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Home My WebLink AboutSAM-05-2016-072553.TIF $A C� Case# SAM-05-2016-072553 CATAWBA COUNTY HEALTH DEPARTMENT d sloe Environmental Health Section /842 sM 05/19/2016 WATER SAMPLE APPLICATION Applicant ALLEN TATE CO, 19460 OLD JETTON RD, CORNELIUS NC 28031 _ C:7046689656 KATHY.DAY@ALLENTATE ALLENTATE .COM Paid By WILLIAM IVEY, 346 TREETOPS DR, STANLEY NC 28164 WIVEY264@CHARTER.NET Site Address: 9524 RIVIERA DR, SHERRILLS FORD NC 28673 SELECTED SAMPLES Bacterial Name of Subdivision: Nitrate/Nitrite Parcel Number: 462802563569 Lot: 1 Block: Specific Directions Description: Reason for Sample:Home is being sold & buyer is requesting sample Type of Well ';41621IM Bor,edijaifiliM Is the well on this same property? l-ra,Yesl,S'" 'f Is outside spigot available to collect sample? Is power on? Has well been tested before? U,nk own`g Results Does the plumbing cone out the top of the well through a sanitary well seal? Does the well ever become cloudy or has there ever been a problem with taste and/or odor? Eiffillifir' Explain Does the well top extend twelve (12) inches above the ground or well slab? L;R{ -;]IYes '';; The well is in: iUllllilE Rdar ilillIMI,,!ip'. ' Does this well supply water to more than one home? ELTLyefign 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 b � 1Kt) Signature or Owner or Agent refiNter\cm e,A tjilk Area 1 FEEiDFSCR!PThON li a — ' IMj illu( �1 77� irD T /, 'l � trFF NT Sl l aLI MiliI tq... E I Li 1 F A01 Bacteriological Sample Fee 05/19/2016 $58.00 Nitrate Sample Fee 05/19/2016 $85.00 ,�Int $143009 !�i h +1) I Il�TOTAL'FEES, 4 ��1t14nlii�i '!�IU{ii i�1�I��_•Gulliwla t ill I NIlu - llthau Lk • . • ■ at l a.PViiuc..—_„+LLI!Ill " ti IIIIL J'111111 r al rsamapplication 5/19/2016 Page 1 of 2 n-Cs-Zoli iaTs53 1 ,r PFa m c ArA LCatawba County Public Health ° i111' 141" ' • COUNTY -y�y www.catawbacountync.gov/environmentalhealth ca*M ilri,*A ;rte Terrell Environmental Health north Co eunw P.O. Box 389, 100-A South West Blvd.,Newton,NC 28658 Phone(828)465-8270.Fax(828) 465-8276 Water Sample Application Sample Requested By Kathy Day Home Phone Property Address 9524 Riviera Dr, Sherrills Ford Business Phone 704-668-9656 Alien Tate Co 19460 Old Jetton Rd, Cornelius NC 28031 Mailing Address Driving Directions HWY 150 to Sherrills Ford Rd, Rt on Island Point, Left on Riviera Dr, house on left 11 �// Sample Requested: Bacteriological X Inorganic Chemical Other X Ni rci,+e��7 Y/T� Sample reason: Home is being sold and buyer is requesting sample Type of Well: Drilled Bored X Dug Other I Is the well on this same property? Yes X No ' Is outside spigot available to collect sample? Yes X No_ Is power on? Yes X No Has well been tested before? Yes No Unknown X Results Does the plumbing come out the top of the well through a sanitary well seal? Yes X No Unknown Does the water ever become cloudy or has there ever been a problem with taste or odor? Yes No X Explain Does the well top extend 12 inches above the ground or well slab? Yes X No_ Unknown The well is located in front rear X left side right side of the house. Does well supply water to more than one home? Yes X No 5/18/2016 ��,�.7. Date Signature of Owner or Agent 1 "Leading the Way to a Healthier Community" E=Pub l.0 Q. 'Health , fT' ,; kk. K2-A C CATAWBA COUNTY �� 100AS0U"CH WEST BLVD � r �HC� NEWTON,NORTH CAROLINA 28658 RECEIPT F..,1 n L) 111141 01.2 v. m PHONE: 828.465.8399 Thursday, May 19, 2016 /842 sM www.catawbacoungmc.gov PAYOR: Ivey, William PAYMENTS TRANSACTION NUMBER: TRC-675310-19-05-2016 PAYMENT DATE: 05/19/2016 PAYMENT TYPE: Credit Card payment by phone INVOICE NUMBER FEE NAME FEE AMOUNT 05-16-328514 Bacteriological Sample Fee $58.00 -O X16=:32851 11x1„ *w,:^":EITEMENINilratdarrnplela I iaina'il ia, gki $8'5661 TOTAL PAYMENTS : $143.00 SAM-05-2016-072553 CASE TYPE: Water Sample WORK CLASS: Multiple Different Samples SITE ADDRESS: 9524 RIVIERA DR, SHERRILLS FORD NC 28673 Applicant ALLEN TATE CO, 19460 OLD JETTON RD, CORNELIUS NC 28031 