HomeMy WebLinkAboutWCOC-08-2016-075170.TIF ,A • CATAWBA COUNTY Case# WCOC-08-2016-075170
if&&p ' Public Health Department Subdivision CHARLES WILSON AND WI
< Environmental Health Division PIN/I 460701366801
� � PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 LOT# 9
/842
9
Name on Permit *MATT BECKHAM, 144 ARBOR RIDGE RD, MOUNT HOLLY NC 28120
Site Address: 3612 DOCKSIDE LN, SHERRILLS FORD NC 28673 ❑� *" fQ
Property Size: Square Feet 23,522.40 Acres 0.54 '�. 'Jjt
Directions: from Charlotte/Hwy 16N/right 150E/left Mt Pleasant Rd/right Dockside Ln/property on left 'o'• ''O.
(old red&white mobile home on left , T
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WELL ABANDONMENT CERTIFICATE OF COMPLETION
Well Type: Individual Well - Dug
WELL-10-2015-066109 INSPECTIONS
INSPECTION# COMP DATE INSPECTION TYPE STATUS INSPECTOR
EHINSP-319879 11/12/2015 EH Well Abandonment Report Approved EH Admin
Received
EHINSP-310807 11/12/2015 EH Well filled with approved Approved Jason Boyd
material
EHINSP-310805 11/12/2015 EH Well Disinfected Approved Jason Boyd
EHINSP-310804 11/12/2015 EH Well Capped with Concrete Approved Jason Boyd
EHINSP-310806 11/12/2015 EH Well Abandonment Approved Jason Boyd
Observed
Contractor - B & K Well Drilling 11/12/2015
ABANDONED BY DATE OBSERVED
Jason Boyd 08/01/2016
AUTHORIZED STATE AGENT APPROVAL DATE
eheelIeoe 08/01/2016 10:47 Page I of I