Loading...
HomeMy WebLinkAbout0685DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 23.11 -1 -44 'J � , ti, 0, 1` 0 11.: ,��a , his '- T i �6 -� iN 11.: 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 #(V�,5 WELL LOCATION Street Address X9'3— a���' T wn Village City Tax Grid Num�e l� 4� � 2!!�dAJ 2� � WELL OWNER Name anjks ti Mailing Address rwJ 1-7 U_ *P )d N -tk SAu Private O Public USE OF WELL ©- primary 2- secondary RESIDENTIAL BUSINESS 0 INDUSTRIAL O PUBLIC SUPPLY O AIR /COND /HEAT PUMP O FARM O TEST /OBSERVATION d INSTITUTIONAL O STAND -BY O ABANDONED O OTHER (specify O AMOUNT OF USE YIELD SOUGHT 5 gpm /# PEOPLE SERVED Z /EST. OF DAILY USAGE �%"DO gal fiCREPLACE EXISTING SUPPLY O TEST/ OBSERVATION 13. ADDITIONAL SUPPLY O NEW SUPPLY NEW DWELLING) 13 DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE DRILLED DRIVEN []DUG aGRAVEL OTHER IS WELL SITE SUBJECT TO FLOODING? YES X NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Alie> Lot No. WATER WELL CONTRACTOR: Name gcw Address: 0 &,c d, IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES '�_/ N0 NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ®ON SEPARATE SHEET — 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 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 spQh a manner as not.to degrade or othezwise contaminate surface or groundwater. Date of Issue: 141011e 19 T-3 ��,����, Date of Expiration 19� Permit Issuing Of cial -- Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller • •' k, me Z4 W1 CI PROPOSAL FOR SE104AGE DISPOSAL SYSTEM REPAIR OWNER'S NAME �; I1121�.51C"►� 11.5 PHONE SITE LOCATION A TM MAILING ADDRESS /7 OdyiM20.1 GU• PERSON INTERVIEWED 0=h PCHD Calaint # Name &Relationship (i.e er tenant, etc.) mp DATE TYPE FACILITY PROPOSED INSTALLER �1F C,4�b)� rely' PHONE Proposal (include sketch locating all adjacent wells): NOTE: Repair must be in same location and of same type as original sewage disposal system. Different location may require submittal of proposal from licensed professional engineer or registered architect. rPP ©j d✓ I 49,1 -P��� i7 o�.r 57 - — Proposal approved Inspector's Wnature & Proposal Disapproved aZ2� topasal approved with the following conditions: 1. Procurement of any Town permit, if applicable. 2. Submission of as built repair sketch in duplicate showing: a. Owner's name. b. Site Street Name, Town and Tax Map number. c. Location of installed components tied to two fixed points (e.g. ,house corners). d: System description (e.g., 1250 gal. concrete septic tank, three precast 6' diam. x 6' deep drywells surrounded by one foot + gravel). e. Installer's name and number. 3. System repair to be perfonmed in accordance with the above proposal and conditions. I, as owner�ip or reported agent of owner agree to the above conditions. SIGNATURE C� -A��� �4 �-- TITLE e t-b I -ems( DATE t Wit' UMS: Whibe (PDD); Yellow Mein BU; Pink (Applicant) b PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES 110 OLD ROUTE 6 CENTER CARMEL, :NEW'-YORK.10512. ( 914) 225 = APPL I CATION TO ABANDON A WATER, WE L L PLEASE PRINT OR TYPE 3CRIPTION OF WORK TO BE PERFORMED: DATE: SIGNATURE: PERM I T This permit to abandon one water well as set forth above, is granted under provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code.and provided that: Within 30 days of the completion of the abandonment of the water well, the applicant shall submit to the Department a certified statement that the information delineated on the application for this permit has been completed. 