HomeMy WebLinkAboutWCOC-04-2016-071163.TIF CATAWBA COUNTY Case# WCOC-04-20 1 6-07 1 1 63
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° G Public Health Department Subdivision MT CREEK TERRACE
4 41/9 07 Y Environmental Health Division PINK 460719521184
"•' / PO Box 389. 100-A Southwest Blvd,Newton. NC 28658 LOT# 7 +ADJ
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Name on Permit JOHN BOUNDS, 4278 BARBRICK ST, SHERRILLS FORD NC 28673-9701
Site Address: 4163 TODD ST, SHERRILLS FORD NC 28673
Property Size: Square Feet 29.620.80 Acres 0.68 ¢ .1'o -1 C
Directions: HWY 150 E TOWARDS MOORESVILLE, TURN LEFT ON TODD ST (ITS BEFORE YOU GET} r .
TO STEAM PLANT) LOT BESIDE 4TH HOUSE ON LEFT ,0�-;*o 0,�
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WELL CERTIFICATE OF COMPLETION
WATER SUPPLY: Well Type: Individual Well
WELL-10-2015-065330 INSPECTIONS
INSPECTION# COMP DATE INSPECTION TYPE STATUS INSPECTOR
EHINSP-322189 04/13/2016 EH Well Record Received Approved EH Admin
EHINSP-321493 04/07/2016 EH Well Head Approved Jason Boyd
Well grouted by Jeff Speagle Lake Norman Well on 3/29.
EHINSP-322045 04/06/2016 EH GPS Data Collection Approved
EHINSP-321494 03/29/2016 EH Well Grouting Approved Jason Boyd
Lake Norman Well Drilling 03/29/2016
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.
Jason Boyd 04/13/2016
AUTHORIZED STATE AGENT APPROVAL DATE
ehwcllcoc 04/13/2016 09:56 Page I or