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00015
WELL COMPLETION REPORT
Z /71
PUTNAM COUNTY DEPARTMENT OF HEALTH
tliviainn. of Fnvirnn.nantal Maalth Sarviras
"
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
anal
Vsis 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
en-'r L�,9N% ;'
ADDRESS ,
�hAW L.ANE, isQd/ /N 1'G% ; Al.
IOCATIO
(No. 6 Street) (Town) (Lot Number)
OF WELL
BIR01 hl / L L P019 U PAT I
BUSINESS
® ❑ ❑ ❑
PROPOSED
DOMESTIC ESTABLISHMENT FARM TEST WELL
USE OF
WELL
❑ OTHER
❑ ❑ INDUSTRIAL ❑
SUPPLY CONDI,TIONING )
DRILLIN
ROTARY R PERCUSSION ❑ El
EQUIPM
T
PERCUSSION. (specify)
CASING
LENGTH ( lest)
DIAMETER(Inchea)
WEIGHT PER FOOT
El ❑ WELDED
ORIVE SHOE
YES ❑ NO
G D
YES NO
DETAIL
THREADED
YIELD
HOURS G.P.M.
❑ BAILED PUMPED ❑ COMPRESSED AIR
YIELD (G.P.M.)
TEST
WATER
MEASURE FROM LAND SURFACE —STATIC (Specl/y feet)
DURING YIELD TEST [feet)
Depth of Completed Will �y
LEVEL
in feet below Land surface:
MAKE
LENGTH OPEN TO AQUIFER (feet)
SCREE
SLOT. SIZE
DIAMETER (Inches)
IF GRAVEL
Diameter of well including
GRAVEL SIZE (Inches)
FROM (feet)
TO (feet)
DETAIL
PACKED:
gravel pack (Inches):
DEPTH FROM
LAND SURFACE
FORMATION DESCRIPTION
Sketch exact location of well with distances, to at least
two permanent landmarks.
FEET
o FEET
r
WELL
0
0�
N
0
J�
Qti
O
a
n
H +�
1P
Ho 1G
O<' tiO4
tiPio
0
If
yield was tested at different depths during drilling, list below
FEET
GALLONS PER MINUTE
0
DATE WELL OMPLETED
fiE /�`%
;DATE-OF REPORT
3/i "7/x'9
WELL GRILLER (Signature) / fO�
)
r1
PLTI'NAM COUN'T'Y DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
DARLY A PAVLETiE JEANTY. S i 9
owner or Purchaser of Building Section Block Lot
Rox STONY DEVELOPERS , tNc.
Building Constructed by
81RCN NiLi- RoAD
Location - Street
PArrERSoM
Municipality
FRAM E 1 S' /N 4 C. E FAM/l. Y
Building Type
QUAKER RIDGE CSTATCS
Subdivision Name
i
Subdivision Lot #
GUARANTEE OF SUBSURFACE SEWAGE DISPOSAL 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 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 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 occupant of the building utilizing
the system.
The undersigned further agrees to accept as conclusive the determination of
the Director of the Division of Environmental Health Services 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 this / - day of 19 �,?( Signature
Own(r) ;- Signature
Corp- ratibn Name (if Corp .)
- :'mac -�,,
Address -� _:
rev. 9/85
mk
Title
`Corporation Name (if Corp._)
Address
I
FTIPL Si1'E LIST- C?' =CV Cat_ a
Ins t- by
1 �
CNZIER
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ea
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b.
Fill i si c- - Date _ of plac_%nt
2. Tr__r . w;1 E A��c_�
1
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PUTNAM COUNTY DEPARTMENT OF HEALTH
Rev. 3 8, 6 Division of Environmental Health Services. Carmel, N.Y. 10512 Enginecr.to Provide Permit q
on CERTIFICATE`OF COMPLIANCE
CONSTRUCTION PERMIT FOR AGE DISPOSAL SYSTEM Permit .N
Located at JR I. R C H N) L L R 614 D Town or Village
Subdivision- Name VA K E Q R I V.6 E 6!?ATESSubd. Lot q 1 Tax Map Block Lot
Owner /Applicant, Name P A R C Y - P A V I, E T T E ,TEA M Ty Renewal_ ❑ Revision ❑
Date of Previous Approval,
,i
` 24 .ANf
Melling Address`'. SHAW Town _ Zip
1RVINGToN . N..Y IOS33 .