'UATE OF IS UE PERMIT ISSUING OFFICIAL STREET ADDRESS TOWN /VILLAGE /CITY TAX GRID NO. _L LOCATION: 2 141 Gj TT SG ,� . 2 �, // - / - 4 L) NAME ADDRESS PRIVATE .L OWNER: C kkAg LAS SO' TIf 14N il 'T 'S0'A) PUBLIC _L TYPE: DRILLED DRIVEN DUG GRAVEL OTHER )TH DATA: WELL DEPTH A)14 ft STATIC WATER LEVEL ft DATE MEASURED A)14 OF WELL: RESIDENTIAL — 'PUBLIC SUPPLY _ AIR /COND /HEAT PUMP _ ABANDONED rimary BUSINESS: _ FARM _ TEST /OBSERVATION OTHER(specify) econdary INDUSTRIAL 'INSTITUTIONAL _ STANDBY _ NAME ADDRESS FER WELL 1TRACTOR: a L ca 17i)'. D #� h IeFE _1:5;� C' Z „` C T y1, XSON FOR 1NDONMENT: A)6W 6,0 L 7_90E_ 17%ZI G L &%P 3CRIPTION OF WORK TO BE PERFORMED: DATE: SIGNATURE: PERM I T This permit to abandon one water well as set forth above, is granted under provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code.and provided that: Within 30 days of the completion of the abandonment of the water well, the applicant shall submit to the Department a certified statement that the information delineated on the application for this permit has been completed. 'UATE OF IS UE PERMIT ISSUING OFFICIAL NOTe5. I. fROreI",TY LINE r-?ATA TAK-eN FKOM 5UI-V5,f OF LAtit75 OF MANY C)e- INO PATED 2-1---5 - 0, PtCEt'AKEtO t37 MA.'—PN STt�I�LING, L.. 2. 5erTlG TANK SHALL M5 Wt:'.2C MOI7EL WP2'700, OIC A(°Ie-O\'° D SX.12 °G�M.f. ! EX.MAG.SWALe N.Y S. t2OUTE IG t Ui CSEiCn Q_`FiY_.J?' - _... a:. C__•.. AQprovad as noted for c.,::_'L1"n : -;ac c . ¢.av2 ±cz;•?e rules am" of tht Pctaac Ccunty H"s th Lep went. T.M. *23.11 -I -4$ PROJECT: PRDF S50S KtIAAI K N .Y. 5. KOUTM 16-t TOWN OF PATTEK50N, NEN YOKK CL IENT CHAIeLES THOWSON li VC-Tt`KAN tzOAL2 PATTEIQYJN NEW YOKK. LAURENT ENGINEERING ASSOCIATES. PC. 73 i PA-- ERSONR NEW YORK, 2563 914: 278-6106 ' CONSULTING SITE ENGINEERS DRAWING . i pleOf . 550S lel✓pA' IK DRAWING No SK SCALE . I ° - 20' DATE : I- 28 -93 DRAWN BY 'T. M. CHECKED BY ' K.W.L. JOB No. 52089' DRAWING No SK 1 40 4D �' W INDO W SINK G { � 1 J I Al Bed aaom s ilao V+ It r N N Wlutzw P�oRn6D ,Owsui�6 Totp 1 4 • siNK ue RANCG si N �� z G12c,L6' vlNgL st tou • �rnllNC� LIVINCO 336 SqF X01 . o 70�� Soso Wlutzw P�oRn6D ,Owsui�6 Totp 1 4 too WA { go /' kolYT (F ».Gr ,QDwsr" a \ .; .:�. t � �•F �. �r��ln'ra�€�v--- O,- "�" —' ° "'r - �..Yr.�'ty;u'k'c.� C .'u` r �i?'°cg�'y'�;'.�x y, .'�.. '- +. .., , r ¢ 4I� G DEPARTMENT OF" IiEALTH� Division:of Environmental Health Services 4 ; Bre wGe ` 1509 1. .5 ll (914x) -. 278 ., ,APPLICATION TO CONSTRUCT A'.WATER WELL 4 ' ` PCHD •PERMITt� WELL LOCATION Street Address T wii .Village City Tax Grid Number R WELL OWNER Name Mallin � s Private tt. �... OPublic. f USE OF .WELL ,-, RESIDENTIAL O PUBLIC SUPPLY (] AIR /COND /HEAT PUMP O ABANDONED primary BUSINESS O FARM D'TEST /{OBSERVATION O 01'HEA (specify f 2,- secondary, INDUSTRIAL O INSTITUTIONAL.' _ ,O.STAND -BY O ,,..Mµ .. AMOUNT .'OF USEYhELDSOUGHT.,� : :�;gpm /:_- PROPLEf�SERVED -� %EST.';:OF DAILY USAGE�'�'c`�'} Rat' REASON FOR REPLACE EXISTING ,SUPPLY .: D TEST /OBSERVATION Q ADDITIONAL SUPPLY v DRILLING _ O NEW SUPPLY' NEW: D IN ' [Y E PE.: - - STING -.WELL = DETAILED- REASON FOR DRILLING' , <- WELL TYPE*.: DRILLED QDRIVEN T aDUG 'QGRAVEL OTHER: Fc - ISNO ,WELL SITE SUBJECT TO FLOODI °NG� YES , ;� -IF TiELL IS LOCATED IN AREALTY= SUBDIVISION, NAME OF SUBDIVISION �.. �Lo tNo . _ =VOTER WELL 'CONTRACTOR Name , t� �, _ a Address. ,. - ; . IS, PUBLIC -WATER SUPPLY .AVAILABLE TO 'SITE wNAbE.