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Home My WebLink AboutWELL-08-2019-120960.TIF 'Print i, WELL CON.TRIICIION RE(:ORJ)(GW'-it For Internal(Jae Only 1,Well l nntractur Information: Robed Teague _ _ _ id.wAIRN river, — -- ��J�—� ckusj • i� _k 1. 1 C 6 J I a--- '�� ..r B&K Well Drilling Inc "• �, S.�,, T G NC Well Cennacrnr(elantart,,n Number' �� 11S.OMR CASING Pr arolskaaad walla)OR UNII.I.jt af,L !� 2857-A ;Poi ( h _ I DIA�iaT[e 1101Clinii . N, r.s Pl4►, ' 1 It• R, ' e v1 la. 1,4 ,4 Company sarree -. -_---— / `r16,1NNER CASING OR TURING Open ta_ai riae rW eTu,.l 11 O [__ n — ! ►w0N 'to muNLTER tniCantas 2.1Vc11 Construction Perini,'N: ,J� l«<777 ft— ft. !n, l.,u nil apphcablr uetl,onunn llal perarnr!t a Uk Loamy.Sine Yana'',e,nit t t } 3.Well L w fr. ft. in.!check well use): .1Water Supply Will: 17,SCREED Pewit Tu mamma : iLA)T WI_i_a_gri illi i NtT A7 •Ayrtrul'utal 0SIuntcipa1Public ft. ft. is. i I Gmihumd(Hcaun&Cowling Supply) Residential Water Supply(single) IL ft. in. 1 --j •In 1ustnabComnlerciai Residential Water Supply isharedl te,GROUT il liii t ki(inn i'AWI To sla71 L44. IF 41111 AC6KFN 7 f2TTW�6-t T2i,i. Van-Water Supply Well: ft. ft. • •lnnitonn fee G. �- L' Recovery Injection) e : l '— �— ft. I fie 1 I Aquifer Recharge °Groundwater Remcdtryton 19 SANDIGRAVEL PACK ifs u,lkabltt I Aquifer Storage and Recovery °Salinity Harrier form 110 tM?LSeoturt si Hop Aquifct Test 0Stormwatcr Drainage It ft. Expenmental Technology °Subsidence Conitol ft. , ft. Geothermal)Closed Loop) °Tracer 24.DRILLING LO (attack additional'hub if roes "m3ronm. iNO'O TO oescairiOr: eats,ha • Geothermal Hatin Cool/in•Return) ■Other ex.lain under N21 Remarks n .ella�� - J rt J.Dale Well(al Compltudlr-,• I) •..Z Well IDS ft• . C - I S �.'�C — de f c ft.' rt. Sa.Well Location: e 1• /p Ii. ft. c° 11 1-6 h�S h. ft. Fa.diry10wr.er Name Facility tDe Iifapplicable) ft. 1 ft. 1 Phyucsl Address.City.mid Zip 1 h. ( ft. I. 31.REMARKS County Parcel Ideni ficmictit Ni.i PIN) Sb.Latitude and longitude In degreeulminutes/secunda or decimal degrees: - (dwell field,one Won;is CIfrc c,C) 22.Certification: Siaai,wn.d rti6.JWillCann, r z'�' Dot. 6.blare)the well(s)OPermanenl at QTempnrary rrrrRRRR��`�'''' 9�!Tung Phu form.I hock:cerf 6.that rho nrllr4 min r*ercl cownucied atarcordan:r 7,is this a repair to an existing well: °Yes or n nnh 1.fA,CAC NC 01170 an U.4.NCAC d!C 0200 1+a!!Cun,nuena 1,n StunJa, and that a If Phu it a/cyan,fill our known well rnn iructton information a r. lain the nanur of the caps of rnn word itat hem prn•ndcd to the well owner rrlwir under 121 renturks xn.'nnn urn the hair of hi.[ann• , 23.Site diagram or additional well deans. You may use the back of thispage to provide additional well sire details or well 6.For Geoprobe/DPT or Cloud-Loop Geothermal Wells having the same constriction details. You may also attach additional pages if necessary. construction.only)OW-1 is needed. Indicate TOTAL NUMBER of wells drilled: [ SUBMITTAL INSTRICT IONS 9.Total well depth below land surface: 1.J (It.) 24a. For All Weill: Submit this form within 30 days of completion of Nell For multiple well,lot all dryvio i(difTTrrnl i,:ramp/r-3 a'00•and 2(?7,10t11 COn51RIC1iO0 to the following 10.Static water level below top of casing:40 (ft) Division of Water Resources.Information Processing Unit. If,wro Er,ri a aMre cnrtiv,use"•' 1617 Mail Service Center,Raleigh,NC 27699-1617 11.Borehole diameter: 6 11`8 (in.) 2db.For Injection Wtlll: In addition to tending the form to the address in Na Air Rotary above.also submit one copy of this form within 30 days of completion of well I2.Vlell construction method: construc:on to the toilossin,t: tie auger.rotary.cable.direct push.etc.) Division of Water Resources,Underground Injection Control Program, FOR WATER SUPPLY WELLS ONLY: 1636 AtaD Service Center,Raleigh.NC 27699-1636 13a.Yield(gpm) Method of test:Air Flow 24c.For Water Supply,Silnlection Wells: In addilioa to sending the form to the aJdtcsslcs) above, also submit one copy of this form within 30 days of Chloe Tabs Amount: t 'i2`aa .oinpletiou of well Conlltn