Loading...
HomeMy WebLinkAbout0499DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 15. -1 -2 BOX 6 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 #f— 8c WELL LOCATION Street Address Brimstone Road Town/Village/City Tax Grid Number T. Patterson 18 -1 -6.14 WELL OWNER Name Mailing Address . ®Private Cardone etal 344 Willis Ave. Hawthorne, NY 10532 O Public USE OF WELL 1 - primary 2 - secondary (TRESIDENTIAL 0 BUSINESS 0 INDUSTRIAL O PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP O ABANDONED O FARM O TEST /OBSERVATION O OTHER (specify, U INSTITUTIONAL O STAND -BY AMOUNT OF USE YIELD SOUGHT 5 gpm /# PEOPLE SERVED 8 /EST. OF DAILY USAGE 800 gal REASON FOR DRILLING UNEW SUPPLY []PROVIDE ADDITIONAL SUPPLY O TEST OBSERVATION OREPLACE EXISTING SUPPLY -0 DEEPEN EXISTING WELL DETAILED REASON FOR DRILLING New Residence WELL TYPE DRILLED ODRIVEN ODUG OGRAVEL ® OTHER IS WELL SITE SUBJECT TO FLOODING? YES X NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Cardone Lot No. 4 WATER WELL CONTRACTOR: Name P.F. Beal & SOns, Inc. Address:Rte: 6) Brewster,. NY 10509 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: Over one mile LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED(see dwg. #1, Job #S.O. 2462 By John H. []ON REAR OF THIS APPLICATION [DON SEPARATE SHEET Prentiss,,P. 31 March 1988 (date) ' (signature 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 s.hall: 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 per it. 3. Submit a Well Completion Report on a form pr ided by the utnam�County Health Depar Pent. ` Date of Issue: 19 Date of Expiration: 2 19 Permit ss ng ff cia White Permit is Non - Transferrable copy: H.D. File ' YellOw cppy. Bw 1 ding Inspector Pink Copy: Owner 287 Orange copy: Well Driller tnui >a Type. F r aine Lot Ares 2.01 Acre Fifi section only X. Depth 3V vd me • 7 53 cu yds. Namhei of Bad rpeme Fnn r pesign ]pow 'G P D -800 PCHD Notification 1s'Be4tdred When FE le completed Separate Sewerage,Systen to consist of 1250 GA.,Septic Tack -d 500' x 24" w. x 184t Deep Laterals To be conatrocted by Address 7 Water SnPPh : Pabllc Sttpply, Flom Address ort R Private;SeatrplyDrtllod.by P•,F., Beal &,, S ales. Rte. 6, Brewster, NY 10509 nt,e,iea,,oi;,„a>;m'.R -O B Fi11:Secton _x.:5808 s4:ft.. f represent that I" am wholly a4 completely responsible_ for the design ani above described will be constructed as shown on'the ipproved amendment County Department 'of.. Health ,'and that on commetion,thereof i "Celt be'wDmitteq to the,A,epirtmenf, ands written - guarantee wild be fuH place in good operating condition any perf, of said sewage disposals tine. of the ipproval of the .Certificate of Construction., Compliance, t will be located as shawn`on the approved plan and that said well w411.6 e-inl County Department of Health. Date 31,-March 1988 Signed- ' APPROV,E'D FOR CONSTRUCTION This :approval expii revocable for c4uj6 or,, ma ran- Or modified whe ':requires a ne l . er ed for ;disposal Of don lev. 187 Date By ion .of the proposed system(s); 1) that the separate sewage disposal system t0 and in accordance with the standards, .rules and regu a ions of e Putnam of Construction Compliance" satisfactory to the Commissioner of'Healthwill the owner, his successors, heirs or aisigns'by the. builder,, that said builder will during the period'of two (2) years Immediately following thedats of the issu- original .system or any repairs thereto; 2) that the drilled well described above inl accordance with -the standards, rubs and regu a ons - of. the Putnam is tvL: -v ars.iiom the .date lU.7aZ ued unless - construction COTmissiondr of yleattl P.E. R.A. License`No 29206 of the building has been undertaken and is IAny change or'alteration of construction Title PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date 2 March 1993 Re: Property of E. & E., & C. &P. Cardone Located at Brimstone Road (T) Patterson Section 15- Block 1 Lot 2. Subdivision of Cardone Subd. Subdv. Lot # 4 Filed Map # Date Gentlemen: This letter is to authorize John H. Prentiss a duly licensed professional engineer X or registered architect to apply for a Construction Permit for a Is'eparate sewage system, to serve the above noted property in accordance with the standards, rules or regulations as promulgated 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 Sanitary Code. Very trul ours, a? > .rt A Signe ., y'k2•rt'�.,d'tril � Prope ty Owner Counters ed: c�, /1 0 ° 29`i 6 344 Willis Ave. F �0THE SIAt �*c Address P.E., R.A., # 29206 .Hawthorne, N.Y. 10532 RD9 -Fair St., Carmel, N.Y. 10512 Town Address 91.4- 769 -9267 914 - 878 -6170 Telephone Telephone PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DEPTH HOLE NO. - HOLE NO. .;A(g _ HOLE NO. G.L. , c6 t 21 h Ali -►i7�N �CJ�t. t1.f..r 3' C9 a, 4 " lboft II 5' 6' 81 9' 10' 11' 12' .13' 14' INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY: �jI T- DATE: DESIGN Soil Rate Used Ij/ Min /1" Drop: S.D. Usable Area Provided �m�t No. of Bedrooms_ Septic Tank Capacity gals. Type y Absorption Area Provided By 5eo L.F. x 24" width trench T` \ Other CCGi1pIJ � �.