•OF PUBLIC.WATER .SUPPLY .eX= -; TOWN /VIL /CITY DISTANCE 26 PROPERTY= FROM NEAREST WATER MAIN D LOCATION SKETCH & SOURCES .OF - CONTAMINATION,PROVIDE ON SEPARATE SHEET (/ � r .' (s'gnature) t: x _ ;PERMIT. TO, CONSTRUCT`._A WATER WELL This :permit to, construct one water well as °set forth above is granted under the provisions <c f Subpart =5 2 ,of Part 5.of the New York,�Saate:;Sanitary Code, ;and pVrovided that within: .. thirtP (30) dags.of:'the completion of water well construction,,the ".appl cant;;shall: 1, Pump the' well until` the water is clear- , 7 21. Disinfect the we] in accordaice with =the requirements of�the- Putnam County - Health Department attached 3 Sti mit :a. Well. Completion Report on i'a form provide :d' by the Putnam ,county Health Department. During' all. well' "drill ng•.operat' ons,_the applicant shall `'take appropriate action .to assure that ri' and all water or waste °products from such well drilling operations be, contained on this. operty and in .such` a .manner as not "to degrade, or o`the wise contaminate` =sur - acert•or• groundwater.'. Date 9-f f s "s:ue`? 19 } b ... Date of Expiration 19 Permit `Issuing ,Of ficial° Permit is Non Transferrable _� White copy HD File Pnk.copy Owner ' 3/89 _ r Yellow :copy, 'Bldg. Insp, Orange,: copy: Well Driller jl DEPARTMENT OF HEALTH Division of Environmental Health Services 4.Geneva Road, Brewster, New York 10509 (914) 278 -6130 APPLICATION TO CONSTRUCT A WATER WELL r 1 -C" PCHD PERMIT #� u � WELL LOCATION Street Address 013 T wn Village City Tax tl � Grid Number WELL OWNER Name t .( - �' Mailing �ddress � � r ! i_ �i�1 l-'�" �� pPrivate O Public USE OF WELL T- primary 2- secondary RESIDENTIAL 0 BUSINESS 0 INDUSTRIAL O PUBLIC SUPPLY 0 AIR /COND /HEAT PUMP O FARM O TEST /OBSERVATION O INSTITUTIONAL O STAND -BY O ABANDONED O OTHER (specify O AMOUNT OF USE YIELD SOUGHT S gpm /# PEOPLE SERVED 2 /EST. OF DAILY USAGE `,0-07 gal fi REPLACE EXISTING SUPPLY 0 TEST /OBSERVATION 12- ADDITIONAL SUPPLY O NEW SUPPLY NEW DWELLING 13 DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE ®DRILLED DRIVEN CIDUG GRAVEL 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES X NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. WATER WELL CONTRACTOR: Name 6 L 01 Address: �� &,rz nl- l IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES _ NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ®ON SEPARATE SHEET (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 thirt, (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 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 s�xA a manner as not to degrade or otherwise contaminate surface or groundwater. Date of Issue: 19 Date of Expiration 1 Permit Issuing Of cial Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller PU_ TNA M COUNTY DEPARTMENT OP HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES 110 OLD ROUTE 6 CENTER — CARMEL, NEW .YORK 10512 (914) 225 =0310 AP PL I CATION TO ABANDON A WATER WE L L PLEASE PRINT OR TYPE 11 ,-CRIPTION OF WORK TO BE PERFORMED: W DATE: ��� SIGNATURE: ��.C� %�C /�- C 6/1 �Q��LC.T PERM I T This permit to abandon one water well as set forth above, is granted under provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that: Within 30 days of the completion of the abandonment of the water well, the applicant shall submit to the Department a certified statement that the information delineated on the application for this permit has been completed. DATE OF IS UE PERMIT ISSUING OFFICIAL STREET ADDRESS TOWN /VILLAGE /CITY TAX GRID NO. _L LOCATION: f9 7J8 TT SC A- AL1'7` 2�. 