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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 92. -1 -6 BOX 36 IN I om r r la Is I Ll to r �, ' �, r, �'L r � ,± r' - I' ol f- :, -� XrL , ,, - - i PUTNAM COUNTY DEPARTMENT OF HEALTH. DIVISION OF ENVIRONMENTAL HEALTH QERVICES y -. —.� •, . . . rt .:.. .: iy.4. 6.t :.i..._ r c ♦ y _ .. ay�I. .. .,r..as.+i ..6. "+. CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR S MENT SYSTEM PCHD CONSTRUCTION PERMIT # v— 99-0 Located at :3Z Pare1 <YK1« H6LLaw - rU0JP1KC Town or Village iFUT/ -J✓tr" V14 LL6- Owner /Applicant Name ,,9d1q RO N M Ulu S 4 L L Formerly Mailing Address Tax Map 2 Block I Lot 6 Subdivision Name Subd. Lot # Am6tz5 ?bi lb 120199 Pul Woni VA L-C _Zip 10679 Date Construction Permit Issued by PCHD O CT, I ( S062- to 1060 0[2e-`664 ROAD Separate Sewerage System built by DAM FI N o ca N -CT2kjc -r t o jJ Address ?6L1K-fK, I L L, fly 10 S'(� Consisting of 12 S Gallon Septic Tank and SOO L.1= or ?V<: TIPS 1 N 2,4" � -r267N mot-( ' Other Requirements: 7' M 1 N 11-1 ye--% CC-P C U R 'T-6 I IJ Q 2,91 N Water. SuonI Public Supply From Address Lf '1 uTNr�YY► q1/� IJ�� or: Private Supply Drilled by F. gEqL 4 Se 1,4 S� I/J c. Address - &U'WJ` , OZ. t) y & sag _. _.. ::__._; ..,..�ButldirlgType:':�fw►�� ° °� • :.:p�M.:IL.�/�_- as, erosion :; ccJntrolbeencompletEd ?,:._,. - . �s'� Number of Bedrooms R Has garbage I certify that the system(s), as listed, serving the above built plans (copies of which are attached), in acc c plans and the standards, rules and regulation iPi Date: ti_ :1- U 3 Certified by 4/ (Design Pro Address 2 Svl1N Wntsk 2Lt1p. 1feLs . NEW i L. C,ko is were cons ed . sentially as shown on the e is ttedHD' on ction Permit and approved Coun ,YDeimen of ealth. UJ X P.E. R.A. �z -o IC ense # roscl 0 Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Public Health Director, such revocati � , modification or change is necessary. q' � .- By: SCJ' Title: bbl �, Date: rte copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy Design Professional Form CC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well 1Lucitiolm= "'" Street Address�kskill Hollo Turnpike, Lot +6 Town/Village: "' ' Putnam Valley Tax Grid# " Mapgt Block I Lot(s) Well Owner: Name: Address: Phoenix Construction, 20 Kramers Pond Rd, Putnam Valley, NY 10579 Use of Well: II-primary 2- 0econdary X Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring .Other(specify) Industrial Institutional Standby Drilling Equipment X Rotary Cable percussion X Compressed air percussion Other (specify) Well Type Screened Open end casing X Open hole in bedrock Other Casing Details Total length 62 ft. Length below grade 61 ft. Diameter - - 6. in.-"- Weight per foot 19 16/ft. Materials: X Steel _ Plastic _ Other Joints: Welded X' 'Threaded Other Seal: X Cement grout - Bentonite.._ Other Drive shoe: .X ,yes No -, -]Liner: ' Yes __L No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes No Hours Second Well Yield Test _ Bailed X Pumped X Compressed Air Hours 6 Yield 5 gpm Depth Data Measure from land surface- static (specify ft) 30' During yield test(ft) 360' Depth of completed well in feet 425' Well Log If more detailed information descriptions or sieve anal are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation (Description ft. ft. Land Surface 38 Drill'n Hit roc at 38' 62--- 1 lint = in =YOCki- set: "casin –= 62 425 Drillin in rock granite If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type sub Capacity 5am Depth 380' Model 5GS07412 Voltage 230 HP 3/4 Tank Type WX302 Volume 86 gal. Date Well Completed 12/4/02 Putnam County Certification No. 001 Date of Report 2/13/03 Well Driller (sign Adam L. Beal N4.➢' ,h: txact location of well with aistances to at least two permanent ianamarxs to De proviaea on a separate sneevpian. Well Drillees Name P. F. Beal & Sons Inc. Address:4 PubnAve., Brasier, NY MP Signature: Date: 2/13/03 Adam L. Beal White copy: HD File; Yellow copy - Building Inspector; -Pink copy - Owner; Orange copy - Well driller Form WC -97 I F�9 IMS ENVIRONMENTAL SERVICES, INC. 15oo SUMMER STREET STAMFORD, CONNECTICUT o6905 NELAC, CT and NY State Certified Environmental Laboratory •. .��.. -. Y- a :a... ..�_ � _ _ y ,..,:_.,,,. ..�..,_.7,,.• ce h� �-wr.. <.� � .. ..a. ...,. rf ...,ate.. -..-i _.. rr :.. ; �� - .. .,a.. ... -tip: .'. n.c .. ,o. s IR o,' � ..y � .w .:�i.,. r - �.,.- ......� .... .. ... ...d.+ 17 • i Mailing Information: Collector's Information: Name: PF Beal & Sons Client: Phoenix Construction Name: ALB Address: 4 Putnam Ave Address of site: Peekskill Hollow/ Rd City: Brewster City: Putnam Valley State: NY Zip: 10509 State: NY Zip: Telephone: 845-279-2460 Fax: 845-279-6613 Telephone: Sample's Information: I Site: tank lot #6 Date:Collected: 4/9/03 Date Received: 4/10/03 ' Preservative: HNO3 Time Collected: 14:30 Time Received: 13:30 Temperature: <4C Lab No.: J032124 Date Analyzed Test Name Result MCL Method 4/10/03 15:00 Total Coliform Absent Absent SMWW 9222B 4/10/03 Chlorine Free Residual <0.1 mg /L N/A SMWW, 4500CIG 4/11/03 Color ND 15 Units SMWW 2120 B 4/11/03 Odor ND 3 TONs SMWW 2150 B 4/11/03 Iron 0.085 mg /L 0.3 mg /L SMWW, 3111B 4/11/03 Manganese 0.015 mg /L 0.3 mg /L SMWW 3111B 4/11/03 Sodium 4.8 mg /L N/A SMWW 3111B 4/11/03 Chloride 14 mg /L 250 mg /L SMWW 4500 CI C 4/11/03 Hardness 190 mg /L N/A SMWW 2340 C 41:9:110;.,..� •- - Nitrate;.. _..- — , -1:10 mg /L _ . -• 10 mg /L;- - SMWN1/4500 NO3E� 4/10/03 10:00 Nitrite <0.1 mg /L 1.0 mg /L SMWWi4500 NO3E 4/10/03 pH 7.63 S.U. 6.5 -8.5 S.U. SMWW4500 H B 4/11/03 Sulfate 10.1 mg /L 250 mg /L SMWW 4500 SO4F 4/11/03 Turbidity 2.26 NTU 5 NTUs SMWW 2130 B 4/11/03 Alkalinity 150 mg /L. N/A SMWW2320 B 4/11/03 Lead .4.21 ug /L 15 ug /L SMWW';3113 B At the time of analysis the sample was acceptable for total coliform N/A = Not Applicable mg /L- milligrams per Liter S.U.= Standard Unit NTU- Nephelometric Turbidity Unit MCL- Max. Contaminant Level TON- Threshold Odor Number ug /L- micrograms per Liter Signature: Michael Lapman President ND- None Detected State #: PH -0218 ELAP M 11715 I Tel 203 961 9911 Toll Free 1 866 567 5097 Fax 203 961 9919 imsenvironmental.com LETTER OF TRANSMITTAL CRON1N ENGINEERING P.E., P.C. May 1, 2003 The Lindy Building; Suite 200 2 John Walsh Boulevard Peekskill, NY 10566 914- 736 -3664 Fax 914- 736 -3693 Joseph S. Paravati, Jr. Assistant Public Health Engineer Putnam County Department of Health 1 Geneva Road Brewster, N.Y. 10509 RE: SHARON MUTNSELL P.C.D.H. PERAW #PV -33 -01 32 PEEKSKILL HOLLOW TURNPM TOWN OF PU NNAM VALLEY THESE ARE TRANSMITTED as checked below: ❑ FOR APPROVAL ❑ FOR YOUR USE ❑ AS REQUESTED ❑ FOR REVIEW AND COMMENT X PLEASE REPLY 1.) Three copies of as -built subsurface sewage treatment system plan 2.) Three certificate of the construction compliance. 