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00187
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
WELL COMPLETION REPORT
Well Location
Street Address:
19. QULikele M
Town/Village:
)04.1 1,
Tax Grid #
Map Block Lot(s)
Well Owner:
Name: Address:
br HarpCi- IVY 125Z y
Use of Well:
1- primary
2- secondary
Y Residential Public Supply Air cond/heat pump Irrigation
Business Farm Test/monitoring Other(specify)
Industrial Institutional Standby
Drilling Equipment
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 ZJ ft.
Length below grade 2-0 ft.
Diameter 6 in.
Weight per foot /9 1 /ft.
Materials: _ Steel Plastic _ Other
Joints: _ Welded Threaded _ Other
Seal: _Cement grout , Bentonite ! Other
Drive shoe: X Yes No
Liner: Yes No
Screen Details
Diameter (in)
Slot Size
Length(ft)
Depth to Screen (ft)
Developed?
First
Yes No
Hours
Second
Well Yield Test
_ Bailed _ Pumped _)� Compressed Air
Hours (a
Yield gpm
Depth Data
Measure from land surface- static (specify ft)
During yield test(ft)
Depth of completed well in feet
Well Log
If more detailed
information
descriptions or
sieve analyses
are available,
please attach.
S
Depth From
Surface
Water
Bearing
Well
Diameter(in)
Formation
Description
ft.
ft.
Land Surface
S_
If yield was tested
at different depths
during drilling,
list:
Feet
Gallons Per Minute
Pump /Storage Tank Information
Pump Type %50b Capacity
Depth 3$6` Model /&/0-/3
Voltage 2-30 HP /
Tank Type LtY Volume
Date Well Completed
z/o �L�
Putnam County Certification No.
003
Date of port
/D l D�
Well Driller, (signature)
NOTE: Exact location of well with distances to at least two permanent landmarks to be provid In a sep at sheet/plan.
Well Driller's Nam 1,9LI-f 4n ``S / 7C, Address: 10 v zt sz caau l %v %Cjrl Z
`Signature: Date:
'rite copy: File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller
Form WC -97
L,
Pi1'TNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONIVIENTAL HEALTH SERVICES
CERTIFICATE OF CONSTRUCTION COMPLIANCE FOMlage
ATMENT SYSTEM
PCHD CONSTRUCTION PERMIT # P "2- 9 7 Located at u �� lal pa�� AA Town or V
-J,4 J(e S'
Owner /Applicant Name ��� ,� n '�; ,�.���,r,L,.� Tax Map /'ill) Block Lot` `X %
Formerly Wes'- n4a-T �. � �L� Subdivision Name
Subd. Lot # 3
Mailing Address /u a L r /%ja 11 4 ..z Zip 1,2- 5z-'
Date Construction Permit Issued by PCHD e / su 1 `7:,
Separate Sewerage System built by 4 ,,L jC an Address
X- 2S'2
Consisting of Gallon Septic Tank and ff� J�Ej "(Ye r-06 S
Other Requirements: Pi�— ; FV7�,A.
Water Supply:
Public Supply From
or: Private Supply Drilled by 4c
Address
Address C Aye -,-1c1q-- 4 ti :; 71t -
Building Type Wu (;Q Has erosion control been completed? c�
Number of Bedrooms Has garbage grinder been installed? Q`fd
I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as-
built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved
plans and the standards, rules and regulations of the Putnam County Department of Health.
Date: f / 3 Certified by4-, M t' - P.E. R.A.
Address I I W A-S' ( flyc- 1� License #
( 2S-1 k
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
revocatio' dificati r change is necessary.
By: Title: (�., Date:
White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional
Form CC -97
r rc l tats :6 r ^ CESARE —ENG.. .
914 278 3656
Julius 1. Cesare, P.E.
19 Washington Court
Pawling, New York 12564
914 -855 -3208
FAX 914 -855 -3216
Nov. 30, 2000
Bruce Foley, Director
Putnam County Health Department
ATT : Robert Morris
1 Geneva Road
Brewster, New York 10509
RE: Quaker Manor SD Lot 3 As -built
10 Quaker Manor sane
t. of Patterson TM # 4.10 -1 -29
Dear Mr. Foley,
Please reference your letter of Nov. 27, 2000 regarding this
project. As per discussions with Gene Reed at the site, the
applicant has installed a 500 gallon auxiliary tank which in
concert with the previously installed pump pit provides for
the required dosage volume plus the,24 hour storage volume.
The location of this additional storage tank is shown on the
as -built plans now in your posseaoion.
Thank you for your cooperation in this matter.
Very truly yours,
Julius T. Cesare, P.E.
NNW M M_
P. 01
BRUCE R. FOLEY
Public Health Dfrectar
DE°ART.NLENT OF
1 Geneva Road
Brewster, New York
HEALTH
10509
LORETTA MOLINARI R.N., M.S.N.
Anociate Public Health Director
Director of Patient Services
Eoriroumental Health (914)279-6130 Fox (914) 278-7921
!iarslnq Services (9141270-6559 WIC (914)279-6678 Fax (914) 278.6085
Early Iaterveattoa (914) 2; 8 - 6014 11ruchool (914) 218 082 Fax (914) 278 - 6648
17033 F-111 0H Oki DRMT131 1814 111 to-UN I toles 11) It"4171
OWNERS NAME: A.I-V- D /-
TAY MAPNUMBER:
E911 ADDRESS: /L ft ooh G .4 tv4-
TOWN:
AUTHORrUD TOWN OFFICIAL:
(Si;�)ature)
DATE: d —
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
address is assigned by an authorized town official. This farm is to be submitted
,with the application for a Certificate of Construction Compliance.
(E91I ERFRM)
Julius I. Cesare, P.E.
19 Washington Court
Pawling, New York 12564
914- 855 -3208
FAX 914- 855 -3216
Nov. 13, 2000
Bruce Foley, Director
Putnam County Health Department
ATT : Robert Morris
1 Geneva Road
Brewster, New York 10509
RE: Quaker Manor Lot 3 As -built
t. of Patterson TM # 4.10 -1 -27
Dear Mr. Foley,
Herewith transmitted is a completed As -Built Package for the
above noted project.
Thank you for your cooperation.
Very truly yours,
Julius I. Cesare, P.E.
A
3
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TABLE
OF . DISTANCES .
X =
NE Corner
Property.:Rod.in
Stone'
Y =.
Point,
on IP.ro.perty� Line
-. (Stake),-
„
Z =
Point
on Pr.'opert' Line (Stake)..
XY -
127.3
XZ -
171,9
YA =
48.7
YB -
60.0
ZA =
39.5
ZB -
54.3'
Ac -
32
Ac`t - 77
Bc
- z9.
BC I . = `
62
` AD -
3'7
AL'i.= '81
BD
- 32
BD': -.'67
AE _
43
AE'- 8.5
BE
- 36%
BE' :_
70. .
AF' -
50
A . 91
BF
-` .40 •.
76
AG =
57
A rt 96
BG
-
47
BG-,''° -_
8'0
A•H :-
63
Ak 4. b0
BH
- 5.2
BH''. -°
8`5
AI -.
75
AI : sj5
BI
-.57
BI*". -
89.
AJ _
91
A --I 0
BJ
- '62
BV' -
..93;
K -
81
AK : !J6-
BK
- 6,9
Bk,. -
99, .. .
Al -
9.9
'AL'- 122-
BL
.- .75
BL! _
1;0.5
A -M
1, 1 3
B-M-
98
N -o
i 5
R� 3 0 �
14 -P
26 •
3-2'
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SG °Oa' oo "E 72 Co_z4�
PUTNA1\4 COUNTY I)1' PARTNIEN "I. OI' HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SN'STEM
Owner or Purchaser of Building Tax Map Block Lot
�►yio2 - {; �.� ! �- CoJ�Sry N-c.TJ U N �terS � —
Building Constructed by TownNillage
Location - Street Subdivision Name
r-10' l-..oT 3
Building Type Subdivision Lot #
I represent that I am wholly and completer responsible for the location, workmanship, material,
construction and drainage of the sewage treatment system serving 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-Counfy 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 an), repairs made by me to such system, except where the failure to
operate properly is caused by the willful or negligent act of the occupant of the building utilizing the
system.
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 0 1�' Day /,L/ Year 900 0 Signature:
„n Title:
Ger ontractor (Owner) - Signature
Corporation Name (if corporation) Corporation Name (if corporation)
Address: r4_
tress: �L� %�,JUer= -� % e
� -- �!�� -- - � 1
Suite 1s_�►k, �11�/ l.� 2 ^Z� State -- -..... — - -- -�lI' .._.
- - - -- -- - - - -- _ p ._1- _s --
Form GS -9-
NE
NORTHEAST LABORATORY OF DANBURY
39 MILL PLAIN ROAD - DANBURY, CT 06811 CT Cert: PH -0404
LABS (203) 748 -7903 - FAX (203) 748 -0652 NY Cert: 11471
LABORATORY REPORT -- WATER SUPPLY TESTING
REPORT TO:
MR. RICHARD ZIEGELMEIER DATE SAMPLE COLLECTED: 9/5/2000
10 QUAKER MANOR LANE TIME COLLECTED: 11:00 A.M.
PATTERSON, N.Y. 12563 COLLECTED BY: JULIE Z.
DATE RECEIVED @ LAB: 9/5/2000
cc:PUTNAM HEALTH DEPT. TESTED BY: LAB #11471
REPORT DATE: 9/11/2000
SAMPLE SITE:
AS ABOVE
SAMPLING POINT:
BATHROOM SINK
SOURCE:
WELL
TREATMENT:
NONE
TEST PERFORMED
RESULT:
MAXIMUM CONTAMINANT LEVEL
BACTERIAL:
Total Coliform (Bacteria)
0
per 100 ml
0 per 100 ml
PHYSICALS:
Color
0
15
Odor
ND
3 Units
pH
6.64
no designated limit
Turbidity
0.8
NTUs
5 NTUs
CHEMISTRY:
Nitrite N
<0.005
mg/L as N
1 mg/L as N
Nitrate N
0.23
mg/L as N
10 mg/L as N
Alkalinity
48.0
mg/L
no designated limits
Hardness
54.0
mg/L
no designated limits
Iron
<0.03
mg/L
0.30 mg/L
Manganese
<0.01
mg/L
0.30 mg/L
[Note: Combined Limit for Iron plus
Manganese = 0.50 mg/L]
Sodium
4.1
mg/L
20 mg/L **
Lead
<0.001
mg/L
0.015***
ml = milliliter
mg/L = milligrams
per Liter
ND = none detected NTU =Units
"Notification Level
* "Action Level
RESULTS BASED ON SAMPLES SUBMITTED:9 /5/2000
SAMPLE, AS TESTED ABOVE: X or MINOT POTABLE
(PER NEW YORK STATE DEPT. OF HEALTH SERVICES STANDARDS FOR POTABLE WATER)
Laboratory Director
*NORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 06037• (860)828 -9787 - FAX (860)829 -1050
TOLL FREE WITHIN CT: 800 - 826 -0105 •OUTSIDE CT: 800- 654 -1230
-
mv
Sheet of
PUTNAM COUNTY DEPARTMENT OF HEALTH -
DIVISION OF EN VIRONIVIENTAL HEATLH, SERVICES
FIELD ACTIVITY - REPORT
:
A,T)T)RFSR.
Street _ Town
='_ State Zip
PERSON IN CHAR-GE:r
p
(1R TN-TFRViF1NFT)
Narne and: Title
Tll
TYPE. OF F.,ACILITY
FINDGS -:
IJJ
J
1, 67e ' 3
4 h
Sw
YS
3 G
b
-
h.