1� - NAME ADDRESS � PRIVATE _L OWNER: l /'�S �� '+ TEJ��/�' : r T T rV PUBLIC _L TYPE: DRILLED DRIVEN DUG GRAVEL OTHER 'TH DATA: WELL DEPTH A)IA ft STATIC WATER LEVEL rv% ft DATE MEASURED A- OF WELL: X RESIDENTIAL — PUBLIC SUPPLY — AIR /COND /HEAT PUMP _ ABANDONED rimary BUSINESS- _ FARM _ TEST /OBSERVATION _ OTHER(specify) econdary INDUSTRIAL _ 'INSTITUTIONAL _ STANDBY NAME ADDRESS rER WELL TRACTOR: '�50 YU r-� /� TESA 11J CG rLL G%' kSON FOR 1NDONMENT: 77,3E Pjl2i L L� ,-CRIPTION OF WORK TO BE PERFORMED: W DATE: ��� SIGNATURE: ��.C� %�C /�- C 6/1 �Q��LC.T PERM I T This permit to abandon one water well as set forth above, is granted under provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that: Within 30 days of the completion of the abandonment of the water well, the applicant shall submit to the Department a certified statement that the information delineated on the application for this permit has been completed. DATE OF IS UE PERMIT ISSUING OFFICIAL NOTES. I. (I-OrEI-,TY LINE VATA TAKEN FKOM 50ICVE'( OP LAN195 OF MAI" V>ETTINO DATED PICENAmr5o eq mAurN 5TIf,II'LING, L.5. 2: 5BfT1G TANK 51 TALL BE W1;17CO MODEL 1102T00, 01r, A?'rr-OVr-O EQUAL. ex. 12"r.M -r. EX. MAC. SWAL.E T. M. * 23. I I - 1 - 4.1 PROJECT: PROP S50S Kr -I0AIK N.Y.S. KOUTr- I (.'t TOWN OF PATTEK50N, NEW YORK CLIENT CHAKLES THOMf SOM Il VCTEKAN KOAD PATTr-M50N . NEW YOKY- LAURENT ENGINEERING ASSOCIATES, PC. 73 rAIRFIELD DRIVE PAT TERSON' NEW YORK 12563 ro (914)278.6108 CONSULTING SITE ENGINEERS DRAWING TITLE . N.Y S. t2OUTE 1G9- ptpp. 550S r\tr •lK l'utnam co-n-6 Department of Iiesl'itat btyision of Environnontal stealth Servlc,: r hoproved as noted for co :form -nne , �:gplioablo Vu:Los and Ttegulation:l of the Putnam County health Department. SCALE : I ' = 20' DATE DRAWN BY: T.K.. CHECKED BY : K.W. L. JOB No.: 92054 DRAWING No 611 - wtNoow SiMK ° { ff I I Al Bed Room �✓ic�5� rt C$wt�ei w1wWw P�oPo�� Ows�irU6 Togo 1�+ OR t q8 siNK 61 aNi p GIR.GL6' VINvi. "71 -Wk. S�FAtR,i Oi. E p -- 0 DIN INS LIVIru 336 Sq�t w 101 bD 50 w1wWw P�oPo�� Ows�irU6 Togo 1�+ OR 334 qu I w I I 3050 U 1 N 00 cv a. 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. Charles Tompson 17 Veterans Road Patterson, New York 12563 Re: Dwelling Reconstruction Route 164 Patterson - TM #14 -4 -17 Dear Mr. Tompson: JOHN KARELL Jr., P.E., M.S. Public Health Director July 2, 1990 It appears that the above -noted building has been reconstructed and revised to include additional living space. Review of our files indicates that to date, an application for approval of the water supply and sewage disposal facilities to serve this structure has not been submitted to this office for review and approval. You are hereby advised that such construction without an approval of the sewage disposal system and well to serve this property constitutes non - compliance with Article III of the Putnam County Sanitary Code.. An inspection of the existing dug well and septic system, consisting of a metal septic -tank -and clay the piping, was