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Home My WebLink AboutSAM-07-2016-074528.TIF �A c----- )G Case# SAM-07-2016-074528 � ,4Y; AIL e CATAWBA COUNTY HEALTH DEPARTMENT d . s►ems Environmental Health Section /$j 07/14/2016 WATER SAMPLE APPLICATION Applicant ROBERT SMITH, 4881 LEEPERS CREEK RD, MAIDEN NC 28650 H:82842803I9C:8285141318 BOBKART @CHARTER.NET Site Address: 4881 LEEPERS CREEK RD, MAIDEN NC 28650 SELECTED SAMPLES Bacterial Name of Subdivision: Parcel Number: 366604540467 Lot: Block: Specific Directions Description: Spigot on the Right side of the house past the deck. Reason for Sample:Buying Property Type of Well [ -rmifi lied_-;_'_ Is the well on this same property? I Yes,_ Is outside spigot available to collect sample? Is power on? ;No P P _ L . - Has well been tested before? I Yess r1 Results Good__ y• _ Does the plumbing come out the top of the well through a sanitary well seal? 1,=, Yes , .1 Does the well ever become cloudy or has there ever been a problem with taste and/or odor? E.LNo_ 1 Explain Does the well top extend twelve (12) inches above the ground or well slab? 1 ;' Na" '] The well is in: Does this well supply water to more than one home? I No '. :,i 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 o %more information, please contact Catawba County Environmental Health at(828)465-8270. / ��/7�9l ��: yn./ Date i / Signature or Owner or Agent ,% `t '' ""C Area 1 FEE DESCRIPTION, ' ;c ' =^ 'i DATE* , T' •.FEE AMOUNT? Bacteriological Sample Fee 07/14/2016 $58.00 n is li 'TOTAL'FFES -,-...:F'' ;r_. ,{ " . ;4 c" $5800 F's rsamapplication 7/14/2016 Page 1 of 2 PriiitrFoiim ;gip; �°!� 'Catawba County Public Health °--- CoUNT1 �e U www.catawbacowrtync.gov/environmentalhealth • qtr .` Environmental Health iF-1 'lr North Carolina P.O. Box 389, 100-A South West Blvd., Newton, NC 28658 Phone (828) 465-8270. Fax (828) 465-8276 bob/2\64 C 06lec- ad" Water Sample Application 42,5.7- _ Sample Requested By gt.//€,�j V} 3rrl ,7-7-i Home Phone - 63/y Property Address 4Y 1 Z/sEet 5 Cg -g. Lt . Business Phone Mailing Address Sitri c Driving Directions ./ It /1/+1 inE4 -Son7H'fi {a A,'FT 41 MeT gAnK 6, Ugdt/tbC 2< Pia4. 21 %/6",, Ncad- 644) (cksr /I/ AEA) �, Wil-EX, -mi�CS t (M.SMCr �a''11 Skc,as ?c� 'k, t�-?..es co. £J OA' ,�,, Coss ;.,-151)6_,= cur er 1,ii 6A lid4 Sample Requested: Bacteriological A Inorganic Chemical Other Cock fir_ Red CA 3/n cry Sample reason: actyiivg U7gC)dhd_,;y Type of Well: Drilled X Bored_ Dug Other Is the well on this same property? Yes /K No Is outside spigot available to collect sample? Yes rC No Is power on? Yes K No Has well been tested before? Yes Al No Unknown Results (j'',t Q/ 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 .' Explain Does the well top extend 12 inches above the ground or well slab? Yes No X Unknown The well is located in front rear V. left side X right side of the house. Does well supply water to more than one home? Yes No 4" Date 7 /`//4 Signature of Owner or Agent at ,flif Aar las_ "Leading the Way to a Healthier Community" z P L➢Io a C .: °Health ` .