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HomeMy WebLinkAbout0709DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 23.12-1-34 I rm I I I I I I - um I -�, r �. W ,,I I. 6 % t'.r LN N o elt] PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CERTIFICATE OF CONSTRUCTION COMPLIANC E TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # G' 9 — 416 Located at NbVG'P- 140 R° P(P Town or Village PmT'o-r'oH Owner /Applicant Name�� �Nh�F��oH Tax Map Block Lot Formerly D15 L60 ) J4"+ FELle t. Subdivision Name LI-ITLI5 Pow MWI 5fimse) Subd. Lot # Mailing Address P-0- BOL VA- MO i+15(AA9 LM-- � N� Zip 1054-1 Date Construction Permit Issued by PCHD a q(o Separate Sewerage System built by Consisting of 100 Gallon Septic Tank and Other Requirements: Water Suuuly: Public Supply From Address N 40� 1% tmtW A4 Lb*E R? IOT41 �! 1.1p /-P 7p-C. NG H Address or: X Private Supply Drilled by PMN 4''t MT Address 10% 17-TV PN94 * NY*L Building Type F-E to 10 VKZ- Number of Bedrooms Has erosion control been completed? yu y Has garbage grinder been installed? X14 I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved plans and the standards, rules and regulations of the Putnam County ep ent of Health. Date: ����`�� Certified by (� P.E. R.A. e n Profes ional Address �� � H P-Qa� b�W N1 Kb License # 6612A Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary 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 modification or change when, in the judgment of the Public Health Director, such revocation orfin or ge is necessary. By: Title: �i Date: White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES , #� * j_; WELL COMPLETION REPORT Well Location Street Address: dr Town/Village: n . Tax Grid # Map W11-Block Lot(s) "mot' Well Owner: Name: Address: Gr C�h5 • Use of Well: 1- primary 2- secondary —� Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment Rotary Cable percussion X Compressed air percussion Other (specify) Well Type Screened Open end casing Y Open hole in bedrock Other Casing Details Total length 60 ft. Length below grade _5�'ft. Diameter 7 in. Weight per foot lb /ft. Materials: Steel _ Plastic _ Other Joints: _ Welded _X Threaded _ Other Seal: Cement grout X Bentonite Other Drive shoe: Yes No Liner: Yes No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First _ Yes No Hours Second Well Yield Test _ Bailed _Pumped Compressed Air Hours Yield 3 a gpm Depth Data Measure from land surface- static (specify ft) During yield test(ft) Depth of completed well in feet -6 � Well Log If more detailed information descriptions or sieve analyses are available, please attach. Depth From Surface Water Bearing Well " Diameter(in) Formation Description ft. ft. Land Surface �g A If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type Capacity Depth Model Voltage HP Tank Type Volume Date Well Completed !10 Putnam County Certification No. 007 Date of Re rt /1 Well Driller (signature) Nu rt: t)pct location of well wrtn arstances to at least two permanen34anarWams to De provraea on a separate sneevptan. 