conducted by a representative of this Department on June 19, 1990. The inspection indicated that the well and septic system does not appear to be adequate for the present structure. Therefore, occupancy of the building is prohibited until improvements to the well and septic system have been approved by the Department. Plans for the improvement to the well and septic system, prepared by a Professional E e istered Architect licensed and registered to practice in New York State must be submi ted for review and approval y hri par °ant-- be+o^re---� construction begins. If you have any questions, please feel free to contact the writer. e t ly ours, JK /jp Job K rell, Jr., E. Public Health Director C2 DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 Mr. Charles Tompson 17 Veterans Road Patterson, NY 12563 Dear Mr. Tompson: JOHN KARELL Jr., P.E., M.S. Public HGaith Director October 28, 1991 Re: Interior Construction Route 164 ( T ) Patterson TM *14 -4 -17 (old) An inspection of the above- captioned property was conducted by a representative of this Department on October 8, 1991. At that time it was noted that the construction of the addition to the existing building on the property has resumed without the required permit from this Department. The proposed addition should be based upon the available septic system area and separation distance of the septic system from the proposed well. Therefore, it is advised that the application for approvals of the well and septic system are submitted to this Department as outlined in the letter dated July 2, 1991, and construction cease until such time the permits are granted to avoid any undue expense on your behalf. you have any questions please contact me at ext. 320. jp John Calbo, Building Inspector, Town of Patterson Very truly yours, Robert Morris Assistant Public Health Engineer 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 May 24, 1990 Charles Tompson 17 Veterans Road Patterson. New York 12563 Re: Garage Route 164 (T) Patterson. TM #14 -4 -17 Dear Mr. Tompson: JOHN KARELL Jr., P.E., M.S. Public Health Director An inspection on the.above- captioned lot by the writer on May 22, 1990, revealed that an extensive renovation is in progress and a second story has been added to the existing structure. At this time, an application for an addition has not been received by this Department. Tax map records (1989) for the above - captioned lot note land and garage, owner, Mary Bettino. During our conversation on May 22, 1990 you stated to me that this information is incorrect -and you are now the owner. If it is your contentio__n that there is an existing well and septic system, this must be verified by a representative of this Department. Please be advised permits are required from this Department before any repair, addition, or alteration is performed on wells or septic systems in Putnam County If there are any questions, I may be reached at ext. 320. Very truly yours, (�Z'bjtll �77 oWo Robert Morris Assistant Public Health Engineer RM /jp 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 October 17, 1990 Charles Tompson 17 Veterans Road Patterson, New York 12563 Re: Garage Route 164 (T) Patterson TM #14 -4 -17 Dear Mr. Tompson: JOHN KARELL Jr., P.E., M.S. Public Health Director An inspection on the above- captioned lot by the writer on May 22, 1990, revealed that an extensive