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PUTNAM COUNTY DEPARTMENT OF HEALTH
Diviallm of Environmental Beath Service. Gomel. N.Y. 10512
kRMT FOR SEWAGE DISPOSAL SYSTEM
'-'TOWN 0
Engineer to Provide Permit #
on CERTIFICATE OF COMPLIANCE
Permit #
m—L—sqaw. Lot
B
jax IVW 8 led 2 Let 1.
Revision —0
Renewal 0
I -PROPERTIES .INC
Dated Piev1oitsApproval
"
,HAMPSHIRE CENTER Y PATTERSON 12563
Bn - B dl - ng - Type .-RE.SIDENCE Lot . Ares Section only Depth _V01-08—
:1
Number of Bedroom,
4 Design Flow G 0 D_ .
PCHD NodBmdon Is Required When F111 [a completed
520
Separate Seienge system to co-misfd-L1 2 5 0 Gallon Sep& Toik snel 264 LF =TRENCHES
!;Fi FrTFD
106e constructed by -,-1, 'Address
Water Sappl) Public Supply From Address'
"
777, 77
Th Be Se I Prtg.CLAd
Private bv
Supply Drilled
"J.
Other Renuhrmentri
I represent that I am wholly and compie e y responsible for the design and location of the proposed system(s), 1) that t piss sga disposal system
Above described will be constructed ai shown on the approved amendment there to and in accordance with the Putnam
0. n standa th e rd
County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" $&list IQs of Healthwill
ba•submitted to the Department. and 'a written guarantee will be furnished the owner, his successors, heirs or tft;b builder Will
place 'in 'jbod operating condition . any part of said sewage disposal system during the 'period of two (2) year m dIs at oil wi da of the lssu-
Arica, of the ip' rov' original system or any repairs ahat t filled I ibed above
p at of the Certificate of Construction Compliance of the orig
:wilt be located as shown on the approved plan and that said welt will be Installed I ord!n.co wjjh jhe stand las r a ns t Putnam
n cco
.County 'Department of Health. OIL
ate Signed P.E. A.
Address
APPROVED' FOR CONSTRUCTION: This approval expires two years from the Oats issued unless construction 4.. dltdl� has &ken and is
revocable for cause of may be amended or modified when considered necessary by.t6* Commissioner of Health. 0 construction
is4u,lres a new
Permit. Approved for diiposal of domestic sanitary sewage. anal /or private at." su y
or p. --w I only.
-3S
lev.
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4.
HAMPSHIRE CENTER • P.O. BOX 74 • PATTERSON, NEW YORK 12563
PHONE (914) 878-8820 FAX (914) 878-8788
I
November.5,1991
Putnam C ouify Board of Health
Two County Center
Carmel, New York 10512
Re! Ziasw..naaagh Properties, Inc_ Lot
To Whom It May Concern:
Enclosed'Pleasepfind:
1) Affidavit - Corporate Owner Application
2) Authorization foi- John Lehman, P.E. to apply for a
Construction Permit
a) _A_ppj� ation
Ic to Construct a Water Well
4) Construction Permit for Sewage Disposal System
5) Test Pit Data Sheet
6) Two sets of plans for construction of SDS System
7) Two sets of plans for construction of house'
8) .:,Certified check for $100
Your assistance is gready appreciated.
Sincerely,
R. Timothy Dwyer
RTD/jd
Enclosures 18;
I
.J a
CO
n JOHN KARELL Jr., P.E.. M.S.
Public Health Director
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
110 Old Route Six Center, Carmel, New York 10512
(914) 225 -0310
November 25, 1991
John Lehman, P.E.
17 River Street C
Warwick, New York 10990
Re: Application;.Stagecoach Road
Lot 4, Patterson
Dear Mr. Lehman:
Enclosed please find your application for the above referenced
property.
We will hold the fee of $300.00 for the resubmission of this application.
If you have any questions, please contact Mr. Karell of this office.
