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Home My WebLink AboutWell Correspondence 00 I � i I STATE OF CONNECTICUT PPt~EN) j STATE DEPARTMENT OF HEALTH Y y 79 ELM STREET HARTFORD, CONNECTICUT == 06106 c : NNCCr� OFFICE OF PUBLIC HEALTH j DATE: June 22,, 1983 TOWN: South Windsor Subject: Inspection of Sewage Disposal System and Private Water Supply at Proposed Day Care Home of Ms. iPatricia Chiarenza., 54 Overlook Ms. Edith M. Provencher Five, On May 4, 1983 Department of Human Resources 330 Broad Street Manchester, CT 06040 X For your information. Please note special recommendations. Follow-up report requested. For necessary action. X Remarks: Enclosed you will note a summary report and a laborator y analysis report (No, 1948) regarding the subjectwater supply. g g PP Y• The results of the laboratory examination meet the requirements for a potable water. Please contact this office should you have any questions concerning this report. I Gregory G. Bonadies$ Principal Sanitarian Environmental Health Services Section i Preventable Diseases Division GGB:llh j Enclosur s (2) i cc: Gerald Schwartz, M.D. Director of Health i' I i I i Phone: 566-3110 i An Equal Opportunity Employer CONNIECTICUT STATE DEPARTMENT OF HEALTH ENVIRONMENTAL HEALTH SERVICE$ INSPECTION FORM CHILDRENS sAARG}NF HOME D A y SUBJECT: S��ti �✓�� ✓_ Conn., Inspection ' of Private Water Supply and Sewage Disposal System of A rr"c�j_ as Proposed Tlester Home TO: ._ Gr e ms/ G �oNti�+cS �A� CAYE FROM: _DATE OF INSPECTION APPLICANT kf e.✓ za P.O. ADDRESS: 4_1 0✓tr /o,K Qr OWNER (NAME AND ADDRESS IF DIFFERENT FROM APPLICANT) : ._ SOURCE OF WATER SUPPLY: _ ,�r� � F_ we f DEPTH: . S° DIAMETER _ _G / COVER AND CURBING O.K.? C0c' J IF NOT, WHAT REPAIRS ARE NECESSARY? DISTANCE FROM WELL TO NEAREST SEWAGE DISPOSAL SYSTEM TYPE OF SEWAGE DISPOSAL SYSTEM SERVING APPLICANT'S HOME: Se wC rs IS IT OPERATING SATISFACTORILY? IF NOT, WHAT CORRECTION IS RECOMMENDED? SEPARATE SYSTEM FOR SINK OR LAUNDRY?_- DISTANCE FROM WELL: /f ANALYSIS REPORT: /9 yB° .ti«r REMARKS: .✓c.v POTABLE WATER COLLECTION/ EXAMFIVAc'TION REPORT This Section for Lab. Division Use OL-at REV.8i79 - LABORATORY NO. TO N,N•. PHYSICAL COMPL I 1.Type or print one set. oriel send to the address below. 2.Reports will be furnished only to local director of F. 48' y health or state agencies. DATE RECEIVED DATE REPORTED TO: State of Conn. Dept.of Health Services, laboratory Div.,P.O.Box 1689 Hartford,CT.06101 NAME OF PROPERTY(Where sample was taken) ADDRESS / •f l �`COLLECTION �/j� L _ TOWN REPORT: ti Ol y/ ! ) 1 ( t I 7`► �+ I t. / d"4 ty COLLECTED BY(Name) COL LECTOR'S NO DATECOLLECTED TIME COLLECTED SAMPLING POINT yJ� )t' M. Name and Address of person to receive Laboratory Report r Well Sem�blic Private I Identification: IN Note Filtered Chlorinated Softened Treatment: U � �� rr ti ....................................... ............... ,i• � Other(Specify) NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(if different from name and address above) Fold Reason For Conformatio to Laws Suspected of Causing Disease Other (Specify or give details here) Here Examination: (Specify) El Details) d � CoOf:mplaints Ccr OWr T�e Sediment Foaming Other(Specify) Use Of Constant Emergency DATEOF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: ® � f'.fc :O ( �, ,� 7° •�„ z: .�. ,, < �!` ...,✓.- Ig+ Source Of Drilled Well Driven Well Dug Well Spring Other(Specify) Water: ��j�) ❑ Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL ,•S DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. In. r Possible Source beptic�I ank Farm Industry Other (Specify) Of Pollution: �t��1 ❑ Special Tests Required: L1 rg ,�• ft/ # Additional Description If Needed: Signature ( r { DATE SENT And Title: 1 LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR /, �.�� TURBIDITY U NITRITE o Sdium a N a J l _t{t a /n Moganese as Mn Nitro NITRATE Alkalinity as CaCO3 Bicarbonate Fluoride cis F gen 7- Constituents "' f "' 2, as AMMON A as Nitrogen (N) Alkalinity as CaCO3 Carbonate Detergent ABS (f J � ) , 0' " ALBUMIN91D Total Hardness as C CO3 Sulfate as SO 4 Hydrogen-ion Concentration (pH) f t Chlorides as Cl L r Iron as Fe �7 D• M MEMBRANE FILTER TEST � �id JU � l7 Coliform Colonies/100ML. Z/74--e CONCLUSIONS: The results of the analysis of this sample- Meet the requirements for a potable water. ❑ Meet the requirements for a potable water; however, the chemical or physic al constituents listed below appear abnormally high for a ground supply, The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable water because: ❑711c Coliform density exceeds acceptable limits. •Ihe presence of the Coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source of this bacterial contamination can be located and removed. ❑7he concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: STATE OF CONNECTICUT Qt M en,T STATE DEPARTMENT OF HEALTH a 79 ELM STREET HARTFORD, CONNECTICUT 06115 ciS _ NNECSG OFFICE OF PUBLIC HEALTH Name: Helen Rollins Date; July 2, 1975 State Welfare Dept. Address: 364 W. Middle Tpke, Town: South Windsor Manchester, Conn. Proposed Foster Home:. Mr, and Mrs. Dale Wilson (� For your information. (_) Please note special recommendations. (_) Resampling requested, (_) For necessary action. LX) Remarks The results of this examinah n indi ate that tha water was safe for drinking at the time and pla�P Of collection. I i r 1, Anthony V. Sardinas Senior Sanitarian ' Environmental Health Services Division AS/pab CC., Alice Turek, M.D. t Director of Health for South Windsor RtiGG`� O�Q�• Mr. and Mrs. Dale Wilson VN An Egiial Opportimity Employer 'ti R CONNFCTICUT STATE DEPARTMENT OF HEALTH ENVIRONMENTAL HEALTH SERVICES INSPECTION FORM CHILDRENS BOARDING HOME SUBJECT: ___. SOUTH WINDSOR,, Conn., Inspection of Private Water Supply and Se-wage Disposal System of Mrs. Dale Wilson as Proposed Foster Home TO: -_David C. WigginDirector, Environmental Health Services FROM: William Sawicki Sanitarian DATE OF INSPECTION —5L22/75 APPLICANT: _M�'• and Mrs. Dale Wilson P.O. ADDRESS: 2 Tdent Road OWNER (NAME AND ADDRESS IF DIFFERENT FROM APPLICANT) : (SAME) SOURCE OF WATER SUPPLY: __._Thrilled Well DEPTH: - 215 ft. DIAMETER 6 inches COVER AND CURBING O.K.? Sealed Underground IF NOT, WHAT REPAIRS ARE NECESSARY? _ ;f DISTANCE FROM WELL TO NEAREST SEWAGE DISPOSAL SYSTEM 75 ft. TYPE OF SEWAGE DISPOSAL SYSTEM SERVING APPLICANT'S HOME: — Septic Tank and Leaching Field IS IT OPERATING SATISFACTQRILY? YES T� _ IF NOT, WHAT CORRECTION IS RECOMMENDED? SEPARATE SYSTEM FOR SINK OR LAUNDRY? NO DISTANCE FROM WELL: ANALYSIS REPORT: Safe REMARKS; The results of this examination indicate that the water was safe for drinking at the time and place of collection. cc: Helen Rollins, Depart. of Children and Youth Services, 3.64 W. Middle Tpke., Manchester, DOH - South Windsor onn. Mr. and Mrs. Dale Wilson, 72 Ident Road, South Windsor, Conn, EHs-82 i 4-73) 3M i OF POTABLE � 8 CONNECTICUT &TATE QIPART NEXT OF.HEAM f--A �. $To LAIN 91WSNlN 7 P.O. 60X 1610,NARTFORO, CONNECTICUT 06101 DATE RECEIVED t21 6F USE BLACK INK OR HEAVY TYPE o NAME OF WATER SUPPLY -- - "liom W, Ullmann Ph.D., Director' Z Z • /S ADDRESS �� P TOWN •S CO / C �'_ECTORLLECT D BY �/ JA //1 / DATECOLLECTED TIME VV COLLECTED PUBLIC SEMI-p Q:J AM PUBLIC PRIVATE !Deports will be furnished only to local director of health or state oger.c;es PM DATE REPORTED l INAME AND �•p 7S I ADDRESS OF L_ SAMPLING POINT TAP, IPPED FROM STREAM, ETC.) I PERSON TO �� -' I RECEIVE LAB. T Yk N I REPORT --— ' TREATMENT NONE `- 1%FILTERED CHLORINATED ❑OWNER'S NAME AND ADDRESS IF.DI ER,€NT :FiOM ABOVE OTHER (SPECIFY) REASON FOR EXAMINATION- IF`USPECTED )F AUS;NG DISEASE_1,1` DETAILS --- -- DAIRY LAWS COMPLAINTS OF I CONFORMATION TO FOOD AND BEVERAGE LAWS ❑ OTHER (SPECIFY) MEAT AND POULTRY LAWS n El COLOR`I COLOR ❑ ' ODOR FOAMING _ ❑ TASTE OTHER APPARENT COLOR ___jTRUE COLOR O ODOR NITRITE TURBIDITY -- - Alkalinity as C00O3 ��, f ��. M ��Qr 9/L Bicarbonate `- NITROGEN - -- _- Mg/L Detergent as ABS CONSTITUENTS NITRATE o c,J t Alkalinity as C00O3 p� Mg/L 0 AS ------ Mg/L Carbonate 0 O t' Total Hardness Mg/L Sulfate as SOq ar NITROGEN (N) AMMONIA C CI• C��J M9/L Mg/L as C000 7 3----------_��C r Mg/L ALBUMINOID ` b' Q5� Mg/L t M9/L Iron as Fe O0 ---- M9/L Chlorides as Cl Mg/L Mg/L Manganese as Mn --- - Mg/L ;odium as No Mg/L _ Mg/L Fluoride as F Hydrogen-ion (pH) p� —- Mg/L Concentration O. MEMBRANE FILTER TEST COLIFORM COLONIES/100ML, CONCLUSIONS: Sample indicates water is: SAFE The results of this examination indicate that the water was safe_for drinking at the time this Sa mple was collected. The results of this examination indicate PROBABLY that the water was probably safe for drinking at the time this SAFEsample was collected, although some of the chemical constituents appear mally water should be suspect if local conditions indicate that the source rof thesefg onslfuenish for a SamPis ofpotend lly I water, The one. The presence of colonies of the coliform group, while not necessarily indicative of dangerous contamination, does ❑ PROBABLY indicate that such contamination might reach the supply to the same extent- The water should be considered as un- UNSAFE safe for drinking until the source of this bacterial contamination can be located and re treat- ment can be provided. Wired�or u^/ilJadfquate treot- UNSAFE The results of both the bacteriological and chemical examinations classifyth contaminated to an extent rendering the supply ° water of PPY unsatisfactory. the time of collection as ElOTHER 91 (9-72) 10M v MAY 29 1017c STATE OF CONNECTICUT �QPpTME/y, �ra U4 STATE DEPARTMENT OF HEALTH 79 ELM STREET HARTFORD, CONNECTICUT 06115 �NECrC OFFICE OF PUBLIC HEALTH 4 ,( r Sn w'L4-T Dear Doctor v"X_%A. 21is is to inform you that the above-named person has contacted us -about. a. proposed day care center in your town. ��Je have sent all the necessary information concerning licensing regulations. Because this is a new- center, we may be asking consul- tants to visit in order to promote a greater understanding of the needs of a good center. The above-named person may be contacting you for further adaice on health and safety, however, the final inspection sh-ould not be made until we have sent you a copy of the center's application, anc erely yours, ,¢ 4 'i .'1 Y h _ . V. Va Bapat$ IxLD. Pediatric Consultant -Wtem na.l and Child. Haalth Section- VUB;ed 11CH 126 (rev. 6/30/71 An Equal Opportunity Employer STATE OF CONNECTICUT �oPaNENr4. STATE DEPARTMENT OF HEALTH s 79 ELM STREET s :~ HARTFORD, CONNECTICUT 06115 0 NEC'ht�, OFFICE OF PUBLIC HEALTH May 3, 1974 Alice J. Turek, M.D. Director of Health pe s Rev. Karl Gurgel 41. Center Street 300 Buckland Rd. Manchester.