HomeMy WebLinkAboutWCOC-04-2016-071817.TIF �pA CATAWBA COUNTY Case# WCOC-04-2016-071817
ti� Q x Public Health Department Subdivision GABRIEL PARK-PH I
G '0t�,;, Environmental Health Division PIN# 460903408388
PO Box 389. 100-A Southwest Blvd,Newton.NC 28658 LOT4 1
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Name on Permit EVERETTE BRIDGES, 7464 SHERRILLS FORD RD, SHERRILLS FORD NC 28673
Site Address: 7498 SHERRILLS FORD RD, SHERRILLS FORD NC 28673 0 ,F ,0', 'j 0
Property Size: 130,680.00 3 4v v
P Y Square Feet Acres
Directions: 150 to Sherrills Ford. 1 mi pass Mollys Backbone, in Front of new Hospice House r,_ !o .,TD
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WELL CERTIFICATE OF COMPLETION
WATER SUPPLY: Well Type: Individual Well
WELL-12-2014-056270 INSPECTIONS
INSPECTION# COMP DATE INSPECTION TYPE STATUS INSPECTOR
EHINSP-323644 04/28/2016 EH GPS Data Collection Approved Jason Boyd
EHINSP-323645 04/28/2016 EH Well Head Approved Jason Boyd
EHINSP-287794 01/21/2015 EH Well Record Received Approved EH Admin
EHINSP-287752 01/20/2015 EH Well Grouting Approved Jason Boyd
B and K 01/20/2015
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 04/29/2016
AUTHORIZED STATE AGENT APPROVAL DATE
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