3 >) Three guaranties of SSTS 4.) Copy of survey showing foundation location 5.) Water analysis 6.) E911 address verification form 7.) $200 for application fee. Should you have any questions or require additional information regarding this matter, please contact me at the above phone number. Thank you for your time and assistance in this matter. Respectfully sub fitted, F lt�enneth M. Murphy Project Designer PUTNAM COUNTY DEPARTMENT OF HEALTH GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM _5qA o >, i-lj WSEL L- 9 2 1 6 Owner or Purchaser of Building Tax Map Block I Lot Building Constructed by 3a P k.rl /-/or�L- w -,✓rn oi-!rt? Location - Street S11-16 .E 1--A MILU Building Type ?Q T IJ rJ r'h VALLE ✓ I TownNillage 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 sen ing 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 pro erty i - �a s : y. jh.4z NY 11 ul�or,ne ig it.a f the occupy t.o .�h it :,utii:i itlg 17.e_... -. r system. j 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 M(A Day l Year 206 T S4612oW M��►S��� General Contractor (Owner) - Signature o---i L--,i Corporation Name (if corporation) Address: 20 KV-,nM Lx 2.1 Ih W o R is A _Q State ; Np fl VAZ_/ Zip 16,59 Signature: Title: On r-4 7'I N a C N •f 7''IZ V cT l !� Corporation Name (if corporation) Address: 166,b one; 6 a t4 Roil a i State PI=E K4K I L- FA i/ Zip i oSAS* j Form GS -97 RRTJCE k- ECILEY b......,. , .. :._ ... Public Health Director LOREY"fA' `MOLINART 'R N., IVIS.N: Associate Public Health Director Director of Patient Services DEPARTMENT OF BEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (914) 278 - 6130 Fax (9.14) 278 - 7921 Nursing Services (914) 278 - 6558 WIC (914) 278 - 6678 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Preschool (914) 278 -6082 Fax (914) 278 - 6648 E911 ADDRESS VERIFICATION FORM OWNERS NAME: TAX MAP NUMBER: E911 ADDRESS: TOWN: AUTHORIZED TOWN OF.' (Signature) DATE: SH(�R6J\J e -AUNsCLL SE c- og�j ; 92- �RLOc - d L© 6 Vp- P k .s A, �A 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 #F address is assigned by an authorized town official. This form is to be submitted with the application for a Certificate of Construction Compliance. CE911 VERHZK 77 ... .. Acting Public Health -Director Director of Patient Services April 11, 2003 Z, ROBERT S. BONDI County Executive DEPARTMENT OF HEALTH I Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 Ken. Murphy Cronin Engineering The Lindy Building, Suite 200 2 John Walsh Blvd. Peekskill, New York 10566 Re: Field Inspection — Munsell i Old Peekskill Hollow Tpk., Putnam Valley TM#92-l-6, Permit #PV-33-01 Dear Mr. Murphy: A site inspection was made for the above referenced project on April 10, 2003. The following -W -in, tod, v. r -go _porre.'� jhe�figjd A cleanout needs to be installed just before the first-45' bend (pipe between septic tank t, and first junction box). 2. The grass-lined swale needs to be provided according to the approved plans. The curtain drain appears to be discharging on the neighbor's property. 4. Re-inspection for the above mentioned comments is required. If you have any further questions, please contact me at (845) 278-6130 ext. 2157. . Sincerely, i �zl Joseph S. Paravati, Jr. Assistant Public Health Engineer JSP:cj 04/07/2003 10:17 9147363693 CRONIN ENGINEERING 1 ! PAGE 01 :?d. ^^'ST. rut *;a'. it. y ✓. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES r— ATTENTION A All information must be fully completed prior to any inspections being wade. 13 GENE I i I For: Fill Trenches X i PCH7 Construction Permit # QV Located. den PEEKSk t 1. H4LLo_1,J fLaft±:b _ (T) M `1 QT r•iA r, VALLC' y Owner /Applicant Name: SHAl2i N thu N..ft~L(- TM 't= Block �_ L'ot'� Formerly: Subdivision Name: Subdivision Lot 9 Is system fill completed? pate: Is system complete? �� 1 _ Date. d T Is system constructed as per plans? r y Is well drilled? ye j Date: Is well located as per plaus? Y6 J 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 PCID Construction Permit and :.. approved plans,.and the Standards. Rules amd Regulations of the Putnam County Department of NN �l rJ( Date-, (,L- 'Z 2 a D 3 _ _ Certified ay: C R o N! �'' PE _&A, RA Design Professional I Address: 2�K u M.h4t�fK „i�"C V t�, P�trf K t� Lic. # i Comments: i I I i i Form FIR -99 APR -7 -2003 MON 09:11 TEL:845- 278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 1 ' i Now Rk f994 '40V N w KV . . . . . . il�� Al-g M— C—t.M, SI-. PA# �4 I fl M HIM for the exclusIve only to! & WATSON, sxwyiw & e2old Spring New York 10516 (877) 3114-159311 -R.. 4845) -4428 (Fax) 266 Wn A/;, 1— :5 Notes 1. COPYRIGHT 2002' by BADE All Rights Reserved. MnauM laws Z. Unauthorized alteration or- -4 licensed land surwwrjs a* of the New York'State Edit J. All certlficatlons are' yuliaf:-i map or ccpies_*bear.1h#',,eri 4., ff uriderpround,: are neither wish in Instruments:,, this -ma ., 5 Mls Dr6iiqrty a H i�� V - , 806ri ?bvff A . I ft forrn�& or 7.T I P Al, MM -4 .-M &v Proposed We// 0 P 7=10�gnlf q� Uor ""7 2.1 pfes thereof only If said ", ents exist and,,! pedotians' nar described: qy. may not be shown oft .which hods not been : ;Should verify title with inam County Clerk's SCALE in. 40*ft OCTOBER 31, 2002 ,We berety certify that the survey shown hereon VM Al this -0 an October 31, 2002 , and-that'Mils survey has been prepared In accordance o V-� S2550124 Arofesslonal LandSL�vqv' Ina ifs 7SM P RINTED S60 IF- AW; & _ZNMNfi-R1,9GP. C. 0 OCT 3 1 2002 .14 ow 4—a.-e NE L AN 0 WRVEYOR L—B—aq iW , uroh LICENSE Na 49769 LSURVEYING & ENGINFFRMP DI ; N-1 for the exclusIve only to! & WATSON, sxwyiw & e2old Spring New York 10516 (877) 3114-159311 -R.. 4845) -4428 (Fax) 266 Wn A/;, 1— :5 Notes 1. COPYRIGHT 2002' by BADE All Rights Reserved. MnauM laws Z. Unauthorized alteration or- -4 licensed land surwwrjs a* of the New York'State Edit J. All certlficatlons are' yuliaf:-i map or ccpies_*bear.1h#',,eri 4., ff uriderpround,: are neither wish in Instruments:,, this -ma ., 5 Mls Dr6iiqrty a H i�� V - , 806ri ?bvff A . I ft forrn�& or 7.T I P Al, MM -4 .-M &v Proposed We// 0 P 7=10�gnlf q� Uor ""7 2.1 pfes thereof only If said ", ents exist and,,! pedotians' nar described: qy. may not be shown oft .which hods not been : ;Should verify title with inam County Clerk's 35 7Z _M � 400 U O j. Q 42' IR VE Y; OF PROPER 7Y PREP. ARAM FCR M§nm 7E VALLEY NEW "YORK SCALE in. 40*ft OCTOBER 31, 2002 ,We berety certify that the survey shown hereon VM this -0 an October 31, 2002 , and-that'Mils survey has been prepared In accordance with' the existing Code of Practice for Land Surveys V-� Arofesslonal LandSL�vqv' Ina 35 7Z _M � 400 U O j. Q 42' IR VE Y; OF PROPER 7Y PREP. ARAM FCR M§nm 7E VALLEY NEW "YORK SCALE in. 40*ft OCTOBER 31, 2002 ,We berety certify that the survey shown hereon was completed by us on October 31, 2002 that this -0 an October 31, 2002 , and-that'Mils survey has been prepared In accordance with' the existing Code of Practice for Land Surveys as adopted by The New,: York State Assoc /at /on of Arofesslonal LandSL�vqv' Ina ifs 7SM P RINTED S60 IF- AW; & _ZNMNfi-R1,9GP. C. 0 OCT 3 1 2002 by LA 4—a.