HomeMy WebLinkAboutWCOC-05-2016-072301.TIF s(') • CATAWBACOUNTY Case# WCOC-05-2016-072301
filth I Public Health Department Subdivision GEORGIA PARK
< kfig K Environmental Health Division PIN# 366703233105
PO Box 389. 100-A Southwest Blvd,Newton. NC 28658 LOT# 8
/8'2 SM
Name on Permit CLAYTON HOMES, PO BOX 132, TAYLORSVILLE NC 28681
Site Address: 3453 MELDONNA DR, MAIDEN NC 28650 0 � 'oti 0 CS
Property Size: Square 20,037.60 0.46 dJSF
Scare Feet Acres
Directions: Hwy 16/left Buffalo Shoals Rd/right Meldonna Dr/lot 8 on left S • •t
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WELL CERTIFICATE OF COMPLETION
WATER SUPPLY: Well Type: Individual Well
WELL-04-2016-071598 INSPECTIONS
INSPECTION# COMP DATE INSPECTION TYPE STATUS INSPECTOR
EHINSP-324746 05/10/2016 EH Well Record Received Approved EH Admin
EHINSP-324997 05/09/2016 EH Well Head Approved Robbie Phelps
EI-IINSP-324998 05/09/2016 EH GPS Data Collection Approved Robbie Phelps
EHINSP-324999 05/06/2016 EH Well Grouting Approved Robbie Phelps
Russell Well 05/06/2016
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 05/09/2016
AUTHORIZED STATE AGENT APPROVAL DATE
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