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HomeMy WebLinkAboutSAM-06-2016-073667.TIF CCA C Case# SAM-06-2016-073667 i 4 CATAWBA COUNTY HEALTH DEPARTMENT U Pao Environmental Health Section \842 sm 06/17/2016 WATER SAMPLE APPLICATION Applicant JOSEPH ANDERSON, 2532 CAMELIA POINTE DR, SHERRILLS FORD NC 28673 H:7049660790C:7186668634 ANDERJOE313 @AOL.COM Site Address: 2532 CAMELIA POINTE DR, SHERRILLS FORD NC 28673 SELECTED SAMPLES Bacterial Name of Subdivision: Parcel Number: 462801275893 Lot: 43 Block: Specific Directions Description: Bacteriological Only* Reason for Sample:New Home Ownership Type of Well Drilled '• t;'; Is the well on this same property? "`:-Ye"s?,I'rllw;IIJ. Is outside spigot available to collect sample? �f!I�Yes ;; r Is power on? MI I Yes-111 Has well been tested before? l:Unknownfd Results Does the plumbing come out the top of the well through a sanitary well seal? aliJnknown Does the well ever become cloudy or has there ever been a problem with taste and/or odor? Fa= Explain =VP ' . %u 0Sl'ip Il141t111 ' Z(MM4@ENidi .,'fly Does the well top extend twelve (12) inches above the ground or well slab? __ The well is in: rignillihv",Front 'with"dr:4 l Does this well supply water to more than one home? gin( Nd"ei , 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 �'7 71/ Signature or Owner or Agent uL V tlrial Area 1 I FEE DESCRIPT4ORI ! �{Iw i' l IIV DATEt i���j FEF!AMOUN Cl Bacteriological Sample Fee 06/17/2016 $58.00 rNfI 1tI ' ��i 1j,1Ii TOTAL F4.5.11 11111LIIt4 r 'Nihhill!t. U'nf (�III���IIR� at�Ilu��dl�l�� $5820,Oi�� LIU."">I ��I 1 lunafDIII aiBUliAi@HWWWUuW7f .,.ri. JJLiidlllr.t YIO.,aze:Lt. .44niuUh 5.91fIlAnourr, lnftR1yl t.,t rsamapplication 6/17/2016 Page 1 of 2 [Print Form cATAI Catawba County Public Health COUNTY www.catawbacountync.gov/environmentalhealth —�_ Environmental Health Nofa'Carolif°_ P.O.Box 389, 100-A South West Blvd., Newton,NC 28658 Phone(828)465-8270.Fax(828) 465-8276 1 RI) E j 3i3 oe. © avi , cam) {W/- f\Sample Application p Sample Requested By t GS ' ! U�IXe" Hom hone��� ^ l V ra J , Property Addres .el) � p . IP r t JBusinessPhone 712-666163 9 Mailing Address l �l.Cii�/(.Ili(„c - -6.4 LC 3)(6-1 Driving Directions She rri I k r el d a, t o ii 10 k PO li14e RA fa c 1 S\o\ QiCIt Di , Sample Requested: Bacteriological /1 Inorganic Chemical f�) nnn1 N. Sample-reason: — r €V) \�—., ,J �Y °-�1 ,G's, Type of Well: Drilled A Bored Dug Other ( ' V� J\T Is the well on this same property? Yes X No Is outside spigot available to collect sample? Yes 4.)( No rower 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-sanitary well seal? Yes No Unknown k Does the water ever become cloudy or has there ever been a problem with taste or odor? Yes No_ Explain 0 nks\o- f\ Does the welltop extend 12 inches above the ground or weWslab? Yes x No Unknown The well is located in front X rear left side right side ;41 of the house. \ / Does well supply water to more than one home? Yes No X Date 1 I � n a 2()1v Signature of Owner or Agent C ,►itt, t ial \ \ "Leading the Way to a Healthier Community" 3zpllthl c ...