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Home My WebLink About0641DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 23.06 -1 -6 BOX 8 C1111'm WK 9 11 AsIs �', ` L� - all f -ti , C1111'm Date JC Adii D at "'brilled 13y Has, �rqslqn Control -1§06A 661Mpkited?, the- above.,premis pg ~ IkIEAL m ` ?RKTOWN MEDICAL LABORATORY INC. P.O. ^Box 99 321 Kear Street Yorktown Heights, N.Y. 10598 245-3203 LOCATIONS: ❑ 321 KEAR ST., YORKTOWN HEIGHTS, N.Y. 10598 245.3203 ❑ 201 BUTTONWOOD AVE., PEEKSKILL, N.Y. 10566 737.8777 P5 MAIN ST., MT. KISCO. N.Y. 10549 666.3335 ONELEIGH AVE, (NEAR HOSPITAL), CARMEL, N. Y. 10512 278.93: LAB # DATE TAKEN: F- -� DATE RECEIVED: lee DATE REPORTED' • - SAMPLE SOURCE: bo f 330 REFERRED BY: / 7�, z L i2S G2��Z� ��% ` ,J COLLECTED BY LABORATORY REPORT f7e- .2o5-Z�:7 mg /L ❑ ACIDITY .................. ............................... ❑ ALKALINITY .... �1 - BACTERIA, TOTAL /mL ......... . ............. ❑ `SOD. 5 DAY ................... ............................... ❑ BROMIDE ................... ............................... O CARBON DIOXIDE, FREE .............................. ❑ CHLORIDE ................... ............................... ❑ CHLORINE ................... ............................... ❑ COD .: ............... .......... ............................... ❑ COLOR ....................... ............................... ❑ CYANIDE ................... ............................... ❑ DETERGENT, ANIONIC ... ............................... ❑ FLUORIDE ................... ............................... ❑ HARDNESS ...............:... .............. .................. ❑ h1PN COLIFORM COUNT/ 100 ml ....... T COLIFORM COUNT/ 100 ml CONFIRMATORY TEST ... ............................... ❑ NITROGEN, AMMONIA ... ............................... O NITROGEN, KJELDAHL ... ............................... ❑ NITROGEN, NITRATE ... ............................... ❑ NITROGEN, ORGANIC ... ............................... ❑ ODOR ....................... ............................... ❑ OIL & GREASE ............... ............................... ❑ PH ........................... ............................... ❑ PHENOL ....................... ............................... ❑ PHOSPHATE (ortho) ....... ............................... ❑ PHOSPHATE (condensed) ... ............................... ❑ PHOSPHATE (total) ....... ............................... ❑ SOLIDS, SETTLEABLE, m1 /L .......................... ❑ SOLIDS, SUSPENDED ... ............................... ❑ SOLIDS. DISSOLVED ... ............................... O SOLIDS. TOTAL ........... ............................... ❑ SOLIDS. VOLATILE ....... ............................... ❑ SPECIFIC CONDUCTANCE .............................. ❑ SULFATE ................... ............................... OSULFIDE .................... ............................... ❑ SULFITE .................... ................ ................ O SURFACTANTS ............ ............................... ❑ TURB101T`: ................ ............................... THESE RESULTS INDICATE THAT THE WATER THE SAMPLE 14AS COLLECTED. THESE RESULTS INDICATE THAT THE WATER NEW YORK STATE ADMINISTRATIVE RULES & FOR THE PARAMETERS TESTED. ❑ ALUMINUM ................................ ............................... ❑ ANTIMONY ................................ ............................... ❑ ARSENIC .................................... ............................... ❑ BARIUM ....................................... ............................... ❑ BERYLLIUM ................................ ............................... ❑ BISMUTH .................................... ............................... ❑ BORON ........................................ ............................... ❑ CADMIUM .................................... ............................... ❑ CALCIUM .................................... ............................... . ❑ CHROMIUM (tot.) ............................ .................. .............. ❑ CHROMIUM (hexavalent) .................... ............................... ❑ COBALT .................................... ............................... ❑ COPPER .................................... ............................... ❑ COLD ........................................ ............................... ❑ IRON ........................................ ............................... ❑ LEAD ........................................ ............................... ❑ LITHIUM ........ ........................ ............................... OMAGNESIUM ................................ ............................... ❑ MANGANESE ................................ ............................... ❑ MERCURY .................................... ............................... ❑ NICKEL ....................:................... ............................... ❑ PALLADIUM ................................ ............................... ❑ POTASSIUM ................................ ............................... ❑ RHODIUM .................................... ............................... ❑ SELENIUM .................................... ............................... ❑ SILICON .................................... ............................... ❑ SILVER ........................................ ............................... ❑ S ODIUM ........................................ ............................... ❑ TIN ............................................ ............................... ❑ ZINC ............................................ ............................... • ...1�.....5... .................• ........ ❑ ................. .................. REMARKS: ..... .! L: IL'. VY.!. �kt�..........k�.f ............. ❑ ............................ � �.. /.. ........... ❑ ........................... ..... ............................... .......... ❑ ... ............................... ........... ❑ .................................... ............................... .......... 0 ............. ................ ............................... ._....... WAS OF A SATISFACTORY SANITARY QUALITY 1411EN DID '_ 1II:ET TILE SATISFACTORY CHEMICAL QUALITY OF REGULATIONS, DRINKI'C 14 GR STANDARDS (PART 72) :JELL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH 3/71 Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL, NEW YORK This report is to be completed by well driller and submitted to County Health Department: together with laboratory report of analysis of water sample indicating water is of satisfactory bacterial quality before certificate of construction compliance is issued. REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION OWNER NAME ADDRESS Marilyn Bedaracco :.Box _33A Cushman Road, Patterson (No. 8 Street) (Town) —' T (Lot Number) Cushman Road Patterson LOCATION OF WELL PROPOSED USE OF WELL BUSINESS Q DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ TEST WELL ❑ SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING ❑ (S(Specify) DRILLING EQUIPMENT ❑ (� COMPRESSED ❑ CABLE El (Specify) ROTARY' Lj�J AIR PERCUSSION PERCUSSION (Specify) CASING DETAILS LENGTH-(feet) • -- 2- DIAMETER (Inches)- 6 WEIGHT-PER-FOOT 19 — • =� _•• - - - n FXI THREADED ❑ WELDED - O �•,._w YES ❑ NO .. ,CASIN YES _. - NO YIELD TEST HOURS G.P.M. ❑ BAILED ❑ PUMPED ® COMPRESSED AIR 8 YIELD (G.P.M.) 20 WATER LEVEL MEASURE FROM LAND SURFACE —STATIC (Specify feet) DURING YIELD TEST [lest) Depth of Completed Well in feet below Land surface: 305 SCREEN DETAILS MAKE LENGTH OPEN TO AQUIFER (feet) SLOT SIZE DIAMETER (Inches) IF GRAVEL PACKED: Diameter of well including gravel pack (Inches): GRAVEL SIZE (inches) FROM (feet) TO (feet) DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET 0 10 Overburden 10 305 limestone If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL COMPLETED 0C.t. 27 082' DATE OF REPORT 1 -27 -84 WELL DRILLER (Signature) be aaraSi, rules ana• reg bate s "P7 APPROVED FOR CO ,revocable for cause or fe. 4"' a ,new, perm ,,: . icate of Construction Compliance" satisfactory to the.