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HomeMy WebLinkAboutWELL-02-2022-165878.TIF WELL CONSTRUCTION REtORE)'(GW-1) For InlerOdLUso0Oolyt . . ., •-v , • .. .4.,-,-. :=.: ...4= '• . IOW)roorraUttirltifartriatfour . Joseph Bailey 11LWATER2ONSS.7.' ,.. , _„ - •- •" 1111[Mt• TV' ". '. . DESCRIPTION 'Wail tb_riitactor;tiamp . - t. 14 ' , , 11. -H./.6r, 14..1—— 5Wf I:,F 717-/re A lie:::. 32714 „ — *Volt CoMmcipiitaitait4u fribcri. . „ ' IS:OUTER CASING(ierAniilt1•-wedweih)'ORTINER(II ' bie),.,-,,'. ,,- ,' -• B &K Well Drilling Inc , ,FROM.. ', TO .:„ DIAMETER 'Itticx,fess. , , CP 11''' .5,-.:11,.._01.14 -.1N..spR4.1 , pv .: ., ' *1 1 '...."Ji A.,. ,,,l• . i..1 I,/1 1,i..../k4i, 16.INNERCA§INGORTUBDIGIgeothermsH'elosed4021 2 .AVell.ConIkuiddit Pcemitliitilei'riVit'"20141A:". 4 I, ' Ft1(31 1°- 'DT Am rrER '.111IMNESS 1'MATIEPUL ; A Ll#al pplikabloWleponvalonirecmyvi,i,,LIIC r9,e1u ',Sam rortimer.0 hq ft. r0. - .,., , l'Well Use,(chceIcIVell use): ''' ft.'• 14.- -, h„. . ,. = ,..- , . Water supply well: 17:SCREEN • - • , — . ' h. - . , mom TO _. DIAMETER, $GOTSIZE TRIMNESS 'ClAtricultund. 1i-jiiiiorcip alleuiSik ' ,o. Odeothermal(hleatIniXotillnit Supp)y) 11.11-orsilatruial Water SuPP*(stniii4 OlothistrialCo'ountrOlitl; .-' "'"'' .13ResidOntiol,Skruter Stipply,(shiutri) 18.G"it'bur--7 : . ''', - .1 ' • - , ,,,, ,; ^. ',,, „ . ,1:1Imgatioe . ,' -, — . . 0.Wcilt100,000 GPLY 'FROM I.av _ . :_, ,StAirAmt, • ,EstreAcEstarr, ocro.siAltourvi, Non-Miter Sitplity Well: ' .. '' ' ' ' ' ' "0 -ft.• , 20' Cr, „Bet110rite, 'Pour' do ic tiMoniloting.. Injection Well: ,„. ) " Iiiktillif,c.nRocht4q, 1 „ 10GrOundwator,Rcintiiidtion . , .. ., - , /.• ; 1 •'— - - le • ' - 19.SAND/GRAVEL PACK-Orapplicablej , CIA,qpifer Stisorge arid Reeoveiir, •-• -4, "1:1SaIhiity,parrier ROM ',F _ 'TO I,SIATFRIAli.7 ',7 4 EMINACEMF„NTSICTHOO 'lAxqllferTeS .=.,. O' S'totOottor-Drainage I .., TEtenentarenhnology LSuisidenceCooirol I r -- .. OGeothermal(Closed Loop '` OTracer '20.,DitILLINGLOOlatuch sddltIonal.shetrilf areaway) ,, - OGcothertirai,(Hcating/Cooling'Root-ni) bOincr(oxphrin undcrin I'Remaiks)-. FROM,' ;TO. s, I.., , ., 0 2ft0E,SvCo-R''li'- -ON 1-iro,0l7a r1' 4.DateWeifs)Completed:,/ 7 Y11DrtOr ' Wft. ' 'l jin _id /d,tn-e 'e*, k 4:1Vell'Lotation; 5 -6.7e7 nN l ' Lly/ - , -'.,1.. . ____ 15571(Ciljueik161,1)t ,1ercellAle..,(Z4H-64,1„, .,,a9' lail r-7 .1: < '--- •-_, ' • '-'-'" , .'1' .0"' , ,„,.- • ,,,, ' 'P. ' ., • i 1/4,1)(iii,51)tf,A Pi ,..RE,y,A).. P-= 7i, r 'ta%tn.,,,441eptificAtionNo.riP*), ' ,..1,-,i6e331 /9/1(4 5 ;r1107-11fE eth - tj , ... 