� ,rya" �O Q(i�FESPIpryA� �y Nam -. Signature S. P.E. R09 FAIR ST 914-878-6170 SEAL CARMEL NEW YORK 10512 USE BY HEALTH DEPARTMEM ONLY: Z O 0 N0. 29206 ��.� ,F ie ST41t � Soil Rate Approved sq.ft /gal. Checked by Date DIVISION OF ENVnM0QTAL HEALTH. SERVICES DESIGN DATA SHEET SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO. Owner Cmme Address, it� \IASiDiJE•��4oAt� Located at (Street) Sec. �Q� rBlock Lot L jeji (indicate n t, ..cross , street) Municipality 't'"C'!�,_RSo t� Watershed. Date of Pre- Soaking j - 6 -•$::. Date of Percolation" .Test HOLE NL74EM CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth to Water Frain Water Level No. Time Ground Surface In Inches Soil Rate Start-Stop Min. Start Stop Drop In Min/In Drop Inches Inches Inches 1 tex5s'161-3 !8 29/ 2102-3 -,WV,0 s7 >-W 3 joj9a -m i % 24 2-40C �7 3 4 5 1 lop- 107A 310 56 - 1 t 2-9 3 s✓ Z/' - ......2 -y� 3 // , NOTES: 1: 2. rev. 9/85 Tests'to-be repeated: at same.. depth until, apprcximately.equal soil rates are obtained at each percolation test hole. All data to' be subnittbd for review. Depth measurements :to be made from top _of hole. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date 6 July 1990 Re: Property of E. /E. & C. /P. Cardone Located at Brimstone Road (T) Patterson Subdivision of Subdv. Lot # Gentlemen: Section 18 Block 1 Cardone 4 Filed Map # This letter is to authorize John H. Prentiss Lot 6.14 Date a duly licensed professional engineer X or registered architect 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 promulgated 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 ,kpGESSI0N/ ;j Sanitary Code. TPR Very tr ly yours c Counters' F ,yo 29206 ��ya 9 4 ��rHE STATED (1 R.A., # 29206 �RD9- -Fair St., Carmel, N.Y. 10512 Address 914 - 878 -6170 Telephone 77J 01 1 � _ Signed :�� Pr I erty Owner 344 Willis Ave. Address Hawthorne, N:Y. 10532 Town 914 - 769 -9267 Telephone Sgifift T Frame lot Arm 2.01 Acre. Fie Smd- 0, X Depth 3!51 ,vdooe. 753 c4. yds . Near of , Four Deaipi Flow G PD 800 PCHD NoWkild.4 Newdrisd Wbea FM Is ampbled Sgwek Sewatw S„tN to asaaiat ,f 1250r"Mn Sepik Took ..a 5D0 x 24" w x,1811 deer) laterals To be eanishadsd.by o Addren Water Sopptn Pills S%16 Ftent Addirew on X ..;o.d..es Dd&db, P.F. Beal & Some,. P.O. Box "B" Brewster, N.Y. 10509 OtbaeReqd4eldanb R -O -B .Fill Section': 5808 sO. ft.: . I represent that .I am wholly and completely responsible for the design and location of .the proposed system($); 1) that the separate few ' di sal stem above described will be constructed as'shown*on the approved amendment there to and in accordance with the standards, rule$ a rpu suns o Mm County Department_ of .IoMRh, end that on completion theieof a!- certificate of Construction Compliance" satisfactory to the. Commissioner of Heenhwill be submitted .to the 0epartmartt, and a written'guarantee will be furnishad the owner, his suoceaoS'. , :heirs or assigns by the builder, that said bulkier will place N port operating.I:ondkion any part of said sewage. disposal system during the per, of two (2) yaa►simntWlatNy following the date of the issue area of the approval of the Certificate of Construction Compliance of the original system or'any rspair$ thereto; 2) that the drilled well described aboea WIN be located as shown on the ap plow ed plan and that sale wall will M Instal Wnn accordance with t standards, rules and rpu aTf o s ;of the Putnam County Department of NNitli. _ Data 8 March 1,993 Signed P.E.X R.A. Address- RD9 -Fair, Stke' el, N.Y. 10512 License No 29206 APPROVED FOR CONSTRUCTION: This approYal expires two years' from the' date issued. unless construction of the building has been undertaken and is revocable for cause or miy be amended or modified when considered neeetsary py the Commissioner of Health. Any change or alteration of construction requires a nave perms . 'Approved ffoorr disposal of domestic sanitary sewage, and /or private water supply only. Rev. /f/� Q �ei� � ? �/ . /� �' -e"C-- !'o 10/88 Data =r ey �l J Title rn PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Re: Property of �; �o e� /p CAL--r 6221P Located at ' - (I,vvSj e )QocLd (T) �ccttL��Sprt Section Block j . Lot Subdivision of + 'wy C6 0,1,7 P Subdv. Lot # + Gentlemen: Filed Map # Date This letter is.to authorize , a duly licensed professional engineeror 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.. x. = Count, Address JOHN N. PRENTISS, P.E. R09 FAIR ST "914- 878 -6170 CARMEL, NEW YORK l0,12 Telephone Very truly yours, Signed 0 r of Property Address y o 1Y - d53 Town 0141) X69 , Telephone I 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 #� WELL LOCATION Street Address Town Village City Tax Grid Number e d 7 i I<— L . WELL OWNER Name , �6.. Mailing Address 34� • ' la a ve- +l 0 U ' e Private � Public USE OF WELL 1 - primary 