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03754
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
N.R.G. Holding Corporation
1006 Brown Street
Peekskill, NY 10566
Dear Sirs;
Jun.e 26, 1989
r
_�i
ENID L. CARRUTH. M.P.H.
Public Health Director
JOHN KARELL Jr., P.E.
Director
Re: Well - NRG Holding Corp.
145 Wood Street
(T) PV - TM #65 -1 -25
The above captioned well complies with the present requirements of
- -the Pu -tnam County Health- -Department-for yield -and sanitary quality
according to the well completion report and laboratory results
submitted,
If you have any questions, please contact this writer at your
convenience.
Very truly yours,
Lawrence C. Werper
LCW:jr Assistant Public Health Engineer
DEPARTMENT OF HEALTH
Division.of Environmental Health Services
110 OLD ROUTE SIX CENTER, CARMEL, N.Y. 10512 (914) 225 -0310
APPLICATION TO CONSTRUCT A WATER WELL r
PCHD PERMIT # ' ix
WELL LOCATION
Street Address
k/04
Sf
Town/ lage City T x
N N 1 A .!'
Grid Number
S- --
WELL OWNER
Name
V �a
Mailing
f-
Address ,J/
, .Ouey r"� /0
®Private
OPublic
USE OF WELL.
1 -- primary
•2 - secondary
OIRESIDENTIAL
E BUSINESS
13 INDUSTRIAL
O PUBLIC SUPPLY O AIR /COND /HEAT PUMP
O FARM p TEST /OBSERVATION
b INSTITUTIONAL O STAND -BY
O ABANDONED
0 OTHER (specify
0.
AMOUNT OF USE
YIELD SOUGHT
gpm /#
PEOPLE SERVED 3 /EST. OF DAILY USAGE gal
REASON FOR
DRILLING
❑ REPLACE EXISTING SUPPLY
[3 NEW SUPPLY NEW DWELLING
❑ TEST /OBSERVATION 12. ADDITIONAL SUPPLY
13 DEEPEN E ISTI G WELL
DETAILED.
REASON FOR
DRILLING
Siddiglodlee
J40 r IV$ Wez-( a
WELL TYPE
DRILLED
DRIVEN
®DUG
0GRAVEL
0OTHER
7
IS WELL SITE SUBJECT TO FLOODING? YES NO
IF WELL IS. LOCATED 7A REALTYl STB)PI371 I N 0 NAME OF SUBDIVISION: Lot No
WATER WELL CONTRACTOR: Name Al eP-5ON -OQi % Address : JWek
IS PUBLIC WATER.SUPPLY AVAILABLE TO. SITE: YES NO
NAME OF PUBLIC WATER .SUPPLY: TOWN /VIL /CITY
DISTANCE TO PROPERTY FROM - NEAREST WATER MAIN:
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED
,q AJ ®oN SEPARATE SHEET
;L �/
(da e) (si ure)
PERMIT
TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above is granted wander the
provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code:, and
provided that within thirty (30) days of the completion of water well construction,
the applicant s.hall-
1. Pump the well until the water is clear.
2. Disinfect the well in accordance with the requirements of the Putnam
County Health Department attached to this permit.
3. Submit a Well Completion Report on a form provided by the Putnam County
Health De artment.
Date of Issue: t Y'+c. 19 ~
Date of Expiration:. �,� 6 19 / ermit ssuing is a
Permit is Non - Transferrable
Rev. 10/88
White copy: H.D. File
Yellow copy: Building Inspector
Pink Copy: Owner
rW- =rvve% ewnrxs. T.7-1 1 r%_4 7 7
WELL l:UP1YLr,11Vly _icr.rVicl
Office Use Only
WELL LOCATION G
Sf REf'T AOORESS: wN/vl UIC TAX G to NUMBER:
WELL OWNER O
E: ADDRESS: �
� PRIVATE
USE OF WELL M
MRESIDENTIAL O PUBLIC SUPPLY D AIR /COND. /HEAT PUMP ❑ ABANDONED
MOUNT OF USE Y
YIELD SOUGHT' S gpm. 1N0. PEOPLE SERVED EST. OF DAILY USAGE J 00 gal.
REASON FOR K
K NEW SUPPLY O PROVIDE ADDITIONAL SUPPLY ❑ TEST /OBSERVATION
DEPTH DATA a
a a
a S
S"�i dl
DRILLING I
Iq ROTARY ❑ COMPRESSED AIR PERCUSSION ❑ DUG
W.EL L_TYPE ❑
❑. SCREENED....._ .f7:.OP_EquENO.:CASING. Y i'OP.FK HOLE.IN.REDRGCX - :.___❑...0?HER - -- ..__.�_.
