HomeMy WebLinkAboutWendy Travis Water Sample 04 05 16.TIF .$A �.'� Case# FLI-04-2016-070829
Cr '' �� CATAWBA COUNTY HEALTH DEPARTMENT
U 10li i h< Environmental Health Section
/842 SM 04/05/2016
WATER SAMPLE FIELD REPORT
Wendy Travis
7774 HUDSON CHAPEL RD, CATAWBA NC 28609
Site Address: 7774 HUDSON CHAPEL RD, CATAWBA NC 28609
Name of Project:
Parcel Number: 470104747078 Lot: B Block:
Initial Collected by: , ,t ( rt9- & off— Date/Time Sampled: R\' lb t1/413D�n�
Type of Sampling Point: ? s Lys1-- As)LA--t 111
Well New or Existing? New Existing 0l-
Type of Well: Drilled 4. Bored Dug Spring City
Does well meet adequate construction standards from what can be observed: V. Yes No
Reason for non-compliance: Defective well cap and/or seal
Piping does not exit through top of well by approved cap and sanitary well seal
Evidence of improper grouting or no grouting
Opening in the well casing or cap
Supply too close to source of potential contamination
Notification: Existing well owner notified that well does not meet adequate construction ? Yes No
Date of Notice:
E9 - rsamfieldreport 4/5/2016 Page 1 of 2
�$A case fi FLI-04-2016-070829
C CATAWBA COUNTY HEALTH DEPARTMENT
U ' lvi Environmental Health Section
r4Z sM 04/05/2016
WATER SAMPLE TEST RESULTS
Wendy Travis
7774 HUDSON CHAPEL RD, CATAWBA NC 28609
Site Address: 7774 HUDSON CHAPEL RD, CATAWBA NC 28609
Name of Project:
Parcel Number: 470104747078 Lot: B Block:
Lab Coliform Analysis Results: Total Coliforms: Fecal / E. Coll: a
No Collection Date Over 30 hours old
Invalid Results: Excessive turbidity Excessive Chlorine
Lab Accident
Lab Tech Initials Ecvµ-t Date/Time Received a`I7a5%don, iro'o Date/Time Completed D 1(Rd L W
RECEIVED
APR 072016
CATAWBA COUNTY
ENVIRONMENTAL HEALTH
E9 - rsamfieldreport 4/5/2016 Page 2 of 2