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HomeMy WebLinkAboutWELL-06-2021-152174.TIF `,STATt. 4312 District Drive ;,�i . North Carolina State Laboratory of Public Health Msc,916 v Raleigh,NC 27699-1918 ..� Environmental Sciences http:f/slph.ncpublichealth.com '<;,:: 1,- Phone: 919-733-7308 Inorganic Chemistry Fax: 919-715-8611 Certificate of Analysis FINAL REPORT Report to: ENVIRONMENTAL HEALTH Name of System: CATAWBA COUNTY ENVIRONMENTAL HEALTH Catawba County P 0 BOX 389 6554 Little Mtn Rd NEWTON, NC 28658 Sherrills Ford, NC 28673 EIN: 566001814EH Delivery: NC Courier StarLiMS ID: ES220414-0011 Date Collected: 04/12/2022 Time Collected: 10:23 By: Blake Perkins Date Received: 04/14/2022 Time Received: 07:39 Sample Type: Raw Sampling Point: Sample tap Well Permit No. WELL-06-2021-152174 Sample Source: New Well Receipt Temp. : GPS Number: Profile: New Well-No Nitrate I Analyte Test Result Allowable Limit Unit Qualifier(s) Arsenic <0.001 0.010 mg/L Barium <0.1 2.0 mg/L Cadmium <0.0001 0.005 mg/L um Calci 8 -------._--------•--- mg/L Calcium _...... ...—_._.. Chloride <5 250 mg/L Chromium <0.02 0.10 mg/L Copper 0.01 1.3 mg/L Fluoride <0.1 4.00 mg/L Iron 0.22 0.30 mg/L Lead <0.003 0.015 mg/L Magnesium 2 mg/L Manganese 0.02 0.05 mg/L Mercury <0.0004 0.002 mg/L Nickel <0.01 0.1 mg/L pH 7.6 N/A Selenium <0.005 0.05 mg/L Silver <0.01 0.10 mg/L Sodium _ _ 5.5 mg/L Sulfate <5 250 mg/L Total Alkalinity 60 mg/L Total Hardness 27 mg/L Zinc 14.74 5.0 mg/L Report Date: 05/04/2022 Reported By: Marc Komlos Page 1 of 1 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: Catawba County Sample ID Number: 152174 Location: main building well, Mountain Creek Park—6554 Little Mountain Rd, Sherrills Ford,NC 28673 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. Do 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).The 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 K ,jamTAT�HO Private Well Information WI�:: y'� �Z iiJ and Use Recommendations NC DEPARTMENT OF HEALTH AND HUMAN SERVICES Division of Public Health For Inorganic Chemical Contaminants County: Catawba Name: main building well, Mountain Creek Park 6554 Little Mountain Rd. Sherrills Ford,NC 28673 Sample ID#: 152174 Reviewer: Megen McBride TEST RESULTS AND USE RECOMMENDATIONS 1. n 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 on(v. ❑ Arsenic ❑ Barium ❑ Cadmium ❑ Chromium ❑ Copper ❑ Fluoride ❑ Iron n Lead ❑ Manganese ❑ Mercury ❑ Nickel n Nitrate/Nitrite ❑ Selenium ❑ Silver ® 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 Health Program at(919)707-5900. 4. ❑ 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. ❑ 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. ❑ Chloride ❑ Copper ❑ Fluoride ❑ Iron ❑ Manganese ❑ pH ❑ Silver ❑ Sulfate n Zinc 6. ❑ a. Sodium levels exceed the U.S. Environmental Protection Agency's(USEPA) Health Advisory level for sodium of 20 mg/I. 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 on(v. ❑ 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 water results,please call the North Carolina Division of Public Health at 9/9-707-5900. Zinc & PRIVATE WELLS i si What is zinc? Zinc is a natural element found in rocks deep underground,air,soil,and water.Zinc is found in What level of zinc should I be the environment as zinc compounds joined to other elements like chloride,oxygen and sulfur. concerned about? Zinc is used to produce metals,batteries,and pennies. The NC Department of Environmental Quality Zinc is also used as a metal coating to prevent rust. developed a groundwater standard of 1 milligrams of zinc per liter of water(mg/L).Ground water Zinc compounds are used to make paint,rubber,dyes, standards are developed to protect public