1 �j Well Driller's Name OJ2 Address: AVY ,& Signature: Date: %lU White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM GIi4UIbE LOi-tb-1 P4C;r10H Owner or Purchaser of Building Building Constructed by poysDom. ?Xim C�$A Mirk MW4A) Location - Street K--'D0Deh ,6 Tax Map Block Lot PR-ITEP-60N Town/Village Subdivision Name Building Type Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is 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 treatment 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 Public Health Director 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: Mont �_ Day Year (�{� General Co racto caner) -Signature 6V,1jL1 st? rot, S�U- cr r_ j fm Corporation Name (if corporation) Address: R (�( [ &C V. Sf ee_ State( Zip Signati Title: (AP Uo E G Rff_1 Fvvrt0H Corporation Name (if corporation) .( Address: Rid cif I State Zi p loa C�- �Ktl My Form GS -97 �/ V. 1JA11iMIM[ M7/ 1AIMJMJM /MIM7!UlJ15AlMIMF"]IMAI"-.I AIAAIM11. IIM IMC IIAIMIMIM IMI MI MIMJMJMI!\A➢I.1/.I]AAtMIMIMIAM .10AIA^IA/11MIM1MIMIM. � SI 5' it r I p Amp I wJ ® - o e : ® [ 111/ 111VVIHVIVYIIINTV11111AI1/ IYIYl 111�iVI1l VIV1/ T. 1/ 11. 111111/ly ➢Vll�ti�'12i1'I.V:11 ?,� i/i.1Y'I•WJi7Y. 1(Fy'V11IIfV:YHTV1111/ 1111 /11IWIi/1liVVlil11I11111V VIb111i/liill1iI11V7yry11f1iCV :'�lV.V11IV1111/W ➢1lMIi HARRY V1. N:CHOLS JR., P.E February 10, 1999 Robert Morris, P.E. Putnam County Health Department 4 Geneva Road Brewster; NY 10509 RE: Individual SSDS Compliance Grouse Construction Powder Horn Road Town of Patterson Dear Mr. Morris: Enclosed are the following: LAURENT ENGINEERi�; ASSOCIATES. P.C. M;LlBRCCK: OFF;C_ CEvT ?.5 Rout* 22 6 MAQ-3 —n Ro*C ar*. %: *r N*W Yar% IC`.4'9 (It g273.6I Ca. (F,t) 273.25:4 CONSULTING SITE ENGINE -A; 1. Five (5) prints of Drawing S -1, "As -Built Plan," dated 02/01/99. 2. "Certificate of Construction Compliance for Sewage Disposal System," dated 2/10/99. 3. "Guarantee of Subsurface Sewage Disposal System," dated 2/4/99. 4. Well Completion Report, dated 11/30/98. 5. Laboratory Report, dated 1/29/99. 6. Application Fee in the amount of $200.00 payable to Putnam County Health Department. If there are any questions concerning the enclosed, please call. Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. Harry W. Ni Is, Jr., P.E. HWN:JM:his 98058 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 Vi i 2UXIIZ-1_1 RD o Village City n12_-Q1—'_11 Tax Grid Number L Z WELL OWNER Name Mailing Address . 1Pr vate - o O.Public USE OF WELL 3-) - primary - secondary ®'RESIDENTIAL 0 BUSINESS ® INDUSTRIAL 0PUBLIC SUPPLY QAIR /COND /HEAT PUMP OABANDONED O FARM O TEST /OBSERVATION p OTHER (specify 0 INSTITUTIONAL O STAND -BY O AMOUNT OF USE YIELD SOUGHT . -S gpm /# 0 REPLACE EXISTING SUPPLY MEW SUPPLY NEW DWELLING PEOPLE SERVED 2 _S- /EST. ❑ TEST/ OBSERVATION D DEEPEN EXISTING WELL OF DAILY USAGE;J Sal Q ADDITIONAL SUPPLY REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE E.JDRILLED ODRIVEN ®DUG OGRAVEL 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES _�—NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: 1_"7- ,r"',vp Eficc Lot No. J? WATER WELL CONTRACTOR: Name __7_7 Address: 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 �9ON SEPARATE SHEET ate (s ature 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 Department attached to this permit. 