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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 83.16 -1 -57 BOX 30 . y s AL 46 J L7 �T wmi� II ' T V r LE I UTNAM COUNTY DEPARTMENT OF HEALT SION OF ENVIRONMENTAL HEALTH SE V1 CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SS PCHD CONSTRUCTION PERMIT # -_PV - 0,1-0$ Located at 69 9 SH H Ill. RAD_ To� or Village Py_ %�1 AM VAULFE Owner /Applicant Name VS. &S?RVCTioN 6DRP• Tax Map 3. Block 2 Lot 57 Formerly Subdivision Name VMER4LD RIDE Mailing Address .YJ Subd. Lot # 6 Zip Date Construction Permit Issued by PCHD JAAlDARV 23, 20n8 Separate Sewerage System built by T. SiI2+NI &AISi' OC77og/ Address .513 WA5R1N4 r�J ST , �EIC� 1t4 Consisting of 1500 Gallon Septic Tank and IN L..F OF Y"Of ARFVR4TE1> PVC PIPE A/ 211 to Cn24VEi - ME9CyIES Other Requirements: IVOAl E Water Supply: Public Supply From Address / 152 8A R4cR STRr_ -6T or: V Private Supply Drilled by ��WAI /4AIDGR&0/V Address Fbp9 4� 1//�(, T/�2,0579 Buildi.�g ype_ ►1 4.a .P. e, ipB±; Has erosion- control-been corspleted? Number of Bedrooms Has gr garbage p ',$1.l e d? WA I certify that the system(s), as listed, serving the above ire s s 4t;' essentially as shown on the as- built plans (copies of which are attached), in accor c ' the °'CHb Co struction Permit and approved plans and the standards, rules and regulations Co .y artm j f Health. f w. Date: 57- Z 3 Certified b V P.E. R.A. (Design Prole ii'al� , �NP� ;�'` Address 2 JOHN q 6 K _ icense # O 62.9 $ 0 Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from 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 revocation, modification or change is necessary. Title: Date: Veopy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 a: -RONIN ENGINEERING, PE, PC - The Lindy Building, Suite 200,,2 john Walsh Boulevard ,Peekskill,.New. York ._.10566 Tel.: 9i4= 7371= '3664`o Fax: 91'4-736 =3693 ` June 9, 2008 Mr. Joseph Parava6 Assistant Public Health Engineer Putnam County Health Department 1 Geneva Road Brewster, New York 10509 Re. VS. Construction Corp. Emerald Mdlge SSTS Construction Permit Marsh Hill Roach- Lot 6 Town of Putnam Valley, New York Section: 84 00, Block. 1, Loh 70 Dear Mr. Paravati, Please find enclosed the following regarding an application for a Subsurface Sewage Treatment Construction Compliance: 1. One (1) Original Bacteriological Test for the Existing Well. 2. One (1) Specification Sheet for Well- X -Trol Well Tank. In addition, the well model for Lot 6 is a Well -X Trol WX 302 Pro. Should you have any questions or require additional information, please do not hesitate in contacting me at the number above. cc: Owner- Val Santucci (V.S. Construction Corp.) File- Paravati- PCDHSantuoci- Emerald -Lot 6- Transgt- 20080609.doc YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 ( 914 ).. 245- 2800__ Albert H: Padovani-,.T= ® B s A Height B Diameter Sys. I Conn.' Factory Pre - charge Working Pressure Ship Wt. Lit. Gal A Ins. mm ins. ins. PSIG B kg Ihs. WX -101 8 2.0 0 A In -Line Models Model No. Tank Vol. Max. Accept. Factor A Height B Diameter Sys. I Conn.' Factory Pre - charge Working Pressure Ship Wt. Lit. Gal mm Ins. mm ins. ins. PSIG PSIGI kg Ihs. WX -101 8 2.0 0.45 321 125/a 203 8 '/4 18 100 2.3 5 WX -102 17 4.4 0.55 381 15 279 11 'A 18 100 4.0 9 WX -103 33 7.6 1 0.42 629 22'/. 1 279 11 'A 28 100 7.0 15 WX -104 39 10.3 1.00 451 173/, 390 15% 1 38 125 9.0 20 WX -200 53 14.0 1 0.81 559 22T390 WX -203 153/6 1 38 125 110.0 45 22 System Gonnection: Steel. 2 100 PSIG is 689.5 kPa, 125 PSIG is 862 kPa System Connection: Steel. Copper Lined Steel Fitting Stand Models Model No. Tank Vol. Max. Accept. Factor A Height B Diameter C Conn. Sys. Conn.' Factory Pre -char a Working Pressure Ship Wt. Lit. Gal mm ns. mm ins. ins. ns. SIG PS G1 kg lbs. WX -104 -S 39 10.3 1.00 489 191/4 390 153/8 111/,6 1 38 125 10.5 23 WX -201 53 14.0 0.81 606 23'/8 390 153/6 113A6 1 38 125 11.4 25 WX -202 76 20.0 0.57 803 316/8 390 15% VA. 1 1 38 125 15.0 33 WX-202XL 98.4 26.0 0.44 971.5 38'/4 390.5 153/8 113A6 1 38 125 16.3 36 WX -203 121 32.0 0.35 1143 45 390 15% 113A8 1 38 125 20.0 43 WX -205 129 34.0 1.00 752 295/8 559 22 23/16 1'/. 38 125 28.0 61 WX -250 167 44.0 0.77 914 36 559 22 2'As 1'/. 38 125 31.0 69 WX -251 235 62.0 0.55 1187 463/4 559 22 23A6 11/4 38 125 41.0 92 WX -255 306.6 81.0 0.411..1432, 563/6,558.8, 22_ 23/,6 W. 38 125 10.0 103 u6V�(_3uz _ .'sZ6 'ou u, 4`7'% ' 60 2b I;1.5 s 1 bbll �12$''i WX -350 450 19.0 10.39 11512 1 611%8 660 1 26 1 TAG 1'/4 38 125 75.0 166 ' 125 PSIG is 862 kPa (Stainless Steel Elbow). ' System Connection: Stainless Steel. Max. Operating Conditions ® Operating Temperature 200° F (93° C) C v A (a ANS INSF 61 Job Name ✓f4N (V Q-1 - FMkk0N7 M1� t `/Y `_ Location ft off MIL.