Banding Type GRAM E InAW F0#11.1 Lot . Area S. 3 8 t9 a c ES Fill Section Only Depth's _ V.lura-
Number of Bedrooms Design Flow G /P /D goo PCHD Notification Is Required When Fill is cowpleted
r. eP
Separate Sewerage.Syetem to consist of �. 1! 1.5 Gallon Septic Took and 810 1 F11"b-
To be constructed by M i k E 4 R A z I p N 0 v jAdress , Q
Water Supply. ` Pdbllc Supply From Address
or ✓ Private Supply Drilled by H ya T T address Ro utf 31( PA ? T �R S e N� I�•y
' Other Requirements
represent hat J am wholly and completely responsible for the design and location of the proposed, system(s); 1) that the separate sewage disposal .system
above - describetl, will be constructed as shown on the approved amendment there to and in accordance with the standards, rules and regulations of e Putrigm
County Department of Health, and that 'on completion thereof a "Certificate of Construction Compliance" satisiactory'to the Commissioner of Health 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
1 place in .goof operating condition any part of said sewage disposal system during the period of two (2) years Immediately following thedate of the itsu-
' c ancii of the :approval of, the Certificate. of .Construction Compliance of the original system or any repairs thereto; 2)*that the drilled well described above
, y will be located as shown on the.approved plan and that said well will be installed in accord nce with th andards,. rules and regu,aons of the Putnam
.Fi CountY Department of 'Health. - ..
i Date , ,,g :. '67 Signed P. E. �.' R.A.
T t Address Z'Z SIN /T I/ R1D1i6 RP;. so wtq rA I_ Aix NrY� License No 1332'1
j APPROVED FOR CONSTRUCTION: This approval.expires one.year. from thedate issued unless construction of the building has_been undertaken and is
?r revocable for'cause;oi may be amended or modified when considered necessary by the Commissioner. of Health. Any change or alteration of construction
requires a new':p mrt. _;Approved fo! disposal ofdomestic'- samtarysewage an r. a water supply - only:
�GO
s' Date a69��
;h_
•: • - r�• is v .ay is �- •��,. DESIGN DATA MM-SUBSUFACE S3qAGE DISPOSAL SYSTEM FIEE NO;.'
Owner DAR1 -Y A 1PAuL61"t6 X ANTYAddress 24 SNAw LqNE, rRyjNGToN, N.Y.
NORT# Of
T ted at (Street) B/R.0 H H It [ RD. . MoRw/N4 siDE DR, Sec. .S Block. / • Lot 9
(indicate nearest cross street)
Municipality. PA T T E R S c N. Watershed
• ■ • �• �• •' Y?. / • Y• ' �• /• �! • � 1 Yes ; •/• •
Date of Pre- Soaking 10 - J o - 8 G Date of Percolation Test / o - 1 - 9 C
HoI.E
NUMBER CL :K TIME PERCOLATION PERCOLATION
Run Elapse Depth to Water From Water Level
No. Time Ground Surface In Inches Soil Rate
Start-Stop Min. Start Stop Drop In Min/In Drop
Inches Inches Inches
l 9:09 - 9:39 30 24 24.4 19
2 9:40 - lo: 10 30 24 24.9 .9
310:11 - 10:41 3o 24 24.7 .7
4 /0:42 - /1 12 30 Z.4 24.7 • 7 43
5
Q2 1 gall - 9: 41 30 24 25. 2 5' 1.2 S
2 9 :42 - /0; 12 3o Z4 25 1
3 10:13 10; 43 30 24 ZS l
4 10:44-
//;/4 30 24 25 1 30
5
9; 43
3o
24
2S
2 9 ;44 - /0,'/*
30
24
2 S I
3 10; If` /0 :45*
36
24-:
ZS 1
410 :46 - 11:16
30
24
ZS I 30
5
NOM: 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
DEPTH HOLE NO. /
G:L. .