''44``
qM
l
r
J
• Y T LM
w
rA
u
f _
r
7L
V
r
-
_
5
:ILLSPR(`MR�
2 ^ -
Signatute and Title
- 'RPP0RT RRr1- TV,Rlj Ni.
acknowledge,receipt of this report SIGNATURE:
402196 Title.
-
PUTNAM COUNTY DEPARTMENT OF HEALTH
n DIVISION OF ENVIRONMENTAL HEALTH SERVICES ��
a. FINAL SITE INSPECTION o 6.
Date: 7 0c,
Street Location TtZ Inspecte y:
rQS,4= x„14„ =r r., f
Town Permit # P — a ;z — 9 7
TM # eV, / c� — a 5 Subdivision Lot # �f'0„ow
1. Sewage System Area
a. STS area located as per approved plans .......... .......:.....:...
b. Fill section - date of placement
3:1 barrier Lgth. Width Avg.Dpth
c. I Natural soil not stripped ...................................................
d. Stone, brush, etc., greater than 15' from STS area..........
e. 100' from water course / wetlands ...... ...............................
III. Sewage System. ,
a. Septic tank size - 1,000 .......C,�� .. ......other.........( '
b. Septic tank installed level ................ ...............................
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 & trenches
e. Junction Box - properly set .:......... ...............................
f. Trenches
T.eng —th required 94 Length installed p
2. Distance to watercourse measured -t-1 d o 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 .................. --3
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. Pump or Dosed Systems
1 Size o pump chamber .............. ..............................Q
2. Overflow tank ........................ ............................... ==
3. Alarm, visual / audio ............:...... ................................ A
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 of Gated per approved plans..
b. Number of bedrooms ......................41... rZ................
IV. Well /4 a.—Well located as per approved plans . ...............................
b. Distance from STS area measured f ;L,0,9 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 plan..
f. Curtain drain outfall protected & dir.to exist watercourse
g. Footing drains discharge away from STS area ...............
h. Surface water protection adequate ... ...............................
i. Erosion control provided ................. ...............................
Rev. 6/97
COMMENTS
f%yp la ,r g o,1<
ad1� ,Z S�eer� (eve(�r5 %n bex
5oine are aep��% Two
,Fx-posc 7".x'w k
f4p,e en r s <�i hs,
-o
o� S�`l�
6.
BRUCE R. FOLEY
Public Health Director
DEPARTMENT OF HEALTH
1 Geneva Road
Brewster, New York 10509
LORETTA MOLINARI R.N., M.S.N.
Associate Public Health Director
Director of Patient Services
Environmental Health (914) 278 - 6130 Fax (914) 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
Date: S/ 7 za
To: X;L / a!5 G S. -K 9 Fax #: 86-6-3a16
'72e� Loar 3
From: Gene D. Reed
Putnam County Department of Health
✓ For your information
For your review
As discussed
No. Pages -a-
(Including cover sheet)
Please respond
Attached as requested
Please call
Notes/Messages
r
.►.
In the event of transmission /reception difficulties, please contact this office at
(914) 278 -6130 ext. 2261.
]pUTNAM COUNTY DEPARTMENT Of. HEALTH...
y ISION. OF ENV UONMENT AL HEALTH SERVICES
I - j
#ORSIEWAGE TREATMENT SYSTEM .�.
M
Z JV
7.
Ad Date.
.�L 0 "License #.
W4. .6m the datt issued unless wnst`k6hn dthe
AJRPR0VItDF0R.00XftRtjCn0N- IWs approval niiri$
sewW ununent jysim has been compided and inspected by the PCHD W is rovociblo for cause or may be am ifiadd or
"
modified wb94onsidered necessary by the Public Health Dir wilor. Any revision or alteration of the approved plan requires
a new pe, prov discharge of domcWc
By:
White copy - HD File; Yellow copy • Building Inspector; Pink copy - Owner; Orange copy - Design Professional
FoMCP -97
20,;j 9G92 84Z VT6 "-5N3-3NUS33., t1t1:40 nHI ee-20 -nno
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONME?YTAL HEALTH SERVICES
REQUSTLOILLWALINSPEC110IN Fors Fill
Trenches
PCHD Construction Permit # e— 2. Z- A e we •k 9 V �
Located &�t--- x4—o^ 4,w M (Y)
Owner /Applicant Name /Qcct/o�cu �► Ica- TM
DBlock— Lot
Formerly & Subdivision Name .. X L::tt id ww^
T9u' . Subdivision Lot #
Is system fill completed? Date
Is system complete? kes
Is system constructed as per plans? yes
`�
Is well drilled? ) T Date
Is well located as per plans?
Are erosion control measures in place?_,
I certify that the systcm(s), as listed, at the above premises has been constructed dad I have
inspected and verified their cotripletion in accordance with the issued PCBD Construction Permit
and approved plans and the Standards, Rules and Regulations of the Putman County Department
of Health,
Date: o { 1 a' Certified PBS" RA
Design Professional
Address 14 Y A;P .0b'W Oae-jr Lic. #L
f 't•�
,4,,-t r,-fa � j2 s`650
Comments: r�
r CAeA /t't,2 t.1 �Y .h ems` 1" ��r `t f
vulk-
-*A 2-4I --
uko �� -6*- cw�y --"9 & () CIO
FOR: p ADAM GENE
Form FIR. -99
I ,
FAX FORM from the OFFICE of +�
l
JULIUS I. CESARE, P.E.
19 Washington: Court
Pawling, New York 12564
PHONE 914 855 -3208
FAX 914 855 -3216
TO: C ,*-)'t V %c=��
of
FROM:
MESSAGE:
page 1 of I
Ea A, /*�o
DEPARTMENT OF HEALTH
Division of Environmental Health Services
4 Geneva Road, Brewster, New York 10509
(914) 278 -6130
APPLICATION TO CONSTRUCT A WATER WELL
PCHD PERMIT #_L
WELL LOCATION
S, Street Address
Town/Village/City Tax
Grid Number
WELL OWNER
Name
Mailing . Address 2a Co /ulorwc DA
-SCo� • 6 6s//
$Mrivate
0Public
USE OF WELL
CP - primary
2- secondary
O RESIDENTIAL
O BUSINESS
0 INDUSTRIAL
O PUBLIC SUPPLY O AIR /COND /HEAT PUMP
O FARM O TEST /OBSERVATION
b INSTITUTIONAL O STAND -BY
❑ ABANDONED
O OTHER (specify
Q
AMOUNT OF USE
YIELD SOUGHT S gpm /# PEOPLE SERVED_ /EST. OF DAILY USAGE Y-&-
0 REPLACE EXISTING SUPPLY ❑ TEST/ OBSERVATION GL ADDITIONAL SUPPLY
ANEW SUPPLY NEW DWELLING 13 DEEPEN EXISTING WELL
REASON FOR
DRILLING
DETAILED
REASON FOR
DRILLING
WELL TYPE
FRILLED
ODRIVEN
ODUG
GRAVEL
O
OTHER
IS WELL SITE SUBJECT TO FLOODING? YES �- NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:
adk/A< /11 Lot No.
WATER WELL CONTRACTOR: Name
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE:
Address:
YES NO
NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY
DISTANCE TO PROPERTY FROM NEAREST WATER MAIN:
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED
O ON SEPARATE SHEET
/h: -7, I
date) (signa
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 provided by the Putnam County Health Department.
During all well drilling operations, the applicant shall take appropriate action to assure that
any and all water or waste products from such well dAhi erations be contained on this
property and in suc a manner as not to degrade or oon urinate surface or grou ndwater.
Date of Issue: 19 Date of Expiration 19 Peng Official
Permit is Non - Transferrable White copy: HD File Pink copy: Owner
X3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Date 1G 2, /9'7c<
Re: Property of Wr-_- 'T' �_5T- IcCy,�LT-4 dZ. ro- n S C-77-
Located at Ro f-A QUA4e,-c 6411 /4
(T) Section /o Block /. Lot ' � Z-7
Subdivision of (Q-A4, R,4-yoR
Subdv. Lot # 3 Filed Map #? Date hol9 6
Gentlemen:
This letter is to authorize ! _f w�,u^ r I. L.ES ARC
a duly licensed professional engineer '� or registered architect
(Indicate
to apply for a Construction Permit for a separate sewage system, to
serve the above noted property in accordance with the standards, rules
or regulations as promulagated by the Commissioner of the Putnam County
Department of Health, and to sign all necessary papers on my behalf in
connection with -this matter and to supervise the construction of said
system or systems in conformity with the provisions of Article 145 or
147, Education Law, the Public Health Law, and the Putnam County Sani-
tary Code.
Countersign
P.E. , R.A. ,
Address'
Telephone
Very truly yours,
Sign 44—
Owner of Property
2� CaUZvNtA< �2 .
Address
( A -hle,, t 7
Town
3
-7 t 1- x7-7
Telephone
� r
D^r 1 1 THE CITY OF NEW YORK DEPARTMENT OF ENVIRONMENTAL PROTECTION
ti� /J /J JOEL A. MIELE, SR., P.E. Commissioner
PHONE (914) 742 -2001
FAX (914) 742 -2027
September 15, 1998
Mr. Julius I. Cesare, P.E.
Blackberry Hill
Brewster, New York 10509
RE: Quaker Manor - Lot #3
Log # 7180
Town of Patterson, Putnam County
East Branch Reservoir
Dear Mr. Cesare:
WILLIAM N. STASIUK, P.E.,Ph.D.
Deputy Commissioner
Bureau of Water Supply,
Quality and Protection
Enclosed please find the New York City Department of Environmental Protection's
(NYCDEP) SUBSURFACE SEWAGE TREATMENT SYSTEM DETERMINATION for the
above referenced property located on South Quaker Hill Road in the Town of,Patterson,
Putnam County, New York (Tax Map# 4.10 -1 -27, Lot #3).
This letter is to inform you that your application to engage in the above referenced
regulated activity pursuant to the "Rules and Regulations for the Protection from
Contamination, Degradation, and Pollution of the New York City Water Supply and its
Sources" (Regulations) was approved on September 15, 1998.
The Department reserves the right to modify, suspend, or revoke this approval based on
the grounds set forth in Section 18 -26 of the Regulations.
The activity proposed in your application only apply to the terms of this approval and are
subject to the Regulations cited above. Failure to comply with the conditions of the
approval may be the cause for suspension of this approval and initiation of an enforcement
action. Should modification, suspension or revocation of an approval be necessary,
NYCDEP will notify the regulated party, via certified mail or personal service, prior to
modifying, suspending or revoking the approval. The notice will state the alleged facts or
conduct which appear to warrant the intended action and explain the .procedures to be
followed.
Prior to the commencement of any construction requiring a building permit, the applicant
must provide at least 48 hours actual notice to the NYCDEP engineer or their
representative making this determination.
465 Columbus Avenue, Valhalla, New York 10595 -1336
w r'
Mr. Julius I. Cesare, P.E.
Re: Quaker Manor - Lot # 3
Page 2 of 2
September 15, 1998
A copy of this determination must be available at the project site during construction. One
set of plans bearing our conditioned stamp of acceptance is enclosed.
Once the project has been completed and inspected by a representative of this
Department, a copy of the As -built plan shall be sent to this office.
If you have any questions regarding this approval, please contact Jannine McColgan at
(914) 742 -2068.
Siincer�ely,
Margaret Lloy N E.
Supervisor Engineering Design & Review
Encl: plans
cc: Robert Morris, Putnam County Department of Health (w /Encl.)