-e NE L AN 0 WRVEYOR L—B—aq iW , uroh LICENSE Na 49769 LSURVEYING & ENGINFFRMP DI C4 ED a d Y U O 1 .... W w O m I' ,w ..k ( F..0 - L1 8" POU"D CONC FONT �1:E1�4.T.roN _... SCALE H'•!'•0• ?v 3301 _ PUTNAM COUNTY DEPARTMENT OF HEALTH HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY, - -- - — -- BEDROOMS - - - -- ALL SUBSEQUENT REVISION jALTERATIONS TO THESE HOUSE PLANS Mb7ST BE SUBMITTED TO THE PCDOH FOR APPROVAL -1 r-Lal Lli JI etas 16 4,3---j th L ENTRY DIVIV& A&L ri All jw Si • -13 A-- OD 4,-o OD C\1 U') Nr -F.2; -3)18 WOG ff IR o. 4 v Wo r " JIM L.0 to, C\1 F/,qST F1-'00R..PL:A iv 5CAUR ILA-EIV5E 389f cn CS) -,j TA T-C6-4 am JA Li —1 IA r-Lal Lli JI etas 16 4,3---j th L ENTRY DIVIV& A&L ri All jw Si • -13 A-- OD 4,-o OD C\1 U') Nr -F.2; -3)18 WOG ff IR o. 4 v Wo r " JIM L.0 to, C\1 F/,qST F1-'00R..PL:A iv 5CAUR ILA-EIV5E 389f cn CS) -,j 20-0 am r-Lal Lli JI etas 16 4,3---j th L ENTRY DIVIV& A&L ri All jw Si • -13 A-- OD 4,-o OD C\1 U') Nr -F.2; -3)18 WOG ff IR o. 4 v Wo r " JIM L.0 to, C\1 F/,qST F1-'00R..PL:A iv 5CAUR ILA-EIV5E 389f cn CS) m m m N U7 V a--1 cn LO m m �I Cy: m m CN m' �f cn m� r ri+ -vo n MJL iry t c# �n Zm . ` 11s r• C.rNC _ irnr_. -- -7 r -± rs - h� •O m . s Ld AI A B _ to'f%a ro =)%ice M=))'i t. � i):y• I I! -- - -- Ld ! �4'CDiN[ SLAX: •� i� ; 1 m m m N U7 V a--1 cn LO m m �I Cy: m m CN m' �f cn m� r ri+ -vo n MJL iry t c# �n — �� -•• -erw r�r /u919 Zm 2'-O • -S� -7 r -± rs - h� •O — �� -•• -erw r�r /u919 LO [ (S) Ld 0 L1 U 0 LLI w I 0 2: r- co (M CS] m 04 LO Nr 1-4 CY) LO 7! (S) 1-4 C14 (S) CS) ml C14, Ol (S) R. !3FI) CL 05 SOS 7W ffr Lo m w Cu a_ Y V O W w O .r �N T �r� FL "E9a Tia7P SCALE .P f rn ti m W ,: •', f i' s ..,a 't Q now or form eiy� w. AtIVIOv.'LOCKWOOD (VACANT LAND)- 5001 is —4'e P£PF PVC 4V 74' CRAWL TRENCF:' (ENDS ARE CAPPED) ` YPF1 . •� J ♦ �� rQF `:_ cL " >y7l ptrpif9lt6pt/ ?p/ !. � 15 .:% N ..4170L.F.- 7',NlN DEEP' 0JP7AW DRAW !r0/ ..t MM NENPORTS AT "O' f if •t/ l .// J/1 / •! , r r_p�J �, :, l(ii �� P9 :t //. tl I:' Wit/ /•. CD- Fl-. 901 ARE, / t t ricnoN soy mp) I � seLF -A:O Pvc.sDaJS PIPS' 'NIIN43'BENDSAND CYEANOI/` 1150 VJLCW CONCRETE _R-7C TRIM• 700 JLD'NELL AB"OC7N£D 45 T } It C2 9 MA JLF.- 4'1•CA5T/RON P/PE ��� /� a scA rot 1 fiV70 4:e SDRJ5 PtC P/PE // �""S" f /�'/���/ / if,.! GJ +DF%ViK //lJ•i�� ,!� r`�+�'Y.��r�li'• w�zr. f ✓.� <%J`Y,%. I EXJSDNO'mal LOCH I/Gw . / (AS SMONN ON SURIEYI - ,. _ _ / Y` Y'�r°M °�`a +� s$ s• . 4 . f . FP?AME�, =• I�: ,, z ' �� �fk � _FDOI�NG DRA4 ROOF' LEADER. VCj EX/S,7NG WA IM, PA no A 7 Exrs'n �� E /fit r .n` � . .. • - sue. ._ ,: / ,.__ .- _� '...,.{ i �}.Fsy, .: yra J �. . .. -.. �S. y ... .y. - se....� �.. ... sroE icE� % %i ^Aft'A - 1.156. ACRES' EXISMIG DP.LL£D ffu 3 `; NS 36 BD 00 N59AiOLL'' '�r ')1,$8' ' O'L D' P.E"EKSKI L H qL L O W R 0A D Luc (oko PeekskNl No/ %w Tump/ke) : SW4' MEN T S YS TEtiA S BU/LT GE SUBS as CONSIST SCALE - 1 . 30 FT. - PERf`OR,, DEEP. a /STANCES TO SOU 774 ENDS. OF "SSTs ` A :A B; 17H END OF7.1ST. TRENCH r716 108 ITN END OF 21VD: '7AENCH 120' NORTH EXD:OF." 3R0;' •TRENCH: !7H END OF 3RD. TRENCH.,, "123.5' : 111" !TX END, OF 47H. TRENCH, 127.5' 112' 7TH END OF 5TFl - TRENCH 133, /TV. END 'OF`6 TH. "TRENCH` 736'' 115` - :DISTANG S TO.'1VOR7H E7VOS. OF SST A B NORTH END'OF, 1ST• TRENCH J,9' 49.5`. NORTH END .OF. 2ND.:..IRENCH •.. 34.5'' 41, ; NORTH EXD:OF." 3R0;' •TRENCH: 32' ' 34.5' No7UH 'END OF 47X ` IREWCN ' .: jj' ' : .'28'F - %N0R774 END.,OF 57X.. TRENCH - ..,j9, 1 24 s5$P,AIPA 'DAM ,FIN 1060 OR PEEKSKA WAIPR',. DRILLED P. F BV 4 f, U, • BREW57E 0 0 rry aT� t O 'k- � o0 V � o h 4 A9 -t jl� a� Y! Y' No or formerly LOCKWOODC r ph A rap set (2002) —\ N1934 407W C -Wy Meng M C- dhe St— MW 0 rz- v s I 11p e OCteonoat 0 Jope�e t � a_out a r _ - - -' Grovel_ _._-- \ s' • 126' of A, AQ@ o Z~ Drive 121 Ph, a Cep Set (2002) *92)_1 ph S Cop S.t (2'- ; S25 '561-24 E forfneffy RAPOS e� form �ODSP: F O F Now or fotyr+erly £EED ® 4i�O, °nom ® y O� W � r 7m � O i c W Wd10 c� T51.42' ph a Cep set (2002 f'i.•. 4N' o SURVEY OF PROPERTY PREPARED FAR Area = 1.155 Acres -- Notes i ®�� ®�� MU9 'SELL 1. COPYRIGHT ?002, 200J" by BADLY & WA7WN Surveying & £nglneering, P.C. All Rights Reserved. Unauthorized dup/Icatlan Is a Wo /at /on of app /Icob /e I S/7UA7£ /N 7HE Maws. ' TOW/V OF PU77VAM (VALLEY 71n /s mop was prepared for the exc/uslve 2. Unauthorized o/terot/on or addition to o document prepared by o e use of and Is cart /fled only to: licensed land surveyor Is a violation of Section 7209 , Sub -DI sl 2 PUTNAM COUNT/ DAN /£L MUNSELL of the New York State Educatlon Low. d A// certlflcotlons are valld for-this map and copies thereof on /y If sold I.. { t NEW .YORK ARDESAR /RAN/ PAIRIC /A COX map or copies bear the embossed seal of the surv&Yw whose signature :: SCALE 1 in. = 40 ft. OCTOBER 31, 2002 nDEL ITY NATIONAL ,7171.E INSURANCE COMPANY OF NEW YORK appears hereon. 4. /f underground Improvements easements, or encroachments exist and i that hereon but only for use /n connection with their are neither vNW& during normal fled surroy operations nor described ! : We hereby the survey shown y certify TIt /e No. RMF -7328. in Instruments provided to these surveyors they may not be shown on was completed by us on October X. 2002 that this map was completed on October 3f, 1002 CENDANT M0R7GAGE CORPARA7/AV Its successors and /or assigns but only this mop. 5 file property may be .affected by instruments which have not been and that this survey has been prepared in accordance with the existing Code of Practice for Land Surveys as their interest-may appear In a 2003 provided to these surveyors. Users of this map should verify title with their attorney or a quollf/ed title examiner as adopted by The New York State Association of mortgage to it. by Ardesar Irani & Pabicla Cox. 6. 7h /s survey Is of property described In the Putnam County Clerk's Professional Land Surveyor; Ina Goer 781 of deeds at page 540, second parcel. 