renovation is in progress and a second story has been added to the existing structure. At this time, an application for an addition has not been received by this Department. Tax map records (1989) for the above- captioned lot note land and garage, owner, Mary Bettino. During our conversation on May 22, 1990 you stated to me that this information is incorrect and you are now the owner. If it is your contention that there is an existing well and septic system, this must be verified by a representative of this Department. Please be advised permits are required from this Department before any repair, addition, or alteration is performed on wells or septic systems in Putnam County. If there are any questions, I may be reached at ext. 320. Ve ruly yours, Robert Morris Assistant Public Health Engineer RM /jp cc: Joe Dapuzzo, Code Enforcement Office, Patterson 10/9/90 John Calbo, Building Inspector, Patterson 10/17/90 Nl- 0 V J r< m N O V O F` Z J Q 14,4RK /N ROCK - X ----- X x ROCK WALL PER DI ED TWS SURVEY' CERTIFIED TO L A K/ 4FR S 77/774E COI,4PAAl Y A SURVEY OF' LANDS O c .MARY BETTINO, DES/CGNATEO 7' AX MAP PARCEL NO. 14-4-17 PUTNAM COUNTY, /UEA1 YORK Q 10 ti F 3 ci 1� iEw SCALE: 1"=20" FER. 4, /990 1103 171 ore", -AV coo 20 DESIGN DATA S=- SUBSUFACE S5gAGE DISPOSAL SYSTEM FILE NO. owner Q —OR L ES — r4V1'rl1&LJ Address /-7 VE7-•7i iq-P J 9,4 / A TTEeSDN Located at (Street) �J: / • s . lei !% r 1(,q Sec. 25. 11 Block �_ Lot � (indicate nearest cross street) ttunicipaiity —iZ)tV /) OF /' 'FTE7eSO � Watershed Ci20 7-D A-) SOIL PERCOLATION TEST DATA REQUIRED TO BE SU&'•I= WITH APPLICATIONS Date of Pre- Soaking / - % 5 3 Date of Percolation Test /- 2e, -&7D HOLE NRIMM Q,OC:R 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 3: 2P,) - 3 X58 ;30 - -. 2?914 - 253/4 2 -�T.-'-' ) 2 3:51�- 4.051 : 30 - 24 25' 2 - / I 3 q'21 -�.'S� .'?o -- .2 20 20 4 4 5 3 4 5 1 2 3 4 5 NO'IE•S: 1.' Tests to be repeated at same depth until appraxiwately equal •soil rates are• cbtaine«i at each percolation test hole., All data to' be suhrdttad for review.: 2. Depth measurements to be made fran top of hole. rev. 9/85• TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. HOLE NO. HOLE NO. G.L. if SA �I �'i S I LT 2' L,, /AM W k0GK5 3' 4' -- 5' 6' 7' 8' 9' 10' 11' 12' 13' 14' INDICATE LEVEL AT WHICH GRO(JNI7AMM IS ENCOUNTERED INDICz�TE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY: N /A DATE =• DESI&N Soil Rate Used 1 .ZU Min/1" Drop: S.D. Usable Area Provided No. of Bedrooms 2 Septic Tank Capacity ► a00 gals Type 6e:� N G . Absorption Area Provided By (a0 L.F. x 24" width trench Other -- - �� p� NEw Name L (%K>✓ N T ENS. SSOG , P . G , Signatur '�" "•' . i".. Address SEAL �ysFC No. 0457et p9Ore SS1oNP� THIS SPACE FOR USE BY 'HEALTH DE:PARZNr ONLY: Soil Rate Approved sq.ft /gal. Checked by Date 1 Wedco industries has been ,manufacturing sep- tic tanks since 1973. There are presently over 50,000 units In service in Western Canada, Ontario, Quebec, the Maritimes and in the North Eastern States of the USA. To insure freedom from leakage, the WEDCO tank Is rotationally molded in one piece. It is the only septic tank which has watertight inlets and out- lets to prevent contamination of wells, lakes, etc... The tank is rugged and highly resistant to im- pact, denting and abrasion, even at the low tempe- ratures encountered in the Canadian North. Because