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Home My WebLink AboutWELL-11-2021-160435.TIF WELL CONSTRUCTION RECORD(GW-1) For Internal Use Only: 1.Well Contractor lnfornmtlon: 'Kyle C. Shaw 14.WATER ZONES Weld Contractor Name FRO,I1 TO I DESCRIPTION 4521-A 35 -760) ft ` 5 r1 ft.NC Well Contractor Certification Number Advanced Weil Drilling, LLC 15.OUTER CASING(far multi-cased wells)ORL1NER(It applicable) ' FROM TO DL M TER THICI.'h'ESS MIAT£RLLL Company Name L� Pr ] ri rt. 6 i° Heavy PVC � IS.INNER CASING OR TUBING(geothermal closed-loop) 2.Well Construction Per/Tilt#: C f ` )!." 22 u - 1 6. 0 i >. FROM TO DLturrIa TRICIQ ESS NiATERI.u. List all applicable Hellca tructionperntffs(i.e. G7C.Con my.State.Variance.etc.) 11. R. In. 3.Weil Use(checkwell use): - ft. IL In_ Water Supply Well: 17.SCREEN 10-4ar1CUlhtiel _FROM TO DIAMETER SLOI SIZE I T'HICIo•�FSS T?LATERIAL ❑Municipal'Public It to in OGEQiitermal(Heating/Cooling Supply) Residential Water Supply(single) R ft in. 0IndusttialiCotnmercial ❑Residenlial Water Supply(shared) 18.maul. ❑Irrigation ❑Wells>100.000 GPI/ FROM TO MATERLU. ESfPL4CEME TMETHOD.tAh1o1M_ Non-Water Supply Well: -0" it 20 ft- Bentonite Poured • ❑ivIrtiitoring ORecovery ft. rt. Injection Well: - D. uifer Rethar e ft n ❑Gmu¢dnater R.sHtediation • i].4quif Storage and Recovery ❑Sal 19.SANDt'GRAVELPACKfirappltmbfe) InityBarrier , FROM To I MAT£RLU. £MPL4CEMEN'TMETHOD ❑Aquifer Test ❑Stomnvarer Drainage ft ft. ❑Experimental Txlinolo_y ❑Subsidence Control n. rt. OGeotliermal(Closed Loup) °Tracer 29.DRILLING LOG(attach additional sheets ifnecessarv) ❑Geothermal(Heating/Cooling Return) OOther(explain under 3-21 Remarks) 41t TO DESCRIPTION(carat,6crniaest raa/roel:trpr,ttrala axe.etc) .� (7 ft �<< Ft r 'r;1 / '� 4.Date Well(s)Completed2,�L/- '-`• Well ID#- -5 ft fac. ft. e_4. a► WellWellI Location: 1 a f` `P-7 It I-i rJ oce-i roc i� ):t!/{ .'✓ef hr rtt,Y�-�;•,, la��^eis tr> • , -I ft. 1 ft: ft i--i.�.r� qe-,� c-e-, X. Facility/Ownerl�ame (iscr',n:;=; C Facility ID4(if applicable) rt. V I / ! ft. ft. Physical Address,City.and 2"ip ft fr. I k 21.REMARKS Cowry Parcel Idoitaleation No (PIN i Sb.Latitude and Iongitude in degreesiminutesfseconds or decimal degrees: (if well field.one tat/long is sufficient) j 22.Certification:'S 7<r /�1q \ '4 . ei i 1 y1' 6.Is(arc)the well(s): L Permanent or CTemporary Stara AaLcr_. ...-2 .,. ,...,4.il ...2....-3 of Cesti[ied Well Contractor Date 3v signing this form,I hereby certsf}•that rho tr ek's)was(t,argil constructed its accordance tsitlr 7.Is this a repair to an existing well: ❑Y•es or nNic 15.4 VC4C 02C.0100 or 15.4 JVC4C e2C.0200 Well Conurrctfon Standards cad drat a copy ff1/ate is a repair fit!out known well cwvtracrian irt(omron'ou and explain the nature of"die of thus record haw been provided to the well owner. t¢cams tinder'121 rerrrvls section or on the bock of this form. 23.Site diagram or additional well details: You may use the back of this page to provide additional well construction info 8.For GeoprobelDPT or Closed-Loop Geothermal Wells having the same construction,only 1 GW'L is needed. Indicate TOTAL NUMBER of wells (add Sea Over'to Remarks Boy).You may also attach additional pages if necesson. drilled: 24.SUBMITTAL I STRUCITONS 9.Total well depth below land surface: 14 e7 5 (1t,) For nurltiple N ells list all depths if m(fcrent(example-3(n�200'and 2 1001 For the G13'-1 within 30 days of well completion per the following: 10.Static water level below top of casing: ( ) 24a. For Al] Wells: Original farm to Division of Water Resources (DWR). Ifxoter!roe'is above caring.use•'+' Information Processing Unit,1617 MSC,Raleighh,NC 27699-1617 11.Borehole diameter: 6 (in) 24b.For Injection Wells: Copy to DWR Underground