health. ointments,and wood preservatives. This standard was developed in 2013. How does zinc get in my The US Environmental Protection Agency developed an aesthetic standard of 5 mg/L.This private well water? standard was developed to prevent metallic taste. Zinc compounds can enter your private well water from erosion of rocks underground.Zinc can also enter How do I test for zinc in groundwater from industrial practices like mining,steel my private well? production,coal burning,and burning of waste. Use a certified lab to test your well water for zinc How can zinc affect my health? every two years,as part of the inorganic panel screen. Contact the private well program at your county Zinc is an essential element,meaning your body health department to assist you with getting your needs it small amounts. It helps with enzyme water tested.Pricing of testing varies from county function,structure,and regulation throughout the to county. body.However,drinking high levels of zinc may cause adverse health effects.You can't smell or see zinc.Zinc may have a detectable taste. What if my zinc levels are high? Drinking high levels of zinc over short periods can You can install a treatment system to reduce the lead to: levels of zinc in your private well.Installing a filtration • Stomach cramps treatment system can reduce the level of zinc in your well water. • Nausea • Vomiting You can also reduce your exposure by using bottled Drinking high levels of zinc over long periods can water or connecting to public water supply,if possible. cause anemia,decreased good cholesterol levels and reduced copper absorption. • MEMORANDUM / Ia ` 90/9 -X TO: hMM 1 n ?/'7 �/ M ?�11(� !l Date / imuvl loin etee k e'J /1'Qifvt C/1`"fk'e fgLL /%p lieS. System Name Responsible Person/Person Contact System Phone p Mailing Address OC r4o f O Q. �1� b� • Nei as �cr ter System g City / / StateSt (7 (Zip Code FROM: �PSSON -so1v1VDel Dl `!n6.?—/62. Name Regional Office Phone g e• MOO /_ '/./) 1 . Public Water Supply Section Regional Office RE: Monitoring Requirements&General Information Transient Non-Community Water Systems The North Carolina Department of Environmental Quality has determined that your water system is a transient non-community (TNC) public water system.Transient non-community public water systems are legally defined as a water system which serves at least 25 people (not necessarily the same people)for sixty or more days each year. It is not necessary that the water system furnish water for drinking, only that the water system is available for drinking, bathing, cooking, dishwashing or oral hygiene. Examples of TNC public water systems include churches, convenience stores, and restaurants.The items listed below were discussed with the above-listed Person Contacted. [ ] Testing requirements for TNC systems:what tests, how often and where they should be collected. • Coliform Bacteria: Collected quarterly from faucets such as a kitchen or bathroom sink. • Nitrate: Collected annually from the Entry Point identified below. • Nitrite:Collected one time from the Entry Point identified below. . SAMPLING SITE LOCATION AND CODE i Test: Sample Location Code: Location: Nitrate/Nitrite E 0 1 (Entry Point) a . Coliform .0 .C2. L b ti ii Q Q a. a II ho LI k iN gA1...... . SAMPLE SITING PLAN IA/ /COMMENTS: . ! 