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Home My WebLink AboutSAM-04-2016-071003.TIF � CO Case tt SAM-04-2016-071003 CATAWBA COUNTY HEALTH DEPARTMENT say Environmental Health Section /842 sm 04/08/2016 WATER SAMPLE APPLICATION Applicant DAVID SEABOCK, 3348 40TH AV PL NE, HICKORY NC 28601 H:828-256-4822C:828-514-1189 Site Address: 3348 40TH AV PL NE, HICKORY NC 28601 SELECTED SAMPLES Bacterial Name of Subdivision: Parcel Number: 372408886081 Lot: 4A Block: Specific Directions Description: Bacteriological Only* Reason for Sample:VA Refinance Requirement Type of Well P111111101B6rrirMiliNil Is the well on this same property? EFTWITi F ri Is outside spigot available to collect sample? L Yes? f1 Is power on? ' ,Yes,',° 'i" NI Vr s 3 ,� t Has well been tested before? =�Yes'< �, Results Atisent�?h�,r;--;� wt��;�r^;=': � ,„,,�,,,;;1 nit W7ag;; Does the plumbing come out the top of the well through a sanitary well seal? i'r ` Ygs-••"`;-] Does the well ever become cloudy or has there ever been a problem with taste and/or odor? Mill O` Explain Does the well top extend twelve (12) inches above the ground or well slab? r Unkn6wn; The well is in: `9 y t w=r Rear rss r°x"3 Does this well supply water to more than one home? L 1 No"°`MCI Water samples will be drawn from an outside faucet unless otherwise specified. Please note that all water samples are ei taken during one visit. The processing laboratories have different protocols and timeframes for reporting results; S 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 II f Signature or Owner or Agent allAMIIIIVASW - -------- t Area 2 id FEE DESCRIPTION - ' if, DATE t' FEEAM OUNT1 F Bacteriological Sam ple Fee 04/08/2016 $58.00 ti ;4iyo ITOTALFEES , i i a 'e "' x ,{m '$ 80Q ito _ ,iettr r _iL•u.«iLiiii_LLu&:.A..,iii e i ii, ak,t TIaiiiiLt _ .'. Val rsamapplication 4/8/2016 Page 1 of 2 ArICn .} - ;: Fxlnt Form � Catawba County Public Health COUNTY www.catawbacountync.gov/environmentalhealth . . ^ — Environmental Health North Carolina P.O. Box 389, 100-A South West Blvd., Newton, NC 28658 Phone (828) 465-8270. fax (828) 465-8276 n Water Sample Application Sample Requested By 1 �I b vt—"�-t A Home Phone �2-� 2-5-6 2-5-6� J�S' 2 1 • Property Address 3 3`1 �o tiori+ !/ vlv k / I" Business Phone(C‘) c} ricd aaLL rifts< Mailing Address Driving Directions St /cf" t ,5*,z//J6 5 2b '7a ,c o7tr 4- PL N'' / T oN Jolt( 60 ioO ydt ` LGFV bo 'J n/L,ve 4/ Sample Requested: Bacteriological )7 Inorganic Chemical Other Sample reason: /261(/-)4" /1/4-M- - I� �QIIffa i by VI Type of Well: Drilled Bored 1.7-Dug Other Is the well on this same property? Yes �No Is outside spigot available to collect sample? Yes ✓ No Is power on? Yes ✓ No Has well been tested before? Yes ;7-No Unknown Results A85cio Does the plumbing come out the top of the well through a sanitary well seal? Yes /' No Unknown Does the water ever become cloudy or has there ever been a problem with taste or odor? Yes No Explain / Does the well top extend 12 inches above the ground or well slab? Yes No Unknown The well is located in front rear V left side right side of the house. Does well supply water to more than one home? Yes No Date g 7W/6 Signature of Owner or Agent Ate,/ % or.