HomeMy WebLinkAboutWCOC-04-2018-098759.TIF dy'' • CA'I'AWBA COUNTY Case WCOC-04-2018-098759
\7 [ n , Public Health Department Subdivision WYNS WEPT PH 2
An T Environmental Health Division PINK 367804612961
4"0. PO Hos 389, 100-A Southwest Blvd.Newton,NC 28658 LOP/ 38
I, .2 s.
Name on Permit JMB HOLDINGS INC, PO BOX 636, SHERRILLS FORD NC 28673
Site Address: 4561 NORTH WYNSWEPT 1)I2.MAIDEN NC 28650 ❑� :3r11;:g.
1E.
Property Size: 32,670.00 0.75 rk ., �W.� '
P nY Square Feet Acres CF
Directions: Hwy 10 to Hwy16 S.Go 7 utiles&Turn Left onto Cay ton Drive.Take Next Left onto N It f i .: '•
1.
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Wynswept Drive. Properly on the left
P It A. .!a;i . r
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WELL CERTIFICATE OF COMPLETION
WELL-01-2018-094128 INSPECTIONS
INSPECTION# COMP DATE INSPECTION TYPE STATUS INSPECTOR
EHINSP-391760 04/23/2018 Eli Well Record Received Approved EH Admin
EHINSP-391848 04/23/2018 EH Well Head Approved Jason Boyd
ElIINSP-391849 04/23/2018 EH GPS Data Collection Approved Jason Boyd
EHINSP-391268 04/17/2018 EH Well Grouting Approved Jason Boyd
Advance Well(Mike Shaw) 04/17/2018
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.
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AUTHORIZED STATE AGENT APPROVAL DATE
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