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HomeMy WebLinkAbout4526DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 85.05 -1 -4 BOX 34 04526 No a so ' r JS I or LJ6 16 ,� , 04526 BREVVSTER LABORATORIES 'Box 224 - "BREWSTER,-' N, Y. WATER ANALYSIS REPORT SAMPLE NO. 3176 SOURCE: Otto Vatne -. Well No, 2 Florence Driue Putnam Valley, N.Y. COLLECTED: April 25, 1974 Bar: L. Nalanchuk & Son.-In' ony In ,. BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method This result indicates the source of the samplt was of satisfactory sanitary quality when the sample was collected., O Per 100 ml. April 27, 1974 -� oy Bickwit P. E. Director �iS Zi rn.e r�o .r u x' c ITEI : c CS r O .l kiu i 1 C111i% T111 1-1 _J c j. p a." i ty - ���.l:�.- ='z�. �l/.':.'c�,`/,�i�!/,`'' eK'::s,'_ .;ti_:e,., _�S.". ��} L'p- •= +:�ti -;5"w �����..a,, >,. .. :'1x.,� �.r Const:rucLEd by y Section ucatlon - Street .S' .e5O 'OeA"L/C a.ding 'Type Block 2/ Lot GUA.RAINTTY OF SEPARF:TE SEWAGE, S`_'STEii I represent that I am igholly and corrjpjetely responsible for the location, '4•:or'_•,_.: anship, material, coi-js ,ruction c_nC� dra:l.n ze of the sewage .4isposal system serving t;h.e above described proD(:,rt-y,. and that it has been constructed as shown on the approved plan or approved airend lent thereto, _. and in accordance wi%il th::: .standards, rules and re ,7ulations of the Putnam County Department of Health, and hereby guaranty- to the oviner, his succes- fors, ,h.eirs .or assigns, to place in good operating condition any. part of laid system constructed b ri tr`lich fail_u to operate for a period of two yearns is *:t lediately the date of initiai use of the sc'�.a e disr.)osal 'Syste..Q, or. any repai7:'S :Fade by ne to such syStelrl, ekept yd 17 ;'re th' failure to operate pro,?; r1y is caused by the .- Pillful or negligent act of' the occu- p4�t of the building utilizing ttie system. Vhc unde.rs:; (7ned Further agrees to accept as conclusi va the der :a termination of �.ne D? rectol, of th:. Division of .'�_�nviro:lrlenLal Health Seams- - vices of the Putnam Cot:nty 1' >cpart..ant of i.ealtn as t:a wT2 ;.et}Aer or not the _. failure of systerra to operate was caused by the willful or negligent act of the occuDant of the NAilding utilizing the system. _ Dated thi s Y. r . �._ day. or OG f 197. Signature / C e�� n •Titl.0 'V/ � �• corpoi�ati��_:, give n.arae r c. e •� - r �. r �, w w r r r r r r r r r .� r r r r .r ear w © r r w tl THREE (3) COPIES ARE R�� ; E (j COPIES OF FINAL PLATS BEQtl!- fD 1ITH T F FOR CERTIFICATE OF CO LP,ETI0N WILL BE ISSUED. GUARANTOR IS TO FILE NOTICE OF DATE OF' F11:11ST USE OF SYSTEM. - - w r r - - w _ - - - w - - - - - _. - - - - _ _ _ - - r ---* Division of Environmental Health Services, Putnam County. Department of 110alt1i ,j t 1 i a WELL COMPLETION REPORT 3/71 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL, NEW YORK �?-?;is:ocornpl�ll�r well. drilJerc�,uhmittgd to hod ty. Health Depanment together with. laboratory rgport of analysis of water sample indicating water is of`satlslactory acteriaft`tauality b$fore 6A.ficl fe 6:6 s�r'ucfion`fr�mpli$hIii! lssUe6:"' REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION OWNER NAME ADDRESS LOCATION OF WELL (No. & Street) (Town) (Lot Number) Pa Q li✓=' ' V(11', PROPOSED USE OF WELL BUSINESS r El ESTABLISHMENT ❑FARM ❑TEST WELL D DOMESTIC 11 SUPPLY ❑ INDUSTRIAL AIR ❑ OTHER CONDITIONING (Specify) DRILLING OTHER R A PERCUSSION PERCUSSION ® 1-1 ❑ ❑ (S If ), CASING DETAILS LENGTH (feet) �` DIAMETER (inches) WEIGHT PER FOOT S © THREADED ❑ WELDED O ES ❑ NO D YES WNo YIELD TEST(. j HOURS G. P. ❑ BAILED ❑ PUMPED JfN COMPRESSED AIR YIELD (G.P.M.) WATER LEVEL MEASURE FROM LAND SURFACE —STATIC (SpecJfy /eet) V DURING YIELD TEST fleet) Depth of Completed Well in feet below Land surface: " SCREEN DETAILS MAKE LENGTH OPEN TO /�UIFER (feet) 7 SLOT SIZE AMETEK (Inches) IF GRAVEL PACKED: Diameter of ell in ding gravel pac (Inches):. GRAVEL SIZE (inches) FROM (1 /t TO (feet) DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with dlatencea, to at l9eat two permanent landmarks. FEET to FEET A N•�1� It2 46-2,37 If yuld was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL COttMPLETED^� DATE OF REPORT WELL DRILLER (Signature) f / /� ? P� Z �v1! �r(;f.t f "� n 7,T-P T S OF Da—e .07-7 Re: F r o p e t*y o Located at S-ct;-n BI o c le: p Dot ot G t, 1 e 1� Ti-Lis 1 e t^:D 1' 1 Z e oll a U a f 0 27 27J 3— C C) I Sz S c .0 c o n n e c lo 147, Educ--l"l-f-on a t=ry Code. .Count-ersic-n�- P Ad a r e 's e Ho a-17`11 7,:D s t.^_-- 1, -n s, C^- n. San Very t•ulv yours, si red AIdres s 177 e2 Tele-oiicne O'- 'JE, Of NEW � .40 44 54 FIEIS� CHEC L LIST , Date: r ' 1 D . __. ° :�'- _ > »Q',., -.`,: _ '�� < .... ... fix. -� ,,.� •r'I ?" - yp'. q�. .a ,.tf_z't".- m> = i-i.-�_ ".- INITIAL SITE INSPECTION lYesI No � Comments Property lines or corners found.. . . . . . Can estimate house location . Will driveway need cut . Must trees be removed: -note these . Is deep hole representativIe.of entire SDS area Additional deep holes needed. . . Sufficient SDS area available considering driveway cut,house loca.tion,separation . . . distances, etc . DEEP HOLE DATA Depth: Water elevation: Rock elevation: Soils descri-Dtio.n: ITIS `' PEC TION I�nsp. by: I I FINAL SITE House located where shown on approved plan.. . SDS located where approved ..., . Width of trench.average Slope of the line and trench acceptable . Room allowed for expansion trenches . . . . . Over_50 ft... from_ swam-p watercourse _ . X6;tu-ra1- soil- not -sari pped or -SDS area unnecessarily graded . . . . . . ... . 10 Ft. maintained from prop.line and 20 ft. from house . Separation of trench from house, well etc. follows plan . . . . . . . . . . . . . . Number of bedrooms checks . . . . . . . Stones, brush, stumps, rubble, etc. greater than 15 ft. from nearest trench . . . . 15 Ft. of peripheral soil horizontally from trench. . . . . . . . . . . . . . Junction boxes properly set Could surface run off from driveway, roads, ground surface, etc. channel near SDS . . area. . . . . . . . . . . . . . . . . .. Does lot drainage appear O.K. in area of SDS. FINAL GRADING OF SITE ACCEPTABLE ve CA fNIMS & Zd Zfi;a7macl ^ vith resput to the approval mquGstod and an vubmaquent acts, relating TWA otao, Pub PUTNAM COUNTY DEPARTMENT OF HEALTH - DNIS-ION OFz.:ENVIR- ONMENTAL=::i AL- TH--�cER -ICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner �hfE.a -e �icc �Er/, LTD, : Address Located at ( Street 6dicate Lo�ENCE Sec. o& Block OS Lot Z/ neares cross street) Municipalit DyT,i, vj 400 4 Ef/ Watershed SOIL PERCOLATION TEST DATA REQUIRED TO:BE SUBMITTED WITH APPLICATIONS -- Hole ---,Number CLOCK TIME PERCOLATION PERCOLATION Elapse Depth to Water Water Level No. Time From Ground Surface in Inches Soil Rate. Start -Stop Min. Start Stop Drop in Min, /in drop _.. Inches Inches Inches IV 2 3 a.' So i o . 'oS 1-5". /✓.., zo 3� 1-514 " B 6 /yl,•y / ,� 5 __.- 1 '�� 9 "���% /cS /✓ 4 Z0� /¢�` /'�� a 8� /%% /N /,I ._. 5 1 2 5 Notes : 1) Tests to be repeated at same depth until approximately equal soil , ,rate. are obtained "at each percolation test hole. All data to be submitted for review. 2) Depth measurements to be made from top of hole. TEST PIT DATA REQUIRED SUBMITTED WITH TO BE SUBMITT WITH APPtICATIC"T DESCRIPTION -OF, SOILS ENCOUNTERED IN-TEST HOT,FS,... '.DEPTH HOLE NO. 0 HOLE ,NO.- Z) HOLE NO 7 "72F-S-7- G.L. 21d/a Q0 77110 611 12" g9404-1^/ !:�AVp 4,q,51.,n C,_11 rA/ 1811 2411 A 301► 36" 42" 54 ti 60 66 7211 if 78 INDICATE 84" LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL TO CH WATER LEVEL RISES AFT R BEING ENCOUNTERED TESTS MADE BY Y a, Date 4 v6. 7 , Ig 73 DESIGN Soil Rate Used jp Min/1 "Drop : S.D. Usable Area Provided S000 No. of Bedrooms _ Se tic Tank Capacity IZ-00 Gals.- Type Co-,✓c Absorption Area Provided By x_5, L.F.x2411 .36 width trench. Name Signature . . CIO Co . Address SEAL Al, THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft/Gal. Checked by N _�.._ _ " e;r;