2- secondary RESIDENTIAL BUSINESS 0 INDUSTRIAL OPUBLIC SUPPLY OAIR /COND /HEAT PUMP O FARM O TEST /OBSERVATION O INSTITUTIONAL O STAND -BY 0ABANDONED O OTHER (specify O AMOUNT OF USE YIELD SOUGHT gpm /# 17. REPLACE EXISTING_ SUPPLY NEW SUPPLY NEW DWELLING PEOPLE SERVED /EST. OF DAILY USAGE.6trJ stal O TEST /OBSERVATION M ADDITIONAL SUPPLY L] DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING C7 c 44 1 WELL TYPE %DRILLED DRIVEN aDUG GRAVEL 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: CARX —A)' E Lot No. WATER WELL CONTRACTOR: Name Address: = Cprit�1&C gg " IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEARESTWATER MAIN: LOCATION SKETCH & SOURCES OF- CONTAMINATION ON SEPARATE SHEET PROVIDED (signature) 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 wall 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 drilling operations be contained on this property and in suc a manner as not to degra or otherwise.contaminate surface'or groundwater. Date of Issue: -� �Z- 19 s Date of Exp' ion 19 ` Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller � >W� ,� CCUMOYHRALM _ >�Jl 1101111111111141 Bear MeeY,ea. CMMNL N.Y. 10112 w O OONQfJA[R7 1 pp l XTM 111M i! SWAM OWN" f= 1'wli / }Board T _ at�Y'S'o•ry TNW •iaalll- A...�,onte. SW W / 4 Tax Mar-- '. / 1a 71 Owe /ApplIemt YAM DOW a[ leodws A�rwd- MoM,, A46M 3 ►� ill « e • Tows Aa log-ne- • no Date Subdivision Annroved Fee Enclosedt -J imnt,nt Soft Ty" - c -1-•;m e. tat Am z • O I QL'r'i° cedes. at Se&asad / — R E Darp Vow G P D yens fapwar swram. syom oo a.wm e[ To M osm*uobd iy A� w ` • waist an Pdwaa. 2evilb DdW Imp. V. 1" ft'i t . SeX f Ofioaa 1�i.. MMO M o f1 e-� 1 1 - - -L. •- -- • 1J I �, f c�,.. Cl 1 lop 4M that I am wholly ale comaletefy responsible for the design and lecatian '6f ter' proposed sydom(q III that the N ate save di MI stem aeose dasaibed will be constructed as shown on the approved amendment there to and M accordance with the standards. rules a W n e O CovIety Deps"Inant of ""*%, and that an completion thereof a "Certificate of Condrudion Compllanoa'• wtisfadory, to the Commiseloner of Naallhwill M submitted to ter Department. and a written "aramee will be furnished the owns. his sucpMwj6 ho►e or aniNts by the Wilder. that old builder WIN peace M per operall" cwldalen any part of aid aawap disposal system durwq the period of two (Z) yeas knmadlately foltowkq the date of the Mw. ~ of ter approeil of ter Certificate of Censtrudlen Compliance of the original system or any repairs therstel 2) that the drilled w;M ~0" ales wit be located as shorn M the aaiproeed plan and that Mid we" will be Instalild in accordance Nh the standarft rule ale rqn i5 1 the putMift Caeinty Departmess of HURL. Da. M 27--' / 9J' s»i»d d ..it...� LIe.ns No Q 41 APPROVED FOR CONfTRUCTIOM This approval expires two yews from the date,_iaf,fed -unless condructlen of the buiMkra has been undertaken and is rMacable for cnrsa M may be swan" a modified when considered necesw►y.0y lit ComnNasldher of HURIL Any Chanp of alteration of eeflatfudkal Rev. wwlraa path^ Apprerw ya alapwf or aoaseslk aanarry sw+rji; iie' a► syys.wu�Y.- ��i 10/8° oar Title .•p C-owity DepeIrtment of "Meth. and that -on 'thencif a "Cwtificati ofconstructitcmpompnoww* satists"Ory.to the comml On Of Mushwill fu a" a written M46W tie- " W-his awmesom Mini W tlita buftw.,*0'"is Ow"ar win -I -ft_ itim of tee jinu OM in O."d �44wow co"Wen'"Opoi lim" '01 aid, isaws"'dwoo"I w It pGrJod"at two til Viaw 'lit Of nap Owft" of I" QMI#ka",Of .. ;o""k2Mm Compolan" -of -the origins sys"m or any repairs therstog 11 that' tho drilled *411 illsewbid s6oft 11,111 wall laft t iallll FA ftoejsj,os Segam" t" igii wj-d Man and that Is will be Indal &c6oft%rw* ho garAlrft iubs sail resulMs7if tow. Putnam coway Oaim rfshMR "Onk. L".N.O rem I ConSirliction Of tItip buAIiiWQ has .been urAOUken and N . ifon of construction IN of Fidlbltl� "nits or allaro ckRw=R 6F cowl"" IMUM SAW UWA=llwGw.sTpM:_.l TINWE TUAMP ff TOW 7 'Law SwkwL Doti i Fmv Addiin O WN. .1 W , 6AI Date SubdIArisigh Fee- Enclosed 13 lap, Setd= 0* EE Fkv G F D 7, L "WMV SYMM to mom of K C Wr- 10illill, 8 s alyals il,: Add S4d"wbW 1;y JE 10q AD go" I that I am wholly aM comiDletw" n s" rempanoble for the ation the IWoqOlRd sydewKS)l4l, that the; Y ate di YI em SlIfte dewili"w.ill be construiCted a• gwtiiiinon the approved amendment there to and:in a4cordentot withihs, standards, rues no refumoans Or 111111 FUTIMIM C-owity DepeIrtment of "Meth. and that -on 'thencif a "Cwtificati ofconstructitcmpompnoww* satists"Ory.to the comml On Of Mushwill fu a" a written M46W tie- " W-his awmesom Mini W tlita buftw.,*0'"is Ow"ar win -I -ft_ itim of tee jinu OM in O."d �44wow co"Wen'"Opoi lim" '01 aid, isaws"'dwoo"I w It pGrJod"at two til Viaw 'lit Of nap Owft" of I" QMI#ka",Of .. ;o""k2Mm Compolan" -of -the origins sys"m or any repairs therstog 11 that' tho drilled *411 illsewbid s6oft 11,111 wall laft t iallll FA ftoejsj,os