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Case# SAM-05-2016-072086
o
4 e Ga CATAWBA COUNTY HEALTH DEPARTMENT
MIEnvironmental Health Section
/842 sM 05/11/2016
WATER SAMPLE FIELD REPORT
Applicant JULIE POHLMAN, 4081 KISER COVE LN, I ERRELL NC 28682
11:8284781017C:704658602I
Site Address: 4081 KISER COVE LN, TERRELL NC 28682
Name of Project:
Parcel Number: 461704526639 Lot 9 Block:
Specific Directions Hwy 150, right Kiser Island Rd. 1 mile right onto Kiser Commons Dr, property straight ahead at stop sign P Initial Collected by: P I' Date/Time Sampled: `S t i - ) C/i (Sa M
Type of Sampling Point:
Well New or Existing? New Existing V
Type of Well: Drilled ✓ Bored Dug Spring City
Does well meet adequate construction standards from what can be observed : t/ Yes No
Reason for non-compliance: Defective well cap and /or seal
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:
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CATAWBA COUNTY HEALTH DEPARTMENT
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WATER SAMPLE TEST RESULTS
Applicant JULIE POHLMAN. 4081 KISER COVE LN, TERRELL NC 28682
H:8284781017 C:7046586021
Site Address: 4081 KISER COVE LN, TERRELL NC 28682
Name of Project:
Parcel Number: 461704526639 Lot: 9 Block:
Lab Coliform Analysis Results: Total Coliforms: Mani- Fecal /E. Coll.. CM*
No Collection Date Over 30 hours old
Invalid Results: Excessive turbidity
Excessive Chlorine
Lab Accident
Lab Tech Initials 1.3T' Date/Time Received 0Q)\in114 \�*. Date/Time CompletedD5tisltt ff00D4
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'#STATE u
~v 'P .O. Box 28047
Si North Carolina State Laboratory of Public Health 4312 District Drive
Environmental Sciences Raleigh, NC 27611-8047
Inorganic Chemistry Phone: 919-733-7308
�'"..��,,„..m`~./ g Fax: 919-715-8611
,.---- Certificate of Analysis
Report To: Name of System: RECEIVED
CATAWBA CO ENVIRONMENTAL HEALTH JULIE POHLMAN JUN 0 7 2016
P 0 BOX 389
4081 KISER COVE LN CATAWBA COUNTY
NEWTON, NC 28658 Courier# 09-70-01 TERRELL, NC 2868NVIRONMENTAL HEALTH
EIN: 566001814EH
StarLiMS ID: ES051916-0003001 Date Collected: 05/17/16 Time Collected: 11:15 AM
Date Received: 05/19/16 Collected By: Robbie Phelps
Sample Type: Raw Sampling Point: Kitchen sink Well Permit#: SAM-05-2016-072086
Sample Source: Well Temp. at Receipt: GPS#:
Sample Description:
Comment:
Inorganic Chemical + Metals I (Profile)
Analyte Result Allowable Limit Unit Qualifier(s)
Arsenic < 0.005 0.010 mg/L
Barium < 0.1 2.00 mg/L
Cadmium < 0.001 0.005 mg/L
Calcium 8 mg/L
Chloride < 5.00 250 mg/L
Chromium < 0.01 0.10 mg/L
Copper < 0.05 1.3 mg/L
Fluoride < 0.20 4.00 mg/L
Iron < 0.10 0.30 mg/L
Lead < 0.005 0.015 mg/L
9 mg/L
Magnesium 3 /L g
Manganese < 0.03 0.05 mg/L
Mercury < 0.0005 0.002 mg/L
pH 6.7 N/A
Selenium < 0.005 0.05 mg/L
Silver < 0.05 0.10 mg/L
Sodium 5.50 mg/L
Sulfate < 5.00 250 mg/L
Total Alkalinity 35 mg/L
Total Hardness 31 mg/L
Zinc < 0.05 5.00 mg/L
Report Date:06/03/2016 Reported By: Veggie_Atoned.
Page 1 of 1
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Private Well Information
human services and Use Recommendations
nc department
of an Re end
For Inorganic Chemical Contaminants
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County: Catawba Name: Julie Pohlman
Sample ID#: 72086 Reviewer: M. Cash
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TEST RESULTS AND USE RECOMMENDATIONS
l. Z Your well water meets federal drinking water standards for inorganic chemicals. Your water can be used for
drinking, cooking, washing, cleaning, bathing, and showering based on the inorganic chemical results'only. You may
have other water sampling results that are not taken into account in this report.
2. E The following substance(s)exceeded federal drinking water standards or the North Carolina 2L calculated health
levels. The North Carolina Division of Public Health recommends that your well water not be used for drinking and
cooking, unless you instal! a water treatment system to remove the circled substance(s). However, it may be used for
washing, cleaning, bathing and showering based on the inorganic chemical results only.
❑Arsenic ['Barium ❑Cadmium ['Chromium ❑Copper ❑Fluoride ❑Lead ❑Iron
❑Manganese ❑Mercury ❑Nitrate/Nitrite ['Selenium —Silver ❑Magnesium ❑Zinc ❑pH
3. E a. Sodium levels exceed the U.S. Environmental Protection Agency's (USE PA) Health Advisory level for sodium of
20 mg/I. The North Carolina Division of Public Health recommends that only individuals on no or low sodium restricted
diets not use this water for drinking or cooking. It may be used for washing, cleaning, bathing, and showering based on
the inorganic chemical results only.
❑ b. Levels over 30 mg/I may pose aesthetic problems such as bad taste, odor, staining of porcelain, etc.
4. ❑ Re-sampling is recommended in months.
5. ❑ Re-sample for lead and /or copper. Take a first draw, 5 minute, and 15 minute sample inside the house (preferably
the kitchen) and if possible a first draw, 5 minute and a 15 minute sample at the well head to determine the source of the
lead and/or copper.
6. ❑ The following substance(s) exceeded federal drinking water standards. Your water can be used for drinking,
cooking, washing, cleaning, bathing, and showering based on the inorganic chemical results only, but aesthetic problems
such as bad taste.odor, staining of porcelain, etc. may occur. You may want to install a household water treatment system
to address aesthetic problems.
❑Barium ❑Cadmium [Chromium [Fluoride ['Iron ❑Magnesium
❑Manganese ❑Selenium ❑Silver npH ['Zinc
For more iuforrnatmn regarding your well water results,please call the North Carolina Division of Public Health at 919-707-5900.
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: Julie Pohlman Sample ID Number: 72086
Location: 4081 Kiser Cove Ln. Terrell.NC 28682
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.)
X 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.
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.
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tiT [�ci CATAWBA COUNTY
U J,:�sl:u"?o��a ^aC P O Box 389-Newton, North Carolina 28658 -(828)465-8270- Fax(828)465-8276 -TDD(828)465-8200
x�g'_ Public Health - Environmental Health Division
1g42 SM
JULIE POHLMAN 6/9/2016
4081 KISER COVE LN
TERRELL NC 28682
REPORT OF WATER ANALYSIS & CONDITION OF SUPPLY
Property Address: 4081 KISER COVE LN, TERRELL NC 28682
WATER ANALYSIS
This certifies that a sample of drinking water was taken from the above address on 05/17/16
and examined under laboratory number SAM-05-2016-072086. Laboratory findings reveal that
this sample was FREE from coliform bacteria at the time of collection of the sample.
CONDITION OF SUPPLY
Your water supply was observed to MEET adequate construction standards
(in regards to well head protection).
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.
Robbie Phelps (828)320-3077
Environmental Health Specialist
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