HomeMy WebLinkAboutWELL-01-2022-164724.TIF WELL CONJUC ION RFCQRD(GW1} For in:etnal Use Only
tiva Cotnrsetor laftwisitiont
Robert Teague 14.'1Y ATER Zfyi'tr
I FAO*I , TO DESCRIPTION
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ft. III5 it SOR•21
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2.Weil Canstsettbn Permit It: te. ft. I ilklirattPphpble rall:aurrucr.onperIut n e LA'.l.:040!.Smart Ycrance rat)
3.Well Use(check well use): ft.
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• Water Supply Well: rxu+i SCREEN17, Dt asirraa0.(� 1
Agricultural Q'vlunicipaL Pubh� ft. �—
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Industrial/Commercial [ 111111
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QlfngaGUn �'. FROM TO M.T/VAL
Noa-Water Supply Well:
it. ft.
0 41onitonns QRctoser}' ft. I h.
injection Well: I R i n.
QAqutfer Recharge Dc,re.adwater Remediahtor.
19.SAVULRAY£LPACK r, �:4 LNrtAcratritRtTtirlD
Aquifer Storage and Raotm Dahl/try Barrier Fermi TO 'UT
QAgtnfct Test ft.QStorrnwatcr Drainacc
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QExpenrncntal Technology QSubsidence Control 1 ft. ft. .
tGeothermalIClosed Loop) QTracer 20.11Rna1:'1G (anal aidliIi ' O'aeo'de°1') s • � 1
FltoNt 1 TO I DESCR1mON t�)�
3Geothertnal(Heating/Cooling Return) f Othcr(explain under 42I Remarks) ft, f x} ft. ,,,1 t ` r '� !
ft. I��5 n.�-' VV�� r
1.Date Well(e)Compktedt� 7-.)-�. Well iUa �f ft.� ft. 1-(k)''() �i���. ���C
Sa.Wctl Location• .C)� 4 tZ Iii�
31'if ICelAIdr1(1Si ft. I fr.
F�thry/Owner Same Fu,lrry LDp Itf app!cable)
1—i1t;)5 t U.S 76 1‘k t( iC ) Qf I ft. ft.
Physical Address.City.and Zip
121.REMARKS
City parcel t,teM.Ftcoiion No iPN1 !
Sb.Latitude and longitude in degreestninutesisecouds or decimal degrees:
(if trc11 fictd one lay gong es aufhcuntl 22.Certification!'"
//?& i/
N - 7 .
t 6toulore ace--m5v4 wen G, .c;ur tktu
6.Ware)the w'ell(s)13Permanent or QTemporary
Bti.:snag this form.,1 intern cerhft that the rrNh n
l wet.+ ,erel Coomtttear to ateordeate
7.is this a repair to an existing well: ❑Yes or �n ,rk 13A+CAC n1C 0140 or:3.4 ACAC VC 02W writ Ctm nave Siskaianl)dad that.
cogs of;its rern,d„os hccnprattdcd to!let cell en,ntr.
lftku it o trpsu,fill twa knorw well einrtnrctmi t ynrmauon rrC!a,n Ike'law,'of test
'elv&undrr 0 1 remark,arcfnrn w on rhr tut k,),/tF:.,lurm , 23.Site diagram or additional Weil details:
r:t
You clay use the bads of this page to provide additional w details
well siu cc Melt
S.For GeoprobtiDPT or Closed-Loop Geothermal Wells haying the samecon You cc!on dRagals. You may also attach additional Raga if tucess
construcnoa,ocly I GW-1 is Deeded. indicate TOTAL NLMBER of wells
drilled: t/1 l �, 51,s+lITTAL it STRUCTtONS
9.Total well depth below land surface: (ft.) 24a. for :All Weil,: Submit this forth within 30 days of completion of wcir
Fir amittpie,alit icy all drlwltr,fdifferent t:.tan,lrlr.422114'aed 2,g/ool constrlcz oc to the followma:
10.Static water loci below top of casing:40 (It) Division of Water Resources.laformatios Practising Unit.
1f,wttr le.e/u,ahn r mar nr,a*r 1617 Mail Service Center,Raleigh,NC 27699..1617
11.Borehole diameter: 6 1/8 (in.) 2.b.For Inicctign went: In addition to sending the form to the addreas in'24a
Air Rotary above. also submit ono copy df this form within 30 days of completion of well
12.Well construction method. construction tO the following:
I I e.watt.rotary.cable.direct p. Ii.eia
Division of Water Resources,Underground Injection Control Program.
