HomeMy WebLinkAboutCamp Dogwood 010024 Water Sample 03 22 16.TIF A C Case# FLI-0000012
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WATER SAMPLE FIELD REPORT
CAMP DOGWOOD
7062 CAMP DOGWOOD DR, SHERRILLS FORD NC
Site Address: 7062 CAMP DOGWOOD DR, SHERRILLS FORD NC
Parcel Number: 460803105023 Lot: Block:
Initial Collected by: PieVi Date/Time Sampled: 3Ja2//ta ID: Bc
Type of Sampling Point: pre P >CM.lL
Well New or Existing? New Existing yl
Type of Well: Drilled y Bored Dug Spring City
Does well meet adequate construction standards from what can be observed: Y.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:
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-BA Case# FLI-0000012
FT Ma �I CATAWBA COUNTY HEALTH DEPARTMENT
-, 'A' v Environmental Health Section
1542 sm 03/22/2016
WATER SAMPLE TEST RESULTS
CAMP DOGWOOD
7062 CAMP DOGWOOD DR, SHERRILLS FORD NC
Site Address: 7062 CAMP DOGWOOD DR, SHERRILLS FORD NC
Parcel Number: 460803105023 Lot: Block:
Lab Coliform Analysis Results: Total Coliforms: cLora , Fecal / E. Coll:
No Collection Date Over 30 hours old
Invalid Results: Excessive turbidity _ Excessive Chlorine
Lab Accident
Lab Tech Initials '✓Ft" Date/Time Received {
°° IIJ V1'QO Date/Time Completed od/L3/n, 160 ecru.
RECEIVED
MAR 2 4 2016
CATAWBA COUNTY
ENVIRONMENTAL HEALTH
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