HomeMy WebLinkAbout3771DOCUMENT CONVERSION SERVICES PROVIDED BY
IMAGING & MICROFILM ACCESS, INC.
www.scanyourdocs.com
631- 589 -8100
83. -1 -11
BOX 29
9 No
I I ��
:
..
of
ML
I I
Bps
9
..R
r*
�
k.6
F.
9
It
IF
03771
6
P,..UTNAM COUNTY. DEPARTMENT OF HEALTH
DIViC ION OF ENVIRONMENTAL HEALTH SERVICES
""APPLICATION TO CONSTRUCT. A WATI W LL
Iplels rint or type PCHD Permit # •� :,I!
We c ' • "
L
treet Address: Town/Village Tax Grid #
3 3 6� LlWff i K-A Al V Ate'? Map S 3 Block I Lot (s)
Well Owner:
Name:
Address:
�• Cf�Gi��
1� Coeftk U_" Rn 4k.KAW((4 C-T- OU30
Use of Well:
Residential Public Supply Air /Cond/Heat Pump Irrigation
1- primary
Business Farm Test/Monitoring Other (specify)
2- secondary
Industrial Institutional Standby
Amount of Use
Yield Sought S_ gpm # People Served 1 Est. of Daily Usage LS gal.
Reason for
Replace Existing Supply Test/Observation Additional Supply
Drilling
New Supply (new dwelling) _� Deepen Existing Well
Detailed Reason
1.J F_ LL 04' L Ftso k WOrU-
for Drilling
0 f�QP.4 b Lj o —So
r.ti aoo' Ora e'k,,
Well Type
Drilled Driven I Gravel Other
Is well site subject to flooding? ................................................. ............................... Yes No
Is well located in a realty subdivision? ...................................... ............................... Yes No
Name of subdivision Lot No.
Water Well Contractor: "f-U- PR«uuE, Address: 4kt y_ %1- (4�NRlit JA 7
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 contamination to e prided on separate sheet/plan.
t� 1r
�±'
o Mae, .6 tc- Loaf .-. �Ag i_iicant_Signat� ?r _ _ �,: �... .4� .
Mae,
I
PERMIT TO CONSTRUCT A WATER 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 drille cert' i by P tnam
County.
Date of Issue (Z t t )of Permit Issuing fficial:
Date of Expiration ! I p c�3 Title:
Permit is Non - Transferrable
White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller
K
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
APPLICATION TO �;.. CO. N_ . S- TRU .. �T .� A WATER
iE P� WELL
D I
G�o
Well Location:
St
St eet Ad� dress: Town/Vil e Tax Grid�7#
LQ 6 &T—
6((-66&T—
l W r Map
Block Lot(s)
Well Owner:
Name:
T, CA
Address:
fIRk-' 6 JE FcQ-11b
(46 tcj� cr- oG
Use of Well:
l/ Residential Public Supply Air /Cond/Heat Pump Irrigation
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 r f —gal.
Reason for
Replace Existing Supply Observation
Additional Supply
Drilling
New Supply (new dwelling) pen Existing Well
Detailed Reason
W ft_L b 11 c S O 0,T— Wo C Kf4a In[ t
Kee A,
PA11e76-tJ R kL. ! fl �- r-u k.
a t f, dJ AKn,
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
Lot No.
Water Well Contractor: dk1Q a rah �J &N- POULL(J(,Address:
Is Public Water Supply available to site? ............................... ...............................
Name of Public Water Supply: ' Town/Village
Yes No
Distance to property from nearest water main:
Proposed well location & sources of contamination to be provided on separate sheet/plan.
Date:. �8 ` 2dz,,
Applicant Signatur
n
PERMIT TO CONSTRUCT A WATER 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 cert.4ied Putnam
County.