1 00 S rM (�/e 2 . e5'7-f c ark • . If you have further questions, please contact the Regional Office at the phone number listed above. • White copy—Central Office yellow copy—Regional Office Revised 8/2018 Pink copy—Water System TRANSIENT, NON-COMMUNITY WATER SYSTEM REFERENCE SHEET CERTIFIED LABORATORIES AND SAMPLE REPORTING: It will be necessary for you to contract with one of the North Carolina State certified laboratories on this website, https://slphreporting.ncpublichealth.com/Certification/CertifiedLaboratory.asp,to perform the required analyses.The selected laboratory will send you a sample collection bottle (sample kit) and a form,which you must complete each time a sample is taken. The water system number(either printed on the reverse side of this memorandum or it will be furnished later),type of sample, date collected and time collected must be included on the laboratory report form.Additionally,the sample location and location code(from the SAMPLING SITE LOCATION AND CODE section on the reverse side of this memorandum) must be included on the form as well. Contaminated samples will require additional testing.Your laboratory will send results of water sample analyses to the state and to you for your permanent records. Records of bacteriological analyses must be kept on-site for at least 5 years while Nitrate/Nitrite test results must be kept on-site for at least 10 years. Questions concerning testing procedures, contracts or forms should be directed to your laboratory. SAMPLING TIPS: • Follow the instructions provided by your laboratory and only use sample containers they provide. • Collect samples only from designated sampling sites. Sample taps should be clean and in good working order. • Remove strainers, aerators, vacuum breakers or hoses from the sample spigot prior to sample collection. Bacteriological Samples • Disinfection of the sample spigot with chlorine and/or alcohol is recommended. • Open cold-water valve and allow water to run freely for 5 minutes. Then adjust the flow until there is a slow, gentle and steady stream. • Handle the sample container and lid with care. Never touch the inside of the bottle or lid and do not allow water to splatter or splash into either. • Do not rinse out the container. Slowly fill the container to or slightly above the 100-milliliter mark and carefully replace the cap. • Sample analysis must begin at the laboratory within 30 hours. Nitrate/Nitrite Samples • Open sample spigot an allow water to run freely for 5 minutes. Then adjust the flow until there is a slow,gentle and steady stream. • Fill sample container and immediately store on ice. • Nitrite samples must be processed by the laboratory within 48 hours. Nitrate samples must be processed by the laboratory within 48 hours, or within 14 days for chlorinated water systems. WELL HEAD DETAIL: 1.Sanitary well Seal(required) DRILLED WELL 2. Insect-proof Casing Vent(downward opening&screened) 3.Check Valve • 4.Sample spigot(with vacuum breaker if threaded)** 2� 3 4/ 5.Concrete slab extending 3 feet in all directions from well casing** **These items are required for systems that were installed After July 1, 1993 and are inspected by your local Health Department for food grade or lodging purposes. 1 Note: Detail is for a submersible pump setup and your well pump setup may be different.Your local Health 5 Department may have additional requirements. white copy—Central Office Yellow copy—Regional Office Revised 8/2018 Pink copy—Water System m, n- �..-..x.--t .F• `...; .b 'I::: .W;�,Z.n-.Lr. . a :.,Cr'''''no n':' 'Cl' 1.: .3.:..ti.-.Y: NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY 4:40s r,0 - Public Water Supply Section nq �C1OMPLIANCE INSPECTIONn REPORT�y( � System Name: . /VI 4It [ 'c k l'iL! ! l,Mf PWS ID#: h���.o/�«n�a A!. A an /' Fr GAY a .Nw • Owner: C tit(NJ J 34 C_o Li ,Kf"v , • #of Connections: • Address/Phone#: Igr,v ?> N e�n • .