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BNMITIi.l: PRDJBCf SANK '�Soil & Forestry Services of the Carolinas, PA °0 8 i 1 a
H1u�BHul NO�IYS p
r-L SEPTIC SYSTEM LAYOUT 5923HAREWELLRO SOIL F���®��� PO Box 832—Mooresville, NC 28115 8
SKETCH MAP �� O1E1 n o
`y GTAWxtcomnY,HOrrxCABOLMA W.r...,LINA..�www.soilandforestryservices.com
JULY 2013
( W-1 l Far Internal Use Only.
Vail i CON,' 'RUCTION I ('OW) (r
1.Wen Contractor lnfornsation: —
1a.WATER'LOfrlS_._,---u.nnnrvi _�_-
Robert Teague sua�t To_ =F' --�"`—
Wcll('nnuannrVanu fl' c fl lj,,.,_—_..
8 K Well Drilling Inc n, ft. _..--------
---_—_—_---
"NC ----_ il wly t Ire _}
t5.0UTP.R CASING for multi trod Z._ M.�TERIAt
t''<IlConrnctort�endlutwnNtnnbcr � MAME kR.,--.-_y fIIICKNLi ---f— --
FROM ft TO IV'
2857-A o rr• (t' CUB SOR•71
Company Nano
t6.INNER CASING ORTUBING ihernaal
TIIIlsi- MATERIAL
L _sootTf` _ in.
2,Well Construction Permit N: ft. h.
r or all applicable+dl,antrv<++on permit ft a• t.-1('.Cowin,Stare.Variance,elr) DIaMETtR h.
a. in,
3.Well Use(check well use): ItSCRe¢N NAtERut.
rRUh=TU
ft. 9WTCIZE TNICRNI51
Water Supply Well: a. i�
Agncultural �Mw iupa6Public
Geothermal f)lcatinglCooling Supply) uidcntial Water Supply(stogie) fL
(I. III-
residential Water Supply(shared) FROM
GROlrT DI AIILT ER
111TCALtL EMPL1CF-M4rT METHOD t.Ntor�7
iflU11 TO
•IrrigationIL It.Nun-Water Supply Well: p,
4 Munnonng /Recovery
(t.
Injection Well: ft. O.
/Aquifer Recharge ❑Groundwater Remediatioo tq,SANDIGRAVEL PACK ■u.,Erril ` _ CNPLAt EM!?'T NF TNnD
ble
/Aquifer Storage and Recovery DSaliulty Barrier HostTn
ft.
=I mom
Aquifer Test �Stormwatcr Drainage
Eeother ntal Technology Subsidence Control
ft. ft.
DRILLLNG LOG(attach additional shee11011111111
ts If seas is act r:c l
Geothermalmol(Ciosed Loop) !Tracer FROM TO DcscxlrTlo' cobr.h 'n�"Olt'ck
Geothermal(Heating/Cooling Return) �(lmer(explain under all Remarks) . a. s . fi. PAINS , S a
4.Date 11'ellls)Completed:3: ")-5�a Well 1Di1
5 a,`t' 6 I'. 1 , .�
P O ft. ft. it T. a►•IM -
r
Sn.Well Location: t.
N*1ms,r,A. N r)vt, Li- MIMI
ft. fr.
Facility:Owner sante Facility ID;I ifapplicabk)
1 f ft, ft.
Physical Addra s,Co.and Zip 21 REMARKS.
Parcel(dent!ficrtion No.(PIN)
County
5b.Latitude and longitude in degrces/miauteshecundi or decimal degrees: 22 Certi
f rf well field,one lavlorp ii tuf iicicnhi -'�,S _��
1Y
N bah
Silauturc u f Ccruficd Wc11Ci m +cunt
6.h(are)the well(s)0Permanent or DTemparary
By.signing this(orty.I lanky crein5,Ihar the uelh'i was lucre):wurrucrcd ui accw act
Yes or
•,lift 11.4 A
n NaCAC-(1W Ohtt)ur l iA.CAC 02C 0200 Kr1 Cu+utrxdiwr Smn,Iunlr and:hat a
7.Is this a repair to sin existing well: � co/rc aflhu record hoi ken pmvidcd to the wrl!cooler..
If aim is a repair..ill our k town well rnn)wcrron information rrplu(n the nature of the 23.Site diagram or additional weU details:
r gwir under P21 remark,trefoil yr an the hark of Mir form You may use the back of this pag IO e ais ide additional well site details or well
f
S.For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same
construction details. You may also anach additional pages if necessary.
construction,only I C V-I is needed. Indicate TOTAL NUMBER of wells SL1l1Ml'fl'ALiNCTRlCrIONS
drilled: ftJ 24a. For All Wel ls: Submit this form within 30 days of completion of well
9.Total well depth below land surface:_ Q ( `
construction to the following.