7. Revised November 21, ?002. Added Foundation to mop. Surrey Sgt Revised November Note 7. Surve y Brought 2003. PRINTED m otherwise brought to date. i•i .9 { .t F) PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL H_ EALTH SERVICES CONSTRUCTION PERMIT F WAGE TREATMENT SYSTEM PERMIT # in L '� Located at OLD P6- 9 -KSKI L L /-/a Lea w R 01 Town of- ?V-1 rJ � r,-i. Lt-c Y Subdivision name Subd. Lot # Tax Map 91- Block Lot 6 Date Subdivision Approved Renewal Revision Owner /Applicant Name SNAR&IQ M UIJSG L L Date of Previous Approval Mailing Address 2 0 IMER.f 1901, JD Ro A O Rj Ti-►A r1 j V,4 L C- Zip o S 7 01 Amount of Fee Enclosed i Building Type Sin) 6t-Vs 6mIt y Lot Area 1. / �'_S-No. of Bedrooms Design Flow GPD 800 Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of I Z S'O gallon septic tank and 6_0o F o F ?6RF0 RATEo ?Ve PlP5 l/J 2/4 `( 6)2/avC -L TfZEA)C H Other Requirements: -7 N v r`i D6-C -P C u fZ i r4 1,-J RBI I IJ ( s 4FCr PLC N� To be constructed by (To re P -r&-'fLr 4 Address _ Water Supply: Public Supply From Address or: _ _'Pri'vate_ Supply Drilled by (Ta `6�E :JET�/Z%"!iti1�w Address'-_ I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that, the separate sewage treatments sy tem described above will be constructed as shown on the approved amendment thereto and in ..accordance with the standards, rules and re ulations of the Putnam County Department of Health, ands that on completion thereof a "Certificate of Construe ; F satisfactory to the Public Health Director will be submitted to the Department, and a wri guar U. ec a she , he owner, his successors, heirs or assigns by the builder, that said builder will place ' goo opedition aii said sewage treatment system during the period of two (2) years immediately f owin a da of iss th�,a pr al of the Certificate of Construction Compliance of the original system or repai theret Signed:.,. �' P. E. X R.A. Date Address 2 S o NN Wpb -l1.1 4/�? i c-L /o s �� License # APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless, construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new jermit. Approved r discharge of domestic sanitary sewage only. `�! By: Title:_A� Date: �ps� i White copy - HD le; Y' llo copy - Building Inspector; Pink copy - wne , ange copy - Design Professional Form CP -97 PUT NAM (COII.TN'11'Y DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH H SIERVIIC ES A.P]PLICA'g ION TO CONSTRUCT A WATER WELL • -Oki a print 6f bype ;c - =P0HD'Per' t #s �` 3 2;— 51 Well ]Location: Street Address: Town/Village Tax Grid # O c p '?iFr7C -f K L L HO (.LO W -Tv aAJ A K C Map 9 2 Block I Lot(s) 6 Well Owner: Name: XHAtzoN =Address: Zo Krzr4nc1zt ?or►P f2oll� p-1uNS� �2vT-�Jl4r, ( 1+LLLSLj Use of Well: —� Residential Public Supply Air /Cond/Heat Pump Irrigation I- primary Business Farm Test/Monitoring Other (specify) 2-secondary Industrial Institutional Standby Amount of Use Yield Sought S gpm # People Served L� Est. of Daily Usage S-0 o gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason M/4 <QZ SO P P L Li FOR W C w 26-,r I O 0J C19 for Drilling Well Type �_ Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes No Name of subdivision N A Lot No. Water Well Contractor: 7o 1ZLx' P 'r VZ/1t/JED Address: Is Public Water Supply available to site? .................................. ............................... Yes No Name of Public Water Supply: 4( own/Village Distance to property from nearest water main: u Proposed well location & sources of contaminati to be pr ided on sep a she Date:.., - 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 requires a new permit. Well to be constructed by a w ter well driller certified by Putnam County. Date of Issue / It— Oz' Permit Is ing Offs 'al• Date of Expiration / ® —// D Title: e Permit is Non- TransfferrabRe White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 i I PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES LETTER OF AUTHORIZATION RE: Property of SyA fZa N Mvrj sC L Located at oLn R ��4- R_SK�LL_ HOLD, t..� TyfzN PIKE� T/V20TNrgr, VgLcL-Lj Tax Map# Subdivision of Subdivision Lot # Gentlemen: Cl 2 Filed Map # Block Lot 6 Date Filed I This letter is to authorize C R01JJ J '_rj1�__ a duly licensed Professional Engineer of to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted propertyi in accordance with the standards, rules or regulations as promulgated by the Public Health Director1,of the Putnam County Health Department, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said wastewater treatment and/or water supply systems in conformity with the p ono cle 145 and/or 147 of the Education Law, the;Public Health Lain, and the.�Putn`uf _ Very truly yours, GOCountersigned: r Signed: P.E., Fb&., # � (Owner of Property) P < OFESSON% Mailing Address. 2 -Spill _ 106 Up Mailing Address: State /4-'W 40f-ri Zip / o�� Telephone: L9 / 44, 7 _T6'- 3 6Y ey o State - „i P LCC `1 iA,y Zip ; / 6 S” 7 5 Telephone: Form LA -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ....: APPLTGATOIV FOR APPROVAL OF: PLANS. FOR A WASTEWATER TREATMENT SYSTEM ' 1 2. 4. 6. 7. Name and address of applicant: S yA RaN.. n u '-J s' a c 2a Kf1r- M4F1 -r Pol-in, 126r4-o Name of project: S s'-r r - PirCle r K IL L Hoi c6 u ti? 3.. Location TN: ru 7-;-,di4 rti Vtq L- L C 1 Design Professional: 0J6"1NEE /2i%JG S.` Address: 2 Drainage Basin: PCCKf K 14, o c Lo V TRo6 K .P 6 Kf ► i LL., k y TXpe of Project: X Private/Residential Food Service Apartments Institutional Office Building Realty Subdivision Commercial Mobile Home Park Other (specify) 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? ............... 11. Name of Lead Agency Exempt Unlisted AJ 0 i /J l� 12. Is this project in an area under the control of local planning, zoning, or other .:.o,.fficial,- �rd�j?ances2. a ..................... :..........:.:. 13.. If so, have plans been submitted to such. authorities? ...:.... ............................... aJ� 14. Has preliminary approval been granted by such authorities? Date granted: 15. Type of Sewage Treatment System Discharge ................. surface water ir'groundwater 16. If surface water discharge, what is the:stream class designation? ..................... N 17. Waters index number (surface) ............:........................... ............................... 18. Is project located near; a public water supply system? ...... ............................... 19. If yes, name of water-supply` . N J Distance to water supply 20. Is project site near a public, se wag e collection or treatment system? ................ 1 N o t 21. Name of sewage: system . N(/'h Distance to sewage system 22. Date test holes observed auc li g�.2o0 2 23. Name of Health Inspector c� 24. Project design flow (gallons -per day) ................................. ............................... X00 25. Is State Pollutant Discharge Elimination System (SPDES) Permit required ?... N a 26. Has SPDES Application been submitted to. local DEC office? .......................... N Form PC -97 2 27. Is any portion of this project located within a designated Town or State wetland? /J 6 28. Wetlands—II) Number -,.,.w't.z.;.- ...... ........ .......................................... ........ 29. Is Wetlands Permit required? ................................ ............................................. Has application been made to Town or Local, DEC office? .................................. . 