* Conn. 06040 So. Windsor Dear Doctor Turek: 7hi.s is to inform you that the above-named person bas contacted _.us-about. a. proposed day care center an your town. T,Te have sent all the necessary information concerning licensing regulations. Because this is a new center, we may be asking consul- tants to visit in order to promote a greater understanding of the needs of a good center. The above named person may be contacting you for further adfxi.ce on health and safety. However., the final inspection sh-ould not be made until we have sent you a copy of the center's application. aLnc erely yours, V. V. Bapat., MD. Pediatric Consultant _ternal and Child. Health Section VVB;ed HCH 126 (rev. (:vW71 An Equal Opportunity Employer, STATE OF CONNECTICUT DEPARTMENT OF HEALTH SER VIC ES '�•° `� BUREAU OF HEALTH PROMOTION & DISEASE PREVENTION NAME: Ms. Edith Provenaher DATE. DePartment of Human Resources Janue�ry 6, 1983 330 Broad street ADDRESS: Manchester, CT 06040 TOWN: South Windsor SUBJECT: Inspection of Sewage DisPosal System and Private Water Proposed Day Care er of Ms. Dalila Sots et at December 16, 1982 44 Willow Street, On ( g ) For your information, ( ) Please note special recommendations. ( ) Follow-up report requested. ( ) For necessary action. ( X ) Remarks. B'nclosed you will note a stu®ary recart AnAa laboTato analysis_ report _(Ho. 28214) E91rding the subject water supnls►. The results of the laboratory examination meet the re uirementa fora Potable water. Gregory G. Bonadies, Principal Sanitarian Housing and Institution Program Environmental Health Section Preventable Disease Division GGB:llh Enclosures (2) cc: emerald Schwartz, M.D. Director of health Phone: 56&3110 79 Elm Street • Hartford, Connecticut ooft 06106 An Equal Opportunity Employer CONNRCTICUT STATE DEPARTMENT Or HEALTH ENVIRONMENTAL HEALTH 6ERVICEi INSPECTION FORM CHILDRENS -ftCelG6�HOME SUBJECT: -__ r , Conn., Inspection of Private Water Supply and Sewage Disposal System of ~—--- , as Proposed-Posttr Home TO: G e 20 r v G /J o.✓a�i rs FROM: ti d T L a L' !4 DATE OF INSPECTION APPLICANT: -Qa �, -Sa7�o P.O. ADDRESS: yv ti/, //ors/ S?'' OWNER (NAA AND ADDRESS IF DIFFERENT FROM APPLICANT) : SOURCE OF WATER SUPPLY: _.Pr'✓4 f c hJ e. DEPTH: . ? DIAMETER COVER AND CURBING O.K.? S 6 S u r 4< c o- 1F NOT, WHAT REPAIRS ARE NECESSARY? DISTANCE FROM WELL TO NEAREST SEWAGE DISPOSAL SYSTEM __ o v e e TYPE OF SEWAGE DISPOSAL SYSTEDf SERVING APPLICANT'S HOME: 5 e yc, c �a iv if f /e 4 c A IS IT OPERATING SATISFACTORILY? 14 �' -AA, t e c �' ,,,,y � � f,o__yeS IF NOT, WHAT CORRECTION IS RECOMMENDED? SEPARATE SYSTEM FOR SINK OR LAUNDRY?_y"A`e- DISTANCE. FROM WELL: ANALYSIS REPORT: # 8'a�y M�� '_ r :�Ivo..►a . �s REMARKS: _ yc Al y EHS-82 !4- M --__--- _-- raTABLE WATER COLLECTION/: EXAMINATION REPORT This Section fo ob:" 'vision Use Ot-8t 'itEv.8/79 ° TORY NO. TO N 1.Type or print one set and send to the at�dress'below. PHYSICAL�COMP�p ` 2.Reports will be furnished only to local director of or state o4encibs. DA RECEIVEDTO:Slats of Donn.Depf.of Health%rviDas OAT. R P beretertr Div,;P.O.Sea 1"9 Hartford,CT.06101 2 Uf •��,�•Q COLLECTION NAME `oF RO R rr ere camp a was to ea) ADDRESS �l REPORT: 3 p't'Q TOWN COLLECTED BY(Name) C LLECT R5N A 01 All ELECTED Tpr1E O LECT D :!A LING ~ �� if, g r Name and Address of pe son to reeefve Laboratory sport Well Sem blic Private Identification: F None Filtered Chlorinated Softened Treatment: Specify)y)........ ...a ❑ ... Other(s eclt •••'- AMEOFrLASTAAT MADE I AST EXAM 1TEOFLASTEA PROPERTY OWNER'S NAME ANO ADDRESS(/t different Prow aetga as addrsea above) F Reason For Conformation to Laws uapectt o ausing Disease r�her Speoity or gJvedyerc�its here ere Examination: ® (Spectly) El(GiveDetails) U Re V eS/ Q Complaints Color Odor oats a invent Doming her(Speoi y) t H40M IqA/ ❑ ❑ a a Of: ElIds/Ker rd,�A Pro ✓t�t.C, 44er Use Of Constant mergeneZ-9-:1 LAST USE NDITIONS THAT MAY AFFECT WATER QUALITY(Specify Supply Source Of Drilled Well Driv� e in tWater: � WEL EPTH WELL DIAMETER CONOITION�O�F CURB AND TOP SEAL Description Of DATE OF LAST PLUMBWG WORK IN SYSTEM Water Source: Ft. In. �v r♦ cd, Possible Source Sept lank f r Ina ry Ot or pecty) v Of Pollution: Special Tests Required: ),IC Additional Description If Hooded:--- Signature And Title: GATE SENT LABORATORY EXAMINATION REPORT: (To be filled our by Laboratory Division APPARENT COLOR Note: Chemical results are in Mg/L. /K TRUE COLOR OR V TURBIDITY 4 : ... NITRITE Sodiu as Na a .1 Magonese as Mn' r � Nitro NITRATE Alkalinity as Co Nitrogen 4/r icarbonote , F noride as F 9 Constituents asn (N) U AMMOi�A Alkalinity Nitroge as CaC or ovate Detergent,as ABS G I d J y T. , ALBUMI��p Total Hartlnsas os �3 Sulfate as SO GG r s Hydrogen-ion tic ration(pH) Chlorides as Cl r 2 �� Iron,as Fe 'a t MEMBRANE FILTER TEST "" « CDIifOrm Colonies/100ML. a- r. Meet the requirements for a potable waterONFCLUSIONSs The results of the analysis of this sample- ❑ Meet the requirements for a potable water,howeirer,J call or physic a1 constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that,*t`It�iltce of these Coastituerlts is a potentially harmful one. y ❑ Do not meet the requirements for a potable wet `.`bectstlMCit f ❑The coliform density exceeds acceptable limits.. prey�.ce of the^roliforrit u while are present, does indicate that such contiimination P� �t necessarily meaning that disease producing organisms Might reach the supply to the same exte6t. The water should be considered as unsafe for drinking ❑until the source of this bacterial costa nihation ran be,locat ed'and removed The concentration of certain chemical or pliyaical co(Istttuents exceeds:acceptable limits. These are as follows: ❑Other. • n . ,y STATE OF CONNECTICUT DEPA R TMENT OF HEALTH SERVICES BUREAU OF HEALTH PROMOTION & DISEASE PREVENTION NAME: Ms. Joan Thistle-Fields DATE: September 16, 1982 Department of Human Resources 330 Broad Street ADDRESS: Manchester, CT 06040 TOWN: South Windsor SUBJECT: Inspection of Sewage Disposal System and Private Water Supply at Proposed Day Care Home of Mr. and Mrs. Anthony Chiarenza, 54 Overlook Road, On August 25, 1982 ( X ) For your information. ( ) Please note special recommendations. ( ) Follow-up report requested. ( ) . For necessary action. ( X ) Remarks. Enclosed you will note a summary report and a laboratory analysis report (No. 19688) regarding the subject water supply. The results of the laboratory examination meet the requirements for a potable water. � V -� o Gregory G. Bonadies, Principal Sani arian Housing and Institution Program Environmental Health Section Preventable Disease Division GGBtllh Enclosures (2) cc: rald Schwartz., M.D. Director of Health - South Windsor Phone: 566-5511/566-2762 79 Elm Str> s Hartford, Connecticut h6bEk 06106 An .Equal Opporiunfty Employer ENS CONNIECTICUT STATE DEPARTMENT OF HEALTH ENVIRONMENTAL HEALTH SERVICES t INSPECTION FORM CHILDRENS BeARBONG HOME DAY C-AR--Ir SUBJECT: -. Sc tt/ i✓%�'�S vJ- _, Conn., Inspection of Private Water Supply and Sewage Disposal System of'''Dr+M —�I,v //c,✓ _ C ti ,4 ra.✓zk , as Praposed-Featsg Home TO: ---Cheeory I'S� yaC{res L>A �R-t- FROM: �4 K _ L �v � `DATE OF INSPECTION ;;�s q __ ,APPLICANT: �('.l►i`re•�z4 P.O. ADDRESS: --LE— O✓er/on !,' �d OWNER (N aME AND ADDRESS IF DIFFERENT FROM APPLICANT) : 5/{�� SOURCE OF WATER.SUPPLY: _ .�r ✓4 fc __c✓e- DEPTH: : _? DIAMETER _— COVER AND CURBING O.K.? sub s yr •Ace _ ` IF NOT, WHAT REPAIRS ARE NECESSARY? DISTANCE FROM WELL TO NEAREST SEWAGE DISPOSAL SYSTEM __ yrcr V -rl, TYPE OF SEWAGE DISPOSAL SYSTEM SERVING APPLICANT'S HOME: — Seat. /c/ IS IT OPERATING SATISFACTORILY? �� /fN� -f—, e ��' ,,✓ IF NOT, "'HAT CORRECTION IS RECOMMENDED? SEPARATE SYSTEM FOR SINK OR LAUNDRY?-_-/✓G,v e DISTANCE FROM WELL: �� A1'ALYSIS REPORT: lQdo ?l$' Met j"e=vtre +e is C REMARKS: ---- POTABLE WATER COLLECT IONI EXAMINATION REPORT This Section for Lab. Division Use olelv.slry ).Type or print one set and send to the address below. A NO. TOW�NO2 ICAL OM LETS 2.Reports will be furnished only to local director of I J^l" health or stets agencies. FDA E R�CEIy 'D ; t9RrT TO: State of Conn.Dept,of Health Services,Laboratory Div.,P.O.!ex 1689 Hartford,CT.06101 1,� " f COLLECTION NAM£ OF' RO ERTY(Where sample was taken) ADDRESS TOWN REPORT: 14/ A w/tJ@P4 ty t•trdrCA 'S"`lt Oric r lCG K Wd ro,rt l� f✓.,d�ftsv COLLECTED BY(Name) COLLECT R' N IMECOLLECTED SAMPLING INT /Q� f it W L J�" I�at 1 d► 00 M. /�r tG f c!✓ r, .✓ 1{ Name and Address person to receive Laboratory Report / Well Semi-Public Private Identification: Lnj None Filtered Chlorinated Softened ElTreatment: ON s P .......e (r....Sp........ec//y)... .............................................the ...................... JNAME OF L B THATMADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(Ifilifferen't from nsFe and address above) Fold Reason For Conformation to Lows-7—uspected o ousing Disease then (SFecity or glue decalts here) Here Examination: ❑ (Specify) ®(Give Details) ❑ Complaints Color Odor Taste Sediment oaF1mtng ®r{Specify) Of:- l�_1l Use Of Constynt meraency DA7EOFLASTUSE C NOITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: rUiI Source Of Drilled Well Driven Well ug�el prt�ng ther7SpecityJ Water: ILJ1 ((_�„__7JJ Description Of WELL DERTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: // Ft. In. Possible Source optic Tank Far In El �u�stry Other fSpecity) Of Pollution: Special Tests, Required: C— Additional Description If Needed: , Signature r !_- DATE SENT And Title: /• �..,.. w.�t .1 �^ LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR TURBIDITY NITRITE. Sodium s No Magonese as Mn 40Vdr Nitrogen NITRATE� r Alkalinity of C0003 Bicarbonate Fluoride os F .? Constituents as AMMONIA / Alkalinity as CaC 3 Carb�nate Detergent as ABS Nitrogen (N) Z 00 O ) r ALBUMiNOID / Total Hardness as C0003 Sulfate as SO4 Hydrogen-ion 1�centration (pH) G p, d , 30 1 t Chlorides as Cl Iron as Fe Syr 16 MEMBRANE FILTER TEST a V l Coliform Colonies/100ML. a 9Meet the requirements for a potable water. CONCLUSIONS:The results of the analysis of this somple- ❑ Meet the requirements for a potable water; however, the chemical or physic a) constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable water because: ❑The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such c-ontantination might reach the Supply to the same extent. The water should be considered as unsafe for drinking until the source of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: ,r STATE OF CONNECTICUT DEPARTMENT OF HEALTH SERVICES BUREAU OF HEALTH.PROMOTION AND DISEASE PREVENTION Nam: Joan Thistle-Fields Dept. of Human Resources DATE: September 23, 1981 ADDRESS: 330 Broad Street Manchester, Connecticut 06040 TOWN: South Windsor, Connecticut SUBJECT: Inspection of Private Well Water Supply of Margaret R. Hamilton, 255 Graham Road C X } For your information. } ' Please note special recommendations. Follow-up report requested. For necessary action. X ) Remarks. Enclosed you will note a summar report and a laborato ry analysis re ort No. 20646 regarding regardilg the subject water supply. The results of the laboratory examination meet the requirements for a potable water. Gregory G. Bo adie�rinc Environmental Health Services Section Preventable Diseases Division GGB/bb cc: Gerald Schwartz, M.D. Director of Health Phone: 79 Elm Street35-9513Har ora, -Connecticut 06115 An Equal Opportunity Employer CONNECTICUT STATE DEPARTMENT OF HEALTH tNSPECTlON FORMA ENVIRONMENTAL HEALTH SERVICES - CHiLDRENS BOARDING HOME SUBJECT: -Seytff W,',✓c(Sor — Conn., Inspection of Private Water Supply and Sewage Disposal System of as Proposed Foster Home FROM: DATE OF INSPECTION 8 ADDRESS: OWNER (NAME AND ADDRESS IF DIFFERENT FROM APPLICANT) : SOURCE OF WATER SUPPLY: Pr+ ✓a f c✓ t/ DEPTH:..