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Home My WebLink About0127DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 3.20 -2 -9 BOX 2 00127 A;�� *� W Y wzLL UVr1r11z11V1V Ar!rVLSl DEPARTMENT OF HEALTH Division Of Environmental Health Services PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use Only WELL LOCATION STREET AOURESS: T-OWNIVIEDIGLICIly TAX GRID NUMBER: South Street Patterson, NY WELL OWNER NAM AODRESS: George Tremblay, Jr. South Street, Patterson, NY PBIVATE ❑PUBLIC USE OF WELL 1 - primary 2 - secondary XiESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP ❑ ABANDONED ❑ BUSINESS O FARM ❑ TEST /OBSERVATION ❑ OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT 5 gpm. /N0. PEOPLE SERVED 5 / EST. OF DAILY USAGE gal. REASON FOR DRILLING %REPLACE EXISTING SUPPLY ❑TEST /OBSERVATION ❑ADDITIONAL SUPPLY []NEW SUPPLY (NEW DWELLING) ❑ DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH 700 ft. STATIC WATER LEVEL 22 ft. DATE MEASURED 7/14/92 DRILLING EQUIPMENT ❑ ROTARY )(COMPRESSED AIR PERCUSSION ❑ DUG ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ❑ SCREENED OPEN END CASING ❑ OPEN HOLE IN BEDROCK ❑ OTHER CASING DETAILS TOTAL LENGTH ft- MATERIALS: Xa STEEL ❑ PLASTIC D OTHER LENGTH BELOW GRADE 30 ft. JOINTS: O WELDED )M THREADED O OTHER DIAMETER —fi_. in. SEAL:)Q CEMENT GROUT ❑ BENTONITE ❑OTHER WEIGHT PER FOOT __19__ Ib. /ft. DRIVE SHOM YES ❑ NO LINER: O YES ONO SCREEN DETAILS DIAMETER (in) 'SLOT SIZE LENGTH (it) DEPTH TO SCREEN (ft) DEVELOPED? FIRST O YES ONO HOURS SECOND GRAVEL PACK ❑ YES O NO GRAVEL SIZE: DIAMETER OF PACK in. TOP DEPTH ft- BOTTOM DEPTH It. WELL YIELD TEST If detailed pumping METHOD: O PUMPED t tests were done is in- t )O(COMPRESSED AIR , formation attached? O BAILED ❑ OTHER :OYES ❑ NO 1P1ELL LOG If more detailed formation descriptions or sieve analyses are available, please attach. DEPTH FROM SURFACE Water Bear- in9 Weli Oia' Imeter FORMATION DESCRIPTION G70E ft. ft. WELL DEPTH It. DURATION hr, min. DRAWOOWN It. YIELD gpm. Land 2 . Soft brown soil. . 2 .700 Mediun to hard white limestone, 600 2 - 600 l/3 700. 6 - 0:. 25. WATER O CLEAR TEMP. QUALITY ❑ CLOUDY HARDNESS ❑ COLORED ANALYZED? OYES ONO ANALYSIS ATTACHED? ❑ YES O NO STORAGE TANK: TYPE Di0ragn CAPACITY GAL. 16 PUMP INFORMATION TYPE sulxnersihle CAPACITY L— MAKER GOULDS DEPTH 400. 7EH 7.412 �230T4- MODEL VOLTAG HP WELL DRILLER NAME MILL. DRILLIN , , ��. , A °DRI sS Putnam .Avenue slGt RE { ,, Brewster, NY R rt .1/ 07 ELLIS A. TARLTON LABORATORY DIVISION OF ELLIS A. TARLTON, ENGINEERS, INC. CHEMICAL 34 PLEASANT STREET DANBURY, CONN. 06813 -2328 WATER - WASTEWATER PHYSIta`AL ` METHODOLOGY BIOLOGICAL P.O. BOX 2328 203- 748 -7903 APHA - EPA - ASTM REPORT OF BACTERIOLOGICAL AND CHEMICAL EXAMINATION OF WATER NAME AND ADDRESS OF F— Mill Drilling, Inc. PERSON TO RECEIVE Putnam Ave REPORT Brewster, NY 10509 DATA 7 J SOURCE OF SAMPLE Water Supply, Tremblay Res. South S -treet Patterson, NY DATE OF COLLECTION JUly 14, 1.992 COLLECTED BY Mill Drilling Hydrogen Ion Concentration COLOR TURBIDITY ODOR CORROSION INDEX LANGELIER DISSOLVED SOLIDS (pH) RYZNAR NTU Mg /L Alkalinity as CaCO3 Bicarbonate Fluoride (F) I Nitrite Mp /L A1g /L Mg/l. Nitrate Mg /L Alkalinity as CaCO3 Carbonate Mg /L Chlorine Residual .00 Mg /L NITROGEN CONSTITUENTS AS NITROGEN (N) Ammonia AAg /L Total Hardness as CeCO3 MO /L Conductivity Micromohos /cm Mg/l. Iron as Fe Mg /L Mg /L Chlorides as CL MO /L Manganese as Mn Mg /L Mg /L Detergent as MBAS Mg /L Sulfate as SO4 Mo /L Mg /L The arithmetic mean of all standard samples examined per month using the membrane filter technique %hall not exceed MEMBRANE FILTER TEST one colony peg 1100ml. Goliform colonies per standard sample shall not exceed 3/50ml, 4/100m1, 7/200mi, or 13 /500.1 Collier. Colonies /100ML In: (a) Two consecutive samples; (b) More than one standard sample when less than 20 are examined per month: or (c) 0 More than live per cent of the samples when 20 or more are examined per month. AT THE TIME THE SAMPLE WAS SUBMITTED: 1. The.resulls of the analysis of this sample were satisfactory and met requirements for a potable water. 