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HomeMy WebLinkAbout3722DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 74.18 -1 -2 BOX 29 03722 :13 li Wr ,.! f - . 90a. `, ��. oil m. ■ ' ■. �� 03722 PUTNAM COUNTY =DEPARTMENT OF HEALTH ENGINEER MUST I DE Division of Environmental Health Services, pROV Carmel, N. Y. 10512 j/ �0 PERM. T # CERTIF �E OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM Town or Village Located at ' f� �cof �W Wt Map Block Owner��_/c 240 -.t�Ad ` kl Xrly .� Tax Map t N Subd. Lot Y Separate Sewerage System built by L' — `�f • Address a'k )y ��,sy Consisting of YGaI. Septic Tank and Other requirements_ r ���� Water Supply: Public Supply From Private Supply Orillod By AO�G �*O�Ifs Address .�� ° '" Building Type F No, of Bedrooms Date Permit Issued Has Erosion Control Been Completed? Has garbage grinder been installed? if 791 I certify that the system(s) as listed serving the above premises were constructed essentially as shown on the plans of the completed work ( copies of which are attached), and in accordance with the standards, rules and regulations, in accordance with the filed plan, and the permit issued by the Putnam County Department Of Health. v Date Certified b P.E. R.A. if Address . ' a License No. Any person occupying premises served by the above system(s) shall promptly take such action as ma/be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate se erage system shall become null and void a$ soon as a public sanitary sewer becomes available and the approval of the private water supply shall become It and void when a Apc water supply becomes available. Such approvals are subject to modification or change when, in 'the judgment of the missy r of Healtrevocation, modification or change Is necessary. r i -n % 7 if I /, e--" cam, , Date a _ BY V Title Rev. 6/85 + 0 a _ WELL COMPLETION- REPORT DEPARTMENT OF HEALTH Division Of Environmental Health Services PUTN .1 COUNTY DEPARTMENT` OF . HEAT,TH Office Use Only 'A U SIR ' AO SS:• WN /VIL / 1 Y TAX GRIO NUMBER: WELL OWNER NAME.- _ ADDRESS: , . a _ WELL COMPLETION- REPORT DEPARTMENT OF HEALTH Division Of Environmental Health Services PUTN .1 COUNTY DEPARTMENT` OF . HEAT,TH Office Use Only WELL LOCATION SIR ' AO SS:• WN /VIL / 1 Y TAX GRIO NUMBER: WELL OWNER NAME.- _ ADDRESS: , . PflIVATE ❑ PUBLIC USE OF WELL 1 - primary 2 - secondary RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /CONO. /H PUMP O ABANDONED ❑ BUSINESS ❑ FARM ❑ TEST/ OBSERVATION ❑ OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT gpm. /N0. PEOPLE SERVED EST. OF DAILY USAGE 2'10 0 gal. REASON FOR DRILLING NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST/ OBSERVATION ❑ REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA ? =� WELL DEPTH — �� ft. STATIC WATER LEVEL 3D ft. DATE MEASURED DRILLING EQUIPMENT X ROTARY . ❑ COMPRESSED AIR PERCUSSION • ❑ DUG ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ❑ SCREENED ❑ OPEN END CASING. AOPEN HOLE IN BEDROCK ❑ OTHER CASING DETAILS TOTAL LENGTH - ft. MATERIALS: )RI STEEL ❑ PLASTIC ❑ OTHER LENGTH.BELOW GRADE ` ft. JOINTS: ❑ WELDED KTHREADED ❑ OTHER DIAMETER " in. SEAL: ❑ CEMENT GROUT ❑ BENTONITE BOTHER WEIGHT PER FOO'i 1b./ft. I DRIVE SHOEfig—YES ❑ NO _ LINER: ❑YES)gNO SCREEN DETAILS DIAMETER (in) sL07 SIZE LENGTH if DEPTH TO SCREEN (ft) DEVELOPED? FIRST O YES ONO HQUAS...._. SECOND -_ -... GRAVEL PACK °YES ❑ NO GRAVEL SIZE: DIAMETER OF PACK in. TOP DEPTH ft. BOTTOM DEPTH ft. WELL YIELD TEST pumping t If detailed METHOD: ❑ PUMPED 1 tests were done is in- COMPRESSED AIR formation ,attached? O AILED O OTHER ; ❑ YES ❑ NO If more detailed formation descriptions or sieve analyses 1AlELL LOG are available, please attach. DEPTH FROM SURFACE