--,-? - -----_ DIAMETER G COVER AND CURBING O.K.? <( 1F NOT, WHAT REPAIRS ARE NECESSARY? DISTANCE FROM WELL TO NEAREST SEWAGE DISPOSAL SYSTEM __ 4✓4r S S � TYPE OF SEWAGE DISPOSAL SYSTEM SERVING APPLICANT'S HOME: 5- f, c r�r✓k /eq ,- /t" IS IT OPERATING SATISFACTORILY? 47- IF NOT, WHAT CORRECTION IS RECOMMENDED9 ------------ SEPARATE SYSTEM FOR SINK OR LAUNDRY? DISTANCE FROM WELL: ANALYSIS REPORT: Y! w A• ire v 7'ffc Ye +rc», c,c/�$ 'g'ar 4 !a d/e REMARKS: _ --------------- EHS Z2 (4-73) 3M -- r Key.3t'v _ t-4 '!=Type o pnnt ore sef 'and send to tf+e address belOWtlVK !VRY NO TOWN:NO. PHYSICAL-COMPLE;T„Bt r #r+ .Repods wall be:fumeshed one"to Iocol director o{ `" = t? sL''� ,i-;- • -"' *= � 7tealth or stat o enc�es " s -•�» ' DATE RECEIVEDr„ - t DATE REPORTED, --`a.. {sski.: iQ: State of Donn Dept.of Health Service:, Laboratory Div.:.P.O.- Hartford CT D6$D} �� COLLECTION NAME OF PROPERTY(Where sample was taken) ADDRESS} r a t. K � REPORT t f G r {7 •�t. a 7 S_4 �j �'ri f'1, r��- � F +F- I �:(!S t-r�.} OLLECTED BY(Name/ COLLECTORSNO DATECOLLECTED TIME COLLECTED SAMPLING POINT � v :__ �-- , �.._ D -`!�/ s7 Y �� .G�M �j tlf Sr�(t e� tt i�s.✓�� et�L '� ,��- ...tome and Address of r n to receive Laboratory,Repot` r y , �^' Semi Public Private - +We11;= .s-•.mot- -� -3r -:._,. �. ��5",^ y f uw, :• �"•*i'�"��-.. +:r, C;�` �"l a,. .-� j •'� c „ -e� 2 � � 1 rT+C y r +��,�: � � � x�' � jdent+fleat+o'n _.._- � �""c' L. "'`�i "r'ft?�, ..tip az•'d+.•� � [ s � �-u �-`- 'None Filtered tChlorinated u Softened Treatment t`�"`-'-S{ �lr.e,... .,+,-.._�7+c /. z/'rf J - e -s,� t-�w ��`.r s _.._ >a'•"' -_'r�':"c• .,,�• .. Other (SPecst_y) NAME OF LAB THAT MADE LAST EXAM DATE OF LAST<EXA ..- rs- -'^• :sy �'--s.:.'S.r-a. :..> x _ ,,;�,,.z i - ">. �'T ROPERI Y OWNER tdAME AND ADDRESS(lt differens from�ame.and"address above) =a 4 ..+.-a n :..>v. ...+:�:� •��"�_r.y._ _ ��•'�•r....:+ �.'� °:=."._..r�� ° � :t �` f¢"Fbld qr _ ��•kut �e;e ecson For vCDnformation to Laws,- Suspected-of Causing Dispose Other(Specify or give details here) xominotton r {Specify) .t., (Gtve Details) ate; �'p dolor"y Odor TosteSediment oam+n -Other fS ecrt �J�•� >,-�� •.�"�:-'#C� �;n� �`� "- � r, ►f 'f.,��'�� . �_w��-'�'� �� ' .(mow- -.,�. �g -�.�,.��.,c�,=�;,. ,�4.,� - _-- Ise OfY -,Constant � Emerggency DATE OF LAST USE -CONDITIONS THAT MAY AFFECT WATER QUAL77YISpecityJ V t ,g• � i � Y'''F 1 �i,�,t -wi ,� L w'7,A'3f�-f�� -'is.l• ..-�i apply: z z ^'' 'Drilled Well 3--Driven Well Dug Well Spring _Other(Specify} n-urce aler'-:�'f-c'.e,..---�� X .,sue �;,.x•- - .a, � 'r,.-x �� .f 'air z- •�. '=�' �'-z,%�-'�` s �.:_-�� -ut�'� � - .t tea, a�o.,r �--.. s� - ;`�5°-`��'"�.�"r'��.�ea_ .a'r=.+c"'� r"'�' ` � -';?ter-�'•- <-�~'" �.� K.-:. �,.��.�- �'�". ,:� .�'"�;'..�e... .�_--. ''� WELL DE�T+in WELT DIAMETER COND1T?ON OF CURB ANDS?OP SEAL r DATE<.OFt_AST-PLUMBING WORKIN.SYSTEM:}2 ater Source r� ft, yL vx : t -Jn �£f1LYr� era - c3F rzr�»� '3r ' assibleSource Septicc Tanker Farm _11ndustry fltheri(SpecifyJ f in Pal lution ;Q .s: At �a� .� ' 3.T L '`' pedal,Testsal—Inm - e Hired 4. M c� C1. _y SLf�yC3 �Ri i.�_YJ ddltlonal Description If.Needed ' - ,- -,�,, �� "s.... �- � :: 4' r - <- �� .�-+�-4--5 -�- r-_�•,�� -�r,�•2'° a i X a3,-.� ..s.a. •S.,x'E^�."`°�"� >is� �"^�;.. -ne,�-' -;w^`r ��¢ke-"„y .r�Y+S •..�,rx-�`�,�. - �,"`.�e"'e".3r_'a4�+�€�a-'>.. Y' s..v �5, '5...:. - �. ' a.>. g .. - '-'r a ..X'-'��•s......�.- wx K,;-' x ��. �� '� "�-s,''"t�`r �a+F=x .'y-' aa��x^ - '. 1 n OtU re .. mot,. 'a'a;� 'a"'�•��-i'. >'�i.- �..� w-j pk-r... 9 �� '`. � f � •w�-r��'.�Y�� -� �rr�c-r Y' Y� e �-�_'�",�"� �A T;E SENT: �.r.,:n n d Title -�� '-�- _ „=�"Y--�s- .. ��. ,��.+"y�� -�-'�"��, •,> ^' tea•--.r � 1 ABORATORY EXAMI .... .. REPORTS�To�efr/lecl�0ut3ry3 vbOratD;y3�tv7S7on� tt Note''Cfiemt of results ore tn:Mg/L�� x PPARENT COLOR _ �e TRUE COLOR x_ t ODOR r%9s TURB7D3TT w � t4ITRITE ' r Ma gone se as hMn x d d ua w r - ? "�..� Sodium-.ns No <,,-_ =-�5� EZ— Nitro end% CITRATE • Ikallnity as_CaCO3- arbonote F{uoride--m seta onst�ituents ��`�_s � u.- ,ay; y� „�;�.F�^T��' `.`'� �'�� ,;n'��•��-z.�-a��,t��.. ��3r-�- sa�s,�s�� *'vs AMMONIAr� Alkoliraity as CaCO2 Carbonate Detergent as ABS Irtrogen (N} a<r vt �' cLas�. r r`" a�fV _YU2 t AiBUMINOID_„ t Tatal Nordness-as CaCLt� Sulfate cs SO �z- �r _ -t.- �,4..�,,,. �-Iydrogen ion Concentration{ H} ;. " c * tSs blondes as CI Iron as Fe r~ � _ �e _ � e:�a ;,j�_�-: �-�_• Coliform Colonies/100ML .��? �#-�_,��.� �`��_ CONCLUSIONS ,The results of the analys+s'af this sample- r v tvJeet theregmrements for apotable water ,� Meet the regiurements for a potable roarer,`however,the chemical or physic al:constituents listed_beelow=appeaz.abnoimally high for aground supply Th 'water should be:suspect if.local conditions indicatethat the-:source of the:e:coastituents is a pocentialIy harmful one w - 7 Do not meet the requirements for a potable water,because _ �: 't The coliform density exceeds acceptable limits. :The presence of the coliform group, while- not necessarily-meamngahat disease,producing organisms;- r-' are present;does indicate that-such contaminazion"might reach the-supply to he ame extent The""wazer should-be considered-as unsafe for drinkingi _; until the source.of rhis_bacterial".contamination can be located and removed 4DThe croncentrauon ofcertain chemical or physical-constituents exceeds acceptablelimits :-These ate �, la _ a 'ud a f El 2 if Other -• .a, �.t�„� _ Y^r-� -a.a3 ' ''t'e, Pit t �.� k :. STATE OF CONNECTICUT . DEPARTMENT OF HEALTH SERVICES BUREAU OF HEALTH PROMOTION AND DISEASE PREVENTION NM4E: Ms. Linda Johnson , DATE: May 8, 1981 Day Care Unit Department of Human. Resources ADDRESS: 330 Broad Street TOWN: South Windsor Manchester, CT 06040 ' SUBJECT: Inspection of Sewage Disposal System and Private Water Supply at Proposed Day Care Home of Nancy Beaulieu, 244 Lawrence Road, April 23, 1981. ( x ) For your information. ( , Please note spacial recommendations, ( ) Follow-up report requested. ( ) For necessary action. ( x ) Remarks, Enclosed you will note a summary report and a laboratory analysis report (#8&631 regarding the subject water supply. Gregory G. Bonadies, Principal Sanitarian Housing and Institution Program Environmental Health Section Preventable Disease Division GGB:ejm , Enc. cc: 4Gerald Schwartz, M.D. Director of Health Phone 566-5511/566-276.2 79 Elm Street — Hartford,"Connecticut 06115 An Equal Opportunity Employer f U I ABL t W�jElt COLLECTION/ EXAMINAVON nnPORT This Section for Lab. Division Use otet.eev.e/79 LA NO. TOWN NO PHYSICAL COMPLETE 1. Type or print one :set and send to the address below. 2.Report's will be furnished only to local director of ;) 7�3 health or state agencies. DA ERE EIVE D TE REPORTED Conn. Dept.of Health Services, laboratory Div., P.O. Box 1689 Hartford, CT.06101 R �)] ! i $ L1-214 I COLLECTION NAME OF PROPERTY(Where sample was taken) I ADDRESS TOWN REPORT: ... `/`� COLLECTED BY(Name) COLLECTOR'SNO DATECOLLECTED TIME COLLECTE13 SAMPLING POINT �s .M. Nam nd Addre person to receive Laboratory Report,i Well Semi-Pu 6lic Private Identification None Filtered Chlorinated Softened Treatment:.... ❑ ❑ ❑ ..................................................... J Other (Specify).fy) .............. J ❑ NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM 2. PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Potd Reason For Conformation to Laws Suspected of Causing Disease Other (Specify or give details here) Here Examination: 1AJul (Specify) ❑(Give Details) ❑ Complaints Color Or Ta❑ �Taste ` Sediment ntFoaming Other (Specify) Of: Q Use Of Constant Emergency DATEOF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: ❑ Source Of Drilled Well Driven Well Dug Well Spring Other(Specify) Water: ❑ El Description Of WELL DEPTH WEAL DIDIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: ? Ft. in. Zu J. 'd Possible Source Septic Tank For Industry Oar (Specify) Of Pollution: Special Tests Required: ! A C C e Additional Description—if Needed: f Signature DATE SENT And Title: ■ LABORATORY EXA MINA TIO SPORT: (T a filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR TURBIDITY d POPE 0, NITRITE Sodium as No Magonese as Mn ®, 01 , 1-1 Nitrogen NITRATE / Alkalinity as CGC03 Bicarbonate Fluoride as F g �My Constituents C), 3 as AMMONIA , Alkalinity as CaCO3 Carbonate Detergent as ABS Nitrogen (N) ":::.: ©I 0 dr 0 ALBUMINOID,. Total Hardness as C00O3 Sulfate as SO4 Hydrogen-ion Concentration (pH) .�Ur 6 ) d, r Chlorides as Cl Iron as Fe MEMBRANE FILTER TEST �, Q Qr Coliform Colonies/100ML. Q CONCLUSIONS:.The results of the analysis of this sample- Meet the requirements for a potable water. Meet the requirements for a potable water; however, the chemical or physic al constituents listed below appear abnormally high for a ground supply. Thr water should be suspect if local conditions indicate that the source of the.:e constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable water because: ❑The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to :he same extent. The water should be considered as unsafe for drinking until the source of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: CONNKCTICUT STATE DEPARTMENT OF HEALTH ENVIRONMENTAL HEALTH SERVICES INSPECTION FORM CHILDRENS HOME D4-1c SUBJECT: _Sc�T ��C.Js Q t�._, Conn., Inspection of Private Water Supply and Dr4/L� Sewage Disposal System ofu/LL4-j! rt v //a+4 � as Proposed Home FROM: .. _ 2 .DATE OF INSPECTION 3��1 APPLICANT: Ntwc �� c lam _ P.O. ADDRESS: L4o✓1^fNG OWNER (NAME(NAME A D ADDRESS IF DIFFERENT FROM APPLICANT) : gig rT �i'cG Ke,✓o(rz K C/6. U,..�tc( ft�iwcf Cre ! t 1/mo') SOURCE OF WATER SUPPLY: +-r✓� e a!z�— DEPTH: . DIAMETER G A� COVER AND CURBING O.K.? e IF NOT, WHAT REPAIRS ARE NECESSARY? DISTANCE FROM WELL TO NEAREST SEWAGE DISPOSAL SYSTEM __ 0 ✓& ° h 37 TYPE OF SEWAGE DISPOSAL SYSTEM SERVING APPLICANT'S HOME: a IS IT OPERATING SATISFACTORILY? �� _ ��%" ,e 1F NOT, WHAT CORRECTION IS RECOMMENDED? SEPARATE SYSTEM FOR SINK OR LAUNDRY?-Al" "lc DISTANCE FROM WELL: _ ANALYSIS REPORT: %?t� L1 G 3 felts trle Y�Lv+rc•n. fS �� c �� r 7<<{ REMARKS: _. /✓7'ti'`y EFTS-82 i 4-737 3M ---- STATE OF CONNECTICUT DEPAR TMENT OF HEALTH SER VICES BUREAU OF HEALTH PROMOTION& DISEASE PREVENTION NAME: Ms. Joan Thistle-Fields , DATE: April 10, 1981 Day Care Unit Department of Human Resources ADDRESS: 330 Broad Street TCWN: South Windsor Manchester, Cr 06040 SUBJECT: Inspection of Sewage Disposal System and Private Water Supply at Proposed Day Care Home of Mr. and Mrs. Melvin Stead, 627 Foster Street, March 23, 1981. ( x ) For your information. ( ) Please note special recommendations. ( ) Follow-up report requested. ( ' ) For necessary action. ( x ) Remarks. Enclosed you will note a surmary report and a laboratory analvsis report (46070) recrardina the subject water supply. Gregory G. Bonadies, Principal Sanitt arian Housing and Institution Program Environmental Health Section Preventable Disease Division GGB:ejm Enc. cc: , Gerald Schwartz, M.D. Director of Health Phone: 566-5511/566-2762 79 Elm Street • Hartford, Connecticut 06115 An Equal Opportunity Employer CONNECTICUT STATE DEPARTMENT of HEALTH ENVIRONMENTAL HEALTH SERVICES INSPECTION FORM CHILDRENS BeO HOME boy CA-AR- SUBJECT: og2_ N u/III�LQZ ___._, Conn., Inspection of Private Water Supply and M I .yICAA� Sewage Disposal System of _ r .