Segam" t" igii wj-d Man and that Is will be Indal &c6oft%rw* ho garAlrft iubs sail resulMs7if tow. Putnam coway Oaim rfshMR "Onk. L".N.O rem I ConSirliction Of tItip buAIiiWQ has .been urAOUken and N . ifon of construction IN of Fidlbltl� "nits or allaro m CLAE'N'T MW 'JbR AW I N G',t%'I'T L,E'-' 1 0'rl m%lrl3-Xtw NORTH AMERICAN � LABORATORIES, INC. CERTIFICATE OF LABORATORY ANALYSIS LAB ID NUMBER: 96 -6366 CLIENT: WIlliam Murphy 130 Brimstone Rd Patterson NY 12563 SAMPLING LOCATION: Kitchen tap COLLECTED BY: not given DATE COLLECTED: 09 /19/96 TIME COLLECTED: 2:00 PM DATE RECEIVED: 09/19/96 DATE OF REPORT: 09/24/96 ANALYTE RESULT* UNITS MAX CNTMT LEVEL" METHOD ANALYZED Total Coliform E. Coli Absent Absent Must be "Absent" Must be "Absent" .. SM18(9223) SM18(9223) 09/19/96 09/19/96 This sample, as submitted to the laboratory, and as compared to the New York State limits for drinking water duality for the tests performed, was: ✓ ACCEPTABLE. _ NOT:ACCEPTABLE. NYS ELAP #11218 Maryann Fasano, Assistant Laboratory Director CT Lab Approval #PH -0171 " Underlined results are unacceptable according to health department and /or US EPA codes. "" Maximum Contaminant Level (maximum permissible concentration allowed by health department and /or US EPA codes). 618 Clock Tower Commons, Brewster, NY 10509 -9241 / 914 - 278 -7600 / Fax 914- 278 -7754 / E -mail: NoAmLabs @aol.com is DEPARTMENT OF HEALTH U0e 1VI WELL. GUMYLE"1'IUN Kt•YVK1 Office Use Only Division Of Environmental Health PUTNAM COUNTY DEPARTMENT OF HEALTH SIREET AOURESS: TAX GRID NUmSER: WELL LOCATION ( e WELL OWNER NAME: ADDRESS: Ur PRIVATE ❑ PUBLIC USE OF WELL 1 - primary 2 - secondary RESIDENTIAL dZPUBLIC SUPPLY O AIR /COND. /HEAT PUMP O ABANDONED ❑ BUSINESS ❑ FARM O TEST /OBSERVATION ❑ OTHER (specify) O INDUSTRIAL O INSTITUTIONAL ❑ STAND -BY ❑ - MOUNT OF USE YIELD SOUGHT _ gpm. /NO. PEOPLE SERVED / EST. OF DAILY USAGE d_gal. REASON FOR DRILLING EPLACE EXISTING SUPPLY CJTEST /OBSERVATION tjADDITIONAt SUPPLY ?NEW SUPPLY (NEW DWELLING) ❑ DEEPEN EXISTING WELD. DEPTH DATA WELL DEPTH ft. STATIC WATER LEVEL —/-7— ft. DATE MEASURED �Q DRILLING EQUIPMENT ❑ ROTARY VICOMPnESSED AIR PERCUSSION ❑ DUG ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE. O SCREENED ❑ OPEN END CASING OPEN HOLE IN BEDROCK O OTHER CASING TOTAL LENGTHi ft MATERIALS:. EKSTEEL O PLASTIC O OTHER LENGTH BELOW GRADE tt. JOINTS: d WELDED O THREADED ❑ OTHER DETAILS - DIAMETER in. SEAL: ❑ CEMENT GROUT . BENTONITE ❑DYNE WEIGHT PER FOOT DRIVE SHOE YES ONO LINEA:OYES NO DIAMETER (in) SLOT SIZE LENGTH (It) DEPTH TO SCREEN (It) DEYELWPED7 SCREEN DETAILS FIRS( _ OYES ❑ ND HOURS SECOND _ GRAVEL PACK O YES O NO GRAVEL SIZE: DIAMETER OF PACK In. TOP DEPTH ft. 80TTOM DEPTH tt. WELL YIELD TEST ' If detailed pumping M H00: O PUMPED tests were done Is in- COMPRESSED AIR , !ormatlon attached? ❑ BAILED O OTHER O YES ❑ NO ELL LOG II more detailed Iase*aion descriptions or sieve analyses are available, please attach. DEPTH FROM SURFACE water 8ear• ing Well oia- meter FORMATION DESCRIPTION p0E It It WELL DEPTH It. DURATION hr. min. DRAWOOWN It. YIELD orm. Land r Fd O Cl000Y HARDNESS O COLORED ANALYZED? OYES ONO LYSIS ATTACHED? O YES ONO rKEJn CLEAR TEMP. STORAGE TANK: TYPE CAPACITY GATE. FORMATION CAPACITY DEPTH VOLTAGE HP WELL DRILLER NAME DATE L ALBERT M. HYATT & SONS, INC. D AOORESS Well Drilling SIGNATURE Rte. S11 R. R. 2 Box 171A r TTERSONd NEV/ YORK 12563 3/89 r 1 Pt1I't�P t f CO UTY DEPP RMaW2 OF HEALTH DMSION OF ENVIRONZ.? 7 P.L RFALTH SERVICES O -.wner or Purchaser of Buildir:g Section Bloc Lot L'444JYV C 116146s / /LJ C. Building Constructed by /,?O ��Li�►S�o.✓E' /C'r�I i76CI -f 3/�, ,e /_, Y_ Location -- Street t•5.uiicir�lity Building Type 0G 0A/� A% Subdivision Narte- Subdivision Lot 4 C-U.3�RA2,7ic.E Or SUSSU?FACE SO,L- -.CE DISPO&�r SYSTEM I represent that I am wholly and completely responsible for the location, wor;a-panship, i7aterial, construction and drainage of the sewage disposal system serving the above descri.be3 property, apd. that it has •been constructed as shown on the 'aooroved olari or approved amiendment. thereto -..and,. in accordance with the standards, rules and regulations of the .Putna.m County.Decart:rP.nt of Health, and ,hereby gua.anteea to Lhe canner, his successors, heirs or assigns, to place in gold operating condition any part of said systei, constructed by me which fails to operate for a period of two years irred; ately following the date of approval of the "Certificate of Construction Compliance" for the seyage disposal system] or any repairs made by P,-Y-- to such system, except where the failure to operate. properly is cause: by the willful or negligent act of the occupant.of the building utilizing the syst =-n. The undersigne(I further agrees to accept as conclusive the detemiration of the Director of the Division of Enviror_�-,enta]_ Health Services of the Putnam County Department of Health as to �.hethe_*- or not. the failure of the system to ooexate Eras used by the willful or negligent act of the occupant of the building utilizing the system_ Dated this j day of 19 Signature Witt i,q/Ut M��Pryy tl e C— .sera. Contractor (Orwrer) - Signat; Corboratici Name (if Coro.) Corporation ire (if Corn.) 130 /.