Injection Control (IUC) Program,1636 MSC,Raleitr_h,NC 27699-1636 12.Well conseruction_method: .;.r f f 24c Wat er and Open-Loop Geothermal Return Wells:Copyto the (Le auger,rotary.cable,direct push,etc.) I county envuoommtal fiNnth department retie county whetelostalled FOR WATER SUPPLY-WELLS ONLY: 24d.For Water Wells producing over 100,000 GPD:Copy to DWR.CCPCI7A 13a Yield(gpm) r ��"t Method of test: Air Permit Program,1611 MISC,Raleigh,NC 27699-1611 13b,Disinfection type:,--) H TH Amount: t(k SBA Co Case# WELL-1 1-202 1-1 6043 5 ��' CATAWBA COUNTY HEALTH DEPARTMENT (� ,,�, Environmental Health Section 1842 5M 06/21/2023 WATER SAMPLE FIELD REPORT Applicant IlULLER RIVER DEVELOPMENT I'ARI'NERS LP,259 TEX"I ILE WAY STE 102,FORT MILL SC 2971 PAM@I3RDEVELOP.COM Land Owner TROY CARVER,345 M('ADEVILLE RD,BELMONT NC 2K012 Contractor *CORNERSTONE 111 PROPERTIES INC,8008 COPORAEI?('I.N IT I)IZ,CHARLOTTE NC:28226 C:7043013229 STAN n;CORNERSTONE3P.COM Site Address: 7133 ROLLING HILLS DR,SHERRILLS FORD NC 28673 Name of Subdivision: A L ROBINSON Parcel Number: 460703036262 Driving Directions East on NC 150,left on Little Mt Rd,Left on Rolling I lills Dr,Right on Duffey Sample Collected by: /wtylv N 1 Vac."( Date/Time Sampled: (ri /23 /4e 300h Sampling Point: c' T' Pi'e tet,p Is well head accessible? Yes I✓ No Reason for inaccessibility_ Well New or Existing? New Existing Type of Well: Drilled ✓ Bored I land 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>= 1 2"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 11:54 Page I of 2 cases WELL-11-2021-160435 �+ C� 6� 1 CATAWBA COUNTY HEALTH DEPARTMENT V ., 14 ,,`, Environmental Health Section 18 4 2 sM 06/21/2023 WATER SAMPLE TEST RESULTS 1pplicant BEJLLER RIVER DI•.VI(LOPMENT PARTNERS LP,259 TEXTILE WAY STE 102,FORT MILL SC 2971: PAM ct BRDEVI'.LOP.COM Land Owner TROY CARVER. 345 MCADEVILLE RD,BELMON 1 NC 28012 Contractor *CORNERS]ONE III PROPERTIES INC,8008 COP ORATE CENTER DR,CHARM"! It NC 28226 C:7043013229 STAN@CORNERSTONE3P.COM Site Address: 7133 ROLLING HILLS DR,SI IERRILLS FORD NC 28673 Name of Subdivision: A L ROBINSON Parcel Number: 460703036262 Lab Coliform Analysis Results: Total Coll forms: CA��V�A Fecal/E.Coli: 01V)Cinf No Collection Date Over 30 hours old Invalid Results: Excessive turbidity Excessive Chlorine Lab Accident tOn10 DO Lab Tech Initials Date/Time Received 01111' Date/Time Completed v " �''+' � � cE1VED Jul 2 6 2023 Environmental Health rsmnfieldreport 06/212023 11:54 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: Buller River Development Partner LP Sample ID Number: 160435 Location: 7133 Rolling Hills Dr, Sherrills Ford NC 28673 Reviewer: M. 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 °,,,, _. Private Well Information 4,4 1' g .„..,,,,..„,d, ,-,,,:-:‘,\) and Use Recommendations NC DEPARTMENT OF HEALTH AND HUMAN SERVICES Division of Public Health For Inorganic Chemical Contaminants County: Catawba J Name: Buller River Development Partners LP 7133 Rolling Hills Dr, Sherrills Ford NC 28673 Sample ID#: 160435 Reviewer: Megen McBride TEST RESULTS AND USE RECOMMENDATIONS 1. Z 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. El The following substances)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, El Arsenic ❑ Barium El Cadmium ❑ Chromium El Copper ❑ Fluoride ❑ Iron ❑ Lead ❑ Manganese El Mercury ❑Nickel n Nitrate/Nitrite El Selenium n Silver El Zinc 3.El 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. 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. ® 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 ® Manganese El pH ❑ Silver ❑ Sulfate ❑ Zinc 6. ❑ 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. El 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 919-707-5900.