3. Submit a Well Completion Report on a form requirements of the Putnam County Health 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 such a manner as not to degrade or otherwise contaminate surface or groundwater. Date of Issue:% 19 l ' -- _ _ �_..._.. Date of Expiration 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 RANDOLPH W. LAURENT, P.E. HARRY W. NICHOLS JR., P.E. August 8, 1996 Mr. William Hedges Putnam County Health Department 4 Geneva Road Brewster, NY .10509 RE: Individual SSDS Vista Delores Rd. Patterson, N.Y. Dear Bill: Enclosed are the following: rr mollo, LAURENT ENGINEERING ASSOCIATES, .P.C. MILLBROOKE OFFICE CENTRE Route 22 & Milltown Road Brewster, New York 10509 (914)278 -6108 - (FAX) 278 -2658 CONSULTING SITE ENGINEERS 1. Four (4) prints of Drawing SS -13 'Proposed SSDS - Lot 13 ", dated 8 -9 -96. 2. "Application For Approval of Plans For a Wastewater Disposal System ". 3. "Construction Permit for Sewage Disposal System ", dated 8 -8 -96. 4. "Application to Construct a Water Well", dated 8- 8 -96.. 5. "Design Data Sheet ". 6. "Letter of Authorization ", dated 8 -8 -96. 7. Two (2) copies of Residence Floor Plan(s), for "Bedroom Count Only ", 8. Money order in the amount of $300.00, review fee. We would appreciate your review, approval and issuance of the Construction Permit at your earliest convenience. Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. Harry W. Nicho r., P.E. HWN:DJ:bd 96054 cc: Mr. & Mrs. DiLeo w /enc. r P.UTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Re: Property of�l Located at os7A yita�PFc /C%� (T) �.+r17' ,Qc'eti� Section Z ,/Z Block / Lot_ 3V Subdivision of Z -1ZnzS PoA,,Z� L1ik_ / Subdv. Lot Filed Map # Date Gentlemen: This letter is to authorize a duly licensed -professional engineer �or x�,gaes a �. ^� ^� ^�' (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 tary Code. Ct/1-1 Coun ersigne P.E., R.A., .�ILRLY'�C G�FF/GE C�.NrRE Address Public Health Law, and the Putnam County Sani- 61141- Telephone Very truly yours, Signed � Owner of Property Ad ess Telephone JE''C -r 1"T A tnC c_- (D N']C"X" APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER DISPOSAL SYSTEH Name and Address of: Applicant: ; 0141V ��CL /cl d J�L��v D � 4r i 2. Name of Project: r�'���SFf.� AS S !3.._. Locatiok(fN /C: AV70-�2 o I A. Project Engineer: � � k/_ �/,T,�,�� 5. Address: Millbrooke Office Cent,, Brewster, NY 10509 License Number: ��� /ZL4 Phone: (914) 278 -6108 6.. Type of Project: _ Private /Residential Food.Service .•.•Cor,•nercial , Apartments Institutional X6bile Home Park Office Building Realty Subdivision Other (specify) 7. Is this project subject'to State Environmental - Quality Review (SEAR)? Tvoe Status (Check One) Type I. Exempt _ Type II. Unlisted. S. Is a Draft Environmental Impact Statement: (DEIS) required? _ X 9. Has DEIS been completed and found acceptable by Lead Agency?• 10. Rame of Lead Agency ti. Is this project in an area under-'the control of -local planning_, zoning, or, other...officials, ordinances? ......................................... y,5 2. If so, have plans been .submitted to such:author.ities? .......... 3. Has preliminary approval beep 'granted by such authorities? Date Granted: -,&Z,/____ ;. Type of Sewage Disposal: System Discharge...... Surface dater _.Ground Waters 5. If surface water discharge, what is the stream class designation ?........ lv/,4 S� waters index number (surface) ....... ............................... .. . !. Is project located near a public water supply system? If yes, mace of water supply LU�.eI Distance to water supply_ : Is project site near a public sewage collection or disposal system ?..... A/,] fume of sewage system Distance to sewage system. Date observed: 23. Name of Health Inspector: Project design flow (gallons per day) ..................................... �' 2. 