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center,Raleigh,NC 27699-1636
13a.Yield(gpm) 3-6 Method of test: A'r FIOi0 24c.for%.}ter Supply&%lettion%efs: lit addition to sending the fora to
the addresstes) above, also submit one copy of this farm wtthin
30
da)s o
f
Chloe Tate r ,�a cosapl of well. coast:omen to the cotaty health departme
nt of
lib.Disinfection aye: Amount. nor,.r.re.inru:f
Analytical Results ,' N TILACYCA
Catawba County Public Health
PO Box 389
Newton, NC 28658
Receive Date: 10/08/2024
Reported: 10/09/2024
For: Michael &Bridget Mitchell 4295 E US 70 HWY
Claremont NC 28610
Comments:
Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst
241008-36-01 Nitrate 164724 <1 mg/L 3532 10/08/2024 CL
241008-36-01 Nitrite 164724 <0.1 mg/L 3532 10/08/2024 CL
Respectfully submitted,
Melissa Myers
NC Cert#440,
NCDW Cert#37755,
EPA#NC00909
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 2
' ST.:k :YILLE
s4 �. idAL'i T1I AL
„_„L, " 1
Ylgr,, '.6:'
122 Court Street Statesville,NC 28677
704-872-4697 www.sa-nc.com
NITRATE/NITRITE ANALYSIS
Note:AU tofatnutioa ttsu:be'sepplied faconvIliaee credit.
WATER SYSTEM ID#: O ( -a0a2., _ I G ct `�2. County: Catawba
Name of Water System: P I I LLA.e( 4- 'fit 1 d,neeA t+ck4)
Sample Type: 0 Entry P Ioint r lSSpecia11Non-compliance c�
Location Where Collected: T/25 J: E. Li.5- w 7 9 0 ! C A 01-'e4"-c,y4 Ai C C/0
Facility ID No. f C-1-�aP.-4
Sample Point: I6- p sirCollection Date 'Collection Time
Collected By: pt./-i'yL+ AN.i kea,.1 10 /0)/ 9-4' - ___.$:5-2, A M
(Mast Print) tMYJDtun7 — (s,-atry ANcPM)
Mail Results to(water system representative):
CATAWBA COUNTY PUBLIC HEALTH Plum;/:l (828)465-8270
ENVIRONMENTAL HEALTH Fax#. L(828)465-8276 '
,PO BOX 389 Responsible Person's email:
f EHAdmin@catawbacountync.gov
NEWTON,NC 28658
}LABORATORY ID#: 37755 0 SAMPLE UNSATISFACTORY 0 RESAMPLE REQUIRED
•
Q QUANTIFIED ALLOWABLE l}1
RE UIRED NOT DETECTED 11 CONTAM METHOD
CODE CONTAMINANT CODE REPORTING
(Lt. R.L) RESULTS.4 LIMIT
1040 Nitrate 353.2 1.00 mg/L X ___,-___ mg/L I0.00 mg/L
r, 1.041 Nitrite 353.2 0.10 mg/L mg/L 1.00 mg/L
*Note:If result exceeds allowable limit,the laboratory must fax analytical results to the State on day test completed.
DATE: TIME:
ANALYSES BEGUN: L o t 0 S /2L __ _ �( P IYI
1txnwtyrvl ,Is;ayyAx..m.
; ANALYSES COMPLETED: E0 -05 / ill ,_.5: j ) r M
I tnsarroc rn is u ry tsinrat
Laboratory Log;':eaa l i -O7 Certified By:
COMMENTS:
2008
Laboratory should tail Results to:
Public Water Supply Section,Attn:Data Entry,1634 Mail Service Center,Raleigh,NC 276994634
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&Bridget Mitchell Sample ID Number: 164724
Location: 4295 E US 70 Hwy, Claremont NC 28610 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.
1
N 0 R T H C A R 0 L I N A
<40 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&Bridget Mitchell—4295 E US 70 Hwy, Claremont NC 28610
Sample ID#: 164724 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.❑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
LI Lead ❑ Manganese ❑Mercury n Nickel ❑Nitrate/Nitrite ❑ 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.
n Chloride ❑ Copper ❑Fluoride ❑Iron ❑ Manganese
❑ 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. ❑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.