CASING L
TOTAL LENGTH ft. M
MATERIALS: ,`92TEEL O PLASTIC O OTHER
LENGTH.BELOW GRADE ft. J
JOINTS: ❑ WELDED 9JHREADED ❑ OTHER
DIAMETER /' in. S
SEAL: ❑ CEMENT GROUT ❑ BENTONITE WTHER
WEIGHT PER FOOT / lb./ft. -
- DRIVE SHOE.P -ES ONO L
L1NER: O YES -)1 NO
SCREEN D
DIAMETER (in) '
'SLOT SIZE L
LENGTH (ft) D
DEPTH TO SCREEN (ft) D
DEVELOPED?
FIRST O
O YES ONO
SECOND H
GRAVEL PACK ❑
❑ YES G
GRAVEL D
DIAMETER T
TOP B
BOTTOM
WELL YIELD TEST If detailefi pumping 1
1PIELL LOG 1f more detailed formation descriptions or sieve analyses
DEPTH FROM W
Water W
Well
FORMATION DESCRIPTION, C
CODE,
ft. f
ft. i
WELL DEPTH D
DURATION D
DRAWOOWN Y
YIELD L
Lana /
/
� w
wOr
0 �
WATER ❑ CLEAR TEMP.
QUALITY ❑ CLOUDY HARDNESS
❑ COLORED ANALYZED? OYES ONO
ANALYSIS ATTACHED? O YES O NO S
STORAGE TANK: TYPE
.. .. c..w _._.: .. r. 4- i... .v..•F.•..a....•.:� •. ;cvs . _.- r..:.... �: r.. r
Yorktown Medical Laboratory, Inc.
321 Kear Street -
Yorktown Heights, N. Y. 10598
(914) 245 -2800
Director: - Albert H. Aadovani 1b1. T. (ASCP) .
�
13 ,Ye
LABORATORY-REPORT ON THE QUALITY OF WATER
INORGANIC NON- METALS mg /L
_ Acidity
_ Alkalinity
_ Chloride
Detergents, MBAS
_ . Hardness, Total
Nitrogen, Ammonia
Nitrogen, Nitrate
Phosphate, Total
Sulfate-'.
_ Sulfide
Sulfite
METALS (.mg /L)
Copper
Iron
Lead
Manganese
Mercury
Sodium
Zinc
MISCELLANEOUS
pH (units)
_ Color (units.)
_
Odor (TON)
_ Turbidity (NTU)
32.025231
LAB #
Date Taken: �� Time
Date Rc' d : Time:
Date Reported: MAY "3 0 1989
Collected By: j-7/?_
Referred By:
Sample Location: -1;71-414-10
f
, va 7, ew , ! 7
Phone #
Phone # Sample Type:
Repeat Test? (check each)
Potable
Non- potable
MICROBIOLOGICAL CFU /100mL = 'STP,_INF
STP - --EFF
GENERAL BACTERIA ;:Other:
_ Standard Plate Count
(CFU /1.OmL)
MEMBRANE FILTRATION TECHNIQUE
✓ Totai. Co.lif.orm._ � ...�.. _
Fecal Coliform
Fecal Streptococcus -
MOST PROBABLE NUMBER TECHNIQUE
Total Coliform Index
Fecal Coliform Index
KEY FOR
TERMINOLOGY
CFU =
Colony Forming Units
CON =
Confluent (q.v. TNTC)
LT =
C = Less Than
GT =
> = Greater Than
N/A =
Not Applicable
S/A =
See Attached.
TNTC=
Too Numerous To Count
REMARKS
/.COMMENTS'(For Lab Use)I
Sample Status:
(check each)
Outgoing
HC1 H,HO3_ _ ..
_
_ H2SO4
_ NaOH
_ ZnOAc
Na -2S203
Other:
Incoming
LE
40c
_
T
k °C
pH
LE 2
_ pH
GE 9
_ pH
GE 12
Other:
ELAP No. 10323
THESE RESULTS INDICATE THAT THE WATER SAMPLE. (Was" (Wasn't) (N /A) 0 F A
SATISFACTORY SANITARY'QUALITY ACCORDING TO.TH NEW ORK STATE PUBLIC DRINKING
WATER CODES, FOR THE PARAMETERS TESTED, AT.THE ME OF SAMPLE COL TION.
.THESE RESULTS INDICATE THAT THE WATER SAMPLE (Did) (Didn't) (N /A) MEET THE
SATISFACTORY CHEMICAL QUALITY STANDARDS OF THE NEW YORK PUBLIC RIN NG WATER
it _ _
Fun. °NZ-' Rti,- -,TTE-RS- TEETE "u; ..s T' `TiE i i "O F: SAMPL%.. Iv;LLLi;!' v
. _...
FCi�e�ajL�� 2 /86(Rvsd7 /87)RWE • {.
Albert H. Padovani, M.T. ASCP), Director
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