� "Leading the Way to a Healthier Community" 3ZPUblic ', 83Health '" � g'A Cpl CATAWBA COUNTY 100A SOUTHWEST BLVD NEWTON.NORTH CAROLINA 28658 RECEIPT PHONE: 828.465.8399 U `a vd►°, Friday, April 8, 2016 1842 sM www.catawbacountync.gov PAYOR: SEABOCK. DAVID PAYMENTS TRANSACTION NUMBER: TRC-651835-08-04-2016 PAYMENT DATE : 04/08/2016 PAYMENT TYPE: Credit Card INVOICE NUMBER FEE NAME FEE AMOUNT 04-16-327024 Bacteriological Sample Fee $58.00 TOTAL PAYMENTS : 558.00 SAM-04-2016-071003 CASE TYPE: Water Sample WORK CLASS: Bacterial SITE ADDRESS: 3348 40TH AV PL NE, HICKORY NC 28601 Applicant DAVID SEABOCK, 3348 40TH AV PL NE, HICKORY NC 28601 H:828-256-4822C:828-514-1189 ** NO PEOPLESOFT ACCOUNT ASSIGNED ** receipt 04/0812016 14:41 Page I of 1 A Casea SAM-04-2016-071003 • ,7"alli '2 CATAWBA COUNTY HEALTH DEPARTMENT U *SW, Environmental Health Section /842 sa 04/13/2016 WATER SAMPLE FIELD REPORT Applicant DAVID SEABOCK.3348 40'FII AV FL NE_(HICKORY NC 28601 H:828-256-4822E:828-514-1189 Site Address: 3348 40TH AV PL NE, HICKORY NC 28601 Name of Project: Parcel Number: 372408886081 Lot: 4A Block: Specific Directions Sulpher Springs Rd,Rd,40th Ave PI NE,left on 40th,go about 2900 yards,house is on the left.�J Initial Collected bv: I' xer ' 'C�(Cat Date/Time Sampled: ti l�)i 6 12: 10 ph Type of Sampling Point: �1JJ,7QIND0 OP `>r-Ck Qt ka-ce, 1 Well New or Existing? New✓ Existing X I Type of Well: Drilled Bored )C Dug Spring City Does well meet adequate construction standards from what can be observed: Yes No OAkKbtt)•• CQNntrk l eap,SS Reason for non-compliance: Defective well cap and/or seal Wel\ lhfJt 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 4/13/2016 Page 1 of 2 ,w'A cases SAM-04-2016-071003 �t a`� CATAWBA COUNTY HEALTH DEPARTMENT v\77 Environmental Health Section \842 SN 04/132016 WATER SAMPLE TEST RESULTS Applicant DAVID SEABOCK,3348 40111 AV Pl.NE.HICKORY NC 28601 1-1:828-256-4822C:828-514-1189 Site Address: 3348 40TH AV PL NE, HICKORY NC 28601 Name of Project: Parcel Number: 372408886081 Lot: 4A Block: Lab Colifotm Analysis Results: Total California: VS/ * Fecal/E.Coli: 01 MN" No Collection Dale Over 30 hours old Invalid Results: Excessive turbidity Excessive Chlorine I.ab Accident 1/�,,J f�'y� �1 l Nay BA Lab Tech Initials Date/Time Received "'-'I I " '1 I 1 Date/Time Completed�"I I1�� I RECEIVED APR 182016 CATAWBA COUNTY ENVIRONMENTAL HEALTH E9-rsa mfieldreport 4/13/2016 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: David Seabock Sample ID Number: 71003 Location: 3348 40th St P1 NE Hickory. NC 28601 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.) 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. X 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 coliform 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 `y G CATAWBA COUNTY U !��1 P 0 Box 389 - Newton,North Carolina 28658 -(828)465-8270 - Fax(828)465-8276 -TDD(828)465-8200 lh, Public Health - Environmental Health Division /842 su DAVID SEABOCK 4/19/2016 3348 40TH AV PL NE HICKORY NC 28601 REPORT OF WATER ANALYSIS & CONDITION OF SUPPLY Property Address: 3348 40TH AV PL NE, HICKORY NC 28601 WATER ANALYSIS This certifies that a sample of drinking water was taken from the above address on 04/13/16 and examined under laboratory number SAM-04-2016-071003. Laboratory findings reveal that this sample was potentially unsafe and should not be used unless boiled or otherwise disinfected. Steps need to be taken to correct the condition of your water supply. CONDITION OF SUPPLY 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. Megen McBride (828)320-3079 Environmental Health Specialist sIr d d N9'iI L` 9 r H lin r 2. % Oi 9 00 vC9 i . li. t�' d,' I Go;p: "Keeping the Spirit Alive Since 18421" ... .... HICKORY hmmt�°� METRO E9-rsamwatersampleletter 4/19/2016 Page 1 of 1