30. Does project require a DEC Stre am Disturbance Permit? ................................. tj C-) 31. Is or was project site used for agricultural activity- involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge application or industrial activity? ............................. Yes/No Quo 32. Is project located within 1,000 feet of existing, or abandoned landfill, hazardous*waste site, salt stockpile, landfill, sludge disposal site or any other potentially known source of contamination? ................................. Yes/No' N 6 DESCRIBE:. 33-- Is there a local master plan on file with the Town or Village? ....... .................... 34: Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site? ............................................................... gJa 35. Are any sewage treatment areas in excess. of 15% slope? ................................ A3 36. Tax Map ID Number ......................................................... Map 612- Block_. L_ Lot 9- 37. Approved plans are to be returned to Applicant Design Professional Mae-Ts dtl ��NOMU:.app-icattonsior-review-andAppfo-�dlotanew-SS--r-S-to-be'"Io'c�ted'�v�the'NYCW�afes be sent to the Department, and need 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 of a project, such as stormwaterplans or the creation of impervious surfaces, and the project applicant should 'obtain the appropriate forms for such activities from DEP and submit those forms to DEP for review and approval. If the application is signed by a person other than the applicant shown in Item I.,the application must be accompanied by a Letter of Authorization (Form LA-97). Failure to:comply'With this provision may be grounds for the rejection of any submission. I hereby affirm, under ' penalty ofterjuty, that in n is form is true to the best of my knowledge and heliqf. False ei peg unishable as a Class A misdemeanor pursuant to Sectio 1 45 LU SIGNATURES& OFTICZ4L TITLES.-' Mailing Address: ................................... I- -5-0hN HM(- t ; PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL- HEALTH SERVICES —'—D; -,: ESIC XDAT-A---SHEE-T'- SUB SURFACE SEWAGE N TEIVI' 20 4gr-31,,?L-a P-4,��D Owner SHPIZOA4 Address Pur,-Mfli.. LIA LO: FS. N-X /0�Pq Located at (Street) 0 LO PC6�K.(jQLL'H0(f-'dW TnjPK Tax Map 612 `81ock Lot 6- (indicate nearest cross street) Municipality (-r) PUTPA h VA t i-Af--A Drainage Basin Fa Ck-rK(LC WOLLOWZQ00K SOIL PERCOLATION TEST DATA Date of Pre soaking Date of Percolation test vlj� 2 2c)o 2 Hole No. Run No. Time Start - Stop Else Time 11, n.) Dpth to Water From Ground Surface (Inches). Start. Stop Water Level --Dro I nc% n es Percolation i Rate Min/Inch C 2 31- SE -3 m4 40 5— K -vsr 36 ICA" z 17/4( C 7 �3 pe 4 5 2 3 0 4 .5 NOTES.- 1. Tests to be repeated'at same depth until approximately equal percolation rates are obtained at each percol a*ti"bn test hole m (i.e. :5 1 min for 1-30 min/inch, :5 2 in 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 4 TEST PIT DATA DESCRIPTION OFSOILS ENCOUNTERED IN TEST HGLES DEPTH HOLE, NO. 1 HOLE NO. HOLE NO. G.L. 0-r -To Pst i 0.5' M 45p i U ri-t lrfzb W�j irfzo VV/j zF40W;U -r-IAJC 4'0^)DLA I-aMrti r-11JC XQt-JA1-(A 4-on/%7 1.0 1.5 2.0 LIT-e TralowAr ME I Tr:�- C,)OQ,rC-' 09AJO I 6RO1161- 2.51 3.0'* 3.51 6a4q M20 0WAJ C 0-0 R -rC X J4/1J 6" VC 4- 4.0' 4.5 C, 1j Tj a d W US—AfW 5.01 5.5 6.0 6.5' 7.01 7.5 8.01 8.51 9.51 10.0 mo-rrttP6 q-r I' M0-F-rt1AJ6' AT 7 '- M6T1r(-1,tJ6 t9r 6" Indicate level at which groundwater is encountered /jo/jt5- e;,,Jcou/,j-FCaED Indicate level, at which mottling is observed Indicate level to which water level rises after being encountered ej Deep hole observations made by:. c8wji/j gw6"11jccfz-1-,JC Date -7- 9 - 2 dolL Design Professional Name: --/j/y&rHct &. appi,&j- Address: 'Z- QA L.,Ch -El U-b Fki,K,f t<v,( . lq. V- 'kel-cc Signature: Design Professional's Seal Cr P 62980 FE50, 617.20 SEOR Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM -For.-UN LISTED ACTIONS Only Z'4 ,Part I -PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. APPLICANT/SPONSOR: 2. PROJECT NAME:, Sharon Munseli SSTS, Old Peekskill Hollow Turnpike 3. PROJECT LOCATION: Municipality Town of Putnam Valley County Putnam County, 4. PRECISE LOCATION: (Street address and road intersections, prominent landmarks, etc., or provide map) South side of Old Peekskill Hollow Turnpike, approximately 1,000 ft. southwest of Peekskill Hollow Road 5. PROPOSED ACTION IS: lNew OExpansion ❑Modificationlafteration 6. DESCRIBE PROJECT BRIEFLY: construction of subsurface sewage treatment system and a water service connection for the construction or a single family house 7. AMOUNT OF LAND AFFECTED: Initially 1.1545 acres Ultimately ' 1.1545 acreg' 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? JjYes ❑No If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? lResidential . ❑1ndustria! ❑Commercial ❑Agricultural ❑Park/Forest/Open space E30ther Describe: Surrounding lands are zoned single family residential J, 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? -IffYes ❑No If yes.jisi agdncy(s) name and permitiappriovals, Town of Putnam Valley= Building Permit, Putnam Co.Healthdept— SSTS& Well Permits 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? Oyes INo if yes, list agency(s) name and permit/approval 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? ❑Yes jNo' I-CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST- OF MY KNOWLEDGE ApplicantISponsor me: Cronin EnalneefinaP.E.. C. /Kenneth Mumby dater 08-21-02 tur jSigLnature: Z L If the action is in a Coastal Area, and you are a state agency, complete a Coastal Assessment Fonh before proceeding with this assessment VVhK 1 A. DOES'ACTION EXCEED ANY TYPE 1 THRESHOLD IN 6 NYCRR, PART 617.4? if yes, coordinate the review process use the FULL EAF ❑Yes o B. WILL ACTION RECEIVE COORDINATES REVIEW *AS PROVIDED FOR UNLISTED-ACTIONS !N 6 NYCRR, PART 617.6? If No, a negative declaration a other involve- d, ageg y..,,_, : - y be upeseean ❑Yes - - C. COULD ACTION RESULT IN ANY ADVERSE ;EFFECTS ASSOCiATED;WITH: THE- FOLLOWINO:'Answe'rs may be handwntteri, if legible:.. C1. "Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, solid waste production or disposal, potential for erosion, drainage or flooding problems ?;..Explain briefly: C2. Aesthetic; agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood' r character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans'or goals as officially adopted, ora change in use or intensity of use of land' orother natural resources? Explain briefly: Alp.. _....__. .., ..