map�� <��BIock_�_ Lot
37. Approved 'plans are to be returned to ..... Applicant Design Professional
_ - NOTE-: A_ll apPlicatiQns' forxexia�V: and' 'oval. of a new SSTS t --bc located witthiir t6NYC Watershed shall
be sent to the Department, and need not be sent in duplicate to the DEP, although the project may require DEP
approval-of the SSTS prior to final approval by the Department. Trojects.,within.the watershed :may also
require DEP review and approval of other aspects of-'a project, such as stormwaterylans 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 l .,the application must
be accompanied by a Letter of Authorization (Form LA -97). Failure to comply with this provision
maybe grounds for the rejection of any submission.
I hereby'affrrm, under penalty of perjury, that information provided on this form is true
`i% tile.best of my knowledge and belief. False statements made herein are punishable as
a Class A misdemeanor pursuant to Section 210.45 of the Pial Law.
.W E��
1 �
• PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
1 -, DES -16i DA'T'A S7H[EE'I' - SU13SUREACE SEWAGE TREATMENT SYSTEM
Owner 113'Ji' 61 BA d e m Address
Located at (Street) cQ�('S Tax Map7lifl Block Lot
indicat nea est cross street)
Municipality Q Drainage Basin
SOIL PERCOLATION TEST DATA
Date of Pre- soaking Date of Percolation Test
Hole No.
Run No.
Time
Start.- Stop
Ma se Time
Min.)
De th to Water :
?rom Ground
Surface (Inches)
Start Stop
Water
Level
Dropp In
IncLes
Percolation
Rate
1VIin/Inch
/A
2
4
-.
5
o
3 .
2
(p ,
4
5
2
5
NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each
percolation test hole. (i.e. s 1 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 -97
Indicate level at which groundwater is encountered
Indicate level at which mottling is observed
Indicate level to which water level.,rises after being encountered i
Deep hole observations made by: - � Date
Design Professional Name: r-
Address:
Signature:
f
y
Professionals Seal
esi n
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
FINAL SITE INSPECTION
Date: % _. ..
Street Location ` ` spP Y
�1. "�tt) fs,�C�.`. � .Owner Ht�ce c �o c
Town Permit #
TM # �2 q v 17 Subdivision Lot #
1. Sewage System Area
a.
STS area located as per approved plans ...........................
b.
Fill section - date of placement
3:1 barrier Lgth. Width Avg.Dpth
c.
Natural soil not stripped ................... ...............................
d:
Stone, brush, etc., greater than 15' from STS area..........
e.
100' from water course/ wetlands ...... ...............................
II. Sewage System
a. Septic tank size - 1,000 .......1,25 . ,:.....other ................
b.
Septic tank installed level ................. ...............................
c.
10' minimum from foundation .......... ...............................
d.
Distribtuion Box
1. All outlets at same elevation -water tested .................
2. Protected below frost .................. ...............................
3. Minimum 2 ft.Original soil between box & trenches
Junction Box - properly set ....................... ..............................
I
Zength required Length installed
2. Distance to watercourse measured 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' /z" diameter clean ....................
9. Depth of gravel in trench 12" minimum ...................
_...... - _.. -,10.
g
Pipeends- capped: ..:::. *. ............................................ . ....__...._.
.:
maze pumps ham
o er ................ ...............................
2. Overflow tank ............................. ...............................
3. Alarm, visual / audio .................... ...............................
4. Pump easily accessible, manhole to grade .................
5. First box baffled .......................... ...............................
6. Cycle witnessed by H.D.estimated flow /cycle...........
III. House/Buildin
a.
House located per approved plans ... ...............................
b.
Number of bedrooms ..........:..:......... ...............................
IV. Well
a. Well located as per approved plans . ...............................
b.
Distance from STS area measured ft ...........
c.
Casing 18" above grade .................. ...............................
d.
Surface drainage around well acceptable .......................
V. Overall Workmanship
a.
Boxes properly grouted ................... ............. ...................
b.
All pipes partially backfilled ........... ...............................
c.
All pipes flush with inside of box ... ...............................
d.
Backfill material contains stones <4" diameter ..............
e.