Date of Issue IZ i t o Permit Issuing fficial:
Date of Expiration l Z: o o Title:
Permit is Non- Transferra e
White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller
Form WP -97
r30
- r cis .' _. • :�_ . -� _..��. -...n
BRUCE R. FOLEY
Public Health Director
. r
LORETTA MOLINARI R.N., 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
December 13, 2001 Preschool (845) 228 - 5912 Fax (845) 228 - 6113
Mr. T. Cabot
10 Copper Beech Road
Greenwich, Ct. 06830
Re: Well Permit Application for Cabot
33 Gilbert Lane, (T) Putnam Valley
TM# 81-1 -11
Dear Mr. Cabot:
This Department has approved the well permit for a well at the above referenced property to
deepen the existing supply.
Please be advised that if site conditions and/or site plans change and/or are revised, thereby -
compromising the minimum required separation distances, siting approval of the well must be re-
.. -• approvedty ihis, Department y - - - - --
The above well to be drilled will be required to be sampled for the parameters listed in Table 1 of
Bulletin ST -19, Putnam County Health Department Policies and Procedures (attached).
All necessary Town permits for the installation of the well are required to be issued prior to well
construction.
Upon completion, it shall be required that the well driller submit a Well Completion Report
along with water quality analysis within 30 days of completion to this office.
Should you have any questions, please feel free to contact the writer at ext. 2157.
Very truly yours,
Adam B. Stiebeling
Assistant Public Health Engineer
ABS:cj
cc: T/Putnam Valley Building Inspector
0
- r cis .' _. • :�_ . -� _..��. -...n
BRUCE R. FOLEY
Public Health Director
. r
LORETTA MOLINARI R.N., 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
December 13, 2001 Preschool (845) 228 - 5912 Fax (845) 228 - 6113
Mr. T. Cabot
10 Copper Beech Road
Greenwich, Ct. 06830
Re: Well Permit Application for Cabot
33 Gilbert Lane, (T) Putnam Valley
TM# 81-1 -11
Dear Mr. Cabot:
This Department has approved the well permit for a well at the above referenced property to
deepen the existing supply.
Please be advised that if site conditions and/or site plans change and/or are revised, thereby -
compromising the minimum required separation distances, siting approval of the well must be re-
.. -• approvedty ihis, Department y - - - - --
The above well to be drilled will be required to be sampled for the parameters listed in Table 1 of
Bulletin ST -19, Putnam County Health Department Policies and Procedures (attached).
All necessary Town permits for the installation of the well are required to be issued prior to well
construction.
Upon completion, it shall be required that the well driller submit a Well Completion Report
along with water quality analysis within 30 days of completion to this office.
Should you have any questions, please feel free to contact the writer at ext. 2157.
Very truly yours,
Adam B. Stiebeling
Assistant Public Health Engineer
ABS:cj
cc: T/Putnam Valley Building Inspector
BRUCE R FOLEY
Public Health Director
DEPARTMENT OF IMALTH
1 Geneva Road
Brewster, New York 10509
0
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) 218 - 6678 Fax (845) 278'- 6085'.
Early Intervention (845) 278 - 6014 Preschool (845) 228 - 6108 Fax (845) 278 - 6648
Disinfection of Well
The following procedure should be used after completion of a new drilled well, the repair or renovation of
any well, or when any well tests unsatisfactory for bacteria.
1. For each 50 foot depth, mix one quart of plain laundry bleach containing 5'/.% chlorine in.5
gallons of water.
2. Pour the solution into the well Run a hose from an outside faucet into the well, then start
the pump. (This pulls the disinfecting solution into the storage tank faster.)
3. Allow water to flow from each tap until a chlorine odor is detected. Where possible, remove the
plug on top of the pressure tank and allow the solution to ,fill the tank completely, then turn off the
pump.
4. Allow the solution to remain in the system for at least 8 hours or preferably overnight
5. Drain the pressure tank and replace the plug. 966 he pump and allow water-to-flow-to -'
waste from each tap until the chlorine odor disappears.
To avoid disruption to the septic tank process, discharge of the chlorine solution in the system
should be done by taking a garden hose and attaching it to the valve at the bottom of the water
storage tank (Usually in the basement). The valve should then be turned on and the water should
be discharged out onto the ground in the yard. When most of the storage tank water has been
flushed, check the odor of the water coming out of the hose. When the chlorine smell has nearly
disappeared, open up other faucets in the house for 15 minutes or until the smell of chlorine is not
detected.
