HomeMy WebLinkAboutTri County Grill Water Sample 06 21 16.LS.PDF -13A Case# FLI-0000123
is f II G� CATAWBA COUNTY HEALTH DEPARTMENT
V ,� ; Environmental Health Section
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WATER SAMPLE FIELD REPORT
TRI COUNTY GRILL
3700 NC 18 HWY, VALE NC
Site Address: 3700 NC 18 HWY, VALE NC
Parcel Number: 265704540635 Lot: Block:
Initial Collected by: Date/Time Sampled: (o7--/bfr //- 9Q.Yy7,
Type of Sampling Point: 5:///K
Well New or Existing? New Existing
Type of Well: Drilled oL Bored Dug Spring City
Does well meet adequate construction standards from what can be observed: 0(1 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:
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$A Case# FLI-0000123
ET 14 ' CATAWBA COUNTY HEALTH DEPARTMENT
v �P Environmental Health Section
18 4 2 sM 06/21/2016
WATER SAMPLE TEST RESULTS
TRI COUNTY GRILL
3700 NC 18 HWY, VALE NC
Site Address: 3700 NC 18 HWY, VALE NC
Parcel Number: 265704540635 Lot: Block:
Lab Coliform Analysis Results: Total Coliforms: ary\tn-i Fecal /E. Coli:
No Collection Date Over 30 hours old
Invalid Results: Excessive turbidity Excessive Chlorine
Lab Accident
0,013111U II' _ 11160
Lab Tech Initials Date/Time Received AL:L7 Date/Time Completed WI M 14) a
RECEIVED
JUN 2 3 2016
CATAWBA COUNTY
ENVIRONMENTAL HEALTH
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