Water Bear- ing Well Dia- Ineter FORMATION DESCRIPTION CODE. tt. tt. WELL DEPTH ft. DURATION hr. min. DRAWOOWN ft. YIELD ggm. Land l WATE$ O CLEAR .TEMP. QUALITY O CLOUDY HARDNESS O COLORED ANALYZED? OYES ONO ANALYSIS ATTACHED? O YES O 140 STORAGE TANK: TYPES CAPACITY 3-o GAL. / v� PUMP INFORMATION �/ TYPE CAPACITY _ `r MAKER DEPTH =3 ®d MODEL _W_1 VOLTAGE 136 HP� WELL OR ER NAME_ DATfc �� / AoD��11/y TuRE .,IA 1051P Yorktown Medical Laboratory, Inc. LAB I ! ' ='7 . c_�car�7�� ' 321 Kear Street Date Taken Time : -7•" -OR7 Yorktown Heights, N. Y. 10598 , K. . .. _ Date ;Rc d:.. ,! .?/ Time (914)245.3203 Date 'Re orted. JAfl�. 27 �988T Director: Albert H. Padovard M. T. (ASCP) Collected B =-/,/ T_ -� Referred By: Sample Location: ti Jf 1(-'VW 7_1 A1e.. Phone # ��/7?✓/f7 -j r/ U� j /�% lOc/�7� Phone . # Sample .Type: . L / Repeat Test? _ (check one) _LABORATORY REPORT ON THE BACTERIOLOGICAL QUALITY OF WATER GENERAL BACTERIA v Standard Plate Count (CFU /1.OmL) (Agar Plate @ 35 °C) MEMBRANE FILTRATION TECHNIQUE (MFT) �! Total Coliform (CFU /100mL) _ Fecal Coliform (CFU /100mL) _ Fecal Streptococcus (CFU /100mL) MOST PROBABLE NUMBER TECHNIQUE (MPN) _ Total Coliform: MPN Index (per 100mL) Fecal Coliform: MPN Index per 100mL) OTHER ANALYSES REMARKS (For Laboratory Use) r?0 0 V Potable _ Non - potable _ STP INF STP EFF _Other: Sample Status: (check each) Outgoing _ Na2S203. Incoming ALE 4 °C _ GT 4 °C _ Other: KEY FOR TERMINOLOGY RDS = Recommend Disinfec- tion of Source TNTC= Too Numerous To Count CON = Confluent ( =TNTC) LT = Less Than (<) GT - Greater Than (>) N/A = Not Applicable LF. a LoRA than er eaual to THESE RESULTS INDICATE THAT THE WATER SAMPLE WAS (WASN'T) (N /A) OF A SATISFACTORY SANITARY QUALITY ACCORDING TO THE E YORK STATE DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT-THE TIME OF COLLECTION. AA For Lab Use Only: Alber 12 /85(Rvsd7 /87)RWE , Yli"1C6 MVd" H/C to LAB OFFICE HOURS (fain Lab): 9AM -5PM9 Mon. -Fri. 9AM -NOON, Sat. PETER C. ALEXANDERSON County Executive ENID L. CARRUTH, M.P.H.: " •' =" '' ""'' 'Public Health Director JOHN SIMMONS, M.D. Deputy Commissioner JOHN KARELL Jr., P.E. DEPARTMENT OF HEALTH Director Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 Memorandum TO: All Engineers and Architects FROM: John Kare ll, Jr., P.E., Director SUBJECT: ADHERENCE TO SANITARY CODE DATE: December 29, 1987 The Sanitary Code states that an application (sand its pesii►it� are not legal until all amounts- required are paid and the Code implies that payments should be guaranteed payab.le. Q All potential permittees and all those responsible for paying fees for Realty Subdivision,-Commercial Sewage and Individual Sewage Disposal Systems, are to be advised that only :CERTIFIED; >CHECKS OR 'MONEY --O,YLll be accepted from now on. This willassure that we are in compliance with local laws and that payment has indeed been received prior to the issuance of official approvals. tew �/�w,,c�1 ZSc�,alrk �xfi 7rrfiA✓� `a f��v PUTNAM COUbTlY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Ow er or Purchaser of Building Section Block Lot Building Constructed by Tv 6T;2Tf' Location - Street Municipality Building Type S vision Name f-44 wCc -L 20 Subdivision Lot # GUARANTEE 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 awperiod of two years immediately following the date of approval of the "Certificate' of Construction Compliance" for the sewage disposal system, or any repairs- nade�- •by- -m- to - -such system, except whe.�E tl-e 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 - 1� day of 19K General Contractor (Owner) - Signature CorporatierrName (if Corp.) R 471� u��'d t L rkne , Address Cc, oS ,& I i I i rev. 9/85 mk Signature Title Address e. II. IV. V. FINAL SITE INSPECTION Z4d fi tA_ G� S 1 JAM �.