C:7046689656 KATHY.DAY.DAY@ALLENTATE .COM Paid By WILLIAM IVEY, 346 TREETOPS DR, STANLEY NC 28164 WIVEY264@CHARTER.NET ** NO PEOPLESOFT ACCOUNT ASSIGNED ** receipt 05/19/2016 09:54 Page 1 of I ,�A O Case n SAM-05-2016-072553 �� G CATAWBA COUNTY HEALTH DEPARTMENT va� Environmental Health Section 1842 sM 05/24/2016 WATER SAMPLE FIELD REPORT Applicant ALLEN TATE CO, 19460 OLD JETTON RD, CORNELIUS NC 28031 C:7046689656 KATHY.DAY@ALLENTATE .COM Paid By WILLIAM IVEY, 346 TREETOPS DR, STANLEY NC 28164 W I V EY264 @CHA RTER.NET Site Address: 9524 RIVIERA DR, SHERRILLS FORD NC 28673 Name of Project: Parcel Number: 462802563569 Lot: 1 Block: Specific Directions Hwy 150 to Sherrills Ford Rd, Right onto Island Point Rd, Left onto Riviera Dr, House is on the Left. Initial Collected by: 172 (op/ Date/Time Sampled: f3--Z4-/6 //2:20 Type of Sampling Point: Ovtr;,6a SD;>of Well New or Existing? New Existing ✓ Type of Well: Drilled r/ Bored Dug Spring City Does well meet adequate construction standards from what can be observed: ,-----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: E9 - rsamfieldreport 5/24/2016 Page 1 of 2 44BA Case# SAM-05-2016-072553 i 7 CATAWBA COUNTY HEALTH DEPARTMENT C r =a`e�►''�s H v tv �, Environmental Health Section a161P /842 sm 05/24/2016 WATER SAMPLE TEST RESULTS Applicant ALLEN TATE CO, 19460 OLD JETTON RD,CORNELIUS NC 28031 C:7046689656 KATHY.DAY @ALLENTATE .COM Paid By WILLIAM IVEY,346 TREETOPS DR, STANLEY NC 28164 WIVEY264 @CHARTER.NET Site Address: 9524 RIVIERA DR, SHERRILLS FORD NC 28673 Name of Project: Parcel Number: 462802563569 Lot: 1 Block: Lab Coliform Analysis Results: Total Coliforms: l N'LYlK/I rl Fecal /E. Coli: O1 }i- No Collection Date Over 30 hours old Invalid Results: Excessive turbidity Excessive Chlorine Lab Accident y �J Lab Tech Initials " " Date/Time Received COI R P I IMO (Date/Time Completed `�5iMu,((.D O&-J RECEIVED MAY 262016 CATAWBA COUNTY ENVIRONS"ENTAL HEALTH E9 - rsamfieldreport 5/24/2016 Page 2 of 2 n _ ( .. \ \ \ \ } : t ` ' ! } § t } � / ( } - - Co — g S ( r _ ® - 0 m ri § - - -s 2 2 { - : ` § 22 ; , % _ / ® ) / / n > \ ( % \ | 2 > t2Df r} ; § f \ \ - \ $ , _ .. I / § \ \ . / \ \ � ocg= ; eeer \ } ( ƒ / / \ \ \ « ® / } 2 ;74 ) ' ` 3 '- } 4 = N O r ±131': R - r O L N ,kx> A 1A- Y L.<7 .7/1 Private Well Information human servfees and Use Recommendations ne dapartment of health and For Inorganic Chemical Contaminants County: Catawba Name: William Ivey Sample ID#: 72553 Reviewer: M. Cash =r .,.+... ...AZ111W.M. .:,1 _a. -.-x«a a.c ,*✓:.,,v , ._. .M TEST RESULTS AND USE RECOMMENDATIONS Nitrate/Nitrites Only 1. ® 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. ❑ 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 install 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. ❑ a. Sodium levels exceed the U.S. Environmental Protection Agency's (USEPA) 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 had 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 ❑Cadmic n ['Chromium ❑Fluoride ['Iron nMagnesium ❑Manganese ❑Selenium ['Silver ❑pH ❑Zinc For more information 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: William Ivev Sample ID Number: 72553 Location: 9524 Riviera Dr. Sherrills Ford, NC 28673 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. (OA tr � CATAWBA COUNTY r9;: "6' P 0 Box 389-Newton,North Carolina 28658 -(828)465-8270 -Fax (828)465-8276 -TDD(828)465-8200 1842 I� Public Health - Environmental Health Division ALLEN TATE CO 6/6/2016 19460 OLD JETTON RD CORNELIUS NC 28031 REPORT OF WATER ANALYSIS & CONDITION OF SUPPLY Property Address: 9524 RIVIERA DR, SHERRILLS FORD NC 28673 WATER ANALYSIS This certifies that a sample of drinking water was taken from the above address on 05/24/16 and examined under laboratory number SAM-05-2016-072553. 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 On 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 SY �, �( n n Ild E.:oalH Keeping the Spirit Alive Since 1842!" GREATER HICKORY nnEnt �`" METRO E9-rsamwatersampleletter 6/6/2016 Page 1 of 1