HomeMy WebLinkAboutSAM-03-2016-070127.TIF `■1 $A IG Case# SAM-03-2016-070127
tji Fr-
CATAWBA COUNTY HEALTH DEPARTMENT
d � :►1•
K/._ Environmental Health Section
ao
$i}Z sM 03/29/2016
WATER SAMPLE FIELD REPORT
Applicant CHRIS JANOSKO, 8337 DRENA DR, SHERRILLS FORD NC 28673
C:9284990402
Site Address: 8337 DRENA DR, SHERRILLS FORD NC 28673
Name of Project:
Parcel Number: Lot: Block:
Specific Directions Hwy 150, Slanting Bridge, Drena Dr, pass Chapin Ln, Property on right
Initial Collected by: R r Date/Time Sampled: 3-2-,- /‘/
Type of Sampling Point: ,\/LJ ii k aol
Well New or Existing? New s,7— Existing
Type of Well: Drilled '✓ Bored Dug Spring City
Does well meet adequate construction standards from what can he observed: G.---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 3/29/2016 Page 1 of 2
A A Case n SAM-03-2016-070127
Y rt� ¢ G� CATAWBA COUNTY HEALTH DEPARTMENT
v74 Environmental Health Section
0
\$4Z sM 03/29/2016
WATER SAMPLE TEST RESULTS
Applicant CHRIS JANOSKO, 8337 DRENA DR, SHERRILLS FORD NC 28673
C:9284990402
Site Address: 8337 DRENA DR, SHERRILLS FORD NC 28673
Name of Project:
Parcel Number: Lot: Block:
Lab Coliform Analysis Results: Total Coli forms: ODO I"I Fecal /E. Coli: ( 1' rii-
No Collection Date Over 30 hours old
Invalid Results: Excessive turbidity Excessive Chlorine
Lab Accident
Lab Tech Initials Date/Time Received L12? jI� lUd-1 Date/Time CompletedU' tflOJ1
RECEIVED
MAR 31 2016
CATAWBA COUNTY
ENVIRONMENTAL HEALTH
E9 - rsamfieldreport 3/29/2016 Page 2 of 2