�I C #,/Rl� 1 X Population: rg C Source: ❑Surface \'Ground o Purchase 1 / " Type of System: ❑Community o Non-Transient,Non-Community n "transient ❑Adjacent • Responsible Person: ELL r t/ �(/ I p^I'r�- // �p /f 2' 9/5 .. Z 2 0 S677 Address/Phone#: cs/f C. /t///� /v/ , 1-6,' 1 / �h e�� //e /o, f A)C' _ .Ql�S DEFICIENCIES/VIOLATIONS: J Each item below is a deficiency/violation of the NCAC Title 15A Subchapter I 8C, Rules Governing Public Water Systems. Rule Specifics e• 1 / - Nib L. ) 5i/sf..-si . • A . ,. f c. ACTION REQUIRED: You are required to take all necessary steps to comply with applicable laws and regulations. The following corrective actions must be taken within q e time frame listed below: I / • TS F� a Pn�. ;. s..�,nti�c : �' ,. crY �ua,�r°f v Cr, � 1'- nt� rP ,y `�n.i✓�//7f__�Y_ ee , ! C foe t` / n rt.,r Ij �� 14/,i.r"F r Ct✓r /Pc Priftel *A, GsfJJ� PAIl 4T IA / .ntA of ...✓1 In N.)I4.0 I Y t_ In r.r+ A aote.M 7•h Or t4ie i A written response must be filed with the Regional Office once these violations are corrected. NOTICE is given that this and any further violations may result in enforcement actions, including civil penalties. • RECOMMENDA TIO NS/COMMENTS: d •n } l — .59tn. hI0 pnI n 4r1 4 �AiftUirlii en 4. 1 .I•nr /. ).., 1l 4'," .Jfo , 1., 64 - Nn e.4 IAli ....v. AA `! 4 NO P 004nNa( PC I SID 6'e Ai' ire_it ' Piet I . IGG Pdae720/A ' ame and Signature of System Representative: v Date: Time: Name of inspector: • Agency/Office Region: r lobe egp/ //�- EVALUATION SUMMARY: r C f �l /' ❑ Significant Deficiency(ies) e DN o NSOA Telephone: 77) / 5iA— /} /y?• `❑,Minor Deficiency(ies) On-site action taken: (// X Recommendation(s) Made • t s Q PC tta y� ! J Y$r/ph�J ✓ /�+/ / . fjl ❑ No Deficiencies/Recomendations J r / • Regional Files(white/original copy) Central Files(yellow copy) Owner(pink copy)" Recipient(goldenrod copy) CIR-101 - Rev.8/18 RULES GOVERNING PUBLIC WATER SYSTEMS ❑ .0201 - Surface Supplies ❑ .0203 - Public Well Water Supplies - Site Approval ❑ .0305 - Contracting or Constructing before Authorization to Construct ❑ .0306 - Deviation from Approved Plans or Specifications ❑ .0309 - Operation Prior to Final Approval ❑ .0402 - Improper Well Construction ❑ .0403 - Surface Source Deficiencies ❑ .0404 - Water Treatment Facilities Construction ❑ .0405 - Storage of Finished Water ❑ .0406/.0900 - Distribution Systems ❑ .0407 - Electrical Systems ❑ .0409 - Service Connections ❑ .0502 - Design for Source Under the Direct Influence ❑ .0600 - Raw Surface Water Treatment ❑ .0700 - Surface Water Treatment ❑ .0800 - Hydropneumatic Storage Tanks ❑ .1000 - Disinfection ❑ .1200 - Protection of Filtered Supplies ❑ .1300 - Operation of Public Water Supplies ❑ .1400 - Fluoridation ❑ .1500 - Water Quality Standards ❑ .1600 - Variances & Exemptions ❑ .1900 -Administrative Penalties ❑ .2000 - Filtration/Disinfection SWTR. ❑ .2100 - Operating Permits ❑ .2200 - Ground Water Systems o-��: a-.....•e.. .--r . .�fi.. ,- ,..n.:.�rn 'tr-.19 a. wow.F.i.....4mic?►,jrc o-°• gN NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY it �� Public Water Supply Section r� �-'yp� °e�r� -• nCOMPLIANCE INSPECTION REPORT System Name: M ou to Q 1 r C r e r ,,. rat f k 11 L e k - Owner: C tk i tk J ['��PWS ID#: S G A t4 IA-�1 #of Connections: / Address/Phone#: N NPopulation: Source: o Surface XGround o Purchase / Type of System: o Community ❑Non-Transient,Non-Community ransient ❑Adjacent Responsible Person: g,,L,L ; C f- P I S' Se)R ,,v_ 77 Address/Phone#: / / `. /// / Y , .} �� '4 + ci f i /4-' IiOC .-2e 73. DEFICIENCIES/VIOLATIONS: Each item below is a deficiency/violation of the NCAC Title 15A Subchapter I8C, Rules Governing Public Water Systems. Rule Specifics 4 No , ! sY,,�-7 X AtCTION REQUIRED: You are required to take all necessary steps to comply with applicable laws and regulations. The following corrective actions must be taken within a time frame listed below:fi �(" C i TS14n C G .