�ii�„�- �srOyE /�- 47rFasL'­' A/Z P.ddress rev. 9/85 mtc Mar es s - Rev, ' 3�g + r PUTNAM COUNTY DEPARTIVMENT OF HEALTH Divislon of Environmental Health Services, Carme1,.N.Y 10512 m Engineer Mast Provide 4 , P.C.H D Permit N CERTIFI OF CONSTRUCTION COMPLIANCE FOR.SEWAGE'DISPOSAL SYSTEM T t'A7750li/ Town or Vlllage Located t /A 8 ?7VIV,47 T Map . �5 .''B ocic / ': Lot Owner /applleaat :Name. U / /Ll. /AM /YlL /�'Pf/r --Formerly---- f! GPLA�°- AO' .Subdivision Name �ARpUNF Subdv. Lot N�_ MaWng Address IA9 see/416MNE OAD Zip /ZS r?? Date Permit Issued •TU B /2. /�� . ig acute Sews e S stem built'b �� , flI /Tfi� Ad Sep g Y . Y dress Consisting of Aq M Gallon Septic Tanya and 37-6 ' LX 24 , k%X /fI Water Supply: Publle Supply Prom Address or: X Private Supply Dried by /?� �L f( 5091/ Address . P0. SOX `!3 "Ff LliSTG.�C? /V'r v !0509 Bull �'�� /�F/V77AL Has. Erosion Control Been Completed? ding: Type Number of Bedrooms rWR45E� Hue Garbage GelnderBeen InstaRedY /► Other Re gairemente I certify,that' the system(s) as listed serving the above premises were- constru tad essentially as shown on e, plans of.the completed work ( copies of which' are attached), and in accordance with the standards; ivles'.and r`eq ions,. in' cord a with il` lan, .'and the :permit issued by the Putnam County Depiwtment Of Health. Oats Certified by P.E. -R.A. Address /%t /GGARM&_ 0, License No. Any person occupy!" promises served by the above system(s) she fl­ rhbtly fake such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage.: Approval of the separate sawerage system shalt become null and voidis soon as a pubV: unitary 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 d(fieation or .change whop, in the judgment of the Commissioner "of Heal ueh =rev n modification or change Is.nocesse►y. Oats Title _s PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIROMMM HEALTH SERVICES INDIVIDUAL %%TER SUPPLY & SUBSURFACE SEA DISPOSAL SYSTEMS ' REVIEW SHEET - CONSTRUCTION PERMIT. DATE REVI v4 BY: DOCUMNTS - Permit Application _ Corporate Resolution Plans - Three sets Engineers Authorization Design Data Sheet (DDS) Deep Hole Log Consistent Perc Results (3) 30" Perc Hole Other House Plans - Two sets If PWS - Letter Variance Request REQUIRED DETAILS ON PLANS Sewage System Plan Sewage System Hydraulic Profile - Gravity Flaw Fill Profile & Dimensions - Volume D or J Box Detail Septic Tank - Size, Detail Well Detail, Service Line if P.VS Trench /Gallery Pump Pit Two -Foot Contours Existing & Proposed Slopes for Driveway Cuts Footing/Gutter Curtain Drains Perc & Deep Holes Located. Representative of Sewage & Expansion Area Expansion Area; shown; gravity flow If PmVed Pit & D Box Shown & Detailed House - No. of Bedrooms Wells & SSDS's w /in 200 ft. of Property Located Property Metes & Bounds House Setback Necessary House Sewer - 1 /4 " /ft. 4 "0; `lope pipe No Bends; Max. Bends 45° w /cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 10' to P.L., Driveway, Large Trees 20' to Foundation Walls 100' to Well; 200' in D'.L.O.D, 150' pits 100' to Stream, Watercourse, Lake (inc. expan) 15' to Drains- Curtain,Storm,Leader,Footing 25' to Catch Basin 10' to Water Line (pits -201) Septic Tanks 10' from Foundation 50' to Well 15' Well to PL GENERAL Legal Subdivision Subdivision Approval Checked . Ex- approval SSDS Adj. Lots Checked Wetland (Town /DEC Permit R & D) Data On DDS Plans & Permit Same PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Re: Property ofG•G�f! Located at (T) Section S Block Z Lot Subdivision of Subdv. Lot # Filed Map # Date Gentlemen: This .letter is to authorize �l�bk*.�. YtCL'tSr�s�S a duly licensed professional engineer or registered architect (Indica e 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, ealth Law, and the Putnam County Sani- tary Code. zy�54 N' PaEN �4iy �o 292Q�O C untersigned: 0FtHESTAtt�� P.E. R.A. , # 192.06 Address JOHN H. PRENTISS R09 FAIR ST 914 -878 -6170 CARREL. NEW YORK 10512 Telephone ery truly yours, igne Own It of Property 344 Willis Ave. Address Hawthorne, N.Y. 10532 Town Telephone ell- boo (0 Izz s Go I ,i / r : a�� PSI P� ►�" AJ . ooc 5. </ g ,k:y a' . ..M VIC, caP l2'� 0 ` o fo- Ile l r.l � JOHN H. PRENTISS, P.E. �F �O RD9 FAIR ST 914- 878 -6170 Ts A'o. 292 ()6 �`�� ��� f�. _"Q _ ... ., .'ARMEL, NEW YORK 10512 ��`TrF SiNZEoE 1 1 NAME: ADDRESS: SITE LOCATION: DATE: STAFF PRESENT: SPECIFIC WAIVER REQUEST: DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, `ew York 10509 (914) 278 -6130 PUTNAM COUNTY DEPARTMENT OF HEALTH SPECIFIC WAIVER William Murphy BRUCE R. FOLEY, R.S. Acting Public Health Director 4 -10B Fox Run Condo Brimstone Rd. Jan. 4, 1996 Bruce Foley, Mike Budzinski, Rob