__...... . C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly "` - C6. Long term, short term, cumulative, or other effects nof'identified in C1 -05? Explain briefly: AID C7: Other impacts (including changes'in use of either quantity or type of energy)? Explain briefly. D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF 'A CRITICAL ENVIRONMENTAL AREA (CEAp Yes .. If Yes, explain briefly E. IS THERE, OR IS THERE LIKELY TO BE; CONTROVERSY RELATED10 POTENTIALADVERSE ENVIRONMENTAL IMPACTS? ❑Yes e— tfYes, explain briefly: fart III:- DETERMINATION OF 51GNWICAN (UE' _o qe compietea oy Hgency : - INSTRUCTIONS:.For each.adverse effect identified above,.determine.whether-It is substantial, large, important..or6therwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural);, (b), probability of. occurring; (c) duration; (d) , irreversibility; (e) geog`taphic scope; and (f) magnitude. Ifnecessary, add attachments or reference supporting materials:. insure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and .adequately addressed." If question, D of Part II was checked yes, the determination of significance must evaluate the'potential impact of`the proposed`action on,the: Check this box if you have identified, one or more potentially. large. or significant adverse impacts which MAY occur r Then ❑ proceed directly to the FULL EAF and /or prepare a positive declaration: ❑ Check this box if you have determined, based on the information andl analysis above and any supporting documentation,'T that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide on attachments as necessary, the reasons supporting this Bete ination:.... _.. _ ....Name of. Lead Agency ..... ........ _ r Type Name of Responsible Officer in Lead Agency Title of espon le fficer s 2 10/10/2002 10:42. 9147363693 CRONIN ENGINEERING 1 I PAGE 01 CRONIN ENGINEERING P.E.,P.C. 2 JOHN WALSiff soul9v- k--t THE LINDY BLDG; SUITE 200 PEEHSSILL, NY 10566 Joseph S. Parmti, Jr. Ken Murphy COMPANY: DATE: P.C,H.D. ocTonn 10, 2002 FAX NUMBER: TOTAL NO, OF PACs" INCLUDING COVER: 1 PHONE NUWER: - SENDERS REFF8FNCE NUM89k Old PeekskM Hollow T=pike Re YOUR REFERENCE NUMNSI : Sharon Mun6ell Putnam Valley Tt1+,1# 92 -1 -6 i 0 URGENT Q FOR REVIEW 13 PLEASP COMMENT ❑ PI,FASB REPLY Q PLEASE RECYCLE sm ConsftwdM Permit Old PedmkM Hollow Tu npike ,rown of Futnam Valley ME&SAGE rnNjWj=- _.,.: �.� .. . �. . M� '• a ..�� U .-7 t - I TEL. (914)736.3664 0 FAX (914)736 -3693 j T T. 1 4 01 . AC TCI • Qa�- a7A -7CP1 NAME: PUTNAM COUNTY DEPARTMENT OF P. 1 RONIN ENGINEERING P.E. P.C. _ The Lindy Building, Suite 200, 2 John Walsh Blvd., Peekskill, New York 1_0566 A Tel. (914)'736 -3664 6"Faxi='(914)73&= 69"3 _ October 3, 2002 Joseph S. Paravati; Jr. Assistant Public Health Engineer Putnam County Dept. of Health 1 Geneva Road Brewster NY 10509 Re: Sharon Munsell Tax Map #92 -1 -6 Old Peekskill Hollow Turnpike Town of Putnam Valley Dear Mr. Paravati: Please find enclosed: 1.) Three copies of the revised SSTS plan 2.) SSTS permit application 3.) 2 sets of new house plans;, The information was revised based on your comment letter dated September 30, 2002. Kindly review the above and should you have any questions or require additional information please contact me at the above number. Thank you for your time and assistance in this matter. Respe ully submitted, Kenneth M. Murphy Project Designer I BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 i I 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/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 September 30, 2002 Kenneth M. Murphy Cronin Engineering The Lindy Building, Suite 200 j 2 John Walsh Blvd. Peekskill, New York 10566 i Re: Proposed SSTS - Munsell Old Peekskill Hollow Turnpike (T) Putnam Valley, TM# 92 -1 -6 Dear Mr. Murphy: i This office has received and reviewed the most recent set of plans for the above mentioned project. We would like to offer the following comments for your review and consideration. ;r • - T :.- ':... .. - ... ... _. . . _. J .:.- _ .,' .� � ..... '_ w r �.rZ. a .0 �,. .ra.. .- ^...v.__"°!• ... ,c--:> ....�... .. ». <.-. -..... _ —I.-- _ "`The pipe between the septic tank and p ump tank needs to be labeled "4 inch PVCI -SDR 35 @ 1% minimum." 2. Label for stone in trench detail should include the words "dust free." 3. The distribution box notes should include "provide speed levelers." 4. Based on the elevations provided in the pump chamber detail, the criteria for one day storage above the alarm is not met. There also appears to be some numbers that are in error. Please check and make . any necessary corrections. 5. Calculations showing head loss due to friction and elevation needs to be provided Ito determine if the proposed pump is adequate. 6. The pump operating range needs to be indicated on the pump curve. 7. Basic required note # 6 is missing from the PCHD construction notes and it appears to have been relocated to the general note section and reworded. The note should appear in the PCHD construction note section and should be worded as it appears in Appendix C. 8. The study as shown in the floor plans constitutes a fifth bedroom. The study needs to be revised to show a 6 foot wide opening with no door or it needs to be eliminated altogether in order to have a four bedroom house. 9. The sittting room or the second floor also constitutes an extra bedroom. The sitting room needs to be combined with either bedroom # 3 or bedroom # 1. A suggestion to j accomplish this is enclosed. f .a . ...:::_.. f: .i.'.. . "'fee pump tarp sfiould'be re orated'- so' t1�at" ile90o-turi�betWe�n "tli�ii��a�`�ri�•ifie "' �' °�`"��` pump tank is eliminated. 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, Joseph S. Paravati, Jr. Assistant Public Health Engineer JSP:cj 0 `BRUCE R. * FOLEY Public Health Director LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 I Date: q j3oly a i J1 To: MurPti� Govn�� Er►y�n�er�v►� ' I Re: Proposed SST: - MuoSe- W Oltl P�Sk!(lf�(loc, Tu�np�ke %jv►ca± V�t(ey .,M tt Dear M urp (y I This office has received and reviewed the most recent set of plans for the above mentioned project. We would like to offer the following comments for your review and consideration. I 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. . i Very truly yours, i Joseph S. Paravati, Jr. Assistant Public Health Engineer JSP:cj formletter evoS� f -vfe-S &jIT or- btA ro, o A, 5u gxcco I ii 'r I� H—Pyc Sv2_ Lab e t for ne ; e I �;.e, u� I II eAc gd 9A -the 21PvA.4; ova s 0t-Di/ de� 4e orre e k le i +i I, it J- - -• -- - � -- - -- -- -- - - - -- — - — � tee. A 41. a- Pp e6LiS �d be __Flea se cbec6( I! xo d mw ke o-h n eceS Sa 1 i - -. � I— - �- �Cv`��i °� -5 -: S� °'"i'vt�— �- eac��o 5_S__du_e �"o `�r_ic- �i_o_v► Gw� e_lev�ti��or� [�ee�l5 J / Je,�erynin e o__ - - - - -i- —A e-Pl_o Posed_ .U_vn is IGll.�2_ ua�� v7 t� e,ds_- requl ce-- _n — ° +e_ pe4CC 4 _4aVe relo eo.hA a 4h -e- j w ee -a>` l hoe Sec Fio h Q h d !" e Wo rc�e� -- Q n vT� '54 vU u( QPp fir- it h e C. 0 �l Cod?- StT.uG�i ra n p.e . —_ — _..�' SeG_�!�or �� _5�1��'�Gl 6e�v✓_or�e<.� �t.5_�+ a _ears %✓� ,� en�iix � �, --� �no�r� 1-6 -_ Ke _f (�o rP lain :S ��i ve_5__ A - �,{�'► b e�i�o ory►�. __ _. e,i;w�lnw�ed aI o &4r i✓► orc�e� a_v_e w ur_�z,d_roow_►_ _ 10, .' --- - - - - -- � � H e U.�,P �►_k_5���1��b� _r_�.(oc��e_�r_�__ so -_f_l�wf_�fG►e —Ro° �t,_r-!�_ _--- - - - - -_ iiii_r r..._ ___I: _t, __� �.