] � S /L 7 Y C44 Y COAM
2'
3'
41 .
5'
6'
7'
8'
9'
10'
11'
12 T,
A02 :1 .'ioa= yr4+1+P el:J4rc &ark *ft*A!K6 i
)ILS :ENC OUrTI PM IN TEST:::HOLES''
HOLE NO. HOLE NO.
lNfoR►yar/oN Fkol►�
APPROvED su8P'v)SI0*► MAP
OF Q yAKER RIDGE ESTATES
13'
14'
INDICATE ' LEVEL AT WHICH C,'f20TJNI7wl= as
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENOOUNTERID
DEEP HOLE OBSERVATIONS MADE BY: -DATE:
DESIGN
Soil Rate Used 31- 45' Min/1" Drop: S. D. Usable Area Provided
No. of Bedrooms S Septic Tank Capacity 1, 2 S0 gals . Type cave /At a -r e
Absorption Area Provided By 840 L.F. x 24 width trench
2 Fr. OP Rum op QANK CiRAWEIL FILL 7`D 6E PcACED' IEIC ,4 ?E"A
Other M o Q rb coN.f T R u c roow+ or
D I f P OJ A� J' yf T6 M
Name 4 N TH o n► Y L,0 S c R I Signature T
r,
Address 2 2 S nT ► T H ►t ► D 4 E *V. R R 2 SEAL
SOV 7H rA cEM, pl.y, <o Sqo `p, X61332=
'r��CC+n i of
THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY:
Soil Rate Approved sq.ft /gal. Checked by Date
DEPARTMENT OF HEALTH
Division of Environmental Health'Services
TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641
APPLICATION TO CONSTRUCT A WATER WELL
PCHD PERMIT
WELL LOCATION
Street Address Town /Village /City Tax Grid Number
B1RCH HILL ROAD PATTERSSoN
WELL OWNER
Name
J'E'AN 7"Y 24
Mailing Address )WPrivate
SHAW LANE, ZAV1N47'o1v, N.Y, 105'33. OPublic
USE OF WELL
( - primary
2 - secondary
XfRESIDENTIAL
O BUSINESS
❑ INDUSTRIAL
❑ PUBLIC SUPPLY O AIR /COND /HEAT PUMP 0 ABANDONED
❑ FARM O TEST /OBSERVATION ❑ OTHER (specify
b INSTITUTIONAL O STAND -BY O
AMOUNT OF USE
YIELD SOUGHT
,s gpm /# PEOPLE SERVED 6 /EST. OF DAILY USAGE J, 000gal
REASON FOR
DRILLING
XINEW SUPPLY O PROVIDE ADDITIONAL SUPPLY O TEST OBSERVATION
OREPLACE EXISTING SUPPLY ❑DEEPEN EXISTING WELL
DETAILED
REASON FOR
DRILLING
o r "PP&. y
WA7C'M TO P ?OP osED A�gw HO L'S E
WELL TYPE
DRILLED
DRIVEN
E]DUG
DGRAVEL
OTHER
IS WELL SITE SUBJECT TO FLOODING? YES X NO
IF WELL IS LOCATED IN A REALTY S_ UBDIVISION, NAME OF SUBDIVISION: Q vA K gR R / DG E E sT AT ES
Lot No. /
WATER WELL CONTRACTOR: Name HYATT Address: RTE 311, PA7'TEeseN
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO
NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY
DISTANCE TO PROPERTY FROM NEAREST WATER MAIN:
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED
O ON REAR OF THIS APPLICATION SON SEP TE S EETo.
(date) (signatur
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. ���c�ial��� �
i ! r ��� -te Date of Issue:���' 19..-� ermit Issuing
Date of Expiration: 19�
t White copy: H.D. File
Permit is Non - Transferrable
Yellow copy: Building Inspector
Pink Copy: Owner
2J87 8 7 rr.- MTl f. 107 11 rN- 1 1-
Anthony Loscri, P.E.