25. Is State Pollutant Discharge Elimination: System (SPDES) 'Permit required ?.. 26. Has SPDES Application been submitted to local DEC Office? ............... / 27. Is any portion of this' project located within a designated'Town or State wetland ? .................... /Vo t 23. wetland ID Number .... 29. Is wetland'Permit• required? ............................................... Has application been made to Town or Local DEC Office? ................ /(,q�_ 30. Does project require.a DEC Stream Disturbance Pe i, it ?_ 31. Is or was project site used for agricultural activity involving application of pesticide$ to orchards -or other crops, solid or hazardous waste disposal, land-Filling, sludge application or industrial activity? ......... YES'or NO X6 32. Is project located-within 1;000,feet of 'existence of abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge .disposal site or any other potential known - source of contamination? .....'........,.YES or No _ Mo DESCRIBE: 33. Is there a local master plan or file with the Town or vi1.1a'ge? ..... 34. Are corm- munity water, sewer facilities planned to be developed within 15 years? �/C 35. Are any' sewage. disposal areas in excess of 15n slope? 35. Tax :Hap ID Number ............................. I........................... — '3 37. Approved Plans a re' to­be. returned to: ................. Applicant Engineer IF the application'is signed by a person oi,her than the applicant shown in Item•1, the. °pplication must be-accompanied by-a Letter of Authorization: Failure to comply with this provision may be grounds for the rejection °of any submission. .I hereby affirm, under penalty of perjury;• that information provided on this form, is true to the best -of my know7e-dye and be 1 ief. Fa Ise sta't�r,ents made herein are punishable es a Class A Hisder,eanor pursuant to Section 210..45 of the Pena 1 Law. l 1 /11' ;iGFdATURES & OFFICIAL TITLES: !4iLIfvG ADDRESS: Millbr .:e Office Centre Brewster, NY 10509 _P(P7.TNAM'COUIZI'X DEPAR'LMWT OF HEALTH DIVISION OF ENVITO64'AL. HEALTH SERVICES DESIGN DATA :SHEET- •SUBSUFACE SEWAGE DISPOSAL .SYSTEM FILE EO. 64ner s/Of /�t/ �`fEG /GI.� piL�o Address 2!Z2,,&'q ,�T6 Cs'�&t✓•r�- t' NY /G►S09 Located at (Street) - Sec. Block _..... ( indicate nearest cross street) Municipality ..... 77`GR_� ©N ...:..... .. ...........'..._.- ......__ Watershed SOIL PERCOLATION TEST DATA••REQUIRED -TO - BE sm&miTrm' WITH APPLICATIONS .07 5 ........_.... /3 Date of Pre- Soakin Date of Percolation Test.... HOLE ...._.._._. _. NUN.IB.ER CLOCK TII,1E PERCOLATION PERCOLATION . Run _ .... __. _.._......... Elapse Depth to Water `ESrom Water.` Level No. Time Ground Surface In Inches Soil Rate 'Start -Stop . Min. - -Start --stop Drop In Min /In Drop Inches. 'Inches Inches 2 6 -/0 1`111V; 164 / .. ek -�-Z- 3 5 A7 2 5 NOTES: 1. Tests to be repeated at saw depth ,until..approximately -eqt a1---soil -rates are obtained at each percolation test hole. All data to b--: submitted for review. 2. Deptl aeasure-nents to be made fr "cm top of hole. TEST PIT DATA REQUIRED TO BE SUPIiITTM WITH APPLICATION DESCRIPTION OF SOILS EM OU'WER D IN TEST HOLES DEPTH HOLE NO. / HOLE NO, HOLE N0.