(- fty Engineer C2aN rrn/ EWE Contractor A /.R_,'1fi✓V � Contractor P.O. No. Specifications Description Standard Construction Shell Steel Diaphragm Heavy Duty Butyl Liner Virgin Polypropylene Coating Blue Enamel' ' Unless TUF -KOTE is specified. All dimensions are approximate. Sales Representative Model No. Ordered 2- Pump Cut -In PSI Pump Cut -Out PSI Pump GPM Rev. 02/05 Submittal data sheets can ONLY be ordered as a 'Submittal Data Sheet Pack', using MC# 4400. They are not available to order on an indi- vidual basis, however each data sheet is available on the Amtrol Web Site and can be downloaded and printed for use as needed. '08- 061-06 08;28 FROM- T -969 P001/001 F -b'(G 1 PUTNAM COUNTY DEPARTMENT OF HEALTH r DIVISION OF ENVIRONMENTAL HEALTH SERVICES ,50SMISlo 0 WELL COMPLETION REPORT WellLbea,two ,- Street•Atld /Village,- "Vk1� TaX.Crid #_ Block" Map _ t�f Lt(s)6— WellOwiler: Name: Address: • Ilse of'1�Ve11. 1- primary 2 secondary--, , .." ly 'Air coid/ieat ' esiiettal piblic Supp pumpIrrigliti n ' ' Business • Farm Test/monitorin Other(specify n Industrial ) Drilling .Equipment jV. Rotary ••• ••• •• -Cable percussion - Compressed air percussion Other (specify) Well Type _ Screened Open end casing _Open Open hole in bedrock Other Casing Details Total length 4-fa ft. Length below grade Diameter in. Weight per foot lb/ft. Materials: _ Steel —Plastic _ Other - Joints: _ Welded r/Threaded 'Other Seal: _ Cement grout ' Bentonite' Other Drive shoe: ' Yes No Liner Yes _ No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes—No Hours Second Well Yield Test _ Bailed _ Pumped Compressed Air Nours4o Yield (ogpm Depth Data Mcasurc from land surface- static (specify ft) During yield test(ft) Depth of completed well in feet (000 Well Log' If more ddtailed iirformatign descriptions or! sieve analyses are available, h please att> ch, Depth From Surface Water Bearing Well Diameter0n) Formation Description ft. ft. band Surface (o t L 0W4 kifdeN pp 6 `� !/'c If yield was tested at different depths during drilling, list: Feet Gallons per Minute Pump /Storage Tank Information Pump Type " . Capacity Depth Surly odel K-S15 ,A F Voltage ' L0 TB' •5 Tank Type -Jpa Volume KA& t' Date Well (Q615 omp CtC J 1 Putnam County Certification No, ato o cpo)l �, / 1 ff t WORD, I�ter�,(signature) W I' �if1�'l N V-1 L+: mact location oI Well wun alsiances w at least two permanent CanamarKs to De provtaea on a separate succupuzi. Well Driller's N e r .4 17(e.rsaly Address: ffe- e r 4 1,4l1 Signature: Date: White copy: H D File; Yellow copy -Building Inspector; Pink copy - Owner; Orange copy -Well driller Form WQ- 't DIVISION. F. ENVIRONMENTAL HE TH SERVICES__, _ - w. 4i r,...�..:'.l,.e.:.x � .,. .... ,. .....- xc:.',� ,...c .. :..: �..:.. K�.o a.,v•.H.:.. rs wF. .r �, .. .a _ - _ _. _ _ ._ � _. .7 :v0 e c � � GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM V.S. 0014 - RUC 110►i CORP Owner or Purchaser of Building 93.1(0 2 5 °4- Tax Map Block Lot V- 6, afJM1JV --r1 CORP. _ PO TMAM VAI.LEYI Building Constructed by ow illage 6 7 MARSH HILL, R ,),qD EMER.4LP RiDne Lo cation - Street Subdivision Name 5 LF- F icy R�s�nEn�c� Building Type Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to. operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the The undersigned further agrees to accept . as conclusive the determination of the Public Health Director of the Putnam County Department of Health as to whether or not t e fai a of the system to operate vas jaused by the willful or negligent act of the occupant of4 di g utilizing the Dat d: nt 05 Day 23 Year � 8 Signature: _ Title: &jtKi44,5r_P75TS L MMACrbit Gen ral^/ on ctor {Owner) - Signature °� n,, Ve 5, ./0nl3TRtJCT1 o!J 6jtp. VAC .SANT/Cc1) ' ( l/F,01 :wWi TF_UC►(_ Corporation Name (if corporation) Corporation Name (if corporation) Address: 3'7 CRdTw -D4m &4p Address: 513 State 0,C,8ln/rh/4 NEW yogK Zip 1056. State_ _lv�tN VQRJ4 ZIP— X95 Form GS -97 05/16/2088 14 :26 May 16 2008 14:20 —1.. ,AB #.. 1.802270 WDERSON WELL DR LS2 BARGER ST !LTTN: NORMAN, SAI ?UTNAM VALLEY, N 9147397156 HP LRSERJET FAX PREMIER ATHLETIC CLU PAGE 02 p.l 321 Kear Street X" Yorktown Heights, N.Y. 10598 (914) 245 -2800 Albert H. Padovani., Director CLIENT #: 2500 NON STAT PROC PAGE: 1 of 7 ,LING DATE /TIME TAKEN: 05/14/OF 09:45 DATE /TIME RECD: 05/14/08 10:25 �►I3 REPORT DATE: 05116108 10579 PHONE: (914)- 528 -1491 ;AMPLING SITE: L T 6 SAMPLE TYPE..: POTABLE PRESERVATIVES: NONE COLD BY: NORMAN TEMPERATURE..: c 4C NOTES...: COLIFORM METH: MF .r ---- r--- ---- r- r --- - -r - m- - - ---- - rr ---ft- -----r-------------- DATE F PROCEDURE RESULT NORMAL - RANGE MET OD 05/14/08 MI T. COLIFORM ABSENT /100 ML COMMENTS: FAX TO 7J9-7156 