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HomeMy WebLinkAbout0043DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 3.-1-72 BOX 1 00043 6N Ir �l, I 00043 l PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner Address . &4 pL F Avg, Located at (Street) Tax Map -3, Block _� Lot (indicate nearest cross street) Municipality P,4TTE�s m,�,D Watershed j5A;ST` ]3 &3"_ SOIL PERCOLATION TEST DATA Date of Pre- soaking / / ;f' 17 5__­_ Date of Percolation 'Vest 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 3�epth :to Water Water From Ground :,:' Level P. 21 Hole loo Run No T��uc Start Ela se Time Surface (Inches) Start Staff Ord )(n Inces Rate >StolxNIEn) MI nInch �IA115.. x Y-1 �J S 4 5 jrj1q ,1 3 - :z Z- , 3 4 3 3 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 DEPTH G.L. 0.5' 1.0' 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 9.0' 9.5' 10.0' TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE NO. ,i HOLE NO. �Z. 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: Design Professional Name: Address: Signature: Design Professional's Seal HOLE NO. Date ; r 2 DEPTH G.L. 0.5' 1.0' 2.0' 2.5' . 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 9.0' 9.5' 10.0' TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE NO. ) HOLE NO. 9- 6,01. HOLE NO. 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 it// e5 Design Professional Name: Address: Signature: Design Professional's Seal 2 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH, SERVICES INITIAL INDIVIDUAL /COMMERCIAL SITE INSPECTION FORM :SECTION Al GENERAL INFORMATION.. Name of Project V r -ZIE T--I County 0JU7-A-1AA✓1 Site' Location, M nn l_ � Atl h� , - - °7 - Building'construction begun `'Extent Is roe within NYC Watershed . Yes 0 No P P rty. . � ................. SECTION B. TOPOGRAPHY (Please check all appropriate boxes) 1. [7 Hilly. f7 Rolling Steep slope F7 - Gentle,slope Flat 2. Evidence of wetlands Low area subject to flooding 'Bodies of water 0 Drainage ditches Rock outcrops 3. Property lines or corners evident ............... ...... a '� s No 4. Do watercourses. exist on or adj om the properly .....-;*. ................ C -./... Yes F7 No 5. Will these affect the design of the sewage system facilities ?............ Yes 'No 6. Do watershed regulations apply in this development ? ......................: Yes F7- No 7 Will extensive grading be necessary? ........................................... I....... Yes 7---j/No 8. Will extensive.fill be necessary for SSTS? ......... ........................... ..... F7 Yes No: 9. Do filled areas exist Mthinthe "SSTS area? ........ ............................... a Yes ErNo. If yes, what is the condition of the fill? a SECTION C. SOIL OBSERVATIONS 10. Appearance of soil: - . Sand Gravel Loam Clay 0 Hardpan a Mixture 11. Observed from: 0 Borings 0 Bank cut [ZJ Backhoe excavations 12. Soil borings /excavations observed by a, 1Zeej ,17 on 8 0 13. Depth to groundwater QA-)JE on 14. Depth to mottling x )o&) F_ __ _ on 15. Are test holes representative of primary & reserve areas ... ...................:....:...... No 16. Soil percolation tests made by ec+�Qk.,; /� ®� r on 17. Soil percolation tests witnessed by �i Sze -oZ on SECTION D (on back) Form ST -1 2 SECTION D. DRAINAGE 18. Will proposed grading materially alter the natural "drainage in this or adjacent areas? a Yes No 19. Will groundwater or surface drainage require special consideration? .::.................. Yes No 20. Will gullies, ditches, etc„ be filled and watercourses Abe relocated ? ......................... Yes ff��No