Far multiple mill hsr ail drplhi Ifd4 rant r,•aanple'J''^U+l'and t It )
401 If (ft) Uhision or Water Rtaourees,Information Processing Unit.
eatic water level below top of casing: 1617 Mail Service Center,Raleigh,NC 27699-1617
�wvr 1nr/a uhnir rnung,asr '• in
24b.For infection Wells: inoadhiti form wihrin the30 df form
of the
address
well
11.Borehole diameter: 6 �I_8 -(In') above.also submit one copy
12.Well construction method:
Air—Rotary conwcuon to the following:
t i s.auger,roury.cabk.direct push etc.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh.NC 27699-1636
FOR WATER SUPPLY WELLS ONLY:
I3a.Yield(gpm)
Air Flow 24c.For Water Supply:Si,injection Wells: In addition oD to sending the formto
Method of teat: the addtessiesl above, also submit uric copy of this form within 30 days of
Chlor Tabs t to tbs completion of well con:tcucuoa to the county health derailment of the county'
13b.Disinfection type:`--
Amount: whale constructed.
Form OW-I Nonh Carolina Depamncnl of Environmental Ounluy-Dwisioo of Wirer Heat-Armes
Revised 2-12,2010
Analytical Results /• STATESVILLE
ANALYTICAL
Catawba County Public Health
PO Box 389
Newton, NC 28658
Receive Date: 11/08/2022
Reported: 11/10/2022
For: Nest Homes LLC 5923 Harwell Rd Catawba NC
Comments:
Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst
221108-27-01 Nitrate 01-2022-164273 <1 mg/L 353.2 11/09/2022 CL
221108-27-01 Nitrite 01-2022-164273 <0.1 mg/L 353.2 11/09/2022 CL
Respectfully submitted,
y71 ,2_ 1p)
Melissa Myers
NC Cert#440,
NCDW Cert#37755,
EPA#NC00909
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 2
$TA ITIU
gNAIY i'iCA,L.
122 Coun Stet Statesville,NC 28677
704.872 4697 w'r. yl.,fa:SByi?10
NITRATE/NITRITE ANALYSIS
,w,.AIL.mM+.i,w n,r Le wo±1•1 v K,pi once m.a„
Catawba
WATT R SYS'ItM IDN: e!0 l-,2 1�, -- County:C...,.__.._.
Nam of Water System:.... /1Je'34 NM•vtei,,,.i,„.,4:
Sample Type: 0 Entry Point peclaVNuf-eompllance
Location Where Collected:.,, s6I13...,. 1A 1�t q ._,fd Cr' N " N<. ...
Facility ID No. -k
folk bla Dale
Sample Point: ._____ --. „+"_..,,,==.."*'"'I S-
„ ;2 11 :U � ?lt
...�.�..0 -.-. s
Collected By:_. e �rii __..,...,....._.. let r:
Mail Results to(water'yam representatirt):
CATAWBA COUNTY PUBLIC HEALTH Phone b: (828)465.8270
ENVIRONMENTAL HEALTH
Pax 0. (828)A65 8276
AetpaaMtAa MNa'.ern;
PO BOX 389 EHAdmingiatawbecountync.8ott
NEWTON,NC 28658 —_,.__._____--...----
1,ADONAl(lR 11)p: 37755 ❑SAMPLE IIINSATISEACTORY ❑RTSAttPLLREQUIRED
REQUIRED W.1 MIME) QUANTIFIED ALLOM'A84&
t'UNTAM t5E3140O REtOATIM1 OMIT is e<R A LI KE34:1.T5• TAW t:O;1F CONTAMINANT COGS DT ILL) (XI
---170 7* m6tl 10.00 man- .
Notatert
to'L 1.00 In$it q
° 1041 Nitrite lt3t O.tO � _� ... .. —...;;®:: „..,,...+ ,...•.^
•No'.e:If result exceeds allowable limit,the taboroImY must fan analytical results to the State on day test completed
DATE: 'TIME:
ANALYSES BEGUN: I Ot 7_`.00r, -" u.
...,f.YSES COMPi..t.l'ED: r 4�_t Oct ,22 _ :5J°1-- $LM
Lahnratary Lag:4: ..2 . 01 L Certified By:_ -- — ...,...>._-.
COMMENTS:-.- ,_
mot LototHADADISLIIDLIBtatito
....,•,..:--<.......e..„r., • .a rno,:aN Mal Smrice Cem<K4INg4,NC:2109.104
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 2 of 2
N 0 R T H C A R 0 L I N A
Private Well Information
1,4
and Use Recommendations
NC DEPARTMENT OF
HEALTH AND HUMAN SERVICES
Division of Public Health For Inorganic Chemical Contaminants
County: Catawba Name: Bruce Sorge—5923 Harwell Rd, Catawba NC 28609
Sample ID#: 164273 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 only. You may
have other water sampling results that are not taken into account in this report.
2. El 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 El Fluoride n Iron
El Lead ❑ Manganese El Mercury El Nickel ❑ Nitrate/Nitrite El 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.
El Chloride ❑ Copper El Fluoride El Iron El Manganese
El pH El Silver El Sulfate ❑ Zinc
6. El 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 only.
❑ 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;'Forth Carolina Division of Public Health at 919-707-5900.
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: Bruce Sorge Sample ID Number: 164273
Location: 5923 Harwell Rd, Catawba NC 28609 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.)