�Prrr'lct"1.) . C ) I �C .. lt'i' I i ©/014 lei'icj i A r " ` .„upe �l��r� 1 n� il'.'Ifaa ✓Y? !!0'S /r'Q / X, r/,„4I1 .,l . ii bC1 P f I/1 O I I t. 1 "� : eI- t' ci I� /ia /'Q1H iT t' �P A written response must be filed with the Regional Office once these violations are corrected. NOTICE is given that this and any further violations may result in enforcement actions, including civil penalties. RECOMMENDATIONS/COM NTS: AA 1 a S1I t16 o U.o to A yl 4 IA k r ri t �^ Sri' 4 -// Q La'. //' r. t r A t' ►t GA. I 4 n J 1e ,e rt 4 AA ci J j,,t ae;c 1� , n A / k ,e ergyr,to H T : 4-/-.) : 5'It-Ie 611'....iii L.7 .1 ' PAiii t4J4'5 Cel P M 7 c 1.-, / ame and Signature of System RepresentatAT: % Date: Time: Name of inspector: Agency/Office Region: fJ4 ,, i//i EVALUATION SUMMARY: CISignificant Deficiency(ies) j))r S a N---- ..J ro h Li s0✓► Telephone: �z)//` S 7,4! yy ❑ Minor Deficiency(ies) On-site action taken: X Recommendation(s)Made .14. j PC11,a , S F7-I / 51-4,1-id le, ❑ No Deficiencies/Recomendations Regional Files(white/original copy) Central Files(yellow copy) Owner(pink copy) Recipient(goldenrod copy) CIR-10l Rev.8/18 RULES t,,OVEI .NJG PUBLIC WATER SVSTF MS [ .0201 - Surface Supplies C:1 .0203 - Public Well Water Supplies - Site Approval .0305 - Contracting or Constructing before Authorization to Construct 1 .0306 - Deviation from Approved Plans or Specifications (.....1 .0309 - Operation Prior to Final Approval .0402 - Improper Well Construction .0403 - Surface Source Deficiencies [ .0404 - Water Treatment Facilities Construction .0405 - Storage of Finished. Water .0406/.0900 - Distribution Systems .0407 - Electrical. Systems 1:7 .0409 - Service Connections .0502 - Design for Source tinder the Direct Influence .0600 - Raw Surface Water Treatment [-] .0700 - Surface Water Treatment [..:1 .0800 - Hydropneumatic Storage Tanks El .1.000 - Disinfection .1200 - Protection of Filtered Supplies l:l . 1300 - Operation of Public Water Supplies .1400 - Fluoridation .1500 - Water Quality Standards .1600 - Variances & Exemptions I.� .1900 - Administrative Penalties Li .2000 - Filtration/Disinfection SWTR Ll .21.00 - Operating Permits I..:I .2200 - Ground Water Systems MEMORANDUM / �J '/))P m e 1 A f ill r1. JS Date TO: ours rr/1 G d�Pe r � A��� ire r1n[1J_ �S System Name Responsible Person/Person Contact 32D-3,i7 -2 Po &y 32 N` �System pPhone (SO , . Ne �� Mailing c ter System P City State Zip Code FROM: lit)e<Irli - 0 t'1tel5,r) -70/1 YCD(o. `&, A IIII��I Name Regional Office Phone b 'I Y SOP , g(.1 fie td Public Water Supply Section Regional Office RE: Monitoring Requirements &General Information Transient Non-Community Water Systems The North Carolina Department of Environmental Quality has determined that your water system is a transient non-community (TNC) public water system. Transient non-community public water systems are legally defined as a water system which serves at least 25 people (not necessarily the same people)for sixty or more days each year. It is not necessary that the water system furnish water for drinking, only that the water system is available for drinking, bathing, cooking, dishwashing or oral hygiene. Examples of TNC public water systems include churches, convenience stores, and restaurants.The items listed below were discussed with the above-listed Person Contacted. [ ] Testing requirements for TNC systems:what tests, how often and where they should be collected. • Coliform Bacteria:Collected quarterly from faucets such as a kitchen or bathroom sink. • Nitrate: Collected annually from the Entry Point identified below. • Nitrite:Collected one time from the Entry Point identified below. SAMPLING SITE LOCATION AND CODE Test: Sample Location Code: Location: Nitrate/Nitrite E 0 1 (Entry Point) 110Q( 1 TyColiform Q L Ma 5 "ge5 2 W p Mao+ � r .