22 Smith Ridge Road
RR 2
South Salem, New York 10590
September 1, 1987
Mr. Robert Morris
Environmental Health Technician
Putnam County Department of Health
Division Of Environmental Health Services
110 Old Route Six Center
Carmel, New York 10512
Re: Jeanty, Birch Hill Road
(T) Patterson
Dear Mr. Morris:
I have revised the previous submission as per your letter
dated July 28, 1987.
Tax Map Number 5 -9 -1,
Section - 5
Lot - 9
Block - 1
Above information from Patterson's Assessors Office.
The closets in the study /den have been removed and the
bedroom count has been raised to 5 (includes loft).
The accompanying new sets of plans reflect all the changes
needed.
If you have any questions please call me during the day at
914 - 285 -251,?
LiJ -.
Thank you f`-k your'•assistance.
Sincerely yours,
Anthony Loscri, P.E.
PETER C. ALEXANDERSON
County Executive
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
110 Old Route Six Center, Carmel, New York 10512
(914) 225 -0310
Mr. Anthony Loscri
22 Smith Ridge, RD RR22
South Salem, NY 10590
Dear Mr. Loscri:
July 28, 1987
C) c
JOHN SIMMONS, M.O.
Deputy Commissioner
JOHN KARELL, Jr., P.E.
Director
Re: Jeanty, Birch Hill Road
(T) Patterson
Review of plans and other supporting documents submitted
at this time relative to the above - captioned project has been
completed. Comments are offered as follow:
1. Tax map number not provided on permit application.
2. Well permit application not submitted.
3. Depth of curtain drain not noted.
4. Standard notes 1, 2, 3, 4 and 5 missing.
5. Design data, i.e., percolation rate and deep test hole
log is not noted on plans.
6. SSDS is to be divided by means of a distribution box or
a dosing system is to be designed, the prior
alternative is preferred.
7. As per subdivision map and submitted design data sheet
percolation rate is to be noted as 31 -45 minutes per
inch, not 30 minutes per inch.
8. Signify junction boxes are to be used in the SSDS on
plans.
9. Loft is to be considered in the bedroom count,
increasing total design to 5 bedrooms.
" N>
-2-
Loscri,
Re: Jeanty, (T) Patterson 7/28/87
10. If study /den is not to be considered in bedroom count,
closets are to be removed from house plans.
11. Sewage system hydralic profile not shown on plans.
Upon receipt of a submission, revised to reflect the
above comments, this application will be considered further.
Very truly yours,
Robert Morris
Environmental Health Techn.
RM;amm
Z
PIV-
V - -
APPENDIX B
PUrtAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES
INDIVIDUAL Va= SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS
� �•x r i �
( o Owne
C
LF trench proviaea
required —
60 ft. max.
Y Parellel to
�v 7
/J- v
REVIEW SHEET - CONSTRUCTION PERMIT
(Street Location)
YES NO DOCUMEN'T'S
Permit Application
Corporate Resolution
Plans - Three sets
Engineers Authorization
Design Data Sheet (DDS)
Deep Hole Log
Consistent Perc Results
Perc Hole Depth
1
s/s
SUBDIVISION
Perc
(3) Fill
ca
House Plans - Two sets
Well a permit; PWS letter
Variance Reauest
GENERAL
Legal Subdivision
Subdivision Approval Checked
Ex- approval SSDS P.dj. Lots Checked
Wetland (Town /DEC Permit R & D)
Data On DDS Plans & Permit Same
REQUIRED DETAILS ON PLANS
Sewage System Plan - (north arrow)
Sewage System Hydraulic Profile - Gravity Flora
contours Fill Profile & Dimensions - Volume
D or J Box;Trench /Gallery; Pump pit details
Septic Tank - Size, Detail
e11 Detail, Service Line if over
Construction Notes
Design Data: perc and deep results .
Two -Foot Contours Existi.ng.& Proposed
Driveway & Slopes Cut
Footing /Gutter,Curtain Drains (discharge OK)
Perc & Deep Holes Located
Representative of primary and expansion
Expansion Area; shown; gravity flow,suff. size
If Pumped Pit & D Box Shown & Detailed
House - No. of Bedrooms
Wells & SSDS's w /in 200 ft. of Proposed System
Property rtes & Bounds
_House Setback Necessary (Tight lot)
House Sewer - 1 /4 " /ft. 4 "0; Type pipe .
