HomeMy WebLinkAboutWCOC-04-2016-071489.TIF ,pA CATAWBA COUNTY Case it WCOC-04-20 1 6-07 14 89
,Tit 2 Public Health Department Subdivision
Q ��1 R Environmental Health Division PIN/t 368703142855
�aV PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 LOT#
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Name on Permit DWAYNE CALDWELL, 5110 S NC 16 HWY, MAIDEN NC 28650
Site Address: 5110 S NC 16 HWY, MAIDEN NC 28650 •'o i S El
764,913.60 17.56 • S
Property Size: Square Feet Acres '
Directions: 8 miles/NC 16 south from Newton/close to Jones Fish Campo � o
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WELL CERTIFICATE OF COMPLETION
WATER SUPPLY: Well Type: Individual Well
WELL-10-2015-065503 INSPECTIONS
INSPECTION# COMP DATE INSPECTION TYPE STATUS INSPECTOR
EHINSP-323044 04/21/2016 EH Well Head Approved Robbie Phelps
EHINSP-323045 04/21/2016 EH GAS Data Collection Approved Robbie Phelps
EHINSP-322632 04/18/2016 EH Well Record Received Approved EH Admin
EHINSP-321916 04/08/2016 EH Well Grouting Approved Robbie Phelps
John Whisnant 04/07/2016
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 04/21/2016
AUTHORIZED S'I'A'I'E AGENT APPROVAL DATE
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