SECTION E. REMARKS 21. If a common water supply is proposed; .has an inspection been made of the existing or proposed source and facilities? ............................................. :................... D Yes No Inspection data 22. Do adjacent wells and /or sewage systems exist? ..................... ............................... a Yes No 23. Additional comments 24. Site observer /inspector -and title �- 25. Date(s) of observation(s)inspection(s) 1 03 /© TEST PIT PROFILES T. Hole # Lot # Hole # 'Lot # Hole # Lot Depth to water Depth to water .Depth to water Depth to mottling Depth to mottling -Depth to mottling Depth to rock/imp. Depth to rock/imp.. Depth to rock/imp. G.L. G.L. G.L.. . 0.5 .0.5 .0.5 1.0 1.0 1.0 2.0 2:0 2.0 3.0' 3.0 3.0 4.0 4.0 4.0 5.0 5.0 5:0 ' 6.0 6.0 6.0 7.0 7.0 7.0 8.0 8.0 8.0 9.0 9.0 9.0 10.0 10.0 10.0 I I BRUCE R FOLEY Public Health Director ATTENTION: LORETTA MOLINARI RN., M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road —Brewster, New York 10509 REQUEST FOR FIELD TESTING. ❑ JOSEPH PARAVATI 0 GENE REED All information below must be ufy completed prior to any scheduling. ENGMEERORFIRM: Zarecki & Associates, LLC REASON: DATE. 8/4/05 PHONE #: (845) 855 -3771 DEEPS: X PERCS: 4c PUMP TEST: ❑ ROAD /STREET:a TOWN: gg„cn� TAX MAP #: _ 3 -1 -72 SUBDIVISION: LOT!#: NIA t l s OWNER: APV DEVELOPMENT, I , LEC 1 l l a'ct�l l NYCDEP CRITERIA FOR JOINT REVIEW AND YMNESSING OF SOIL TESTING YES NO ❑ 91 Proposed SSTS within the drainage basin of West Branch or Boyds Corner Reservoirs. ❑ W Proposed SSTS within 500 feet of a reservoir, reservoir stem or control lake. ❑ IN Proposed SSTS within 200 feet of a watercourse or a DEC wetland. ❑ ti Proposed SSTS design flow greater than 1000 gallons /day or SPDES Permit required. ❑ w Proposed SSTS for a Commercial 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 answered yes to any of the questions, NYCDEP must witness the soil tests. This Department will coordinate a mutually suitable time for field testing with 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 tests, it will be the sole responsibility of the design professional to schedule re- witnessing of the soil testing with NYCDEP. /a 1 FOR E ONLY DATE: TIME: COMMENTS: (FIELDTEST) i eZARECKI & ASSOCIATES, L.L.C. Engineers - Surveyors • Architects 11 West Main Street PAWLING, NEW YORK 12564 (845) 855 -3771 FAX (845) 855 -3772 TO: Putnam County Dept. of Health 1 Geneva Road Brewster, NY 10509 WE ARE SENDING YOU: ® Attached ❑ Shop drawings ® Prints ❑ Copy of letter ❑ Change order 1 � i I I �� � DATE: 9 -8 -05 1 JOB NO.: 2005.023 ATTENTION: Mr. Gene Reed RE: Velardi 2- Lots /Cushman Road Pawling/Patterson, NY ❑ Under separate cover via ❑ Plans ❑ Samples El the following items ❑ Specifications COPIES DATE NO. DESCRIPTION 1 8 -4 -05 Request for Field Testing Application 1 7 -5 -02 Subdivision Map -Filed Map 11414 prepared for Velardi 1 8/05 Survey of Property prepared for Velardi THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ® For your use ❑ Approved as noted ❑ As requested ❑ Returned for corrections ❑ For review and comment ❑ ❑ FOR BIDS DUE ❑ Prints returned after loan to us REMARKS: COPY TO: SIGNED: ❑ Resubmit ❑ Submit ❑ Return copies for approval copies for distribution corrected prints If enclosures are not as noted, kindly notify us at once. Client Copy NIF ROBERTS N/F LENTEX CO. ! i 7g5870 e \ al % �c�.` -�,cr 22858• TOPOGRAPHY SHOWN FROM ACTUAL FIELD SURVEY IN ASSUMED DATUM. J Jai •,` �� ...� ... - _. - -- - -- ; -...� L"o O z� S N�0 00, -\•° d O -� REA = j F 54 AC`. NIF ROBERTS