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.
X 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.
Total Coliform
Bacteria, E. coil &
PRIVATE WELLS
What are total coliform bacteria
and E. coil?
Total coliform bacteria are a group of microorganisms found d
in soil and surface water.Total coliform bacteria water tests
look at all coliform bacteria in water.This includes fecal
coliform bacteria,which are a group of bacteria found in the '4""
intestines and feces of animals and humans.
E.coli or Escherichia coil is a type of fecal coliform bacteria.
There are many strains of E.coil. When should I be concerned
about coliform bacteria or E. coli?
How does coliform bacteria and You should be concerned if coliform bacteria or E.coil are
E. coli get in my private well water? present In your well water.
Rain may wash coliform bacteria or E.coli from soil on The NC Department of Environmental Quality
the surface to groundwater.Coliform bacteria or E.coli developed a groundwater standard of 1 colony of
can also enter your water if your private well is poorly coliform bacteria in 100 milliliters of water(colonies/
constructed,cracked or unsealed. mL).Ground water standards are developed to protect
public health.This standard was developed in 2013.
How can coliform bacteria The US Environmental Protection Agency requires
follow up testing and treatment when coliform bacteria
or E. coil affect my health? or E.coli is found in any public water supply system across
Most coliform bacteria and E.coli strains will not make you the country.Public drinking water guidance are based on
sick.The presence of some types of coliform bacteria in the public health protection and cost of treatment/testing at
water signal the presence of feces or sewage waste. Feces large utilities.These rules were established in 1989 and
and sewage wastes are usually the source of the disease- updated in 2014.
causing organisms.
Total coliform bacteria and E.coil water tests are used as How do I test for total coliform
indicators for the presence of disease-causing organisms. bacteria or E. coil in my
The following are some disease-causing organisms or
pathogens that could be present in your water: private well?
• Bacteria that cause diarrhea and vomiting, Use a certified lab to test your well water for coliform
• Protozoa that cause dysentery, bacteria and E.coli every year.Contact the private well
• Viruses that cause polio and hepatitis,and program at your county health department to assist you
• Helminths,such as roundworms and tapeworms, with getting your water tested.Pricing of testing varies
that cause chronic diarrhea. from county to county.
Percent of Private Wells Tested � "111.1.1111dipatiVall. .
With Detection of E. toll, 2011-2013 •, Ir►
isp.,„..priixorma A ugh up, ,w4
mr.,,,,..... „, ioniiiii_____, N„,, ,
41,1,1440 ___ ____
vie
Percent of Private Wells Tested With Mill; 'nil al��l�,�
Detection of Total Coliform, 2011-2013 t liar � '416 loptimmi&majr" 4 t 4i I �
r� �;+ ire �i ,.
° a_ �� NI >
rviNkitjii
= 50/o with detection L-a stip
r -zed 11..,., ._��'�
25.1-50%with detection
<25%with detection
0%with detection itiPIP..
Insufficient data(<10 wells tested)
What if total coliform bacteria Where can I find more
or E. coli levels are present? information about total coliform
Shock chlorination is a method to remove bacteria bacteria, E. coli and my well?
contamination in private wells.If contamination persist Visit the NC Division of Public Health's Private Well and
you can install a treatment system to reduce the levels Health Program website:http://epi.publichealth.nc.gov/
of bacteria in your private well.Treatment systems that oee/programs/wellwater.html.
reduce the level of bacteria in your well water include:
• Ultraviolet(UV)filtration treatment system There you can find:
• Contacts for your county private well program
You can also reduce your exposure by using bottled water • Total coliform bacteria or E.coli in well water maps
or connecting to public water supply,if possible. • A guide for selecting a treatment system
• Other private well resources
Where are total coliform bacteria You can also call the Private Well and Health Program
and E. coli found in NC? at 919-707-5900.
Coliform bacteria are detected throughout NC.About 260/0
of wells sampled for microbial contamination in NC from Where did this information come
2011 to 2013 tested positive for coliform bacteria.Yet, from?
there are several areas in NC with at least 50%of wells with
coliform bacteria present.See map for areas with high Centers for Disease Control and Prevention:www.cdc.gov/
coliform bacteria detections, healthvwater/drinking/private/wells/disease/e coli.html
E.toll is detected throughout NC.About 2%of wells Environmental Protection Agency:https://safewater
sampled for microbial contamination in NC from 2011 to zendesk.com/hden-us/sections/203309158-E-coli-0157-H7-
2013 tested positive for E.coll.Yet,there are several areas National Sanitation Foundation:www.nsf.org/consumer-
in NC with at least 250 of wells with E.coli present.See resources/water-quality/water-filters-testing-treatment/
map for areas with high E.coli detections. contaminant-reduction-claims-guide
iie I NC Department of Health and Human Services•Division of Public Health•Epidemiology Section•Occupational and Environmental
d; Epidemiology NJ
Branch•Private Welland Health Program•bttos://eni.oublichealth.nc.qov/oee/orograms/wellwater.html• NCDHHS is an
/:
vub ext" equal opportunity employer and provider.•09/2019