Mr. John Calbo, Building Inspector, Town of P6tterson(w /Encl.)
James Covey, NYSDOH
Thomas Scott, owner
Bxc: Sadosky
H. Meltzer
Lloyd /McColgan
File
465 Columbus Avenue, Valhalla, New York 10595 -1336
V
a.-
�ORK CITY DEP�QTME l
New York City
z L)ROP Department of
r�r
Environmental Protection
`,RUNMENTAI ?V-0 �O
SUBSURFACE SEWAGE TREATMENT SYSTEM DETERMINATION
Pursuant to the authority granted under:
Article 11 of the New York State Public Health Law;
Rules and Regulations For The Protection From Contamination, Degradation and Pollution
Of The New York City Water Supply and Its Sources, 15 RCNY Section 18 -39 (or Chapter
18); and
10 NYCRR Appendix 75 -A Wastewater Treatment Standards - Individual Household
Systems.
New York City Department of Environmental Protection makes the following determinations
with respect to the sewage disposal system(s) plan described below:
Name of Project: Quaker Manor Lot 3
Tax Map Number - 4.10 -1 -27
Location: South Quaker Hill Road, Town of Patterson, Putnam County, NY
Owner: Thomas Scott
Address: Properties East, L.L.0 c/o Thomas Scott
20 Colonial Drive
Danbury, CT
203 - 792 -4776
Drainage Basin: East Branch Reservoir
Type of Sewage Treatment System and General Description:
Subsurface Sewage Treatment System for a 4 bedroom residence. The system consists
of a 1250 gallon septic tank and 800 lineal feet of absorption trench and is designed to
treat 800 gallons per day sewage effluent. Additional area exists for 100% replacement
of the absorption area. The system shall be installed in accordance with the two plans
titled Quaker Manor SD Lot 3 'Plans' and 'Profiles and Details', dated May 8, 1996, last
revised September 1, 1998, prepared by Julius I. Cesare, P.E..
Dates of Site Inspections and Soils Tests
Deep Hole Tests - 1994, July 1998
Percolation Tests - 1994, July 1998
Page 1
465 Columbus Avenue, Valhalla, New York 10595 -1336
SUBSURFACE SEWAGE TREATMENT SYSTEM DETERMINATION
( XX ) Approved ( ) Denied
Conditions of Approval:
Where fill will be placed on the subsurface treatment system area, trees shall be cut at ground
level. The area shall then be plowed perpendicular to the ground slope to a depth of 8 inches.
The fill shall be placed on the perimeter of the site and pushed into place in such a manner
as to minimize soil compaction.
2. Prior to the commencement of any construction requiring a building permit, the applicant
must provide at least 48 hours actual .notice to the NYCDEP engineer or his representative
making this determination.
3. The facility shall be constructed and completed in accordance with the engineering report,
plans submitted, specifications provided, which form the basis of this approval, and in
accordance with the conditions of this determination.
4. This approval shall expire and thereafter be null and void unless construction is completed
within two (2) years of the date of issuance orwithin any extended period of time approved
by NYCDEP upon good cause shown.
5. The applicant will provide "as built" plans to NYCDEP, certified by the engineer.
6. When installed the system must be operated and maintained in accordance with NYCDEP
Regulations and all other applicable regulations and/or standards.
7. , In the event that the material submitted is inaccurate or misleading, this approval is not valid
and construction of the SSTS is in violation of NYCDEP Regulations.
8. This determination constitutes approval only of the physical design of the septic system for
proposed installation and operation on a watershed of the New York City Water Supply. An
approval of the septic system design does not effect any existing property rights, title, or
interest, including without limitation, any public or private restrictions upon the use of the
land. Therefore this determination shall not be considered to be a grant or waiver of any
property right.
9. The sewage disposal system shall be constructed in conformity with the data and plans as
approved or commented upon. Any change in the system must be approved in advance of
construction by this Department and any other agencies with regulatory authority, including
but not limited to county and state department of health.
Page 2
465 Columbus Avenue, Valhalla, New York 10595 -1336
SUBSURFACE SEWAGE TREATMENT SYSTEM DETERMINATION
10. The system shall receive only the domestic sewage from the structures shown on the plans.
The nature and quantity of flow from the structures shall not be changed without prior
approval of this Department and the Department of Health.
11. All parts of this system are to be operated and maintained properly. In no case is sewage or
sludge to be exposed or any other unsanitary or unsafe condition to be created because of the
use of this system. Guidance on standards is found in the Waste Treatment Handbook issued
by the New York State Department of Health under New York State Code of Rules and
Regulations (10 NYCRR Part 75).
12. Whenever sludge and scum shall so accumulate in any septic tank so as to occupy together
at any point more than one -fourth of the distance between the bottom and the flow line, the
tank shall be cleaned.
13. Whenever sludge and scum are removed from any septic or settling tank or any part of the
system it shall be done in such a manner as to cause no nuisance, and the material shall be
disposed of in accordance with all applicable regulations.
14. This approval shall not be construed to invalidate any rule or regulation enforceable by local
authority having jurisdiction.
Date: September 15, 1998
Determination made by:
Margare?Llyd, P
Supervisor
Engineering Design and Review
Recommended for Approval:
annine M. McColgan
Staff Civil Engineer
Engineering Design and Review
This determination letter must be maintained by the applicant and be readily available for inspection
at the construction site.
Page 3
465 Columbus Avenue, Valhalla, New York 10595 -1336
PUTNAM COUNTY DEPARTMENT OF HEALTH
MION. OF ENVIRONMENTAL HEALTH SERVICES J C
r t NSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM
PERMIT #
ZZ-
Located at
N
Subdivision name J,,e, &4Ac,, - Subd. Lot # 3
Date Subdivision Approved 2(7
Owner /Applicant Name ag) 14,, Lee
Town or Village &Tr—E:),-Fj ' d AO'
Tax Map Cf(lo Block Lot Z
Renewal Revision
Date of Previous Approval �i Al
Mailing Address 12,6 (�z /01414z Zip y 6
Amount of Fee Enclosed
Building Type Wcw b (Fg: Lot Area 47 -TT No. of Bedrooms �4 Design Flow GPD
Fill Section Only Depth Volume
PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED
Separate Sewerage System to consist of 2 gallon septic tank and 4 7 ' `7� crrr'
Other Requirements:
To be constructed by
Water Supply:
Public Supply From
Address
Address
or: --"" Private Supply Drilled by 4 ArIZO-, =y✓ 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 treatment system described above will be constructed as shown on the approved amendment thereto and in
accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion
thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the
Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said
builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years
immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original
system or any repairs thereto.
R.A.
Date 6 A-196p-
7 License # W( U
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
modifi;e- d wh onsidered necessary by the Public Health Director. Any revision or alteration of the approved plan requires
a new, i prove r discharge of domestic sanitary Wnly, �� L3-0 By: �✓ Title: Date: (
White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional
Form CP -97
?...- -�... ,,..- a .c^P -.... _ -. ._t .:. -_, -p-.. ..:�._.� ...:� ,.t•._. _... -. ..- ... -, ": •. -. - _ > s'�a-+'^ - -
PuTNAM CODNTY DEPAIZTbO1Nl' OF HEALTH
DhIdoa d HwAwseatd Hedtb Saevlees, Coneac N.Y.1OS12 Prune Poe- 0
Q� as C6RTMICATE OF COMMIANCE
NSTRUCIMIN_PEW FOR SEWAGE DISPOSAL SHSR Pasdt �
Town ofyy811180,: .
Name f�u.�tlr -i� J�1J�iYo� Sabd. Lot i Tax MaP Lot
N.111110 f psi– sT K=W2�i ' ?.its Irc Reamwd —° Revhba p
Date of P.revbu Approve,
a AeAsa.. (_Lo /y/o+e Rn ANX K 0''' y6 &✓ Tote.
Zki
Date
Subdivision ApRroved J-2-
1- r Fee Enclosed Amn „ref :500
Bwkftg
.. Val o'ab mil. Lot :''Area 33
FUt Secdoa 0* � - votame
Nober of Beshwom i �� '2- ,,..�� Dedgt Flow G P D � `S PCHD Nof cadw b Regabed Wbon Fm h a mphted
Separate Sewmy Sygh m to t ali �Goloa SMW Torah erg
To be emokeded by Add..�ae
Water Soppy: Pdit Sttp * Frew Address
on 1/ Mate Sqm* Dead by sa.f..a.
Other R".akenoopm
1 represent that 1 am wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate sewage dispoml system
above described will be constructed as shown On the approved amendment there to and in accordance with the standards, rules a regu ns o • Mm
County Department of Mealth, and that on completion thereof a "Certificate of Construction Compliance” satisfactory to the Commissioner of Healthwill
be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or anions by the builder, that said builder. will
9IWQ In good operating condition any part of said $*wage all sal system during the period of two (2) yeas Immediately following the "to of the issu-
ance of the approval of the Certifkate of Construction Corn I of the orig 1 sy of a •pairs thereto: 2) that the drilled well described above
will be located as shown on the approved plan and that mid well will stalled in ccords w standards, rubs and ngu a1i%ns of the Putnam
County Department Off Mullth.
Dot /. "l ![S ®J Sgn P.E.t_ R.A.
/
APPROVED FOR CONSTRUCTION: This approval expirei two y
revocable for cause or may be amended Or modified when Cons dot
►e0uins �nevy per�Approved for disposal of domestic
mni r
?eV:. DTI_ /2 / _;/1' -
LO/88 Dole- By
License
the date issued unless constr Ction of the building .has been undertakan and is
ary by COTmissioner of Health, Any Change or alteration of construction
ge, a / D /lusts water supply only.
� Title
Julius I. Cesare, P.E.
64 Blackberry Drive
Brewster, New York 10509
914 - 279 -7115
Bruce Foley, Director
Putnam County Health Department
4 Geneva Road
Brewster, New York 10509
ATT Robert Morris
RE: Proposed SSTS West East Land LLC
South Quaker Hill Road, Lot #3
T. of Patterson
Dear Mr. Foley,
June 25, 1998
fferewith transmitted are four sets of revised plans for above
noted project which contain all comments contained in your letter
of June 18, 1998.
Very truly yours,
Julius I. Cesare, P.E.
T
- ;*-r
DEPARTMENT OF HEALTH
Division of Environmental Health Services
4 Geneva Road
Brewster, New. York 10509
Tel. (914) 278-6130 Fax (914) 278-7921
June 18, 1998
Julius Cesare, P.E.
RD #7, Blackberry Hill
Brewster NY 10509
Re: Proposed SSTS: West East Land LLC.
South Quaker Hill Road, Lot #3
(T) Patterson
Dear Mr. Cesare:
BRUCE R. FOLEY
Public Health Director
Review of plans and other supporting documents submitted at this time relative to the above - regarded
project has been completed. Comments are offered as follows:
The construction of this sewage disposal system may be subject to local wetlands regulations. You
should contact local wetlands officials in this regard.
If percolation tests in the revised SSTS area were not witnessed by a representative of the New York
City Department Environmental or the Putnam County Department of Health on this lot, percolation
test must be witnessed by a representative of this Department.
If deep test holes in the revised SSTS area were not witnessed by a representative of the New York
City Department of Environmental Protection on this lot, deep test must be witnessed by a
representative of this Department.
1) The curtain drain and curtain drain discharge pipe is to be a minimum of 15
feet from any component of the SSTS.
2) Curtain drain discharge point to daylight is to be a minimum of 20 feet
downgrade of the SSTS.
3) Curtain drain is to extend across the entire length of the SSTS.
4) Curtain drain should be relocated 15 feet from the first trench.