- OWNER �AA -- Inspected 'by 4. IM # OR SUBDIVISION LOT # 1 YES NO SEWAGE DISPOSAL AREA a.. SDS area located as per.approved plans _. b. Fill section - Date of placement 2:1 barrier.. LGTH WIDTH AVG.DPTH c. Natural soil not stripped d: Stone, brush, etc., qreater than 15' fran SDS area. e.. 100 ft. fran water course /wetlands. SEP&GE DISPOSAL SYSTEM a. Septic tank size - 1,000 ,250 ?� b. Septic tank installed level c. 10' minimum fran foundation d. No 900 bends, cleanout within 10 ft. of 45" bend e. DISTRIBUTION BOX 1. All outlets at same elevation - water tested 2. Protected below frost 3. Miniman 2 ft. original soil between box and trenches - f. JUNCTION BOX - properly set S . g. TRENCHES 1. Length required - Length installed 2.'Distance to watercourse measured: ft. 3. Installed according to plan 4. Distance center to center 5. Slope of trench acceptable 1/16 - 1/32 " /foot. 6. 10 feet fran property line - 20 feet - foundations 7. Depth of trench < 30 inches fran surface 8. Roan allowed for expansion, 50% (� 9. Size of gravel 3/4 - 11" diameter 10. Depth of gravel in trench 12" minimum 11. Pipe ends cappexa h. PUMP OR DOSE SYSTE M3 1. -Size -of- -puny chInber 2. Overflow tank 3. Alarm, visual /audio 4. Pump easily accessible manhole to grade 5. First box baffled 6. Cycle witnessed. by Health Department estimated flaw per cycle HOUSE a. House located per approved plans. b. Number of bedroom: WELL . a. Well located as per approved plans b. Distance fran SDS area measured -,o ft. c. Casing 18" above grade. d. Surface drainage around well acceptable. OVERALL WORKMASHIP a. Boxes proper y grouted 1` b. All pipes partially backfilled X c. All pipes flush with inside of box d. Backf ill material contains stones < 4" in diameter e. Curtain drain installed according to plan 1 f. Curtain drain outfall protected & dir.to exist.watercours g. Footing drains dl.schar a away from SDS area h. Surface water protection adequate i. Errosion control provided on slopes greater than 15 %. 1 z �. x�n°+. `.,..�. ', .,,A .N.• :rr �, 't"; tt esw 1iwi. -r,�`a, ' s'.�.�'"�-y`• t�`7�r�; .: Kx'"�"'�''•� ^s �. ^ � 4'" r�TT�r�.,°°3�:i�;'ik` _ �1. � k s� Mi'� Qp ` PUTNAM COUNTY'DEPARTI!tIENT OFHEALTH Rev. 3186 i oeetoProvldePermit# Division of Environmental Hesdth Seevlcee Carmel NiY.1051? Eogln �J on CERTIFICATE OF COMPLLANCE' - , . � 'r Permit N / !!�� '•"" CONSTRUCTON PE FORS „ AGE DLSPOSAL SYSTEM ,Q s /(% I6; 0 A Town or Village 77 5abdlvlsioa Name Tea MapBlock Lot Renewal „_❑ Revision ❑ Owner /Applicant Date of Ii revioas Approval �p Melling Address / / war G /® Town ' . f 1/ ZIp u `: Banding Type O /�L Lot Area zi; �C° FIll Secdon On1Y Depth Volmne Naniber of Bedrooms • Des �0;. ' : PCBD Notification is!,Regalreil When Fill is completed, ign,Flow G /P /D Separate Sewerage System to consist of Ganon Septic Tank To;be conscted by !< �" CtJ Address CGd (ii Water Sappy; Pabnc Supply From Address.I / orr Baivate Supply Dialled by address lII/ Other. Requirements ti d r �, c 1, :. vot lei ! represent, at•I am wholly and`completeiy responsible for th' tles�gmand location of the propose0 systems) 1). that the separate: sewage didposal. system above ;tlescnbetl;will be constructed as shown on the approved amentlment thereto and m accordance wdh the ia- ndarq's rules arid, regu a ions o e Putnam County ' Oepactment of ", Health ,,antl that on comDlet�on thereof a Certificate:'of Construction t omphance sat�sfactory,to the Commissioner•ot Health will be sut milted %to the Depa►tmentj and a wntten guarantee wJl be furnahotl, the owner„ his successors heirs or assigns by the Dwider; that said; builder will place ,in good operatmg: condition any part of said sewage; tlisposal'. system.,during the. nod'of two 2S: years immediately followirig thedate of -the issu- ance,,, of the; approval of; the Cert�fitata ioi ConstrucLOn Compliance, -of the; ongmal•system.or,any repairs thereto; -2) that the drilled well described above will be focated'as shown -on the approved Dian antl that said well will be install accor ce with the standards 'rul and .regu a-1a ns of t e `Putnam County Depart et o Health Date ..Sighed' • — `:. 