Curtain drain & standpipes installed according to plan..
f.
Curtain drain outfall protected & dinto exist watercourse
g.
Footing drains discharge away from STS area ...............
h.
Surface water protection adequate ... ...:...........................
i.
Erosion control provided ................. ...............................
Rev.
1/97
orm S -
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OE ENVIRONMENTAL HEALTH SERVICES
CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM
PERMIT # \ l ! --2 l ""
Located at
Subdivision name - VV1 Subd. Lot #
38-
Date Subdivision Approved ��012� 44�i
� - T1: V
Owner /Applicant Name - �G� i^ LES
. Mailing Address
Town or Village 10t
Tax Map�� Block Lot
Renewal Revision
Date of Previous Approval
Zip I
Amount of Fee Enclosed
Building Type Lot Area No. of Bedrooms Design Flow GPD_O
Fill Section Only Depth Volume
PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLEX
Separate Sewerage System to consist of �'%�('� gallon septic tank and
Other Requirements:
To be constructed by : 6E 8Ri_Pffl l l/1P Address
Water Supply.;
_Public_ Supply_ From Address
Private Supply Drilled by V e (,Q Address
-T,
I represent that I am wholly and completely responsible for the design and location of the proposed system(') and that the
Aeparate sewage treatment syg&m described. above will be constructed as shown on the approved amendment th ereto 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 writteh'.1ta ranUel.will be furnished the owner, his successors, heirs or assigns by the builder, that said
builder will place in g od operatirigcondrtion any part of said sewage treatment system during the period of two (2) years
immediate) follovvTg ,.the, d# 0Xthe issuance o e approval of the Certificate of Construction Compliance of the original
system or any repairs
r.
Signed:
Address
R.A. Date 12—A Ci
License #'
APPROVED FOR CONSw . M_ ION: This approval expires two years from the date issued unless construction of the
sewage treatment system has been completed and inspected 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
anew permit. Ap ve arge of domestic sanitary sewage only.
By��J Title: �S �� Date:
White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design P ofessional
Form CP -97
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
APPLICATION TO CONSTRUCT A WATER WELL
please print or type ' PCHD Permit
Well Location:
Address: Town/Village Tax Grid #
IZ- T LY \ $ Map
Block 1 Lot(s)
Well Owner:
Name: V
Address:
paAyLlv, &A
1
oq�opnc-
Use of Well:
Residential Public Supply Air /Cond/Heat Pump rrigation
1- primary
Business Farm Test/Monitoring
Other (specify)
2- secondary
Industrial Institutional Standby
Amount of Use
Yield Sought gpm # People Served Est. of Daily Usage gal.
Reason for
Replace Existing Supply Test/Observation
Additional Supply
Drilling
New Supply (new dwelling) Deepen Existing Well
Detailed Reason
for Drilling
Well Type
Drilled Driven Gravel
Other
Is well site subject to flooding? ................................................. ...............................
Yes No
Is well located in a realty subdivision? ...................................... ...............................
Yes___,_ No
Name of subdivision q LAn
Lot No.
Water Well Contractor: TQ 1` L%1pDAddress:
Is Public Water Supply, available to site? .................................. ...............................
Yes No
Name of Public Water Supply: Town/Village
Distance to property from nearest water main:
Proposed well location & sources of contaminatioAtoe. pro vided on sep to sheet/plan.
Date: .- . G, _ Applicant _Signature:: -
- _
PERMIT TUCQ ,4RUCT A 4" WELL
This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the
Putnam County Sanitary Code and 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 or their designated
representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the
requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form
provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or
well driller shall take appropriate action to assure that any and all water and waste products from such
well drilling operations be contained on this property and in such a manner as not to degrade or otherwise
contaminate surface or groundwater.
APPROVED_FOR CONSTRUCTION: This approval expires two years from the date issued unless
construction of the well has been completed and inspected 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 permit. Well to be constructed by a water well driller certified by Putnam
County. C_
Date of Issue - Permit Issuing Officia)�` --'
Date of Expiratio - g Title: •
Permit is Non- ransf rrabl -
White 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:
tnu .. .. .. � .. . _� - Lts. t . �. -,.. e.. f4 ,... R .l .. .c ..... ..� i. .: .L .. r an __ r ♦n.-9�: =a¢:s .t �. ♦ � •a 0.4.�..i•.