COMMENTS: MFTC THESE RE; SATISFAC7 -AND.. EPA I - TESTED" � SUBMITTED BY: ABSENT SM 18 -20 9222B T9 INDICATE THAT THE WATER (WAS) (WAS NOT) OF A ,Y SANITARY QUALITY ACCORDI TK NEW YORK STATE ERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS THE - TiME :..4F._. CO.L L CTION -, r .: rector , M.T. ELAP# 10323 106-103 -101 0j:0j rmum- Pabho Health Direeror DEPA$T MNT OF HEALTH I Geneva Road, 13rowster, New York 10509 T —Kid Y00Z/002 F -519 Associate Public 14valth Director Director of Patient Services Environmental Health (843) 278 - 6130 Pax (845) 278 - 79121 Nursing $ervlceo (843) 278 - 6558 WIC (843) 278.6678 Fix (843) 278.6085 Early Intervenden/i'reschooi (845) 278 - 6014 ltan (844) 272 - 6648 TAX MAP NUMBER: im ita `° I — Eel E911 ADDRESS: b 1 490 Y a.a. RwD TOWN: PUTNAM V &LEE AUTHORED TOWN OFFICIAL: 6aill � (SiSnat re) DATE: S—/ 9 /o 9 The Putnam County Department of Health will not issue a Certificate of construction Compliance unless the above fon11 is completed, i.e., a legd E911 address is assigned by an authorized town official, This farm is to be submitted with the application for a Certificate of Construction Compliance. (H91 lcerfrm) RONIN_ ENGINEERING, PE, PC The Lindy Building, Suite 200, 2 John Walsh Boulevard, Peekskill, New York 10566 May 23, 2008 Mr. Joseph Paravati Assistant Public Health Engineer Putnam County Health Department 1 Geneva Road Brewster, New York 10509 Re. VS. Construction Corp. Certificate of Construction Compliance 4 Bedroom Residence 69 Marsh Hill Road Town of Putnam Valley, New York 10579 Section; 83.16, Block. 1, Lot 57 Subdivision Lot 6 of "Emerald Ridge" Dear Mr. Paravati, Enclosed for your review and approval please find the following items regarding the application for a Certificate of Construction Compliance at the above referenced project: 1. One (1) Certified Check in the amount of $300 ade payable to the Putnam County Health Department. 2. Three (3) Copies of a two (2) year guarantee signed by the Owner & the Installer 3._ Foul (4 .lfVe}! CarpJtion.FZep�rts signed::tiy_Norman :Aridei-sori (Thylll Drillers 4. One (1) Copy of Satisfactory Results of a Water Analysis by a Yorktown Medical Laboratories, a NYSDOH Approved Laboratory. 5. One (1) E911 Address Verification Form verified by the Town of Putnam Valley. 6. Four (4) Certificates of Construction Compliance 7. Four (4) Sets of "As- Built' Plans signed and sealed by Timothy L. Cronin III, the Design Professional. 8. One (1) Copy of As -Built Foundation Survey by Donnelley Land Surveying. Please review the above items at your earliest convenience and should you have any questions or require additional information, please do not hesitate in contacting me at the number above. Respectfully Submitted, . Z James W. Teed Project Engineer cc: Val Santucci- Owner File- Paravati- PCDH- Santucci -Marsh Hill Road -Lot 6-SSTS As- Built- Trans- JT- 20080523.d t SI-IERLITA AMLER, MD, MS, FAAP Commissioner of Health LORE°'TTA MOLINARI, iK M0' Associate Commissioner of Health May 1, 2008 Timothy Cronin P.E. The Lindy Building Ste. 200 2 John Walsh Blvd. Peekskill, NY 10566 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health Re: Field Inspection — VS Construction Marsh Hill Road (T) Putnam Valley, Tm # 83.16 -1 -57, Lot # 6 .f. i� r ear Mr. Cronin: The above referenced separate sewage treatment system can be backfilled. There are no further comments to be addressed at this time. you _1_iave� any further Questions, :plea_se contact me at '(845) 278 -6130, -ext. 22 61: GDR:kly Sincerely, ) Gene D. Reed Sr. Environmental Health Engineering Aide Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool(845)278 -6014 Fax (845) 278 -6648 FINAL SITE INSPECTION Date: inspected by: Street Location ��J ���u � Owner V.-S. (aN/ 7'rl LCCjOiV Town U-rN A M . VALQF Y Permit # _ ✓ — O 1. Sewage Svstem Area a. STS area located as per approved plans .......... I.......I......... 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 ...... ............................... IL Sewage Svstem - ®. O a. Septic tank size - 1,000 ... :..... 1,250 ......... other.. ... b. ' Septic*tank installed level ................ ............................... c. 10' minimum from foundation .......... ........................... :... d. Distribution Box 1. All outlets at same elevation -water tested ............... ... 2. Protected below frost .................. ............................... 3. .. Minimum 2 ft. Original soil between box & trenches e. Junction Bog - properly set .......... ............................... 6. Irenches , 1. Length required 7 Length installed Z /Y� 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. Pipe ends capped ........................ ............................... g. Pump or Dosed Svstems 1. Size of pump chamber ................ ............................... 2. OverEov,= ta► k ..::.:.::::......:.. 4 ........ ............................... 3. Alarm, visual/ audio :.......:........... ............................... 4. Pump easily accessible, manhole to grade ................. 5. First box baflled .......................... ............................... 6. Cycle witnessed by H.D.estimated flow /cycle........... III. House/Buildina a. House located per approved plans ... .............................,r ;1 b Number of bedrooms .................. ............................... IV. Well Well located as per approved plans .......:.......... ... b. Distance from STS area measured �d y 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. 12/02 `I lo&) r � t AA M., W "M �e o� WARM / � MM 's v_ WAtM MM WME 4 .. , III M ME _• FM `I lo&) 108 -0428 14.56 FROM- Pox -r® 2-70 — �92,t T -885 P0011001 F -466 .. _rJ`)11rM IDMSIQN OF ENVIRONMENTAL HEALTH SERVICES ATTENTION © ADAM REQUEST FQ_R F'TNAT. TNSPECTIO All information must be :fully Completed prior to any inspections being made. ❑ GENIC 0 JeW P. For: Fill Trenches PCHD Construction Permit # FV 01 —08 Located: IA-r 6 !.aM99jxV ItTlUe 14 x Mjg. Rb (V) roTN&4 Vift4p, Owner /Applicant Name: ,_•,5Ay,6- 'P-ucTUA1 -D-48, TM 89 - Block 1 Lot 5!j Formerly: SU p Subdivision Name: F—M.e 15 R o D &P- Subdivision Lot # Is system fill completed? _AI% Date: AV Is system complete ?s - bate: ®2 _ Is gxmtem constructed as per plans? Is well drilled? 14ES Date: D bsk)5 Is well located as per plazas? Are erosion Control measures in place? I certify that the system(s), as listed, at the above premises has been t ve inspected and verified their completion; in accordance with the issue Coni f'on ermit and approved plans and the Standards, Rules and Regulatio s-6 f'h to ti ent of Date: f� S D8 Certified by: " Design Address: 9 JOY 9 ' t/W(I*Sr Comments: t Form FIR -99 �/ /CP— /� C � y COUNTY DEPARTMENT OF4, EALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICI - .'<: - CONST R-U C`-niION- PEI '= %aR-&EWAGE:TREA-TMEP'f- SYSTEM PERMIT # C G Locatedat O�j Subdivision name C– m-e- r-- W K td5 e Subd. Lot # Date Subdivision Approved Ac Ve m 6e I `% Z o c - Owner /Applicant Name VL C cno S �V v c V0 Mailing Address 3 7' C vy 'R 01 r-. e{ Amount of Fee Enclosed Building Type - 1 u W I of Area No. of B e Fill Section Section Only Depth _ own rVillage y+r<<i3O c, Tax Map 24, . Block J Lot 70 Renewal Revision Date of Previous Approval zip 0j" edrooms Design Flow GPD Volume Separate Sewerage System to consist of rib gallon septic tank and L • d Other Requirements: To be constructed by ' —ry D Address — Water Su 1 : Public Supply From Address or:. Private S?jpplyDrilled:b_y g_ .- ! - - - - T Address,.- I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatmentsystem described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and re ons of the Putnam County Department of Health, and that on completion thereof a "Certificate of Constructi 60%ri tisfactory to the Public Health Director will be submitted to the Department, and a written guar ante 1 1 kd owner, his successors, heirs or assigns by the builder, that said builder will place in good perat� ig'c , altion any�� s . d sewage treatment system during the period of two (2) years immediately followin the date q th ,�i sua 6e c 'tt�'iie ajip ,ova of the Certificate of Construction Compliance of the original system or any repairs thereto: x Signed: Address 1 -JOHN l tso E. t/ R.A. Date N00566 License # dl'n2- 9Q APPROVED FOR CONSTRUCTION: 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 a new permit. Approved for discharge of domestic sanitary sewage only. By: Title: Q � Date: X B 0 White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 R®NIN ENGINEERING, PE, PC The Lindy Building ,_Suite 200, 2 John Walsh Boulevard, Peekskill, New York 10566 Tel.i 9i4 -c36= 664'6 Ftax: 14=736 January 18, 2008 Mr. Lany Werper Assistant Public Health Engineer Putnam County Health Department 1 Geneva Road Brewster, New York 10509 Re. V.S. Construction Corp.- Emerald Ridge SSTS Construction Permit Marsh Hill Road- Lot 6 Town of Pubiam Valley, New York Section: 84.00, Block: 9, Lot: 70 Dear Mr. Werper, Please find enclosed the following regarding an application for a Subsurface Sewage Treatment Construction Permit Renewal at the above referenced lot: 1. Four (4) Revised Subsurface Sewage Treatment System Construction Permit Plans for the above referenced lot (Renewal) Should you have any questions or require additional information, please do not hesitate in contacting me at the number above. .i R ully Submitted, James W. Teed, Jr. Project Engineer cc: Owner - Val Santucci (V.S. Construction Corp.) File- Werper - PCDH - Santucci - Emerald -Lot 6- Trans- t- 20080118.doc SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORET'1['A:MOLLN�I.