• G.L. i 2' 3' G4t�I 4, 6' 7, ,> 7 � .. 10' 12' 141 INDICA'T'E LEVEL AT MHICH GROUND4RTIM IS.ENCOUNMPM &Aw- INDICATE LEVEL TO WHICH MATER LEVEL RISES P.r -'TER BEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY: DATE: DESIGN' Soil Rate Used -51`ID Min /111 Drop: S.D. Usable Area :'rovided No, of Bedrooms �! Septic 'Tank Capacity /ZSU gals: Type ecNG Absorption Area Provided By L.F. x.24" width'trench Other name __.P�7�idG�iF/yk'/�/r iP�SdGS.G. Sigreture Address ��iQGYJ I� i)� /�F l AIZ -gy SEAL THIS SPACE FOR USE BY HEALTH .DEPARTMENT ONLY: Soil Rate Approved _ sq.ftfgal. Checked by _ Date ........... - ......... 48 SECOND FLOOR DINING ROOM 13• 0- x 12'•0- 4828 =.-1344SF 48 oc, KITCHEN MORNING AOOAA Fl RST FLO 0 R 4828 BATH BEDROOM A DRESSING BEDROOM J. WALK' 1J' -0 "x 10'-0* IN CLOSET T _7 MASTER BEDROOM 17-0 BEDROOM 2 OPEN 13' 0- r 15'.8- STUDY SECOND FLOOR DINING ROOM 13• 0- x 12'•0- 4828 =.-1344SF 48 oc, KITCHEN MORNING AOOAA Fl RST FLO 0 R 4828 " . YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heightsv N.Y. 10598 (914) 245-2800 Albert H. Padovani, Director LAB #: 93.802332 CLIENT #: 8641 ' NON STAT PROC PAGE 2 WALLACE, DOUGLAS DATE/TIME TAKEN: 01/20/99 08:30A P.O. BOX 154 DATE/TIME REC'D: 01/20/99 09:30A MOHEGAN LAKE, NY 10547 ' REPORT DATO 01/29/99 PHONE: (914)-734-1187 SAMPLING SITE: LOT 139 LITTLE POND HILL � : PATTERSON NY COL'D BY: OUGLASWALLACE NOTES...: KT ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE ESTATES SAMPLE TYPE..! POTABLE PRESERVATIVES: NONE . TEMPERATURE..: COLIFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ RESULT NORMAL 7 RANGE METHOD pH pH SCALE IN WATER RANGES FROM 1-14. MEASUREMENT OF pH IS ONE OF THE IMPORTANT AND FREQUENTLY USED TEST~ IN WATER CHEMISTRY. ' WATER WITH A LOW pH MIGHT BE CORROSIVE TO METAL PIPES AND FIXTURES. THE NORMAL RANGE OF pH IS 6.570 815. Hd TOTAL HARDNESS IS DEFINED AS THE SUM OF THE CALCIUM & MAGNESIUM CONCENTRATION, BOTH EXPRESSED AS CALCIUM CARBONATE5 IN MG/L. THE HARDNESS MAY RANGE FROM 0 TO HUNDREDS OF MG/L, DEPENDS ON THE SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED. SOFT WATER: 0-70 MG/L ' VERY HARD WATER: ABOVE 100 MG/L MODERATELY HARD WATER: 70-140 MG/L MG/L F MILLIGRAM PER LITER HARD WATER: 140-300 MG/L ^(1 grain/gallon = 17.2 MG/L) - SUBMITTED BY: Director ELAP# 10323 ` /Ai.TIll Qo�edAppiCnet hL�e �.�/ /ri.9 I%/GFD `WUU"� " Date at Ptevksn A pprOYd Maus Aimee �n d1V ! G Town • ,c *4 / 2!a2 9 Date Subdivision Apgroyed Fee Enclosed Amnlint ». Bombs iy}e �[tG�.— Lot An& Fm Sande, o* N�ntiae 1 p it au Dedso Flow G P D - OrJ P ®N@d8wfi = le Ri q�Wbs FM 1S a PW" S�panM Srvre ap SYNW le emold of Calm Sapli Tm* ea11_�;fz'f 14 Wendmitad by i %sue Addma Wnler sgnta Pd&e Swy Ft Adihe an X Jill. .&**'Driad by T137> AaIkMss 0" R"d Neelift ` 1 ►epremht':thata am wholly and,eompletely responsible forth* design and.location of the propose system(y; 1) that the • male fesr di salt atom above dNpitleA .will be "Constructed as shown on the approved amendment there to and in accordance with the standards. rules a rpu ns o County O�partnlMlt of iiakli, and that on comp, NA thereof a "Certificate of Construction Compilance" satisfactory to the Commissioner of Mealthwlll Oa aubmltte0- to .tIM- .,Oeoartniwrt, and a .written guarant" 'win.bo