6. Use the water normally except for drinking and cooking purposes for one week. Collect a
sample of water in a laboratory container for bacteria analysis. Any NYS DOH Certified
ELAP Laboratory (Environmental Laboratory Approval Program) can be used for the
analysis. It is also of equal importance that you retest 7 -10 days after disinfection for
coliform bacteria. If there is no problem with contamination, the water test after 10 days
will remain good if the disinfection was done properly.
7. Should the bacteria re -test fail; contact a well driller or this department at 845 -278 -6130 for
further assistance.
r �
NYS CERTIFIED LABORATORIES FOR
DRINKING WATER AND WASTE WATER ANALYSIS
IN PUTNAM COUNTY AREA
AQUA ENVIRONMENTAL LAB
56 Church Hill Road
Newtown, CT 06470
(203) 270 -9973
DUTCHESS COUNTY HEALTH DEPARTNIENT LABORATORY
387 Main Mall
Poughkeepsie, NY 12601
(914) 486 -3411
NORTHEAST LABORATORY OF DANBURY
39 Mill Plain Road
Danbury, CT 06811
.(203) 748- 7903..
SEVERN TRENT ENVIROTEST LABORATORIES
315 Fullerton Avenue
Newbutgh, NY 12550
(914)562 -0890
WESTCHESTER COUNTY LABORATORIES AND RESEARCH
2 Dana Road
Valhalla, NY 10595 "
Att: Jerry Babski
(914) 593 -5590 .
YORKTOWN MEDICAL LABORATORY, INC.
321 Kear Street
Yorktown Heights, NY 10598
Att: Albert Padovani
(914) 245 -3203
certlab.wpd
► 'b
..18
.. v-.\,` .•:. ?v.`k.x:C \ \ \ \ \ }:T::k \:v::\: :: C,\\ �\.\ , ^. \.:•: \�..,?, \1ti, \;;.}:; },:?: \: \nv . \. \�.;.'�':�^�+� ?' VT.'M1�\ �•^\ ���
\ \:"LC ?n'h.:�:t::..- ..1..:. -\: Avh\ \: \N•'.:: \::.t}:::a:J »:.....:vv v.v.;: ?. ::. ::�5 \T::.v. -wiv: �•. • :v \ : vvj� .h`Y.v`. ` \� \ \ \�\
vv. \vv +'v: ^'• ?.v.: ?:.v..x; •: i;•i ?kv? tic ??}:b:::?n: ?A�i�v: \?::::: v .. ..tin?.:�C�. Lh�v *��`�� ♦ v .�� v J .E
:.v:•v ^::Lti�.•tii \i ?: <:S::L}•.'v Q: ?iC \•? ' v\:•:•: C: wi�??.ti^:: v:: iU:: Y.. j;? i:'': i• ^.:, }:i; }::ii::i?.::'i�:v.::" .... ... \:;h•::::•.::i:h..::' ^..1A-. �4�\:•: �•?C. \:.:..�:..:
CONTAMINANT MCL (1)(4)(5)
Coliform bacteria
Any positive result is unsatisfactory
-Lead
0.015 mg/l (15 ug/1)
Nitrates
10 mg/1 as N
Nitrites
1 mg/l as N
Iron
0.3 mg/1
Manganese
0.3 mg/1
Iron plus manganese
0.5 mg/1
Sodium
No designated limit (2)
pH
No designated limit
Hardness
No designated limit
Alkalinity
No designated limit
Turbidity
5 NTU (3)
NOTES: (1) Maximum contaminant level.'
(2) Water containing more than 20 mg/1 of sodium should not be used
for drinking by people on severely restricted sodium diets. Water
containing more than 270 mg/1 of sodium should not be used by
people on moderately restricted sodium diets.
(3) NTU means Nephelometric Turbidity Units.
(4) mg/1 means milligram per liter.
(5) ug/1 means microgram per liter.
b. A Well Completion Report signed by the well driller, including the results of at
least a 6 -hour pump test (See Appendix K).