5) Curtain drain should be noted as 7 feet deep on the plan and detail.
6) Pump pit detail is not to show control box, alarm light and bell.
7) Pump pit detail is to note total depth of the pump pit and the dimension from
the effluent line invert to the bottom of the chamber.
8) The minimum distance from the well to the septic tank or pump pit is 50 feet.
This is to be noted on the plan.
a &"
Letter to: Julius Cesare, P.E. - June 18, 1998 -2-
Upon receipt of a submission, revised to reflect that above comments, this application will be
considered further.
Very truly yours,
Robert Morris, P.E.
RM:tn Public Health Engineer
t s 7c
SSDS DESIGN REPORT
QUAKER MANOR SUBDIVISION
LOT # 3
ee✓.
1<71z�lw"
P I
QUAKER MANOR SD LOT # 3
4 Bedroom Design
Design Flow: 4(200 gal /bed) = 800 Gallons
Perc Rate: Tom'
Application Rate: 0.8 0.6 0
o.6 11.7 7
Req. Area: 800/6-8 = Tett-
1s77 667
Req. Field Length: ?0t O / 2 =!5ft
Septic Tank: 1250 Gallons
7`7p.o
RLI : 8-19. 6
Use � lines, 4W long each Syslem'and Expansion
So" SIO / _
P"i'e►. ClIef
a ,
G AJ 3
PC e
Sic l��-n
'.. 2 K5--oaxe -.0 � y-z,S�
�J �C/�✓ [-ear/'? d"P- 1511,lec"
____ __
....... - --------- ------ ------ ....... ... .....
___� 1�1�
s J- e 3 __
_�REQUIRED 'SUBMITTED 1-.ITF APPLICATION
TO BE
-TON N-OWRI-MMIN TEST HOLES
Address ..SEAL
THIS SPACE FOR Uk' �V_,�JW4WH`DE?ARTMENi T. 014LY:
Soil Rate Approved b
Ft/Gal. Checked
rq
, -
&7
DEUP111
TEST PIT DATA 1U:QU -UM) TO W' SUBAITITI) 111'111 APPLICATION
DESCRIPTION OP SOBS EN000RrERLD IN TEST BOLL'S :
I EOLC . NO. I IOL.E N0. 2 HOLE; tom. •
6 "I ,
12" JSih�+�I1� ��►r'►- -
18"
24"
30"
36"
42"
48"
5411
60" qj
66"
72"
-7811
9!N! qA
r � e
£3 4 " 14 0617� on of �+
*7.s' &k#4Fb&W
INDICATE LEVEL AT WI1ICEi GROUNDRATER IS
IITDICATE LEVEE, To VMCH «TER LEVEL RISES AFTER BEING ENOOUNTE RED
DEEP HOLE OBSERVATIONS MADE WtLj * Jdc - DATE :. / A?
DESIGN
Soil Pate Used Miq/1" Drop: S.D. Usable Area Provided
I-Io. of Dedroms Septic Tank Capacity gals. Type
Absorption Area Provided 13y L.F. x 24" width trend
r
Other
rjarr& Julius i . Cesare, P.E. Signature
AddresdBlackberry ffii@ SEAL
`nF No. 41126
Brewster, New York 10509 , AROrCSS1014
'MIS SPACE FOR USE BY HEAL'111 DEPAIrlMWr ONLY:
Soil Rate Approved sq. ft;/gal. Checked by J Date
1'
2'
3'
4'
5'
6'
7'
8'
HOLE NO. A
HOLE N3.
A if
HOLE NO. ^ L)
9'
_
P ...
�
Y0
10' -. .
Nam--
Address R r 2T� zZ--
S K-. ' a i
CO
SEAL
1980
f32F� s��c-rt. � .�(_ l O So°l
. � \�.L' ,l_ '. • � �, �,
. �•fw vn�'�
n
13'
T US SPACE FOR USE BY IMALTH DEPARDERr ONLY:
/
14'
Soil Rate Approved ;q _ f t,/ga1 _
nDImm LF'VF.L AT WHIGS: GRIOONDWATFR
IS
I� A
.. :.
BEn1G
3. 5
nmichm LEVEL To mca .. wATER
LE =, RISES AFTER
DEEP, HOLE OBSERVATIONS MDE BY: f- u v I L h � 11%
7 I b 8
DESIGN .
960C S(-
Soil Rate Used 1-45 Mi.nA
Drop: S-D.
Usable Area Provided
No. of Bedroo is
Septic Tank Capacity
1 Z.
gals. Type C- ` •y �-
Absorption Area Provided By
$U G L.F. x 24" width trench
Other C .. 2 Y/t I N
J r .► .v `> S r LL
_
P ...
�
Y0
Nam--
Address R r 2T� zZ--
S K-. ' a i
CO
SEAL
1980
f32F� s��c-rt. � .�(_ l O So°l
. � \�.L' ,l_ '. • � �, �,
. �•fw vn�'�
i
T US SPACE FOR USE BY IMALTH DEPARDERr ONLY:
/
Soil Rate Approved ;q _ f t,/ga1 _
Date
p(11NAM COUNTY DEPARTMERr OF HEALTH
DIVISION OF ENVIRCtM= HEALTH SERVICES
DESIGN DATA SHEET- SUBSUF'ACE SEWAGE DISPOSAL SYSTEM FILE NO.
.Owner W60- r �l'J Address k-.-/o-WA-Ile -PR VA- le -eurL>
Located at ( Street) ..S • a 4 AKr f {r y 2 G Sec. . / Block / Lo t-2- '7
(indicate nearest cross street).
Municipality
Watershed C.4A% y
Date of Pre- Soaking %yt -
61,(7/9 7
Date of Percolation Test
6 �� 7 A?
HOLE
NUMBER CLOCK TIME
PERCOLATION
PERCOLATION
Run Elapse
Depth to Water Fran
Water Level
No. Time
Ground
Surface
In Inches
Soil Rate
Start -Stop Min.
Start
Stop
Drop In
Min/In Drop
Inches
Inches
Inches
z 1 /:f� �;d 3 0 �' 3/f- Z0 7 /d'
4
5
1
2
3 6(S'c- Td #A
5
NOTES: 1. Tests to be repeated at same depth until approximately equal soil rates
are obtained at each percolation test hole. All data to'be submitted
for review.
2. Depth measurements to be made fran top of hole.
rev. 9/85
IEEr- SUBSU[TCC SWAGS DISPOSAL SYSIT-,t•1 FILC I Ii.
___ Jam• ��
L 44 cor P. ..lack Fo r bcs
Address._pump hoc-mc Qd . r - 2cje.,r 0`4 70.SorA
;; trod at (Street) ��yl l Rd Sec. block _ Lot aG �
(indicate nearest cross street) (30)
licipality 0_6I 4ecr,-, Watershed . Gro,foh
SOM .PII200LUMN MT DATA RBOUIRM TO BE. SUDMIIIT.D WXIII APPLICKrIMIS
_e of Pre- Soaking 7-/V Date of Percolation Test 7 -1y
�L
IBM CIACK TIME PI�tOQL?L'CION FLZtWLR'itOtl
n Elapse Depth to Water Zran Water Level
Tito Grand Surface In Inches Soil Mate-
Start-Stop Min. Start. Stop . Drop In Min/In Drop
Inches. Inches Inches
aV
a g C R
iF
-' Qw-t e ! used )'n boom of- ho le.
Alor
� -
SEAL
r2_
3:03
3a 1.�
a:Da
2:3 a 30
a:33
3:03._ V
-
3
30
fO 5
a g C R
iF
-' Qw-t e ! used )'n boom of- ho le.
Alor
� -
1. 7Dest9 to be repoated� at cacr�e depth ttnhS.I upproocimaEely egtL�]. roJ�..F?bks...N�.�•
are obtained at each percolation test hole. AU data to' L» submdttt "
for review.
2. Depth neasurenents to be made •fran hop of bole.
'Os
SEAL
.4c:
1. 7Dest9 to be repoated� at cacr�e depth ttnhS.I upproocimaEely egtL�]. roJ�..F?bks...N�.�•
are obtained at each percolation test hole. AU data to' L» submdttt "
for review.
2. Depth neasurenents to be made •fran hop of bole.
'Os
Dv OF E2-Arjjz(>Z-!:-24Gll-
lj:)
WITNeSSO BY MEL P.C.H•b.
om S;=-
O.wne.r LOFT CORP. IJOhd M&-S IZdres-,,.
r,o--,t-3 at (St--e--t) S, QUAke-A HILL 1300-b Block Lot
(indic-- te nearest* cross street)
Cl"'%C)T
MAM" pa.Lity I Watex-shei ON
QUAISER MANOa - SURDIOStON
con P-c---COr-;k=CN �T MM RSO=XD TO PC SO'EtaTM) WMH APPIXO—*rICNS
1>-t-- cf Pre-Scakina 7/27/89 Date of Pe--co3ztica Test
BO=-
Clr
M AT TCU
p
roin
Dq2th to
R---ter EN--(=m
Wet= 1pavell
NO.
Time
Grcund
SUX:Zac--
In Inches
sail- -Rate
C tart7-Stpo Hin.
Start.
Stoop
Drop In
Min/Xn Drco
inches
X-riches
Inches
:f0le
0: 1 10:-59 . �V:v y
a4"
.3ol
2
1% %13
a q 31j
9.6
ae Ile
y3�YN
h.3
C3 'Ok-i -#j)
a33 /y,,
oLe
so rates
1- Tests to b-, rcc��te:3� at szwc deoth until approx-imatelly equal soil tc-5
are obtainc3 at each percolation t,--st hole. All data to be SUL-ndttC6
for revic,4.
2- Dcoch rersuraTx--nL,, to be Tc6c. from Lop of h0le.
PUTNAM COUNTY DEPARTMENT OF HEALTH
jj DIVISION OF ENVIRONMENTAL HEALTH SERVICES
D\EnSIGN'DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM
Owner 1/� e'er - C Address 2e4 G/Wo 'surf V/i ':2 6a 'vy
if
Located at (Street) S. Qc t„oceL, A4ij A-P Tax Map .ACS Block Lot 2 7
(indicate nearest cross street)
Municipality Drainage Basin 6)W-T— dkA-*
SOIL PERCOLATION TEST DATA
Date of Pre - soaking �71�i p C P az r &2 y Date of Percolation Test
254 .
Hole No.
Run No.
Time
Start - Stop
Ela se Time
Min.)
De th to Water
From Ground
Surface (Inches)
Start Stop
Water
Level
Drop In
Inches
Percolation
Rate
Min/Inch
3
2
31
3
3
�4
5
1
2
3
4
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. < 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'
W11
7.5'
8.0'
8.5'
9.0'
9.5'
10.0'
TEST PIT DATA
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
HOLE NO.
Qu
HOLE NO.
Y 1
R
a
Indicate level at which groundwater is encountered
Indicate level at which mottling is observed
HOLE NO.
Indicate level to which water level rises after being encountered
Deep hole observations made by: Date .S/ i
Design Professional Name: r
Address: �1r4elc crw� C if �P�� of NE;V Yoh
2trr w S�- /�J �`Vg 1. CFS,� 4
Signature:
Design Professional's Seal
�Fp .4'0. 41126.
AROFESSI ONP�
2
APPLICATIONS
Speciii designed for the
lollowil :y uses:
• Homes
• farms
• Trailer courts
• Motels
• Schools
• Hospitals
• industry
• Ellluent c�vstems
SPECIFICATIONS
Pump:
• Solids handling capabilities:
% maximum.
Discharge size: 2' NPT.
Capacities: up to 128 GPM.