6 P E R.A Address � Zee License No; zz APPROVED FOR CONSTRUCTION This +'approval exp ires_;Isw�yew,trom the -Gate issue unless construction of the building has been undertaken and is ievocable fiiu se oi. may be amended or riiotl�f�ed when considered n essary ,by the Commissioner of Health. -,.Any change, or alferation of construction requires a permit. ApprovetlforAis oral of,:domestic sanita ste• water supply only.• Date /= ri "1 ®. BY Titie. ° i ' DEPARTMENT OF HEALTH Division of Environmental Healtb Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 - - - A:PDLICATION. TO CONSTRUCT.A- WATER- _W.ELL -,;_- �:• . PCHD PERMIT # .� WELL LOCATION Street Addres o A4 U/r Town /Village /Cit Tax D8 ,o �t cz Grid Number (' - Z, —/ WELL OWNER Name /� Address za GpIrrivate ❑ Public USE OF WELL primary 2 - secondary ARESIDENTIAL ❑ BUSINESS ❑ INDUSTRIAL ❑PUBLIC SUPPLY O FARM O INSTITUTIONAL QAIR /COND /HEAT PUMP ❑ TEST /OBSERVATION ❑ STAND -BY 0ABANDONED ❑ OTHER (specify O AMOUNT OF USE YIELD SOUGHT _'f-' gpm /# PEOPLE SERVED .- /EST. OF DAILY USAGE PW gal REASON FOR DRILLING DKEW SUPPLY []PROVIDE ADDITIONAL SUPPLY ❑REPLACE EXISTING SUPPLY ❑DEEPEN EXISTING WELL O TEST /OBSERVATION DETAILED REASON FOR DRILLING -2 t- &J 41671,0 67- WELL TYPE WDRILLED DRIVEN ODUG GRAVEL OTHER IS WELL SITE SUBJECT TO FLOODING? YES ie"' NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: 114P !rlt3 O ' Lot go. �0,�,�lo��Z za WATER WELL CONTRACTOR: Name a r�" Address: lfr ul-I Ld IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES i,,"' NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DSST.ANCE.TO- _PROP.ERTY._.FROM .K:EARSC j�iATE.R.M.AIN:: ___ _.... �._..__,. _._..__...._.__ �...._ _..._.:.._.:..,._:. LOCATION SKETCH & SOURCES OF CONTAMINATION ON REAR OF THIS APPLICATION (date) PROVIDED ON S -RATE SHEET - (signature). PERMIT TO CONSTRUCT :A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. Date of Issue: V�.. �5 19 Date of Expiration: 19 er �tIssuing Official Permit is Non- Transferrab e R /fif L i PETER C. ALEXANDERSON County Executive _. DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 May 1, 1987 William F. Zeiler, P.E. Concord Road Mahopac, New York 10541 ej'� Dear Mr. Zeiler: RE: Proposed SSDS Ericksen Roberts Drive Putnam Valley 66 -2 -1 JOHN SIMMONS, M.D. Deputy Commissioner JOHN KARELL, Jr., P.E. Director Review of plans and other supporting documents submitted at this time relative to the above captioned project has been completed. Comments are offered as follows: X Property metes and bounds are missing f;_ ...- ...:_..__.r.._....P,r.ov- ;-de- deaai= le�d- :-- d- r- awi,n•gs o r di si:ri bu`tiron._ box, junction boxes, septic tank, trenches and well . Show clay barrier around fill section in plan view. Upon reciept of a submission, revised to reflect the above comments, this application will be considered further. Very truly; yours , A AB:pt Asst. Public Health Engineer J File AB APPENDIX B PUTNAM COUNTY DEPART1,j= OF HEALTH - DIVISION OF ENVIRONMENTAL HE'ALTE SERVICES INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS REVIEW SHEET - CONSTRUCTION PERMIT (Name of Owner) (Street Location) CONMENTI`S YES I NO I DOCUMENTS Permit Application Corporate Resolution