polyethylene is completely unaffected by most chemicals, the WEDCO 'tank never corrodes or rots and requires no protective coatings as some other tanks do It is approved by the Ontario Ministry of Health and by the Canadian Standards Association (CSA) Can 3- 866•M -79; Also meets Quebec BNQ 3680 -901 and 3680 -505 standards. Also approved; ih most;, North Eastern States of the U.S.A. The WEDCO tank, installed accordirig', to in= structions specified by the manufacturer and con= Z orming to the department of the environment, is manufactured to withstand a life span of" twenty (z0) years- SPECIAL FEATURES & BENEFITS a Wide range of sizes and shapes available. K Complies fully with CSA and ministry of environment standards. s Tanks are equipped with child -proof lids. • No heavy equipment required for installation. Can be transported in a pick -up truck. • Can be floated across water to an island property. • Not affected by phosphates, water softeners or other chemicals. • WEDCO tanks feature a unique, patented elbow design that ensures water -tight inlet and outlet connections. .� 9 Designed to last over twenty years with proper installation. J i SPECIAL FEATURES & BENEFITS a Wide range of sizes and shapes available. K Complies fully with CSA and ministry of environment standards. s Tanks are equipped with child -proof lids. • No heavy equipment required for installation. Can be transported in a pick -up truck. • Can be floated across water to an island property. • Not affected by phosphates, water softeners or other chemicals. • WEDCO tanks feature a unique, patented elbow design that ensures water -tight inlet and outlet connections. .� 9 Designed to last over twenty years with proper installation. J HOW A SEPTIC TANK WORKS 50IL -LEVEL RISERS - -= �_. _ i M_0 rrc. --- SCUM OUTLET •� —' = _ i _IDS _ EPC „T I 5� ;i�1 VTR• ;if ; ;� OPTION - s INC. , The vVEDCO septic tank is a -v atertight reservoir that receives and treats sevvage before it is filter_ -d and purified through the weeping field. The T Y elbow at tine inlet slovvs flow of water and forces solids ,o the bottorn. Sups, grjases and floaters stay at the surface and form a scum. The T( elbow at the outlet prevents floating matter from getting into the weeping field. IMPORTANT The cEpaeity of aseptic tar k, i3 depend,2.nt on the number of bedrooms in a• house. ALWAYS COtiSVLT YOUR MUNIOPAL OR HEALTH INSPECTOR BEFORE INSTAL- LING A SEPTIC SYSTEM. MODEL OF A EENNI FIELD BA.CKFILL 24 IN. — STRAW 2 IN. — PERFOWi -'D PIPE CRU5HED STONE - 12 IN. ?CV NON- PERFORATED PI ?E RIGID C=--� PERFORATED PIPE There are many Types of weeping fields. The number of feet of perforated pipe and size of field is governed by the percolation of the soil. Your local Inspector will advise you. The function of a weeping field is to distribute the effluent from the septic tank into a dry soil. Effluent is distributed in perfo- rated drainage pipes set on a crushed stone bed. Pipes must be level and set with the holes underneath. IMPORTANT EVEF DRIVE A VEHICLE OVER A Ir;fePINIG FiELD OR A SEPTIC TANK; SNOW SHOULD NOT Br REMOVED V %'HERE A SEPTIC SYSTErA IS iNSTALLED AS IT INSULATES THE SYSTMI AND PREVENTS FP,EEZINIG. to ��1 \\ SURFACE HOLDING TANK MODEL 5211 The tank is rugged and high!y resistant to irn. pact, denting and abrasion, even at the low temper- atures encountered In the Canadian North. It is