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HomeMy WebLinkAboutSAM-05-2016-072204.TIF A,14$A � Case# SAM-05-2016-072204 ,.tc is CATAWBA COUNTY HEALTH DEPARTMENT v►`' ~' Environmental Health Section \842 sm 05/10/2016 WATER SAMPLE APPLICATION Applicant RANDY SIGMON, 1708 SETTLEMYRE BRIDGE RD, NEWTON NC 28658 H:828-464-4219C:828-381-6303 Paid By ROBIN SIGMON, 1708 SETTLEMYRE BRIDGE RD, NEWTON NC 28658 Site Address: 1708 SETTLEMYRE BRIDGE RD, NEWTON NC 28658 SELECTED SAMPLES Bacterial Name of Subdivision: Parcel Number: 373006287290 Lot: Block: Specific Directions Description: Reason for Sample:US Farm Gap Organic Certification Type of Well PillINI ill!IBoredd 111111lP I Is the well on this same property? II01 PYeeLrffi . Is outside spigot available to collect sample? rifillifWAIM Is power on? EEL Yesit'1k Has well been tested before? Fraf6ll111tlJ Results Does the plumbing come out the top of the well through a sanitary well ilikLiteAdlii Does the well ever become cloudy or has there ever been a problem with taste and/or odor? ' 'Nolte Explain Does the well top extend twelve (12) inches above the ground or well slab? ea r;Yee The well is in: Will 1 'Rear 'Mgr Does this well supply water to more than one home? Vlutliln Noll Water samples will be drawn from an outside faucet unless otherwise 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. Date t I. ( Signature or Owner or Agent " .R. it • ea Area 2 y r1h° null' IIIRI@lP i'X14 ^i`1"111111FISMI' 'r,, i'�t"9� 1m iii rl .3;'ll'J itIiL' , th IIliAUltlnl it I FEE DESCRIPTIONII'llll�'li ,261 lau. DATFI11II ,uOihU dlll'FFE'AMOUNTPI I ..14",2611,.. u l: r�.�,�w �u uur ' Bacteriological Sample Fee 05/10/2016 558.00 C91i8gllli Iiilillrii'I�'�I'i�I111TOTALII E°°Eslhll;I1 111 llllli�lI'IIIIIIllll1l"�IIIIIIIiJJ'lihIij gJllliiI IilII(II1''n�mmllllfllll4/t�rnill!III?Initlllll0ln''Aunn1IIS58 0001 �i" Jibt" .I,NUJn•�.. n :.ujWQILIWWWOUr .�w.uil1Nlillnl1114 •.. ..21 UIW° �' rsamapplication 5/10/2016 Page 1 of 2 ATr \ �� ' III A Catawba County Public Health Print Form it 1('`:-1 1 www.catawhacountync.gov/environmentalhealth f `= y Environmental Health r;h c n P.O. Box 389, 100-A South West Blvd., Newton, NC 28658 Phone (828) 465-8270. Fax (828) 465-8276 Water Sample Application 7 ` J 1/2/ , Sample Requested By aI n Ay 5 V117�0 IA^ j� Home Phone 'GC('- qt ! /-? Property Address 170 i .`t/lent re 13eiG( ICai Business Phone D 2 ft' 3O/- 6 03 Mailing Address 1`J 2.iADel / `j v in?Th 5'7 /D�r�iviingDDiirections I onu Ne�.u$O-rt -f �'Rad: D �5-44-:oh -Pal - Ytclkrfjvx (� 64 Cow/Oyc6(ar ion e)/— le V nil ftle 'tio D(4j// - ( 5 /1e�1e.a Sample Requested: Bacteriological✓/nl Inorganic Chemical Other [ —(pit dCOy / Sample reason: US �Rrm (a0. ©,rre.c. �ft C Ztt oy-. Type of Well: Drilled Bored ✓ Dug Other Is the well on this same property? Yes ✓ No Is outside spigot available to collect sample? Yes 7 No Is power on? Yes ■ No Has well been tested before? Yes No V Unknown Results Does the plumbing come out the top of the well through a sanitary well seal? Yes ✓ No Unknown Does the water ever become cloudy or has there ever been a problem with taste or odor? Yes No t/ Explain Does the well top extend 12 inches above the ground or well slab? Yes ./ No Unknown The well is located in front rear i left side right side of the house. Does well supply water to more than one home? Yes No ✓ IImo�,, � � � ._ Date 5/9 / dI/� Signature of Owner or Agent {�/ / a ,_/uw-- 01 ,•Leciaiii?the Wnii to i H>.o thkr , mti 8D :... ys�P' p CATAWBA COUNTY G 100A SOUTHWEST BLVD NEWTON,NORTH CAROLINA 28658 RECEIPT n��yr `� V�VVe•. PIiONE: 828.465.8399 U int!' * X440,3-. 1842 sM www.catawbacountync.gov PAY OR: Sigmon, Robin PAYMENTS TRANSACTION NUMBER: TRC-670 1 87-1 0-05-20 1 6 PAYMENT DATE : 05/10/2016 PAYMENT TYPE: Credit Card 163526537 INVOICE NUMBER FEE NAME FEE AMOUNT 05-16-328184 Bacteriological Sample Fee $58.00 TOTAL PAYMENTS : 558.00 SAM-05-2016-072204 CASE TYPE: Water Sample WORK CLASS: Bacterial SITE ADDRESS: 1708 SETTLEMYRE BRIDGE RD, NEWTON NC 28658 Applicant RANDY SIGMON, 1708 SETTLEMYRE BRIDGE RD,NEWTON NC 28658 H:828-464-4219C:828-381-6303 Paid By ROBIN SIGMON, 1708 SETTLEMYRE BRIDGE RD,NEWTON NC 28658 ** NO PEOPLESOFT ACCOUNT ASSIGNED ** receipt 05/10/2016 12x48 Page 1 of I 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: Randy Simon Sample ID Number:_72204_ Location: 1708 Settlemyre Bridge Rd Newton. NC 28658 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 eolith= 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. �gA • jjifl CATAWBA COUNTY ��p P O Box 389-Newton, North Carolina 28658 -(828)465-8270 - Fax (828)465-8276 -TDD(828)465-8200 ti 1'4''1 Public Health - Environmental Health Division /842 RANDY SIGMON 5/19/2016 1708 SETTLEMYRE BRIDGE RD NEWTON NC 28658 REPORT OF WATER ANALYSIS & CONDITION OF SUPPLY Property Address: 1708 SETTLEMYRE BRIDGE RD, NEWTON NC 28658 WATER ANALYSIS This certifies that a sample of drinking water was taken from the above address on 05/16/16 and examined under laboratory number SAM-05-2016-072204. 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 NOT TO MEET adequate construction standards. Non-Comp Reason: Incorrect Piping Exit Supply too close to source of potential contamination. Less than 25 feet from house. NOTES *The results of any water analysis only reflects the quality of the water at the time of the sampling. **Good results on improperly constructed supplies are possible, but your supply should not be considered reliable due to the potential for conatamination. If you have any questions concerning your water sample analysis, please call me at the number bel Megen McBride (828)320-3079 Environmental Health Specialist 111,1 fA['[lPdl¢EIU�,I 1 t `II':°tl1 °€ "Keeping the Spirit Alive Since 1842!" OREM FR HICKORY 'mrem�` METRO E9-rsamwatersampleletter 5/19/2016 Page 1 of 1