Plans. - Three sets Engineers Authorization Design Data Sheet (DDS) Deep Hole Log s/s Consistent Perc Results (3) Perc Hole Depth SUBDIVISION Perc Fill cd House Plans - Two sets Well permit; NIS letter Variance Request GaQERAL Legal Subdivision Subdivision Approval Checked _ Ex-approval _ SSDS Adj . Lots Checked Wetland (Tcwn/DEC Permit R & D) Data On DDS Plans & Permit Same RBQUMM DETAILS ON PLANS Sewage System Plan - (north arrow) Sewage System Hydraulic Profile - Gravity Flow Fill Profile & Dimensions - Volume D or J Box;Trench /Gallery; Pump pit details Septic Tank - Size, Detail Well Detail, Service Line if over Construction Notes Design Data: Perc and deep results . Driveway & Slopes Cut Footing /Gutter,Curtain Drains (discharge OK) Perc & Deep Holes Located Representative of primary and expansion Expansion Area;shown;gravity flow,suff. size If Pual)ed Pit & D Box Shown & Detailed House - No. of Bedroans Wells & SSDS's w /in 200 ft. of Proposed System Property Metes & Bounds House Setback Necessary (Tight lot) House Sewer - 1 /4 " /ft. 4 "0; Type pipe . No Bends; Max. Bends 45° w /cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 10' to P.L., Driveway, large Trees,Top of fi' 20' to Foundation Walls 100' to Well; 200' in D.L.O.D, 150' pits 100' to Stream, Watercourse, Take (inc. expa 15' to Drains - Curtain, Leader, Footing 35'to catch basin,stonndrain,piped watercour. 10'. to Water Line (pits -201) 50' intermittent drainage course Septic Tanks - 10' fran Foundation; 50' to v�11 15' Well to PL lit%(( �rf fit "jlTtJ,�t I ' PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Re: Property of Z1'K��%' lU_CA41 G .e /LI seS ; Located at[ I-6 iUI,, �/lc'7.J j XC62Cs2' -S (T) % Section Block Lot Subdivision of Subdv. Lot ## AA&16 -7- ht ZO Filed Map # Date Gentlemen: This letter is to authorize A4j11&t-4d&t a duly licensed professional engineer or registered architect (Indicate to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the standards, rules or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in. connection with this matter and to supervise the construction of said .in- c'uxrfor•mity- - w--ith. _.the-- p:ravis i oits--oF 1.45 5r _ ..._.. 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Countersigned: P.E. , R�rA. , # Address C LJ 4 -;6p- 1171 Telephone Very truly s = � =? d Signed Owner of Prop: i:i�ty rj 7) CDAJ i/ N AD Address Telephone DESIGN DATA SHEET- SUBSIMCE SEWAGE DISPOSAL SYSTEM FILE NO. Owner �J,P /CVS,5/ Address 77 �a,�1���1r'� �' .SYo-s -sue - Located at (Street)L ! & Vl674) /�) /1 a[3�i �/�'• Sec. Block Lot / (indicate nearest cross street) Municipality �� �d.% Watershed Date of Pre- Soaking /o _ Date of Percolation Test HOLE gyp. 3.; /j,'0 S" -3o 2 s- j NUMBER CLOCK TIME 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 3 gyp. 3.; /j,'0 S" -3o 2 s- j 30 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 TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES. - - ..._ ..;.HOLE N0. - -- DEPTH. HLE .NO G.L. Jif - L_ - -T 2' 3' 4' 5' 6' 7' 8' 9' 10' ill 12' 13' 14' INDICATE LEVEL AT WHICH 'GROUNDWATER. IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED 3 / DEEP HOLE OBSERVATIONS MADE BY: DESIGN -- Soil Rate Used '20-310 Min /1" Drop: S.D. Usable Area Provided 6'0661 -'F No. of Bedroans Septic Tank Capacity 00 Absorption Area Provided By L.F. x 24" width trench Other 7 1WO. a /c- VJ o K i < % Name AliCLI',1901 j6� Z 6-( ' Signatur Address leo-rb 0 !// 9A/ _Z i Z- SEAL � C_ A, /, 11�i THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: gals. Type COPe- o i�i.