HomeMy WebLinkAboutWELL-05-2016-072069.TIF ,&5A CATAVBA COUNTY D Yti�0' - 0 Case# WELL-05-2016-072069•
.C:' giti� Public Health Department r- Subdivision
CelLi�i 376301279838
_....^P.1 '"I Environmental Health Division i PIN#
?°t� 1'0 Box 389. 100-A Southwest Blvd,Newton, NC 28658 '2..e �� C • LOP/ A-4
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NAME ON PERMIT: RANDY PHILLIP MOSER, 4061 CARLTON DR, CLAREMONT NC 28610
Site Address: 4942 ROCK BARN RD, CLAREMONT NC 28610
Property Size: Square Feet: 17,859.60 Acres:0.41
Directions: 1-40/ Rock Barn Rd Ext/ left on Rock Barn Rd /go past Golf Course!cross Bridge across from Community
Rd/just above 3nd Mobile home on right/vacant lot
WELL PERMIT
WATER SUPPLY: Individual Well
SETBACKS:
1. BUILDNG FOUNDATIONS 25 FT.
2. EXISTING & PROPOSED SEPTIC SYSTEMS MIN. 50 FT.
3. EXISTING & PROPOSED SEPTIC REPAIR AREA MIN. 50 FT.
9 . SEWAGE PUMP SUPPLY LINE 50 FT.
5. UNDERGROUND STORAGE TANKS 100 FT.
6. STREAMS/BROOKS/CREEKS 50 FT.
7 . LAKES/PONDS RESERVOIRS 50 FT.
ALL OTHER POSSIBLE SOURCES OF GROUND WATER CONTAMINATION 100 FT.
The well driller must verify all setbacks before drilling the well.
If the well driller is unable to maintain any of the above setbacks,
contact Catawba County Environmental Health at (828) 465-8270
before drilling the well.
Grouting Depth: Minimum 20 Feet
Casing Height: 12" Above Land Surface
All newly constructed private drinking water wells are required to be sampled in accordance with the North
Carolina Rules Regarding Private drinking Water Well Testing (15A NCAC 18A .3800). The fee for this
sampling is included in the cost of the well permit. It is the applicant or property owner's responsibility to
notify Environmental Health when the well is ready for sampling.
Water samples will be drawn from an outside faucet unless othenvise specified. Please note that all water samples are
taken during one visit. The processing laboratories have different protocols and timeframes for reporting results;
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.
Megen McBride 05/06/2016
AUTHORIZED STATE AGENT APPROVAL DATE
ehpcm,il 05/06/2016 09:59 Page 1 of3
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