__�/ as Proposed Home TO: 6 e�or G !Jc ,/0. 11ieS FROM: �c!/4 r _ __ •r_ L q .r—___DATE OF INSPECTION _dkdoN a3. 19e APPLICANT: ___`M t_ Mrs S to-k C4 P.O. ADDRESS: Fags 'Ter ST OWNER (NAME AND ADDRESS IF DIFFERENT FROM APPLICANT) : SOURCE OF WATER SUPPLY: DEPTH: . - ! d DIAMETER __ 6 COVER AND CURBING O.K.? — � �� 4161 IF NOT, WHAT REPAIRS ARE. NECESSARY? DISTANCE FROM WELL TO NEAREST SEWAGE DISPOSAL SYSTEM __ O y`r TYPE OF SEWAGE DISPOSAL SYSTEM SERVING APPLICANT'S HOME: Srn 7 c ta,✓x IS IT OPERATING SATISFACTORILY? i°T ;_ � M t o-� ,.�s�``t, 1F NOT, WHAT CORRECTION IS RECOMMENDED? SEPARATE SYSTEM FOR SINK OR LAUNDRY?--A/, ✓e- DISTANCE FROM WELL: _. ANALYSIS REPORT: 0 7 0 ,ti e cTs the rej&,•,re,«..✓TS �cr a /0e �a d/e S'C'o o/) REMARKS. _ No-✓ • EIi;I-82 �4-?3�3M __�.-- .--__._. ... ._ . .. . _ __ _____._. POTABLE WATER COLLECTION7m� EXAMINATION REPORT This Section for Lab. Division Use OL-81 REV.SIN 1.Type or print one set and send to thw'oddress below. LAB TOWN NO. PHYSICAL COMPLETE �s 2.Reports will be fumished only to local director of health or store agencies. DATE RECEIVED DATE RE RTED TO: State of Donn.Dept.of Health Services,Laboratory Oiv.,P.Q tlfex lbti•tlsrlferd,CT,06101 r C COLLECTION IA111F ere sample was taken) ! �t TOWN REPORT: /yr ell;tn/ Sf 31pp rd 1tM $ Ss•�ty k/. vt�ssr COLLECTED BY(Name) COLLECT SN LIN IN Name and Address dF iferson.to receive Laboratory Report well Semi-Public rivate Identification: None Filtered Chlorinated Softened 1j 11 s / O Treatment: ❑ ❑ El El ........... L NAME OF LAI9 THAT MADE LAST EXAM DA PROPERTY OWNER'S NAME AND ADDRESS(it different from name and address above) Fold Reason For Con format. n to Lows _ Suspected of Causing iseas* r Fectfy or give details ere 7Tera Examination: (Specity) ❑(Give Details) Complaints Color Odor Taste Sediment nt oa❑ming ter(Specify) Of: Q Use Constant tant mergency DATEOF LAST USE N 1 NS THAT MAY AFFECT WATER QUALITY(Specify) Supply: IUD Source Of Drilled •ll rvs❑n We ug❑e pri❑ng ter Deo Y Water: ❑ Description Of WELL DEPTH LL DIAMETERCONDITION OF CURB AND TOP SEA DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: /9a Ft. In. V I► T ON C rit I $14 Possible Source sprit on arm n ustry Other Dec Y Of Pollution: ❑ ❑ ❑ Special Tests Requirod C + M Additional Description 1 44 ed. Jt�4 D Signature ATE SENT And Title: LABORATORY EXAMINAT/ REPORT: o be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR TURBIDITY. NITRITE Irk Sod' m as No aganese as Mn T Nitrogen NITRATE V(J'f/' Alkalinity as Co CO3 Bicarbonate Fluoride as F Constituents ✓ a r v ,Z as AMMO b/0 ; Alkalinity as Co Carbonate, Detergent as AS$ Nitrogen (N) 0 ALBUMINOID ' Total Hardness as CoCO Sulfate os SO4 Hydrogen-ion Concentration (pH) Chlorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. 0 CONCLUSIONS:The results of the analysis of this sample- Meet the requirements for a potable water. ❑Meet the requirements for a potable water;however,the chemical or physic al constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of the.:e constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable water because: One coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water, should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: J r r STATE OF CONNECTICUT DEPARTMENT OF HEALTH SERVICES a BUREAU OF HEALTH PROMOTION & DISEASE PREVENTION WIE: Ms. Shirley Pierce DATE: September 29,, 1981 Department of Human Resources 330 Broad Street ADDPMS: Manchestery CT 06040 TOWN: South Windsor SUBJECT: Inspection of Sewage Disposal System and Private Water Supply at Proposed Day Care Home of Ms. Joan Horenstein., 64 Overlook Road, On August 24, 1981 ( X ) For your information, ( ) Please note special recommendations, ( ) Follow-up report requested. ( ) For necessary action. ( X ) Remarks. Enclosed you will note a summary report and a laboratory_ analysis report (No. 20128) regards the subject water supply. The results of the laboratory examination meet the requirements for a potable water. Gregory G. Bonadies, Principal Sanitarian Housing and Institution Program Environmental Health Section Preventable Disease Division GGB:llh Enclos es (2) cc:',Gerald Schwartz' M.D. Director of Health - South Windsor Phone: 566-5511/566-2762 79 Elm Street 9 Hartford, Connecticut 06115 An Equal Opportunity Employer w CONNECTICUT STATE DEPARTMENT OR HEALTH ENVIRONMENTAL HEALTH SERVICES INSPECTION FORM CHILDRENS BOAMMG HOME _ DAB c,q R-F SUBJECT: . r�I �✓ ✓�i.�t-___-, Conn., Inspection of Private Water Supply and � Sewage Disposal System of_ f'z•� r_/7��+ Sep'„/ � , as Proposed-d C-A 2E er Home FROM: Df, dri� v. — _-°_DATE OF INSPECTION APPLICANT: '{� �s+d'_ e.;r� P.O. ADDRESS: 64 2c( OWNER (NAME AND'ADDRESS IF DIFFERENT FROM APPLICANT) : — SOURCE OF WATER SUPPLY: DEPTH: . __ ? DIAMETER COVER AND CURBING O.K.? c C/ _.._. IF NOT, WHAT REPAIRS ARE NECESSARY? DISTANCE FROM WELL TO NEAREST SEWAGE DISPOSAL SYSTEM _v✓e,r S 7` TYPE OF SEWAGE DISPOSAL SYSTEAT SERVING APPLICANT'S HOME: IS IT OPERATING SATISFACTORILY? .4Z flY - 7,,-, 7• ,,_� yes IF NOT, WHAT CORRECTION IS RECOMMENDED? SEPARATE SYSTEM FOR SINK OR LAUNDRY?-_— DISTANCE FROM WELL: —. ANALYSIS REPORT: '20 Y.4e YeL y,✓eFhc.. �S for cZ �„ f4 �� REMARKS: i;✓A `fe ___._ POTABLE WATER COLLECTION/ A `EX)tMINATION REPORT This Section for Lab. Division Use OL-EI REV.8179 _ LABORATORY NO. TOWN NO. HYSICAL COMPLETE 1. Type or print one set and send to the address below. 'gus r �r '),k' } 2. Reports will be furnished only to local director of t health or store agencies,-_r DA —1 q' 'DATE REP R ED ' TO: State of Conn. Dept.of Health Services,Laboratory Div.,P.O. Box 1689 Hartford,CT. 06101 COLLECTION NAME OF PROPERTY(Where aample was taken) ADDRESS p I TOWN r f REPORT: �; +7.t/ !e' �, t/ Cv tr I i^ /� (� ra Le/ •.✓fir< ; COL,LLECTED BY(Name) COLLECTOR'SNO OAT COLLECTED TIME COLLECTED SAMP ING IN Name and Address o p .son to receive Laboratary Report Well Semi-Public Priv4te ❑Identification: r 9 None Filtered Chlorinated Softened `eo Treatment: ® ❑ ❑ ❑ NAME F LAB HAT MADE LAST EXAM DATE OF LAST ENAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Fold Reason For Conformation 4o Laws Suspected of Causing Disease Other (Specify or give details here) Here Examination r /1 (Specify) ❑(Give Details) ❑ Complaints Color Odor Tae Sediment Fong Other(Specify) Of: Q }� Use Of Constant Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: 10 tub Source Of DriIF%54 DriveE Well Dug Wei Spr�g Other(Specify) Water: LAJ El Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. G In. 'f e . Possible Source Septic Tank Farm Industry Other (Specify) Of Pollution: ❑ Special Tests / Required: c f_ A.j Add,tlopal Description If Needed: /14 h a ATE SENT Signature And Title. 1t`/ LABORATORY EXAMIN ION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR y TURBIDITY A/ NITRITE Sodi as No Magonese as Mn O, oav n NITRATE �, Alkalinity as C00O3 Bicarbonate Fluoride os F Nitrogen . Constituents G� e a$ AMMONIA Alkalinity as CaCO3 Carbonate Detergent as ABS . Nitrogen (N) Q / 0 } �� ALBUMINOiD Total Hardness as C00O3 Sulfate as SOq Hydrogen-ion Concentration (pH) -moo / of 7 U, . U Chlorides as Cl Iron as Fe- MEMBRANE FILTER TEST Coliform Colonies/100ML, CONCLUSIONS:The results of the analysis of this sample-Meet the requirements for a potable water. ❑ Meet the requirements for a potable water; however, the chemical or physic al constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of the:a constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable water.because: ❑IThe coliform density exceeds acceptable limits. The presence of the coliform group, while not,necessarily meaning that disease producing organisms. are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: AY"�iMh�• .')1:;"A R I II:r1Y 01,' 11L•';11,11i SL'R 1'lt'LS' • _ �.i j I3l1hI: lf' OI I9t -l! III NIt<)MOIJON & IA( i'IZI:1'iNIIUN NAME: Ms. Shirley Pierce , DATE: April 30, 1981 Day Care Unit Department of Human Resources ADDRESS: 330 Broad Street TOWN: South Windsor Manchester, CT 06040 SUBJECT: Inspection of Sewage Disposal System and Private Water Suppl at Proposed Day Care Home of Sue Brainard, 110 Robert Drive, April 15, &l. ( x ) For your informrition. { ) Please note special recoDme ndationsa ( ) Follow-up report requested. { ) For necessary action. ( x ) Re: a,rks. Enclosed you will note a summary report and a laboratory analysis report (#7890) regarding the subject water supply. Your attention is directed to the comments under Remarks by Mr. Laiuppa in the summary report. V Greg ry G. Bonadies, Principal Sanitarian Housing and Institution Program Environmental Iiealt;h Section Preventable Disease Division GGB:ejm Enc. cc: ;;Gerald Schwartz, M.D. Director of Health , 566-5511/566-2762 CONNRCTICUT STATE DEPARTMENT OF HEALTH ENVIRONMENTAL HEALTH SERVICES Ab INSPECTION FORM CHILDRENS �9AfflXNG HOME dy C*ItrL SUBJECT: _.&-v� '� i✓:�cl�r Conn., Inspection . of Private Water Supply and Sewage Disposal System of Sv_'?__ 1^a:.✓•:rc -- , as Proposed Poker Home TO: ._ Cte4ory G FROM: �---DATE OF INSPECTION u //O /IGb<.r • - / drLuc APPLICANT: __5�_�_ � P.O. ADDRESS: OWNER (NAME ANb ADDRESS IF DIFFERENT FROM APPLICANT) : SOURCE OF WATER SUPPLY: r vc/`, a%c // DEPTH: _ c�' { DIAMETER �_ G COVER AND CURBING O.K.? L f t c/ IF NOT, WHAT REPAIRS ARE NECESSARY? DISTANCE FROM WELL TO NEAREST SEWAGE DISPOSAL SYSTEM __ o ve TYPE OF SEWAGE DISPOSAL SYSTEM SERVING APPLICANT'S HOME: S to *4.✓ -t- /�•c H. ✓S ', C /a/ IS IT OPERATING SATISFACTORILY? t h/� � y e .� :w 4:7` i •t/ e IF NOT, WHAT CORRECTION IS RECOMMENDED? SEPARATE SYSTEM FOR SINK OR LAUNDRY?—_.. MvAle DISTANCE. FROM WELL: '`� ANALYSIS REPORT: 5g 9d Mec`ry_ re��., re�e e,/7s r q 'e. , 414 Sv�q�Y REMARKS: _ S�d.v;�1 i✓ S --- 5l,�f1/,, <r,' �Se rS 7- 5#", 4-1 j e- 4?dv, EHS-82 i 4-7373M - A,? POTABLE WATER COLLECTION/ EXAMINATION REPORT This Section for Lab. Division Use OL-aI-REV.8/79_ 7.Type or print one set and send to the address below. LABORATORY NO. TOW .NO:rt, PHYSICAL COMPLETE 2.Reports will be furnished only to local director of =�° health or state agencies. DA L.a ^ED I •- ATE REPORTED TO:State of Conn. Dept.of Health Services, Laboratory Div., P.O. Box 1689 Hartford,CT. 06101 4 Z7 ?1 COLLECTION NAME OF •PROPERTY(Where//sample was=n) AD_bRESS TOWN REPORT: $cl aJ p .�o✓f I�, ✓W S c i COLLECTED BY(Name) COLiECTOR'SNO. DATECOLLECTED TIMECOLLECTED SAMPLING POINT %� M. Name ifind Addres4,6f person to receive Laboratory Report" Well Semi-Public Pr'v e (� Identification: ❑' N_o�ne Filtered Chlorinated Softened Treatmen ❑ ❑ J .............. .................................................................... -/ Ot❑her (Specl�j L� NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(if different from name and address above) _ Fold Reason For Conformation to Laws Suspected of Causing Disease Other (Specify or give details here) Here Examination: ❑ (Specify) ❑(Give Details) ❑ Complaints Color Or Taste 'Sediment nt Foaming Other(specify) Of: Q Use Of Constant Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply ❑ . Source Of Drilled Well Driven Well Dug Well Spring Other(Specify) Water: IILV�11 Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: /0 O Ft. 6 In. b r t t d' t C.. t'i Possible Source peptTank Farm Industry Other (Specify) Of Pollution: Special Tests DD Required: 1.4 C We rh Additional Description If Needed: Signature DATE SENT And Title: ZE:. LABORATORY EXAMINATION EPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR TURBIDITY (3 0 )VT 9AR �� d'. 