ap- proved by the Canadian Standards Association (CSA) Can 3- 866 -M -9. The tank has a 4In. standard opening equipped with a special neoprene seal_ It has a std. 20 in. manhole on top center for clean out. It may be co- vered over by six (6) in. of soil as it is reinforced inside by 8 posts. Structure provides for installation of a built -in alarm system to warn when tank should be emptied. This tank can be installed totally on the surface and be set with decorative concrete blocks, low flowery edge or any type of lawn decoration. Where larger volume is required tanks can easily be connected together. WEDCO SEPTIC TANK CHART /dad f 0 IN 36 42 20 35 40 20 35 40 20 52 53 20 j 600 730 900 900 WP 3600 I 485 146 50 53 39 44 I 20 ? 1000 w` z _ter 1 LB, / IN -� IN j WP 2300 j 310 130 42 50 WP2700,:5— 350 118 1 50 53 ' WP 3400 365 122 49 53 WP 5000 I - 145 �64 W? 3400 365 95 1 49 1500 /dad f 0 IN 36 42 20 35 40 20 35 40 20 52 53 20 j 600 730 900 900 WP 3600 I 485 146 50 53 39 44 I 20 ? 1000 WP4000 ' 400 107 L 53 68 52 56 20 ( 1050 i WP 5000 I 600 I 145 51 64 48 53 20 1500 i 51'11 /SURFACE : 'HOLDING TANK. 5D0 ' 158 79 30 27 20 i 15o i i Chart showing dimensions, volumes and ALLWEDCO SEPTIC TANKS MAYBE CON - weight of all septic tanks; also height of inlet. VERTED TO HOLDING TANKS. and outlet. I p.v. c . CT`iP•) � 5-Xl5TING 5TON t✓ WALL °u -APPS l~x l5T . 55P5 A(Zf-�A 20 L.F. AID50t�>''TlO9 Ttee NcN CT-sr.) - /JUNGTl01.1 C�I�C �T'!P.) 7wzeq-�. TANK G AOAN CB e5. >;X . 12 "G•M •P. EX . MAC. 5WALt✓ N.Y S. f2DUTE ICI- LAURENT ENGINEERING ASSOCIATES, PC. 73 FAIRFIELD DRIVE PATTERSON, NEW YORK 12563 RANDOLPH W. LAURENT, PE. (914) 278.6108 -(FAX) 278 -2658 HARRY W NICHOLS, JR., PE. IN CONSULTING SITE ENGINEERS February 3, 1993 Putnam County Health Department Route 312, Geneva Road Brewster, NY 10509 Att: William Hedges Re: Proposed SSDS Repair NYS Route 164 Town of Patterson, N.Y. Dear Bill: The applicant proposes to repair a subsurface sewage disposal system and to drill a new well on his parcel on Route 164, Patterson, N.Y. With regard to this proposal enclosed are the following: 1.. Drawing SR -1 "Proposed SSDS Repair ", dated 1- 28 -93. (3 copies) 2;.... "Proposal For Sewage Disposal System Repair ", dated.1- 20 -93. 3 -: "Application to Construct a Water Well ", dated 1- 28 -93. 4. "Application to Abandon a Water Well ", dated 1- 28 -93. 5. "Design Data Sheet ". 6. Wedco Septic Tank Specification Sheets. 7. Sketch of approximate existing SSDS area. Kindly review the enclosed and contact us with your comments or approval at your earliest convenience. Very truly yours, C NT ENGINEERING ASSOCIATES, P.C. I Randolph W Laurent, P.E. RWL:bd 92084 cc: C. Thompson w/1 ea. Boyd Artesian R. D. No. Carmel, r Well, Co., Inc. Rte. 52 J. Y. 10512 (518) 576 -4550 (914) 225 -3196 Putnam County Health Dept. Rt. 312 & Geneva Road Brewster, New York 10509 Att: William Hedges Re: Charles Thompson Property Rt. 164 No. 2936 Patterson, New York Dear Bill, January 5, 1992 We would like to drill a well for the above referenced person at his Rt. 164 location. Access for our drill rig is virtually impossible through Mr. Thompson's property; but he has been granted permission from his neighbor for us to access his property through theirs, thus enabling us to drill his well within 5' from his rear property line. Please advise. Thanks Sincerely, Henry M. Boyd v President