-m., gli7AA C- 1 CATAWBA COUNTY c' I00A SOUTHWEST BLVD NEWTON, NORTH CAROLINA 28658 RECEIPT Q -.eot -1; , a� e�►e�1 PHONE: 828.465.8399 'rte d v__. Thursday, July 14, 2016 1842 sM www.catawbacountync.gov PAYOR: Smith, Robert PAYMENTS TRANSACTION NUMBER: TRC-732535-14-07-2016 PAYMENT DATE : 07/14/2016 PAYMENT TYPE: Credit Card INVOICE NUMBER FEE NAME FEE AMOUNT 07-16-330415 Bacteriological Sample Fee $58.00 TOTAL PAYMENTS : 558.00 SAM-07-2016-074528 CASE TYPE: Water Sample WORK CLASS: Bacterial SITE ADDRESS: 4881 LEEPERS CREEK RD, MAIDEN NC 28650 Applicant ROBERT SMITH, 4881 LEEPERS CREEK RD, MAIDEN NC 28650 C:8284280319 ** NO PEOPLESOFT ACCOUNT ASSIGNED ** receipt 07/14/2016 08:22 Page I of I IL4y,---A- C� Case N SAM-07-2016-074528 „ i� f ii CATAWBA COUNTY HEALTH DEPARTMENT Q, 'seo K.. �o1s�� Environmental Health Section 8t�2 sM 07/20/2016 WATER SAMPLE FIELD REPORT Applicant ROBERT SMITH, 4881 LEEPERS CREEK RD, MAIDEN NC 28650 H:82842803I9C:82851413 18 BOBKART a CHARTER.NET Site Address: 4881 LEEPERS CREEK RD, MAIDEN NC 28650 Name of Project: Parcel Number: 366604540467 Lot: Block: Specific Directions Hwy 321 South to Maiden, Left at BB&T Bank onto Providence Mill Rd, Right onto East Maiden Rd & go approximately 4 miles, crossing Buffalo Shoals Rd go about I mile, Right onto Leepers Creek Rd, Cross Bridge & go up hill, House is on the Right w/ Red Pickup Truck in driveway. Initial Collected by: Date/Time Sampled: 7-204/ i 2-. Y5i.� Type of Sampling Point: ie,9t 6zrt t!f d1 c frt /// Well New or Existing? New Existing ✓ Type of Well: Drilled i.,/Bored Dug Spring City --hs .I„�If- ft)4 Does well meet adequate construction standards from what can be observed: Yes ✓ No —/luf 12- v-z ,r04 Reason for non-compliance: Defective well cap and /or seal { i 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 7/20/2016 Page 1 of 2 c A e Case u SAM-07-2016-074528 H�f 4 • �,i CATAWBA COUNTY HEALTH DEPARTMENT v 'lata: Environmental Health Section \842 51A 07/20/2016 WATER SAMPLE TEST RESULTS Applicant ROBERT SMITH, 4881 LEEPERS CREEK RD, MAIDEN NC 28650 H:82842803I9C:8285141318 BOBKART@CHARTER.NEI' Site Address: 4881 LEEPERS CREEK RD, MAIDEN NC 28650 Name of Project: Parcel Number: 366604540467 Lot: Block: Lab Coliform Analysis Results: Total Coliforms: a06P. fl Fecal / E. Coli: Oi No Collection Date Over 30 hours old Invalid Results: Excessive turbidity Excessive Chlorine Lab Accident 1 Lab Tech Initials I4 Date/Time Received On ISI ID 1 /O Date/Time Completed t/ l I`t}t IRF l WOO Ph RECEIVED JUL 2 2 2016 CATAWBA COUNTY ENVIRONMENTAL HEALTH E9 - rsamfieldreport 7/20/2016 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: Robert Smith Sample ID Number: 74528 Location: 4881 Leepers Creek Rd. Maiden NC 28650 Reviewer: M. McBride 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. 91)CATAWBA COUNTY V�� P O Box 389 -Newton, North Carolina 28658 -(828)465-8270 - Fax (828) 465-8276 -TDD(828)465-8200 Public Health - Environmental Health Division 184 ROBERT swill 8/26/2016 4881 LEEPERS CREEK RD MAIDEN NC 28650 REPORT OF WATER ANALYSIS & CONDITION OF SUPPLY Property Address: 4881 LEEPERS CREEK RD, MAIDEN NC 28650 WATER ANALYSIS This certifies that a sample of drinking water was taken from the above address on 07/20/16 and examined under laboratory number SAM-07-2016-074528. 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 NOT TO MEET adequate construction standards. Non-Comp Reason: Other No sample tap Not 12" above ground NOTES *The results of any water analysis only reflects the quality of the water at the time of the samp **Good results on improperly constructed supplies are possible, but your supply should not be considered reliable due to the potential for conatamination. 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 0pSHCARp N 'y � 1,Melh ry Ill:'wawa € "Keeping the Spirit Alive Since 1842!" aar..rA �` HICKORY ,�miem n"`' METRO E9-rsamwatersampleletter 8/26/2016 Page 1 of 1