3 NITRITE Sodi in No Magonese as Mn Q i 0M s Nitrogen NITRATE_ Alkalinity as C00O3 Bicarbonate Fluoride as F Constituents 3. 2 r as AMMONIA .R Alkalinity as C00O3 Carbonate Detergent as ABS Nitrogen (N) (s ALBUMINOID Total Hardness as C00O3 Sulfate as $Oq Hydrogen-ion Concentration (pH) e- 0► 0 Y , Chlorides as Cl Irorkas Fe MEMBRANE FILTER TEST 1 d'* Coliform Colonies/100ML. Q 'CONCLUSIONS:The results of the analysis of this sample- Meet the requirements for potable water. ❑ Meet the requirements for a potable water; however, the chemic r physic al constituents listed below appear abnormally high for a ground supply. Thr water should be suspect if local conditions indicate that the source Of the,:e constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable water because: ❑IThe coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to;he same extent. The water should be considered as unsafe for drinking until the source of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: Other: SOt�1LivN �tt){� ` User Oft Jail riC vtct� aiiwUlu be adv4ed of the Sodium content. EDAr510A©A I 0%r%T 1? JEriaE IIJC:K Qrt, NH.i+- STATE OF CONNECTICUT PpTMEN> STATE DEPARTMENT OF HEALTH 79 ELM STREET HARTFORD, CONNECTICUT 06115 c ? OFFICE OF PUBLIC HEALTH Name: Joan Thistle Date: April 30, 1976 Dept. of Children and Youth Services l',ddr ess: 364 West Middle Turnpike Town• South Windsor Manchester, Connecticut 06040 Proposed Foster Home: Mr. and Mrs. Lawrence Burgess ' For your information. (�) Please note special r ecolrjacndctions. (�) ilcsa 1pling requested. (�) For necessary action. (x) iemarks See "Remarks" ._nthoirrj V. >ard inas ;senior S�zni w�ian Envia onriontal Health SerV_1 ces Division AS/j el cc: Mr. Terry V. Sprenkel, Town Manager Mr. and Mrs. Lawrence Burgess CONNF-CTICUT STATE DEPARTMENT OF HEALTH ENVIRONMENTAL HEALTH'SERVICES , INSPECTION FORM p CHILDRENS BOARDING HOME SUBJECT: __ 4 ��w`N�s� —, Conn., Inspection of Private Water Supply and Sewage Disposal System of—L-�w�gN�ti. �41t��4s___ , as Proposed Foster Home TO: _�c:.y _ l I Q W i N i It _AQP_ FROM: Atat�T 11_—Z _t.S�_5_saaZ,la 'tory DATE OF INSPECTION _ APPLICANT: s._. u P.O. ADDRESS: .3 D��-St. OWNER (NAME AND ADDRESS IF DIFFERENT FROM APPLICANT) : SOURCE OF WATER SUPPLY: i DEPTH: .___i10 __ _ DIAMETER COVER AND CURBING O.K.? — We At1 Q wet( o i- : L bjQL_CC-'QSC _ EL Lji4c� 1 al�(-_a. p IF NOT, WHAT REPAIRS ARE NECESSARY? DISTANCE FROM WELL TO NEAREST SEWAGE DISPOSAL SYSTEM�3 G t ee ` Ste« cT ��.r ass TYPE OF SEWAGE DISPOSAL SYSTEM SERVING APPLICANT'S HOW «, i g N L a C\,. Nq, S ewe. C:r ��e� S e,*�A c:C t.n LLs� IS IT OPERATING SATISFACTORILY? V IF NOT, WHAT CORRECTION IS RECOMMENDED? SEPARATE SYSTEM FOR SINK OR LAUNDRY?___!�0N E- DISTANCE FROM WELL: — _-_-ANALYSIS REPORT:, I.A N L".0 fp_ Cr.%r L IRL 112 J&I L IU� REMARKS: _00.'� "�_ �,w.�� o� `��h��cx� , 1{ccu�ve►2_ ��_ h��tzc�l:�. L. _S F S Ld it l 1 X 10 C I , CE RJP� - _j N k(�'C� 'vv�C�,/ �u.5tt � ✓�� v�n c . b 1-�m.1�- 1� C.O Iv 5_�. '� � ' LoeA� 5 10 Q_CIL ed, Wl- 1 d " ��5 �� c1 IT —8P -7,4_ 73) (71 spa iVY1 07 $I T -� 1�N O'D 0 C4 . �aYt�1�7N� S!S YJN -;?Al ,vr -�1 �.�� J"v -0 *70 u ! ..a ar y a •.- OFPOTABLE WATER. •• GURNMI6U1 51AIt UtPAKII1M Ur HtAL111 OF P SEND LABORATORY DIVISION _ y T IECeIVEOf TD P.O. BOX 1689,HARTFORD, CONNECTICUT 06101 ,; +. William W. Ullmann Ph.D., Director PLEASE USE BLACK INK OR HEAVY TYPE _ J NAME OF WATERS"LY �.� ,ttyL. ADDRESS C TOWN in I 4- COLLECTOR'S NO. COLT, TED BY !' OAT I OLLECTED TIME COLLECTED PUBLIC SEMI PU LIC PRIVA 1` i I �C.' A M ❑ cx~ Reports will be furnished only to local dice or of health or state agencies DATE REPORTED 44, • 74 SAMPLING POINT (TAP, DIPPED FROM STREAM, ETC.) NAME AND _ ADDRESS OF PERSON TO RECEIVE LAB. E 1 `{ �� TREATMENT REPORT LONE ❑CHLORINATED ❑ FILTERED ❑ OTHER (SPECIFY) OWNER'S NAME AND ADDRESS IF DIFFERENT FROM ABOVE REASON FOR EXAMINATION- IF SUSPECTED OF CAUSING DISEASE GIVE DETAILS ❑DAIRY LAWS COMPLAINTS OF CONFORMATION TO FOOD AND BEVERAGE LAWS ❑ - MEAT AND POULTRY LAWS ❑ ❑ COLOR ❑ SEDIMENT OTHER (SPECIFY) (', '`` , , ❑ ODOR ❑ FOAMING d ❑ TASTE ❑ OTHER APPARENT COLOR TRUE COLOR ODOR TURBIDITY Alkalinity as CaCO3 NITRITE �, Q Q ,� Mg/L Bicarbonate 7 L Mg%L Detergent as ABS Mg/L NITROGEN Alkalinity as C00O3 CONSTITUENTS NITRATE �r. 3 Mg/L Carbonate n , Q Mg/L Sulfate as SO4 Mg/L AS Total Hardness — ---�-71 _.._— -- NITROGEN (N) AMMONIA �. Cj (��j Mg/L as COCO3 �i.J [moo Mg/L Mg/L ALBUMINOID �U, QU Mg/L Iron as Fe 0 • D Mg/L Mg/L Chlorides as Cl 8. Mg/L Manganese as Mn Mg/L Mg/L Hydrogen-ion (pH) �' 2 Sodium as No Mg/L Fluoride as F Mg/L Concentration MEMBRANE FILTER TEST COLIFORM COLONIES/I OOML. CONCLUSIONS: Sample indicates water is: SAFE the results of this examination indicate that the water was safe for drinking at the time this sample was collected. The results of this examination indicate that the water was probably safe: for drinking at the time this sample PROBABLY was collected, although some of the chemical constituents appear abnormally high for a sample of ground water. The SAFE water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. The presence of colonies of the coliform group, while not necessarily indicative of dangerous contamination, does ❑ PROBABLY indicate that such contamination might reach the supply to the some extent. The water should be considered as un- UNSAFE safe for drinking until the source of this bacterial contamination can be located and removed or until adequate treat- ment can be provided. a UNSAFE The results of both the bacteriological and cheaticel examinations classify the water at the ti�ofFo11eftl contaminated to an extent rendering the suppl unsatisfaoctery. ' E: ! ' �v 1 S a r 1p t o s c K i� t(,,Ir_ Ll S P }5 ►,.vr�r?f.ci FV_1 OTHER fg-T?I ,OM �e Ne SECOR APR 1 QS NT STATE OF CONNECTICUT °P �s S TA. TE DEPARTMENT OF HEAL'THail y 79 Ei.M STREET HARTFORD, CONNI:CTICUT 06115 c ? hacene OFFICE OF PUBLIC HEALTH llama: Beverly Pagani Date: March 2, 1978 Dept. of Social Services. Address:- 364 West Middle Turnpike Town: South Windsor Manchester, Connecticut 06040 Proposed Foster Home Barbara & Joseph Dagenais, South Windsor (_) For your information. �b (`) Please note -special recommendations. _a 1g7� ► g (,) Resampling requested, For necessary action, Remarlcs 1 Alan Buz etti Senior S 'tarian wTironmental Health Services Division AS/3el cc: Barbara & Joseph Dagenais, 14 Lewis Drive, South Windsor Sidney H. Curtis, M.D. All E(pull Opportunity Employer a CONNF.CTICUT STATE DEPARTMENT OF HEALTH ENVIRONMENTAL HEALTH SERVICES INSPECTION FORM CHILDRENS BOARDING HOME SUBJECT: _._��+ � Conn., Inspection of Private Water Supply and Sewage Disposal System of G e OVD�t��=�1�+� , as Proposed Foster Home FROM: �rcN�1_� t�2�" ) _j1_�� t1�t}.—DATE OF INSPECTIO E N � APPLICANT: r�As P.O. ADDRESS: OWNER (NAME AND ADDRESS IF DIFFERENT FROM APPLICANT) : SOURCE OF WATER SUPPLY: _.. R c�� _C v 3 S �r e� _,sod' bt Lz c.,,,2_ DEPTH: _ DIAMETER COVER AND CURBING O.K.? IF NOT, WHAT REPAIRS ARE. NECESSARY? DISTANCE FROM WELL TO NEAREST SEWAGE DISPOSAL SYSTEM.AvZ9G' T•F&V�A_w C� t�e1C� TYPE OF SEWAGE DISPOSAL SYSTEM SERVING APPLICANT'S HOME: c- ;�vv 6; IS IT OPERATI G SATISFACTORILY? A41va MAL'i 4 A(gn-J k+ Ce%j4e-R-*_70 IF NOT, WHAT CORRECTION IS RECOMMENDED? SEPARATE SYSTEM FOR SINK OR LAUNDRY? DISTANCE FROM WELL: ANALYSIS REPORT: "� :..: .eR i��z s u_t ic'l -�a �.� (Ak, L REMARKS: a ti 12 R e a c.k._+� ' p �('�L onus VnnetJ s� V,.%x i.-( ,Lp.'?M I `^1•6 e w.I� �;2-- - �uC� "to S l.l5C"elo�LQ't� i N—0-6,15° Lk t r�E.4� o _ N. [�1�-1�L 1 N e.�Nl I cam. snn.\Ake_ EHS-82 (4-73) 3 �. rV rnt3L`t...wATER COLLECTI`ON� T _ r - n. - , z EXAATION REPORT This Section for Lob. Division Use COL-81 $3EV. 12-74 1. Type or print one set and send to the211/ow. LABORATORY NO. TOWN NO. =PH2.Reports will be furnished only to local director of health or state agencies. DATE ECEIVED_ , Ij DATE REPORTED TO: Conn. State Dept. of Health, Laboratory Diva, P.O. Box 1689 Hartford, CT 06101 AME OF PROPERTY(Where sample was taken) ADDRESS r COLLECTION r TOWN REPORT: COLLECTED BY( e) LLECTOR'SNO DAT COLLECTED TIME COLLECTED SAMPLING POINT ~ A, `` 6Ih a 1:2 -r '= M. I t Name and Address of�'ei6son to receive Laboratory Report; I Well Se; i❑Public Private' Identification: I�",I�' Treatment None Filtered Chlorinated Softened : IL�.1/ ❑ \` J Other (Specifyj••'•••.' NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Fold Reason For' Conformation to Laws Suspected of Causin Disease Other pecify or Here g give details here) Examination: ❑ (Specify) ❑(Give Details) Color Odor Taste Sediment Foamin Other(Specify) � Complaints ❑ g Of: ❑ ❑ Use Of Constarie Emergency {DATEOF LAST U E CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: ❑ �fv:.r� �G Source Of" Drilled W-ell Driven Well Dug Well Spring Other(Specify) Water. Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: �`.. Ft., `/r In. �� f Possible Source Septic Tank Farm Industry Other (Specif Of Pollution; ❑ .. ❑ ❑ 1-1 Special Tests �J N r Required: AJ Additions Description If Needed: Signature r� DAT SENT And Title: \\ c._ C7t ;. LABORATORY EXAMINAT► SPORT: ( obe filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR TURBIDITY NITRITE (� Sodium as Na Maganese as Mn �ry®� Nitro NITRATE Alkalinity as en 9 a 03 Bicarbonate Fluoride as F Constituents d� � ( as AMMO N A n-p� Alkalinity as o CO3 Carbonate Detergent as ABS Nitrogen (N) Z �t O ALBUMINOID//)� Total Hardness as CaCO3- Sulfate as SO4 Hydrogen-ion Concentration (pH)4 Q `V� Chlorides as Cl Iron as Fe AMW ��_T�/ / « MEMBRANE FILTER TEST 0 Coliform Colonies/100ML. CONCLUSIONS:The results of the analysis'of this sample- Meet the requirements for a potable water. Meet the requirements for a potable water;however,the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable water because: El The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present,does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical Constituents exceeds acceptable limits. These are as follows: Other: Ale f ) :' ) N c �7 h 9 A M Ce_ '' A; STATE OF CONNECTI UT �QppT~ENTQw STATE DEPARTMENT OF HEALTH a � > 79 ELM STREET HARTFORD, CONNECTICUT 06115 OFFICE OF PUBLIC HEALTH September 3, 1974 Alice J. Turek, M.D. Director of Health pe: Miss Ann Doremus 1540 Sullivan Street 29 Elwood Rd. South Windsor, Conn. 06074 Dear Doctor Turek: z This is to inform you that the above-named person has contacted .us -about. a. proposed day care center 3n your town. TJe have sent all the necessary information concerning licensing regulations. Because this is a new center 9 we may be