HomeMy WebLinkAboutWELL-10-2020-140124.tif $A C� Case# WELL-10-2020-140124
�� CATAWBA COUNTY HEALTH DEPARTMENT
7 Environmental Health Section
g 4 Z SM 06/21/2023
WATER SAMPLE FIELD REPORT
Owner CHARLES III MOORE, 171 PLANTATION DR,MOORESVILLE NC 28117-5820
C':7043018910 CHARLES.MOORE a,LPL.COM
Contractor *MASHBURN DEVELOPMENT,INC., 19242 LAKE NORMAN COVE DR,CORNELIUS NC 28031
C:7045764907 ANDREW@MASHBURNDEVELOPMEN1'.COM
Site Address: 2569 Mt Pleasant RD,Sherrills Ford NC 28673
Parcel Number: 460801272351
Driving Directions From sherrills 1I ford rd turn W on Mt Pleasant Rd Approx 1/4 mile on right large gravel drive
Sample Collected by: �l is Lt Im ; I�etL1 Date/Time Sampled: D7,12ti/2.3 // r 0 Ar-N
Sampling Point: 3QY►...? -Q O�
Is well head accessible? Yes ✓ No Reason for inaccessibility
Well New or Existing? New Existing
Type of Well: Drilled V Bored Hand Dug Punch
Does well meet adequate construction standards from what can be observed: Yes No
Items of non-compliance: Evidence of improper grouting or no grouting
Well does not meet a required setback(comment)
Improperly constructed sanitary well seal
Well head not term at>= 12"above finished grade
Well head missing vent
Well head does not have a threadless tap
Well missing identification plate or pump tag
Wire conduit opening not sealed
Other(comment)
Comment:
rsamfieldreport 06/21/2023 11:07 Page I oft
�.1�A Co Case# WELL-10-2020-140124
�� CATAWBA COUNTY HEALTH DEPARTMENT
Environmental Health Section
Ig 42 cm 06/21/2023
WATER SAMPLE TEST RESULTS
ncr CHARI.,ES III MOORE. 171 PLANTATION DR,MOORESVILLE NC 28117-5820
C:7043018910 ('I IARI,ES.MOORE@LPL.COM
( tom actor *MASHBURN DEVELOPMENT,INC., 19242 LAKE NORMAN COVE DR,CORNELIUS NC 28031
C:7045764907 ANDREW a,MASHBURNDEVELOPMENT.COM
Site Address: 2569 Mt Pleasant RD,Sherrills Ford NC 28673
Parcel Number: 460801272351
Lab Coliform Analysis Results: Total Coliforms: obv^" 'i- Fecal/F.Coli: 00001
No Collection Date Over 30 hours old
Invalid Results: Excessive turbidity Excessive Chlorine
Lab Accident
Lab Tech Initials CAI Date/Time Received g Date/'Time CompletedWV OH
RECEIVED
JUL 2
Environmental Heal+.h
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