�•1. 12 I) 3 Dais 5 a c' �f � ��� �� ,� " ram SAMPLE SITING PLAN COMMENTS: 0 D S f4,7 P c5 If you have further questions, please contact the Regional Office at the phone number listed above. White copy—Central Office Yellow copy—Regional Office Revised 8/2018 Pink copy—Water System TRANSIENT, NON-COMMUNITY WATER SYSTEM REFERENCE SHEET CERTIFIED LABORATORIES AND SAMPLE REPORTING: It will be necessary for you to contract with one of the North Carolina State certified laboratories on this website, https://slphreporting.ncpublichealth.com/Certification/CertifiedLaboratory.asp, to perform the required analyses. The selected laboratory will send you a sample collection bottle (sample kit) and a form, which you must complete each time a sample is taken. The water system number (either printed on the reverse side of this memorandum or it will be furnished later), type of sample, date collected and time collected must be included on the laboratory report form. Additionally, the sample location and location code (from the SAMPLING SITE LOCATION AND CODE section on the reverse side of this memorandum) must be included on the form as well. Contaminated samples will require additional testing. Your laboratory will send results of water sample analyses to the state and to you for your permanent records. Records of bacteriological analyses must be kept on-site for at least 5 years while Nitrate/Nitrite test results must be kept on-site for at least 10 years. Questions concerning testing procedures, contracts or forms should be directed to your laboratory. SAMPLING TIPS: • Follow the instructions provided by your laboratory and only use sample containers they provide. • Collect samples only from designated sampling sites. Sample taps should be clean and in good working order. • Remove strainers, aerators, vacuum breakers or hoses from the sample spigot prior to sample collection. Bacteriological Samples • Disinfection of the sample spigot with chlorine and/or alcohol is recommended. • Open cold-water valve and allow water to run freely for 5 minutes.Then adjust the flow until there is a slow,gentle and steady stream. • Handle the sample container and lid with care. Never touch the inside of the bottle or lid and do not allow water to splatter or splash into either. • Do not rinse out the container. Slowly fill the container to or slightly above the 100-milliliter mark and carefully replace the cap. • Sample analysis must begin at the laboratory within 30 hours. Nitrate/Nitrite Samples • Open sample spigot an allow water to run freely for 5 minutes. Then adjust the flow until there is a slow, gentle and steady stream. • Fill sample container and immediately store on ice. • Nitrite samples must be processed by the laboratory within 48 hours. Nitrate samples must be processed by the laboratory within 48 hours, or within 14 days for chlorinated water systems. WELL HEAD DETAIL: 1.Sanitary well Seal (required) DRILLED WELL 2. Insect-proof Casing Vent(downward opening&screened) 3. Check Valve 4. Sample spigot(with vacuum breaker if threaded)** 1 I 2N 3 4� 5. Concrete slab extending 3 feet in all directions from well II casing ** **These items are required for systems that were installed After July 1, 1993 and are inspected by your local Healthkflit\ Department for food grade or lodging purposes. 1 Note: Detail is for a submersible pump setup and your well pump setup may be different. Your local Health 5 Department may have additional requirements. White copy—Central Office Yellow copy—Regional Office Revised 8/2018 Pink copy—Water System