A minimum well yield of 5 gpm is required. For yields less than 5 gpm see
Appendix F for procedures on performing a 24 -hour well pumping test. The
results of the 24 -hour pump test are to be submitted .to the Department for
review and a determination will be made regarding utilization of the well for
supplying potable water to the dwelling. If the new well is found acceptable,
00 �
' s 'lip
0 oil
YOU
t
•v. e� l� - Syr _: 1.;
:r u � s '� yam, �� �y' .:.;: �4 ````.• � ,� ' � � �^`ti.:;\
Cori 14
jug rQ Y • y y t, � `�
v
n 2 O V 0 .. , ... .. . t� � • .tea..+.... t �`� y� a . � r� - r
yx on
.
`._
���.%�\ � � +�'}� A a� a •�i yiF�'r�d�.F'`�' t *.[ k Cv't^ �' � � 3 -, -, 7 �.1
r• -t Y r �'zd r("" J.d. `T"`4 c?:t �v rY s �.. 4L. . Y s � -.� Y >ry, � cam:.
>.yyy+ '1 a ti �i tY �zz t S tc f t
u
ri- 3 ('
f-T S l �'�'+5� Z��1 �.,t+%'1'k�F �y�:. ,•1:'VVYlJC -..:
6Wx `�' �' �*k .t'f G< ' �` 4• i />+,r xi 4 �t�'y i Y _ s.F .._ ` t y L
Y �a'"l., -f:'. ♦ !} .A .K> �' wC'" �'y � � '•sus. �.n� ',� � _ z J`,.�p
. •'� .' YP � - rte_ �� `��'
k t
rt j
a',
\ t lO
i
�..
50
/
Ito AC. CAL
AL
l
51
r
76 AC. CAL
19 (1 _
I
83.08
^rtAl
��• l Y l y j• tt OJk
/ 58.16 AG CAI. /999"""
239.28 At CAL 3 Q
M a f
4C,47-4 <.
j
a4 6 1� _
j 796 AC 4! 0 15
5 14
6.66 At q 3.46 `�M 16 p �
•17
8.79 AC.
178 : I.x X .0
«ab
. _ J
a 8.29 Z� .�
83.50
83.49 -�
.24
83.58
83.57
BRUCE R. FOLEY
Public Health Director
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
December 13, 2001
Mr. T. Cabot
10 Copper Beech Road
Greenwich, Ct. 06830
Re: Well Permit Application for Cabot
33 Gilbert Lane, (T) Putnam Valley
TM# 81-1 -11
Dear Mr. Cabot:
This Department has approved the well permit for a well at the above referenced property to
deepen the existing supply.
Please be advised that if site conditions and/or site plans change and/or are revised, thereby
compromising the minimum required separation distances, siting approval of the well must be re-
approved by this Department.
- _. ......., ._.. w ._ .... ._ ,
The above well to be drilled will be required to be sampled for the parameters listed in Table 1 of
Bulletin ST -19, Putnam County Health Department Policies and Procedures (attached).
All necessary Town permits for the installation of the well are required to be issued prior to well
construction.
Upon completion, it shall be required that the well driller submit a Well Completion Report
along with water quality analysis within 30 days of completion to this office.
Should you have any questions, please feel free to contact the writer at ext. 2157.
Very truly yours,
Adam B. Stiebeling
Assistant Public Health Engineer
ABS:cj
cc: T/Putnam Valley Building Inspector
BRUCE R. FOLEY
Public Health Director
0
LORETTA MOLINARI R.N., M.S.N.
Associate Public.. Health Director
Director of Patient Services
DEPARTMENT OF HEALTH
1 Geneva Road
Brewster, New York 10509
Environmental Health (945)279-6130 fax(945)279-1921
Nursing Services (845) 278 - 6558 VIC (845) 278 - 6678 Fax (845) 278 = 6085
Early Intervention (845)278!.6014 Preschool (945)223-6109 Fax(845)279-6648
Disinfection of Well
The following procedure should be used after completion of a new drilled well, the repair or renovation of
any well, or when any well tests unsatisfactory for bacteria.