No Bends; Max. Bends 450 w /cleanout
SEPARATION DISTANCES SPECIFIED ON PLAN
Fields
10' to P.L., Driveway, large Trees,Top of fi'
20' to Foundation Walls
100' to Well; 200' in D.L.O.D, 150' pits
100' to Stream, Watercourse, Take (inc. expa
. 15' to Drains - Curtain, Leader, Footing
35'to catch basin,stormdrain,piped watercour.
10'. to Water Line (pits -201)
11V 1 50' intermittent drainage course
Septic Tanks .
10' fran Foundation; 50' to well
15' Well to PL
t�t/�11 �'zzI -,,II A i f
PUINAM COUN'T'Y DEPARTMERT OF HEALTH
DIVISION. OF _ HEALTH SERVICES
DESIGN DATA SHEET - SUBSUFACE SEWAGE. DISPOSAL SYSTEM FILE NO.
Owner 0AR LY PAW L ff TT E TEANTY Address Z4 SNAw LANE, IRVINGTON, N• y 105,3?
n+oarm 69
Located at (Street) Q/R c H HILL RD. k7wi v 4 sib e' PR. Sec • Block . Lot
(indicate nearest cross street)
Municipality PA T T E R Soar Watershed
Date of Pre- Soaking
10-10-86
Date of Percolation Test / 0 Oro
HOLE
4:41..,
3o
Z4
NU-1BER_ 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
10; 45'
30
Inches Inches
Inches
1 q ; o9 - 9 ;39
30
24 24.9
• 9
2 9:40 - W 10 .30 24 24.8 • $
3 10;11 - ►o:41 3o Z4 L4.7 117
4 10:4Z -I/.* 12 30 24- 2.4,7 .7 43
0
5
<3j .1
4:41..,
3o
Z4
25.15 1,25
2
9:42 1o; 12
3o
24
2S 1
2
9144-
3
10;13 - 10;43
30
Z,4-.
ZS 1
to; IS -
10; 45'
30
24
4
lo, 44.- 11; 14
30
44
ZS 1 30
5
<3j .1
9 :t3 •
9 #43
3o
t4
L5 1
2
9144-
10 14
30
Z4
ZS
3
to; IS -
10; 45'
30
24
ZS' 1
4
/o; 46. -
11:16
3.o
L4 . .
ZS' l 30..
5
1. Tests to be'repeated at same depth until approximately equal soil rates
are obtained at each percolation test hole. All data to' be suhritter3
for review.
2.' Depth measurements to be made fran top of hole.
rta. 9/85
G.L.
it
2'
3'
4'
5'
TEST PIT DATA REQUIRED TO BE
DESCRIPTION OF SOILS EN
HOLE NO.
S /LtY CLAY I-6A M
IN TEST
HOLE NO. HOLE NO.
IN PoRMAT/ 6N fI�OM'1
APPR6VED P
OF QUAKER R/DevE ESTATES
6'
7'
8'
9'
10'
11'
12'
13'
14'
INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED 46 �� f
DEEP HOLE OBSERVATIONS MADE BY: DATE:
DESIGN
Soil Rate Used 30 Min /1" Drop: S. D. Usable Area Provided /5,000 s.f.
