HomeMy WebLinkAboutWCOC-08-2016-075195.TIF \51 CATAWBA COUNTY Case# WCOC-08-2016-075195
I Public Health Department Subdivision
4<, `(; Environmental Health Division PIN# 368902581117
PO Box 389, 100-A Southwest Blvd,Newton, NC 28658 LOT/ 2
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Name on Permit JOSEPH LASALA, 116 KILBORNE RD, MOORESVILLE NC
Site Address: 5467 THREE SISTERS LN, CATAWBA NC 28609 Et�� S,
Property Size: Square Feet 43,560.00 Acres t `�• • L
Directions: travel N Sherrills Ford RD, Turn Son Buffalo Shoals RD, 1/4 mile turn left onto Battle Run ' I •
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Community,right onto Muskey DR at the end on the end _�:tr �
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WELL CERTIFICATE OF COMPLETION
WATER SUPPLY: Well Type: Individual Well
WELL-04-2016-071586 INSPECTIONS
INSPECTION# COMP DATE INSPECTION TYPE STATUS INSPECTOR
EI-IINSP-332154 07/25/2016 EH Well Head Approved Robbie Phelps
EHWSP-332153 07/25/2016 EH GPS Data Collection Approved Robbie Phelps
EFIINSP-326264 05/25/2016 EH Well Record Received Approved EH Admin
EHINSP-324239 05/04/2016 EH Well Grouting Approved Robbie Phelps
Advance Well 05/04/2016
WELL DRILLER DATE DRILLED
Well permits are valid for 5 years from the date of issuance and are subject to suspension and/or revocation from
non-compliance with appropriate state and local rules and regulations, or if false information was given in order to obtain a
permit. Wells shall be constructed in accordance with all state and local regulations and rules.
The Well Completion Report must be submitted to the Health Department within 30 days upon completion of a well.
Robbie Phelps 07/25/2016
AUTHORIZED STATE AGENT APPROVAL DATE
elmellcoc 08/02/2016 09:36 Page I of I