�I, Associate Commissioner of Health January 17, 2008 DEPARTMENT OF HEALTH Geneva Road, Brewster, New York 10509 Cronin Engineering The Lindy Building, Suite 200 2 John Walsh Blvd. Peekskill, NY 10566 Re: To Whom It May Concern: ROBERT I BONDI County Executive Director of Environmental Health Proposed SSTS — VS Construction Corp. — PV -01 -08 Marsh Hill Road, (T) Putnam Valley TM # 84. -1 -70 This office has received and reviewed the most recent set of plans for the above - mentioned project. We would like to offer the following comments for your review and consideration. 1. Site map shows Lot 4. 2. Deep test hole # 13 should be 3 feet not 4 feet from lite brown sand to brown coarse sand on plans. This office will continue its review upon consideration of the above - mentioned comments. Please feel free to contact me at est. 2163 if any questions arise. LCW /kly Very truly yours, Lawrence C. Werper Public Health Engineer Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH INDMDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEMS _ �_ », ..:i€E H15 �iliiis: "1 "�*&Dit idST iiUCFiON PERMF NAME OF OWNER: �,� C O rJ 75 V e T, W STREET LOCATION: REVIEWED BY: RM, GR, AS S ATE: TAX IvIAPm: (CONFIRMED) 6 Y N DOCUMENTS Z (�L�PERMIT APPLICATION (REQUIRED DETAILS ON PLANS CONT'D) (HOUSE SEWER -' /" FT. 4 "0'; TYPE PIPE CAST IRON _)L YELL PERMIT OR PWS LETTER�� BENDS; MAX BENDS 450 W /CLEANOUT PC -97 RENEWALS—- - LETTER OF AUTHORIZATION ((_)SITE NOTE E) (_ DESIGN DATA SHEET (DDS) FILL SYSTEMS CORPORATE RESOLUTION O' HORIZONTAL; PAST TRENCH SLO _ES 3:1 :T0 GRADE SHORT EAF (_)UILL SPECS/ FILL NOT PLANS -THREE SETS (_) PRO IMENSIONS (�(_} USE PLANS -TWO SETS EXPANSION AREA (_)�ARIANCE REQUEST FILL GREATER TH E ^ SUBDIVISION J� LEGAL SUBDIVISION LULU CLAY BARRIER (�(�FILL CERTIFICA OTE SUBDIVISION APPROVAL CHECKED LUN PT GA UUP RC RATE i G L�(_)VOL. O AN FOR R.O.B., UNCLASSIFIED & IMPERVIOUS (_)GILL REQUIRED DEPTH LUUJS RATION DISTANCE FROM TOE OF SLOPE LU(—�U TAIN DRAIN REQUIRED GENERAL RT ENCH L)ULF TRENCH PROVIDED 60FT MAX. (_) GATE D IN NYC WATERSHED PARALLEL TO CONTOURS (_j CANS SUBMITTED TO DEP 100% EXPANSION PROVIDED (_)D LEGATED TO PCHD EP APPROVAL, IF REQ'D DETAIL/DUST FREE CRUSHED STONE OR WASHED GRAVEL U( ,i GEOTEXTILE COVER (DEEP TEST HOLES OBSERVED (�LERCS TO BE WITNESSED SEPARATION DISTANCES ON PLAN - FROM SSTS 10' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL (�( SEX- APPROVAL SSDS ADJ, LOTS C_JC VVETLANDS (TOWN/DEC PERMIT REQ'D ?) 20' TO FOUNDATION WALLS 100' TO WELL, 200' IN DLOD,150' TO PITS (_ j/ (___)DATA ON DDS PLANS &PERMIT SAME 100' TO STREAM, WATERCOURSE, LAKE. (inc. expan) U(li )•PRE 1969 NEIGHBOR NOTIFICATION L__)L,,�ETTER BUZBA 50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER -- (- jTJ10' TO WATERLINE (nits -20' - FLOOD.RLE�'A''ICI�N�'4T!f S�in��.. 50 , INTI;RMITTENT'1)RA1NAGE COiTJRSE•...... _ .......,._ _ .... _ U(d8OIL TESTING LOTS >10 YEARS OLD 200'/500' RESERVOIR, ETC. 150' GALLEY SYSTEMS REQUIRED DETAILS ON PLANS _ (10' MIN TO LEDGE OUTCROP SEWAGE SYSTEM PLAN - (NORTH ARROW) SSDS HYDRAULIC BROFILE SEPTIC TANK (±' 10' FROM FOUNDATION; 50' TO WELL GRAVITY FLOW WELL CONSTRUCTION NOTES 1 -15 DESIGN DATA: PERC & DEEP RESULTS CU DIMENSIONS TO PROPERTY LINES' L_ �LOCATION OF SERVICE CONNECTION L_J2' CONTOURS EXISTING & PROPOSED _� LMIN 15' TO PROPERTY LINE DRIVEWAY & SLOPES, CUT SLOPE (FOOTING /GUTTER/CURTAIN DRAINS (_)SLOPE IN SSTS AREA7. �(520 %) . USDA SOIL TYPE BOUNDARIES C_) REGRADED TO 15 %, IF REQUIRED TITLE BLOCK; OWNERS NAME ADDRESS DOSE/PUMP SYSTEMS; TM #, PE/RA; NAME, ADDRESS,'PHONE# U)U)PUMP NOTES ((�) DATE OF DRAWING /REVISION (UUDOSE 75% OF PIPE ME/DOSE VOLUME NOTED (DATUM REFERENCE U)UDETAIL FOR CE MAIN, (PIPE TYPE, ETC.) LOCATION OF WATERCOURSES, PONDS �.:'(J_PIT AN - OX SHOWN & DETAILED LAKES,WETLANDS WITHIN 200' OF P.L. LL) STORAGE ABOVE ALARM PROPOSED FINISH FLOOR AND CURTAIN D _ dcBASEMENT ELEVATIONS (UUSTANDPIPES, 5' BOTH , ETAIL WELLS & SSDS'S W/IN 200' OF SSTS UU15' MIN to CDS=> o, 20' -4 %, 25' -3 %, 35' -1 %, 100 % -<1% PROPERTY METES &BOUNDS EROSION CONTROL FOR HOUSE, WELL & (– JL -)20; MIN DISCHARGE /100' with 182 cons day discharge SSTS, EROSION CONTROL NOTE C—) to NON - PERFORATED PIPE COMMENTS: J lle% ' S'.x C I ✓.i D' ' ' • /1-7--h/ 7 (IUMIlE, ET)09 /01 /00 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES _. -. . = : ^APPLICATION FOR APPROVAL OF.PLANS F',OR A WASTEWATER TREATMENT SYSTEM 1. Name and address of applicant: j/S 6'VVS6-uc) 2. Name of project: Gm e,- l J L o f W � 3. LocatioraN: T►,:b2a w, V I/e 4. Design Professional:-Ti;o!' l L. Crv-o m1tt- 5. Address: 2- o ,ky, W- 6. Drainage Basin: PQ e- i6 sc (k �6 l o w gpb 'Pee- \C- S(C t (< , W-1 '10S'64 h Type of roiect: 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 Exempt Type II Unlisted 9. Is a Draft Environmental Impact Statement (DEIS) required? ......................... A41 10. Has DEIS been completed and found acceptable by Lead Agency? ............... 