No. of Bedrooms 4 Septic Tank Capacity I, 2 S0 gals. Type cowcaerf
Absorption Area Provided By 84 0 L.F. x 24" width trench
Other Z Fr- of Rum of 8gNK Qn2 *vEL F /GL To SE P «CCD D .490-A
P /Z"R TO ccrsTRuct/*N ei D/lPolAl sysr roNd
s
Name 4 M TN oN Y L O S C R I Signature
Address ZZ SM I rN R /v4 F RP- R R 2 SEAL r
S'ovTH f AtEM � /v,y /OS90 y ��
`CFO �61332•Z G�
THIS SPACE FOR USE BY HEALTH DEPAMlENT ONLY: ��FESSIONP�
Soil Rate Approved sq.ft /gal. Checked by Date
\ V
\
35
�O
J
TOTAL LENGTH OF FIELDS a 840 L.F
SEPTIC FIELD PLAN
SCALE S' - 20'
34
F`
J
ti
LOCATION TABLE
POINT
No.,
DISTANCES
CORNER A
CORNER 8
1
37' -4'
65' -0'
2
46' -0°
75' -0"
3
50' -5°
80' -0'
4
67' -4"
105' -2"
5
93' -0°
133' -5"
6
97' -6'
137' -3"
7
101' -9'
141' -0'
8
i
145' -4'
9
113' -0'
150' -8°
10
.119' -8'
156' -3"
11
124'-3"
159' -B"
12
71' -2'
10B' -4"
13
76' -10"
113' -0'
14
82' -0'
.117' -2°
15
88' -2'
122' -5"
!6
95' -5'
128' -6°
17
103' -0°
135' -0"
18
109' -0"
19
54' -0'
64' -4"
20
58'-6"_.-*
69' -5°
21
65' -0'-
i
22
71' -3 ",
82' -0"
23
78' -6"
89' -2'
24
85' -8"
96' -3"
-_ - -?r _-
-92
102' -6"
26
99' -0'
109._0"
27
74' -0"
66' -3'
28
79' -3"
73' -0'
i
84' -6'
79' -4"
30
90' =91
86' -10'
31
97' -0'
94' -2"
32
102' -10"
100-B"
ti
LOCATION TABLE
POINT
No.,
DISTANCES
CORNER A
CORNER 8
1
37' -4'
65' -0'
2
46' -0°
75' -0"
3
50' -5°
80' -0'
4
67' -4"
105' -2"
5
93' -0°
133' -5"
6
97' -6'
137' -3"
7
101' -9'
141' -0'
8
107' -0'
145' -4'
9
113' -0'
150' -8°
10
.119' -8'
156' -3"
11
124'-3"
159' -B"
12
71' -2'
10B' -4"
13
76' -10"
113' -0'
14
82' -0'
.117' -2°
15
88' -2'
122' -5"
!6
95' -5'
128' -6°
17
103' -0°
135' -0"
18
109' -0"
19
54' -0'
64' -4"
20
58'-6"_.-*
69' -5°
21
65' -0'-
75' -9"
22
71' -3 ",
82' -0"
23
78' -6"
89' -2'
24
85' -8"
96' -3"
-_ - -?r _-
-92
102' -6"
26
99' -0'
109._0"
27
74' -0"
66' -3'
28
79' -3"
73' -0'
29
84' -6'
79' -4"
30
90' =91
86' -10'
31
97' -0'
94' -2"
32
102' -10"
100-B"
33
109' -6"
107' -7°
34
143' -3°
136' -0"
35
173' -9"
208' -8"
rucnam counsy Ueparcmen' oZ n"n-L" '
iivision of Environmental Health servicb.
kpproved as noted for conformance with
a;r,'_icable Hules and Regulations of the
?utnam County Health Department.
n,
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AS BUILT SEWAGE DISPOSAL SY
'THIS IS TO CERTIFY THAT THE DISPOSAL SYSTEM WAS FOR
CONSTRUCTED AS INDICATED ON THIS PLAN AND THAT THE
SYSTEM WAS INSPECTED BEFORE IT WAS COVERED OVER. P A U L E T T E D A R L Y J E A N T Y
THE SYSTEM WAS CONSTRUCTED IN ACCORDANCE WITH ALL
STANDARD RULES AND REGULATIONS OF THE PUTNAM COUNTY
DEPARTMENT OF HEALTH AND THE NEW YORK STATE
DEPARTMENT OF HEALTH.- BIRCH HILL ROAD
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Wtnam County Department of Heslt&
BTvleion of EavironaMtal Health serum SEPTIC' FIELD PLAN,-
&pproved as noted for oonformance with
applicable Hines and HevAatlQM Ot the SCALE i" 20+
LEGEND
PERCOLATION TESTS
EXISTING WELL
EXISTING CONTOURS
PROPOSED CONTOURS
PROPQSED N1
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