asking consul- tants to visit in order to promote a greater understanding of the needs of a good center. The above-named person may be contacting you for further aftice on health and safety. however, the final inspection should not be made until we have sent you a copy of the center's application. Sinc erel y yours, V. V. %pat, W. Pediatric Consultant .Mtevn tt and Child. Rsalth Section.. VVB sed HCH 126 (rev. 6✓30,M An Equal Opportunity Employer STATE OF CONNECTICUT �pPQT"EaTOwj < CC" STATE DEPARTMENT OF HEALTH y 79 ELM STREET HARTFORD, CONNECTICUT 06115 ��OHpEcn`�: OFFICE OF PUBLIC HEALTH May 29, 1975 Alice Turek,, M.D. Director of Health Fe: Miss Nancy Tantalo 41. Center Street 1086 Farmington Ave. Manchester.9 Conn. 06040 W. Hartford Dear Doctor Turek: Ma* open a d.c.c. in So. Windsor This is to inform you that the above-named person has contacted _us --about- a- proposed day care center in your town. "le have sent all the necessary information concerning licensing regulations. Because this is a new center, we may be asking consul- tants to visit in order to promote a gxeater understaniing of the needs of a good center. The above-named person may be contacting you for further aftioe on health and safety. however, the final inspection sh wuld not be made until we have sent you a copy of the center's application. Una erel y yours, V � . . V. V. Bipat�, T&D. Pediatric Consultant - _-.Xitmmal..and Child Health Section- VVB:ed MCH 126 (rev. 6/30 RECEIVED HEALTH DEPT. MAY 3 01975 TOWN OF MANGBESTEB,CT. An Equal Opportunity Employer r�L� STATE OF CONNECTICUT STATE DEPARTMENT OF HEALTH � =y� 79 ELM STREET HARTFORD, CONNECTICUT 06115 � hNECTG OFFICE OF PUBLIC HEALTH RECEIVED HEALTH DEPE'„ APR 31975 TOWN Of MANCHESTER,PT- April 1, 1975 Alice _.'.Turek, M.D. Director of Health pe: Mrs. Rochetta Bothur 41 Center Street 121 Overlook Rd, ManclW3ter,Conn. 06040 So. Windsor Dear Doctor Turek: Ihis is to inform you that the above-named person has contacted _us'-abcut. a proposed day care center in your town. We have sent all the necessary information concerning licensing regulations. Because this is a new center, we may be asking consul- tants to visit in order to promote a gxeater understanding of the needs of a good center. The above-named pens on may be contacting you for further aftice on health and safety. However, the final inspection should not be made until we have sent you a copy of the center's application. Sine erely yours, V. V, Bapat , T&D, Pediatric Consultant Child Health -Section. VVB:ed HCH 126 (rev. 6/30/71 An Equal Opportunity Employer STATE OF CONNECTICUT PpTMENT STATE DEPARTMENT OF HEALTH Y y 79 ELM STREET HARTFORD, CONNECTICUT o6115 NEC OFFICE OF PUBLIC HEALTH November 8, 1977 Mr. Paul F. Talbot Town Manager Town Hall : Don Bacchus 1540 Sullivan Avenue 350 Foster Rd. South Windsor, Conn. 06074 Dear 11 kc Mr. Talbot: This is to inform you that the above-named person has contacted _,us__�about._..a._}proposed day care center in your town. We have sent all the necessary information concerning licensing regulations. Because this is a new center, we may be asking consul- tants to v-jait in order to promote a greater unde rstarxlJng of the needs of a good center. The above-named person may be contacting you for further adrim on health and safety. dowever, the final inspection should not be made until we have sent you a copy of the center's application. Si.nc erely yours, V. V, Bapat, 11D. Pediatric Consultant 1per�al__ _Gb.1 1 cl_He a7 Ala-Sec.-F�j txr�- VVB:ed ITCH 126 (rev, b13f73. � ' - Rece/ \ ` . No VFD a " , T 9 191 oo®f SOO Weed,� 9 r An Equal Opportunity Employer STATE OF CONNECTICUT �129.91MEN1, STATE DEPARTMENT OF HEALTH a ,� 79 ELM STREET HARTFORD, CONNECTICUT 06115 cO�NECT�S`s OFFICE OF PUBLIC HEALTH February 14, 1978 Sidney H. Gurus M.D. Director of Health Pe: Ms. Willa Natarajan 93 Highwaod Drive 48 Tudor Hill Rd. Manchester, Conn. 06040 So. Windsor Dear Doctor Curtis: Zhis is to inform you that the above named person has contacted _us--about--a_proposed day care center in your town. We have sent all the necessary information concerning licensing regulations. Because this is a new center, we may be asking consul- tants to visit in order to promote a gxeater understanding of the needs of a good center. The above-named person may be contacting you for further aftice on hea7.th and safety. However, the final inspection should not be made until we have sent you a copy of the center's application. Sine erely yours, V. V. ga}at j 10. Pediatric Consultant -_ i l -and Sea Ah-Sec ti sit. VVB:ed MCH 126 (rev. 6/3af71- An Equal Opportunity Employer STATE OF CONNECTICUT 4Q91 atNENT0 ' STATE DEPARTMENT OF HEALTH a 79 ELM STREET HARTFORD, CONNECTICUT 06115 c�NNECT�'�• OFFICE OF PUBLIC HEALTH August 11, 1977 Mr. Paul F. Talbot Town Manager Fe: Mrs. Barbara Sullivan Town Hall 817 Pleasant Valley Rd. 1540 Sullivan Ave. South Windsor Conn. 06074 Dear DMMdV= 16. Talbot: MU8 is to infoxm you that the abovae-nr-%nad person has contacted ..us-about- &-propowed day cp-re center in your town. We have sent all the necessary information concerning licensing regulations. Because this is a new center,, ve may be asking consul- tants to visit in order to promote a groaner understanding of the needs of a good center. The above-named person may be contacting you for further adrio on l.esl th and safety. dowever, the final inspection should not be made until we have sent you a copy of the center's application. SLnc erel y yours, V. V. BApat, 14.D. Pediatric Consultant _snd _GbA-IA Jiaal th--Secsti-0n- VVa:ed ITCH 126 (rev. 6/W77_ An Equal Opportunity Employer STATE OF CONNECTICUT STATE DEPARTMENT OF HEALTH r� ?~ 79 ELM STRfiE'I' HARTFORD, CONNECTICUT 06115 MANIC OFFICE OF PUBLIC HEALTH January 11, 1977 Town Hall Health Department Donna Adcock South Windsor, Conn. 06074 Acting Dear k= Director: xhis is to inform you that the above-named person has contacted ,us_about_.a_ proposed day care center in your town. 14e have sent all the necessary information concerning licensing regulations. Because this is a new center' we may be asking consul- tants to visit in order to promote a greater understanding of the needs of a good center. The above-named person may be contacting you for further ad7iae on lieml th and safety. however, the final inspection should not be made until we have sent you a copy of the centers s application. Unc erel y yours p V. V. Bapat i &D. Pediatric Gonsultant #e�zjal.._and .CIMIct ILsa7th--S i.on- VVB:ed 14CH 126 (rev. 6/30/71 An Equal Opportunity Employer r` STATE OF C O N N E CT1 C U T p�EN STATE DEPARTMENT OF HEALTH 79 FU M STREET HXRTFORD, CONNECTICUT 061.15 NMECTV OFFICE OF PUBLIC HEALTH 566-2575 October 3, 1977 5 = Ms. Cheryl :Lynn Ferris, Director Gc` tv The Sunshine Nursery School D.C.C. 1738 Ellington Road QC� South Windsor, Conn. 06074 °wn®�$0uthw`°ds°C Dear Ms. Ferris: N This is to inform you that you have met the minimum requirements for a six-month child day care license for a maximum of 18 children to be present at one time. The following requirements must be met in this six-month period for you -to receive a regular two-year license. 1. An outdoor play yard so located and protected for safety as to avoid the possibility of receiving bodily injury from accident hazards shall be provided (PHC Section 19-13-D17(a)(3) �• Fencing shall be provided for protection of outdoor play area. 2. Where a center serving children under the age of three does not have a staff nurse, a consultant nurse shall visit weekly (PHC Section 19-13-D18a(c) (6) ). Plan for consultation shall be developed, including 'time spent at the center, areas of consultation, and arrangements for supervision. 3. A 'thermometer shall be placed in the refrigerator for use in maintaining correct temperature. 4. Screens shall be installed for the kitchen windows. 5. Both toilet room doors shall be made self closing. Upon receipt of the $15.00 fee, we shall forward this license to you. Checks for child day care lidneses should be made out to Treasurer - State of Connecticut, and mailed 'to the State Department of Health, Maternal & Child Health Section, 79 Elm St., Hartford, Connecticut, 06115, within two weeks of receipt of this letter. Thank you for your cooperation. Very truly yours, • f (Mrs.) Josephine L. Miser, Coordinator Child Day Care Center Licensing Program JIM:mph Maternal and Child Health Section cc: Paul Talbot, Town Mgr., So.Windsor An Equal Opportunity E11fp'0yer -`.',ALE1 DII' -CTO2,< IY',,P CTTOI'T Oil C';ILD DAY CA;?_; C" TT_-L.S BA8.',D OR WGUL:,TI0 19-13-D15-10 OP T':,' _UBLIC 7-SALT`" COD:] OD T?^ :'TAT-3 Or. COIr"_;CTICU DLFIITITIOI�: As used in sections 19-43b to 19-431, inclusive, ;;child day care center-: means 'any facility which offers or provides a program of supplementary care to five or more unrelated children outside their oym homes on a regular basis for a Part of t to twenty-four '_tours in one or more days in the week. PU7POS;0 Or IITBPD-CTION: To insure that all child day care centers fulfill the -requirements of the Public ealth Code in such-a manner as reasonably to insure the safety, health and development Of children. ITAF.' OF CIiILD DAY CAMI C_LTTL,,The Sunshine Nursery School & Day Care Center ADD'11,j 0 ' C TTM 1738 Ellington Rd., So, Windsor, Ct. 6 Tel.,,-' at center 44-2310 .street Town Zip Code �I 0P DI_ CTQII, Cheryl Lynn Ferris G-IM-.MR(S) or P O;T C ( ;) Same TYP:i OP BUILDUTG Business Bldg. - Lower Level I7MG°,M0 L_.OoD (R:]S I TIAL), -.TO. Business & Residential ORMATIO_T Oi� C�;I'TJ I. DT x;OLLi. TT Ai IX AT X Al.-, X A11- R 5�. AI MO a.m. Days Center is open: I.:0 %Pl. TU.Pi.`�.' �ew'T �{-T'"Uii.?:.t '' T.PT.� 2 .rsll I;Iontlis center operates: -'" .t3O p.m. 12 mos. Total cIv ldren enrolled: I.'a:. ,;` children present at one time 25 -lTumber of ��aee?,s to 2 year olds PIE- 5 Hours or more 2 to 3 yeax olds 2 3 to year olds 2 r. to 5 year ole.s _ 6 P.T. 5 to 6 year olds over (specify) - IT. M-_' IN C-IAPLG. OL C" LD� i A. Are 2 responsible adults on the premises at all times? Yes. B. Give names of all staff, includin" substitutes mad consultants; Position at center; daily.hours and ('_ays they are employed; trainin.L and/or past e:,7perience for eac.i (If different from attached application). (See former application) C. Tf center serves children under 3 yrs. 9 is reotLtred mirsing eel-vice prowidad?- Ig 'required ,staff c::ild ratio 1-4 met? Yes. f - 2 III• =4 �� -D`� (the following information ::ust be kept on file at center) A. Date of last fire marshal Is certificate of approval tint ve .-, e- 77 B. Health records O C 1. Has each person working; in the center had a current medical examination showing !Mood health? Yes, ,,Ias each staff person had a negative TB test -or- satisfactory x-ray within three years? If caring for infants or toddlers less than 3, every year?Yes (A doctor's statement in supportj of these must be on file at the center. All new staff meribers must have these examina- tions prior to actual employment.) 