1. For each 50 foot depth, mix one quart of plain laundry bleach containing 5'/.% chlorine in 5
gallons of water.
2. Pour the solution into the well. Run a hose from an outside faucet into the well, then start
the pump. (This pulls the disinfecting solution into the storage tank faster.)
3. Allow water to flow from each tap until a chlorine odor is detected. Where possible, remove the
plug on top of the pressure tank and allow the solution to fill the tank completely, then turn off the
pump.
4. Allow the solution to remain in the system for at least 8 hours or preferably overnight.
5. Drain the pressure tank and replace the plug. Start the pump and allow "water toioR�fo `' "� _
waste from each tap until the chlorine odor disappears.
To avoid disruption to the septic tank process, discharge of the chlorine solution in the system
should be done by taking a garden hose and attaching it to the valve at the,bottom of the water
storage tank (usually in the basement). The valve should then be turned on and. the water should
be discharged out onto the ground in the yard. When most of the storage tank water has been
flushed, check the odor of the water coming out of the hose. When the chlorine smell has nearly
disappeared, open up other faucets in the house for 15 minutes or until the smell of chlorine is not
detected.
6. Use the water normally except for drinking and cooking purposes for one week. Collect a
sample of water in a laboratory container for bacteria analysis. Any NYS DOH Certified
ELAP Laboratory (Environmental Laboratory Approval Program) can be used for the
analysis. It is also of equal importance that you retest 7 -10 days after disinfection for
coliform bacteria. If there is no problem with contamination, the water test after 10 days
will remain good if the disinfection was done properly.
7. Should the bacteria re -test fail; contact a well driller or this department at 845 - 278 -6130 for
further assistance.
J8
i a•. ;•...... :• v.: r\ ;CSC: \ \C : �..\.
..:•. \:�: •.`�•.:•... \:.a:, : �.,.,. ?�::+ •:..:\ ;., . , \•:.��� �
<• �c:. o�y:::•??:• x`:^ � :� :����:...:::�•:.,::.`.\,.. :.: • ?v;• at��;.u•.t• :aa:.v \��. ?::��;•.C. . \ \\ �:ti \ \.r \ \�.;
?♦ \
?\ A•\+• : ? ?.v \m;::•`x:::i•:�i ?:•:iiii. �? i:??: viv?`:: •`:?::::nt:•::•::: \•: ::: ?ii ?:•: $ ? ?:::v`:..'... :•::': :v. .:.':•� ::::.::::n::.�:t:.... .. ....
CONTAMINANT MCL (1)(4)(5)
Coliform bacteria
Any positive result is unsatisfactory
Lead
0.015 mg/l (15 ug/1)
Nitrates
10 mg/l as N
Nitrites
1 mg/1 as N
Iron
03 mg/1
Manganese
0.3 mg/1
Iron plus manganese
0.5 mg/l
Sodium
No designated limit (2)
pH
No designated limit
Hardness
No designated limit
Alkalinity
No designated limit
Turbidity
5 NTU (3)
NOTES: (1) Maximum contaminanf level.
(2) Water containing more than 20 mg/l of sodium should not be used
for drinking by people on severely restricted sodium diets. Water
containing more than 270 mg/1 of sodium should not be used by
people on moderately restricted sodium diets.
(3) NTU means Nephelometric Turbidity Units.
(4) mg/1 means milligram per liter.
(5) ug/1 means microgram per liter.
b. A Well Completion Report signed by the well driller, including the results of at
least a 6 -hour pump test (See Appendix K).
A minimum well yield of 5 gpm is required. For yields less than 5 gpm see
Appendix F for procedures on performing a 24 -hour well pumping test. The
results of the 24 -hour pump test are to be submitted .to the Department for
review and a determination will be made regarding utilization of the well for
supplying potable water to the dwelling. If the new well is found acceptable,
110 AC. CAL.
• u .iii -'
i
51
76 AC. CAL.
Izz
AL
83.08
e
239.28 AC. CAL
° % t IC47 AC.