6 iotal heads: up to 123 feet
TDH.
6 Mochank. eal: silicon
carbide -rotary seat/silicon
carbide- stationary seat, 300
1111CS stainless steel metal
Paris, BUNA -N elastomers.
omperature:
1041(40 °C) continuous
t 1401 (60 °C) intermittent.
tE fUleners: 300 series
ttalnless steel.
qUl)ableol;� �t ing dry
VOW damage to
�ftponents.
1.111414r:
�pte phase :' /, HP, 115
Ot 230 V 60 Hz, 1750 RPM;
OP, 115 V, 60 Hz,
x`+00 RPM; %z HP —1'/2 HP,
"0 Hz, 3500 RPM.
kit to over!!;;
�vatic reset.
11 B Insulation.
• Three phase: ' /z HP —
1' /z HP 200/230/460 V,
60 Hz, 3500 RPM. Class B
insulation, overload
protection must be
provided in starter unit.
• Shaft: threaded, 400 series
stainless steel.
• Bearings: ball bearings
upper and lower.
• Power cord: 20 foot
standard length (optional
lengths available).
Single phase: ' /a and' /2 HP
—16/3 SJTO with three
prong plug. % -1% HP
—14/3 STO with bare leads.
Three phase: ' /2 -1' /z HP
—14/4 STO with bare
leads. On CSA listed
models — 20 foot length..
SJTW and STW are
standard.
METERS FEET
0
a
w
U
� 1s
a
z
0
J
a
p 10
s
0
Goulds
Submersible
Effluent Pump
M.
0910411
wunwi SIMNAD usocunON S P
FEATURES
Impeller. Cast iron, semi -
open, non -clog with pump -
out vanes for mechanical seal
protection. Balanced for
smooth operation. Silicon
bronze impeller available as
an option.
Casing: Cast iron volute
type for maximum efficiency.
2' NPT discharge adaptable
for slide rail systems.
Mechanical Seal: Silicon
carbide vs. silicon carbide
sealing faces. Stainless steel
metal parts, BUNA -N
elastomers.
Shaft: Corrosion - resistant
stainless steel. Threaded
design. Locknut on three
phase models to guard .
against component damage
on accidental reverse rotation.
Motor: Fully submerged in
high -grade turbine oil for
lubrication and efficient heat
transfer.
Designed for Continuous
Operation: Pump ratings are
within the motor manufacturer's
recommended working limits,
can be operated continuously
without damage.
Bearings: Upper and
lower heavy duty ball bearing
construction.
Power Cable: Severe duty
rated, oil and water resistant.
Epoxy seal on motor end
provides secondary moisture
barrier in case of outer jacket
damage and to prevent oil
wicking.
0 -ring: Assures positive
sealing against contaminants
and oil leakage.
M\ \MMMMMMMMM 11M■,• ��
0210"', �mm���� Mme■ ''
w4b"10mrs MM mmmmmmmm
WMIUMM M W MMMMMMMMMMNMJ
■mmygooffigm�� ■ ■ \��i�MMMM
MMMORMMMMEff
1=016 � MM�0►�MM►rt�M O ■MMME SIM
WN 141M ::::::C ::�s_::�C:i: s'
• CMIME :::C::::�:::C:EC:
0 10 20 30 40 50 60 70 80 90 100 110 120 130GPM
0
IN
CAPACITY
20
30 math
C�
0
PARTS
Item No.
Description
1
Impeller
2
Casing
3
Mechanical seal
4
Shaft
5
Motor
6
Bearings - upper and
lower
7
Power cable
8 1
0 -ring
MODELS
Goulds
Submersible
Effluent Pump
5 6 �� C
4
8 3
3885
...........
t
Order No.
HP
Volts
Phase Max. Amp. RPM Solids M. (Ibs.)
WE0311 L
115
9.4
WE0312L
1
230
4.7
1750
56
WE0311 M
SWE0511NH, SCI
a
115
9.4
WE0312M
IOIII��III�IIII�
230
1
4.7
WE0511H
115
13.0
WE0512H
230
6.5
WE0538H
200
3.9
WE0532H
230
3
3.4
WE0534H
460
1.7
60
WE0511 HH
115
1
13.0
WE0512HH
230
6.5
WE0538HH
200
3.8
WE0532HH
230
3
3.3
WE0534HH
460
1.65
WE0712H
230
1
10.0
WE0738H
�
200
6.2
WE0732H
208 -230
3
5.4
3500
WE0734H
460
2.7
70
WE1012H
230
1
12.5
WE1038H
200
65
8.1
WE1032H
1
208 -230
3
7.0
WE1034H
11
460
3.5
75
WE1512H
230
1
15.0
80
WE1538H
206
10.6
!'..
WE1532H
208 -230
3
9.2
WE1534H
460
4.6
11/
80
WE1512HH
230
1
15.0
WE1538HH
200
10.6
WE1532HH
208 1230
3
9.2
WE1534HH
460
4.6
METERS FEET,
--
120
35
110
MEN
30
100
I
W
�
MUM,,
loll
u 25-
3
a
i
°
701
J 20
H
�
15
50
10
40
No
2 0I
s
01
10
0I
0
0 10
L.
20 30 00 s0 60 70 60 90 100 GPM
10
20
m3ln
CAPACITY
rrn
PERFORMANCE RATINGS (gallons per minute)
WE0511H WE0511HH
Order WE0512H WE0712H WE1012H WE1512H WE0512HH
WE0538H WE0738M WEIOJBH WE7538H WE0538HH
N0. WEOJIIL WE0311M WE0532H WE0732H WE1032H WE1532H WE0532HN
WE0372L WE0312M WEOSJ4H WE0734H WE1034H WE1534H WE0531HH
HP 'h 'h '/z '/. 1 1' /z '/z
RPM 1750 1750 3500 3500 3500 3500 3500 :}I
5 - - - - - - 60 wi
10 80 65 - - - - 56 .. ;1
15 60 57 69 90 104 128 53 •4�
20 36 45 60 83 98 122 48 *J)
25 25 50 76 92 116 45 'Gj
30 38 67 85 109 40
3 35 26 58 78 102 35 -2
40 15 47 70 94 30:
d 45 36 62 86 25
50 25 52 77 18.
55 17 42 67 12
60 8 32 56 3,4
1!`
pump applications.
SWE0511NH, SCI
a
IOIII��III�IIII�
PERFORMANCE RATINGS (gallons per minute)
WE0511H WE0511HH
Order WE0512H WE0712H WE1012H WE1512H WE0512HH
WE0538H WE0738M WEIOJBH WE7538H WE0538HH
N0. WEOJIIL WE0311M WE0532H WE0732H WE1032H WE1532H WE0532HN
WE0372L WE0312M WEOSJ4H WE0734H WE1034H WE1534H WE0531HH
HP 'h 'h '/z '/. 1 1' /z '/z
RPM 1750 1750 3500 3500 3500 3500 3500 :}I
5 - - - - - - 60 wi
10 80 65 - - - - 56 .. ;1
15 60 57 69 90 104 128 53 •4�
20 36 45 60 83 98 122 48 *J)
25 25 50 76 92 116 45 'Gj
30 38 67 85 109 40
3 35 26 58 78 102 35 -2
40 15 47 70 94 30:
d 45 36 62 86 25
50 25 52 77 18.
55 17 42 67 12
60 8 32 56 3,4
1!`
110
DIMENSIONS
(All dimensions are in inches. Do not use for construction pur
D " /a,'/z,' /� and 1 HP =15'
except for model WE0712H and WE1012H = 18'; 114_HP =18'
8' /i
t
�J
KICK- BACK L_tJ'l1
4
EFFLUENT EJECTOR SYSTEM -
Effluent ejector system Package Includes.
offers ease of ordering Submersible EffluentF
and installation. A single 12LorWE0311140
ordering number specifies -- Mercury Level
A2.5 (115V).
a complete system designed Basin A7- 180tS, Bair
for most residential and Check Valve A9 -2P'1
commercial sump and Order No.: SWE03��
SWE0311M. �
effluent
pump applications.
SWE0511NH, SCI
a
65
21
46
70
11
35
75
25
80
15
!'..
110
DIMENSIONS
(All dimensions are in inches. Do not use for construction pur
D " /a,'/z,' /� and 1 HP =15'
except for model WE0712H and WE1012H = 18'; 114_HP =18'
8' /i
t
�J
KICK- BACK L_tJ'l1
4
EFFLUENT EJECTOR SYSTEM -
Effluent ejector system Package Includes.
offers ease of ordering Submersible EffluentF
and installation. A single 12LorWE0311140
ordering number specifies -- Mercury Level
A2.5 (115V).
a complete system designed Basin A7- 180tS, Bair
for most residential and Check Valve A9 -2P'1
commercial sump and Order No.: SWE03��
SWE0311M. �
effluent
pump applications.
SWE0511NH, SCI
a
14 -16.4 (2187) —Text 12
PROJECT I.D. NUMBER 617.21 SEAR
;t Appendix C
State Environmental Quality Review ;
SHORT .ENVIRONMENTAL ASSESSMENT _FORM
For UNUSTED ACTIONS Only' `
PART 1- PROJECT INFORMATION (To be completed by Applicant or Project sponsor)
1. APPLICANT /SPONSOR
2. PROJECT NAME,
WE-)-f *T- Lu
g' 3 S f r
3. PROJECT LOCATIO
Municipality'• fir/" .. W/'+" County:. .... .
4. PRECISE LOCATION (Street address and road Intersections, prominent etc., or provide map)
SO'..')14 Q44k&• 071/ An //laandmaft/,
.4,161 -Si OA4 )/ A` J'
5. IS PROP OSED ACTION:
New , Expanslon ' El ModificatioNalteration"
6. DESCRIBE PROJECT BRIEFLY:
Pr r �►:s ::
7. AMOUNT OF LAND AFFECTED:
tia
0 O„
Initially • acres Ultimately" acres
8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS?
[;�res ❑ No If No, describe briefly
9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT?
Residential El Industrial ❑ Commercial ❑ Agriculture ❑ PaWForest/Open apace Other
10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL.
STATE OR LOCAL)?
_
.. .i, ... .., '
es w 0 No If yes, list agency(s) and pennlVapprovals
} (
- •tilt 1 '.y: •, . j � , .'.S:a Cz ?, o-- ., ^i 'r ,Yo.. i- 4h . .., _-. .. 9. •fa.
11 ; . OOES,ANY ASPECT OF THE ACTION HAVE A CURRENTLY:VALID:PERMIT OR APPROVAL?
O:No . K yos, list agency name and permit/approval
., .._.
12. ASSAA RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION?_
' No
I. CERTIFY THAT.;THE INFORMATION PROVIDED ABOVE IS TRUE TO THE'BEST OF MY KNOWLEDGE
.Applicant/sponsor name: – ....w0ate: -••.
/
V' ��:•�
Sii,nature: 4 ! J
:;N. the action, Is, In the,. Coastal Area -, -and you area - state-lagertcy;: omplete ":the
Coastal Assessment Form before proceeding with this assessment
OVER .......,.
1
a �
I
I
t
I
f
a \
i
PUTNAM CO(NrY DEPARDMT OF HEALTH
DIVISION OF ENVIROIM?rAL HEALTH SERVICES
AFFIDAVIT- CORPORATE OWNER APPLICATION
FOR PMMIT APPLICATION SUBMITT ED TO PUTNAM COUNTY HEALTH DEPARTMENT
TO: Ccnnnissioner of Health
In the matter of application for:
represent that I am an officer or employee of the corporation and am authorized
to act for �-
(Nar6d of Corporation) /
having offices at `Z p C._ e
Whose officers are:
President: -5�
(Name and address)
Vice - President:
(Name and address)
Secretary:
(Name and address)
Treasurer:
(Name and address)
and that I am and will be individually responsible for any and all acts of the
corporation with respect to the approval requested and all subsequent acts
relating thereto.
