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Home My WebLink AboutSAM-03-2016-069952.TIF �A C Case# SAM-03-2016-069952 % CATAWBA COUNTY HEALTH DEPARTMENT li vdsvr Environmental Health Section U G 1842 SM 03/10/2016 WATER SAMPLE APPLICATION Applicant LEE SAKOLSKY, 8331 NOLLEY LN, SHERRILLS FORD NC 28673 C:7326917653 LSAKOLSKY @YAHOO.COM Site Address: 8331 NOLLEY LN, SHERRILLS FORD NC 28673 SELECTED SAMPLES Bacterial Name of Subdivision: Parcel Number: 461601278108 Lot: 6 Block: Specific Directions Description: Bacteriological Only* Reason for Sample:Refinancing Type of Well T 2t Drilled5111 =` Is the well on this same property? di A Yes Is outside spigot available to collect sample? Kes Is power on? ,xRS - Has well been tested before? 4iticel7s75273 Results Does the plumbing come out the top of the well through a sanitary well seal? EFiYesa Does the well ever become cloudy or has there ever been a problem with taste and/or odor? No € Explain Does the well top extend twelve (12) inches above the ground or well slab? `aj(es2a` The well is in: iT,r_ itt FEront allEM Does this well supply water to more than one home? aWo Water samples will be drawn from an outside faucet unless otherwise specified. Please note that all water samples are taken during one visit. The processing laboratories have different protocols and timeframes for reporting results; therefore, you may receive several different reports concerning your water sample. For questions or more information, please contact Catawba County Environmental Health at(828)465-8270. Date .3 I.3 PM. • Signature or Owner or Agent TIIf�T171TIiAe t 'Jm Area 1 FEE DESCRIPTIO i n ret -tcii?iiiir t u x # ., ro d TFEEAMOUNTir;^, Bacteriological Sample Fee 03/10/2016 $58.00 TOTALFEES 4. £ , q ia�s °es 5 V�`51,51: 858 nos e ��aa."` 7tb1. '? ..,.3..4..E ner_ai . ._ J_.a.`-"tom?G_6V ,i.R':.o-an.SaY_ncPs.+>•T=s . x..,..,c.�.3 rsamapplication 3/10/2016 Page 1 of 2 t d $.T 1 n „s.� z rt .:' : cATAN ,.,„, 3PrInt Form r 1A. Catawba County Public Health CC)UN I l r '' N„ vww.catawbacountync.gov/environmentalhealth `" �€ ? ° EnvironmentaLUealth Noah c n:, P.O. Box 389, 100-A South West Blvd.,Newton, NC 28653 Phone (328)465-8270. Fax (828) 465-8276 Water Sample Application Sample Requested By Lee Sakolsky Home Phone732-691 -7653 Property Address 8331 Nolley Lane Business Phone Mailing AddressSherrills Ford NC 28673 Driving Directions �/ Sample Requested: Bacteriological ^ Inorganic Chemical Other Sample reason: Refinancing Type of Well: Drilled X Bored Dug Other Is the well on this same property? Yes X No X/ Is outside spigot available to collect sample? Yes X No Is power on? Yes/ N No Has well been tested before? Yes X No Unknown Results �"'Jt ' Does the plumbing come out the top of the well through a sanitary well seal? Yes X No Unknown \ Does the water ever become cloudy or has there ever been a problem with taste or odor? Yes _ No X Explain Does the well top extend 12 inches above the ground or well slab? Yes X No Unknown The well is located in front X rear left side right side of the house. Does well supply water to more than one home? Yes No X Date 3/10/2016 Signature of Owner or Agent 'u ,Wv • 4 "Leading the Way to a Healthier Comma, ity" s 3z b a C ,cr 81 Health x� , , _ n .. gHA CATAWBA COUNTY 100A SOUTHWEST BLVD NEWTON, NORTH CAROLINA 28658 RECEIPT in aP N PHONE: 828.465.8399 \ (3 wady it Thursday, March 10, 2016 \ /842 sm www.catawbacountync.gov PAYOR: Sakolsky, Lee PAYMENTS TRANSACTION NUMBER: TRC-635125-10-03-2016 PAYMENT DATE : 03/10/2016 PAYMENT TYPE: Credit Card payment by phone INVOICE NUMBER FEE NAME FEE AMOUNT 03-16-326035 Bacteriological Sample Fee $58.00 TOTAL PAYMENTS : $58.00 SAM-03-2016-069952 CASE TYPE: Water Sample WORK CLASS: Bacterial SITE ADDRESS: 8331 NOLLEY LN, SHERRILLS FORD NC 28673 Applicant LEE SAKOLSKY, 8331 NOLLEY LN, SHERRILLS FORD NC 28673 C:7326917653 ** NO PEOPLESOFT ACCOUNT ASSIGNED ** receipt 03/10/2016 14:56 Page 1 of 1 $A C� Case ft SAM-03-2016-069952 6-7 CATAWBA COUNTY HEALTH DEPARTMENT d Environmental Health Section \842 sM 03/21/2016 WATER SAMPLE FIELD REPORT Applicant LEE SAKOLSKY, 8331 NOLLEY LN, SI-IERRILLS FORD NC 28673 C:73269I7653 LSAKOLSKY a.YAHOO.COM Site Address: 8331 NOLLEY LN, SHERRILLS FORD NC 28673 Name of Project: Parcel Number: 461601278108 Lot: 6 Block: Specific Directions l6S/lefts on Hwy 150/right on Slanting Bridge Rd/left on Drena Rd/Right on Giles Ave/1st left on Nolley Ln Initial Collected by: P- r Date/Time Sampled: 3 -2 I-/ H • )--4 r, Type of Sampling Point: 14"42-1( ken J Well New or Existing? New Existing (/ Type of Well: Drilled L../Bored Dug Spring City Does well meet adequate construction standards from what can be observed: Yes No Reason for non-compliance: Defective well cap and/or seal Piping does not exit through top of well by approved cap and sanitary well seal Evidence of improper grouting or no grouting