11. Name of Lead Agency 12. Is this project in an area under the control of local planning; zoning, or other . official_s,.ordinanbes?........... ... .................... :....................... .................... :.......... _ 13. If so, have plans been submitted to such authorities? ........ ............................... . 14. Has preliminary approval been granted by such authorities? -- Date granted: 15. Type of Sewage Treatment System Discharge ................. surface wafer 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? ................ Al o 21. Name of sewage system Distance to sewage system --- 22. Date test holes,observed k 04 23. Name; of Health Inspector j�,�. �� rG va 4L 7 7 24. Project design flow (gallons per day) 25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?... Alv 26. Has SPDES Application been submitted to local DEC office? ......................... Form PC -97 2 27. Is any portion of this project located within a designated Town or State wetland? A10 28. Wetlands ID Number ... ............................... .. etlands Permit required? ... . ................... ............................... Has application been made to Town or Local DEC office? �-- 30. Does project require,a DEC Stream Disturbance Permit? .. ............................... A/c 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge�application or industrial activity? ....................... Yes/No e 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 n% DESCRIBE: 33. Is there a local master plan on file with the Town or Village? ......................... Ves 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site? ................................ ............................... 35. Are any sewage treatment areas in excess of 15% slope? . ............................... & o 36. Tax Map ID Number .......................... ............................... Map VN. Block l Lot 37. Approved plans are to be returned to ..... Applicant Design Professional NOTE: All applications for review and approval of a new SSTS.to be- located within the -NYC Watershed shall_ - - " be sent to the Department, and deed not -be sent in duplicatefto tfie DEP, although the project may require DEP approval of the SSTS prior to final approval by the Department. Projects within the watershed may also require DEP review and approval of other aspects of a project, such as stormwater,plans or the creation of impervious surfaces, and the project applicant should obtain the appropriate forms for such activities from DEP and submit those forms to DEP for review and approval. If the application is signed by a person other than the applicant shown in Item I .,the application must be accompanied by a Letter of Authorization (Form LA -97). Failure to comply with this provision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury, that information to the best of my knowledge and belief. False state Wn a Class A misdemeanor pursuant to Section 21,0 SIGNATURES & OFFICIAL TITLES: Mailing Address: ................................... Z 13 lvc� P- 0- etsbl( , NY /vs- U PUTNAM COUNTY DEPARTMENT OF HEALTH °. - _: •::: . �A� "�13��N �Y "'EN ` lY���7.`.IiY'1N�AL A1��LT� i�ER T' ��i� ... •. _ _ ......... _. LETTER OF AUTHORIZATION RE: Property of V.S. Construction Corp. Located at Marsh Hill Road UN Putnam Valley Tax Map # 84 Block 1 Lot "-:� Subdivision of Emerald Ridge Subdivision Lot # (O Filed Map # 309 3 F Date Filed ((vv-e v, Gentlemen: This letter is to authorize Timothy L. Cronin 111, P.E. a duly licensed Professional Engineer I ✓ I or Registered Architect to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Depa i���}t o sign all necessary papers on my behalf in connection with this matter and to su wise c n of said wastewater tretment and /or water supply systems in Pr: �< o PP Y Y conformity ' th ision le 145 and/or 147 of the du ion Law, the Public Health `Law, and -the ,d ail; -� '"ode. ;a - .,��.. ' Very trul y .� Countersigned: `� `�''FO " 629s °�;\,P� Signed: P.E., R.A., # 0629 �ti0FE5S\u (owner fPrope ) Mailing Address Cronin Engineering P.E., P.C. Mailing Address: V.S. Construction Corp. 2 John Walsh Boulevard, Peekskill 37 Croton Dam Road, Ossining State New York Zip 10566 State New York Zip 10562 Telephone: (914) 736 -3664 Telephone: (914) 447 -4647 Form LA -97 617.20 SEAR ,,. Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM -:.. .For UNLISTED ACTIONS,.Only.e_.. Part 1 - PROJECT INFORMATION (To be completed by Applicant or Proiect sponsor) 1. APPLICANT /SPONSOR: 2. PROJECT NAME: VS Construction Corporation Construction of Single Family Residence 3. PROJECT LOCATION: Municipality: Town of Putnam Valley County: Putnam County 4. PRECISE LOCATION: (Street address and road intersections, prominent landmarks, etc., or provide map) West side of Marsh Hill Road, 2600 ft. north of intersection of Marsh Hill Road and Peekskill Hollow Road 5. PROPOSED ACTION IS: ENew ❑Expansion ❑Modification /alteration 6. DESCRIBE PROJECT BRIEFLY: Construction of a new single family residence, ssts and private water supply. 7. AMOUNT OF LAND AFFECTED: Initially 2.321 acres Ultimately 2.321 acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? ❑s Yes ❑No If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? E®Residential ❑Industrial ❑Commercial ❑Agricultural ❑Park/Forest/Open space ❑Other Describe: Surrounding lands are zoned R -2 (Single Family Residential) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? EYes ❑No If yes, list agency(s) name and permit/approvals Town of Putnam Valley — Building Permit 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? IYes ❑No If yes, list agency(s) name and permittapproval Town of Putnam Valley -Site Development Approval 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION? ❑Yes E■ No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/Sponsor e: Cronin Engineering P.E. P.C. /Patrick Bell Date: January 11, 2008 Signature: If the action is in a Coastal Area, and you are a state agency, complete a Coastal Assessment Form before proceeding with this assessment OVER 1 PART II- ENVIRONMENTAL ASSESSMENT (To be completed by Agency) A. DOES ACTION EXCEED AV TYPE 1 THRESHOLD IN 6 NYCRR, PART 617.4? if yes, coordinate the review process use the FULL EAF ❑Yes CKO B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative declaration may be superseded by another..invo ve gency d C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: Answers may be handwritten, if legible. C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: �b C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: r ' C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly: 46 C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: /i b C6. Long term, short term, cumulative, or other effects not identified in C1 -05? Explain briefly: G V C7. Other impacts (including changes in use of either quantity or type of energy)? Explain briefly: E. IS THERE, Of3/fS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ❑Yes o If Yes, explain briefly: Part III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) _..INSTRUCTIONS: For.each adve.rse..effect identified above, determine whether it is substantial, large, important or-,otherwise lgigiiiflcaht: 'Each effect *8h uld be a`ssesse -d iii cdnnectibn witn its'(a) °setting (i:e. urban or'rural); (b) probability of occurr _ ing; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question D of Part II was checked yes, the determination of significance must evaluate the potential impact of the action on the environmental cnaractenstics of the ULA. TCh ck this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. he proceed directly to the FULL EAF and /or prepare a positive declaration. heck this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide on attachments as necessary, the reasons supporting this determination: -=4 12 En " e C^``" Print or Type Name of Responsible Officer in Lead Agency QC /V ai Name of Lead Agency V-/vI 4 - Title, esponsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) Zq date AFFIDAVIT - CORPORATE OWNER APPLICATION FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT To: Public Health Director In the matter of application for: Subsurface Sewage Treatment System Construction Permit (TM #: �q — , - 70 ) I Val Santucci represent that I am an officer or employee of the corporation and am authorized to act for: Name of Corporation: V. S. Construction Corp. Having offices at: 37 Croton Dam Road, Ossining, New York 10562 Whose Officers Are: President - Name: Val Santucci Address: 37 Croton Dam Road, Ossining, New York 10562 Vice President - Name: Address: Secretary -Name: _ - Address: Treasurer - Name: Address: and that I am and will be individually responsible for any to the approval requested and all subsequent acts relating Signed: Title: Sworn to before me this day of 449 -g Not tary Public, State of New York No. 4989872 qualified in Dutchess County Commission Expire; December 16, corporate Seal Form CA -97 f the corporation with respect RONIN ENGINEERING, PE, PC The: Lindy - Building, Suite• ;200, 2 John Walsh Boulevard,.P_eekskill New York:10566 -- L: -(. . . :. djp .