HomeMy WebLinkAboutWCOC-08-2016-076119.TIF �� • CATAWBA COUNTY Case# WCOC-08-2016-076119
.Q' P . ! Public Health Department Subdivision
—.`'r�y �,ti Environmental Health Division PIN#
366702880506
tti. PO 13ox 389. 100-A Southwest Blvd,Newton,NC 28658 LOT// 9
180 �^
Name on Permit 'AMERICA'S HOME PLACE/ STATESVILLE, 1206 GREENLAND DR, STATESVILLE NC 28677
Site Address: 3654 N OLIVERS CROSS RD, NEWTON NC 28658 a- 67 r J.
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Property Size: Square Feet 40,946.40Acres Ci• -
Directions: HWY 16 S.N OLIVERS CROSSROADS, LEFT PAST RUHAMA CHURCH RD WILL BE OPEN r k r A�
FIELD WITH MAILBOX#SIGN FOR 3652 � �• �To }
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WELL CERTIFICATE OF COMPLETION
WATER SUPPLY: Well Type: Individual Well
WELL-06-2016-073805 INSPECTIONS
INSPECTION# COMP DATE INSPECTION TYPE STATUS INSPECTOR
EHINSP-334396 08/24/2016 EH Well Record Received Approved EH Admin
EFIINSP-334262 08/22/2016 EH Well Head Approved Robbie Phelps
EFIINSP-334261 08/22/2016 EH GPS Data Collection Approved Robbie Phelps
EHINSP-334260 08/19/2016 EH Well Grouting Approved Robbie Phelps
Russell Well Drilling, Inc. (Chris Russell) 08/10/2016
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 08/24/2016
AUTHORIZED STATE AGENT APPROVAL DATE •
ehwelleoe 08/24/2016 16:25 Page 1 of 1