Sworn to before me this,-2 Y�b day
of A4��' 1 ( / 107
h
Title:
Corporate Seal
20
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
APPLICATION FOR APPROVAL OF PLANS FOR
A WASTEWATER TREATMENT SYSTEM
1. Name and address of applicant: WGTr 6)""T ,LA-yp ,t.L C
`e –tbkn sea-7-
-u co 10 nth V14 . 90a"V44 2 G• IVAe 0 6IP-//
2. Name of project:aug4,- 11 4•ra. Sp )*1-7 3. Location TN: _ �% PhTTVX_ Xa v
4. Design Professional: 4 ,1u, /. CZ-- :P'0KC
6. Type of Project:
j Private/Residential
Apartments
Office Building
5. Address: XLaek
/��- �.s "�• /1f `�, 1051► s
Food Service
Institutional
Realty Subidvision
Commercial
Mobile Home Park
Other (specify) —
7. Is this project subject to State Environmental Quality Review (SEQR)?
Type Status (check one) ....................... ............................... Type I Exempt
Type II Unlisted
8. Is a Draft Environmental Impact Statement (DEIS) required? ......................... /fo
9. Has DEIS been completed and found acceptable by Lead Agency? ....:..........
10. Name of Lead Agency
11. If this project is an area under the control of local planning, zoning, or other
officials, ordinances? ................. ...............................
12. If so, have plans been submitted to such authorities? .......................................
13. Has preliminary approval been granted by such authorities? "Date granted:
14. Type of Sewage Treatment System Discharge ................. surface water k groundwater
15. If surface water discharge, what is the stream class designation? ....................
16. Waters index number (surface)
17. Is project located near a public water supply system? ....... ............................... A(a
18. If yes, name of water supply Distance to water supply
19. Is project site near a public sewage collection or treatment system? ................ 012
20. Name of sewage system ^' Distance to sewage system -`
11. Date test holes observed 4 KLx 22. Name of Health Inspector 11W
7/77 s-trw 31EW
SrFdr Der 9 O
Form PC -97
2
23. Project design flow (gallons per day) ................................. ............................... '0 0
24. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?... —
25. Has SPDES Application been submitted to local DEC office? .........................
26. Is any portion of this project located within a designated Town or State wetland? /J�0
27. Wetlands ID Number ............................................................ ...............................
28. Is Wetlands Permit required? .............................................. .........:.....................
Has application been made to Town of Local DEC office?
29. Does project require a DEC Stream Disturbance Permit? .. ............................... IN
30. 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 Vu
31. Is project located within 1,000 feet of existing or abandoned landfill,
hazardous waste site, salt stockpile, landfill, sludge disposal site or any
other potential known source of contamination? ... ............................... Yes/No
DESCRIBE:
32. Is there a local master plan on file with the Town or Village? .........................�
33. Are community water and/or sewer facilities planned to be developed within
15 years in or adjacent to project site? ................................. ...............................
34. Are any sewage. treatment areas in excess of 15% slope? 910
35. Tax Map ID Number ..................... �C /! .............. .......... Map / Block 27 Lot
36. Approved plans are to be returned to ..... Applicant X` Design Professional
If the application is signed by a person other than the applicant shown in Item l .,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 of perjury, that information provided on this form is true
to the best of my knowledge and belief. False statements made herein are punishable as
a Class A misdemeanor pursuant to Section 210.45 of the Penal Law.
SIGNATURES & OFFICIAL TITLE
Mailing Address: ...................................
Julius I. .Cesare, P.E.
64 Blackberry Drive
Brewster, New York 10509
914 - 279 -7115
June 5, 1998
Bruce Foley, Director
Putnam County Health Department
4 Geneva Road
Brewster, New York 10509
RE: Quaker Manor Lot #3, Re- submission
Dear Mr. Foley,
We are herewith submitting the appropriate materials for a re-
application of the above approved SSDS. The applicant is
desirous of moving the house location which is the reason for
this re- application. In relocating the house, the system will
become a pump system rather than a gravity system as previously
approved.
In addition, because of this change it seemed logical to switch
the system and the proposed expansion area so as to simplify
initial construction. We also included herewith an updated
design report.
Thank you for your cooperation in this matter.
Very truly yours,
Julius I. Cesare, P.E.
DESIGN DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO.
Owners Qv n h Address
Located at (Street) sou l Qom` ��-�' Sec. / ;/o Block / Lot-_
(indicate nearest cross street)
Municipality Watershed
SOIL PERCOLATION TEST DATA RBQU= TO BE SURM IZ`I'ED WIM APPLICATIONS
Date of Pre - Soaking Date of Percolation Test 17 ! 7
HOLE
NUMBER
CL=
TIME
PERCOLATION
PEROC)LATION
Run
Elapse
Depth to Water Fran
Water Level
No.
Time
Ground Surface
In Inches
Soil Rate
Start -Stop Min.
Start Stop
Drop In
Min /In Drop
\,
Inches Inches
Inches
1
%r'l0
I•YO ����5
ISM /,� dorms
%
...�®
3
A 4'12
2 X12- J .4 " / -f s
F
17
4
5
1 .
2
3
4
5
1
2
3
4
R
NOTES: 1. Tests to be repeatedat same depth until approximately equal soil rates
are obtained at each percolation test hole. All data to'be quhmitted
for review.
2. Depth measurements to be made -fran top of hole.
rev. 9/85
\1Z -_
ro r-U NPM COUM DEP =FM—I= OF fi✓P1,TH - DIVISICN OF ENVIRGN ffi 1— - , HrUTH S?ITIC =S
LN- rlIEURL Ut?`� SUPPLY SuE---JRF?C SLVIC^c DISPS. -'L St5TE`^S
° Far r.n INSP=CN REFGFcT
'c SV - L a, c � ize. -JAL, T � �e Q' &' /% re,/
(ri�rc_ of Cwner) (Street Lcca-ticn )
INI'T'T LT SITE TNSPEr`I'ICN ' I = I No
wetlands cn /or prox_ mat_ to pr �re_*ty .......:...... I .�
Prco,a lines or corne_m found ................... I, I
Can est rat_= hcusa lcc ticn ....................... t1l Ir
Will dr =rc,;�y nee cat ............................ I
lest trees be, ramved - note these... ........... I'
Peep holes represent=_tive of Entire SDS ar=...... I lr
P:.:diticr =� ce`-p holes n-- e3 ....... . .............. A' I
Suf- iclent S:)S are=. ava' � able considering r-3,vewzy �� I
cut, house 1CGt1on, 5 _�a_raLan di 5'�'^_ ^_CE�,E=C_
Miace_--t wells/ septic_
.D. H. 1 Lot- .�
De_ `Z to G:w.
teptz to roc{
.Soil Descr_Dt?cn
0 ft.
3 ft. sipry !4CLO7 /
+1
6 ft_
9 ,ft_
D. H. 2 Lot 3
Depth to G.W. rEDt•1 to recd
Ecil D`=crirLticn
3 ft.
I
6 f; SyL,�
�-14i y P e. eve
fl
9 ft. � � ► � I
12 ft.
- e
INSP_ BY: t r
D -H _ - reso Hole
C_W- •-GrctLnd ate_
D.H. 3 Lot -
Depth to G.W. DeptZ to recd
- 0
ft.'
3
ft_
• 6
ft_
9
ft.
12 ft.
Sail r_scioticn
DATE:
FINAL SITE I NSP=C,)N INSP . BY : I )ES ( NO I CCVl E �ri5
Ecuse SSDS lccatea per approve3 plan ....... ......
I,z ^.gt^ of trench re —a-sred
Width of trench eve ace
Slcce of file line and trench accemtable.........
Rcan aI cwer for ex-,:,--risicn trenches .............. I I
3 over 100 ft. fran wate r-c-urse ....................
Natural soil not stripe or SDS area I
unnecessarly creed ............................
10 ft. maintained fran prcce---ty line and
20 ft. fran hcuse ...............................
Distance well to SSDS (ft_) ......................
Rmice_ ...... .................
* of be3roars cz�;s -
Stenes, brush, rubble, etc., gr==t —PI I
'! thGh 15 ft. fran ne.Frast trench ................
=1
15 ft. of peripher-cl soil horizonta-l—ly
frantreacz ....................................
°=Faxes proce --lv set ...............................
' Cculc surface runoff f_an drive:q.-v, rca-:s,
crcund surface, etc., charinel ne`r SDS ar . -
Lc == lot d_* a?r�ce appear CK•,' ar ?- of SDS.:...... ( ( I
• --,,.- r-^nrn'r, nv c --n-,- ter^" ='7T* ter^ . ... � 1 i
PUTNAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
John M. Sivawns, M.D.
Deputy Commissioner of Health - FIELD ACTIVITY REPORT -
Sheet of
r
INSPECTION
NAME W,
ADDRESS
N
W «AW"
S
MAILING ADDRESS
P.O. Box Post Office Zip code
TELEPHONE
PERSON IN CHARGE OR INTERVIEWED S o
Name and Title
DATE f' 5 2
TIME ARRIVED
INSPECPOR:
TYPE FACILITY
TIME LEFT
Signature and Title
PERSOIS IN CHARGE OR INTERVIEWED:
I acknowledge this Field Activity Report. SIGNATURE:
6/86 TITLE:
Orig. Routine
Orig. Complain
Orig. Request
Canpliance
Complaint Comp
_ Final
Group Illness
Construction
Reinspection
Field, Sampling Only
Field Conference
Explain
TELEPHONE:
APPENDIX 3
PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES
INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS
REVIEW SHEET for CONSTRUCTION PERMIT
STREET LOCATION SQ �'P e^ �IIIJ . d, NAME OF OWNER CUes� 4y %r ^vS' e
BY B. HEDGES R.MORRIS OTHER ✓ + DATE /_Lj f TAX MAP #
DOCUMENTS.