Very truly yours,
Christine Johnson
Intermediate Clerk
CJ
I
5
r PUTNAM COUNTY DEPARTMENT OF HEALTH 1
Re 3/86 Division of Environmental Health Services, Carmel, N.Y. 10512 Oka
\\ Engineer Must Provide
` P.C.H.D. Permit #— P-38 -90 —
CERTIFI OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM TOWN OF PATTERSON
Town or Village
Located at ` STA OACH ROAD Tax Map 8 Bloch 1 Lot 3
Owner /applicant Name MXCWTA �PANZAR I NO Formerly ----- Subdivision N STAGE COACH g b� Lot q 6
MaWng Address SEVEN LAKES, BOX 918. WEST END,, N.C. Zip 27376 Date Permit Issued 9/12/90
Separate Sewerage System bunt by R.F. BRILL Address Box 506, Miller St., Pawling, NY 12564
Consisting of 1250 . Gallon Sepdc Tema and 580 L.F. OF LATERALS
Water Supply: Public Supply From Address
or: X Private Supply Drilled by M I LL DR I LL I NG, I NC. Address PUTNAM AVE., BREWSTER, NY 10509
Building Type WOOD FRAME Has Erosion Control Been Completed? YES
Number of Bedrooms THREE '(3) Has Garbage Grinder Been Installed? NO
Other Requirements
I certify that the system(s) as listed serving the above premises wer conetructed essentially as shown on the plans of the completed work ( copies
of which are attached), and in accordance with the standards, rules a regulations,( aQrdance wj+-h the filed plan, and the permit issued by the
Putnam County Department Of Health. `� t , �,` `1
Date May 13, 1991 Certified by {r�`/�r"� P.E. X R.A.
Address 6 ALBERMAC COURT
License No. 61468
Any person occupying premises served by the above system(s) shall promptly take $\CN ac� as mak1be necessary to secure the correction of any unsanitary
conditions resulting. from such, usage. Approval of the separate mwera sys and t lie me nul and void as soon as a Dub(': sanatory sewer becomes
available and t e approv I of the private water supply shall become nut and wn& when a public water supply becomes available. Such approvals are
subject t0 p+e ificatlon ►Change when in heeA�judgment of the C rvd&al f e of Health, revoeatlon, modification or change IIsslVlnecoslary.
Date g B y Title L�—/t/f�
PUTNAM COUMIY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
JOSEPH F. & MARGARET H. PANZARINO.
Owner or Purchaser of Building
Stix Builders, Inc.
Building Constructed by
Stage Coach Road
Location - Street
Town of Patterson, NY
Municipality
Wood Frame
Building Type
8 1 3
Section Block Lot
Stage Coach Properties, Inc. -Phase 1
Subdivision Name
Lot #6
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 Environinental 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 13th day of May 19 91
v ( Owher) - Signature
Corporation Name (if Corp.)
Address
rev. 9/85
mk
SignaturejGl
Title
Corporation'Name (if Corp.)
Address
Q► O/,
►�
* ,
WELL COKPLE110N ruirval.
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
PUTNAM COUNTY DEPARTMENT OF HEALTH
Office Use Only
,
,
WELL LOCATION
STREET ADDRESS: WN /VI ! IIY TAX GRID NUMBER:
Stagecoach Pass Patterson, NY Lot #6
WELL OWNER
NAME: ADDRESS:
Joseph P, Panzarino
IRP81VATE
PUBLIC
USE OF WELL
1 - primary)
2 - secondary
RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP O ABANDONED
BUSINESS ❑ FARM O TEST /OBSERVATION O OTHER (specify)
❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑
A MOUNT OF USE
YIELD SOUGHT gpm. /NO. PEOPLE SERVED 2-4 / EST. OF DAILY USAGE gal.
REASON FOR
DRILLING
.REPLACE EXISTING SUPPLY ❑TEST /OBSERVATION ❑ADDITIONAL SUPPLY
j3NEW SUPPLY (NEW DWELLING) ❑ DEEPEN EXISTING WELL
DEPTH DATA
WELL DEPTH 365 _ ft.
over-
STATIC WATER LEVEL . ft.
DATE MEASURED 4/1 R/_ql
DRILLING
EQUIPMENT
❑ ROTARY 19(COMPRESSED AIR PERCUSSION ❑ DUG
O WELL POINT O CABLE PERCUSSION ❑ OTHER (specify):
WELL TYPE
❑ SCREENED O OPEN END CASING KI OPEN HOLE IN BEDROCK O OTHER
CASING
DETAILS
TOTAL LENGTH _ ft-
MATERIALS: Q STEEL ❑ PLASTIC D OTHER
LENGTH BELOW GRADE L40_— ft.