2. Is there on file for each child a current individual health record cortpletedlana signed by a doctor? including inoculations f�or�'DPT Y� Smal pox Polio X2a_ _,Oasles Yes _ , and Rubella Yes IV- D.AYSI. AL SETTTp A. Indoor Area: (30 sq. ft. is the minimum space requirement per child. This is exclusive of kitchen, halls, bathrooms or any space occupied by adult furniture.) Total usable floor space treasures 881 sq. ft. ALnber of rooms used 2 , " Plea.surements of each room: (to be sent in) boom I i-ZZoom-�i 2` Room Loom 1. Lavatories :lumber of toilets available to children_ 2 Type(flush) Yes ?umber of wash basins available to children 2 Are toilet facilities adequate for number of hill?; Yes (minimum requirement is 1 toilet for 15 children) If toilets are more than 1111 high, is step provided?—Us � Are toilet seats open front type?� Location of lavatories to nursery school, Ha12%wav Vo 'Mnts 2. :^ood an Beverages Is a d nking fountain available? No Satisfactory? Types o cups provided? Paler Proper ood storage? r Refrige ator's temperature? --degrees - 3 _ 3. -dealtn and )afety 7tandards and Sanitation a. ?lan for �:eeting emergency situation? Yes - see application Plan for required health consultation?�s Isolation area location? Yes Is washable cot available for iso ation Is first aid kit adequate?_Yesocation of kit safe_ b. Is refuse properly disposed? Yes Are odor 7 rioted? � !� Are screens effective? fled sere Qn.for k �n 4 DpoY Is linhting adequate? es ' na1n :1 candle a J i temperature registers go degrees. Is thereto Teter hunk; at caildren's level? Nam_`W4 1 get. Is there evidence of peeling or flaking of painted surfaces? ,(If so, attach -a..ple in separate envelope.) Is lead fy a paint used? es (If a.ns-rojer is "not' or "unknown" indicate plan for analysis if peeling or .flaking paint is present.) Are all rooms in good .repair? Yes Jo -ent Are floor cover nns s e and c ean. Yes �o�.•,-gent ._.......,_ Is house keeping satisfactory? X= n Joruient Is equipment clean and in satisfactory repair? Yes jomment Are any hazards present? Comment Are stairs used es if so, are they in satisfactory condition and protected? Railing .. (to outside) c. Is water supply public or private?,. � if private supply, is protection vtqua Indicate plan for analys Is main plumbing system Iuithout SVS or faults? Yes Is se"age disposal connected to public seiter?Yes _ If not, specify type 3atisfa tc or-YX"____.�„� r d. Is swirming pool used by children? type? Indicate means of protection If siiimreing pool is to be constructed, plansmust be N/A approved by the state department of health (Public :ealth rode regulation 19-13--B33) . See also riegulation 19-13B34 regarding approval by Cie local director of health of "Artificdal bathing place without controlled water supply". 13. Otatdoor Play Area: (?5 sq. ft. minimum space requirement per child) Total usable play area ,rQsq. ft.: Typo-.or_3urfa 4aZ assy& .hard top Is pl_aq area T-iell protected? i to...be provided A- r 4 _ V, PROMiA Is there provision for quiet play alternating; TPoith active play? Yes Is indoor and outdoor equipment adequate for number of chil.dren7as Jomments: VI. L:E ADDITI{;:1AL ITS :z' PEr�TAI'' TG CE-?TZ.L S ;i,&" J C.LIIDhX-T M,AL-T ;`IVE r"OUP 3 OR W�TO ;-c A. Kitchen Is all kitchen equipment clean, in good repair and properly stored? Yes Is handling.,w sh� inngg and storage of utensils, straws, etc. satisfactory? Yes Underline treatment used for sterilizing dishes after washing: 2 minutes at 1700 o r z minute in. boi.1-4 ng water, or 2 minutes in chlorine bath at least 50 p.p.ni, or hot air sterilizer at least 1800P for 20 minutes) Toilets: Adequate number, location, sanitary, with lavatory for handwashing provided with hot and cold running water other than in kitchen, and individual towels? Adequate facilities for storing top clothing? Do food handlers appear neat and clean? Yes Comments on sanitation: Pmr„goods_.rI �da to b us d B. Meals Is the weekly menu posted at center? Yes Jook? Director ":.1'ho plans the meals? rec_or C. 4aps Are individual cots provided? Yes _ Does each ch:'.d use his own blanket? Yes Ts individual storage provided? y_�,� . Is bedding clean? Yes Is 2 feet of space provided between cots? Y,es Or are cots alternated head to foot? Yes .:ommenta,* State impressions, strengths, weaknesses, recormendations to day care center director and plans for follow-up (use back of sheet if necessary) : Do .you approve the center for a day care license now? Six month X Two year completed By Ruby S. ThoWon SSignature-Position a Authorized '3y2d-v� �'+�-� 1-1011 89 C ev. .4/7:E Direwor Of :.ie -aternal and child _iealth Section Date of Inspection 9/6/77 CO;TNTECTICUT STATE DEPART. 'TT O� -MALTH Application for License Child Day mare Center Complete three copies, answering all items as they apply to your--center. Keep one copy on file at your center. Return two copies tot Maternal, and Child Health Section Connecticut State Department of dealth 79 Elm Street Hartford$ Connecticut 06n 5 1. Name of Center Sunshine Nursery School and Day Care Center Loaation Address 1738 Ellington Rd. South Windsor 0607 Number and Street or Road Town or City iip Telephone at Center 644-2310 Mailing address (if different; i.e. RFD or P.O. Box, etc.) Directions for reaching center from Hartford 84 East to exit 94, left at stop sign, first left to next stop, then left again over overpass,, straight to light at intersection, straight through light, bldg. on right. 2. Director(s) Cheryl Lynn Ferris Address 130 Benedict Dr. Telephone 644-8747 3. Operators) ,youth Windsor, CT (person or group legally responsible for operation of center) -Address Same As Above Telephone fit• Type of operator: a.Voluntary non-profit agency b.Government agency Church Local Parent cooperative State School or university Federal C•A•P• agency c.Proprietary Other agency(specify) R_ Single owner Other (specify) 5. Type of building in which center is locateds Residence School Church Building used only for day care Other Off. ce Bldg. Has the facility been inspected and approved by local In ild.ing official for compl i Anr8.w t�,-.e+.��_g Raai r-- T i-f mod. �i 7.d• r`�r3e,7 (Verif'leation.must be. -juppl i ad.) Yes »_2 6. Does the center oomlq with local zoning ragulationsT. Yes_Z._.�jo� (verification of zoning approval must be supplied 3 ?+ Date of annual fire�.marshal=s certifioato_ of approva L, A �'0°)_77 (Signed copy of current certificate must-be posted at `caEnter 8. Sources of financial support: Taut moneg: Focal State DCA 01IR Other Federal-OE r 9- Enrollment: Total enrolledAge range of enrollees2j_q .olds Age range of children you will accept?2 j-5yr Max3�mM present at one time?25 uT� daily attendance kept?__--".��..._, record-Se 100 operation of center: Indicate number of groups at each session on the days the center is open. AM: lion Tues Wed Fri Sours PH: t7onr,Taes�Jed_Thurs I ionths center ope 11. Fri Staff in charge of children (paid or volunteer):* Name and position Education, special State days and employed training, and work hours of day at en a (specify) center _. .. C.- saQz Degree 1 Cheryl L Ferris Sept. 76 Keystone dNurseryNursery Blmfld. Ear�ry LeCtr. (dead teacher) M.C.C. Day Care CTr. Mon.-Fri. Ctr Supply evidence of required year's supervisedexperience.) :00 Blmfld. hih 2. Donna M. Leahy Sept. 76 Blmfld. Early Learn.Ctr. 3. St,! Josephs Col e M.C.C. : Oam-S:OOpm Mon.-Fri. Other staff at center and their responsibilities:* 1. Sandra Ferris-Volunteer after school- Child Detelopment Class. 2. Will be having Student Teachers from So. Windsor High in Oct.- June through Mrs. Wirth. 12. Describe your plan for the use of services of an early childhood education consultant, * name, with center-.* credentials, and approximate time and duties 13. Outline program objectives-* On file from previous application 14. Describe program activities (relate to 13)r* On file from previous application • 3 - 15. Health Program: a. Is pre-empliyment certificate of good health on file for each staff member, including negative tuberculin test or normal chest x-ray within the last tr ree years? Yes y Now Certificates of good healtha required annually. Do staff menbers who care for children under 3 years have an annual. negative TB test or normal chest x-ray? Yes_X__No� h. Is a current certificate of admission, including health status and required immunizations and signed by physician on file for each child attending your center? Yes y No- Is a developmental record maintained_and on file for each child attend- ing your center? Yes— Lido c. 'Will records showing parent or other responsible person to be called in case of emergency plus written permission from parent or guardian if any other person is to call for the child be kept on file at the center? Yes4X .'o d. Indicate arrangements for emergency health care, i.e., physician on call or hospital emergency room service. Outline stated policies of doctor or hospital for accepting children for emergency treatment. Manchester Memorial Hospital-emergencies with written parents permission and phone consulting to parents. e. Is there an area available for isolation of a sick child? -yes Describe plan for care of sick child at center. gee isolated till parent/and/or Dr. Stuart Marsh contacted f. Nam s of staff persons responsible for first aid at center? (At least'one trained person must be available at all times.) Cheryl L. Ferris-Red Cross Certificate g. Describe required nursing service for centers caring for children (under three) including description of duties, tine involved, and whether there is a written contract. Public Health Nurses-Pat Lanning, Joann Kilgore-Audio Visual Testing h. Describe plan for required health consultation from qualified personnel, i.e., physician.. public health nurse, community health agency, other. Consulting Physician-3 doors away-Dr. Stuart Marsh,pediatrician i_. Describe other consultant arrangements, as indioatedi.e., dental., serial. sex`v��;ar.xuz x tj.crs��-rl�.i7_cb deve�_c�ptt�en , etc. ,. Describe Plans for + p parent. contact +�nd%r i�rolvetaant with. the center pragajn' Parents Nights and conferences. Parent participation in Holiday Parties, Field Trips,Group Activities. Progress reports 17. Food services: available. 11eal s provided s Breakfast? .no_ H j dday? V e Pyen=I g? n n Snacks provided: Ail? yew Who plans the food service?Director Where is food preparedikitchen in school menus be prominently posted a week in advance, dated, and kept on file for 3 months at the center? yes Attach 2 copies of samples of 4 weeks of menus including all snacks and meals served. On file from previous application Eating and drinking utensils: Disposable?—y s Other Dishwashing facilities: Machine? Hand? Yes Refrigerator: Yes yes No 18 Sanitation: ?dater supply: Public yes Private If private, indicate plan for periodic testng.