Y
ERMIT APPLICATION
MAVVELL PERMIT PWS LETTER ✓G' .- . ;t
En IiK61NEERS AUTHORIZATION _
K ESIGN DATA SHEET(DDS) P vvi e- /n ,' G
ORPORATE RESOLUTION A, 0 S 2,
DESIGN
THREE SETS
Eff-HOUSE PLANS -TWO SETS 41lo-pe e- e;
VARIANCE REQUEST 1_o S_
SUBDIVISION
FT-1 LEGAL'SUBDIVISION
FT-1 SUBDIVISION APPROVAL CHECKED
M PERC RATE
CD FILL REQUIRED DEPTH
m CURTAIN DRAIN REQUIRED MSTANDPIPFS
Y,N
KI EXP. AREA; SHOWN; GRAVITY FLOW, SUFF.SIZE
mJF PUMPED PIT & D BOX SHOWN & DETAILED > r'�` ,
Q� OUSE - NO. OF BEDROOMS
WELLS & SSDS'S WAN 200 FT. OF PROPOSED SYSTEM
ROPERTY METES & BOUNDS
HOUSE SETBACK NECESSARY (TIGHT LOT)
m HOUSE SEWER - 1 /4 "/FT. 4 "0; TYPE PIPE
ED NO BENDS; MAX. BEC C_lNDS.45° W /CLANOUT
.Nc.a�rvzr
J
FILL SYSTEMS
w
LYBARRIER
m 1O.FI' HORIZONTAL: SLOPE 3:1 TO GRADE
YF ILL SPECS m FILL NOTES
w� TLL CERTIFICATION NOTE
[DEPTH GAUGES
ED FILL PROFILE & DIMENSIONS /c)� L
m/VOLUME [[
GENERAL m FILL IN EXPANSION AREA
m EX- APPROVAL SSDS ADJ. LOTS
m WETLAND ( TOWN/DEC PERMIT REQ ?) TRENCH
m DATA ON DDS PLANS & PERMIT SAME LF TRENCH PROVIDED =60 FT MAX
C17 PRE- 1969 - NEIGHBOR NOTIFIFICATION PARALLEL TO CONTOURS
m LETTER BUZBA 100% EXPANSION PROVIDED
CI7 100 YR. FLOOD ELEVATION ,
REQUIRED DETAILS ON PLANS F,20'TO WAGE SYSTEM PLAN - (NORT OW) TO P.L., DRIVEWAY, LARGE TREES TOP OF FILL �DS HYDRAULIC PROFILE GRAVITY FLOW FOUNDATION WALLS 15' WELL TO P.Ib' V CONSTRUCTION NOTES (GRINDER NOTE) TO WELL, 200' IN D.L.O.D., 150' PITS DESIGN DATA: PERC AND DEEP RESUL S TO STREAM WATERCOURSE LAKE (INC.EXPAN)
TWO -FOOT CONTOURS EXISTING PROPOSED a,--�--�/50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER
iRIVEWAY & SLOPES CUT F200'10 ' TO WATER LINE (PITS -20')
FO TING /GUTTER/CURTA4DWNS INTERMITTENT DRAINAGE COURSE
ROSION CONTROL HO ,WEL SSD FT. RESERVOIR ETC.m 150 FT. GALLEY SYSTEMS
EROSION CONTROL NOTE m JY MIN TO C.D. S= >5 %,201- 4 %,251- 3 %,30'- 2 %,35' -1 %,100' <1%
PE C & DEEP HOLES LOCATED 20' MIN TO C.D. DISHARGE /100' WITH 182 CONS DAY DIS.
OPRESENTATIVE OF PRIMARY AND EXPANSION S PTIC TANK
LOCATION MAP M 10' FROM FOUNDATION; 50' TO WELL
COMMENTS:
_ ('A'V- 1G_94 17:41 1[1:I.IHTEF' S! IF'F'L':' '=;Liu
New York City
Department of
Envlronmontal
Protection
Bureau of Water
Supply & Wastewater
Coflection
Sources Division
(914) 742.2012/3
Division of drinking
Water Quality Control
(914) 742.2080
465 Columbus Ave.
Suite 350
vawlla, New York 10395.
1336
Commissioner
RICHARD D. GAINER, P.E.
Deputy Commissioner
D wr P
Julius Cesare, P.E.
Blackberry Hill
Brewster, New York 10509
Dear Mr. Cesare:
TEL
May 10, 1994
',e: Quaker Manor SSTSs
(T) Patterson, Putnam County
The Department has inspected the deep holes, witnessed the percolation tests
and inspected the sites for ten proposed individual subsurface sewage disposal systems
(SSDS) for the proposed project. The lots are shown on the site plan labeled Final Plat
Quaker Manor and dated 4/4/94. The ten SSDSs for lots 1 -10 meet the requirements
of 10 NYCRR Appendix 75 -A. The ten sites as located on the Final Plat are approved
for SSDSs. Requirements for final individual SSDS drawings for construction approval
will follow shortly.
Should you have any questions, please call: 914 - 742 -2065.
Sincerely,
Ja s N. Roberts, P.E.
Program Engineer
xc: Town of Patterson Planning Board
Putnam County Department of Health
r' Julius I. Cesare, P.E.
Blackberry Hill
Brewster, New York 10509
914 - 279 -7115
May 15, 199.6.
Bruce Foley, Director
Putnam County Dept. of Health
4 Geneva Road
Brewster, New York 10509
Att: William Hedges
RE: SSDS Quaker Manor Lots 1 -10
Dear Mr. Hedges.,
We are herewith transmitting completed construction
permit - submission packages for the above noted 10 lots
of the Quaker Manor Subdivision.
This letter will serve as a transmittal letter for all
10 submissions. A copy of the letter will is included
in each of the submission packages.
In accordance with department requirements we are
submitting the following:
1. A completed Construction Permit Application.
2. A letter of authorization for the Engineer
for each lot.
3. A corporate resolution for each lot.
4. An Engineers Design Data report for each lot.
5. Three sets of plans sealed by the Engineer
containing all the required data as outlined in
the Departments policies.
6. As these lots are being sold unimproved but
with SSDS Approval, we are not submitting specific
house plans for each lot. Be advised the Lots
1 -8, and 10 are designed for four bedrooms and
lot 9 for three bedrooms. We will advise buyers
by providing copies of this letter that they are
to provide you with house plans before start of
construction.
7. We are providing Well Permit Applications on
lots 1, 3,'4, 6, 8, and 10. Wells already driven
page 1
d'
will be used on lots 2, 5, 7 and 9. Logs of these
wells are herewith included.
8. A certified check in the amount of $3,000.00
to cover the combined fees on all 10 lots is
herewith included.
The field data, for lot 5 would indicate that no fill
is required for the system design and a two and one
half foot fill required for the expansion design. The
plans are presented as such, however the toe of slope
for the expansion fill will encroach upon the now to
be constructed system. The two options are to build
the system in fill or to request a waiver for
construction of the expansion fill at this time. As
the deep holes in the system area show more that
sufficient depth it would not be good engineering
judgment to construct a fill. We are therefore
requesting a waiver of the requirement that the expansion
fill be constructed at this time.
Please be advised that during the course of the
subdivision design representatives of the NYCDEP did
visit the site, review all available test data and
determine what additional testing would be required.
All that testing was completed and witnessed by them
and again by your department. A copy of the NYCDEP
letter is herewith included in each of the submittal
packages.-
Thank you for your cooperation in this matter.
Very truly yours,
rc
Julius I. Cesare, P.E.
page 2
. tiYYr.LVl/.J.A 1"1
P[TI'NAM COUNTY DEPARD= OF HEALTH
DIVISION OF EWIRONMEJrAL HEALTH SERVICES
AFFIDAVIT- CORPORATE OWNER APPLICATION
FOR PERMIT APPLICATION SUBMITTED TO PUTNAM OOUNTY HEALTH DEPARTMENT
TO: Cammissioner of Health
In the matter of application for:
I/ _T00-1 e J I.PJ/ f
represent that I am an officer or employee of the - orponation za�d am authorized
to act for s �i',STF�f%Lrh�i_/� LC C
-( Name -of ' Corporati n )
having offices at 20 /a vIoi -C
7A.,,4 tot.
.Whose officers are:
President:
(Name and 4LdEfress)
Vice-President:
(Name and address)
Secretary:
( Name and',\addres s )
Treasurer:
(Name and addre�-
and that I am and will be individually responsible for any and all acts of the
corporation with respect to the approval requested and all subsequent acts
relating thereto.
Sworn to before me this day
Of �_ r`r (. nKo-
:�, C, P 1 j�jr -.Z7(jj�
c
Signed:
Title: X/� �-
corporate Seal
20
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Date �P2/L 2. /9 9 �
Re: Property of Wcsr e4-s'r ReAtrx,
Located at
(T) P,sa,y Section 40 Block /. Lot 2 S�
Subdivision
Subdv. Lot # 3 Filed Map # Date
Gentlemen:
This letter is to authorize ,�z.I w4 u c f .ESARgz
a duly licensed professional engineer '� or registered architect
(Indicate
to apply for a Construction Permit for a separate sewage system, to
serve the above noted property in accordance with the standards, rules
or regulations as promulagated by the Commissioner of the Putnam County
Department of Health, and to sign all necessary papers on my behalf in
connection with this matter and to supervise the construction of said
system or systems in conformity with the provisions of Article 145 or
147, Education Law, the Public Health Law, and the Putnam County Sani-
tary Code.
Countersign
P.E. , R.A. ,
J Z.+e "
Address
105-62
Telephone
Very truly yours,
Si gnu
'Owner of Property
2-- C2-�� %vt10-t De
Address
P ,A' rc `c.. 7
Town
2—x --'s -711- 7
Telephone
SSDS DESIGN REPORT
QUAKER MANOR SUBDIVISION
LOT # 3
JAN
QUAKER MANOR SD LOT # 3
4 Bedroom Design
Design Flow: 4(200 gal /bed) = 800 Gallons
Perc Rate: 11 -15
Application Rate: 0.80
Req. Area: 800/0.8 = 1000
Req. Field Length: 1000/2 =500
Septic Tank: 1250 Gallons
RLI: 819.0
Use 12 lines, 42' long each Sysyem and Expansion
.-- --- ._ - -.
TOPS FORM 4151
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Date PrLIL
Re: Property of Wr-c7
Located at duAjen, #Y /1
(T) _ 1P'a to &V Section /o Block /. Lot " � 27
Subdivision of aAZIM RA•YOR
Subdv. Lot # 3 Filed Map # 2:�79 Date
Gentlemen:
This letter is to authorize
a duly.licensed professional engineer '� or registered architect
(Indicate
to apply for a Construction Permit for a separate sewage system, to
serve the above noted property in accordance with the standards, rules
or regulations as promulagated by the Commissioner of the Putnam County
Department of Health, and to sign all necessary papers on my behalf in
connection with.this matter and to supervise the construction of said
system or systems in conformity with the provisions of Article 145 or
147, Education Law, the Public Health Law, and the Putnam County Sani-
tary Code.
Countersign
P.E. , R.A. , 41,G// Z4
A4//
Address
9/ 2 ?9 7// s
Telephone
Very truly yours, _
Sign
Owner of Property
2e- CVLe)N(-4c oe .
Address
(%
PC -1
P U T N AM COUNTY D E PA R T M E N T OF H EA U T H
APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER DISPOSAL SYSTEM
i Narpe and Address of Applicant:
l 20 Co 41 PXtl� l' /WOW C1vy. D
2. Name of Project �(v'�+ /%?MXw• S� le7'3 Ssog 3. Location T /V /C: -t- PM-V"ws►
4. Project Engineer: a, /ur Z. 5. Address: 44#tC 4 , /-J,l/
�4�!
License Number: 1t 21C Phone:2 %S -7//�
6•. Type of Project:
_ Private /Residential Food Service Commercial
Apartments Institutional Mobile Home Park
4_ Office Building Realty Subdivision Other (specify)
7. Isvhis project subject to State Environmental Quality Review (SEAR)?
T Ypi Status (Check One). Type I.. Exempt
Type II. - Unlisted
8. Is z Draft Environmental Impact Statement (DEIS),required? ............. /
g H as DEIS been completed and found acceptable by Lead Agency? ...........
10. Nam: of Lead Agency
Is this project in an area under the control of local planning, zoning,
o r }they officials, ordinances? ......... ...............................
12. If o, have plans been submitted to such authorities? ..................
11.
13- H a spreliminary approval been granted by such authorities? "-Date Granted:
14. T y p of Sewage Disposal System Discharge...... Surface Water 'o-� Ground Waters
15. If surface water discharge, what is the stream class designation ?........
16- W a trs index number (surface) ........... ...............................
17. Is :roject located near a public water supply system? a
1$• I f ;es, name of water supply
w!1
Distance to water supply
I s ;roject site near a public sewage collection or disposal system ?..... &-a
D h ter. of sewage system Distance to sewage system
1 • test holes observed 22. Name of Health Inspector:
1,3• F:�'g"(ect design flow (gallons per day) ..................................... 1111Z 0
..... ............................... 0
2.