RE: Property of
LETTER OF AUTHORIZATION
Located at�.n'Cki_t
T/V Tax Map # Block Lot
Subdivision of
Subdivision Lot # L Filed Map # �!51 � Date Filed \A
Gentlemen:
This letter is to authorize Boifrb oAeh
a duly licensed Professional Engineer ')( - or Registered Architect to apply for the required
wastewater treatment and/or water supply ermit(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 treatment and/or water supply systems
in conformity a _proyisions of Article .145- and/or 147 of the Education Law the Public Health
,
Law; and ie County S i ary Code.
K'A `.
Col
P.E
I
State Zip
Telephone:
Very truly
Signed;
(Owner of Property)
Mailing Address: 17 S fI7, vff t� I)/?.
State /V
Telephone: L?j � / —
Form LA -97
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH
INDIVIDUAL WATER SUPPLY & SUBSURFACE, SAVAGE TREATMENT SYSTEMS
REVIEW SHEET FOR CONSTRUCTION PERiMIT / Q
STREET LOCATION L' / �/ �G«'i,e_ NAME OF OWNER �R�/� -/N 464�j 4
REVIEWED BY' /�/�: DATE TAX MAP
Y DOCUMENTS
PERMIT APPLICATION
PC4
WELL PERMIT _ PWS LETTER
LETTER OF AUTHORIZATION
DESIGN DATA SHEET (DDS)
CORPORATE RESOLUTION i
` ",1adRT EAF�,
P HREE SETS
WOETS - --
ARIANCE REQUEST
SUBDIVISION
LEGAL SUBDIVISION
pgSUBDIVISION APPROVAL CHECKED
J-_ RATE Z_
FIL�QUIRED DEPTH
CURTAIN DRAIN REQUIRED
Fn�1 �6 W�►- 'FEItSI-IID���' �
SUBMITTED TO DEP
ATED. TO PCHD�/��
TTGVAL, IF REQ'D
FAT HOLF 0BSERVED_
LSDS -A�DJ. LOTS'
9L=A=S(1_Q PERMIT REQ'D?
DATA ON DDS PLANS & PERMIT SAME
PRE 1969 NEIGHBOR NOTIFICATION
LETTER BI/ZBA .
100 YR,FLOOD ELEVATION ( /
OTHER REQ'D PERMITS)
REOUIRED DETAILS ON PLANS
SEWgGE SYSTEM PLAN - (NORTH ARROW)
BSDS HYDRAULIC PROFILE GRAVITY FLOW
EONSTRUCTION NOTES l
9PIGN DATA: PERC & DEEP RESULTS -�
T CONTOURS EXISTING & PROPOSED ,
DRIVEWAY & SLOPES, CUT
FOOTING /GUTTER/CURTAIN DRAINS
COMMENTS:
EROSION CONTROL:HOUSE,WELL, SSDS
PERC & DEEP HOLES LOCATED
REPRESENTATIVE OF PRIMARY & EXPANSION
OCATION MAP ?