JOINTS: ❑ WELDED M THREADED ❑ OTHER
DIAMETER r6 in.
SEAL: ® CEMENT GROUT O BENTONITE ❑OTHER
WEIGHT
PER FOOT — 19 1b./ft.
DRIVE SHOE 0 YES O NO
I LINER: G YES O NO
SCREEN
DETAILS
DIAMETER (in)
'SLOT SIZE
LENGTH (1t)
DEPTH TO SCREEN (ft)
DEVELOPED ?'
FIRST
O YES ONO
HOURS
SECOND
GRAVEL PACK
❑ YES
❑ NO
GRAVEL
SIZE:
DIAMETER
OF PACK in.
TOP
DEPTH ft.
BOTTOM
DEPTH 11.
WELL YIELD TEST If detailed pumping
METHOD: ❑ PUMPED t tests were done is in-
LT COMPRESSED AIR ,formation attached?
❑ BAILED O OTHER Cl YES O NO
WELL LOG )f more detailed formation descriptions or sieve analyses
are available, please attach.
DEPTH FaOM
SURFACE
Water
Bear-
in9
welt
Dia-
meter
FORMATION DESCRIPTION
CaoE
ft.
ft.
WELL DEPTH
It.
DURATION
hr, min.
ORAWOOWN
ft,
YIELD
gpm.
Land
Surface
9R
Hnrdpm P. cobbles.
9 F)
9q
Weathered. be-d rock,
200
2-30
200
2 1/2
365
6
250
7 /2
MATER X(CLEAR TEMP.
QUALITY ❑ CLOUDY HARDNESS
❑ COLORED ANALYZED? ❑ YES ONO
ANALYSIS ATTACHED? )U((YES ❑ NO
EE
STORAGE TANK: TYPE nlrmhrlm
CAPACITY 62 GAL. 16
WELL DRILLER NAME DATF4 /2Z/
Mill Drilling, Inc. J
ADDRESS Putnan .Avenue SIGMMRE Gj^ _ '&cJf In
Brewster, NY 10509 ��/(J
Pnhqi3M
PUMP INFORMATION
TYPE qi 1I mgrs 1 h l P_ CAPACITY 7
��n
MAKER molds DEPTH _250
[MODEL- 7EHO7 VOLTAGE HP3_
ELLIS A. TARLTON LABORATORY
DIVISION OF ELLIS A. TARLTON, ENGINEERS, INC.
" CHEMICAL
PHYSICAL 34 PLEASANT STREET DANBURY, CONN. 06813 -2328
BIOLOGICAL P.O. BOX 2328 203 - 748 -7903
NAME AND
ADDRESS OF
PERSON TO
RECEIVE
REPORT
WATER - WASTEWATER
METHODOLOGY
APHA - EPA - ASTM
REPORT OF BACTERIOLOGICAL ANb CHEMICAL EXAMINATION OF WATER
[—Mill Drilling, Inc.
Putnam Ave
SOURCE OF SAMPLE
Water Supply, Panzarino
Lot 6 Stage Coach Pass
Patterson, NY
Brewster, NY 10509
l_ DATE OF COLLECTION April 30, 19 91
DATA COLLECTED BY Mill Drilling
Hydrogen Ion
COLOR
TURBIDITY
ODOR
CORROSION INDEX
DISSOLVED SOLIDS
Concentration
LANGELIER
(PH)
RYZNAR
NTU
Mg /I
Alkalinity as CaCO3
Fluoride (F)
Bicarbonate
Nitrite
Mg /L
Mg /L
Mg /I
Alkalinity as CaCO3
Chlorine Residual
NITROGEN
CONSTITUENTS
Carbonate
AS
Nitrate
Mg /L
Mg /L
0 M0/
NITROGEN (N)
Total Hardness
Conductivity
as CaCO3
Ammonia
Mg /L
Mg /L
Micromohos /cn
Mg /L
Iron as Fe
Mg /L
Mg /l
Chlorides as CL
Mg /L
Manganese as Mn
Mg /L
Mg /1
Detergent as MBAS
Mg /L
Sulfate as SO4
Mg /L
Mg/I
The arithmetic mean of all standard samples examined per month using the membrane tiller technique shall not exceed MEMBRANE FILTER TEST
one colony per 100ml. Conform colonies per standard sample shall not exceed 3/50m1, 4 /100ml. 7/200ml, or 13/500ml Collform Colonies /1100ML
in: (a) Two consecutive samples; (b) More than one standard sample when less than 20 are examined per month; or (c)
More than live per cent of the samples when 20 or more are examined per month. 0
AT THE TIME THE SAMPLE WAS SUBMITTED:
DA 1. The results of the analysis of this sample were satisfactory and met requirements for a potable water.