6 A61
j 796 AC. I c I
.. 5 ., 14 e lit 449 lu
666 AC. 3 AC. j� 13 16
I e 1.:1 AC U
2 te9 9
78 IBoMA
i,• 8.79 AC. A °C
54
&26 83.50 to aG
'1ne23'-
83.49 a °
83.58
a
Fa
WCE R. FOLEY
"M
r6d
-LORMA -MOLLNARI—RIB:, .X
Associate Public Health Director
Director of Patient Services
DEPARTMENT OF HEALTH
I Geneva Road
Brewster, New York 10509
E.aviroameaul Health (914)278-6130 Fax(914)27i-7921
Nursing Senices (914)278-6SS9 Far (914)279-608S
Earl} Intervention (914)279-6014 Far (914)278-6(A8
WIC (914) 279 - 6679 Fax (9141) 273 - 6035
NEIGHBOR NOTIFICATION
N
APPLICATIONS FOR WELL PEMMITS
Applications to the Department of Health for Well Per6ts will not be reviewed until such time as
the Director of Environmental Health Services of the D.-partment of Health is provided with proof
that notification, of the application for construction was made to all property owners within 200 feet
of the proposed well location. A location map (a tax map would suffice) with all properties shown
within 200 feet of the proposed well location must also be provided to the Department. An example
location map is attached.
Not fication sh,01 mean receipt by each property owner of a copy of the attached notification form
along with a copy of the latest site plan.
Proof of receipt of notice by property following.,..
-owners can include either of the follo rig..,-
1. Copies of registered mail receipts. (Return receipts)
2. Copies of the notification form signed by the contiguous property owners.
Falbire to provide the Department with adequate documentation of the performance of the notice will
result in our delaying, action on the application until proper notice is executed.
Transmittal of this notification should be sent to the all property owners withi 20DO fset of the
proposed well location, by the applicant or well driller. A format of this notificatio, for is attached
for your use.
BP,F/%Wtn
August, 1999
BRUCE R. FOLEY
Public Health Director
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
December 13, 2001 Preschool (845) 228 - 5912 Fax (845) 228 - 6113
Mr. T. Cabot
10 Copper Beech Road
Greenwich, Ct. 06830
Re: Well Permit Application for Cabot
33 Gilbert Lane, (T) Putnam Valley
TM# 81-1 -11
Dear Mr. Cabot:
This Department has approved the well permit for a well at the above referenced property to
deepen the existing supply.
Please be advised that if site conditions and/or site plans change and/or are revised, thereby
compromising the, minimum required separation distances, siting approval of the well must be re-
approved by this Department.
The above well to be drilled will be required to be sampled for the parameters listed in Table 1 of
Bulletin ST -19, Putnam County Health Department Policies and Procedures (attached).
All necessary Town permits for the installation of the well are required to be issued prior to well
construction.
Upon completion, it shall be required that the well driller submit a Well Completion Report
along with water quality analysis within 30 days of completion to this office.
Should you have any questions, please feel free to contact the writer at ext. 2157.
Very truly yours,
Adam B. Stiebeling
Assistant Public Health Engineer
ABS:cj
cc: T/Putnam Valley Building Inspector
BRUCE R FOLEY
Public Health Director
DEPARTMENT, OF HEALTH
1 Geneva Road
Brewster, New York 10504
LORETTA MOLINARI RN, M.S.N.
Associate Public-Health Director
Director of Patient Services
Environmental Health (845) 278 - 6130 Fax (845) 278 -1421
Nursing Services (845) 278 - 6558 WIC (845) 218 - 6678 Fvc (945) 278 - 6085
Early Intervention (845) 278 - 6014 Preschool (845) 228 - 6108 Fax (845) 278 - 6648
Disinfection of Well
The following procedure should be used after completion of a new drilled well, the repair or renovation of
any well, or when any well tests unsatisfactory for bacteria.
1. For each 50 foot depth, mix one quart of plain laundry bleach containing 5'/.% chlorine in 5
gallons of water.
2. Pour the solution into the well. Run a hose from an outside faucet into the well, then start
the pump. (This pulls the disinfecting solution into the storage tank faster.)