vmOru to the count)' health deparoowt of the county Lab.Disinfection type: when cunsu•JLIcJ. Form OW-1 Nonh Caeoiina Department of En+rronrnrn'i Quality•D.stamoii of Water P.e,otrcet Revised:-2b2016 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: Andrew&Juli Haines Sample ID Number: 120960 Location: 6193 Sulphur Springs Rd, Hickory NC 28601 Reviewer: Megen 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 your water sample. Total Coliform are a group of related bacteria that are(with few exceptions) not harmful to humans. A variety of bacteria, parasites,and viruses, known as pathogens, can potentially cause health problems if humans ingest them. EPA considers total coliforms a useful indicator of other pathogens for drinking water. Total coliforms are used to determine the adequacy of water treatment and the integrity of the distribution system It is recommended that your well water be re-tested to verify that the result is accurate. Fecal coliform bacteria were detected in the sample. I)o 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). "I'he 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. N 0 R T H C A R 0 L I N A ,�r`3 W*aTf n�o9' Private Well Information r N i. �t:ys • `tic • P _C • i• QU.a. • „ and Use Recommendations NC DEPARTMENT OF HEALTH AND HUMAN SERVICES Division of Public Health For Inorganic Chemical Contaminants County: Catawba Name: Andrew&Juli Haines—6193 Sulphur Springs Rd, Hickory NC 28601 Sample ID#: 120960 Reviewer: Megen McBride TEST RESULTS AND USE RECOMMENDATIONS 1. ® Your well water meets federal drinking water standards for inorganic chemicals. Your water can be used for drinking, cooking, washing, cleaning, bathing, and showering based on the inorganic chemical results only.You may have other water sampling results that are not taken into account in this report. 2. ❑ The following substance(s)exceeded federal drinking water standards or the North Carolina 2L calculated health levels.The North Carolina Division of Public Health recommends that your well water not be used for drinking and cooking, unless you install a water treatment system to remove the circled substance(s). However, it may be used for washing, cleaning, bathing and showering based on the inorganic chemical results only. ❑ Arsenic El Barium ❑ Cadmium ❑ Chromium ❑ Copper ❑ Fluoride ❑ Iron ❑ Lead ❑ Manganese ❑ Mercury El Nickel El Nitrate/Nitrite El Selenium ❑ Silver El Zinc 3.❑ While your lead levels do not exceed federal or state standards, the North Carolina Division of Public Health has concerns with any detection of lead. Should you have any questions please contact the NC Private Well and I Iealth Program at(919) 707-5900. 4. El Re-sample for lead and/or copper. Take a first draw and 30-second flush sample inside the house (preferably the kitchen sink)and a first draw and 4 minutes flush sample at the wellhead to determine the source of lead and/or copper. 5. El The following substance(s)exceeded aesthetic drinking water standards. Your water can be used for drinking, cooking, washing, cleaning, bathing, and showering based on the inorganic chemical results only, but aesthetic problems such as bad taste, odor, staining of porcelain,etc. may occur. You may want to install a household water treatment system to address aesthetic problems. El Chloride El Copper El Fluoride ❑ Iron El Manganese ❑ pH ❑ Silver ❑ Sulfate ❑ Zinc 6. El a. Sodium levels exceed the U.S. Environmental Protection Agency's(USEPA) Health Advisory level for sodium of 20 mg/1. The North Carolina Division of Public Health recommends that only individuals on no or low sodium-restricted diets not use this water for drinking or cooking. It may be used for washing, cleaning, bathing, and showering based on the inorganic chemical results only. ❑ b. Your sodium level exceeds 30 mg/I and may pose aesthetic issues such as bad taste, odor, staining of porcelain, etc. 7. ❑ Re-sampling is recommended in months, to reinvestigate . For more information regarding your well wafer results,p/ease call the North Carolina Division of Public Health at 919-707-5900.