Morris, Wm Hedges Waive requirment for placement of fill in the expansion area of the proposed SDS DOES THE PROPOSED VARIANCE REQUEST POSE A HEALTH HAZARD OR ENVIRONMENTAL CONTAMINATION PROBLEM? YES NO WILL DISAPPROVAL RESULT IN A SIGNIFICANT HARDSHIP? YES NO DISCUSSION The purchase of the lot by Murphy was based on a valid permit that did not require fill in the expansion area. When the permit was renewed PCHD required the expansion area filled. REQUEST APPROVED OR DENIED Apppnvpn xx DENIED REASON FOF2• DENIAL N/A DffCTOR OF PUBLIC HEALTH DATE: Jan. 11, 1996 14.16.4 (2/87) —Text 12 PROJECT I.D. NUMBER 617.21 SEQR Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART 1— PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. APPLICANT /SPONSOR 2.. PROJECT NAME 3. PROJECT LOCATION% Municipality / 7 70--5 C17 County 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or p ovide map) LL 7 5. IS PROPOSED ACTION: New ❑ Expansion ❑ Mod if icationlalteration 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND FECTED: Initially = acres Ultimately acres 8. VILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? Yes ❑ No If No, describe briefly 9. WHAJ IS PRESENT LAND USE IN VICINITY OF PROJECT? ❑ Industrial ❑ Commercial ❑ Agriculture ❑ Park/Forest /Open space ❑ Other bjy1�„esidential escribe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE LOCAL)? / / s ❑ No If yes, list agency(s) and permit /approvals � �y ��_ C /y P p /�� 11. DQES ANY ASPECT OF THE ACTION HAVE A CURRENTLY V PERMIT OR APPROVAL' — �v ��G /^ 11 �o� r' e, T y jrl.gv No If yes, list agency name and permit /approval 12. AS A RESULT OF PROPOSED ACTION WILL /,JESTING P RMIT /APPROOVAL REQUI MODIFICATION? ./ ❑ �S Yes No P G' 5 -'�1' f' C / �rf� .° �` /� .�- e.- J -S 1 CERTIFY THAT THE INFORMATION PROVIDED ABOVE fS TRUE TO THE BEST OF MY KNOWLEDGE Applicant /sponsor name: !�V/'� -�/4 O�- ���PHi Date: �2 Signature: If the action is in .the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment NEW YORK STATE DEPARTMENT OF HEALTH - Bureau of Community Sanitation and Food Protection Specific Waiver from Requirements of Part 75 and Appendix 75- A,10NYCRR for Individual Household Sewage Treatment Systems NIOWMA114 I PERMIT # SW 1 -96 Last N WV Fnt Ul Name of Applicant Murphy William No. street C VTown Stu. zip Address 4 -10B Fox Run Condo Patterson N.Y. 12563 Site Location Brimstone Rd. Patterson N.Y. 12563 1. Reason why site does not meet 10NYCRR Appendix 75 -A (check appropriate box(es)): Separation distance cannot be achieved. _ Excessive slope. High groundwater. _.J Inadequate depth to bedrock or impermeable layer. Soil unsuitable. - -, Inadequate depth to bedrock within the 100% required Other (explain) expansion area without Ehe p acement of run of• bank"*.... material. .......................................................... ............................... i 2. Proposed design or conditions cf waiver: The applicant request that the requirement to.fill the I expansion area of the proposed sewage disposal area be t _ fwaived. All other conditions of approval to be comple.ted...at ...::.......................... ....................._........... ............................... _................................ ............ : i 3. The prcoosed design may have :ne following limitations (check appropriate box(es)): i Increased risk of well or spring contamination. i Increased risk of s:..,rface water contamination. Expected design life of the system will be diminished. Operation of sewage system is subject to mechanical problems. ' Other (explain) Ex anSion of the sewage di sxmsal sy- tPm wi i i ,- n Yo the additional expense of fill.. placement if and when trie sewage disposal system needs to be replaced or expan e in e future. Additional information attached i t Construction pursuant to this waiver request should not pose any foreseeable health or environmental problems. In accordance with New York State Department of Health Administrative Rules and Regulations, Part 75.6 (b), a waiver is hereby granted. This waiver may be revoked by the i uing official for a change in conditions for which this waiver was granted. fiE'RESEIJ W"A N ER OF HEALTH l ORIGINAL - Local Health Agency Jan. 11, 1996 ................................... ............................... DATr DOH -1326 (7/92) COPY • Applicant/Design Professional (GEN -152) 4 -1OB Fox Run Condos Carmel, NY 10512 November 28, 1995 Board of Health Department Town of Patterson To Whom it May Concern: My wife and I purchased a two acre lot (lot #6.14) located on Brimstone Road, Patterson, in August 1995. Before purchasing the property I went to the town hall to get a copy of the Board of Health Approval and a map of the lot. At this time the BOHA indicated that the septic area required 413 cubic yards of fill for a four bedroom home. I also found out that the BOHA had lapsed and would require reapproval. We were told that the amount of fill needed would