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Home My WebLink AboutSAM-06-2016-073740.TIF $A CO Case# SAM-06-2016-073740 /c °�'� .7 CATAWBA COUNTY HEALTH DEPARTMENT °Pe1sa►e� Environmental Health Section I /8 4 /r..1 06/20/2016 WATER SAMPLE APPLICATION Applicant JERRY WILLARD, 2125 PAYSEUR ST, MAIDEN NC 28650 C:8282346514 Site Address: 2125 PAYSEUR ST, MAIDEN NC 28650 SELECTED SAMPLES Bacterial Name of Subdivision: Parcel Number: 365713133091 Lot: 32 Block: C Specific Directions Description: **Requesting sample to be taken from Kitchen Sink. Reason for Sample:Odor in Kitchen Sink & Washing Machine Type of Well j lI Drilled " - - lli1111 Is the well on this same property? f YegC Is outside spigot available to collect sample? tla:?vrNolhliL i1 Is power on? 11pyl 'Yes Has well been tested before? FAIENOTEED Results nnm Does the plumbing come out the top of the well through a sanitary well seal? Unknow`njj Does the well ever become cloudy or has there ever been a problem with taste and/or odor? =Y-'es 2 J Ex lain NotI,C!Odd"iO'dorroril° 2"uss `n I ,, ; ti.'...F,rint,Forrriw ; cAT , `, " , Catawba County Public Health COUNTY : www.catawbacountync.gov/envirmuncntalhcalth ;,; �f u ;tk Environmental Health North Coroltna P.O. Box 389, 100-A South West Blvd., Newton, NC 28658 Phone (828) 465-8270. Fax (828) 465-8276 Water Sample Application q Sample Requested By -Jerry J . Oil lay �p Home Phone g — 23y/ - & .ri/tf Property Address ai . 5 PAty.seur Si-. MtrtdPn N Business Phone Mailing Address I. t - t ` I• f 2PGSn Si / Driving Directions 'TQK-t 1/4_,_56- e bt, t0N.�- �« . �t� Ea r 7D Clyde e ST' enAvtA t%Lk+) e 4 of r.ivoft t turkt YI3Itii pu10 PaYsear. ( Cr � Sample Requested: Bacteriological /Inorganic Chemical � Other Sample reason: O490`r Kt fe ,4 td Si Sivl r'l 0.-QC st e__° Type of Well: Drilled Bored Dug Other Is the well on this same property? Yes l.""No / // Is outside spigot available to collect sample? Yes No ✓ Is power on? Yes t/ No / Has well been tested before? Yes No ✓ Unknown Results / Does the plumbing come out the top of the well through a sanitary well seal? Yes No Unknown i/ Does the water ever become cloudy or has there ever been a problem with taste or odor? Yes No Explain 00 3l" Clou.-&y ., Lo [`� nHLy �, LUQ . Does the well top extend 12 inches above the ground or well slab? Yes No Unknown The well is located in front rear �/ left side right side of the house. / Does well supply water to more than one home? Yes No ✓ Date Cs 720/-20/ 49 Signature of Owner or Agent (9- 1,47 l,(J. v-1 3 d '— "Leading the Way to a Healthier Community" Public °' N . °Health r �A CACAWBA COUNTY Ell �i IOOA SOUTHWEST BLVD a L; NEWTON, NORTH CAROLINA 28658 RECEIPT Rr,w.:�'r b it WWI /.-f PHONE: 828.465.8399 K,._p� Ivdsv Monday, June 20, 2016 842 Stt \ww.catawbacountync.gov PAYO R: \VILLARD, JERRY PAY NI ENTS TRANSACTION NUMBER: TRC-696880-20-06-2016 PAYMENT DATE : 06/20/2016 PAYMENT TYPE: Credit Card INVOICE NUMBER FEE NAME FEE AMOUNT 06-16-329648 Bacteriological Sample Fee $58.00 TOTAL PAYMENTS : $58.00 SAM-06-2016-0737=10 CASE TYPE: Water Sample WORK CLASS: Bacterial SITE ADDRESS: 2125 PAYSEUR ST, MAIDEN NC 28650 Applicant JERRY WILLARD, 2125 PAYSEUR S1, MAIDEN NC 28650 C:8282346514 ** NO PEOPLESOFT ACCOUNT ASSIGNED ** receipt 06/20/2016 16:31 Page 1 of 1 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: Jerry Willard Sample ID Number: 73740 Location: 2152 Payseur St. Maiden, NC 28650 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.) 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. X_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. ijft�, CATAWBA COUNTY d r",t,4 .< P O Box 389-Newton, North Carolina 28658 -(828)465-8270 - Fax (828) 465-8276 -TDD(828)465-8200 Clj "f"'° Public Health - Environmental Health Division /842 sm JERRY WILLARD 7/11/2016 2125 PAYSEUR ST MAIDEN NC 28650 REPORT OF WATER ANALYSIS & CONDITION OF SUPPLY Property Address: 2125 PAYSEUR ST, MAIDEN NC 28650 WATER ANALYSIS This certifies that a sample of drinking water was taken from the above address on 07/05/16 and examined under laboratory number SAM-06-2016-073740. Laboratory findings reveal that this sample was potentially unsafe and should not be used unless boiled or otherwise disinfected. Steps need to be taken to correct the condition of your water supply. CONDITION OF SUPPLY Your water supply was observed to MEET adequate construction standards (in regards to well head protection). 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 ?q4 d d NNii Sf.:: 4, in a 9 s'IPzooezo z 11.€i "Keeping the Spirit Alive Since I842!"fi HICKORY GREATER HICKORY e( m?cp METRO S.E9-rsamwatersampleletter 7/11/2016 Page 1 of 1