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HomeMy WebLinkAbout0183DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 4.10 -1 -23 BOX 3 00183 PUTNAM ANALYTICAL LABORATORY 10 Stoneleigh Avenue Collection Depot of YORKTOWN MEDICAL LAB INC. Carmel,'N. Y. 10512 225 -5563 X992 #1545 YML#13862 RESULTS OF. EXAMINATION OF WATER DATE COLLECTED 8/6/79 OWNER DATE RECEIVED Hal Barrett. (.builder) 8/6/79 CITY, VILLAGE, TOWN & /OR NAME OF SUPPLY DATE REPORTED ' South Qauker Hill Road, Patterson, New York 8/8/79 SAMPLING POINT well @ above address BACTERIA PER ML. (Agar plate count at 35 0C.) 5 CHLORIDES (CI) - mg. /1. (F) - mg-A. COLIFORM GROUP (Mcst probable No./l 00ml.) 0 Mr T NITRATES (as N) - mg. /t. 3i RESIDUAL CHLORINE AS RECORDED AT SAMPLING POINT I POINT OF TREATME141 I I I These results indicate that the water was YES of a satisfactory sanitary quality when the sample was colle ted. n A. H. PADOVANI, M. T. (ASCP) 0 WELL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH 3/71 / Division of Environmental Health Services f COUNTY OFFICE BUILDING - CARMEL, NEW YORK This report is to be completed by well driller and submitted to County Health Department together with laboratory report of analysis of water sample indicating water is of satisfactory bacterial quality before certificate of construction compliance is issued. REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION OWNER NAME Charles Tucker ADDRESS 16 N. Goodwin Ave Elmsford, NY LOCATION OF WELL (No. & Street) (Town) (Lot Number) 28 Saginaw Rd.. Patterson, NY PROPOSED USE OF WELL F_V1 BUSINESS DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ TEST WELL if ) 11 SUPP Y ❑ INDUSTRIAL ❑ CONDITIONING El (Specify) DRILLING EQU PMENT OTHER ❑ ROTARY � A R PERCUSSION 1:1 PERCUSSION El i ) CASING DETAILS LENGTH (toot) 22 DIAMETER (Inches) 6 WE: HT PER FOOT 19 a THREADED ❑ WELDED —I E S O X YES ❑ NO CASING ED? X YES NO TEST ❑BAILED ❑PUMPED LJ COMPRESSED AIR HOUR G.P.M. 1 O YIELD (G.P., 1 O WATER LEVEL MEASURE FROM LAND SURFACE —STATIC (Specify toot) 23' DURING YIELD TEST fleet) total drawdown Depth of Completed Well in feet below Land surface: 480 t SCREEN MAKE LENGTH OPEN.TO AQUIFER (feet)' DETAILS SLOT SIZE DIAMETER (Inches) IF GRAVEL PACKED: Diameter of well including gravel pack (inches): GRAVEL SIZE (inches) FROM (feet) TO (feet) DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET 0 6 overburden 6 480 ledge If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL COMPLETED DATLE VffPORT WELL DRILLER (Signature) d Owner or Pu c aser of Building ng Constructe /14erjelo Municipality Section -i, M. Z_ Location ZL.Preet Block Bu li dlng Type,- Lot GUARANTY OF SEPARATE SEWAGE SYSTEM I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage disposal system serving the above described property, and that it 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 guaranty to the owner, his succes- sors, 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 initial use of the sewage disposal 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 occu- pant of the building utilizing the system. The undersigned further agrees to accept as conclusive the de- termination of the Director of the Division of _-Hhvironmental Health Ser- vices 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 9 act of the occupant of the building utilizing the system.�� Dated this 7 day of (J�LA\ 19� Signature ,z T- . Title ! �� If corporation, give name and address) THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION WILL BE ISSUED. GUARANTOR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM. Division of Environmental Health Services, Putnam County Department of Health G AA E-� Address'.— Owner Ae:,t4 C I-ot A 4 'k� Building T­ Area Number *-Bedrooms Total Habit Separate Sewerage Systern'...t.o. consist of Gal Septic Tank. and v" VAM�r M Square Fee To be constructed by r= � Address q 77777T- Water Supply: Pg.b.l_ic Supply From iT t 7., Ty r Priv te. to be drilled by LA� a u Address on Other Requirements I represent Ahat .1, im'wh-olly'.arid.