� Aeoywl PROFESSIOXO'' Soil Rate Approved sq.ft /gal. Checked by `""'"'r Date PUrNAM COUNTY DEPAMU'VT OF HEALTH - DIVISION OF ENVIRONMENTAL. HEALTH SERVICES IN- DIVIDUAL WATER SUPPLY SUBSURFACE SEWAGE DISPOSAL SYSTEMS FIELD PECTION REPORT. INSP. BY: (Name of Owner) (Street Location) INITIAL SITE INSPECTION YES NO C n%IE 7S Wetlands on /or proximate to property.............. Property lines or corners found ................... Can estimate house location ....................... Willdriveway need cut ............................ Must trees be•renoved - note these........... .. Deep holes representative of entire SDS area...... P.dditional deep holes neede3 ...................... Sufficient SDS area available considering driveway cut, house location, separation distances,etc... Adjacentwells /septics ............................ Arms to urccosed well location for drilling._... D. H. 1 Lot, Depth to G.-W. -.�-- Depth to rock 0 ft. 3 ft. 6 ft. 9 eft. .12. ft Soil Descr D. H. 2 Lot Depth to G. W. Depth to rock 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. D. H. - Deep Hole G.W. - Groundwater D.H. 3 _ Lot - Depth to G.W. Depth to rock 0 ft.' 3 ft. 6 ft. 9 ft. 12 f t.- Soil r— DATE: FINAL SITE INSPECTION INSP.BY: YESI NO CC1'S House SSDS located per approved plan ............. Length of trench measured Width of trench average Slope of tile line and trench acceptable.......... Room allowed for expansion trenches ............... Over 100 ft. from watercourse .................... Natural soil not stripped or SDS area unnecessarlygraded.......... .............. 10 ft. maintained from. property line and 20 ft. from house .............................. Distance well to SSDS (ft.) ...................... Numberof bedrooms checks ........................ Stones, brush, stumps, rubble, etc., greater than 15 ft. from nearest trench ................ 15 ft. of peripheral soil horizontally fromtrench...... ........ ....................... Boxes properly set................................ Could surface runofffran driveway, roads, - ground surface,, etc., channel near SDS area.... Does lot drainage appear OK•,in* area of SDS::....... FINAL GRADNG OF SITE ACCEI ABLE .. .. ... i w '<7f HEMLOCKS PXRA0'- 64 As Bfj,,-r 2),-,cA)c,#v1 ow— FIZZ we'-' Dacd- 7, too, 3 &70 'R 105-.3: /,o. , 0. x f J. 2*, '* 9:.,1' x4l -Z+yih! I , z' .r' /01.z' '97 "07 10 /32.3 , /3L7% I 1 1.1", Izz.5 143.r /24.1 w '<7f HEMLOCKS PXRA0'- 64 As Bfj,,-r 2),-,cA)c,#v1 ,4 8 7, 9.130 3 105-.3: /,o. , 0. x f J. 2*, '* 9:.,1' I , z' .r' /01.z' f Z7.3' 10 /32.3 , /3L7% I 1 1.1", Izz.5 143.r /24.1 4*.44. CX.R A- & IV Y4 "lAr. 121,114, Z rffS 19 TO CERTIFY THAT THE SETAGE DISPOt/A' ST ST WAS COINSTRUMM, A _T S T'rCAT9M 0i'l THIS PLAN AL THE SYSTT..'! V,"AS T'-'�­. ' _ . -'In;L IT WAS CO ED OVhR t -!'­­:D IN ACCORAWE WITH ALL Tu'OF THE PUTUAM MU, TTY DEPARTI T 01, 7'x 16'.VPA Se'94z: AORIZOAM91 O Sci le 7 4; 7 -rer ry Z io -4 0 --is OW-MlYlVis--ellIewl Opp All J At elf 5 h2rl A & "A&Mle-AlWqX rucluam Jivision of Environmental ��..lth Servioet Approved as n/tlrdfo'gV)(_/ r conformance with ._dP &licabllo R-1-- and Regiliations of the 'at "a P C "ul"' , County Ith Deportment. t qtAnature Ti SEPT/, C DES 16 Al HERBERT 10- SUSAN lelfle //Sle/v X170,9T,_- " 7-Ae 70AIN 0,0`Pl17Wq1P7 )XZZ—FY-ParAIAM e,00N7_Y- _WY A < SeAx_-_._ 50, e24; Z -, e14 _30, 1?6 7 ?"ea.R. A4A' 450 ey Ar- Sw(,-e: Alo✓VW OF NEW ID pt4 F. A' IROV,9 S41qY;eX.0,le N>P e*0Ale0A0.0 ?,0,9P - 1%V11eV,'9e - A�✓-,w YAW,< 1054 4 (914) 1,26 - 4 764 ;Z� N °o y G90 _. --OYE y 0 i i. o' .. u 4'P,*. C.I. P, _L_ /I.v. Same Y4 Y/Y. vzoo.Cc, Strnc i T,u LL_.7 i L I.-lizoJ74"I t- pJO-L pJu' - - ROAD , 100' P.LA -Iv SG/gL.E: /,.,.50' b /8'1✓/oL � lrq N/1Rw.w1 PROF /.CE �o ,LEGEND t' Too So/ L O SEPT /c 7q v,< /'^� T Sic 7-.y L l y- CY/ W O /V.E • 's -::.