24. Is State Pollutant Discharge Elimination System (SPDES) Permit required ?.. /ll�
25. Has SPDES Application been submitted to local DEC Office? ...............
26. Is any portion of this project located within a designated Town or State
wetland? .................................. ...............................
27. Wetland ID Number ...................... ...............................
28. Is Wetland Permit required? ...... ............................... ......
Has application been made-to Town or Local DEC Office? ..................
29. Does project require a DEC Stream Disturbance Permit? ...................
30. 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 or NO
31. Is project located within 1,000 feet of existence of abandoned landfill,
hazardous waste site, salt stockpile, landfill, sludge disposal site or t/
any other potential known source'of contamination? ..............YES or NO
DESCRIBE:
2: Is there a local master plan or file with the Town or Village? A
33. Are community water, sewer facilities planned to be developed within 15 years? X4
�4. Are any sewage disposal areas in excess of 15% slope? ....... 'so
;5. Tax Map ID Number . ............................... ......................&0 27
6. Approved Plans are to be returned to: Applicant Engineer
f the application is signed by a person other than the applicant shown in Item 1, the
pplication must be accompanied by a Letter of Authorization. Failure to comply with this
rovision may be grounds for the rejection of any submission.
I hereby affirm, under penalty of perjury, that information provided on this
form is true to the best of my knowledge and belief. False statements made
herein are punishable as a Class A Misdemeanor pursuant to Section 210.45 of
the Penal Law.
IGNAIURES & OFFICIAL TITLES:
pz.
U 0 avc-
AILING ADDRESS: � J�'hoc. --- __
r%t r"I"A n VA
RnUAM COUNN DEPARTMENT OF HEALTH
DIVISION OF'ENVIRONMENTAL HEALTH SERVICES
AFFIDAVIT- CORPORATE OWNER APPLICATION
FOR PERMIT APPLICATION SUBMITTED TO PLUNAM ODUNTY HEALTH DEPARTMENT
TO: Commissioner of Health
In the matter of application for:
represent that I am an officer or employee of the corporation and am authorized
to act for
(Nape of Corporation)
having offices at
Whose officers are:
President:
L
Vice - President:
(Name and address)
Secretary:
(Name and address)
Treasurer:
(Name and address)
and that I am and will be individually responsible for any and all acts of the
corporation with respect to the approval requested and all subsequent acts
relating thereto.
Sworn to before me this day
of f�,' t ( / 19P
C-oovn r
ti
Sign
Title:
Seal
411
QUAKER MANOR SD LOT 0 3
4 Bedroom Design
Design. Flow: - ..4(200. gal/bed) 800 Gallons,.
Perc Rate: Tom`
Application Rate: 0.8 c;,.60
o.6 17.7
Req . Area: 8 0 0 / e-.-6 = 14XX)"
js 7 T 66
Req. Field Length: 1-&"/2 =5$0
Septic Tank: 1250 Gallons
RLI: 819.0
Use �i lines, 42' long each System and Expansion
�l rvt rep• ��/' =l9 �
fEer- SUASUEACC SOQ'111GC DISPOSAL, SYSIT -1.1 ~ S
FJ-LC t 1J.
Loa=f CO f {�, J a c K Fo t bC f v�•C I -�,�
/ 1uklress ,pr�mn har�sc Q� A
or '--zJ
rated at (Street) y,.kc►' �lc�f IPc�I Sec.
(indicate t�earesk cross street) - Dlock _ Lol Z
iwlicipaiity (30)
'
Watershed
SOM : PEnmrATTrm . T£S`r
DATA ItD(K.►IPM TU
BE. SUBM ITIED
Wrill 11PL'uarri(X•1S
3 to of Pre- Soakipg 7
„ Y
Date of Percolation
Test
IOtZ-
CLOCK TINE
MOOLAMM
tun�t
ro. Elapse
T
Depth to: Watet:. Fran
Ytater.%ve1
FL•ZtUU1IC1iCRd
►'
Start Stop Min.
Grcxmd Sarface`
Start
It t Inches
=Soil !fate
Stop `
Inches Inches
Drop In
Indies
tiin/in Drop
2a :33/
roe,
SEAL.-,
-19 Obaurel used in bo&'M o•f- hole..:
�� Sts to be i:epmbeX dt same depth anti -1 a
are ebtainod .at each PPreocimateLy egtL.il. ro��.,fi/1��y*�� 7'
pervolatioa test dole. 1111, data to' !r_ S1ti2fl�tCg " "'
for review.
2. Depth measarcmnents to' b-- made -tract top of 1101e.
Moof
s� ry
r Iy
lot
-z-�-
l�tvl:;ii:ci cx� - i:rllx^•:•:�?••t::t. iz!•:�t:t7s :;i•;.y1c�.:_
W i TNeSSO BY MEL P•C/ H•(7
=iG-1 PVrA Si1L- r- S'Ji3SUC -:C S: -4TJGZ OLSiMNL St51 ".'M-
1'J.c NJ.
01
p�rr:e_ LOFT CORK A radress
Loc=ted at (St=em) ., Q t A kc-A Ni" ROAD '- Block
' Lot 26A
(in ie-'te ne re5� cross sere -et)
QLLAKFR MANOR 8UBDIVcStdN
Wat _''Shei CRoTON
MLs c Parity
qnr, � sxuy �az� �I°M clo pc sua%aq-=) w-TtA APPTSC��'iCt�S
Date cf Pre -Scat ng J 2 %/S 9 Date. of Pe colata ca Tes,, 7/
��9
BOLE,..
] � ('r�C•C TLS P_ 1I TIC�I
P LIMICH
R 'E32 e . Dent_ ; W t�t�~ F_'ca
< Tim Grciuxi 5c:lu
_
SiAD ' :
1?zC_6 Xn
M]11�.'.1 lilC_p
?yes <:
-" 3a"
�N
2
1. :�0: yi - .0..59 �g :ay"
Z 11:13 - 11:'y5 MIN ` aN" 4 49
.
-' 'r.,.3,N:
•! "V' /al.
y3 /y"
�3
a,
, �''; y` 6' a3`3�y
- -
_.
441 - is ;y� 3oM� N cl3 /y,,
s
'te
3
4
Le
3
1
_
^�
N{y,
,�• korESSIONP�
_ Des`s to be re_pe-ated• at .zme deodi until aooroxinlately c=-ua7. 5Oi = es
are obtaine3 at mch Percglation test hole_ )\11- data to be SUL- nitten
for revic,4.
2_ De3t11 rrrzsuren° It to be mnZc. L'rcn trop of bole.
1•
2'
31
TEST PIT DATA RDOUIRED TO BE SUBMITTED WIM APPLICATION
DESCRIPTION OF SOILS ENOOUNTMM IN TEST HODS �f
HOLE NO. A HOLE NO. • HOLE NO.
6Gt•
4
-
i+!
Via7LitV�ii.1
\Jl`..7 IY7L�i W. �•. ` 3 ('•� ' �`•••
,tDEEk'„HOLE
t
t nESIGN 9bOc Sr
�SoilRate IIse3 �1 45 Mu�/1" Drop s S D ;IIsaiale Area Provided
t10 of Bodrooms ` .
Septic Tank (hp3city I Z SL
.
6'
G
Ai�sorpt� on Area Provided . By 24" width trench
Other
C:,27Htn� Jr„�t
,.
Nan o�.��
GoQ�r„vs �L. g t'�
o
Address I2. r> S
fLTE ZZ— J p t
SEAL
•
Co �'
.; .1980
777� R 77.
..icexr`RrsFS =' Eo 3''
n .�a..►.JVa�.ca�� a�ur-.. av .
-
i+!
Via7LitV�ii.1
\Jl`..7 IY7L�i W. �•. ` 3 ('•� ' �`•••
,tDEEk'„HOLE
t
t nESIGN 9bOc Sr
�SoilRate IIse3 �1 45 Mu�/1" Drop s S D ;IIsaiale Area Provided
t10 of Bodrooms ` .
Septic Tank (hp3city I Z SL
.
Ai�sorpt� on Area Provided . By 24" width trench
Other
C:,27Htn� Jr„�t
,.
Nan o�.��
GoQ�r„vs �L. g t'�
o
Address I2. r> S
fLTE ZZ— J p t
SEAL
•
Co �'
.; .1980
O So°T 1 L l • , dFw
J•
mus SPACE EDR USE BY [ECALM DEPAMMENT ONLY:1 \\
pROFE= :StUN��
Soil Rate Approved
`fit- Lr/9a-k-
Date
REQUIRED TO -B>, SUBMITTED ,1•.'TTN APPLICHTIGII P
EfP'1.1OIk OF SOJL ;' EII "OUi�tT�-REb II.- TEST
_•,, K _ , iiOLE I10`,�3 HOLNO.
Vj
�� .I?X•'rc'i�!+ .:',� fYr t, f1�.1t �k � ; t '`•�
r ,,
r.
1?• r' / z
} y -• N F ;- '...:.:.. .. ., ... _. ... a.. ' W -0 / 7' rte. . .
f
t' -
v c t e
. �
Nth' QraV-Q c
i,.+r.F.....:: -s. .t ;+. -. " 7r �'n.7ari x S t -�Xt yy�'? }#24 ,i ��_ w, •.
IICATE LEVEL AT. , I MCH . GROUND WATER I3� ENCbUNTERED
ND �i'✓$l�i Y ` ! � � `� �.
IMICATE LEVEL'TO WFIICH WATER`LEVEL RISES 'AFTER BEING ENCO
'PES'T'S MADE BY , vex
DESIG
So;? Rate Used Mira/1. Drop , ,SAD. Usabl0'-Area fiProvided
No, of Bedrooms . Septic. Tank Capacity - Gals ' Type
Absorption Area � Proy a By ' - . L. F jc2 "�6 . - - .... . .width trenc
.
,
rnaA
Sc
; . igna. ure
Adiress
,O SEAL
_
i< _
A w r
�IIS SPACE FOR U L'+
DM RTIMIT 014IY: i.
--Ida Rate Approved ."'%..,..-* Checked by e
�OFEss l V s P"' �\
., PUINAM COURrY DEPARTMERr OF HEALTH
DIVISION OF ENVIRCNMENTAL HEALTH SERVICES
DESIGN DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO.
Owner V0'j" fi Address Cm /,.o►,n7 !7R T�Aayfax
Located at (Street) .S • O Y JkCr f , %' P Sec. . / Block / Lot2 i
(indicate nearest cross street)
Municipality fAl f;) � a" Watershed C12�.y
SOIL PERCOLATION TEST DATA PMUIRED TO BE SUBMITTED WITH APPLICATIONS
Date of Pre- Soaking JW C/r7 /97 Date of Percolation Test 6 ��7197
HOLE
NUMBER CI= TIME PERCOLATION PERCOLATION
Run Elapse Depth to Water Fran Water Level
No. Time Ground Surface .,In Inches Soil Rate
Start -Stop Min. Start Stop Drop In Min /In Drop
Inches Inches Inches
z
/% ? -31d-. 20
3 30
4
5
1
2
3 70 *Avk,
5
2.
rev. 9/85
Tests to be repeated
are obtained at each
for review.
Depth measurements tc
at same depth until approximately equal soil rates
percolation test hole. All data to'be submitted
be made fran top of hole.
#X Sr PIT Iu1TA RU)UIlUED M BE SUBt9ITIM W1111 'APPLICATION
DESCSt=ION Or SOILS M0Uall= IN TILT ElOL>:S
nom NO. if .: S h
G.L.
IiOLC :W.