0 2. The results of the analysis of this sample were satisfactory for a potable water but certain of the chemical or physical constituents were high. These are as follows:
0 3. This sample was not satisfactory since it did not meet the bacterial requirements for potable water. The presence of organisms of the coliform group Ina sample of potable water is
undersirable and, while not necessarily Indicating the presence of any disease - producing organisms, does indicate that such contamination might survive to the same extent. The
presence of organisms of the coliform group may also indicate that the treatment was not adequate at the time the sample was collected.
El4. This sample was unsatisfactory as a potable water because certain chemical or physical constituents were above' acceptable limits. These are as follows:
COMMENTS
The bacterial analysis showed no organisms of
time the sample was collected which indicated
the coliform group at the
the water potable.
S;,
Certified .....:.................................................. ......:.................:.�.... ...................•..
FTlt:t Cv Cc�=
J -
♦. ^CVO '..�1 v
CRIER 6W C)
= Zs z CR CL'tJT /SG�I ,-
= t-7 - -c - I I I I
E:-,C 2TC= lr=-is as per a roved v!=,—
Dam of piaca rent
_
- 2.1 ter, `Y LC-77 w , + _P K<c_D
C_ Pa--= � sci_ r_ct I
cr ==L- 1.51 t''Lr1 1.]' f:rm
e_ 100 ft_
I =. Cz---aa D T S' CS?L STC =i
Ee=+ ±c tank s-z= - 1,000 _
G
7a.
E. C_ cr Cr::y pl`nc
G_ Ic COJ LGr� CI C__:Ct L %_ -7%T 1 10 _- C� ��s LG:G I ( I
_
- -_�
elev,G _C- ate teE
PrCt - r C f_cst l
cr-,C sc h ;= Z=
Line 13" Lmn—e crac =_
C- I
1 -r h ni =r - U Tc =��_! ? -cam.^ Q
(
I
�. Di__ =�_c =_ - wit= T- -�.•.__= u. — ='�= ` __ -"'� ® a I � _ I
CF �'_ C.1 cC' - =�! °_ 1/ C - IJ32 "/=CG`_ I I
C 10 i -- =- ::' C.CCcT L i 1 -_ - 20
E. Rc= al! = az -Cr
1_'' X)1Ces Lam= �_c! 1. 'T h. dKf—] 1 1
U_ D�rL1 c= C= i al in t= =.rGh 1•!" r : --r. 1 I I I
? pi=a
h_ r_2 CR I,CS= c: Ms I
I I
1 Size of r-. c= pr .
2.G`cE_ cam
= t-7 - -c - I I I I
CII 5 _GLcs =—L-z-
-- -
V.
G
E. C_ cr Cr::y pl`nc
C.
Line 13" Lmn—e crac =_
- =C° arc Dry.
b_
1_'' X)1Ces Lam= �_c! 1. 'T h. dKf—] 1 1
stcnes < r„ i
C_
F-- ct2.nc Cr= = C..`.arC° aScV f=an C_'� c
_
c• 'sC= wat_ C.Ct�'t_C'1 aCEL'L�?L°
CII 5 _GLcs =—L-z-
-- -
WOOD FRAME `.
TYlr Lot Aire 1 .8391 AC
F® Secfbti -001Y talilli, .