- -- _-�___� - ---_ - _ o . _. Disr.PiBUT/oN Ba.r- `__ _- -= w, -crr.z -fr 3 ' • 1 � PE.PCO<gT /OAJ TEST�LE ( 7cs. oo - naeo) ti DEEP TsT S/OL6 O WELL T Sod _ _ 4 • QiA. �.PF. P/PE ' gyp. 94 ' �r � /. SEw,°6.ED /sPOSl1,GSyST,EM To B.EI.USrALL,EOTo Lo.UFa.P/'/ %O S.°.EG /fiCATidUS / � /! ! ,�� ASS. rrfR>I/ BYT. bE�IIT. VAMCDUNTyII ,FA.[ >NOEP.9.PTi'I.ENT, /./ . -` 1��;�� Qpav Z. , QEroav E. 9LLT .E.ES�tirsvN /O'Df,_S.'S.D.A. //� � �4a � ' .3 T. E. G. P. EASD`. c!. veAreo. va. �w, s�Drs' oasvcFi.E <osC.ExPA�ts!ovA.P.E.v ' , / �� t Df �P RG w. • To, �E�' Y, 3' /CALLYi/AR.r.EOI/t/T,E,I'AeutJp ��O,Egpry/�Yi.U6 OY �p� k° 8P ; Cort srPUt>/ avFuiP .fF�>Js.7oBE.9sLOwcolTESE -,.g FrcFPr cr'�/ AS.PEdUGP.EOiJR Ak&rRUGTiD.0 OiTMEsYSTEM. �3a °O' SAS � 4. CaureAeroeTo, T .usrq<t,SEPriGToF <ow8rd,P.vvrry % �,�, Jr. %✓EL< %p EXTEND IB i�BOYEF /Nq,[ tiRllOE. Putr!fim County Department of Health s Divisio., a"' aironmenta' i 3_ih ServiC ®d ad £or C, - ^ applir. snd'Re _ - s of z e s0 Putnam County Health Deis::;; .S.EPT /C DES /G ignQture & Title Date b, G, G' //, - PREPARED FOR flMW72- r/✓ r,%-' TOWN OFPUTNA/V WZ-1ZY- ,P1,171 COt11V7-Y-NE- A1YO.PK P•e14 20, /967 - /z' roe aso cr.• Rcd : AMY s /987 Qi' P.P,EOq.PED BY F.E /L.ER Asse.eP>.e,Y T,'w.�e s �'QOF•fS.S' /ONA,L ENC /N,EE.Q ¢` .LEND SURY.EYOR s<eP. i,�• r mar -� Covco.eo .Poq� - �/q/ro�,gc - iY'Ew Yoer /054 / (914) 626 - 4764 1 i i .E { OF NEK. f` ' Owi ca � O t: QY6 .UO4TN Pwe! e° �- O /00' A' Leo � � BlORSe N °o y G90 _. --OYE y 0 i i. o' .. u 4'P,*. C.I. P, _L_ /I.v. Same Y4 Y/Y. vzoo.Cc, Strnc i T,u LL_.7 i L I.-lizoJ74"I t- pJO-L pJu' - - ROAD , 100' P.LA -Iv SG/gL.E: /,.,.50' b /8'1✓/oL � lrq N/1Rw.w1 PROF /.CE �o ,LEGEND t' Too So/ L O SEPT /c 7q v,< /'^� T Sic 7-.y L l y- CY/ W O /V.E • 's -::.- -- _-�___� - ---_ - _ o . _. Disr.PiBUT/oN Ba.r- `__ _- -= w, -crr.z -fr 3 ' • 1 � PE.PCO<gT /OAJ TEST�LE ( 7cs. oo - naeo) ti DEEP TsT S/OL6 O WELL T Sod _ _ 4 • QiA. �.PF. P/PE ' gyp. 94 ' �r � /. SEw,°6.ED /sPOSl1,GSyST,EM To B.EI.USrALL,EOTo Lo.UFa.P/'/ %O S.°.EG /fiCATidUS / � /! ! ,�� ASS. rrfR>I/ BYT. bE�IIT. VAMCDUNTyII ,FA.[ >NOEP.9.PTi'I.ENT, /./ . -` 1��;�� Qpav Z. , QEroav E. 9LLT .E.ES�tirsvN /O'Df,_S.'S.D.A. //� � �4a � ' .3 T. E. G. P. EASD`. c!. veAreo. va. �w, s�Drs' oasvcFi.E <osC.ExPA�ts!ovA.P.E.v ' , / �� t Df �P RG w. • To, �E�' Y, 3' /CALLYi/AR.r.EOI/t/T,E,I'AeutJp ��O,Egpry/�Yi.U6 OY �p� k° 8P ; Cort srPUt>/ avFuiP .fF�>Js.7oBE.9sLOwcolTESE -,.g FrcFPr cr'�/ AS.PEdUGP.EOiJR Ak&rRUGTiD.0 OiTMEsYSTEM. �3a °O' SAS � 4. CaureAeroeTo, T .usrq<t,SEPriGToF <ow8rd,P.vvrry % �,�, Jr. %✓EL< %p EXTEND IB i�BOYEF /Nq,[ tiRllOE. Putr!fim County Department of Health s Divisio., a"' aironmenta' i 3_ih ServiC ®d ad £or C, - ^ applir. snd'Re _ - s of z e s0 Putnam County Health Deis::;; .S.EPT /C DES /G ignQture & Title Date b, G, G' //, - PREPARED FOR flMW72- r/✓ r,%-' TOWN OFPUTNA/V WZ-1ZY- ,P1,171 COt11V7-Y-NE- A1YO.PK P•e14 20, /967 - /z' roe aso cr.• Rcd : AMY s /987 Qi' P.P,EOq.PED BY F.E /L.ER Asse.eP>.e,Y T,'w.�e s �'QOF•fS.S' /ONA,L ENC /N,EE.Q ¢` .LEND SURY.EYOR s<eP. i,�• r mar -� Covco.eo .Poq� - �/q/ro�,gc - iY'Ew Yoer /054 / (914) 626 - 4764 1 i i .E { OF NEK. I . W I 3 I W 7 U h 0 Z a � O Wi ¢I SOLID ROCK 2 MIN GROUT EAL HICKNESS 12 CASING 20 FT. MIN. LENGTH UNDER ANY CONDITIONS. I USE CLAY PUDDLE CORE BETWEEN CASING AND r"DRILL HOLE. CASING, . MIN.' IN ROCK 54NI74RY SEAL ON WELL CAP - SCREEN VENT /- WELDED SLEEVE P TYPE COUPLING .�.