HomeMy WebLinkAboutWCOC-06-2016-073050.TIF 4 CATAWBA COUNTY Case# WCOC-06-2016-073050
APublic Health Department Subdivision LAKEPOINTE SOUTH
QVIR(Al 0a Environmental Health Division PIN# 462801269196
PO Box 389, 100-A Southwest Blvd, Newton,NC 28658 LOT# 16
/8. 1 ,
Name on Permit KENNETH JAMISON, 2612 PENNGATE DR, SHERRILLS FORD NC 28673
Site Address: 9271 BELLE PINES CT, SHERRILLS FORD NC 28673 0 0"..-1., ,0
Property Size: Square Feet 31,363.20 Acres 0.72 • {]t
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Directions: 150 to Shetrills Ford Rd to Island Point Rd to Camden Points Rd turn R go to Belle Pines �` ? a ; •• r
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WELL CERTIFICATE OF COMPLETION
WATER SUPPLY: Well Type: Individual Well
WELL-10-2015-065755 INSPECTIONS
INSPECTION# COMP DATE INSPECTION TYPE STATUS INSPECTOR
EHINSP-326991 06/02/2016 EH GPS Data Collection Approved
EHINSP-326990 06/02/2016 EH Well Head Approved Jason Boyd
EHINSP-326903 06/01/2016 EH Well Record Received Approved EH Admin
EHINSP-326922 06/01/2016 EH Well Grouting Approved Jason Boyd
B & K Well Drilling 06/01/2016
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.
Jason Boyd 06/02/2016
AUTHORIZED STATE AGENT APPROVAL DATE
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