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Home My WebLink About4096DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 83.72 -1 -53 BOX 31 L �i - it -� { J , !j PUTNAM COUNTY DEPARTMENT OF HEALTH W' l 02-,91 4 DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well Location Street Address: Nardi n Road Town/Village: k, Peekskill Tax Grid # 83.72 -1 -53 Map Block lot(s) Well Owner: Name: Address: Robert Hochberg, PO Box 103, Nardin Rd „Lake Peekskill , NY Use of Well: 1- primary 2- secondary xx Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring OtheOpecify) Industrial Institutional Standby Drilling Equipment Rotary Cable percussion xx Compressed air percussion Other (specify) Well Type Screened Open end casing xx Open hole in bedrock Other Casing Details Total length 51 ft. Length below grade 50 ft. Diameter 6 in. Weight per foot -19 lb/ft. Materials: xx Steel _ Plastic _ Other Joints: _ Welded _ZX Threaded _ Other Seal: xx Cement grout _ Bentonite Other Drive shoe: xx 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 xx Compressed Air Hours 6 Yield 7 gpm Depth Data Measure from land surface-static (specify ft) 170 During yield test(ft) 600 Depth of completed well in feet 845 Well Log If more detailed information descriptions or sieve analyses are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface 5 Brown soil 5 845 Hard . rey granite If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information 465 0 Pump Typ %ubmersi b(T@Pacity ] CpM Depth 460' Model 7GS10412 Voltage 230 HP 1 TankTypBja. h agm Volume 40 gal. 600 1 2 845 7 Date Well Completed 9/14/9.8 Putnam County Certification No. 2 Date of Report 9/17/98 Well er (si nature) . ,. iNuiz: txact location or wets wits aistanees to at teasi two permanent ianurnarxs to or, piuviucu uu a bcpa►a,v �.�� -r•w,. We11 Driller's r .MILL L INC,, 75' Putnam .Ave o , .Br. ewster, N .!4dclr Ya Signature: Date: 9/ 17198 Robert M. Mill, President White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 39 -3 MHL>L 1P><a9 Z ROAD - DANBURY, CT 068111 )203) 748 -7903 - FAX (203) 748 -0652 LABORATORY REPORT -- WATER SUPPILY TESTING MILL DRILLING 75 PUTNAM AVENUE BREWSTER, N.Y. 10509 SAMPLE SITE: SAMPLING POINT: .SOURCE: TREATMENT: TEST PERFORMED BACTERIAL: Total Coliform (Bacteria) PHYSICALS: _ -. pH Turbidity CHEMISTRY: CT Cert: PIS -0404 NY Cert: 11471 DATE SAMPLE COLLECTED: 10 /23/98 TIME COLLECTED: 4:30 P.M. COLLECTED BY: RUSS DATE RECEIVED @ LAB: 10/23/98 TESTED BY: LAB #11471 & 11301 REPORT DATE: 11/6/98 HOCHBERG, ASPEN Ct., LAKE PEEKSKILIL, N.Y. BOTTOM OF TANK WELL NONE; RESULT: 0 per 100 ml 8.16 0.54 NTUs MAXIMITM CONTAMINANT, LEVEL 0 per 100 ml no designated limit 5 NTUs Nitrite N <0.01 mg/L as N 1 mg/L as N 11301 -Nitrate N 0.01 mg/L as N 10 rirng/L as N Alkalinity 58.0 mg/L no designated limits Hardness 44.0 mg/L no designated limits Iron <0.10 mg/L 0.30 mg/L Manganese 0.039 mg/L 0.30 mg/L [Note: Combined Limit for Iron plus Manganese = 0.50 mg/L] Sodium 19.8 mg/L 20 mg/L ** Lead <0.005 mg/L 0.015*** m1= milliliter mg/L = milligrams per Liter ND = none detected NTU =Units * *Notification Level ** *Action Level RESULTS BASED ON SAMPLES SUBMITTED: 1'0/23/98 SAMPLE, AS TESTED ABOVE: ® OTABLE or � OT POTABLE ER NEW YORK ORK STATE DEPT. OF HEALTH SERVICES STANDARDS FOR POTABLE WATER) Laboratory Director oNORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 060370 (860)828 -9787 - FAX (860)829 -1050 TOLL FREE WITHIN CT: 800 - 826 -0105 o OUTSIDE CT: 800 - 654 -1230 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL W please print or type PCHD Permit # Ae.- % 7 Well Location: Street Address: ToIwn/Village Tax Grid # 83.72 -1 -53 Nardin Rd. Lake Peekskill Map Block Lot(s) Well Owner: Name: Address: PO Box 103, Robert Hochberg Nardin Rd'.,'Lake Peekskill, NY 10537 Use of Well: xx Residential Public Supply Air /Cond/Heat Pump Irrigation rima Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought 5 gpm # People Served 4 Est. of Daily Usage '.','gal. Reason for xx Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason Has ubl is water supply in summer for Drilling Well Tye xx Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No xx Is well located in a realty subdivision? ...................................... ............................... Yes No xx Name -of tit ivisiptlt _ n .a ..... ....... .LotN'o. Water Well Contractor: MILL DRILLING, INC. Address: PUTNAM AVE., BREWSTER, NY 10509 Is Public Water Supply available to site? ................................. ............................... Yes x No (summer Name of Public Water Supply: Town/Village Distance to property from nearest water main: == Proposed well location & sources of contamination t e provided ou se ate sheet/plan. Date: 1.2/.4/97 Applicant Signature: obert M. Pre ident -MILL DRILLING, . 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 certified by Putnam County. Date of Issue -�)c�oy e /% 9,sf Permit Is mg Officialy� �'�-- --� Date of Expiration Title: �,/ ....YCiniit is No&Transferrable White copy - HD file; Yellow copy - Building Inspector; 'Pink`copy - Owner; Orange copy - Well driller Form WP -97 only) ,L... ..:,.J PUTNAM COUNTY ENV HEALTH SRVCS 98 FEB 20 PM 2:20 „ AISL Go a 4 a` .37 119 SS 29 N/ s I I I � I I j �qQp`�r n ni '�o \ ` Y 8 \ � �• ` � � t°36 ` IA.AIA 63 ``_% . ``. �'N `rr Pp� `\`' I•ry , 1• ♦� `�, arc irJ \9 Y ` � �\J \a ♦ `d„ \ 61 /44/ /I O .y PawrcaT STREET 1 \gin \\ti a� 47`\ �\ \`♦ milp - -- - - L "o — y »wrouus .•....•....... anlXaa aXXaanr aawavawa»a. amain ur XJau i 8 .64 83.65 PREL I M I NARY - SCALE WIN, '. auaaa am-1. laa Ia�N anaiiuw 83.73 a 5 TOWN OF PUTNAM VALLEY aXl '' °mt7. _ - a[GI4 artaln lIK -I 1°00L 0 °""01 ur —10 rm a ram avmur --- fYAan� Ia1 UI K fa "9pa1p1p'° win w»a » 83.80 83.81 8 S PUTNAM COUNTY, NEW YORK arta mir »NIQNM1 —r -inn wrtawr_.t•u• ne nua aXemio w Xmt iX rtn la to - n!ml ,,,....,, .,.. 187 7p 4. I f/o ;o 'r 1A 000". IA all Vol JL 0 • it tato -I L b FVV liev that I hove purveyed ARISTOTLE BBB URNAZ0,89 PoC. &.0,0 We /.0" •vq M ; "Oe PC -W do .0,7 0,= 4A.0 d��,ff LAND SURMORS-PLANMRS W ow p: P'O'-! rO 7 - , - � -, * , , w. ..,- . .— .. .. -7 -;4 d w6a xp&66/, ", Azrff✓",�-4- P'Oe"ep, 2 Er C-6 -d-6 ez Now 10 114010 N.Y. 100ul ' W 1, .. (914)5.3-0100 FPX 914-633-1762 p1lootiniho Arr✓4- County Cloth' 0 Office Mvislon of Land AM,& 04 mop 'Lly. v I hove toe aeQd oil ou lating Wiltling 9 oe%d fineo 61 moves couis and havo GhOwn I ho it positrons horogn pyroOY COM0,019d: 6V/ .7 oo.*,PD• Mag0ralled. ae r on Ocala of Ong inch to 'rap feel fp e,w.g e4v& e6i -4 049 b ............ ZA W4 V Sp APAL .4 b M !I.z M > Z > E<z M G) Z. M M p Robert E. Hochberg Victoria M. Billings 422 9th Street Brooklyn, NY 11215 February 17, 1998 Mr. Robert Mill Mill Drilling Inc. Putnam Avenue Brewster, NY 10509 Re: 61 Nardin Road Lake Peekskill, NY Dear Bob, MILL DRDLUNG, INc. PL'rN,AM AVENUE BREWSTER, N,y, 9050,9 Enclosed you will find for your file the proofs of mailing and/or delivery for the notifications. Please let us know if there is anything else we need to do. Yours truly, ` i n M it s c. g Olt i L ;JN4 . :7- rR fm 'T I f ;11 NI L tj C" DATE 12/5/97 PAY TO THE Putnam Co. Department of Health.. ORDER OF: Teeravest Corp. Park Britwster,, NY 10509 --db WELL DRILLING PERMIT: Rmmdr-k', =K#7 AMOUNT $100.00 OD aE APPENDIX E FORMAT CONSTRUCTION PERMIT NEIGHBOR NOTIFICATION LETTER To: i James Cottrell ff 51 Reichert Street Lake Peekskill, NY 10.537 TaxMa-P# 83.72-1-52 Dear.+" Mr. Cottrell; Date 2/2/98 i RE: Department -of Health Review of Proposed SewageTreatment System for Property Name: Robert E Hochberg Address: 61 Nardin Road Town: Lake Peekskill NY 10537 Tax Map #: 83.72 -1 -53 ' Please be advised that an'application for a Construction, Permit.relative.to the construction of a sewage system and/or well proposed for the captioned property has been made to the Putnam County Department of Health. Attached please find a copy of the latest site plan. If you °hare •-ally - questions, concerns or" information which may bear on the Health Department's review of this application, you may call,the Health Department at 278 -6130. Very truly yours,