LJ
Vabtme
Nttioe ei Dairlw FOUR, (4) _ Dedge Flow G P D 800 -GPD P® NodRa lam Is Ne4dred Wbm Fm Is cimpMted
. *miP S.7 to oMlit rt SapW tmdi aid 580 L. F. OF LATERALS
. ._
To be o ilt ,by - TO' BE DETERMINED Add,
WW Ste: Fire bq*.F Adorn
X ywvafi.`�r Ddad.by TO .BE DETERMINED
Otba1T lRae�liwlartii
1 rwasent that I am 'W"lly' and compNtely , refpoesibke for tM design and location of. the Proposed' systemis)1 1) that the p rata sew di fat s slam
above despibad,;win M eaistrunitW }s shown ogtM approved amendrtlent tMe to an0 in sccorAnnx with tha stangsrdS., rulesa rpu ns o � m
County DigeAlvi nt of fMMlth, and that on eorhplitbn;tM►eof r !COrtifkat of Coest►uctlon Compliance" YtidsCtory to tM Commisflonar of Maltltwill
be subfnitted, to the Deoirtenwrt •and; a written puanntr►e will, 0i. furnhlls0 tha owner, his sucostso►f. ;hairs or, assigns by, the bulkier, that yid bulkier will
rweo in pod:ooiratlnp condition icy pik o1 -said Swaps fl4"1 systi n.4urin0'tha gwiod ;;7;;;(a) (a) y*A immadisiely following the'ate of the law-
Moe of the approval of tIN Cartifkite of Construction, Compliina of the original systern.or• any ("airs thereto= 2) that the.drilled well,' ' a lbW b6ow
sslN W lotatei as slioror.on ihm4pprosed pini and Chit said' wNt wilt be Installed sCCOrWn" `wH :the A* rds, rules and rep -MM s of the' Putnun A 1.0 County OspRrnalnt of NMlth. ' pe
Data August. 8,, 1990' 'Y
APPROVED FOR CONSTRUCTIONt This approval expiiastwo
revocable for, Cause-or. I kifil IrMidifiedwhShco6il
now as a new' T N ' AYprovad for 411IMMI of domoat
3ev (r ` iir
LO/88
(nad
E • OR 1256 License No 61468
om the date atl u HISS. stru"n' of the building .has been undertaken and Is
rY by t' ".1 ssio of ►feanh. Any Change or alteration of Construction
tk y a /or t eta supply only.
Title ��
�0
DEPARTMENT OF HEALTH
Division of Environmental Health Services
TWO OUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641
APPLICATION TO CONSTRUCT A WATER WELL
PCHD PERMIT
WELL LOCATION
Street Address
STAGE COACH ROAD
Town/Village/City Tax
T. OF PATTERSON
Grid Number
WELL OWNER
Name JOSEPH F. Mailing Address 27376 0Private
& MARGARET H. PANZARINO SEVEN LAKES, BOX 918, WEST END, NC O Public
USE OF WELL
1 - riP wary
2 - secondary
® RESIDENTIAL
❑ BUSINESS
13 INDUSTRIAL
O PUBLIC SUPPLY O AIR /COND /HEAT PUMP
O FARM O TEST /OBSERVATION
L7 INSTITUTIONAL O STAND -BY
❑ ABANDONED
O OTHER (specify
O
AMOUNT OF USE
YIELD SOUGHT
5 gpm /# PEOPLE SERVED /EST. OF DAILY USAGE gal
REASON FOR
DRILLING
MNEW SUPPLY O PROVIDE ADDITIONAL SUPPLY
OREPLACE EXISTING SUPPLY 0DEEPEN EXISTING WELL
O TEST /OBSERVATION
DETAILED
REASON FOR
DRILLING
POTABLE WATER SUPPLY FOR NEW RESIDENCE
WELL TYPE
IDDRILLED
DRIVEN
ODUG
O GRAVEL
® OTHER
IS WELL SITE SUBJECT TO FLOODING? YES X NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: STAGE COACH PROPERTIES
Lot No . 6
WATER WELL CONTRACTOR: Name TO BE DETERMINED Address:
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO
NAME OF PUBLIC WATER SUPPLY: N/A TOWN /VIL /CITY
DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: N/A
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED
[]ON REAR OF THIS APPLICATION ON S A TE SH T
8/31/90
(date) N Aigna*re)
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.
�. 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 prov by the Putnam County
Health Depa tment.
Date of Issue: 19�
Date of Expiration: 19
Permit Issuing Official
White copy: H.D. File
Permit is Non - Transferrable
Yellow copy: Building Inspector
Pink Copy: Owner
2/87 rlranrrc T.Tol 1 rW-i l 1 r�r
PU,rNAM CDUWY DEPARTMENT OF HEALTH
DIVISION OF ENVIRORCRIAL HEALTH SERVICES
LOT 6
DESIGN DATA SHEET- SUBSUFACE SDgAGE DISPOSAL SYSTEM FILE NO.