�" Is hot water available? Yes X No Sewage disposal: Public Private septic tank X Other :lumber of toilets: 2 Sumber of washbowls: 2 Arrangements for drinking watery Fountain 4therpa ercu,.,,p d .Spenser 19. Do you provide transportation? .. no Bus? Car? If so, describe plan for safe supervision of children, including approval of meblzl e- r - Ccmm3:ssion. - 5 - 20. Floor pla:- and description of indoor premises: P (use4ble) Total square fee; of usable program floor space_ 881 sq. -lip. of rooms Sketch floor plan for each room used by the day care center. Show dimensions in feet; indicate functions of each room. Indicate entrances, exits, doors, Windows, corridors, storage areas, bathroom facilities, kitchen,office or conference area (if available) and isolation area. (Scale drawing not required) Please be accurate about available ro ram area, exclusive of Permanent instillations, adult desks and furniture, storage areas. ti Y 21. Sketch and description of outdoor premises; . of square feet Of usable outdoor play: space Type of surface of play area �r�sa- Uacktop Plan for safeguarding play area_ Fencing. blo k d -of f_'hi a�;�„ for riding to s. Draw sketch showing dimensions in feet, location of outdoor to indoor premises, driveways and highways or roads. Indicate location of steps, pools, cesspools, wells, brooks, major play equipment and buildings in immediate area and use of these buildings. NOTE: The licensing authority (State Health Department) must be notified of any change in plan of operation involving facility, staff, chil- dren served at any one time from that indicated on this application. Additional approval is required for continued licensure if there are changes in the conditions on which any earlier licensure is granted. The official license to operate a child day care center must be post- ed on the premises of the center in a conspicuous manner. i To my personal knowledge the facts as stated in completion of this application are true. 9igAa;fuie_o]0U&i_;Kd_ua1 completing applicationLtnd responsibility with center. .Date March 22, 197$ 3., a ? CO80 ifiii" } t1ii. a 3.r 'Tb6 suns, .ue . d D C,Ceuter 1 ., `. d , ""for, .tea. . hrris: This is`to tnfom you that you have met the d ai a-n r8qui is for a` six nth child day care license for maximm of .'`..225 children Lo bs present,at one, tissE. . Approval for this si.x months license is coetibm"it upem closing of the tenter at the expiration date as stated by.:the--oruer/ operator, August 27. 19 O , upon ,receipt of the $15 fee, we- shall forward this license to you. Checks for cbild daycare Licenses should be made out to Treasurer State of Con Dicticat, and. sailed to the State Departmont o ea�t�i, Kajej ' T=iealth Section, ?9 MLmStreet, Hartford Connecticut,: o6n5, within two weeks of receipt :of this`letter.` Thank you for your cooperation. Very truly youre, (ma ROW S's. . Thiwpson Day Care Svgran Specialist RST.lb cc3 Paul.:F. Talbot, kinager Town Hall, So. Windsor ZQ 8 jQNr�Q fsO�l fe�2 8 STATE OF CONNECTICUT �QPp1MENTOw STATE DEPARTMENT OF HEALTH W 79 ELM STREET HARTFORD, CONNECTICUT 06115 �c0 NNECTG OFFICE OF PUBLIC HEALTH April 41 1978 Sidney H. Curlis, M.D. Director of Health 93 Highwood Drive 11e: The Sunshine Nursery School and Day Manchester, Conn. 06040 Care Center 1738 Ellington Rd.v So. Windsor Dear Doctor: This is to inform you that the above named child day care center has been licensed by the State Department of Health for a maximum of 5 children. ,.,:re have forwarded a six--month license to them. which ex- pires 8-27-78. Sincerely, 4 V. V. Bap t, _�.D. Pediatric Consultant ITatertal and child Health S ection VVD:ed I`_V-H 131 APR 1 1 19781, 9 ToWR 0$South Windsor An Equal Opportunity Employer STATE OF CONNECTICUT QPQtMENT STATE DEPARTMENT OF HEALTH 79 ELM STREET HARTFORD, CONNECTICUT 06115 r�CpyN y OFFICE OF PUBLIC HEALTH October 12, 1977 Paul F. Talbot Town. Manager T50Hall Sullivan Avenue 1540 Re: The Sunshine Nursery School and Day South Windsor, Conn. 06074 Care Center1738 Elli ngton Rd. Dear Doctor: This is to inform you that the above named child day care center has been Licensed by the State Department of Health for a maximum of 25 children* 1,16 have forwarded a six-m- - license to them. which ex- pires 2-27-78. Sincerely., 4 4 �. ,t� V. V . $a:p i.D. Pediatric Consultant A}aternal and child Health S ection VVB:ed I_UH 131 RECEIVED OCT 1 41977 � 2 'fawn of South Windsor N An Equal Opportunity Employer STATE OF CONNECTICUT STATE DEPARTMENT OF HEALTH 79 ELM STREET HARTFORD, CONNECTICUT 06115 OFFICE OF PUBLIC HEALTH March 23, 1977 Mr. Paul P. Talbot, Town Mgr. Town Hall Re: The Sunshine Nursery School & Day 1540 Sullivan Avenue Care Center South Windsor, Conn. 06074 1678 Ellington Rd. Dear Doctor: This is to inform you that the above named child day care center has been licensed by the State Department of Health for a maximum of.... .14 children. We have forwarded a six-month .License to them.which ex- pires 8-27-77. Sincerely, � > P , �AV V. V. Ba�t .i.D. Pediatric Consultant Iyaternal and health S ection ZTT)3:ed 1-0111 131 VED z o'A'9 2 4 t � Woofs®ufh Winds®r An Equal Opportunity Employer STATE OF CONNECTICUT ��QPPtMEyT�' STATE DEPARTMENT OF HEALTH 79 ELM STREET HARTFORD, CONNECTICUT 06115 N ' OFFICE OF PUBLIC HEALTH May 16, 1977 Mr. Paul. Talbot Town Manager Town gall Re: The Sunshine Nursery School. and Day 1540 Sullivan Avenue Care Center South Windsor, Conn. 06074 1678 Ellington Rd. Dear Doctor: This is to inform you that the above named child day care center has been licensed by the State Department of Health for a maximum of 18 children. 14e have forwarded a six-month license to them.which ex- pires 8-27-77. Sincerely, V. P s Pediatric Consultant aTaternal and 'lhild health S ection VVA:ed I`JI1 131 RECEIVED M.AY 1 81977 i Town of South Windsor � fro ro � . An Equal Opportunity Employer CONNECTICUT STATE DEPARTMENT OF HEALTH Phone: 566-2490 LABCRATORY DIVISION Biochemistry P.O. BOX 1689 -- HARTFCRD, CONN. 06101 10 Clinton St. Collection Data and Analysis Report of Paint Samples for Lead Collected by: ` ,.�„�— �N_o �-�5. Date Collected: 6- /` 7 7 Report to: Date Rectcl4AAab3. 54 PH '77 Date Reported: 977 J � d Address of Specimen Collection: Laboratory Lab. Collec Number Unit # tor's # Identifying Location of Sample % Lead 116Z3 a. 1us` YVN00 w ��as;Ar Oi OL-191 - - kC, STATE -OF CONNECTICUT pTMEN SOP xA 9T w S7-ATE Dh-/)AKTMENT OF HBALT 1fAR1*F(_)RI), CONNECTICUT 06115 NNCCTc, F"F ICE OF PUBLIC HEALTH Name: Mrs. R. Thompson Date: Conn. State Dept. of Health June Ili, 19?7 Address: Maternal and Child Health Division Town: South Windsor, Ct. Day Care Cons., Room 613 Subject:. South Windsor Ct. ; Inspection of the South Windsor Co-Op Nursery, 7?1 Ellington Road on June 1, 1977, For your information. Please note special recommendations. Follow-up report requested. ( X ) For necessary action. ( X ) Remarks. Please note the remarks contained in the body of Mr. _ Savino's report. -- Alan J. Buzze i, Chief Sanitarian mm: Environmental Health Service Divisi cc: Paul F. Talbot, Town Manager V South Windsor Town Hall 1540 Sullivan Avenue, South Windsor, Ct. � RECE vfp Z. JUN1 7-1977 � 8 Town of South Windsor 9� All I:yurrl OpportFmity Employer ti x CONNECTICUT STATE DEPARTMENT OF HEALTH June 10, 1977 ENVIRONMENTAL HEALTH SERVICES DIVISION cc: Mrs. Thomson SOUTH WINDSOR, CONN., AN INSPECTION Maternal & Child Health SUBJECT: OF THE SOUTH WINDSOR CO-OP Division NURSERY, 771 ELLINGTCK ROAD ON JUNE 1. 1977 Paul F. Talbot To: David C. Wiggin, Director Town Manager Environmental Health Services Division 1540 Sullivan Ave. South Windsor From: Daniel J. Savino Sanitarian The writer was accompanied during the inspection by Mrs. Thomson from The Maternal and Child Health Division of the State Health Department. COR ENTS AND OBSERVATICNS: 1. This facility is served by both City water and sewer. 2. The building appeared to be adequately maintained, both inside and outside. However, the cellar area was in need of more regular maintenance. 3. The area planned for kitchen space would be adequate if the present sink were removed and replaced. If only single service items are to be used, then a single compartment sink would be satisfactory, subject to the approval of the local Director of Health. 4. Paint chips for lead analysis were taken from the window casing and the wall panel covering the entire lower wall portions of the room. See the attached analysis sheet. Both chips showed lead levels that are considered unsatisfactory. CCKCLUSIONS AND RECOMMENDATIONS: 1. If this building continues to be used as a Day Care/Nursery facility, then the hazard caused by the presence of lead paint must be abated. Lead paint must be removed from, or covered over in those areas that are within reach of a young child. This would be any surface within four feet from the floor. See the attached sheets concerning the removal of lead paint for more specific information. 2. The cellar needs more regular cleaning. 3. The present kitchen sink ia'to be replaced if a continual food service program is intended for this room. DJS/ch i i FRQU TFIS-19A (4.75)5K v - . J > ; STATE OF C O N N E CTI C UT /IoP" ~FNl a STATE D I; P A R T Al is N 7' (_) I. 11 E A L T H iIAF''I1:01} 1), CONNIiCTICUT 06115 F ICE OF PUBLIC HEALTH Name: Ms. Ruby Thompson Dace: August 2l�, 1977 Maternal & Child Health Division Address: 79 Elm Street -Town: South Windsor, Ct. Hartford, Ct. SLIbject: South Windsor, Ct.; Inspection of Proposed Day Care Center, 17 1{� Road on August 10, 1977. �_x ) For your information. RECEIVED 8 i.____,) Please note special recommendations. AUG 2001977 Follow-up report requested. Iowa of w Windsor 9 \,Q Cr—) For necessary action. (._ ) Remarks. Please note the remarks contained in the body of Mr. _ Savino's inspection report. — 0 Alan J. Buzze t P:ri ,gal Sanitarian uw� rnvir.onlnontri1 1th St-rvice Division Mr. Paul Talbot, Town Manager South Windsor Town Hall South Windsor, Ct. �Lr 1? Junl {)))�rnit;nl<in 1'nl�,lnr;r r CONV?&CnCUT SPATE DEPARTMENT OF HEALTH August 23, 1977 w ENVIRONMENTAL HEALTH SERVICES DIVI8ION cc: Ruby Thompson SOUTH WINDSOR$ CONN.: AN INSPECTION Maternal & Child Health SUBJECT: OF A PROPOSED DAY CARE FACILITY AT 1738 ELLINGTON ROAD ON AUGUST 10. 1977 To: David C. Wiggin, Director Environmental Health Services From: Daniel J. Savino Sanitarian The writer was accompanied during the inspection by Ms. Cheryl Ferris, Super- visor of the Day Care Center. COMMENTS AND OBSERVATIONS: (1) There are no screens on any of the windows or outside doors. (2) The toilet room doors are not self-closing. (3) The mechanical ventilation fan in the men+s room was not working at the time of the inspection. (4) There was no impervious surface on the wall where the kitchen stove is to be located. (5) The floorescent lights in the "kitchen" are not adequately protected. (6) Paint chips were taken for lead analysis from both the large white L-shaped room and the small green room. Both areas are satisfactory and present no lead paint hazard. See the attached lead analysis report. CONCLUSIONS AND RECOMMENDATIONS: (1) Screens are needed for the windows and all outside doors, unless this building is to be air-conditioned at all times. (2) The toilet room doors are to be made self-closing. (3) The ventilation fan in the menus room is in need of repair. (4) A nor-absorbent, easily cleanable surface is to be provided for the area behind where the stove is to be located. (5) Plastic guards are to be installed over the fluorescent lights in the "kitchen". (6) No lead paint hazards were observed at the time of inspection. DJS/fa FROM.EHS-13A (4.75) 5K