�_ ►, r` ti i i PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH 'INDIVIDUAL WATER SUPPLY &,SUBSURFACE SEWACrF�TI�T+4T1f+iENT SYSTEMS =' REVIEW SHEET FOR CONSTRUCTION PERMIT NAME OF OWNER: l "i �n Se I I STREET LOCATION: _fiPP/d /ecksk,ll lk/l-w Tamp, Ore REVIEWED BY: RM, GR, ,S, SRDATE: a nag TAX MAP#: (CONFIltMED) Y N DOCUMENTS L(__)PERMIT APPLICATION L_JWELL PERMTT OR PWS LETTER (J�___)PC -97 0 J(�LETTER OF AUTHORIZATION (DESIGN DATA SHEET (DDS) / LL6LJSHORT EAF E (PLANS -THREE SETS )HOUSE PLANS - TWO SETS )(--)VARIANCE REQUEST SUBDIVISION L_)ULEGAL SUBDIVISION • UUSUBDTVISION APPROVAL CKED L--)L-)PERC RATE (_-)UFILL REQUIRED DEPTH UUCURTAIN DRAIN REQUIRED IN ATERSHED / TED TO DEP ( IF REQ'D (DEEP TEST HOLES OBSERVED U(ZPERCS TO BE WITNESSED (_)�X- APPROVAL SSDS ADJ, LOTS �ETLANDs �(�W (TOWN/DEC PERMIT REQ'D ?) (__)DATA ON DDS PLANS & PERMIT SAME U 77(_}PRE 1969 NEIGHBOR NOTIFICATION vv- ( (' 0100 YP- FLOOD ELEVATION W/I 200' U(__)7 SOIL TESTING LOTS >10 YEARS OLD / REQUIRED DETAILS ON PLANS Y eGRAVITY SEWAGE SYSTEM PLAN - (NORTH ARROW) SSDS HYDRAULIC PROFILE ( OCONS UF LOW CONSTRUCTION NOTES 1 -15 DESIGN DATA: PERC & DEEP RESULTS i/ 2' CONTOURS EXISTING & PROPOSED (DRIVEWAY & SLOPES, CUT (.(,JFOOTING /GUTTER/CURTAIN DRAINS 7( a( US DA SOIL TYPE BOUNDARIES (�C--)TTTLE BLOCK; OWNERS NAME ADDRESS TM#, PE/RA; NAME, ADDRESS, PHONE# (DATE OF DRAWING/REVISION Y / N (REOUII2ED DETAILS ON PLANS CONT'Dl 0UHOUSE SEWER - W FT. 4 "0'; TYPE PIPE CAST IRON _)NO, BENDS; MAX BENDS 45' W /CLEANOUT RENEWALS (--)USTTE NOTE 0��GE) (_,)L-)10' HORIWTAj4-P'AST TRENCH SLOPES 3:1 TO GRADE UUFILL SPE NOTES 1 -5 b �� UUF ., OFILE & ONS1 (UUFI L IN EXPANSION ` FILL G ER THAN 2 FEET (UU CLA ARRIE (Jy�, (-JUFIILL A, ATION NOTE UUVO N PL WD.B., UNCLASSIFIED & IMPERVIOUS UUS ARATION E FROM TOE OF SLOPE TRENCH �� ULF TRENCH PROVIDED TO 0 60FT MAX. AO FT "?At UPARALLEL TO CONTOURS rw- D vs z v 4 U(_�100% EXPANSION PROVIDED ,rro��.c rrr s SEPARATION DISTANCES ON PLAN - FROM SSTS (✓U10' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL J( 120' TO FOUNDATION WALLS C/ 0100' TO WELL, 200' IN DLOD,150' TO PITS (�0100' TO STREAM, WATERCOURSE, LAKE (inc. expan). _)(�50' TO CATCH BASIN, 351 STORMDRAIN; PIPED WATER 10' TO'WATER LINE (pits - 20') (u-3150' INTERMITTENT DRAINAGE COURSE 2001/500' RESERVOIR, ETC. i 150' GALLEY SYSTEMS (�( )10' MIN TO LEDGE OUTCROP SEPTIC TANK CLZU10' FROM FOUNDATION; 50' TO WELL WELL L16LJDEWENSIONS TO PROPERTY LINES L-clULOCATION OF SERVICE CONNECTION 15' TO PROPERTY LINE SLOPE (�:6VLOPE IN SSTS AREA 54-9- (S20 %) (�(, f�f// REGRADED TO 15 %,1[F REQUIRED DOSE/PUMP SYSTEMS (__)PU T NOTES pJe"t° °,_ . F VOLIE ( N )HOSE 75% OF PIPE VOLVOI TWEIDOS TM NOTED (LAM$,WETLANDS -WITtM ZOO'., OF F.L. q4 (�✓ (_)PROPOSED FINISH FLOOR AND BASEMENT ELEVATIONS WELLS & SSDS'S W/IN 200' OF SSTS UU��PROPERTY METES do BOUNDS C-t/- (__,)EROSION CONTROL FOR HOUSE, WELL & SSTS, EROSION CONTROL NOTE COMMENTS- (REVSHEET)09 /01/00 AY STORAGE ABOVE' AI;. R1Vg -- - = %" n,5 "pv 94 o r CURTAIN DRAIN CRL c S kNDPIPES, T BOTH SIDES, . DETAIL 5 cRa ' MIN to CDS =>5 %, 20'-4 %, 251-3%,351-1 %,100 % - <1% mar MIN to CD DISCHARGE /100' with 182 cons day discharge MIN to NON - PERFORATED PIPE X CRONtWENGINEERING P.E., P.C. The Lindy Building; Suite 200 2 John Walsh Boulevard Peekskill, NY 10566 914- 736 -3664 Fax 914 - 736 -3693 Putnam County Department of Health 1 Geneva Road Brewster, N.Y. 10509 � ^� -f;•. ...�' -.,ir �i7.vi = :��.. ?� •....wi�Y: . o : ,. � ..;,. s i. n, i n.- - �F s.',oa ..c�. .iii; . .. ! �� August 21, 2002 RE: y SSTS CONSTRUCTION APPLICATION SHARON MUNSELL OLD PEEKSKILL HOLLOW TURNPIKE TOWN OF PUTNAM VALLEY THESE ARE TRANSMITTED as checked below: i ❑ FOR APPROVAL ❑ FOR YOUR USE ❑ AS REQUESTED ❑ FOR REVIEW AND COMMENT X PLEASE REPLY WE ARE SENDING YOU attached 1.) Three copies of subsurface sewage treatment_ system plan 2.) Three SSTS construction- permit' application' a 3.) Letter of authorization 4.) Application for approval of plans 5.) Soil data sheet 6.) Short environmental assessment form 7.) 2 sets of house plans i 8.) Updated survey 9.) List of property owners notified 8.) $300 certified check for application fee The information is provided based on our July 8, 2002 joint site inspection with Gene Reed and ensuing discussions. Please review at your earliest convenience. Thank you for your assistance in this matter. 5 i :Z Wd 9 Z 911v,ZQ Sans H1.1'V-`JH ANN iinno i wvk ina et I tav I Respectfully submitted, Kenneth M. Murphy Project Designer i i 1)T Situs: 33 PEEKSKIL., HOLLOW TPKE, PUTNAM VALLEY NY 10579 -0222 R006 APN: APN: 2800 -092 -000 -0001 -001 00 RectSale Dt: 05/1111994 05/11/1994 Total Value: County: PUTNAM, NY Sale Price: Land Value: Use:, SFR Doc #: 1244 -3 • Impry Value:. :. _ Map Pg: " O(3=0 Z i70 1st M.' $: . •.,,� ..tea. =.�. _ .i� Prop Tax Munic: PUTNAM VALLEY TOWN State Use: 210 Lot Area: Township: Cnty Use: Zoning: Owners: SCHROETER CRAIG Census: Phone: Mail: 33 PEEKSKILL HOLLOW TPKE; PUTNAM VALLEY NY 10579 -3222 R006 2) Situs: , NY Land Value: APN: 2800 -092 -000 -000 -002 00 Rec/Sale Dt: 02/07/1981 02/1981 County: PUTNAM, NY Sale Price: Use: RESIDENTIAL LOT Doc #: 775 -678 Card #: Map Pg: 2800 -092 -000 1st Mtg $: Munic: PUTNAM VALLEY TOWN State Use: 311 Township: Cnty Use: Owners: BYRNES JAMES Mail: 82 PEEKSKILL HOLLOW RD; PUTNAM VALLEY NY 10579 -3213 R006 3) Situs: , NY APN: 2800 -092 -000 -0001 X04 00 Rec/Sale Dt: County: PUTNAM, NY Sale Price: Use: RESIDENTIAL LOT Doc #: Card #: Map Pg: 2800 -092 -000 1 st Mtg $: Munic: PUTNAM VALLEY TOWN State Use: 311 Townshi . , ., :.:__ . = my Use: _... P'. Owners: LOCKWOOD MILTON W Mail: PO BOX 2510; PEEKSKILL NY 10566 -8910 5019 C/O WM LOCKWOOD 4) Situs: 36 PEEKSKILL HOLLOW TPKE, PUTNAM VALLEY NY 10579.3221 R006 APN: 2800 -092 -000 -0001 -005-000 RectSale Dr 12/24/1981 1211981 County: PUTNAM, NY Sale Price: $108,500 Use: SFR Doc #: 781 -540 Card #: Map Pg: 2800 -092 -000 1 st Mtg $: Munic: PUTNAM VALLEY TOWN State Use: 210 Township: Cnty Use: Owners: GOODSPEED PETER & ANTONIA Mail: , 36 PEEKSKILL HOLLOW TPKE; PUTNAM VALLEY NY 10579 -3221 8006 Total Value: Land Value: Impnr Value: Prop Tax. Lot Area: Zoning: Census: Phone: Total Value: Land Value: Impry Value: Prop Tax. Lot Area: $'152,950 $70,400 $82,550 1,1'16".68'' 97,574 109.00 $11,000 $11,000 $80.31 20,038 109.00 845/528 -6997 $6,300 $6,300 $45.99 23,925 Zoning: Census: 110.00 Phone: Total Value: $182,800 Land Value: , $61,300 Impry Value: $121,500 Prop Tax: $1,334.62 Lot Area: 57,935 Zoning: Census: 109.00 Phone: ©1996 Win2Data 2000 Page: 1 of 2 r G ' 5) APN: County: Use: 'Ca"rd# Munic: Township: Owners: Situs: NY $61,100 Impry Value: 2800 -092 -000 - 0001 -006 -000 Rec/Sale Dt: 12/2411981 PUTNAM, NY Sale Price: $108,500 RESIDENTIAL ACREAGE Doc #: 781 -540 Map Pg1 "2800 -092 -0001st Mtg $: :.,_.. RESIDENTIAL LOT Doc #: 708 -1160 PUTNAM VALLEY TOWN State Use: 311 Map Pg.