-completely, responsible for tfiedesignano location of the proposed system(s); 1) that:.top separate seNivige,dispoml system here'- PuR above described will.,be constructed as shown on the approved'arnendment t ' -to and in accordance with the standards, �#Ies an 'o?­'JT7e nam County Department of ..Health, 4ndthitcn completion thereafa"Iceirtificate of Construction C�ompliance" . satislacto-,y to the-Commissi.ne'r of Healthwill be 'submitted to the 6ep6rtme'nt;' and 'a written guarantee will.be furnished the owner, his successors, heirs 6r::asiighs,by-the'tiuilder, that said builder Will place in *good operating c6nditioiri- any part of said -sewage disposal system during' ' two (2) years immediately-following the,date of the issu., the - period 0 ance 'of. the' apOr6vii;-Ic4.'thb ceWiificiie of.-Consti6ctid'n Cornp !ianc .-e �of.'the* original system 4or iepaiis theretc; i) Wai-the' drilled well,- described' above, pian a instal and reguiTtionS t, rd will be located as sihbwh on'tifi nd that sa�id willwiill be e in accordancii. w -hr' standar"di.-4616i" hLe, :.P nn_,��.x County Department !df Health . P ' Date Signed' Address ♦ Licens N STRUCTIOW'Thl! t- iss ­n_ d �u - EdristAidtidii -of the -..bUilding ha bd' APPROVED FOR' ON alipro,41 expires one V6a n q C, s . eK.-undvrtal,(6n 'and 'is u Ae? �Ue sMoner .of Any c ange, or alteration of construction revocable for cause or 'may, be-amended or cl hen considered necessary by­the C h re quires a new It; pr. ply* only permit. Approved for disposal domestic Ir sa age, . f"2 or pri ater sup .29 Date By Title.- 3 PUTNAM ,COUNTY DEPARTMENT OF HEALTH Division of. EnVironmenta/ Hea /th SerGices; :Carme% N. Y f0512 , r - CONSTRUCTION PERMIT - FO.R::SEWAGE. DISPOSAL <SYSTEM _Qt �• (5.?J� Town or 'Village a l Located at�+.�0� �1t�1 Section Block Subdivision Lot' Job AIDOA Owner ,0�Q8e, is &AL Address fib, 'J S6i t� ' Building TYPe "e�(�E�G Lot Area- •��-'� 1V!•(C'_ �. i i ©�.� Number of. bedrooms.' _ Total Habitable Space ­Square Feet Separate Sewerage• System to; consist of 9Ci Gal 'Septic .Tank �3 (J lineal feet :X - �� width trench _ To tie constructed by ��, �� `�OA3�� Address Water SuPPIy Public-.SuPPIy From ` - �Priyate Supply, to be drilled, by . - Address : 1 Other Requirements S Irrepresent that l am wholly and completely.responsible -for the design and location, of the proposed -system(s)y 1) that the separate sewage disposal system . r above:descr�bedwiIi be constructed as st own on .the approved amend mentthere to and in' accordance -with the'stantlar`ds,:rules an regulations o the, u nam f County :Department 'of Health, and;ttfat on completion'thereof,a "Certificate of,Construeflon Cornpliancel,. sati5factoey to the Comm"issionei.of HealthwilP be submitted to the 'Department-, -and `a .written-guarantee' will;'be furnished the owner, his succeiiors heirs or,.assigns by the_, builde"r -,'that said builder will ' place- in good`.opeeating. condition any (part, of `said..sewage disposal system during_the: period of two (2) years immediately following.thedate of the.itsu- i< ance. of the approval :of the: Certificate' of Con-structiom Compliance of the original system or any`:repairsfjh'ereto;2)'that the drilled_we16 described above Will be- located as shown on the approved -,plan and that said well will be installed in 'accordance with °.ttie $ dp id' s; .rules and -- regulations of the ',Putnam 3 County Department 'oofHealthh, // Date " '' V`�`' f l i e� r` Signed F E ' v { - � r Address -�� 7_t� 5 Licens o � 9 D �r - - „- - _ ., - yy , A:PPROVED,F -,OR CONSTRUCTION: This approval expires one year from the date• issued —less con'strf�ct�on of tFie` building has been undertaken' and is - kevocable. for-,cause or,rriay be arriended•ormodified When cdnsidered necessary by the-C" o Sioner. of Health Any - change -or alteration of construction requires a new permit: -Approved for of domestic y sewage and r w pl�i only .., �" Date �'�� BY it l PUTNAM