- FROM PUMP TO PIMP :LL CASING ^ -� �1 BUSHING OR LAD CAULKING TYPICAL SECTION OF DRILLED WELL _ s ASPHALTIC r I I SEAL I+ I ' -+ INLETI i �,l I RBOLTS I I O OUTLET 4 =0" it- 5 -D° CONCRETE SEPTIC TANK III L I J SLABS POURED IN PLACE I ARE DESIGNED TO I I SUPPORT A MIN. LOAD OF 300 P.SF. Ll PLAN LOCATION STAKE -----.. -� ' • MIN. ' REMOVABLE MANHOLE, REMOVABLE MANHOLE, 20••!MIN. OPENING BA R$ 6`OL. 136" MAX. ; 20•• dflN. OPENING 4 rr I T SOLO Por wiles TIGHT CAST IRON;, PIPE, WITH I TIGHT JOINTS' 1 14 /FT MI'-SLOPE INLET CAULKED JOINT :SANITARY TEE ' I JOINTS, GRADED 1'!8 ` /FT. MIN. OUTLET '-► ti' CAULKED JOINT SANITARY TEE 6` MIN. WALL THICKNESS FOR POURED IN PLACE CONCRETE t P£A GRAVEL OR � . $ ECTION �� CLEAN SAND , . TYPICAL 1200 GAL. CONCRETE SEPTIC ' TANK SF,PTIC DETAILS prepared for of NE PM F. prepared by. ✓ 1 . WILLIAM F. ZEILER Professional Engineer S Land Surveyor Concord Road - Mahopac -New York 10541 (914>628-4764 FO ?a0F[SS(00* • 2 003 i .. I $. aSPHALTIC SEAL 2 INVERT OF INLET BERT n ' I F OF OUT LE T. IN I I L:OUIU LEVEL I �- BAFFLES MAY BE I m fJ_- r , , USED INSTEAD OF SANITARY TEES I~ I W 2 C I'• CEMENT PARGING �� c ON INSIDE � ' o P -.J JOINTS, GRADED 1'!8 ` /FT. MIN. OUTLET '-► ti' CAULKED JOINT SANITARY TEE 6` MIN. WALL THICKNESS FOR POURED IN PLACE CONCRETE t P£A GRAVEL OR � . $ ECTION �� CLEAN SAND , . TYPICAL 1200 GAL. CONCRETE SEPTIC ' TANK SF,PTIC DETAILS prepared for of NE PM F. prepared by. ✓ 1 . WILLIAM F. ZEILER Professional Engineer S Land Surveyor Concord Road - Mahopac -New York 10541 (914>628-4764 FO ?a0F[SS(00* • 2 003 i .. I $. BUILDIIKI PAPER, UNTREATED 24 �� �EARTH BACKFlLL t i SECTION MIN. 3/4, MAX. 1 ".1. OR CRUSHED r STONE. t� DISPOSAL INLET -A- Bofile • Removeoble Cover noI I -- 4" PERFORATED PVC 4B" MIN. PIPE, GRADE ' I/16 '- f /31' /FL 60" MIN. PROFILE GROUND WATER t" ROCK 1 CONSTRUCTION NOTES SUBSURFACE SEWAGE DISPOSAL SYSTEMS & WELL WATER SUPPLIES S" MIN. - It" Max, i SERVING SINGLE FAMILY RESIDENCES 2" MIN, 1 1 3" 6" MIN. BOTTOM OF TRENCH GRADED 1 /16 /PT. Basic Required Notes 1. Tell trees within 10 feet of the proposed SSDS shall be removed. 2. SSDS to be 9nspected by the design engineer /architect and the Putnam pDimty Health Department after construction and prior to backfill. I TRENCH DETAIL (INSTALL 6� ON CENTER) 3. loo trucks, machinery, building materials, nor excavated earth shall be allowed in the sewage disposal area. Construction of SSDS to be in DISTRIBUTION BOX DETAIL /{ // n� PIPE — P prepared by Cu.?TA //V ORA /N WILLIAM F. ZEILER Professional Engineer S Land Surveyor If N 0 a�W� Concord Road- Mahopac -New York 10541 rfsrFO az (914)628-4764 3 43 FaolESSw +�°` :accordance with these plans, any revisions thereto, and the rules and regulations of the permit issuing governmental agency. 4. Minimum well yield of 5 gpm is required. Yields less than 5 gpm 'gill be inuediately reported to the Putnam County Department of Health. Notes Required When Fill Proposed 1. Fill must be allowed to stabilize for 60 to 90 days following placement .z.nd be inspected by the Putnam County Department of Health for acceptance, prior to installation of the sewage system. Date of placement must be reported to Putnam County Department of Health. • ° °• 2. ],,un of bank 'fill shall be suitable for sewage absorption, be free of fines °,° Or ether unsuitable table material and shall have an in -place percolation rate • at least equal to that in the natural soil after the required stabilization °•o° to period. The engineer /architect shall perform a final percolation test in o • o • the fill .after stabilization. o 3: impervious fill, clay barrier, shall be a dense clayey soil with little or ho sewage absorption capacity. u o °® e" o • ' ° ° C 0 SEPTIC DETAILS • °o •e prepared for 0 00 6' O •Da NEW •oO /TE;. /l� FYi'1;%" ci.I !/,!'�!!%j c- �t�/7�fC'i� of OF r09 �P�� PIPE — P prepared by Cu.?TA //V ORA /N WILLIAM F. ZEILER Professional Engineer S Land Surveyor If N 0 a�W� Concord Road- Mahopac -New York 10541 rfsrFO az (914)628-4764 3 43 FaolESSw +�°`