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Home My WebLink AboutWELL-11-2021-161661.TIFr WELL- it - 2..o).1 - It lCCI 4111111 CATAWBA COUNTY HEALTH DEPARTMENT • Environmental Health Section WATER SAMPLE FIELD REPORT & TEST RESULTS Owner: STOOP ADRIANUQOLDS MICHELLE Owner's Address: 7976 VISTA VIEW DR,SHERRILLS FORD,NC 28673-9277 Phone#&Email: ( I -i) Ch5"2`I'7 u") Site Address: 4942 SURFWOOD,SHERRILLS FORD, NC 28673 Parcel#: 460604846203 Subdivison: /� qq Sample Collected By: �w .., /`I 1 �� Date/Time Sampled: j/t)3/a"� �� 30 f►M Sampling Point: W t t 1 h-e-4.01 Is well head accessible? Yes V No Reason for inaccessibility Well New or Existing? New V Existing Type of Well: Drilled V Bored Punch Hand Dug Does well meet adequate construction standards from what can be observed?: Yes: I/ 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 in.above finished grade Well head missing vent Well head does not have a threadless tap Well head missing identification plate or pump tag Wire conduit opening not sealed Other(Comment) Comments: Lab Coliform Analysis Results: Total Coliforms:Pi 4" Fecal/E.Coli:Vl WI ' No Collection Date Over 30 hours old Invalid Results: Excessive turbidity Excessive Chlorine Lab Accident Lab Tech Initials: a Date/Time Received: << /oa 12'5 15 9 n DateITime Completed:h`"" ''` 1 v O at , IV Lt/o0.3- 3:tic pM Sp°ke `-o owner VI'd, P1,0.-t, 5avc r,.-sklA.s vef,61ly, �nta;Ind t,,eII calorigualto„ NOV 5 2025 ►$s4raef:ms q,.h..ot will d,r,'U12.fs it A-. • Environmental Healthy Analytical Results STA'TESYILLE . } _ ANALYTICAL Catawba County Public Health . PO Box 389 Newton, NC 28658 Receive Date: 11/04/2025 Reported: 11/05/2025 For: Michelle Olds:4942 Surfwood Dr, Sherrills Ford, NC 28673 Comments: Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst 251104-50-01 Nitrate 161661 <1 mg/L 353.2 11/05/2025 CL 251104-50-01 Nitrite 161661 <0.1 mg/L 353.2 11/05/2025 CL Respectfully submitted, i�y �¢lL LC 1G Melissa Myers NC Cert#440, NCDW Cert#37755, EPA#NC00909 PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 1 of 2 122 Court Street Statesville,NC 28677 704-872-4697 www.sa-ne.com . ' NXTRATEMTRITE.6.NALYSIS . M:mAl tek:sadva mntbelt:wrK3 krxngli.me um% • WATER SYSTEM ID#: 14 1-L l [_c 01 l`1 C 166 t County: Catawba Name of Water System: Mic-ke,lkk Olds . Sample Type: 0 Entry Poifntt XSpecinl/Non-compliance t 1 r Location Where CollIlelcted::+ 4-t4.P. S41s�WOaA1 2 f, Skiff i 11f FOCa, ('I� aeci3 Facility ID No. I g 1 Fa(�1 Sample Point:• W G Ul i've.41.4 4I Collection Date 1 Collection Time Collected By: 1idyl- "y:ka-4,I /I 03/ 2S' ' f j:7 6 A M (Platt Pri4 (MMIDDIY:•) (Siat4'hMei ) Dail Results to(water system representative): CATAWBA COUNTY PUBLIC HEALTH Phone#:I.(S28)465-8270 ENVIRONMENTAL HEALTH Paz#, I (828)465-8276 4 . • , PO BOX 389 RespcnsiblePerson'semal: . . 'EHAdinin@catavabacountync.gov • NEWTON,NC 28658 ]LABORATORY iD#: 37755 . 0 SAMPLE UNSATIS:ACTORY ❑RESAMPLE REQUIRED • CDATAPF. METHOD 'NOT DETECTED QUANTIPMD ALLOWABLE COD;, CONTAMINANT • CODE REPORTiNGL1KciT (i.e.<RR.L) RESULTS* MIT (R.R.L) (X) i 1040 • Nitrate 3532 1.00 mg/L mg/L 10.00 mg/L d , L 1041 Nitrite • 353.2 0.10 mg/L X _—— mg/L 1.00 mg/L 4 *Note:If result exceeds allowable limit;the laboratory must fax analytical results to the State on day test completed. I DATE: TIME: ANALYSES BEGUN: t /1 /06 /2 S _ 7:+d 5 A- M pa:9n!rYl 0,—,,.tsxiy. ANALYSES COMPLETED: 01 0 5 / 2 S 1:- , M 1 rnac�arm) rsoa ry.mr<, ,l Laboratory Log;i:2511 04("51).01 Certified Sy: - C.:4— COMMENTS: - . 2.70E . Laborator'should Malt Results to: . Public Water Supply Section,Attn:Data Entry,1634 Mail Envier Center,Raleigh,NC 27593-1634 PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 2 of 2 r ‘,6..Ym 4 4312 District Drive ', North Carolina State Laborato of Public Health MSC 1918 ig ai,11.--,g," Raleigh,NC 27699-1918 , Ili �� 'i v', Ili 'mac;- Environmental Sciences http://slph.ncpublichealth.com ".Rt �' • Phone: 919-733-7308 ` �" Inor anic Chemist Chemistry Fax: 919-715-8611 Certificate of Analysis FINAL REPORT Report to: ENVIRONMENTAL HEALTH Name of System: CATAWBA COUNTY ENVIRONMENTAL HEALTH Michelle Olds P 0 BOX 389 4942 Surfwood Dr NEWTON,NC 28658 Sherrills Ford,NC 28673 EIN:566001814EH Delivery: NC Courier StarLiMS ID: ES251105-0132 Date Collected: 11/03/2025 Time Collected: 11:30 By: Dwight Mikeal Date Received: 11/05/2025 Time Received: 08:37 Sample Type: Raw Sampling Point: Well head Well Permit No. WELL-11-2021-161661 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 <0.0005 0.005 mg/L Calcium 26 mg/L Chloride <5 250 mg/L Chromium <0.02 0.10 mg/L Copper <0.01 1.3 mg/L Fluoride 0.105 4.00 mg/L Iron 0.116 0.300 mg/L Lead <0.003 0.015 mg/L Magnesium 6 mg/L Manganese 0.044 0.05 mg/L Mercury <0.0004 0.002 mg/L Nickel <0.01 0.1 mg/L pH 8.1 N/A Selenium <0.005 0.05 mg/L Silver <0.01 0.10 mg/L Sodium 7.4 mg/L Sulfate 10.4 250 mg/L Total Alkalinity 91 mg/L Total Hardness 89 mg/L Zinc <0.05 5.0 mg/L Report Date: 11/18/2025 RECEIVED Reported By: '� Marc Komlos DEC 2 2025 Environmental Health Page 1 of 1