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HomeMy WebLinkAbout0646 (23.06-1-32.2 (Formerly 23.06-1-31))DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 23.06 -1 -31 I I I . H, -m I -, _ . IL �r - L Ll - ,L ti ,, 22 ; . 61 - Ir PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner ?,Z:-B, 'Deyel©pnm,e!, + Go�cp, Address (p e:y fc)� Located at (Street) -I- 3 j/ Tax Map 23 !c Block �_ Lot _ (indicate nearest cross street) Municipality PAr7-g -gsou Drainage Basin x,57- 3]2,A NGf-/ SOIL PERCOLATION TEST DATA Date of Pre - soaking ' f / % / `f3 Date of Percolation Test Y zez Hole No. Run No. Time Start - Stop Ela se 1VIi Time �n.) Dep th to Water )From Ground Surface (Inches) Start Stop Water Level Drop In Inches Percolation Rate Min/Inch 6 .2o ��- 2 3c 2 4 5 31-0 2 ,'33 - 'c� Al - 01 � � ;_0 4. 5 1 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are ootamea at eacn percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 DEPTH G.L. 0.5' 1.0' 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.0' 5.5.' 6.0' 6.5' 7.0' 7.5' 8.0' 8.5 9.0' 9.5' 10.0' 1) TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE NO. HOLE NO.. HOLE NO. 3 Indicate level at which groundwater is encountered �/1/©c� Indicate level at which mottling is observed . Q / ®K P Indicate level to which water level rises after being encountered ,/f/ e Deep hole observations made by: j;�]2 Date ?7 Design Professional Name: Address: Signature: Design Prof John M. Simmons, M.D. PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES Deputy Commissioner of Health - FIELD ACTIVITY REPORT - Sheet �_ of INSPECTION NAME ,%, B, -D r_-V F_z o z,m PRN i C yR P; _ Orig. Routine Orig. Complain ADDRESS Cveg Look 'PA 'P,4TTF`R6 oN Orig. Request No. Street Town TM No. Compliance Complaint Comp MAILING ADDRESS Final P.O. Box Post Office Zip Code _ Group Illness Construction TELEPHONE Reinspection PERSON IN CHARGE // Field, Sampling Only OR INTERVIEWED Field Conference Name and Title Other �erGO�lt-f'ioh DATE TYPE FACILITY &oA- 5ufALe �S Rr�p_- IC TIME ARRIVED 3 a O ;2M TIME LEFT s'2 Explain FINDINGS: Two - fYe_ o O'� ee l e e INSPECTOR: TELEPHONE: - 6 Si.gna ure an _Titjk PERSON IN CHARGE OR INTERVIEWED: I acknowledge this Field Activity Report. SIGNATURE: 6/86 TITLE: pro i e-_- M44.1,,21 zy RECORD OF PHONE CONVERSATION Time:O Date: Person calling: v' epd Phone #: 2_7t3— / p Reason Inspection: �nd /or Peres: Scheduled Field Meeting Time: �,_ ; v 0 Date: 2 -3Z2 e Cep r0 Y Y N Tentative /to be confirmed ( ) ( ) Town- Road/Street- Tax Map #: `. > , a 6 ~ l — :3 % Comments: IL AVE) �- f21 i lad a U� TD f, to fa y/ PA 0.51 AC. CAL 6 1.36 AC 1.28 1 A" QOM t.GG AC. CAL. STATE ROUTE mlua IvAnn 3Z2 L95AC. ­Ad' ig 2.32 ;C. CAL 64 A CAL R 34 E29 AC. CAL. 35 — — — — — — — — — — — LEGEND MAP 23.06 4 M IT PRELIMINARY SCALE 23.0711 TOWN OF PATTERSON q;a -cam 9—MICT UN F CALW B tmcm 2 09 23.10 NAM COUNTY. NEW YORK 365 f