-Suit a -,,2 Tel.: 914 - 736 -3664 •Fax: 914 - 736 -3693 January 11, 2008 Mr. Joseph Paravati Assistant Public Health Engineer Putnam County Health Department 1 Geneva Road Brewster, New York 10509 Re: V.S. Construction Corp.- Emerald Ridge SSTS Construction Permit Marsh Hill Road Lot 6 Town of Putnam Valley, New York Section: 84.00, Block. 1, Lot: 70 Dear Mr. Paravati, Please find enclosed the following regarding an application for a Subsurface Sewage Treatment Construction Permit mat the above referenced lot: 1. One (1) Affidavit of Corporate Ownership authorizing Joanne Pitt Bruscki to represent Should you have any questions or require additional information, please do not hesitate in contacting me at the number above. Respectfull Submitted, James W. Teed, Jr. Project Engineer cc: Owner- Val Santucci (V.S. Construction Corp.) File- Paravati -PCDH- Santucci - Emerald -Lot 6-Trans-A-200801 1 1.doc Victoria Manor, LTD. 2. One (1) Letter of Authorization authorizing Cronin Engineering P.E., P.C. to apply for a construction permit at the above referenced lot. 3. One (1) Certified check for $500 made payable to the Putnam County Health Department on behalf of the above referenced application �~ ~ T -X-Z. F-biir�(4). ubsurface Seyi�e:T[eatment.Sy tr? a C n ! ctionYr �imif PFBS:.fs�ra #tie` love - referenced lot (Renewal) 5. Four (4) Subsurface Sewage Treatment System Construction Permit Applications for the above referenced lot (Renewal) 6. Three (3) Sets of proposed House Plans at the above referenced lot. Should you have any questions or require additional information, please do not hesitate in contacting me at the number above. Respectfull Submitted, James W. Teed, Jr. Project Engineer cc: Owner- Val Santucci (V.S. Construction Corp.) File- Paravati -PCDH- Santucci - Emerald -Lot 6-Trans-A-200801 1 1.doc PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES 'DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner VS. w. s 6v A wt Address D.w, VJ. Ds� , "V Y c' S-6 2. Located at (Street) A-- r 41 l l Tax Map '�N . Block l Lot 70 (indicate nearest cross street) Municipality ?v40. w, \f" l (e y Watershed 6! e. lC SLt I I 1--1¢ I k ow Bry e L SOIL PERCOLATION TEST DATA Date of Pre - soaking 0-F -0'i-01 Date of Percolation Test 0-7- -07- °1 NO. Hole Run No. Time Start - Stop Elapse Time (Min.) Depth to Water From Ground Surface (Inches) Start Stop Water Level Drop In Inches Percolation Rate Min /Inch 1 ,022 10 a4 3 S a q,l 2 10N6_ fit' a � jl� 2-1 3 t1 �3_ 1, 2-1 3 4 5 13 1 tots_ /04G 3 tl' - 11 30 tSS- ;_I 3 10 4 1143 -1213 30 t 'Z 3 /0 5 1 2 3 4 5 NOTES: 1... Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. <_ 1 min for 1 -30 min/inch, <_ 2 min for 31 -60 min/inch). All data to be submitted for review. 2. Depth. measurements to be made from top of hole. Fomi DD -9i P2.1of'- TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO.D1 0 t J911 G.L. C, 0.51 1.0' 1.5' 2;0, LJ( le (fit S 2.5' 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' oil 9.5' HOLE NO.D 12- q HOLE NO. it Indicate level at which groundwater is encountered A/ rV-P__ &A C_C L.1- Indicate level at which mottling is observed G Indicate level to which water level rises after being encountered. Deep hole observations made by: 6>Z vi,w Date C"2 - , Z 1, Vd-- . ,/ - i- - , , / Design Professional Name:--I 'lo ► - 4!f 6, 6-axIn Address: J— —T-1; L, I,, Lt-i — ( C, L-1 R/I ('4 Signature: los'-66 Design Professional=s Seal -101011�-' 91" 6,29801 4i .. I "'N , ROOF LEAMIER & ..- ,,FOOTING QRAIN LOT 7 T )N BOX LINSTALLATION)l 'LOT 6- Are4=101,085 Sq. Ft. t=2.3206 Acres O vv/ la , ROOF LEAMIER & ..- ,,FOOTING QRAIN LOT 7 T )N BOX LINSTALLATION)l 'LOT 6- Are4=101,085 Sq. Ft. t=2.3206 Acres O vv/ ON RATE OF 8 TO 10 MINUTES PER ,HES -Y DONNELLY LAND SURVEYIN 'DATED FEBRUARY 5, 2004 WITH ALD RIDGE SUBDIVISION AND SITE LED IN PUTNAM COUNTY CLERKS AS -BUILT S.S.T.S. LOCATION DISTANCES DESCRIPTION A B SEPTIC TANK CENTER 15.6' 33.9' JUNCTION BOX # 1 27.6' 36.2' JUNCTION BOX # 2 30.0' 32.8' JUNCTION BOX # 3 33.4' 30.2' JUNCTION BOX # 4 37.4' 28.7' JUNCTION BOX # 5 41.9' 28.4' JUNCTION BOX # 6 46.7' 29.4' JUNCTION BOX # 7 51.8' 31.5' '.- 57:1'_ . _U:6` TRENCH 1 END 85.3' 88.2' TRENCH 2 END 88.5' 87.2' TRENCH 3 END 88.0' 86.6' TRENCH 4 END 89.9' 86.4' TRENCH 5 END 92.2' 86.6' TRENCH 6 END 94.8' 873 TRENCH 7 END 9 97.7' 8 88.4' TRENCH 8 END 1 100.9' 8 A S-BUIL T AS -BUILT WELL LOCATIOI DESCRIPTION _... .. WELL,......... _: TRENCH 7 END 9 97.7' 8 88.4' TRENCH 8 END 1 100.9' 8 89.8' T AS -BUILT WELL LOCATIOI DESCRIPTION _... .. WELL,......... _: