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HomeMy WebLinkAbout4550DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 85.05 -1 -31 BOX 34 04550 .. IN or Lim, . . r� ,... i to No i ri .. ' u 04550 '. it"n.ta(�^^t _.G.,,,, > S�^:s e•. erzx t+ 7`Z' C. a> d i �' yx -z. ,r "nr t y fI / ({rT PUTNAM COUNTY DEPARTMENT OF V1 H• � � '� l ' ' Re / 3/86 `•Dlvlelon of Envlronmentaf Biealth SeMe Carmel N 1':1051? " - Et�glneer,to Pmvtde Permit - on CERTIFICATE OF CO MP . ONSTRUCTION PERMIT FOR'SEWAGE•DISPOSAL SYSTEM Permit q Gardi.neer Road ! i - Located at - To or Vllbtge Snbsloq divi Name Mieide d" 'Map DrA" _ 6g < t Ta: Block ! Joann Compton Renewal_O' Revision p Owner /Appllcan! Name ., Date o one A Male Aearesa 2520 00 koace Harding Blvd Ted 10.' Little Neck, N._Y.. 11362...; .: ,.... 1 -Story Frame 1.3 Acres Buitdlag: Ty" Let Area. FM ecdon OdY Deptb` Yohm+e Npmber of Bedrooms Dealgtt Flow G/P /D PCfID Notification isRegtihed When FIB is-c" ompleted 1'000' ¢y ' , a Separate Sewerage System to conalat,of Gallon Sepde Tank and 333 O 2 Trench To W coneteacted by William_: bring naare.a 3468 Deerfield Avenue Yorktown Hts NY., or: X Prlvate Sapply Dales b Other Rey.enta, J., f t ±' . B OR' 1 represent thit'l, am wholly and completely responsibl, above 'descrvbed..will be co, ristructed as shownon the app County Department 'of Health, and that on completi be submitted to the Department, and a written guar place in good operating 'condition any pert of said I. ante of the approva on l of the Certificate of Cstruct will be located as shown on*the approved plan andrthat i County Department of Health.' - Date August . 18, 1986 Add:e:i 1 Nort APPROVED FOR .CONSTRUCTION Thi.s approval ea revocable for cause or may be amended or modelled wt requires a new permik 'Approved for disposal, of do Date ersoh�"r 6l Barger., Street Putnam Valley, - N.Y. vPl in SPntie Area to grade area for gravity. . feed, iCo rIi >r the'design and locst,on of the; propoael! y ®dd, that the separate sewage , disposal- system pgf � ved,ainendment there. to and. inaccot3it ios, rules an regu a_ wns o e, u nam r t thereof a •Certificate..'of Constru- 'tlgry to the Commissioner: of Healthwill, tee will be'.furnished the owner Oli sstfas; li sp no by the bulldeii,'that said'buJder, will '� vage disposal }system during th ; �, two y ediately following theCate'of, the issu- JIA/� O'd6mpliance of the origi reM ;here 't�st. the drilled well de scribe0 above V Ewell will tie installed to n sccogpa with �+e starAs, utps Ind cegu a� ons of , ttie Putnam = r i Signed P. (E. R.A. 'rid' e .Road._ Feeilts , 1V 5 License No 27846 0 he date ues one yer from t �Wn c �r� tt� building has been undertaken and is considered necessary by the `Com iy 7s r Itu`' any change or alteration of construction stic'.sanitary sevlago and / r private fist r so .re .,,.. .r �. a •� tt• • • <. b..t. .........a � +✓. .. .._... ..a .. .: - +�a Y..l ..•-.. • _. at• � 4 - � r. .I.. .. ��... .a _.. .. ..�. ... ..��.. ..s ... _. . In DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 CAI ICAT ;C► ; _ ?(D� —,C NST.RU,CT.. . WATER WyZ1, -,> PCHD PERMIT # WELL LOCATION Street Address Ga.rdineer Rd & Town /Villa ge City y Tax ,Gxi ,Numbex o . Finnerty Rd %tn Valle Qo 11AA y7 33 WELL OWNER Name Address Joann Compton 252 -00 Ha•race harding -Exp JIPrivate 13 Public USE OF WELL 1 - primary 2 - secondary 19 RESIDENTIAL O BUSINESS ❑ INDUSTRIAL a ❑ PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP O FARM 0 TEST /OBSERVATION L7 INSTITUTIONAL O STAND -BY 0 ABANDONED ❑ OTHER (specify D AMOUNT OF USE YIELD SOUGHT 5 gpm /# PEOPLE SERVED 4 /EST. OF DAILY USAGE 600gal REASON FOR DRILLING ANEW SUPPLY ❑PROVIDE ADDITIONAL SUPPLY ❑REPLAC & EXISTING SUPPLY ®DEEPEN EXISTING WELL. [3TEST /OBSERVATION DETAILED REASON FOR DRILLING u-ns-CrUCTI-rig a liew WELL TYPE DRILLED DRIVEN ®DUG ® GRAVEL ® OTHER IS WELL SITE SUBJECT TO-FLOODING? No YES NO IF WELL IS LOCATED IN .A REALTY SUBDIVISION, NAME OF SUBDIVISION: .Ma-p 1319A Yes Dring Farm amended Lot No. WATER WELL CONTRACTOR: Name Anderson Well Drillers Address: Barger St Putnam Val] IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO NAME OF PUBLIC WATER SUPPLY:�nA TOWN /VIL /CITY DISTANCE - TO P�?.OPE:tTY ' FAJM NEAREST ' WATER MAIN.: Norte LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED August 309 W6 REAR OF THIS APPLICATION []ON SEPARATE SHEET (date) VAr (signature) PERMIT TO CONSTRUCT A WATER WELL This- permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2'. Disinfect the -wel1 in accordance with the-- requirements of the - Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. '1 r Date of Issue 7 19�- Date of Expiration: 7 19 '151 ermit Issui ficia Permit is Non - Transferrable 0 8/86 DESIGN DATA SHE ;I'- SUBSUFACE SEWAGE DISPOSAL- SYSTEM FIr,E NO. Owner JoAnn Compton Address 252-00 Harding Expressway Little Neck Located at (Street) Gardineer Road X68 In Block 9 Lot 3.2 (indicate nearest cross street) Putnam Valley Municipality Watershed _ Hudson River SOIL MOQLATION TEST DATA REQUIRED TO BE SEM IrTIED WITH APPLICATIONS Date of Pre- Soaking Aug 17, 1986 Date of Percolation Test Aug 18, 1986 HOLE 9.:57 21 19.75 22.75 3.00 NUMBER C11= TIME 2 .. ^ PIItCQLAZZON 22.75 .:. PERCDLATION Run 3 10s29 Elapse Depth to Water From Water Level 22.75 No. 8.:67.. Tune Ground Surface In Inches Soil Rate 22--75 Start -Stop Min. Start Stop Drop In Min /In Drop 19.75 22.75 3.00 Inches Inches Inches (1) 9 02 9155 23 18.00 21.00 3.00 7.67 1 9x58 10:23 25 18.00 21.00 3.00 8.33 2 1Os28 1004 26 18.00 21.00 3.00 8.67 3 1007 11s23 26 18.00 21.00 3.00 8.67. 4 (2) 1.9:36 9.:57 21 19.75 22.75 3.00 7.00 210101 10:25' 2 .. ^ 19.75. 22.75 .:. 3.00 - :._:.... 8 o0- 3 10s29 10:55 26 19.75 22.75 3.00 8.:67.. 4. 10 15 9, 11:27 28 19..75 22--75 3.00 9.33 5 11 :29 11 :57 28 19.75 22.75 3.00 9.33 1 2 3 4. 5 NOTES: 1. Tests to be repeated at same depth until approximately equal soil.rates are•cbtained at each..percolation test hole.. All data:to'be sukmitted for review. 2. Depth measurements to be made fran top of hole. rev. 9/85 TEST PIT DATA,REQUIRED TO BE SUBMITTED. WITH APPLICATION 51- 6' 7'' 8' .. 91 101 12' 13' 14' _ d. INDICATE LEVEL AT WHICH' GROUNDWATER IS .ENOOUNTERED None ' INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER'BEING ENCOUNTERED None John .S. Romeo Aug 17, 1986 DEEP HOLE OBSERVATIONS MADE BY: . PATE: DESIGN Soil Rate Used 8-10 Min /1" Drop: S.D. Usable Area Provided 50000 SF No. of Bedrooms 3 Septic Tank Capacity 1000 gays. Type Masonry Absorption Area Provided By 333 L.F. x 24" width trench Other ® ®a Name John S. Romeo Signature Address 1 Northridge Road Ste, Peekskill, N.Y. 10566 o ��6 p �s L�r.•�r �. THIS SPACE FOR USE BY HEALTH DEPARM14EM ONLY: °mc+mam ®ffi' Soil Rate Approved sq.ft /gal. Checked by Date DESCRIPTION 'OF SOILS ENCOUN FRED ' IN TEST"HOLES ,. Perc rerc Deep Deep DEPTH- . -_•_ . . ♦ r Y!f:,. HOLE NO. ;._... r1t � .. -. F _ . r _HOLE M ::W-i'<S :i N^. -R'. :..__ v . . . � . .- HOLE NO . . �•`1!'.V .��. . .� ?P�... + %�� T. Q- .�:F�� -.:. G.L. Topsoil " Topsoil Topsoil Topsoil Topsoil Topsoil Topsoil Topsoil sandy,loam sandy.,loam sandy loam sandy,loam 2' some' large aomP large some large somP large stones. stones stones stones 3� 51- 6' 7'' 8' .. 91 101 12' 13' 14' _ d. INDICATE LEVEL AT WHICH' GROUNDWATER IS .ENOOUNTERED None ' INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER'BEING ENCOUNTERED None John .S. Romeo Aug 17, 1986 DEEP HOLE OBSERVATIONS MADE BY: . PATE: DESIGN Soil Rate Used 8-10 Min /1" Drop: S.D. Usable Area Provided 50000 SF No. of Bedrooms 3 Septic Tank Capacity 1000 gays. Type Masonry Absorption Area Provided By 333 L.F. x 24" width trench Other ® ®a Name John S. Romeo Signature Address 1 Northridge Road Ste, Peekskill, N.Y. 10566 o ��6 p �s L�r.•�r �. THIS SPACE FOR USE BY HEALTH DEPARM14EM ONLY: °mc+mam ®ffi' Soil Rate Approved sq.ft /gal. Checked by Date pURMM OOUNTy DEpARDMU OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ~, INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS . f l0 0 - - 3•l^ - REVIEW SHEET - CONSTRUCTION PERMIT DATE_ REi PD•� (Name f Owner) (Street tion) -� CONPEN'i'S YES 1,, NO DOCUMENTS Permit Application Corporate Resolution Plans -Three sets s/s Engineers Authorization Design Data Sheet (DDS) SUBDIVISION _ Deep Hole Log Perc Consistent Perc Results (3) Fill 30 ".Perc Hole cd Other House Plans - Two sets If PWS - Letter if wel11permi.t Variance Request LF trench provided 3 REQUIRED DETAILS ON PLANS required - - Sewage System Plan 60 ft. max. / Sewage System Hydraulic Profile - Gravity Flow . Fill Profile & Dimensions - Volume D or J Box;Trench /Gallery; Rnnp pit details Septic Tank - Size, Detail Well Detail, Service Line if over Construction Notes Design Data Two -Foot Contours Existing & Proposed ,,-Driveway &. Slopes Cut Footing /Gutter Curtain Drains Perc & Deep Holes Located Representative of Sewage & Expansion Area Expansion Area; shown; gravity flow,suff.: size + "If - .Pumped Pit 1&: D• Box Shown & Detailed . - °`- - 3 House - No of Bedrooms Wells & SSDS's w /in 200 ft. of Property Located ytin. 'IL Property Metes & Bounds -� House Setback Necessary (Tight lot) ,A ;. House Sewer - 1 /4 " /ft. 4 "O; Type pipe No Bends; Max. Bends 45° w /cleanout SEPARATION DISTAvU�S SPECIFIED ON PLAN Z Fields 10' to P.L., Driveway, Large Trees 20' to Foundation Wa --- 11'y v b t,; LD 100' to Well; 200' 1 D.L.0.D, 150' pits C 100' to Stream, Watercourse, Lake Unc. expan) �c �, 15' to Drains - Curtain, Leader, Footing 4 �,.. c .351to catch basin,stoundrain,piped watercourse y= uJ 10' to Water Line (pits-201) r 50' intermittent drainage course Se tic Tanks L.CA 10 1 fran Foundation; 50' to well 15' Well to PL GENERAL Legal Subdivision Subdivision Approval Checked Ex- approval SSDS Adj. Lots Checked Wetland (Town/DEC Permit R & D) Data On DDS Plans & Permit Same . wO. e._. a c - r /Cy ° � S 49� 9/ j A A P PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date July 15, 1986­1­ Re: Property of Joann Compton Gardineer Road Located at (T) Putnam Valley Section68 III Block 9 Lot 3.2 Subdivision of Amended Map Dring Farm Filed Map 1319A 1980 Subdv. Lot # p # Date Gentlemen: This letter is to authorize John S. Romeo a duly licensed professional engineer X or registered architect (Indicate to apply for a Construction Permit for a.'separate sewage system, to serve the above noted property in accordance with the standards, rules or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said :�_._�: -� - �-yst- erg• --or -s;Ts= terms -ice �ai�` t ,�r►3t�y=-- c�r�h��Yxe- �ogvi-s tans- .'vf= Ar�ic1�_ =2 �-�ar_.:�__..:::_...:.r, 147, Education Law, the Public Health Law, and the Putnam County Sani -. tary Code. Very truly yours, %% Signed � jwner of Propert Countersigned: l" Intercounty Abstract P . E . , $XAX , # 27846 252-00 Hora e _ Hard ' ng F.xp Address 1 Northridge Road Little Nec #, N.Y. 11362 Address Peekskill, N. Y.10566 Town 0 737 - 1056 a "_ Telephone 0 J u Telephone b� \b\ PUTNAM COUNTY DEPARTMENT OF HEALTH _ ­Oj ONMEINTTA, . DEALTT 1. CERTIFICATE OF CONSTRUCTION COMPLIANCE FO + ATMENT SYSTEM PCHD CONSTRUCTION PERMIT # PV - V''_ ?1• 4 Located at �f� /�,� Town or Village Owner /Applicant Name. A56v2,/v ]' ': Tax Map . ?5 C Block _ Z Lot 3 Formerly Subdivision Name QZ1N6,. f=Aairl I'R nul�j�,f /�,1v� Subd. Lot # Mailing Address �. 9 4Sn2 �,'' T191Lj/Vk /v/' Zip L Date Construction Permit Issued by PCHD Separate Sewerage System built by Mirc-S&j PGi/Mj3ij✓GyC. Address SJmMir-,2,?7Ar4a>y/L Consisting of _ ` _i Q Gallon Septic Tank and 3 Other Requirements: Water Supply: Public Supply From Address /S J.- AAAe 6-/e ST-' or: Private Supply Drilled by 1t1j1I h+A1 ky"sjA1 j' Address. Pc�; ,y4m -_ :B` iii ldsng- Type_L- /00&J; J' 3�%s' ._� .I ac ro ion poi tr "o1:.1 e�n•%omplet�d.2...,_ .: �-,�` -,=-'. 6 ._ e. . Number of Bedrooms 3 Has garbage grinder been installed? 4,0 I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved plans and the 7ndards, rules and regulations o the Putnam County Department of Health. Date Certified by P.E. R.A. AC -- tz •f * soc, (Design Professional) Address '7�' SFc.Yt &0, Su yT; < m 104c,, N1' icy// License # 0 '7 `iS X17 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 revoc ion, modificat' n or change is necessary. r /�c By: / Title: Date: Z "?,D' --O 2-- White copy - HD ile; Uw copy - Building Inspector; Pink copy - wner; range copy - Design Professional Form CC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES _. WELL COMPLETION REPORT _ -toca -t on " "" eef Audiess: wn/Village: Tax Grid # Map $`f, i6 block Lot(s) Well Owner: Na e: Address: Use of Well: I- primary 2- secondary >e— Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment - i4 _ Rotary Cable percussion Compressed air percussion Other (specify) Well Type Screened Open end casing Open hole in bedrock Other Casing Details Total length S ft. Length below grade j3 r . Diameter (o it in. Weight per foot alb /ft. Materials: X Steel _ Plastic _ Other Joints: _ Welded ?4 Threaded _ Other Seal: x Cement grout _ Bentonit.e Other Drive shoe: se Yes _ No Liner: Yes x- No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes No Hours Second Well Yield Test _ Bailed . _ Pumped >e Compressed Air Hours Z Yield 20 gpm Depth Data Measure from land surface- static (specify ft) e) During yield test(ft) Depth of completed well in feet .2. GO � Well Log If more detailed information descriptions or sieve anajyses are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface 13 G " (O If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type Ai t3 Capacity �C Depth 200 Model 5J j Voltage Z3 0 HP '12 Tank Type t<e x Volume 76 PM k, Date Well Completed Putnam County Certification No. Date of Report jell Driller (signature) z NU'fEi pact location of well with distances . to at least two permanent landmarks to ne provsged on a separate sneettpsan. Well Drillers Name Address: /.1Y 621x •� Aa Signature: Date: .� e White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 YML E�UIR[��ENIAL SERVlCES ` (914) 2450eaW dL�� Kear �treet Albert H. Padovani, Director LAB #: 93.200286 CLIENT #: 55125 STAT PROC PAGE 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ MICELI PLUMBING 79 STEINER DR MAHOPAC, NY 10541 DATE/TIME TAKEN: 01/30/02 12:00P DATE/TIME REC'D: 01/31/02 12:15P REPORT DATE: 02/06/02 PHONE: (914)-490-4493 SAMPLING SITE: 28 FINNERTY DR, PUT VALLEY,NY SAMPLE TYPE..: POTABLE : WATER TANK PRESERVATIVES: NONE COL'D BY: ROBERT PANNY TEMPERATURE..: < 4C NOTES...: ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ COLIFORM METH: MF DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD PUTNAM CNTY PROFILE 01/81/02 MF T. COLIFORM ABSENT /100 ML ABSENT 1008 01/31/02 LEAD (IMS) <1 ppb 9-15 ppb 9101 01/31/02 NITRATE N%TROG 2.36 MG/L V - 10 9139 01/31/02 NITRITE NITROG <0.01 MG/L N/A 9146 01/31/02 IRON (Fe) <0.060 MG/L 0-0.3 mg/1 2037 01/31/02 MANGANESE (Mn) 0.012 MG/L 0-0.3 mg/l 2037 01/31/02 SODIUM (Na) 20.0 MG/L N/A 01/31/02 pH 6.6 UNITS 6.5-8.5 9043 01/31/02 HARDNESS,TOTAL 182 MG/L N/A 01/31/02 ALKALINITY (AS 110 MG/L N/A COMMENTS: FAX TO 845-621-4038 COMMENTS: BACT THESE RESULTS INDICATE THAT THE WATE WAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORDI E NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. Pb/Cu LEAD limits for p/ EPA Lead & Copper than 10% of their than 15 ppb and a treatment must be potential. �blic schools are set at 15 ppb. Rule for Public Systems requires that no more distribution points have a LEAD value of more COPPER value of 1.3 mg/L, else water undertaken to reduce the waters corrosive Fe/Mn If both iron and manganese are npresent their total value present, shall not exceed 0,5nJ/L._` . . v`~ ` YML ENVIRONMENTAL SERVICES 321 Kear Street (914) 245-2800 Albert H. Padovani, Director LAB #: 93.200286 CLIENT #: 55125 STAT PROC PAGE 2 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ MICELI PLUMBING 79 STEINER DR MAHOPAC, NY 10541 DATE/TIME TAKEN: 01/30/02 12:00P DATE/TIME_REC'D: 01/31/02 12:151::- REPORT DATE: 1 02/06/02 PHONE: (914)-490-4493 SAMPLING SITE: 28 FINNERTY DR, PUT VALLEY,NY SAMPLE TYPE..: POTABLE : WATER TANK PRESERVATIVES: NONE COL'D BY: ROBERT PANNY TEMPERATURE..: < 4C NOTES...: COLIFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD Na No limits for Sodium are proscribed. Suggested guidelines state that for people on a sodium restricted diet,the water should contain no more than 20 mg/L of Sodium. For those on a moderately restricted diet, a maximum of 270 mg/L of Sodium is suggested. pH pH SCALE IN WATER RANGES FROM 1-14. MEASUREMENT OF pH IS ONE OF THE IMPORTANT AND FREQUENTLY USED TESTS IN WATER CHEMISTRY. WATER WITH A LOW pH MIGHT BE CORROSIVE TO METAL PIPES AND FIXTURES. THE NORMAL RANGE OF pH IS 6.5 TO 8.5. CONCENTRATION, BOTH EXPRESSED AS CALCIUM CARBONATE, IN MG/L. THE HARDNESS MAY RANGE FROM 0 TO HUNDREDS OF MG/L, DEPENDS ON THE SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED. SOFT WATER: 0-70 MG/L VERY HARD WATER: ABOVE 300 MG/L MODERATELY HARD WATER: 70-140 MG/L MG/L = MILLIGRAM PER LITER HARD WATER: 140-300 MG/L (1 grain/gallon = 17.2 MG/L) SUBMITTED BY: Director ELAP# 10323 �4W"7 ` YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown H i ''` N Y �' 10598 Albert H. Padovani, Director LAB #: 93.103181 CLIENT #: 12403 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ NON STAT PRQC PAGE 1 MICELI, ROBERT DATE/TIME TAKEN: 11/15/01 12:30 25 SUMMIT RD. ABSENT DATE/TIME REC'D: 11/15/01 12:40 MAHOPAC, NY 10541 11/15/01 REPORT DATE: 11/24/01 ppb 0-15 ppb 9101 PHONE: (914)-628-6688 NITRATE NITROG SAMPLING SITE: FINNFRTY RD, PUTNAM VALLEY, NY 0 - 10 SAMPLE TYPE..: POTABLE : KITCHEN TAP 00.01 PRESERVATIVES: NONE COL-D BY: LEE ANN DfRITO 11/15/01 TEMPERATURE..: < 4C NOTES...: ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ � CDLlFORM METH: MF DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD PUTNAM CNTY PROFILE 11/15/01 MF T. COLIFORM ABSENT /100 ML ABSENT 1008 11/15/01 LEAD (IMS) <1 ppb 0-15 ppb 9101 11/15/01 NITRATE NITROG 5.82 MG/L 0 - 10 9139 11/15/01 NITRITE NITROG 00.01 MG/L N/A 9146 � �^ _�, 11/15/01 IRON (Fe) 3.28 MG/L 0-0.3 mg/l 2037 11/15/01 MANGANESE (Mn) 0.055 MG/L 0-0.3 Mg/1 2037 11/15/01 SODIUM (Na) 32.9 MG /L N/A ~~� 11/15/01 PH � 7.1 UNITS 6.5-8.5 9043 11/15/01 HARDNESS,TOTAL 166 MG/L N/A 11/15/01 ALKALINITY (AS 106 MG/L N/A 1 >1 TUFO3IPITY <TUR. ��,.~i ` �� ~,' 1f�.0�NTU (>-5 NTU COMMENTS: FAX TO 845-628-9121 COMMENTS: ACT THESE RESULTS INDICATE THAT THE WATE WAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORD E NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS ` TESTED, AT THE TIME OF COLLECTION., Pb/Cu LEAD limits for public schools are set at 15 ppb. EPA Lead & Copper Rule for Public Systems requires that no more than 10% of their distribution points have a LEAD value of more than 15 ppb and a COPPER value of 1.3 mg/L, else water treatment must be undertaken to reduce the waters corrosive potentia1. Fe/Mn If both iron and manganese are'present, their total value combined shall not exceed 0.5 mg/L. BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH I 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 January 16, 2002 Chris Caralyus - Beyer & Associates 78 Secor Road Bryant Pond Plaza Mahopac, NY 10541 Re: Proposed SSTS Compliance: Torres, Finnerty Road (T) Putnam Valley TM#85.05-1-31 Dear Nft. Caralyus: Review of plans and other supporting documents submitted at this time relative to the above- regard, d project has been completed. Comments are offered as follows: rovide all information required on well completion report relevant to pump /storage tank Please flush and resample the well supply for Iron, Sodium and Turbidity. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Very truly yours, Shawn Rogan Public Health Technician SR/jp YML.ENVIROMMENTAL SERVICES 321 Kear Street X91L He (914) 245-2800 Albert H. Padovani, Director LAB #: 93.103181 CLIENT #: 12403 NON STAT PROC PAGE 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ MICELI; ROBERT 25 SUMMIT RD. MAHOPAt, NY 10541 DATE/TIME TAKEN: 11/15/01 12:30 DATE/TIME REC'D: 11/15/01 12:40 REPORT DATE: 11/24/01 PHONE: (914)-628-6688 BAMPLING SITE: FINNERTY RD, PUTNAM VALLEY, NY SAMPLE TYPE..: POTA8LIE : KITCHEN TAP PRESERVATIVES: NONE COL'D BY: LEE ANN DIRITO TEMPERATURE..: < 4C NOTES...: COLIF8R11 METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD PUTNAM CNTY PROFILE 0-15 ppb 9.101 11/15/01 MF T. COLIFORM ABSENT /100 ML 11/15/01 LEAD (%MS) <1 ppb 11/15/01 NITRATE NITROG 5.82 MG/L 11/15/01 NITRITE NITROG <0.01 MG/L 11/15/01 IRON (Fe) 3.28 MG/L ~- 11/15/01 MANGANESE (Mn) 0.055 MG/L 11/15/01 SODIUM (Na) 32.9 MG/L 11/15/01 pH 7.1 UNITS 11/15/01 HARDNESS,T8TAL 166 MG/L 11/15/01 ALKALINITY (AS 106 MG/L COMMENTS: FAX TO 845-628-9121 ABSENT 1008 0-15 ppb 9.101 0 - 10 9139 N/A 9146 0-0.3 mg/l 2037 0 ... O.3 mg/l 2O37 N/A 6.5-8.5 9043 N/A N/A -`0 U�' COMMENTS: BACT THESE. RESULTS INDICATE THAT THE WATE NOT) OF A SATISFACTORY SANITARY QUALITY ACCORD HE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TINE OF COLLECTION. Pb /Cu LEAD limits for p/ EPA Lead & Copper than 10% of their than 15 ppb and a treatment must be potential. ablic schools are set at 15 ppb. Rule for Public Systems requires that no more distribution points have a LEAD value of more COPPER value of 1.3 mg/L, else water undertaken to reduce the waters corrosive Fe/Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg/L. a PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ..... _ _.. _. .. a WELL_ _COMPLETION REPORT._. Weil Location S eet Address: wn/Village: — Tax Grid #_ Map XS_, VS B lock 1 Lot(s) 31 Well Owner: Na e: IV Address: Use of Well: 1- primary 2- secondary >e— Residential Business . Industrial Public Supply Air cond/heat pump Irrigation Farm Test/monitoring Other(specify) Institutional Standby Drilling Equipment �_ Rotary Cable percussion Compressed air percussion Other (specify) Well Type Screened Open end casing Open hole in bedrock Other Casing Details Total length S ft. Length below grade . Diameter 6 " in. Weight per foot alb /ft. Materials: X Steel _ Plastic _ Other Joints: _ Welded --- Threaded _ Other Seal: x Cement grout _ Bentonite Other Drive shoe: se 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 'oe Compressed Air Hours Yield 2-0 gpm Depth Data Measure from land surface- static (specify ft) During yield test(ft) Depth of completed well in feet 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 ' G �� If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type Capacity Depth Model Voltage HP Tank Type Volume Date Well Completed IFM0/ Putnam County Certification No. q Date of Report Well Driller (signature) NU ft' t ' /rxact location of well with distances to at least two permanent landmarks to be provided on a separate sheetiplan. Well Drillees Na=40110, �n" Address: Signature: �, _ Date: SJ�9 White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 and Associates Tel,(8 —15 y . Y . _Jt "rf fa �'� ;tJ- _ '�^ ,',... ,.q. �. .a .. Y .}�•,: =. �•',jiJr•�,._ Bryant Pond Plaza, Suite Fax. (845) 628 -1905 Mahopac, New York 10541 February I1, 2002 Mr. Shawn Rogan Public Health. Technician Putnam County Department of Health 4 Geneva Road Brewster, New York 10509 Re: Torres Residence Finnerty Road, Putnam Valley Tax Map 85.05 Block I Lot -31 Dear Mr., Rogan, As per your letter dated January 16, 2002 the following is in response to your comments: E losed is the original Well Completion Report with the requested pump /storage tank information. Enclosed is anew copy of the water test results. I trust the above materials are adequate for your approval and completely satisfy your previous comments for the above project. However, if you have any questions concerning this project, please do not hesitate to call me @ 621 -4756. Yery46A ,Y s, Chris Caralyus Project Manager PUTNAM COUNTY DEPARTMENT OF HEALTH `� �-� A DIVISION OF ENVIRONMENTAL HEALTH SERVICES �... •...±p..d:yee.: �+..aV.H h V.`..:n^_•.5'..cie''+7 *9:s�= -} eW�L :%.!I1�.A.dZi.d31�CT.`-".•'C'". atrP`.?7c ^. -y �...4v! rVPia� Well Location S eet Address: wn/Village: Tax Grid # Map g5ISBlock / Lot(s) 31 Well Owner: N e: Address: Use of Well: 1- primary 2- secondary ><- Residential Business Industrial Public Supply Air cond/heat pump Irrigation Farm Test/monitoring Other(specify) Institutional Standby Drilling Equipment fir[_ Rotary Cable percussion Compressed air percussion Other (specify) Well Type Screened Open end casing Open hole in bedrock Other Casing Details Total length . Length below grade z3 . Diameter 6 It in. Weight per foot L_lb /ft. Materials: X Steel _ Plastic _ Other 'Welded Joints: -7,, Threaded Other Seal: xt Cement grout _ Bentonite Other Drive shoe: se Yes ^ No I 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 Hours Z Yield 20 gpm Depth Data Measure from land surface- static (specify ft) During yield test(ft) Depth of completed well in feet Well Log If more detailed information or.,_ descri . . p _ sieve analyses are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface G ' . _ ,. - - !� 0 -L_�- _- - _ _ _ If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type Capacity .. Depth Model Voltage HP Tank Type Volume Nell Completed f/t/i 0 / Putnam County Certification No. _/ Date of Report Well Driller (signature) ' d ,� NO E: [Exact location of well with distances to at least two permanent landmarks•to be provided on a separate sheet/plan. Well Driller's Name 4/�s^ Address: /.: Signature: �,, _ �� Date: sJ�9 White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 Beyer and Associates 78 Secor Road, ..; TeL (845) 621-4756,,,, - Bryant Pond Plaza, 'Suite 5 Fax (845) 628-1905. Mahopac, New York 10541 January 3, 2002 Mr. Robert Morris Putnam County Department of Health 4 Geneva Road Brewster, New York 10509 Re: Torres Residence Finnerty Road, Putnam Valley Tax Map 85.05 Block 1 Lot 31 Dear Mr. Morris, Please find the enclosed materials for the As Built submittal for the above referenced property. This submission includes the following items: 1. Certificate of Construction Compliance 2. Three copies of Guarantee of Subsurface Sewage Treatment System 3. Well Completion Report 4. Water Analysis Report 5. Three (3) sets of As -Built Plans :...._......... .:. _ .. 6..:..Application.fee of.$200 7. E911 Address Verification Form I trust the above materials are adequate for your approval and completely satisfy your previous comments for the above project. However if you have any questions concerning this project, please do not hesitate to call me '@ 621- 4756. Ve 1 yo s, Chris Caralyus Project Manager BRUCE. R. - F.O_LEY .'4ylic �He`altli� DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 j. QRETTA MQLINARI RN., M.S.N. �tssoc�ute -Pudic `-Hedlth 'Director Director of Patient Services Environmental Health (914)278-6130 Fait (914) 278 - 7921 Nursing Services (914) 278 - 6558 WIC (914) 278 - 6678 . Fax (914) 278 - 6085 Early Intervention (9i4)278-6014 Preschool (914) 278 -6082 Fax (914) 278 - 6648 E911 ADDRESS VERIFICATION FORM OWNERS NAME: TAX MAP NUMBER: E911 ADDRESS: TOWN: FU T W-k U t�Utq AUTHORIZED TOWN OFFICIAL: ' (Signature) DATE: m The Putnam County Department. of Health will not issue a Certificate of Construction Compliance unless the above form is completed,. i.e., a legal E911 address is assigned by an authorized town official. This form is to be submitted with the application for a Certificate of Construction Compliance. (E911 VEFS M) PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM ►2l2V1 Owner or Purchaser of Building Tax Map Block Lot i (C2(i lfIltih�/ 7 , N ` 6"/- N���a'h Ila( -)-)vi , Building Constructed by TownNillage J Location - Streee Subdivision Name Building.Type Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewagc, 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 system: 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 the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated: /Month id Day Year Zoo j f'eneral Contractor (Owner) - ignature i ICjz i I �( ,j vil j tj Corporation Name (iflco oration) Address: 2 S' h, ,r 2,/ In -- / o 114 — State Zip 0 s / Signature: Title: Corporation Name (if corporation) Address: State Zip Form GS -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM �Li21� � • 1 ��f�G�� �S�OS / Owner or Purchaser of Building Tax Map Block Lot Building Constructed by Location - Street' Building.Type TownNillage Subdivision Name 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 saw -age 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 . system. - _ ... 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 the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated: onth 0 Day 3 i -ear Zoo General Contractor (Owner) - ignature lm icJ l I pl L) M b ice,,, r N`C- orporation Name (if`co*oration) Address: A State /U Zip .Signature: Title: Corporation Name (if corporation) Address: State Zip Form GS -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM Building Constricted by Location - Stree L✓Ja,n &4rt,�F ayle::, Building.Type TownNillage pg/ && F,4g"ell (eE�cA,014,11 rr�it/i Subdivision Name 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 Depart ment 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 system. 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 the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. , Dated: onth 10 Day 31 -ear Zoo Q'eneral Contractor (Owner) - ignature irn icy l �l UV, orporation Name (if,co*oration) Address: State Zip o� .Signature: Title: Corporation Name (if corporation) Address: State Zip Form GS -97 Owner or Purchaser of Building Tax Map Block Lot Building Constricted by Location - Stree L✓Ja,n &4rt,�F ayle::, Building.Type TownNillage pg/ && F,4g"ell (eE�cA,014,11 rr�it/i Subdivision Name 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 Depart ment 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 system. 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 the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. , Dated: onth 10 Day 31 -ear Zoo Q'eneral Contractor (Owner) - ignature irn icy l �l UV, orporation Name (if,co*oration) Address: State Zip o� .Signature: Title: Corporation Name (if corporation) Address: State Zip Form GS -97 YML ENVIRONMENTAL SERVICES 321 Kear Street i YorRt�o H cdnts 10598.. � , �r�.-`��-�`t�' N.Y. ' ~ ' (914/� ����2\�}0 � Albert H. Padovani, Director LAB #: 93.103181 CLIENT #: 12403 NON STAT PRO(-., PAGE MICELI, ROBERT DATE/TIME TAKEN: 11/15/01 12:a) 2 � SUMMIT RD. ' DATE/TIME REC'D: 11/15/01 12:40 MAHOPAC, NY 10541 REPORT DATE: 11/24/01 PHONE: (914)-628-6688 SAMPLING SITE: FINNERTY RD, PUTNAM VALLEY, NY 'SAMPLE TYPE..: POTA8LE ; KITCHEN TAP ' PRESERVATIVES: NONE LEE ANN DIRITO '- - ' - TEMPERATURE;.: 4-40 NOTES...: COLIFORM METH: NF' ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD Na No limits for Sodium are proscribed. Suggested guidelines state � that for people on a sodium restricted diet,the water should � contain no more than 20 mg/L of Sodium. For those on a moderately restricted diet, a maximum of 270 mg/L of Sodium i is suggested. / pH SCALE IN WATER RANGES FROM 1-14. MEASUREMENT OF pH IS ONE OF THE IMPORTANT AND FREQUENTL USEDTESTS IN WATER CHEMISTRY,, WATER WITH A LOW pH MIGHT BE CORROSIVE TO METAL PIPES AND FIXTURES. THE NORMAL RANGE OF pH IS 6.5 TO 8.5. —GONC�:NTRATION, B8TPV UM CARBONATE-� HARDNESS MAY RANGE FROM 0 TO HUNDREDS OF MG/L, DEPENDS ON THE SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED. SOFT WATER: 0-70 MG/L VERY HARD WATER: ABOVE 300 MG/L MODERATELY HARD WATER: 70-140 MG/L MG/L = MILLIGRAM PER LITER HARD WATER: 140-300 MG/L (1 grain/gallon = 17.2 MG/L) i SUnMITTED BY: | Aloerl k raoovanz, � Director ' ELAP# 10323 PUTNAbI COUNTY DEPARTMENT OF HEALTH I DIVISION OF ENVIRONI MENUAL HEALTH SERVICES FINAL SITE INSPECTION - Date: jj..1 0( j Inspecte Street Locati 1K N V& 2Y'f Q vk Owner { V2 �E Town T\T— Permit # 0\(— LS 7 TM 9_ 7-15 O!57 — j — Subdivision Loi # 1. Sewage System Area a. STS area located as per approved plans ........................... 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 ...... ............................... II. SeNiaQe System a. septic tanl s �25.......other ................ b. Septic tank ... ............. ............................... 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 Box : properly set ......:.... ..........:.................... f 4 renc es . �Lei required -3 � .- Length installed 31 S - 2. Distance to watercourse measured Ft..... i . ® 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.`lz ". diameter. clean .................... 9. -Depili`of-graveiyin- ttltnch'12" 10. Pipe ends capped..... : ................ .. ............................... g. PumD or Dosed Systems 1. Sin of pump chamber ................ ............................... 2. Overflow tank ............................. ........................ ........ 3. Alarm, visual / audio .................... ............................... 4. Pump easily accessible, manhole to grade ................. 5. First box baffled ............... ......................... ::............... .. 6.- Cycle witnessed by H.D.estirnated flow /cycle........... III. House/Building •. a House located per approved plans ..................... ........ b. Number of bedrooms ....................... ............................... . IV. Well a. Well located as per approved plans ............................ b. Distance from STS area measured�6 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 & dir.to exist watercours g. Footing drains discharge away from STS area ............:.. h. Surface water protection adequate... .. ....................... ........ ; +.,,, ­111;11.A �� .. BRUCE 'R. ' FOCEY Public Health Director LORETTA "MOLINARI K.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 [Poo Early Intervention (845) 278 - 6014 Fax (845) 278 - 6648 November 9, 2001 Preschool (845) 228 - 5912 Fix '(845) 228 - 6113 Beyer and Associates . 73 Secor Road Bryant Pond Plaza Mahopac, New York 10541 Re: Torres, Finnerty Place (T) Putnam Valley; TM# 25.05 -1 -31 Dear Mr. Beyer: This office has conducted a final site inspection of the SSTS and well for the above referenced project on Wed ay, November 7, 2001. oncrete at bo septic tank inlet and outlet hall be. moved: 100 % nsio ser e trenches to be staked in th fiel ° Perco on test to r n a witnessed in 1 to al. Note Please sched le point . ent for t e pert to locati. digging and pre- soak. . r test to be r th 1 g day (24 hr. pre -s k). ua 'ty of m Ial m also be collected and siev tested for comparison with current PCHD "fill ,; t.' criten . - , It shall be noted that 7 laterals of 54' -0" resulting 378 lineal feet of trench installed for approved 3.0 bedroom dwelling exist. Completion/construction of additional bedrooms in basement area in conjunction with piped bathroom and ejector pump shall require prior PCHD approval. . F. The septic is approved for installed three (3) bedroom dwelling. Completion of basement area will be considered a bedroom, requiring a four (4) bedroom septic design. Please contact this office vial RFl -99 for additional inspection when ready. . This office will continue. its review upon consideration of the above mentioned comments. Please feel free to contact me at ext. 2157 if any questions arise. Very truly yours, __ Adam B. Stiebeling Assistant Public Health Engineer ABS:cj PUTNAM COUNTY DEPARTMENT OF.HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES • DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner, 1 -0 af-L > S Address Located at (Street) Tax Map Block Lot (indicate nearest cross street) Municipality Watershed SOIL PERCOLATION TEST DATA Form DD -97 $ple No Run No Time Start Stop EIa se Time �1VIin.) . Depth to Water G ou d From r n Surface (Inches} 'Start Stogy Water e L eve Drop Ia Inches tt Percoia on Rate M�n/Inci� 3o Z :: 3 (O, 0 2 3 4 5 va 2 3 4 5,� -- 1 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 FILE No.373 11/06 '01 02 :23 ID :BEYER &ASSOCIATES r FAX :8456281905 PAGE 1 PUTNAM COUNTY ]DIEIPARTMENT OF HEALTH DIM ION OF ENVIRONMENTAL HEALTH SERvIc ES ATTENTION 2 0 ADAM GENE RE MST FOIL FINAL IN PE 'PION For: Fill All information must be fully completed prior to any Trenches inspections being made. PCHD Construction Permit # Located: t-1NNePry_ PLAC Owner /Applicant Name: T8 k& _42 25.Q5 _ Block I Lot _ Formerly: � : Subdivision Name Subdivision Lot # Is system fill completed? NIPt Date: !1 5/0 l Is system complete? -- -- _ _ _ qr,5 Date: l'1 S o Is system constructed as per plans? L/tl$ Is well drilled? 5 Date: Is Well located as per plans? e5 Are erosion control measures in place? I certify that the system(s), as listed, at the above premises has been constructed and I have inspected and verified their completion in accordance with the issued PCHD Construction Permit and approved plans and the Standards, Rules and Regulations of the Putnam County Department of Healih. _... :.. Date: Certified by. . FE RA Design Professional Address. &44 '' tf55bC /R} i «� 2 Call. R17 Lic. # d ! M �---- Comments: Form FIR-99 NOV -6 -2001 TUE 15:10 TEL:845- 278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 1 PUTNAM COUNTY DEPARTMENT OF HEALTH N DIVISION OF ENVIRONMENTAL HEALTH SERVICES ONSTRUCTION PERM GE TREATMENT SYSTEM PERMIT # — Z 1 a �� Located at r /�►//V /Z3r"i /Q ®�9� Town or Village /fit/ T/O(" 11,41- 6Y Subdivision name L2&&&: X,r_ Subd. Lot # 4_ Tax Map &Coo Block Lot Date Subdivision Approved le) / �.2/ 9 0 Renewal X Revision Owner /Applicant Name C� � tic ®Q&5S Date of Previous Approval 1/-1 7 Mailing Address 3 d ENiEi 5001 d9 /E RRONK . Al)"' / Zip /0 yn- Amount of Fee Enclosed 130n Building Type 1Nwp FiUrnE Lot Area MW No. of Bedrooms Design Flow GPD 40D koulc✓ Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of . L�,S'D gallon septic tank and LX' Y/pEiVGH�S 2 Other Requirements: To be constructed by 91 69t 6 Cons i - Address /`4gyP�e. N jl Water Supply: Public Supply From Address h ivatc--Supply Drilied� by � �v,�,�tr :,r ^ rz -i-�: rr ti Address -� v I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate a sewag-e- treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: P.E. R.A. Date Address '? F S i5e n N� License # 07-1, 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 co sidered n ss by the Public Health Director. Any revision or alteration of the appro ed plan requires s ,.new p t. Ap ove ch r e of domestic sanitary sew ge only. Title: Date: Of 6/4 'n File; Yellow copy - Building Inspector; Pink co - Owner; Orange copy - Design Pr fessi nal Form C i a s PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO-CONSTRUCT A WATER WELL please pint o ? type PCHD `Permit # Well Location: Street Address: Town/Village Tax Grid # T )204;0 .4LZ4Cr Map MS "Block / Lot(s) % Well Owner: Name: Address: WDLE D 'rS Apr &cwX0 Aje lo V65- Use of Well: _� Residential Public Supply Air /Con eat 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 jfiop gal. Reason for Replace Existing Supply Test/Observation Additional Supply Dialling �_ New Supply (new dwelling) Deepen Existing Well Detailed Reason v 3,660000M HOME for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding. . Yes No Is well located in a realty subdivision? ...................................... ............................... Yeses No Name of subdivision D& W6 FARIM Lot No. Water Well Contractor: Address: Is Public Water Supply available to site? ............... ............................... T............ Yes No _ Name of Public Water Supply: Town/Village Distance to property from nearest water main: IVIA- Proposed well location & sources of contamination to be provided on separate sheet/plan. Date:. f � _..- .Applicant Signature:-- _ 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 re u. s a new permit. Well to be constructed by a waste well ler certified Putnam ' I � ! n Date of Issue ' I V1 0 Permit Issuing Date of Expiration I I d 1 -11 0,3o Title: Permit is Non- Transferr 1 White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 i PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES. _ - 4- :... -:L. - - - -: :.� - . A6g)'LICATION FOR APPROVAL OF PLANS-= EORt:.; f. A WASTEWATER TREATMENT SYSTEM 1. Name and address of applicant: - AINIQU - �c�R.9 n/Y . 4&6S 2. Name of project: 1-7k E4nT /OD,q-O 3. Location9v: zj/�7-iUr V 4. Design.Professional: .5.. Address: 6. Drainage Basin: j-bolp 1. i2/ yL'l'L /324 P e Al)" /0,S 5// 7. Type of Project: 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 Type II 9. Is a. Draft Environmental Impact Statement (DEIS) required ?� ............:......... 10. Has DEIS been completed and found acceptable by Lead Agency? ............... Exempt X Unlisted A/c: 11. Name of Lead Agency 12. Is this project in an area under the control of local planning, ;oning;..or other b iicials, ,orci ina icea% - ..................................... ... z ' ........................... " 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 water ✓ 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? ....... ............................... A10 . 19. If yes, name of water supply. Distance to water supply 20. Is project site near a public sewage collection or treatment system? ................ 7 21. Name of sewage system Distance to sewage system 22. Date test holes observed.: 23. Name of Health Inspector AQq,�a S 24. Project design flow (gallons, per day) ................................ ............................... 6,60 25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?... 1/ 26. Has SPDES Application been submitted to local DEC office? ......................... •— 27. Is, any port ion of this project located within a designated: Town or State wetland? Wy 28. Wetlands ID Number ........................................................... ............................... 29. Is Wetlands Permit required? ........... ............. .:..... .................. Has application been made to Town or Local DEC office? ................ :................ 30. Does project require a DEC Stream Disturbance Permit? .. ............................... 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 /G-3 32. Is project, located within .1,000 feet of existineor abandoned landfill, hazardous waste site,.-salt stockpile, landfill, sludge disposal site or any.- other potentially known source of contamination? ............................... Yes)No DESCRIBE: 33. Is, there a local master plan on file with the Town or Village? .........................1�� 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site ? .................................. ..............:............ _ 0 35. Are any sewage treatment areas in excess of 15% slope? . ............................... 10 ' 36. Tax Map ID Number ................ :..: ........:...................... Map &1,69 Block Lot 3/ 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 _. _....- .. r. _b .� "' ...� .......,, _ be sent to•fh� 3eli itm nt; an need riof be sent in duplicate to the 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 stormwaterylans 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 l .,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 provided on this form is true to the best of my knowledge and.belief. False statemerrts'made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the Penal Law. SIGNATURES & .OFFICIAL TITLES: Mailing Address :... : ...................... n:rlt PUTNAM COUNTY DEPARTMENT OF HEALTH ' DIVISION OF ENVIRONMENTAL HEALTH SERVICES . PLICATION ';FOR:AP- PROVAL- .OF.:PLANS> FO R, . A WASTEWATER TREATMENT SYSTEM 1. Name and address of applicant: 2. Name of project: __ ,lgvEe PI-)AI) 3. Location9V: '/1/4it4 4. Design Professional:_ l3�y' 2 /��s�, 5. Address: S. 56ccz f A" Sdi7_ 6. Drainage Basin: _/ t IpA j2j U y� ,g>t tjpr�e ,, Al } /OS }!� 7. Type of Project: ,Y 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 X Type II Unlisted 9. Is a Draft Environmental Impact Statement (DEIS) required ?-.-. ...................... /1/0 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:.:. .... officials; ordinances? ... .:.......:...:..........:..:.:. '.................................................. 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 water ✓ 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? ....... ............................... A10 19. If yes, name of water supply Distance to water supply 20. Is project site near a public sewage collection or treatment system? ................ _4_42 21. Name of sewage system Distance to sewage system 22. Date test holes observed ° O 23. Name of Health Inspector ApIM 5ma� t/r 24. Project design flow (gallons per day) ................................. ............................... 6 (90 25. Is State Pollutant Discharge Elimination. System (SPDES) Permit required ?... Vo 26. Has SPDES Application-been submitted to local DEC office? ......................... •— PA ! 27. Is any portion of this project located within a designated Town or State wetland? Ay 28. Wetlands ID Number ........ ............................... ................. ............................... —29.- Is"Wetlands Permit required ? ..............: Has application been made to Town or Local DEC office? ............................... 30. Does project require a DEC Stream Disturbance Permit? .. ............................... �x/Q. 3.1. 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 A/-Z> 32. Is project located within 1,000 feet of existing or abandoned landfill, i hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potentially. known source of contamination? ............................... Yes/No DESCRIBE: 33. Is there a local master plan on file with the Town or Village? ................ .I...... ... 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? . ............... ................. _ 0 ° 36. Tax Map ID Number .......................... ............................... Map ffo. Block _Lot 3/ 37. Approved plans are to be returned to ..... Applicant_ Design Professional NOTE: Ail ap„gligA�ggsfor review and approval of a a ew SSTS-to be_ located_oxitfn:.-the NYCINate Yslied shall`.i - be sent to the Department, , rid iieea not be sent in duplicate to the 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 ofa 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 l .,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 provided on this form is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the Penal Law. el SIGNATURES & OFFICL4L TITLES. f,----C 68:4 Wd. U AON 00.: 7 Mailing Ad �1 ,;. r a ti•� � .......... 1f1 /�r�/� �✓,L S �// PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIROMENTAL HEALTH SERVICES SUBSURFACE 8tWAG-E ;I'REA'iMENT;tSYSTFA -' - °' Owner Nittolo Land Development Address 404 Sheffield Court, Brewster, NY Located at (Street) Finnerty Place Tax Map 85.05 Block 1 Lot 31 (indicate nearest cross street) Municipality Putnam Valley Drainage Basin Hudson River Date of Pre - soaking 11/6/00 PROPOSED LOT 1 SOIL PERCOLATION TEST DATA Date of Percolation Test 11/7/00 Hole No. Run No. Time Start — Stop Ela se Time (Min•) Depth to Water From Ground Surface (inches) Start Stop Water Level Drop in Inches Percolation Rate Min/Inch P -1 1 11:50 -12:04 14 21 24 3 4.6 2 12:04 -12:32 28 21 25 4 7 3 12:33 -12:54 21 21 24 3 7 4 5 .P-2 1 12:38 -1:08 30 21 24 3 10 ' 1:07 -1:43 36 3 1:43 - 2:19. 36 21 24 3 12 4 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. Form DD -97 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES - . -..... ✓" i. GG. :T._ e_ .... .. '.a: .. .. .: a.:a``S.`- 'i`�`` .. - -.�s ....�....... •w.� .... -. _.C:iJ•. �"::.tr -� v''K. ,... ..'..�� � ... •a..:n ._i,`F� .. rS 6.-^+ DEPTH HOLE NO. 1 HOLE NO. 2 HOLE NO. G.L. 0.5' 1.0' 1.5' 2.0' 2.5' 3.0' 3.5' A-0' 4.5' 5.0' '5.5' 6.0' WOODED WOODED TOP SOIL(0 -8 ") 0 -14" TOPSOIL BROWN SANDY LOAM (8 -27 ") BROWN SILTY SANDY LOAM (14-31") IF IF COMPACT CLAY LOAM (31 -52 ") OLIVE BROWN SANDY LOAM (27 -80") OLIVE BROWN CLAY LOAM W SAND AND GRAVEL (52 -72 ") GWT @ 72" 6.5' GWT ® 80" o �� 7.0' 7.5' 8.0' 8.5' 9.0' X9:5' '10.01 Indicate level at which groundwater is encountered 72" (TP_2) Indicate level at which mottling is observed N/A Indicate level to which water level rises after being encountered 72" Deep hole observations made by: Adam Stiebling — PCD0H; Chris Caralyus — BA Date 11/9/00 Design Professional Name: Beyer and Associates Address: 78 Secor Road, Bryant Pond Plaza, Suite S Signatti Design Professional's Seal id i is Fri I • €3q�g \ '`: 11l �• .� �r re � e, � � � s�t�f , } y�fL3 t� � i 4 Ykty, PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIROMENTAL HEALTH SERVICES Owner Nittolo Land Development Address 404 Sheffield Court, Brewster, NY Located at (Street) Finnerty Place Tax Map 85.05 Block 1 Lot 31 (indicate nearest cross street) Municipality Putnam Valley Drainage Basin Hudson River SOIL PERCOLATION TEST DATA Date of Pre - soaking 11/6/00 Date of Percolation Test 11/7/00 PROPOSED LOT 1 Hole No. Run No. Time Start — Stop Ela se Time gin•) Depth to Water From Ground Surface (inches) Start Stop Water Level Drop in Inches Percolation Rate Min/Inch P -1 1 11:50 -12:04 14 21 24 3 4.6 2 12:04 -12:32 28 21 25 4 7 3 12:33 -12:54 21 21 24 3 7 4 5 P -2 1 12:38-1:08- 30 21 24 3 10 3 1:43 -2:19 36 21 24 3 12 4 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. Form DD -97 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. —1 HOLE NO. 2 HOLE NO. G.L. 0.59 iff 1.59 2.0 2.5' 3.0' 3.57 4.0' 4.5' 5.0' '6.0' 16.59 � 7.0' '7.5' WOODED I TOP SOIL(0 -8') BROWN SANDY LOAM (8-27") OLIVE BROWN SANDY LOAM (27-80") GWT @ 80" WOODED 0-14" TOPSOIL BROWN SILTY SANDY LOAM (14-31") CONTACT CLAY LOAM (31-52") r OLIVE BROWN CLAY LOAM W SAND AND GRAVEL (52-72") GWT @ 72" 8.0' 8.51 9.09 5 '10.0, Indicate level at which groundwater is encountered 72`9 (TP-2) Indicate level at which mottling is observed &A Indicate level to which water level rises after being encountered 72,1 Deep hole observations made by: Adam Stiebling – PCDOH; Chris Caralyus – BA Date 11/9/00 Design Professional Name: Beyer and Associates Address: 78 Secor Road, Bryant Pond Plaza, Suite 5 Mahopac, N. Y 10541 Signature: Design Professional's Seal :4, C:D en CD 8.0' 8.51 9.09 5 '10.0, Indicate level at which groundwater is encountered 72`9 (TP-2) Indicate level at which mottling is observed &A Indicate level to which water level rises after being encountered 72,1 Deep hole observations made by: Adam Stiebling – PCDOH; Chris Caralyus – BA Date 11/9/00 Design Professional Name: Beyer and Associates Address: 78 Secor Road, Bryant Pond Plaza, Suite 5 Mahopac, N. Y 10541 Signature: Design Professional's Seal :4, 110, 2'1 Ft Z r, 14.16.119195)— Texl12 PROJECT I.C. NUMBER.. 617.20 SEAR Appendix- State Environmental Ouallty Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only DADT I_eonjotT INFORMATION rra be comoleted by Acolicant or Protect aDDnsori 1. APPLICANT /SPONSOR 2. PROJECT NAME N121 U L Cn U S. PROJECT LOCATION: Munle1pa1lly County 4. PRECISE LOCATION (Slret address and road Inl.ra.ctlont, prominent (andmarl s. etc., Or provide map) 'NOP -TH CAfr COAT 16t (9F &1j401A1ffX 41v)5) firv&cT f' %e0_40. S. IS PROPOSED ACTION. New 0 ExDanslon ❑ MOdlflcalIONallarallon G. DESCRIBE PROJECT BRIEFLY: COK/Y— L 170K) 4/E-t,,/ '3 &004'm 1AVS6 �7VV L,,iCL(, A✓.O 7: AMOUNT OF LAND AFFECTED: f�S ± Initially (7,; acre U.lumal.ly - acre S. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTF.;'IONS7 }es ❑ No If No.. descn0e briefly. 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? MIA681dantfal :: I_ndua lal.:... -.; 6mJCommerOfal•• .:•:- ,;. ®'A9alcuuuro ,• ®ParlJFaevOpen spaeA,. _ . Other oescrl0si c�.AjTllec-..._*z6A is ltee�lD &17 /,'}G 10. DOES ACTION 114VOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, -STATE QR LOCAy7 Yas D No It yes, Ilsl ppencAs) and Permlvapprovals 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VAUD PERMIT Olt APPROVAL7 Ye 0 NO If yea, Iqt ppFnry name and PvaPP�'v *4m V,jer n�AlAjr ✓.�...� - Cs�����is� ��v�, /OLOOH C ss 7 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMMAPPROVAL REQUIRE MODIFICATION'! eyes O No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE 19 TRUE TO THE BEST OF MY IWOWi.E:4E App1►unWPonow flan»' G 144 r Slonslure: If the action Is in the Coastal Area, and you are a •tats agency, complete the Coastal Assessment Form before proceeding with this assessment OVER PART If— ENVIRONMENTAL ASSESSMENT (To be completed by Agency) A DOES ACT10n EXCEED A4v TYPE I THRESHOLD IN 6 NYCRR. PART 617 it 11 yes, eoorOrnale the rtvlew process ant use the FULL EAF Yes n No E YYIll4Arr1��"±iECE�1�E C�iOR,^in swD V1E!" g3:�p�YiI�EQ FOR UNUS ?ED ACTIONS IN 6 NYCRR. PART 617.6° If NO a nepao.e 0euara!10• me, be aupeneoe. br another 111voive0 agency Yes No C COUID ACTION RESU.' In ANY ADVERSE EFFECTS ASSOCIATED,WITH THE FOLLOWING (A••wets may be hanOwtater, of Ieolple Cl Es-sling sr• quality. su ►lace or groundwater quality or quantity. noose revels existing traffic patterns. solid waste prodhictior 0' 01600$7 polent+s' 101 erosror wainage or flooding problems s Explain briefly C2 AesiflelrC. agriculture'. arCnat010grCal. historic. Or, other naturol or cultural resources, or community at neighborhood CharaClet l E 60111e bbelly C: vopetellor or fauna. I1sn, shellfish Or wildlife species. signotrcont habitats, or rnrootehad Or engangereid species? Explain briefly Cs t• rommunity -s existing plans or 00816 as Olhcrally adopted. or o change in use Or Intensity of use of land of other natural resources s Explain briefly C$ Growth, Suoseauenl oe+eiopment. or related activities likely to be Induced by the proposed action') Explain briefly. Q . CE Long toter, snort tern:, e6penute0ve of other effects not identified In C1•05? Explain brlafty. 4. CJ; C7 Olne ImDSClS.GrleluE�etg changes in use of either quantity of type of energy)? Explain briefly. C} [^;. • .�,. fir:.; -•}. -•-- v� D WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLl$ OENC,) F,,A CEA's ' G Yes ❑ No _E_ 1S THERE. OR IS THERE LIKELY TO BE. CONTRO.V.ERSY RELATED TO POTENTIAL ADVERSE ENViRONMENTALIMPACTS? ❑ Ye No 11 Yes, explain biletiy' PART III — DETERMINATION OF SIGNIFICANCE (To be completed by Agency) i INSTRUCTIONS: For each adverse effect identified above, determine whether It is substantial, large, important or otherwise significant. Each effect should be assessed ih connection with Its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; .(d) Irrsveralbility; (e) geographic scope; and (f) magnitude. 11 necessary, add attachments or reference supporting materia)s. Ensure that explanations contain sufficient detail lo'show that all relevant adverse Impacts have been Identified and adequately addressed. It question 0 of Pan a was checked yes, the determination and significance must evaluate the potential impact of the proposed action on the environmental Characteristics of the CEA. .� ❑ Check this box If you have Identified one or more potentially large or significant adverse impacts which MAY occur. Then'proceed.directly to the FULL EAF and/or prepare a positive declaration. ® Check this box if you have determined, based ion 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 seasons supporting this determination: ore R Lead Agency lVN Or Type Name or Itelpionsl5le Officer M Load AeenCv vitro ol VIKIII 1 oeneture of esponsr • 0119of so Lead Aefncr 118hature of 1t "ref III aillowl from faiRm—obit o Ker fe t 2 14.16 -4 (9A5) -7011 12 PROJECT I.D. NUMBER. 617.20 SECIR ie' i• }'Y . _ '- ...r.,,. ' 1,' ci - .4- �h•.^o TP. .p:.•..�:. -, w -ii "t State Environmental Ouallty Rwlew SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I— PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. APPLICANT /SPONSOR 2. PROJECT NAME �iJ121 v � �'J2 v 3. PROJECT LOCATION: Municipality P r✓ County 4. PRECISE LOCATION (Street address and road Intersections, prominent landmark,, etc., or Provide map) NO Pny cAf r Coy&N6c c9F G1i4o1N 410 F11v1/c-tr7-,v 100W, b. IS PROPOSED ACTION. New ❑ Eapanslon ❑ ModlNcatlon1atteratlon 6, DESCRIBE PROJECT BRIEFLY: -o/v3_ %/�r/c��lorz/ d% �Ci � 3 ,C0 014 16 ,/ 17✓V UfCGL o9�✓� 7 :. AMOUNT OF LAND AFFECTED: Initially - 0; 5 -t acres ultimately S - acre 1. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTF.71ONS? OQa. ❑ No If No, descrlt* briefly, O. WHAT 15 PRESENT LAND USE IN VICINITY OF.PROJECT7 ._ ._.._�...::.._ �M,IdeMl,l 0(nduatrlN,._ ®.CortlTterPl�sl,.. ❑Ap►IeulfuEe,.._ :�Par1tlF,ornUOpeP epee,•. ❑OtMr Describe: CIA/ T %/ 10.. DOES ACTION INVOLVE A PERMIT APPROVAL. OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL. .STATE QR LO!CAW? i3 Yes 0 No If yea, list agency(s) and perrnlVapprovale • 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VAUD PERMIT OR APPROVAL7 ®•Y" ❑ No_ If yn, list agency naew and PermIL16pproval • . _S S TS 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REOUIRE MODIFICATION7 eyes 0 No 1 CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOW=4E Appl►cant,sponso► namr' G Date: - – Signature: It the action Is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER I PART 11— ENVIRONMENTAL ASSESSMENT (To be completed by Agency) A ODE5 A�.t10h EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR• PART 617.7 It yet,, coordinate the review process •ne use the FULL EAF s °�? r;3t! • 'w Yes n NO E' WI l ,�1i'�irc itfCEi�E�COA� S ? Q. REMIO".AS��ROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR. PART 61T.6� Ii NO a naaat .: oPCNrwiv mar Ot supetseortl o, anolne, Inv' 1,00 agency �` ` Yes NC ... C COULD ACTION RESU:T IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING IA•'wers may be hanOwillfer, d Iegibre C/ E+,%lin; s,' Quality. surface or groundwater Quality or Quantity, noose levels existing traffic patterns. solid wre%te Proaaclior' 0' disoosa p0le1%tia' for erosto• drainage or fiood,ng problems) Explain briefly C? Aesthetic. set Icullura'� arc hatologieal. historic. Of Other halurol or Cultural resollreer, or Community Or neighbOthOpd ChSte0e11 Expl•ie briefly C2 vopetalror or fauna. fish, shellfish of wildlife species. significant habitats, or threatened or ondaneatod specter? Explain briefly Ca A. r0nimun,fy'S Sit 1511n; plena or 0081% es off ciauy adopted. or o Change in use or Intensity of use of land Or Other natural resources "explain brief cs Giowin. subseavent development. or related activities likely 10 be in 6609#d by the proposed action') Explain briefly. Q 17 CE, Lon` tetR, snort tern;. cumulative of Wner efforts nor identified m C1•C67 Explain briefly. CIO IY i M CT Othe• ampsos11mcrudin; changes in use.of either Quantity Or type Of energy)? Explain briefly. CD D WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CEA+ G Yes (] No - E iS11kEAE::Oa '15:'TwEaE LIKELY TO BE: CONTROVERSY, RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ® Yes ❑ NO If Yea, explain briefly e l 1 PART III— DETER MINATiON OF' SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS; Foi each adverse effect identified above, determine whether it is substantial, large, Important or otherwise significant. Each effect Should be assessed it connection with Its (a) setting (Le. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (1) magnitude.•If necessary, add attachments or reference supponing materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question D of Pan II was Checked yes, the doterminotion and significance must evaluate the potential Impact of the proposed action on the environmental characteristics of the CEA. y Check this box if you have Identified one or more potentially large or significant adverse impacts which MAY occur, Than proceed directly to the FULL EAF and/or prepare a positive declaration. ® Check this box It 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: arse o, 1*43 Agency una or ype Namt of Hpons, a ,let m lei Agency vitro o erpan obli ,let ianetwt of Hponsi • 011icti in Lead Alttnc► Signature of ewrer III 31110MI f01n responsible O -ctrl to le .., PUTNAXCOUNTY DEPARTMENT OF HEALTH : - - 'D.WISIPN OF ENVIRONMENTAL HE ALM SERVICES Subdivisionof Subdivision Lot # If Filed Map # Date Filed /4 Gentlemen: I ' his letter is to authorize �M. Z, I M-21 a duly licensed Professional Engineer X or Registered Architect to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance es,or regWad Hi4h 7 itector of the Putnam !�ith thes ons as pi66ulgated by. the County Health Department, and to sign all necessary papers on my behalf in connection wi th this matter and to supervise the construction of said wastewater treatment and/or water supply systems in conformity with the provisions of Article 145 and/or 147 of the Education Law, the Public Health Law, and the Pumm County Sahitdy- C 0*de`<- Countersigned- Signed: P.E., kA., # ;owns of propcm)D Mailing Address /40 Mailing Address: J-5 !mac State Telephone: State VDIt Zi-P Telephone: ( C.-I / �) Form LA-97 Beyer and Associates 78. Secor Roa Tel. _ Bryant Pond Plaza, Suite S Fax. (914) 628-1905 �^ Mahopac, - New York 10541 November 14, 2000 Mr. Adam Stiebling Putnam County Department of Health 4 Geneva Road Brewster, New York 10509 Re: Torres Residence Finnerty Road, Putnam Valley, NY. Tax Map 85.05 Block I Lot 31 Dear Mr. Stiebling, Our client, Enrique Torres, proposes to construct a single-family residence at the above address to be serviced by an individual subsurface sewage treatment system and a private drilled well. We are hereby applying for a construction permit for the construction of the SSTS and drilled well. Enclosed please find a copy of the following items for your review and approval: • Construction Permit for Sewage Treatment System Letter ofAuthorization �iplllication fit Approvzl'of Plirfrs for a`TWastewater- Treatin�rit �ystein. - _� ., z..,. Application to Construct a Water Well • Design Data Sheet • Short Environmental Assessment Form • Plan and Profile- Separate Sewage Treatment System (3 copies) • Fee — Cert ified Check in the amount of $300 • House Plans (2 Copies) " I trust the above materials are adequate for your approval and complete the submission for the above project, However if you have any questions concerning this project, please do not hesitate to call me @ 621 -4756 Very truly yours, Chris Caralyus ' Project Manager f 29 PUTNA.M COUNTY DEPARTMENT OF HEALTH ISI0-N -OF ENNgR0NI'ENAL HEALTH - SERVICES INIITU L INDIVIDUAL /C011 MERCUL SITE INSPECTION FORM SECTION A..QENERAL INFOR AIATION r Name of Project (T)M �/ County. Site Location +' N �4 �9� L b Building construction begun O Extent Is proorty within NYC Watershed ? ................. 0 Yes >g�No SECTION B. TOPOGRAPHY (Please check all appropriate,boxes) 1. Hilly a Rolling a Steep slope.. __. - ,Gentle slope - -a Flat­---------- - 2. F� Evidence of wetlands Low area subject to flooding F—I Bodies of water ainage•ditches ock outcrops 3. Property lines or comers evident ....................... ....:.......................... F Yes o -= 4. - --Do water courses exist on or adJ oin the roe rty? ............ a. Yes o P 5. Will these affect the design of the sewage system facilities ?... .......... a Yes Do watershed regulatioiis apply in this development ?......... : :::.......... Yes No .. 7 - Will extensive grading be necessary?.. :..:.......:.. = jam: Yes .... 8. Will extensive fill be necessary for SSTS? ......... ............................... 9. Do filled areas exist within the SSTS area? ........ ............................... If yes, what is the condition of the fill? Yes �o Yes No SECTION C. SOIL OBSERVATIONS 10. Appearance 'of soil: and .ravel oam Clay. Hardpan Mixture 11. Observed from: a Borings B c 2:0Backhoe excavation40( 12. Soil borings /excavations observed by (/ on 13. Depth to groundwater (r —Q� on 14. Depth to mottling 15. Are test holes representative of primary & reserve areas... ........................... 16. Soil percolation tests made by 17. Soil percolation tests witnessed by ' SECTION D (on back) on Yes No on sm Form ST -1 2 SECTION D. DRAINAGE 18. Will proposed grading materially alter the natural drainage in this or adjacent areas? s F--]No 19. Will groundwater or surface drainage require special consideration? .................... Yes yNo' 20.. Will gullies, ditches, etc., be filled and watercourses be relocated ? ......................... -1 Yes SECTION E. REMARKS 21. If a common water supply_is proposed, has an inspection been made of the existing or proposed source and facilities? .......:........................ ............................... Q Yes No Ins` &tion data 22. Do adjacent wells and/or sewage systems exist ?....... : ::..... Yes No 23. Additional comments 24. Site observer /inspector and title 25. Dates) of observation(s)inspection(s) - - r�.. �C` TEST PIT PROFILES - Hole # _J_L9t #_ _ ... - ._Hole # .... -- Lot.# .. _ ._ _Hole U­ :: - ,- - - -.: -: -: -Lot # Depth to water V7 ' Depth to .water 1 Z r� Depth to water :Depth t, mottling. - Depth to mottl'irig' -� Depth to mottling - m i Depth to rocklimp._ Depth to rock/imp.. `� + Depth to rock/imp. G.L. ..G.L. p �r , ►� --��, G.L. 0.5 2i- -- 0.5 0.5 1.0 �� O-q-�j -- - - 1.0 1.0 - --- - _r 3.0 - 3.0 3.0 ! /... 0 4.0 Z ,I 7 - (� - 4.0 � ' SZ 4.0 5.0 �7 5.0 r+�t ' 5.0 6.0 ' ,. 6.0 6.0 7.0 $ 7.0 7.0 '8.0 8.0 J�Z e 8.0 _ 9.0 9.0 �tia..l L� 9.0 10.0 _.. 10.0 �� l7° �, �7 �i 10.0 0 ; 11 . ' `FILE No .255 11/22 '00 23:22 I D: BEYER&ASSOC I ATES FAX :6281945 PAGE 1 s....p• fqd . ,.,w .. �� .,. ^I �' �• � � �•M. �f V � J i .... . �. C' .�w:yq.n BRUCE R. FOLEY Public Health Director LORE'ITA MOLINARI R.N., M.S.N. Asaoeiate Public Health Dirccter Director of Patient Services DEPARTN ENT OF HEALTH I Geneva. Road Brewster, New York 10509 REQUEST FOR FIEL.DI .STING ATTENTION: STIE ING ; 4rGENE REED All information below must be L Il completed prior to any scheduling. DATE: ENGINEER OR FIRM: l Elf- V�--AffQe- , PHONE REASON: DEEPS: PERCS: n. PUMP TEST: o ROADISTREET: t eukc TOWN: /V/f�! (i%�C. L.fiC� TAX MAP #• SUBDIVISION: FdEQ MAP 9 IqP4 LOT #: OWNER: 41611- --44177-01-0 1"'towDl4c 501M -will I IN I 5k YES NO D IIt' D Q o 'q' Proposed SSTS within the drainage basin of West Branch or Boyds Corner Reservoirs. Proposed SSTS within 500 feet of a reservoir, reservoir stem. or control lake. -1Prop9sed SSTS p €$ tvattrcol se or a BEl- wetland Froposed -SS' TS design flow greater than 1000 gallons/day or SPDES Permit required. Proposed SSTS for a Commerical Project. It is the responsibility of the design professional to provide the above information prior to soil testing. This Department will determine the NYCDEP project status (Joint or Delegated) based on the response. If you answeredyeer, to any of the questions, NYCDEP must witness the soil testing. This Department will coordinate a mutually suitable time for field testing with the PCDOH, the Design Professional and NYCDEP. If a project has been determined to be Delegated based on the above response and -then subsequent information indicates NYCDEP is required to witness the soil testing, it will be the sole responsibility of the design professional to schedule re- witnessing of the soil testinr with NY(_DEP_ FOR COU \TY LSE ONLY 11 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIROMENTAL HEALTH SERVICES �. ei�i a .. .: ru.l r .eRc .'�ti .�4ru 1 . � ...•tea• -�b�. '1 .` .�A> -�C`_ '. D�'SI+G1V 77ATA'ST3E]ET SI1 S FACE' SIEWAGE TREATWN' T S'YSAM' Owner Nittolo Land Development Address 404 Sheffield Court, Brewster, NY Located at (Street) Finnerty Place Tax Map 85.05 Block 1 Lot 31 (indicate nearest cross street) Municipality Putnam Valley Drainage Basin Hudson River Date of Pre - soaking 11/6/00 PRI)PnRFI) LOT 1 SOIL PERCOLATION TEST DATA Date of Percolation Test 11/7/00 Hole No. Run No. Time Start — Stop Ela se Time (M M•) Depth to Water From Ground Surface (inches) Start Stop Water Level Drop in Inches Percolation Rate Min/Inch P =1 1 11:50 -12:04 14 21 24. 3 4.6 2 12:04 -12:32 28 21 25 4 7 3 12:33 - 12:54, 21 21 24 3 7 4 5 P -2 1 12:38 -1:08 30 21 24 3 10 2 1:07 -1:43 36 21 - 24 .3 12 3 1:43 - 2:19 36 21 24 3 12 4 5 - 1 2 3 4 5 VOTFC- 1 TPCtc to he reneated at same depth until annroximately eaual percolation rates are obtained at each percolation test ( i.e. 5 1 min for 1 -30 min/inch, 52 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. tole. Form DD -97 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES Indicate level at which groundwater is encountered Indicate level at which mottling is observed . Indicate level to which water level rises after being encountered - Deep hole observations made by... Date Design Professional Name: r Address: Signature: Design Professional's Seal - o I � i1w�13 `I J � 9N R 11 _50.Op• j 1� Op 005, /r 0'' 1 j i / 0— 630 Ct S \ N a SOSS ! 1SIX3 of ,o of oz/ I i I i 1 1 1 1 I� I I I (III to I 1 11 I in u) -D I m_o IL I I IIII n I IIII 1 \\ Im of 1 I DyN I I III \ 1 (PROPOSED 3 BEDROOM _ 1 v� o I °I 111 j 1 1 F.F. = 625t 110, of I vlt I m1 j 1 j 1 I (MIN. D I I 111 \ 1 I I cIIIII 111 of z11 j1 -I I I c5 I I II II k I 11j1 j in •- �. .. /�� _ I j. 1 11!11 1 40 - \ \ OVER 10(�' TO \ cn 1 1 STREIM III o �I�ILo____ 2� �� —J� _ 1 -- - -I1� 111• m� O- ��- / S49- 28'10 "E 145:00' o o sr�•.. •s:;"�� ci i0- ,+�..- _'.a' c. _. ,..c: �'� -u:.,s? v•at.. ., .n,�fiJ•....�a r•u /,ii rA..o', o. ..'a..�'.. _ .i _ �. J',..c.. r_ �c .a., - -75 00 10' IN XP. io O� 145.00' S49'28' 10':El s m \" -A \ . o of t to s OVER 100` X0 N� 5•R \G .G °RP "'� I � � � STREAM � cr w� i \ o 52 o p \ \ 9, z l . o 3 BED. HOUSE \ \ I I F.F. - 626t \ BASEMENT - 617.0 u�I I© ® ice• �`\ /WELL P \ 0� 6 PvG . i y23 5 P / 50 ' R " g0 S600.� — �e3p0p0 .. .: J -.... f. -. 7�: .i ,_•r +•�._ -.'�.l '"....._., y. y`.H :'tb n:�:.- .ter.:- .r,. <.. f.. - a . f. ^�- _ _ - `- J'.- -. t�'.�: Si.. _. _ t - -.. � .. -