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Home My WebLink About0050DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631 - 589 -8100 3.15 -1 -1 BOX 1 00050 ') Y ± 1,117. ��.A WAR 6 J661 00050 Sent By: TOWN OF CARMEL ENGINEERING; 9146287085; JUN-lb-00 SAT 9:07 AM PUNAM Cloy ENV HEALTH Sep -8 -00 13:08, FAX N4. 19142787921 Page 1/1 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIUtONMwTAL HEALTH SERVICES ATTENTION ❑ ADAM GENE A DZ EM MAY INSPECILQW For Fill AS infoMation must be &lly completed prior to any Trenches �s iospections Was made. PCHD Cowuu ' F it # Located: L (I) (M — 417yow N Owner /Applicant Name: TM_ $lock L Lot J_ Formerly: Subdivision Name: Subdivision Lot # Is system fill completed? Date: Is System complete? Date: 9 Is system constructed as per plena? Is well drilled? l�aCr S' Date: Is wail located as per plans? Are erosion control measures in place? I certify that the system(s), as listed, at the above premises has been coamucted and I have inspected and verified their completion in accordance with the issued PCHD Coasttucdon permit and approved plans and the Standards, Rules and Regulations of the Purnam County Department of Health. Date: Certified by: _ 1ltA Design Professional Address: y Lic. # S-32-77 : Commeots: ( 12J; 3 Form FIR-99 P. 1 PUTNAM COUNTY DEPARTMENT OF HEALTH s DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE INSPECTION Date: y i oz Inspecte ?��n Street Location L�A,P/'1 oNE y /l /GL 1P�e. Owner G� 0 �,42EM Town P,1 rT,�re 9,A/ Permit # a /D - o® TM #_ 3 ; -5 - f - 1 Subdivision Lot # 1. Sewaee Svstem 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. Sewage S stem a. Septic tank size - Cl;evel ......... 1,250 ......... other ........... b. Septic tank install ..... ...... ............................... 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 & trenc e. Junction Box - properly set ........ ............................... f. rT encT es T_-E-en-g-th required /00 Length installed 1 F 2. Distance to watercourse measured lDo Ft..... 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' /z" diameter clean ............... 9. Depth of gravel in trench 12" minimum .............. 10. Pipe ends capped ................................... ................ g. PumR or Dosed Systems Size ot 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.estimated flow /cycle.... III. House/Building a. House per approved plans ............................ b. Number of bedrooms ................. ............................... IV. Well a. Well located as per approved plans .......................... b. Distance from STS area measured 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 p f. Curtain drain outfall protected & dinto exist water( g. Footing.drains discharge away from STS area........ h. Surface water protection adequate ........................... i. Erosion control provided .......... ............................... r3 , 14 < ° 1 a M i Y A it f :is is m ~ .:� :mot 506 Al 1A ft ' r \ 5C)' x IQ- y .rte ✓ f y v�`~ \ f, _ - i