Opening in the well casing or cap Supply too close to source of potential contamination Notification: Existing well owner notified that well does not meet adequate construction ? Yes No Date of Notice: E9 - rsamfieldreport 3/21/2016 Page 1 of 2 Case# SAM-03-2016-069952 474 ri CATAWBA COUNTY HEALTH DEPARTMENT ► Environmental Health Section /844'43/90 03/21/2016 WATER SAMPLE TEST RESULTS Applicant LEE SAKOLSKY, 8331 NOLLEY LN, SHERRILLS FORD NC 28673 C:73269I7653 LSAKOLSKY@YAHOO.COM YAHOO.COM Site Address: 8331 NOLLEY LN, SHERRILLS FORD NC 28673 Name of Project: Parcel Number: 461601278108 Lot: 6 Block: Lab Coliform Analysis Results: Total Coliforms: � Fecal / E. Coli: Qd No Collection Date Over 30 hours old Invalid Results: Excessive turbidity Excessive Chlorine Lab Accident y Lab Tech Initials Date/Time Received °MO W H J 2 Date/Time Completed ) l fr I ID we RECEIVED MAR 2 4 2016 CATht'vBA COUNTY ENVIRONM NTML *IEALTH E9 - rsamfieldreport 3/21/2016 Page 2 of 2 North Carolina Division of Public Health Occupational and Environmental Epidemiology Branch, Epidemiology Section BIOLOGICAL ANALYSIS REPORT Private well water information and recommendations County: Catawba Name: Lee Sakolsky Sample ID Number: 69952 Location: 8331 Nollev Ln. Sherrills Ford, NC 28673 Reviewer: M. Cash • Initial Sample: X Confirmation Sample BIOLOGICAL ANALYSIS RESULTS AND RECOMMENDATIONS FOR USES OF YOUR PRIVATE WELL WATER (These recommendations are based on biological analysis only.) X No coliform bacteria were found in your well water. Your water can be used for all purposes including drinking, cooking, washing dishes, bathing and showering. Total coliform bacteria were detected in the sample which indicates that harmful bacteria from human or animal waste could enter the well. Do not use the water for drinking or cooking unless it has been boiled for 3 minutes. You may use your water for all other purposes including washing dishes, bathing or showering. Your well water needs to be re-tested to verify that the result is accurate. Fecal coliform bacteria were detected in the sample. Do not use the water for drinking, cooking, washing dishes, bathing or showering. If the re-test shows contamination by bacteria contact your local health department for assistance. There may be a problem with the construction of the well, the groundwater source, or operation of the well. The well needs to be inspected by the local health department or a local well contractor to determine the problem with the well and to give guidance on how to correct the problem. Your well water was tested for biological contaminants (total coliform and fecal coliform bacteria). The results were evaluated using the federal drinking water standards. Drinking water may contain substances that can occur naturally in water or can be introduced into water from man-made sources. Total coliform bacteria are found in soil and fecal coliform bacteria are found in animal and human waste. Total eoliform or fecal coliform bacteria in well water indicate that the well may have structural problems or that the well was not properly disinfected. If you have been drinking the well water and are pregnant, nursing, have a child in the household under 5 years of age, or immunocompromised (such as an individual with AIDS, cancer, hepatitis, dialysis or surgical procedures) inform your physician of these results at your next visit. If the contamination continues, you should investigate the possibility of drilling a new well or installing a point-of-entry disinfection unit which can use chlorine, ultraviolet light, or ozone. For further information please contact your county health department or the Occupational and Environmental Epidemiology Branch at 919-707-5900. gA O tip CATAWBA COUNTY U P 0 Box 389- Newton.North Carolina 28658 -(828)465-8270 - Fax(828)465-8276 -TDD(828)465-8200 6 Public Health - Environmental Health Division 18. 2 su LEE SAKOLSKY 3/28/2016 8331 NOLLEY LN St-IERRILLS FORD NC 28673 REPORT OF WATER ANALYSIS & CONDITION OF SUPPLY Property Address: 8331 NOLLEY LN, SHERRILLS FORD NC 28673 WATER ANALYSIS This certifies that a sample of drinking water was taken from the above address on 03/21/16 and examined under laboratory number SAM-03-2016-069952. Laboratory findings reveal that this sample was FREE from coliform bacteria at the time of collection of the sample. CONDITION OF SUPPLY Your water supply was observed to MEET adequate construction standards (in regards to well head protection). NOTES *The results of any water analysis only reflects the quality of the water at the time of the samp If you have any questions concerning your water sample analysis, please call me at the number below. Robbie Phelps (828)320-3077 Environmental Health Specialist ,60,c440;/.., n 7: mw zmx 2 "Keeping the Spirit Alive Since 1842!" GREATER HICKORY ^�^s eL�a METRO E9-rsamwatersamplelettor 3/28/2016 Page 1 of 1