`Cammission urnisiied•,the owner, ills successors,; airs, or :assigns by. the build- Is Aisposal system. during the :period; of two :(2) year`s: immediately.' ion Compliance;of the original eyatem;gr, any r`epaiis thereto] 2): i'•and thae said weh':,iill be : nstalled.`in• a'ocordance with the Stan= 0 �1 �E R.A. /ua�rrd a:; 8. z3 �. License No' red uniess construction. of" the building has been undertakers -and is Commissio Health Any,change:or alteration of construction r i Knrate_.w er..suP_ a ati Department?Af Health and.that on completion thereof -a !Tc submitted to the Department; and a written guarantee will_ will place in-,,..goo 3 operating condition any: Part of•said-s the issuance of the approval of the Certificate oE`Con'st• "described above will be located as;ehown on the:approvsd" ilationa of the Putnam County Department Of Heal �. � Signed• Address.' /AI NS Uf1G Q2v� , „ AffLue L Title PUTNAM COUNTY DEPARTMENT.OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY:. OFFICE BUILDING, CARMEL, N. Y. 10512 . DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner ..� J' /` tl,�yg- Address S I,2ei/ /01-t- ROAD rA7 — RSo.�+I . y Located at (Street uSHn9y,v RoD`kT311 Sec. Block Lot Z d3cate_ nearest cross: s ree ._... ,. Municipality T1 Q�' ��1�E So At Watershed .SOIL PERCOLATION TEST.DATA..REQUIRED . TO BE SUBMITTED: WTTH',APPLICATIONS o.. e. Number ...:.._,... CLOCK.....TIME PERCOLATION .. 'PERCOLATION dun Elapse Depth to W&ter Water ve , . No..... :::,......: :.:_,.:.::<:.:..::.. Time ...... From Ground Surface in Inches- . ,.....Soil Rate Start-Stop `° Min. Start .Stop Drop.in Min. /in drop Inches Inches ..Inches. 2..:.,9.::5/- :_%.0.'0:9 > B. M i.n/ . Z eJ. '► s. ,. ! J ,, .. .:. ... /. 8nii a �i IV IV T 4 r e? `4i► )V N 2 jorS.7:,:11,D2 SA1 Al, 2¢,- 2S 1 s nn�NhIV 3: 11.`43 1:,'09 - 6iriIm 24" 2S" ;.� �N �,✓ . t1 :/p �.af G ..,.. �.ea:�,v 2+� " 2J " i �orNai IV _. . f 4i %).. p P, Note;: *6 l s to.be repeated at same depth until approximatelyy equal soil rates ar ined-at each percolation test hole.. A11.data to be submitted for review:.: 2) Depth` measurements, to be made from top of hole 7211 7811 . . 84 " eLAYISNS'oiL INDICATE LEVEL'AT WHICH GROUND WATER IS ENCOUNTERED AaVE INDICATE LEVEL TO -WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED Nov TESTS MADE BY :. �/,+M E-5 Og d1 ,V 5 j �� S". Date 8114181 DESIGN Soil Rate Used . .�,. „.. Min/1''Drpp: S. D. Usable Area �rovided 9 0 o F7 S rcc 04:, No. of Bedrooms Septic Tank C ty �0® Gals e Tx De AElM Comc. Absorption Area Provided � By Sa L. F. 244 �'j '— w 8nc Address A/.3'.9kueK 54.VD, ' SEAL s - o � o. pcwet_� v,ve- jN /2 S 33 � b° o -08023 �� s "HEALTH °° ° THIS SPACE FOR USE BY DEPARTMENT ONLY: Soil Rate Approved'. Sq. Ft /Cal. Checked by Date N M REOU /RED } 900 CAL. MASLWRY SEPT/C TANK 429 L /A6 Fr. OF 24" TRENCH IN j' R.O.B. F /LL _ INSTALLED 900 GAL. MASONRY SEPTIC TANK; 440 L /N. FT. OF 24" TRENCH 3" R.O.B. FIL L 60 DR/VEWAY—_ LOT 2 1.356 ACRES r e \ 900 GAL \so' ovcr,£s AS BU /L r SEPr /C 5r5rEM , t . \ \ \ MIA SCWRr \ S£Pr /C TANK. \ \ PREPARED FQ? MR. S MRS. HILGER TOWN OF PArrERSON Pt r/ NT Y, N.Y. W . F PLAN f k'uL'tmw. CuU,,l Cy ;�a.: Lw�ul ul tlealLL Division of Enviro:naantal Health Service - \� owed as note r conformance with ,. j ppl ble Rules an 'r ,caabionS Of. the 4 t c He 1''' epaz°tment. e �K #NY BOX2� q. f 6 o s rtneture m, a Rate . ✓ULY '1964. n. n PUTNAM COUNTY DEPARTMFM T OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Res Property of Located at. Date Section Block Lot Gentlemen: This letter is to authorize a duly licensed professional engineer V or register d architect' (Indicate). to apply for a Construction Permit fora separate sewerage 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 14 7, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Ver truly yo w Signed er o rop N t Countersigned: Ad ess F0 (Seal) Telephone OVER Address DEC -1 1982 PUTNAM COUNTY ele hone DEPT. OF HEAM-1 r