2. The results of the analysis of this sample were satisfactory for a potable water but certain of the chemical or physical constituents were high. These are as follows: 3. This sample was not satisfactory since it did not meet the bacterial requirements for potable water. The presence of organisms of the coliform group in a sample of potable water is undersirable and, while not necessarily indicating the presence of any disease- producing organisms, does indicate that such contamination might to the same extent. The presence of organisms of the coliform group may also Indicate that the treatment was no! adequate at the time the sample was collected. e. This sample was unsatisfactory as a potable water because certain chemical or physical constituents were above acceptable limits. These are as follows: COMMENTS The bacterial analysis showed no organisms of the coliform group at the time the sample was collect.ed which indicated the water potable. Certified ' ' DEPARTMENT.OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT # P_ K4'Ll WELL LOCATION Street Address South Street .. Town /Village /City Tax Patterson NY Grid Number WELL OWNER Name George Trenbla ..Address Jr.'.,' So, Street Patterson NY X) Private o Public USE OF WELL 1 - primary 2 - secondary )(WESIDENTIAL O BUSINESS ❑ INDUSTRIAL ❑PUBLIC SUPPLY QAIR /COND /HEAT PUMP O FARM ❑ TEST /OBSERVATION b INSTITUTIONAL O STAND -BY 13ABANDONED ❑ OTHER (specify O AMOUNT OF USE YIELD SOUGHT 5 gpm /# PEOPLE SERVED 4 /EST. OF DAILY USAGE gal REASON FOR DRILLING EJNEW.SUPPLY O PROVIDE ADDITIONAL SUPPLY MEPLACE EXISTING.SUPPLY.. O DEEPEN EXISTING WELL (:]TEST/OBSERVATION DETAILED REASON FOR DRILLING Shallow well point. Water- is.. contcminat with c0 1 om and t ere ore unusable, WELL TYPE X RILLED ®DRIVEN ®DUG ®GRAVEL O OTHER IS WELL SITE SUBJECT TO FLOODING? YES )0( NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: hl a -Lot No. WATER WELL CONTRACTOR: Name MILL DRILLING..INC, Address: Putn Avenue, Ty .nr 1 IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES )Q�_NO NAME OF PUBLIC WATER SUPPLY: p/a TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAINWa LOCATION SKETCH.& SOURCES OF CONTAMINATION PROVL )E]ON REAR OF THIS APPLICATION TE WT 7/2/92 (date) (signature) Rohprt M. Mi11. President- TIM DRILIING-, INC, 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 well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form p vided by the Putnam County Health Deportment. Date of Issue: 1/ 19 7 �' � �w Date of Expiration: �1 Ui19 ermit Iss i fficial Permit is Non - Transferrable (-,13: 25HN H-T.L11-1 l•iLL L.IMILL11-40 I Ll r otnUOD r . ula� lici i for Well Permit frcm Mill Drilling, Inc. for George Trffiblay,, Jr. sj�� George 1"retlay, Jr, So. Street Patterson, NY ..Ilk DAVID D. BRUEN County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services March 27, 1986 Mr. & Mrs. George Tremblay South Stret PO Box 184 Patterson, New York 12563 RE: House conversion TM 4, B1 8, Lot 11 (T) Patterson Dear, Mr. & Mrs., Tremblay: JOHN SIMMONS, M.D. Deputy Commissioner This Department has received your letter dated March 20, 1986 regarding the conversion of your five - bedroom, single - family dwelling into a two - family residence. An inspection of the site was made by this office on March 26, 1986 and the septic system appeared to be in good working condition. Consequently, this Department has no objection to the above noted conversion of your house, provided that no additional bedrooms are constructed. Please note that the actual conversion of the dwelling is in the purview of the Town Building Inspector. Kindly advise us if there are any questions. V y t ul y yo s, i L� Michael J. Bu zins i Public Health Engi e r MJB:mk cc: J. Calbo, BI (T) Patterson JK File TWO. COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 VIC, L", da i ki ski" 'o da, a ti c�l A,E Wp 14 CV P #'e r l U /0L i,?,F /CL cz AL "- I-gal(cIll'-I r 4, 6 4o A A) c s aw "CT C� Z- e. 17 0/2 7/C�-') to lam, ( a, lZ21c-,ki x �'"-z_ %' �_ z`". 7c: j � � � c� ?`Gi � �: C�c � r � lam � c� 7�l � S� .1�% � 5 ��+ u lDt G.J� � ��'�E�� ecc, 6 f CHRISTINA *SOUTH STREET & GEORGE TREMB LAY P:O. BOX 184, pATTERSON., NY 12563 UA�rk t7-- �7 VIC, L", da i ki ski" 'o da, a ti c�l A,E Wp 14 CV P #'e r l U /0L i,?,F /CL cz AL "- I-gal(cIll'-I r 4, 6 4o A A) c s aw "CT C� Z- e. 17 0/2 7/C�-') to lam, ( a, lZ21c-,ki x �'"-z_ %' �_ z`". 7c: j � � � c� ?`Gi � �: C�c � r � lam � c� 7�l � S� .1�% � 5 ��+ u lDt G.J� � ��'�E�� ecc, 6 f