HomeMy WebLinkAboutWELL-10-2021-159657.TIF WELL CON l
STtUCTION RECORD(GW-1 For internal Use Only:
1.Was Cestrecter Information:
Joseph Bailey l�1wA
Wall
IKON TO T oreCnirrWfi
3271-A nor- AlQ n ^/a,.�CAneir Zy4e
MC Mier Caearaeatr Corso ca,oa miaow 15 OUTER CASING(far web)
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3.Weil Use(check well use): rt, ti to
Water Supply Well: 17.SCRUM
IMAM To DIAMETER St•OT MT.a TTIl(Krt5a MAT[AIAL
Agriculture/ OMunki Public h, h. in.
Geothermal(Hcating/Coolurg Supply) dermal Water Supply(single) fat A. in. -4
bidwtrialco m ercial ORaajdcuuaI Water Supply(shared) U.GRovi
Irrigation *ROM To MArre/M, twee tCENEIT METHOD A.MOL t1I
Pfau-Water Sttpply Well: (L , h
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A
Very OSabnity Soria re0M 70 MATERIAL ENnACEMEYT METHOD
Aquifer Test ❑Slormwata Drainage ft. rt.
Eatpe<itaetsial Technology OSlesidence Control R h.
Geothermal(Closed(oop) Dinner *DRILLING LOG(.stock a++faoweistwltalf meteedenl_
Geothermal Meeting/Cooling Return) f Other(explain under on Remarks) rnoM To orxKt o+teewr.a iq.eta"*rawer Rt».ironer.dt..rci i
!.Date Welke)Camplead: well tiatl irp7..2` h n . --
1.� �_(�«wrj�oL — -- ,
saw Well Loader: 5 j
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hedgerow Nue aril Delifapplicabk) 0 h. 9 i wit'�d (
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Physical Adhe y,red Z. h rt.
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Casey Parcel ldentfiuisoe No (PIN) _.- .-- —H
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Sb.Ladtsde sad Jsttps.de Is degrseartatlattta/Mcooda or decimal degrees: ---- ------- _____i
Of well brit,ass wing is refaces* 22.Certification: /
N W V
4L4f.Nate)lee well(s)inPermaseat or f iemponry 5 f tare ofuIsi Coins iat I hr.eh.t t,Aura rAr.eiti, .a, lwr.rl tw,•w ui,64[044u.r
7.Is this a*spat*M err etladatg well; [3 Yes orrEifFr— rah I SA NGC 01C 0100 w I . NC 4C O2C 0200 H'el!Comrrurftoe Standard*and*Aar a
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rep*eider all eorrab soda r oa site boat of idad fa no
13.Slk diagram or additional well details:
' I.Fee Gee/rsbsfDPTsr Owed-Loop Gee lsornial Wells having the aarru You may use the beck of this page to provide
additional well sitedetails or roll
oonettuatlats,only I OW-I is needed. Indicate TOTAL NUMBER of wells construction details You may also attach additional Nigel if necessary
bilked:
cf $UBS117TAL INSTRUC'TIQN.S
p'Tatalwog�mow load s.ftne 225 (r) 24a. For All Wells: Submit this form iuiUan 30 days of completion of well
Fee solute wort err alf again(deferete feaawple..4100 and 241001
construction to the following.
IL Stade sake In*below top of cuter40 (h•) Division ofWolter Resources,Iaformarios Processing Lilt,
rues►ine16 thew twig we-•- 1617 Nall Service Center,Raleigh,NC 2 7699-1 6 1 7
ll.Ierabok disnie ri 6 1/8 (la.) 24b.for Infection wells: In addition to iendmg the form to the address in 24a
Air Rotary above.also submit one copy of this form within 30 days of completion of well
12.Wall crvtrectiaa method: consou icon to the following
411111001,tit NIP.wiry.able,boo ph,tt )
Dhisioa of µ'ater Resources.Lrdcrground injection Control Program.
FOR WATER SUPPLY WELLS ONLY: oy lr 1636 Mail Sery ce Crater.Raleigh.NC 27699-1636
13a."lid(gp♦I) JQ Lrjlr/ Method of test:,4) /C/C/ 24c.for 11 error Somas £ Injection Welly in addition to sending the form to
the addressees) above. also submu Doe copy of this form within 30 days of
13b.1)WrtkesMs type: Chior labs Amoral: t 112lea completion of well construction to the county health department of the county
where constructed.