V. E Xk. `AREA; SHOWN; GRAVITY FLOW, SUFF.SIZE
PUMPED, PIT & D BOX SHO ED-
USE - NO.OF BEDROOMS
WELLS & SSDS'S WAN 200' OF PR POSED SYS. ,a✓�
PROPERTY METES & BOUNDS
OUSE SETBACK NECESSARY (TIGHT LOT) �-
T.ONOBENDS; USE SEWER - 1/4" FT. 4 "0; TYPE PIPE
MAX.BENDS 45° W /CLEANOUT
CLAY BARRIER
10- FT. HORIZONTAL; OPE 3:1 TO GRADE
FILL SPECS FILL NOTES
FILL CERTIFIC ON NOTE
DEPTH GU S
FILL PR ILE & DIMENSIONS
NCHTROVIDED" `60`FT'MAX __ — -�
PARALLEL TO CONTOURS --�
100% EXPANSION PROVIDED
SEPARATION DISTANCES SPECIFIED
ON PLAN - FROM SSTS
r
10 PO L DRIVE_ LARG TR S: � y FILL
20' TO FOUNDATION WALLS 15'WELL TO PL
100' TO WELL, 200' IN DLOD, 150' PITS
-I00' TO STREAM WATERCOURSE LAKE (inc. exp
0' TO CATCH BASIN, 35' STORMDRAIN, PIPED WA
TO WATER LINE (pits -20')
50' INTERMITTENT DRAINAGE COURSE
0'/500' RESERVOIR, ETC. _ I50' GALLEY SYSTEMS
15'min to CDS= >5 %,10'- 4 %,25'- 3 %,30'- 2 %35' -1 %,100' -< o
20' in to CD discharge /I00'with 182 cons day discharg
SEPTIC TANK
10' FROM FOUNDATION; 50' TO WELL
R
FORM ST-2
i
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( Filed September 14, 7970 as ;�cp No. 815-8)
_ LOT 47' ! i
N 33002'10 " E ! radial)' 256.56' _
R = 400.00' N 3rado�
to /a.
G = 21029."10" °°s: op-se
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L = 150.00 C �f •
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PVC
�CdPP�'L Y� aj stone we
48 �,
4'$ Area ; 54,300 Sq. Ft.
we /+" /Fri (: 1.2465 Acres) i
rough _ dirt and grovel driveway G� 2
6' l TYv)
d 5"
f•
ar pole J&Ma CAn G l
guy cable 1
AP ' • `sue °3� .l�..kro,.► ' . '
clJ e
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Qcb
46�
6 D ce�6e� �� � t �6 00 ,
S 7969 E ,S 3
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s'I,iT.OBiu l:UUt,cy ueyst•wueu� ut tte�i.Lt�, F
Division of Environmental Health s®rvloek
o 1L t'c. i Sr, n C.
approved as noted forlonformusr with
%pplioable Holes and iftulatione ;at tie
?ut am County lth Department,.
i , +1
SYSTEM
COMPONENT
DISTANCE
TO
INT, IN FEET
"A"
B.
C.
"D ".
WELL
79' -0"
88' -0"
1260 GAL. CONC.SEPTIC TANK
29' -0"
38' -0"
JUNCTION BOX NO.
1
80' -0"
64'•4"
2
80'4"
64'-8"
3
81' -0"
67' -0"
4
83' -0"
681•8"
6
86' -0"
63' -0"
END OF ABSORPTION TRENCH, PT NO.
a
44' -0"
20' -0"
b
46' -0"
26' 4"
c
48', 0"
.30' 4"
e
66' -0"
41' -0"
If
124' -0"
96' -0"
g
126' -0"
98' -0"
h
126' -0"
99' -0"
1
127' -0"
100' -0"
j
128' -0"
102' -0"
t
1. THIS IS TO CERIFY THAT THE SSDS WAS CONSTRUCTED AS SHOWN ON THIS PLAN AND THAT THE SYSTEM
WAS INSPECTED BY ME, JOSEPH C. BARBAGALLO, P.E., PRIOR TO BEING BACKFILLED. THE SSDS WAS
INSTALLED IN ACCORDANCE ALL STANDARD RULES AND REGULATIONS OF THE PUTNAM COUNTY HEALTH
DEPARTMENT AND THE NEW YORK STATE DEPARTMENT OF HEALTH.
2. SURVEY SHOWN WAS PREPARED BY BAXTER LAND SURVEYING, P.C. DATED DECEMBER 4,1887 AND
UPDATED ON JULY 3,1888.
R.P.K. PRECISION HOMES
PARTRIDGE LANE, PUTNAM VALLEY, NY OF NEW
PUTNAM ACRES, SECTION B - LOT 48 5 ��
T.M. 74.17, BLOCK 1, LOT 48
SSDS AS -BUILT CERTIFICATION
JCB PLANNING, DESIGN & DEVELOPMENT
�D „ 102 WARREN ST, SOMERS NY 10589
JULY 10- 1998
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