decrease because we plan to build a,three bedroom contemporary. After we received the new BOHA, we were shocked to see that the amount of fill had more than doubled to 926 cubic yards. I spoke with Bill Hedges regarding my problem, and-he explained to me that the town had experienced some problems with builders constructing homes larger than approved for and then selling the real estate. Because of this the town now requires allowance for 100% expansion of the septic. Bill suggested that I write a letter explaining my problem. I am not a builder, I am a New York City Fire Fighter. My wife and I will be residing in the three bedroom home we build, which is more than adequate space for the two of us. In the event a problem were to occur, the septic area will still be easily accessible after the house is constructed. Because we had not accounted for the significant increase in fill when we were totaling the cost of the lot, excavation and house construction, any assistance you can offer in re- evaluating the fill requirement would be greatly appreciated. Thank you for your time. Should you need to contact me, I can be reached at (914) 228- 5643. Sincerely, William R. Murphy s4 Q BRUCE R. FOLEY, R.S. Acting Public Health Director DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 PUTNAM COUNTY DEPARTMENT OF HEALTH SPECIFIC WAIVER NAME: William Murphy AGGRESS: 4 -10B Fox Run Condo SITE LOCATION: Brimstone Rd. Jan. 4, 1996 DATE: STAFF PRESENT: Bruce Foley,-Mike Budzinski, Rob Morris, Wm Hedges SPECIFIC WAIVER Waive requirment for placement of fill in the REQUEST: expansion area of the proposed SDS DOES THE PROPOSED VARIANCE REQUEST POSE A HEALTH HAZARD OR ENVIRONMENTAL CONTAMINATION PROBLEM? YES NO WILL DISAPPROVAL RESULT IN A SIGNIFICANT HARDSHIP? YES NO DISCUSSION The purchase of the lot by Murphy was based on a valid permit that did not require fill in the expansion area. When the permit was renewed PCHD required the expansion area filled. REQUEST APPROVED OR DENIED Apppnvpn XX REASON FOq. DENIAL N/A Dr ECTOR OF PUBLIC HEALTH Jan. 11, 1996 DATE: _ DENIED N 14 -16.4 (2187) —Text 12 PROJECT I.D. NUMBER 617.21 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I— PROJECT INFORMATION (To be completed by Applicant or Project sponsor) SEOR 1. APPLICANT /SPONSOR 2. PROJECT NAMEC,� / 3. PROJECT LOCATION' , _ G Municipality `7 '° %s C'7 County 4. PRECISE LOCATION (Street address and road Intersections, prominent landmarks, etc., or pf ovide map) S -r v cY o rA✓ \ � J 5. IS PROPOSED ACTION: New ❑ Expansion ❑ Modification /alteration 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND FECTED: �+ Initially acres Ultimately acres 8. ILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? Yes ❑ No If No, describe briefly ' 9. WHHZA IS PRESENT LAND USE IN VICINITY OF PROJECT? El ❑ ❑ Other k'scribe: rtsidential ❑ Industrial ❑ Commercial Agriculture Park/Forest /Open space 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE QR LOCAL)? s ❑ No If yes, list agency(s) and permitlapprovals //JGi y E ANY ASPECT OF THE ACTION HAVE A CURRENTLY V PERMIT OR APPROVA� 11. DI" ❑ No If list agency name and yes, permitlapproval ' z4 G7 12. ,AS A RESULT OF PROPOSED ACTION WIL�,,F STING P�ERMIT/APPROOVAL REQUIR MODIFICATION? Yes ❑ No :5 .S -2 I CERTIFY THAT THE INFORMATION PROVIDED ABOVE fS TRUE TO THE BEST OF MY KNOWLEDGE Applicant /sponsor name: <'yi �-�A� / - /4�i���y Date: Signature: I= If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER NEW YORK STATE DEPARTMENT OF HEALTH y Bureau of Community Sanitation and Food Protection Specific Waiver from Requirements of Part 75 and Appendix 75- A,1ONYCRR for Individual Household Sewage Treatment Systems .- . PERMIT # SW 1 -96 Last Nang f'nt ►t.L Name of Applicant Murphy William No. street C�tylrown slay Address 4 -10B Fox Run Condo Patterson N.Y. 12563 No. Street c4yaown sum 4 Site Location Brimstone Rd. Patterson N.Y. 12563 Ij! Mile] . :3 • t 1. Reason why site does not meet tONYCRR Appendix 75 -A (check appropriate box(es)): , Separation distance cannot be achieved. Excessive slope. High groundwater. J Inadequate depth to bedrock or impermeable layer. € I Soil unsuitable. .x i Other (explain) Inadequate depth to bedrock within the 100 required .-- r 4 expansion area witRoilt Ehe placement of run of bank....... material. - 2. ProposEd design or conditions c`. waiver: The applicant request that the requirement to.fill'the expansion area of the proposed sewage disposal area be waived. All other conditions of approval to be - comple.ted...at.... time..:: Q... ..tw.on.sr.tict�.on.....::..... - ......................................... The prc.:)osed design may have the following limitations (check appropriate box(es)): Increased risk of well or spring contamination. i Increased risk of surface water contamination. Expected design life of the system will be diminished. Operation of sewage system is subject to mechanical problems. xi Other (explain) Expansion of the sewage i sz�onsaI m cui I I reallir-e the additional expense of fill, placement if and when ............ . t e sewage disposal system needs to be replaced or expanded in tne future. Additional information attached Construction pursuant to this waiver request should not pose any foreseeable health or environmental problems. in accordance with New York State Department of Health Administrative Rules and Regulations, Part 75.6 (b), a waiver is hereby granted. This waiver may be revoked by the i uing official for a change in conditions for which this waiver was granted. REPRESEN ATIVE OF MIS StONER OF HEALTH i ORIGINAL - Local Health Agency Jan. 11, 1996 ......f ......................................... ............................... OATi_ DOH -1326 (7/92) COPY - Applicant/Desi n Professional (GEN -152) D 4 -1OB Fox Run Condos Carmel, NY 10512 November 28, 1995' Board of Health Department Town of Patterson To Whom it May Concern: My wife and I purchased a two acre lot (lot #6.14) located on Brimstone Road, Patterson, in August 1995. Before purchasing the property I went to the town hall to get a copy of the Board of Health Approval and a map of the lot. At this time the BOHA indicated that the septic area required 413 cubic yards of fill for a four bedroom home. I also found out that the BOHA had lapsed and would require reapproval. We were told that the amount of fill needed would decrease because we plan to build a three bedroom contemporary. After we received the new BOHA, we were shocked to see that the amount of fill had more than doubled to 926 cubic yards. I spoke with Bill Hedges regarding my problem, and he explained to me that the town had experienced some problems with builders constructing homes larger than approved for and then selling the real estate. Because of this the town now requires allowance for 100% expansion of the septic. Bill suggested that I write a letter explaining my problem. I am not a builder, I am a New York City Fire Fighter. My wife and I will be residing in the three bedroom home we build, which is more than adequate space for the two of us. In the event a problem were to occur, the septic area will still be easily accessible after the house is constructed. Because we had not accounted for the significant increase in fill when we were totaling the cost of the lot, excavation and house construction, any assistance you can offer in re- evaluating the fill requirement would be greatly appreciated. Thank you for your time. Should you need to contact me, I can be reached at (914) 228- 5643. Sincerely, William R. Murphy 111 -I1p � ,..... _ .... 111 t'1� -I � L'�'���i:U► �'?a��' ;� t cr I Cam: . � 3 t'I• In el J •� � I IF Si • I r ( `r 14..11 I oT L ¢ 4 b .T ®{ i L• � • • � � F r i I I d tf `Ills _ )/ lir li 1 , ] 4 '' �8 : ri t i' t'iY Q i 1 4 11 iT. I 'ri d hh ._. ,tL .�k�l t t ) j,� f I '1.' , .I,I I[� NI�1�y) ,�'a h� •alll f t] J� I •a't� 4� {I AU ;L.' a •'� p.� i^'>tr: •1,,. • ��{' I��P I } it �j r,1.�� �'fj a'Ir S` 11, lik 4 �' I I�djY`` 1 . u ! 1 II u (4• ti �. /, 1.,141 1 ���� -��'f� q �1'� �r.. +: o- ?.{ i �' 1 i' -I r � t' � � '�y�,��?� j (ire +•4�(`, I` 'f • 1 e .K..: -pTw { �tti .w r n � I r 111 �• � 1 ,� 1 � s j 1' to Q NJ D p O NJ a flo M1. ca j ©. I>1:;,,, I,� .. 1 I III• � � 'ai. -�„ •1 .fit '.ia,:. '.,1 r. .l':. ' •III 3 �, 4� � •�� Fwl 9 F 4L QI.17,, of •ZI � x m'. -' `�;`• OL ' N.. ..., . , 111 -I1p � ,..... _ .... 111 t'1� -I � L'�'���i:U► �'?a��' ;� t cr I Cam: . � 3 t'I• In el J •� � I IF Si • I r ( `r 14..11 I oT L ¢ 4 b .T ®{ i L• � • • � � F r i I I d tf `Ills _ )/ lir li 1 , ] 4 '' �8 : ri t i' t'iY Q i 1 4 11 iT. I 'ri d hh ._. ,tL .�k�l t t ) j,� f I '1.' , .I,I I[� NI�1�y) ,�'a h� •alll f t] J� I •a't� 4� {I AU ;L.' a •'� p.� i^'>tr: •1,,. • ��{' I��P I } it �j r,1.�� �'fj a'Ir S` 11, lik 4 �' I I�djY`` 1 . u ! 1 II u (4• ti �. /, 1.,141 1 ���� -��'f� q �1'� �r.. +: o- ?.{ i �' 1 i' -I r � t' � � '�y�,��?� j (ire +•4�(`, I` 'f • 1 e .K..: -pTw { �tti .w r n � I r 111 �• � 1 ,� 1 � s j 1' to Q NJ D p O NJ a flo M1. ca j ©. I>1:;,,, I,� .. 1 I III• � � 'ai. -�„ •1 .fit '.ia,:. '.,1 r. .l':. ' •III 3 �, 4� � •�� Fwl 9 F 4L QI.17,, of •ZI � x m'. -' `�;`• 0 I• J 1 S N f 0 &lPZ -z- \° Gob i Aso ti" a r' IPJ C 1°' 47-' 43• &a "i'`2 fir• 4 woc?M ! i loOCo r i . • 4' , J i... i t � Y11.'ClMlaI Count JT LL''()ii'1' �i!'La'a'i Ul f1Ei�l��G� rivision "of En�ri•roz7L�.nta.1 health Servic�- pproced as Lll �' :1� fil.'•_' „'.ijil '.71 u`2.i" Oe :P ith oblics.ble -tiles an-I 'qtr;;; ,�'_.4:ions of thiE ;imam C .. I � �'1:;�tiln �:i 7'e d•. °P S it rn �„ .�, .. 41 SE Dj IAJble Lp OAJ: qA 4N 'gT T F�. ' t � Y11.'ClMlaI Count JT LL''()ii'1' �i!'La'a'i Ul f1Ei�l��G� rivision "of En�ri•roz7L�.nta.1 health Servic�- pproced as Lll �' :1� fil.'•_' „'.ijil '.71 u`2.i" Oe :P ith oblics.ble -tiles an-I 'qtr;;; ,�'_.4:ions of thiE ;imam C .. I � �'1:;�tiln �:i 7'e d•. °P S it rn �„ .�, .. 41 SE Dj IAJble Lp OAJ: qA 4N 'gT T F�.