HomeMy WebLinkAboutWCOC-04-2016-070905.TIF /c x CATAWBA COUNTY Case# WCOC-04-2016-070905
/.v 2, Public Health Department Subdivision
2 '' Environmental Health Division PIN# 461603011610
'�� PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT#
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Name on Permit BETTY NIXON, 8054 MOUNTAIN SHORE DR, SHERRILLS FORD NC 28673 Mr Jr ) /
Site Address: 8000 MOUNTAIN SHORE DR, SHERRILLS FORD NC 28673 J
3005640 0.69 0 •a r •On
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Property Size: Square Feet Acres ` �_ '..
Directions: From inNewton South on 16 turn left atr r Lin " 1
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96f7d50b-1466-4395-9c79-5933e834318b s' 4 {
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WELL CERTIFICATE OF COMPLETION
WATER SUPPLY: Well Type: Individual Well
WELL-08-2015-064177 INSPECTIONS
INSPECTION# COMP DATE INSPECTION TYPE STATUS INSPECTOR
EHINSP-321668 04/06/2016 EH Well Head Approved Robbie Phelps
EHINSP-318167 02/23/2016 EH Well Head Failed Robbie Phelps
*Needs caulk around electrical wires at the wellhead.
EI-IINSP-318166 02/23/2016 EH GPS Data Collection Approved Robbie Phelps
EHINSP-316239 01/28/2016 EH Well Grouting Approved Robbie Phelps
EHINSP-316238 01/27/2016 EH Well Record Received Approved EH Admin n
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B & K Well Drilling. Inc. 01/27/2016
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.
Robbie Phelps 04/06/2016
AUTHORIZED STATE AGENT APPROVAL DATE
cltweIlcoc 04/06/2016 13:03 Page 1 of 1