* 2800 -092 -000 1 st Mtg $: Cnty Use: $86.87 GOODSPEED PETER & ANTONIA PUTNAM VALLEY TOWN State Use: 311 Lot Area: 12/1981 Mail: 36 PEEKSKILL HOLLOW TPKE; PUTNAM VALLEY NY 10579 -0221 R006 Total Value: $61,100 Land Value:; $61,100 Impry Value: APN: .Prop Tax: .!, � .`:$446:09 i Lot Area: j 57,064 Zoning: PUTNAM, NY �-' Sale Price: Census: I 109.00 Phone: RESIDENTIAL LOT Doc #: 708 -1160 6) Situs: NY j APN: APN: 2800 492 -000 -0001-007 -000 Rec/Sale Dt: 03/30/1973 03/1973 Total Value: $11,900 County: PUTNAM, NY �-' Sale Price: Land Value: $11,900 Use: RESIDENTIAL LOT Doc #: 708 -1160 Impry Value: j Munic: Card #: Map Pg.* 2800 -092 -000 1 st Mtg $: Prop Tax. $86.87 Munic: PUTNAM VALLEY TOWN State Use: 311 Lot Area: 21,465 Township: Cnty Use: Zoning: i Mail: Owners: LOCKWOOD MILTON Census: I 109.00 Phone: Mail: PO BOX 2510; PEEKSKILL NY 10566 -8910 8019 CIO WM LOCKWOOD 7) Situs: 28 PEEKSKILL-HOLLOW TPKE, PUTNAM VALLEY NY 10579 -3221 R006 APN: 2800 -092 -000 -0001 -008 -000 Rec/Sale Dt: 02/12/1998 01/12/1998 Total Value: County: PUTNAM, NY ��.. Sale Price: $159,500 Land Value: Use: SFR Doc #: 1419 -86 Impry Value: Card #: Map Pg: 2800 -092 -000 1 st Mtg $: Prop Tax: Munic: PUTNAM VALLEY TOWN State Use: 210 Lot Area: Tqwnshig: Grty:Uss. ... Zoning: Owners: KERN LISA A Census: OBRIEN FRANK M Phone: Mail: 28 PEEKSKILL HOLLOW TPKE; PUTNAM VALLEY NY 10579 -3221 R006 $179,000 $49,300 $129,700 $1,306.87 33,541 109.00 845/526 -4103 0 1996 Win2Data 2000 Page: 2 of 2 go - s •Pt RE;A D / I �' / /. ' •j ♦• J 5,x.5 2 \� ' ' S \ W j 109.` ��E, \;.�� ors ro � � a9: o• s OJ j�, r 1 U 'l L® y j3 � � oo pE P` ` ♦�; i • o. 0.oLD wEL � I I• '1 ;o1m CERT/fIE-O TO F/RJfr 7174-4; 1N•f61Rq1VCE CoMPgNy qt la COLON /AL iyIORTGAGEE CORP. i T�►+'` lea i v, N ._50.33 PCM ), I I j O p Q, • - CERT/fIE-O TO F/RJfr 7174-4; 1N•f61Rq1VCE CoMPgNy qt la COLON /AL iyIORTGAGEE CORP. i T�►+'` lea i v, N ._50.33 PCM ), I I j 05/21/2002 09:22 9147363693 CRONIN ENGINEERING 1 i PAGE 01 T<i ti<cw �i �..�ey�'T,. , � 41 � - n ✓j!1 -..�/1 �Qii ::��d:. �� i BRUCE R FOLEY Public Health Director ATTENTION: .1.Y ^;Rtiv R •.e \�`f�.. o\ .`...�.ya.�- .i..•�.n'.�. :.•�!`.. .►y: �P}r� DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 W4111 W-1 a 10-43 IS 91 ! ❑ ADA.NI STIEBELING XGENE REED LORE'ITA MOLINARI R.N.. M.S.N. Anoom Nblic Health Direvar ' Director of Patina Services i All infonmation below must be fWLv completed prior to any scheduling. DATE-j" 2 Z dd ENGINEER OR FIRM: C.9 0""k' s; 1M C � M r PHONE 9: + 4 -7 -) REASON: DEEPS: k PERM ❑ PLC TEST: ❑ : 01-0 P940K H 1LL di—Low R Q14t) TOWN! fk4-rtJpr, VIq I_L�01 TAX NLkN: t�L � 6 StMDMSION: LOTF: OWNER: aI\J i- 4uNsE L L ITS NO ❑ at/ Proposed SSTS within the drainage basin of West Branch or Boyds Corner Reservoirs. o Proposed SSTS within 500 feet of a reservoir, reservoir stem or control lake. i G Proposed SSTS within 200 feet of a watercourse or a DEC wetland. 0 Proposed SSTS design flow greater than 1000 gallousidzy 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 tesbag. This Department will determine the NYCDEP project status (Joint or Delegated) based on the response. If You answered Xz 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 bas been determined to be Delegated based on the above response and then subsequent information indicates NYCDEP is required to witness the soil testing, k will be the sole responsibility of the design professional to schedule re- witnessing of the soil testing with NYCDEP. j FOR COUNTY USE ONLY DATE: 7 / tip MAY -20 -2002 MON 19:31 TEL:e45- 278 -7921 TIME: NAME: PUTNAM rnI INTY nPPnPTMFNT � nr Travis lb ® ............ Ng--kppV" . VW gg-qj ,�-- -I K I COD so 1 PUTNAM COUNTY DEPARTMENT OF HEALTH' ;ISION,OF;EROINIET'IL HEALTH SERCESr, INITIAL INDIVIDUAL /COMMERCIAL .SITE INSPECTION FORM SECTION A: GENERAL INFORMATION . Name of Project dd jlAjS�L/ (T)(V) Site Location County PvLvAd Building construction begun / o Extent Is property within NYC Watershed ? ................. ❑ Yes dNo SECTION B. TOPOGRAPHY (Please check all appropriate. boxes) I. ❑ Hilly ❑ Rolling ❑ Steep slope ❑ Gentle slope Flat 2. ❑ Evidence of wetlands ❑ Low area subject to flooding ❑ Bodies of water Drainage ditches ❑ Rock outcrops 3. Property lines or comers evident ....................... ............................... Yes 7,fN,01 4. Do water courses exist on or adjoin the property? .......... ..................... ❑Yes ...... - No - . -.- .. _ .: 5. Will these affect the design of the sewage system facilities ?..........., Yes No ❑ E 6. Do watershed regulations apply in this development ? ....................... F--] Yes No 7 Will extensive grading be necessary? ................................................ Yes No . 8. Will i�it6fi�sifvefilf be necessary for SETS? ....... ............................... P Yes No ❑ � j 9. Do filled areas exist within the SSTS area? ........ ............................... ❑ U Yes —,�/No If yes, what is the condition of the fill? SECTION C. SOIL OBSE TIONS 10.. Appearance of soil: Sand. ❑ Gravel ❑ Loam. lay ❑ Hardpan. :❑ Mixture 11. Observed from: ❑ Boiings Bank cut ' Backhoe excavations 12. Soil borings /excavations observed by on 13. Depth to groundwater on 14. Depth to mottling 3 o 'O �� /� ®/� - on 15. Are test holes representative of primary & reserve areas...viy,� .., I 16. Soil percolation tests made by p Ta2 5 on :2 17. Soil percolation tests witnessed by P on SECTION D (on back) Form ST-1 i I e.. J � ,t^iu . (� :•V'Y 'V n tY.• � w. ♦ a �%j"�•'J. C .. � t.w�•:.. ....4r.5��:. SECTION D.. DRAINAGE 18. Will proposed grading materially alter the natural drainage in this or adjacent area 19. Will groundwater or surface drainage require special consideration? .................. 20. Will gullies, ditches, etc., be filled and watercourses be relocated ? ......................... SECTION E. REMARKS 2 .i,R /.. ._;�s.<;+42. ..,w �.•� ...art/......, �. »s .n s? Y ffNo Yes No ;0 Yes To 21. If a common water supply is'proposed, has an inspection been made of the existing or proposed source and facilities? ................................. ............................... Yes No Inspection. data 22. Do adjacent wells and/or sewage systems exist? ................... .. .............................. Ef Tyes' 0 No 23. Additional comments 24. Site observer /inspector and title 25. Date(s) of observation(s)inspection(s) % /d a TEST PIT PROFILES Hole # Lot # Hole # Lot # Hole # Lot # Depth to water `� Depth to water ivy,/ Depth to water .Depth to mottling a.- = -Depth to mottling !- 'ro . Depth t o .mottlYng Depth to rock/imp. iriGN,-' Depth to rock/imp. Noti; Depth to rock/imp. iurai� G.L. G.L. G.L. 0.5 fe 9 7-5, 0 1�� 4.0 Gfi� 6.0 1 7.0 r, ,•„ e aaw 7 a Gra i3 roar s� 5a n� 41rt vim/ 8.0 9.0 �V 10.0 0.5 1.0 2.0 310 4.0 5.0 6.0 7.0 8.0 % 9.0 10.0 0.5 1.0 2.0 3.0 4.0 5.0 6.0 7.0 le/ 8.0 9.0 10.0 G Z, 1 7-6P eel, f5° �0 4 f 8.0 % 9.0 10.0 0.5 1.0 2.0 3.0 4.0 5.0 6.0 7.0 le/ 8.0 9.0 10.0