3. Allow water to flow from each tap until a chlorine odor is detected. Where possible, remove the
plug on top of the pressure tank and allow the. solution to fill the tank completely, then turn off the
pump.
4. Allow the solution to remain in the system for at least 8 hours or preferably overnight.
5. -Drain the pressure tank and replace the plug..-Start the'pump 'a'ri'&'aUow v,-ater to-file-w- 4 -6-
waste from each tap until the chlorine odor disappears.
To avoid disruption to the septic tank process, discharge of the chlorine solution in the system
should be done by taking a garden hose and attaching it to the valve at the bottom of the water
storage tank (usually in the basement). The valve should then be turned on and the water should
be discharged out onto the ground in the yard. When most of the storage tank water has been
flushed, check the odor of the water coming out of the hose. When the chlorine smell has nearly
disappeared, open up other faucets in the house for 15 minutes or until the smell of chlorine is not
detected.
6. Use the water normally except for drinking and cooking purposes for one week. Collect a
sample of water in a laboratory container for bacteria analysis. Any NYS DOH Certified
ELAP Laboratory (Environmental Laboratory Approval Program) can be used for the
analysis. It is also of equal importance that you retest 7 -10 dates, after disinfection for
coliform bacteria. If there is no problem with contamination, the water test after 10 days
will remain good if the disinfection was done properly.
7. Should the bacteria retest fail; contact a well driller or this department at 845 - 278 -6130 for
further assistance.
18
.CONTAMINANT MCL (1)(4)(5)
Coliform bacteria Any positive result is unsatisfactory
N0.015 mg/l (15 ug/1)
tes 10 mg/1 as N
tes 1 mg/1 as N
Iron 0.3 mg/1
Manganese
Iron plus manganese
_ Cnr�inm
0.3 mg/l
0.5 mg/1
No desianated limit (2)
pH No designated limit
Hardness No designated limit
Alkalinity No designated limit
Turbidity 5 NTU (3)
N0'E5: (1) - Maxmium
(2) Water containing more than 20 mg/1 of sodium should not be used
for drinking by people on severely restricted sodium diets. Water
containing more than 270 mg/1 of sodium should not be used by
people on moderately restricted sodium diets.
(3) NTU means Nephelometric Turbidity Units.
(4) mg/1 means milligram per liter.
(5) ug/1 means microgram per liter.
b. A Well Completion Report signed by the well driller, including the results of at
least a 6 -hour pump test (See Appendix K).
A minimum well yield of 5 gpm is required. For yields less than 5 gpm see
Appendix F for procedures on performing a 24 -hour well pumping test. The
results of the 24 -hour pump test are to be submitted to the Department for
review and a determination will be made regarding utilization of the well for
supplying potable water to the dwelling. If the new well is found acceptable,
00.
• �.i+ r�-v+. ... w�.. �csF ..�i x - --, .-. -. p.'<'�- �.'\.i - /�. -':: ..- .��e�rr'or: .. � . / � �Y�r �,� ;y � !� 'i /°'�. a�.: o_.
v �
\ r
� 1 a /• 50
t mod' /
10 A&
i — , � .: r r .. .. b�, i.:. . wr •o. � . Sv�. - •r ..e .�-.. � ,. C&,...... .., R, r : i .. - .;.. �• — . ..r ... :.n , t
2. f 9�
51
. a
9 + 76 AC. CAL
'' • 3 -1 - h ` \
�• P/0 8( •
- -- - - -- -- - - -- ,�.--- ��;g7 - --
j a
AL
,. Q ,''t't • 83.08
86
a + �' N
• 58.16 AC. CAI—
Dom AC. CAI. � 7
L.
lr'�
j 796 At S a1 ~o 15
' i4
Je 1_; Ix
6.66 AC MG a i'' K k :6 J `✓ �`
AC I� 12 13 -I.n ACS
83.
8 79
Ac. Lx At u �—
„ 3.7e L
3 �L54 AC.
8.26 83.50 ���
ti.
- r 83.49 K •24_
83.57 83.58,
- r � l