-~\ - k , °Health C=/t-0 >) ot;.. `il B-k CATAWBA COUNTY O 100A SOUTHWEST BLVD NEWTON,NORTH CAROLINA 28658 RECEIPT pmam� evaP PHONE: 828.465.8399 U l wa �'C Friday, June 17, 2016 1847, sm www.catawbacountync.gov PAYOR: Anderson,Joseph PAYMENTS TRANSACTION NUMBER: TRC-693884-17-06-2016 PAYMENT DATE: 06/17/2916 PAYMENT TYPE: Credit Card INVOICE NUMBER FEE NAME FEE AMOUNT 06-16-329581 Bacteriological Sample Fee $58.00 TOTAL PAYMENTS : S58.00 SAM-06-2016-073667 CASE TYPE: Water Sample WORK CLASS: Bacterial SITE ADDRESS: 2532 CAMELIA POINTE DR, SHERRILLS FORD NC 28673 Applicant JOSEPH ANDERSON, 2532 CAMELIA POINTE DR, SHERRILLS FORD NC 28673 H:7049660790C:7186668634 ANDERJOE313 @AOL.COM ** NO PEOPLESOFT ACCOUNT ASSIGNED ** receipt 06/17/2016 1437 Page 1 of 1 ICA Case d SAM-06-2016-073667 O�ti , 1 CAIAWBA COUNTY HEALTH DEPARTMENT P �' Environmental Health Section /8 41 sM 06/22/2016 WATER SAMPLE FIELD REPORT Applicant JOSEPH ANDERSON, 2532 CAMELIA POINTE DR, SHERRILLS FORD NC 28673 H:7049660790C:7186668634 ANDERJOE3I3 @AOL.COM Site Address: 2532 CAMELIA POINTE DR, SHERRILLS FORD NC 28673 Name of Project: Parcel Number: 462801275893 Lot: 43 Block: Specific Directions Sherrills Ford Rd coming South at Sherrills Ford Elemenetary, left onoto Island Pointe Rd, Left onto Camelia Pointe Dr, 1-louse is on the Right. Initial Collected by: 12_ I Date/Time Sampled: G,e2:1-_16/ / I2_ Type of Sampling Point: 0vh1 L CYI)Ipi- Well New or Existing? New Existing 1.7- Type of Well: Drilled ✓ Bored Dug Spring City Does well meet adequate construction standards from what can be observed: I Yes No �// // I Reason for non-compliance: Defective well cap and /or seal T Cam no-f- b¢ %LT-srmN-0-q 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 6/22/2016 Page 1 of 2 41V)A C� Case 4 SAM-06-2016-073667 NT fl $ G, CATAWBA COUNTY HEALTH DEPARTMENT rm`'1335i►1 y Environmental Health Section U ��'4114,C o-' � /842 sm 06/22/2016 WATER SAMPLE TEST RESULTS Applicant JOSEPH ANDERSON, 2532 CAMELIA POINTE DR, SHERRILLS FORD NC 28673 H:7049660790C:7186668634 ANDERJOE313 @AOL.COM Site Address: 2532 CAMELIA POINTE DR, SHERRILLS FORD NC 28673 Name of Project: Parcel Number: 462801275893 Lot: 43 Block: Lab Coliform Analysis Results: Total Coliforms: n-li.tne..f Fecal / E. Coli: Ci2A4 No Collection Date Over 30 hours old Invalid Results: Excessive turbidity Excessive Chlorine Lab Accident Lab Tech Initials Date/Time ReceivedGDI 1W 141-1 Date/Time Completed OrO/o164/3'0n, /61'c 's RECEIVED JUN 2 4 2016 CATA'vVBA COUNTY ENVIRONMENTAL HEALTH E9 - rsamfieldreport 6/22/2016 Page 2 of 2 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: Joseph Anderson Sample Ill Number: 73667 Location: 2532 Camelia Point Dr. Sherri lls Ford. NC 28610 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 coli form 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. �A , �G, CATAWBA COUNTY cJ Ikipo P 0 Box 389 - Newton, North Carolina 28658 -(828) 465-8270- Fax(828)465-8276 - TDD(828)465-8200 �'4/ Public Health - Environmental Health Division 1842 sM JOSEPH ANDERSON 6/30/2016 2532 CAMELIA POINTE DR SHERRILLS FORD NC 28673 REPORT OF WATER ANALYSIS & CONDITION OF SUPPLY Property Address: 2532 CAMELIA POINTE DR, SHERRILLS FORD NC 28673 WATER ANALYSIS This certifies that a sample of drinking water was taken from the above address on 06/22/16 and examined under laboratory number SAM-06-2016-073667. Laboratory findings reveal that this sample was FREE from coliform bacteria at the time of collection of the sample. CONDITION OF SUPPLY NOTES *The results of any water analysis only reflects the quality of the water at the time of the sampling. If you have any questions concerning your water sample analysis, please call me at the number bel Robbie Phelps (828)320-3077 Environmental Health Specialist eareAeo„Nlp r alrH �nd 1,2, '1� B;.=o o i";1.;3 Spirit p Nix --„ Ct�emiz 8 ”Keeping/he i Alive Since 1842i�r GREATER - rt " rl HMETRO E9-rsamwatersampleletter 6/30/2016 Page 1 of 1