HomeMy WebLinkAboutWELL-09-2021-157708.TIF .411111 Case# WELL-09-202 1-1 5 7708
CATAWBA COUNTY HEALTH DEPARTMENT
V , ® Environmental Health Section
sa 10/25/2022
WATER SAMPLE FIELD REPORT
Owner Y1'.NG XIONG,5012 WAVER WHEEL DR,CONOVER NC 28613-7122
H:8282346801
Site Address: 4276 DEAL RD,CLAREMONT NC 28610
Parcel Number: 376302852122
Driving Directions Bunker I-lill School Rd, Deal Rd,approx. 1 mile on Right p
Sample Collected by: abz Ierk+A Date/Time Sampled: I ql--6//'2- i) O.2 A-AA
Sampling Point: s if f e 7
Is well head accessible? Yes 1 ✓ No Reason for inaccessibility
Well New or Existing? New tJ E isting
Type of Well: Drilled Bored I land Dug_ Punch
Does well meet adequate construction standards from what can be observed: t/ 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 10/23/2022 08:18 Page 1 of 2
galftbk Case# WELL-09-202 1-1 57708
CATAWBA COUNTY HEALTH DEPARTMENT
Environmental Health Section
18 2 sM 10/25/2022
WATER SAMPLE TEST RESULTS
Owner YENG XIONG,5012 WAVER WHEEL DR CONOVER NC 28613-71 22
H:828234680I
Site Address: 4276 DEAL RD,CLAREMONT NC 28610
Parcel Number: 376302852122
Lab Coliform Analysis Results: Total Coliforms: Decal/E.Coli: a,q,a:„L&
No Collection Date Over 30 hours old
Invalid Results: Excessive turbidity Excessive Chlorine
Lab Accident
11 ��MM t4SS
Lab Tech Initials Date/Time Received 10. ' l`'1U° Date/Time Completed 1°11 122 GLKt,
rsanfieldreport 10/25/2022 08:18 Page 2 of 2