HomeMy WebLinkAboutWCOC-02-2016-069429.TIF 48 • CATAWBA COUNTY Case# WCOC-02-2016-069429
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Public Health Department Subdivision
ivision
G .�_ Y Emironmental Health Division PINK
279011764543 K\-
PO Box 389, 100-A Southwest I3Ivd,Newton.NC 28658 LOT#
/84 30
Name on Permit HELEN STILLWELL, 5897 PITTSTOWN RD, HICKORY NC 28602
Site Address: 5897 PITTSTOWN RD, HICKORY NC 28602 0 : o•I- 0
44,866.80 Acres 1.030 7 f • ,Pro a rt Y Size: S q uare Feet
Directions: 127 S, from Hickory LEft onto Bethel Church Rd, Right onto Pittstown Rd, 1/2 mile -house is in ' t; ' q 'I
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the curve, Brick house at end of driveway. ?�
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WELL CERTIFICATE OF COMPLETION
WATER SUPPLY: Well Type: Individual Well
WELL-10-2015-066113 INSPECTIONS
INSPECTION# COMP DATE INSPECTION TYPE STATUS INSPECTOR
EHINSP-318022 02/19/2016 EH Well Head Approved Megen McBride
EHINSP-318021 01/26/2016 EH Well Head Failed Megen McBride
missing pump tag
EHINSP-314288 12/29/2015 EH GPS Data Collection Approved Megen McBride
EHINSP-314287 12/29/2015 EH Well Grouting Approved Megen McBride
EHINSP-314285 12/28/2015 EH Well Record Received Approved EH Admin
Robert Teague- BRK 12/28/2015
WELL DRILLER DATE DRILLED
Well permits are valid for 5 years from the date of issuance and are subject to suspension and/or revocation from
non-compliance with appropriate state and local rules and regulations, or if false information was given in order to obtain a
permit. Wells shall be constructed in accordance with all state and local regulations and rules.
The Well Completion Report must be submitted to the Health Department within 30 days upon completion of a well.
Megen McBride 02/19/2016
AUTHORIZED STATE AGENT APPROVAL DATE
ehwellcoc 02/23/2016 08:25 Page I of I