how OW.I \:pith Caroline Dep.nmcni of Emuonrrrnui Quality.p,.q,oe of i atct Resource Ra.aod 2.21.20I 6
„ICA C'O Case# WELL-10-2021-159657
�� t ��� CATAWBA COUNTY HEALTH DEPARTMENT
I- Environmental Health Section
t9y,
1$4 Z SM 02/13/2023
WATER SAMPLE FIELD REPORT
Applicant *FIRST IN FLIGHT CONSTRUCTION,INC, 111 CHURCHILL LN,MOORESVILLE NC 28117
C:98072I 1249 DOUG@FIRSTINFLIGHTCONSTRUCTION.COM
Owner MICHAEL SCALISE,428 W DIVISION ST,ITASCANC 60143
ErN a i l 1 ? g C:423-503-7554 W1 I C+n c e ( SC_a.t Se. @ c Y'- k 1 Vt,c b M
Site Address: 7761 ANGLERS WAY,SHERRILLS FORD NC 28673
Name of Subdivision: ANGLERS COVE
Parcel Number: 460602752116
Driving Directions Hwy 150,turn on Slanting Bridge Rd,right on Anglers Way
Sample Collected by: Dv,I g�� I” l�e.&.1 Date/Time Sampled: 01/1 i/d.3 I0 0 3
Sampling Point: 50..E P t� TO,p
Is well head accessible? Yes v< No Reason for inaccessibility
Well New or Existing? New V Existing
Type of Well: Drilled � 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 02/13/2023 12:35 Page 1 of 2
Case# WELL-l0-2021-159657
;1 j CATAWBA COUNTY HEALTH DEPARTMENT
. 11
/� Environmental Health Section
02/13/2023
WATER SAMPLE TEST RESULTS
-----
Applicant *FIRST IN FLIGHT CONSTRUCTION,INC, 111 CHURCHILL LN,MOORESVILLE NC 28117
C:9807211249 DOUG@FIRSTINFLIGIITCONSTRUCTION.COM
Owner MICHAEL SCALISE,428 W DIVISION S"I',ITASCA NC 60143
C:423-503-7554
Site Address: 7761 ANGLERS WAY,SHERRILLS FORD NC 28673
Name of Subdivision: ANGLERS COVE
Parcel Number: 460602752116
Lab Coliform Analysis Results: Total Coliforms: c '`'"^" i- Fecal/E.Coll: Ol/"tiriT
No Collection Date Over 30 hours old
Invalid Results: Excessive turbidity Excessive Chlorine
Lab Accident
Lab Tech Initials Date/Time Received O'.' .J'1 r 'CytL Date/Time Completedol/ ` l /7 I t000 r
314
RECEIVED
[Fa
Environmental Health
rsemlieldreport 02/13/2023 12:35 Page 2 of2
Analytical Results Jr. STATESVILL
ANALYTICAL
Catawba County Public Health
PO Box 389
Newton, NC 28658
Receive Date: 02/22/2023
Reported: 02/23/2023
For: 10-2021-159657: Michael Scalise, 7761 Anglers
Way
Comments:
Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst
230222-35-01 Nitrate 159657 <1 mg/L 353.2 02/22/2023 CL
230222-35-01 Nitrite 159657 <0.1 mg/L 353.2 02/22/2023 CL
Respectfully submitted,
/J
Melissa Myers
NC Cert#440,
NCDW Cert#37755,
EPA#NC00909
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 2
kliiii sLi"Ari TiAtl.
‘111111
122 Court Street Statesville,NC 28677
704-872-4697 ts ww 51,-,Bc com
NITRATE/NITRITE ANALYSIS
NSW 1.Y;.....f-n•noo-,T4P+to 4-ar').a te.ocarlii.c.c,ea,
WATER SYSTEM ID#: I 0 - ).-1:).-4% - 15-915'7 Count): Catawba
______
Name of N‘glee ti)stem: P1 ; IN 1 5,:"..),i , s•'..
Sample T,pe: 0 Elul, Point 0 SpecislAon-compliance
Location Where Collected• r') 110 A t's,,)142-1-c VNJA-I-1 S ki?..fr,11:, F-4.-..c1 NC_ D. R6ri3
• 1 I
4-`)
Faciiit, II) a.N -4' -,4
Simply Point: :T_.;\ P Collection Date Collection I line
Collected By: 11'4 :_}.1----f ( .• 2
i 5r/1 _a N
•4 P.0 .ii Mail Results to 11%atur 1±.stem representative):
CATAWBA COUNTY PUBLIC HEALTH rt.„„,.u: (828)465-8270
ENVIRONMENTAL HEALTH 1.,,,, (823)465-8276
PO BOX 389 ItrspanOhle Perom's entail.
EHAdmin@catawbacountync.gov
NEWTON, NC 28658
-- ,
1 A ROLLA!DRY II)#: 37755 0 SAMPLE CNSATISFACIOR1 Ci RI,SAMI'l I REV) 110.0
I ,,() ti.11) gg DEILe nu QUANII/11D
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,IISIASII\A\i K!NiR I i\C.1 IMIt 0 e RRLi
tit (X)
— — — --.....--------
1040 "%Mute y.,3 Z 1 00 mg 1
mit.1 10 00 trig,•I
1041 'slim. 151.7 0 10 mg 1 rrw,.1 1 00 mg.!
'Note 11 result escceils allowable linni,the labotatop,must .t,,.tr:.1:i),,-11 1,-,I.:,:),1'.. •-• ,-.!.., .:•I c,),),rkt,..,1
1 DAIL: 11‘1 t
ANALVSES BEC,I.N: 02 " 2 7 23
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ANA1.1 SEN(ONIPI 14 I ED: 0 / 2-2- 7Z,
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I.aborator) Log••:;Z 3 0 IL? •-•:;/J__at Certified By: C -_
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(ONIIETS:
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Laboratory should Mall Results lin
r-t);),c Wata S.nr,71 Solon,Ann !Sits Fnn) 16.14 Mae Sen K C CcnTer.Rai:ogh.Sit!776951.i tI4
419.71S.64117
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 2 of 2
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: Michael Scalise Sample ID Number: 159657
Location: 7761 Anglers Way, 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
�� sn Private Well Information
and Use Recommendations
NC DEPARTMENT OF
HEALTH AND HUMAN SERVICES
Division of Public Health For Inorganic Chemical Contaminants
County: Catawba Name: Michael Scalise—7761 Anglers Way, Sherrills Ford NC 28673
Sample ID#: 159657 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 on(v. 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 ❑ Barium ❑Cadmium ❑ Chromium ❑ Copper ❑ Fluoride ❑ Iron
0 Lead ❑ Manganese ❑ Mercury 0 Nickel ❑Nitrate/Nitrite ❑ Selenium ❑ Silver
❑Zinc
3.n 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.
n Chloride 0 Copper n Fluoride ❑ Iron ❑ Manganese
❑ pH ❑ Silver ❑ Sulfate ❑ Zinc
6. n 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 DiviAiru, o f Public !krill!, al 9/9-707-5900.