Owner' JOSEPH F. PANZARINO Address Seven Lakes, Box 918, West End, N.C. 27376
Located-at (Street) STAGE COACH ROAD Sec. 8 Block Lot
(indicate nearest cross street)
Municipality TOWN OF PATTERSON Watershed
.■ ■ a • Mrs w y �, r �� My�� .�Mr s �►
r— ■
Date of Pre - Soaking Date of Percolation Test
r..
HOLE
NUMBER CL,OCR 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
1 PERCOLATION DATA OF 20 MIN. /IN. AS TAKEN FROM APPROVED SUBDIVISION PLAN, FILED MAP #2425.
2
3
NOTES: 1: ";`bests to be, ;repeated at same depth until apprcximately equal- soil rates
,ar-e. ^obtained: at each percolation test hole. All data to* be submitted
2. Depth`ineasurements to be made fran top of hole.
rev. 9/85
LOT 6
TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
DEPTH ROLE NO. A** HOLE NO, 1 HOLE NO.
G.L.
8" 6' SILTY
SANDY LOAM WITH
ROCKS
4
51
61
ROCK @ 61
71
81
10,
-011-811 TOPSOIL
8" m- 8' SILTY
SANDY LOAM
2
120
13'
14'
INDICATE LEVEL AT WHICH GROUNDWATER, IS ENCOUNTERED NONE
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED _N/A
DEEP HOLE OBSERVATIONS MADE BY: HOLES #1 #2 BY JOSEPH -ZARECK1,.P EPATE: 74.24/90
**DATA FOR DEEP TEST HOLE 'A' AS TAKEN FROM APPROVED SUBDIVISION PLAN, FILED MAP #2425.
DESIGN
Soil Rate Used 20 Min/1" Drop: S.D. Usable Area Provided 5000+ S.F.
No. of Bedrooms FOUR (4) Septic Tank Capacity 1250 _ gals. Type PRECAST CONCRETE
Absorption Area Provided By 580 L.F. x 24" width trench
160
Name JOSEPH ZARECKI, P.E. -Signature
Address 6 Albermac Court SEAL
Pawling, New York 12564
THIS,SPACE FOR USE BY HEALTH DEPARTMENT ONLY:
85
I Date
W
Soil Rate Approved sq.ft/gal. Checked by
I,P•
•.SET
I P.
-. -:.LOT i*0
_W 1..L
Is
'-K250 GAL.
.: SCpiIG TANK
1715TRIlrtLTIOFI
p.,.
pRP/BWA `�i �
:ST:AGE
'DIIvIEN✓1O.N
TABLE
cA r,.G2..
115 .
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WELL 7i7 HOUSE .CORNEf2 . .
Putnam County Department of Health
Division of Environmental Health Servioe9
Approved as noted for oonformanoe with
11 ble Rules and Regulations of the
naw t tY Health Departure t.
Signature 6 Title D to
ai T PLAIN : A5 LUIL.T GF S"ITAI2Y DIOFos,AL.SYST=._.M.
t�TRS IS TO GEtRTIFY 71•IAT THE SEWAGE DISPJF.�AL SYSTEM WAS
CON .S•TIRUCTED AS INDICATED ON .THIS PLAN AND THAT 'THE SYSTEM
WAS INSPECTED OW ME G}EFOPS IT WAS COVC—:kEp OVER, THE
SYSTF_M WAS CON97I2UCTI =0 IN s>GCg2C7ANGL WITH ALL STANOA120
$RULES AND RECGULATIONS OF THE F::�UTNAM COUNTY C7_- -PAI _'T'MENT u
-CF HEALTH AND THE STATE 0P NEW YORK tP PARTM6NTG1= H`L.TH,
LZEV,l. P.G.H•D.• COMMENTS 5 •22.91
�OFNEWy SANITAFZY'DI9P05ALSY6T@M "AS- BUILT°
CPy H 4R = cF05EPH F..& NWRdARST H-PANZARINO,Lar
y�o Foy 7 5TA&M,.G0ACH Cam, •T /PATTVP -61 Tl JN,Y,
APPROVED er: 9:' ••gyp ' �'�
- r DATE: O NWYQI. PPOJEOY NO. ' X10 • OE86N BY:
JOSEPH ZARECKI, P.E., Consulting' Engineers
• . y� e�
Pawling, ANew YorkC12564, 914 Street 855 -3771
SITE PL -AN A6-e' UILT ,N 1 Gg