furnished the'ownw. his rucceoors. heirs or• anipn by the bulkier, that said bulkN► will "Ice aft, pod Opeietinp .eormulon "y pert of Yid mwe" disposal sYste during the period of two (2) YeWsAmmedist9ly, following the deb of the Issu- aria of the app' mi rof .M the •CertNkita of 'Constructiofi Compliance or a original cyst or any repet(s t o; 2) the drilled well described above saw be WAW ei Mown qn the approved plan and that said wall will t►a inst in •accoidan wNh reanaa ru 169USTO s of the Putnam County OeWR ".mm Is. Oats S ne RE%// A A. License No �O1c's .�IL_ APPROVED. FOR: CONSTRUCTION: This'appromial expires two years from them" he der uni constr ctNn of the building has been undertaken and Is revocable for cause or may be amended or, modified, when considered MC"Ury by •the Commissioner 'of MeeRh, Any change or alteration of construction "quir" jilnew permit.' Approved for disposal of don"Ic unit sewage, end /or ale water supply only. /� Qvs$ Wte/ / K�r� �/ 7�i ev Title .y YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 (914)-245-2800 AlbePt H. Padovani, Director LAB #: 93.802332 CLIENT #: 8641 ~~~~~~~~~~~~~~~~ ~~~~~�~~~~~~~~~~~~~~~~~~~~~~~.~~~~~~~~~ . NON STAT PROC PAGE 1 WALLACE, DOUGLAS ' DATE/ TIME TAKEN: 01/20/99 06:30A P.O. BOX 154 DATE/TIME REC'D: 01/20/99 09:30A MOHEGAN LAKE, NY 10547 REPOR7DATE: 01/29/99 PHONE: (914)-734-1187 ' SAMPLING SITE: LOT 13, LITTLE POND HILL ESTATES SAMPLE TYPE..: POTABLE : PATTERSON NY PRESERVATIVES: NONE COL'DBY: DOUGLAS WALLACE TEMPERATURE..: NOTES...: KT ------------------------------- --- ~_` �----------- COLIFORM METH: MF ------- DATE FLAG PROCEDURE RESULT NORMAL - RANGE ' METHOD PUTNAM CNTY PROFILE ' 01/20/99 MF T. COLIFORM 'ABSENT 1100 ML ABSENT 1008 01/20/99 LEAD (IMS) <1 ppb 0-15 ppb 9101 01/20/99 NITRATE NITROG 0.40 MG/L 0 - 10 9139 01/20/99 -NITRITE NITROG <0.01 MG/L ' N/A 9146 01/20/09 JRON (Fe) ' <0.060 MG/L 0-0.3 mg/l 2037 01/20/99 MANGANESE (Mn) <01010 MG/L 00.3 mg/l 2037 01/20/99 SODIUM (Na) 11.5 MG/L N/A 01/2p/99 pH 6.9 UNITS 6.5-8.5 9043 . 1/20/99 ,HARDNESS,TOTAL 96.0 MG/L N/A . 01/20/99 ALKALINITY (AS 56.0 MG/L N/A 01/20/99 TURBIDITY (TUR <1 NTU 075 NTU COMMENTS: BACT THESE*RESULTS INDICATE THAT THE WATER NOT) 'OF A SATISFACTORY SANITARY QUALITY ACCORDIN�=�B�TH� NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THETfME OF COLLECTION. ` Pb/Cu LEAD limits for p EPA Lead & Copper than 10% of their than 15 ppb and a treatment must be t ti l po �n a . ablic schools are set at 15 ppb. Rule for Public Systems requiret that no more distributipn points have a LEAD value of more COPPER yaIue of 1.3 mg/L, else water � undertaken to reduce the *atevs corrosive ' Fe/Mn If both'iron and manganese are present, their total value combined shall not exceed 0.5 my/L. ` Na No limits for Sodium are proscribed. Suggested guidelines state that J r,peopleon a sodium restricted c}iet,the water should contain no more than 20 mg/L of Sodium. For those on a moderately restricted diet, a maximum of 270 mg/L of Sodium is suggested. PUTNAM COUNTY DEPARTMENT.OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES FIN SITE INSPECTION 6P0V1ZN;-7P- HeeN Date: a 7 ` Inspected by: Street Location 1�,:s -1`a �Plore -,, ( Z, Owner Town 7ff er7!5aw Permit it G: 9 9 TM r Subdivision Lot 9 4;4-1 av" (/ ii I. Seys-age System Area ; a. STS area located as per approved plans ........................... b. Fill section - date of placement 3:1 barrier Lgth. Width Avg.Dpth c. Natural soil not stripped ..................... ............................... d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from water course/ wetlands ...... ............................... II. Sewage Svstem a. Septic to k-size - 1,000 :...... .......other ................ b. Septic tank installed level. ................ ............................... c. 10'.. from foundation .......... ............................... d. Distribtuion Box 1. outlets utlets at same elevation -water tested ................. 2. Protected below frost .................. ............................... 3. Minimum 2 ft. Original. soil between box & trenches Junction Box - properly set ....................... ............................... engtFi required 14<-/e Length installed So 2. Distance to watercourse measured-1- 2 ooFt.......... 3. Installed according to plan ......... ............................... '4. Slope of trench acceptable 1/16 -1/32" /foot ............. 5. 10 ft. from property line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface .................. 7. Room allowed for expansion, 100% ........................ 8. Size of gravel 3/4 -1 %2" diameter clean .................... 9. Depth of gravel in trench 12" minimum ................... 10. Pipe ends capped ........................ ............................... g. Pump or Dosed Systems Size of pump c am F r ................ ............................... 2. Overflow tank ............................. ............................... 3. Alarm, visual / audio .................... ............................... 4. Pump easily accessible, manhole to grade ................. 5. First box baffled ........................ ............................... 6. Cycle '"itnessed by H.D.estimated flow /cycle........... III. House/Buildiniz a. house locat6d per approved plans ... ............................... b. Number of bedrooms ...................... ........ IV. Well a �t a. Well located as per approved plans . ............................... b. Distance from STS area measured -t--/ Q e9 ft........... c. Casing 18" above grade .................. ............................... d. Surface drainage around well acceptable ....................... V. Overall Workmanship - a. Boxes properly grouted ..:................ ............................... b. All pipes partially backfilled ........... ............................... c. All pipes flush with inside of box ... ............................... d. Backfill material contains stones <4" diameter: ............ e. Curtain drain & standpipes installed according to plan.. f. Curtain drain outfall protected & dir.to exist watercourse g. Footing drains discharge away from STS area............. h. Surface water protection adequate ... ............................... 1 1 ® II® Y�� 4 ivs IBM Wam i ©s Imm a ;, „..� )SAL ) ON NS— =D )R- DE- 'ORK (K lqoi 00 L MU -7— ILI 'Ll ju c cryoo p) AO 0.1 to A "rANK t lb ---j Ex 15T- 4 6 R. c I. h I JA 00- C11 00 ui 1 'I al Ld Wfew- I. h I JA 00- C11 00 DIMENSION CHART (in ft.) No. A B I 35' S2' 3 sit 14' 7 gl' lot' g 64' 9 74' ►►g' 10 00' 22' Eye,' ►2 9 I ' 129 ►3 90, 44' (4 5'1' 49' 15 ro4' 64' I(o "10' (00' g 80 ?4' i q 65' � /