COUNTY DEPARTMENT OF.HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO ���c�l— 10 Owner- �";�;�',�.1 l,il���_� Address �Ow"V-AA ii Located at ( Street � Block Indicate e neares cross s reet Municipality Pcj-an, Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole i; 10 Number CLOCK TIME PERCOLATION 3 PERCOLATION Run, Ejapse Depth to Water Water revel z I No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in _ Min. /in drop t Inches Inches Inches 2 t 4S i; 10 3 12 cC) z I 4 Q 4 5 1 2 3 4 Notes: 1) Tests to be repeated at same depth until apppproximatelyy equal soil rates are obtained at each percolation test hole. All data to be submitted for review. 2) Depth measurements to be made from top of hole. TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. HOLE NO. G. L. 611 12" 18" 24" 30" 36" 42" 48" 5411 60" 66" 72" 78" 84 l INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEIN TESTS MADE BY : DESIGN Soil Rate Used—,2(,- Min/1 "Drop: S.D. Usable No. of Bedrooms 7 Septic Tank Capacity —' U Absorption Area- Provided By 36" ;z HOLE NO. C ENCOUNTERED Date t 72 Area Provided C? _ Gals, ,! idth - trench. ivame �,�e_ �- k'� l i_ -IV. _, bignature ; , Address Ss�� SEALS ,��� #,, zarr �: c THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft /Gal. Checked by Date •^4.3 �,r; � j � ':,'�^�"� S+r 7.!'� � � �, �'6b5� l °� `• fD uS. " I I„ - � .� .. !. ad ttp P' 1 N�. J4 W Jl IzA ION t o. 4 p .R I f�,7.7:5*"�t� .�.1j9�'•�� ..:� W'VM�Cl�.... jf�i; ; °�i - 1 � ' � � i f$ . - y i f. i ,; �� 1?T4 'Ts � jiouse plans OAK. Porcs presoaked? Conck. results for 3 runs » :vlv log "K Corporate AM vidual Authorization for erigifiieer letter from Water Supply 11' applicable If variance requested-such noted on plans S; apps if charge is proposed,) Existing corybcurs shown Rhow new contours) Slopes for driveway cuts, etc. shown. Uater sei-vice line location Footing.drain, etc. location I Top slope, bottom slope of f Ir4 i 0-1 Percolation tests and deep test pit location T L 0 IAJ Septic tank size and conformance to std. 3 B.B. house minimum House setback shown Plan and profile SrZ shown or reference made Property boundaries (metes and bounds-cleariy shown j VCTHF '0 1 to Foundation walls 01 to Nearest well 51 to Curtain drain D I to water line (pits-201 .51 to storm drain .11 Al .01 to large trees 01 from foundation to septic tank 5 to pipe from leader drain & f6d­t�l�ngrdln ) / | � / Date • 1 . . ' Insp.by- 1111T.YML 23I1•E II'SPEC 10711 Yes No Ccm!ron.ts Prcnc -ty lines or corners found . ..i estimate house location . . . . . . . Will driveway reed cut . . . . , I✓ruo trees be rereoved -note these Is deep hole representative of ent_re SDS area _ Additional deem 'r :cles needed. Sufficient SES area available considering driveway cut, house iocation,.separati on . . . distances, etc. DEEP ?IDLE, DAM ' Dapth:• � Water elevation: Rock elevation: - Soils description: ' . te: .� FINAL SITE 'IT'SFECTIO ?? nsp. by:, House located where shown on approved plan. . -. 1G't9;;'1:4t -v!' 'h�t3rsc— {"•f "i•r�a�u�0_.__ -:� Width of trench average � Slope of tole line and trench acceptable '- .. i - -. '" Room alloyed for expansion trenches Over 50 ft. from s*.•:amp,...atercoarse . . . . .. .Natural soil not stripped or SDS area _ unnecessarily graded . . . . _ 10 Ft. maintair-ed from prop.lino and / 20 ft. from house . . . . . ✓ Separation of trench from.,house, well ` etc. follows plan . . . . . . . . . � Number of bedrooms checks . . Stones, brush, stumps, rubble, etc. .--eater than 15 ft. from nearest trench 15 Ft. of peripheral soil horizontally from trench . . . . . . - . . . . . Junction boxes prope_•ly set Could surface run off from d^iveeray, roads, ground surface, etc. channel near SDS, , area . . . . Does lot drainage appear O.K. in area of SDS FIDI<'L GRID-LNG OF SITE ACCEPTABLE MIN TYPICAL CONC. SMTJ SEPTIC TANK 4w N wk 4-r low lug- Aug We 4. ID P *ISN 'FIRST 'SYSTEM FOR T1 14c, 510c ROWARO lick (ZAE NEW To Te-zs6l'i Wk OF PAI, 75 M d bate OrcOng No.