'lie -5,7c1 ':sii,,piii hid.and longIctsdellidet,:iieSiiiiiitufesIseco'nd's orAiedmerdegrees: — . .. , . fil.WOillicld...onc IsUlanAl!suiRciAnIk .,. t .22.Certiti'ifoni ":"•'''''' 'jr.P4'.-'.:Ii,4.''. '- -,,— .-'''' -- ' "" - -'NY • .i- . , • .. a e L e' , ' '''' '' _ I. . ' ' e t , OP. '6.1s(atephe well(s) i ermanept,-:or ,E1Tempoiary. 'i' ''' ' ?'" 1. , •,- AL, ,,,,,, gning..1v:o 41vn thae,krk err y,.illeitli e.-!,#1,4 ifoi.64`eril ra.wn,rmil'rcirectrdoe'kelatk. 7.,Iiii Is a repair to 4ii>dittint ticii:, 'ElYe-,S, Or Lble ,' lid At4C01C,I1 MO Pr 154#..._Aq02C-11.7P9,Weg Ca'attUrdgm'S'aPia*aiWt141:4CaFF. f.,• , #. rphil iJi4,repc0;-fittaui.knolt*e_qtrinst;iicitaiiihri/ayrin did erp/Riiilhg nature,n1k oPhis record,fins-hfef emiided to t4e$irti.iiieni,r; i, repair under r,21'remailale6ilafifeiri,oillhi liaa.oliPliforpL 23.,Site diagram,or'iiitlitionii0vollitetolls: , • • .„,... - 4,-, =.,": •".__,_'' Si For.Geoprobe/DFT'Or=CloserliiirOpiGebtherroli 3,y04.110ifig,the sem:e You may use the back of this page to An:iv:hie adittiOrial ii=leli consuUctiOn info ==-, ,noniulictiOn;only't t.v.==1)i ricedcd,'TotlicUtc TOT7%1INETMSER:of IA:Oils suridSee,i0vee:juRerrraiks'Box):,You.may ulsoatinohOddiriiiiiil:Fragoilfor-Psciry.;.' ', , „.•=', *ilk:. -,,- • - - . • ...- .24.SUBMITTALINSTRULtIONS ,' ..f $,. 9.Total,weitileptit•tielowAind soiNUor-...= . 12 0-.) - . 114 iSnbmitthis,GY.44%vita);'Ilk days completion per thei.biloiring: fornoritOle iivly:11(1411diyMig!dfficreib(iiirnIple,,..1f#(1Vpilit2@f00) o i Static stirrer level top_f cos ; ,.._6ift.) 40`i 242:for All''Wellsr.o0rigiiiilrfarm.16 biViiiiiil‘o of'Vitus''llcs,ourccsAD*14, ..f. . ;o,: ! ,e,-''-4_ . - .11.',',710-tevel,ris"airo.reratirsitur 7.4."'" 4 - ' "' IniP'PP' alio?Processing:thin,1417 msg.R.aic4ih:NC21699-1647- 6 fil'il , ,. 24h.For Injection Wens:eOpto,DAV-It,ljndergrouild,Injection tontra(1134 II.Boroliblediametiri, --„..-(lm) --, ' , ,PrOgiam„l636,..MSCfileigh,N2-7.699J,T.S36'. - -,Airkfary. ' a:We;tonitruCtion‘methbu:at: '..,-.ti - - — - -1.1e.Fee Water Siinpiv int eitienl:Ltiop"Ge-otherroullieturt:Weliirtirpyto ihn lie;,114VGIotarY,cabir.4ifectiniih,55 4." ' ' "`h - --,'.--.:'.4.1 -' county environmental hualthdepurtrhen(of theuounty'wheithistalled. • '' '- • ... TOR,VATEILSUPPLYWEELS ONLY: _,.: 24d.For4ster:Weilt producing over 100,000'GPD:.tri).-'rto DV* caitu .-- ,13a.Yield(gpro). ' . - Method of lest:.Ali_ ft1-1 . _ Permitfrogram.1,61 k MSc.RAleiglts„NO,,27.1599;•1,6,11, 1 , dr-Tabs 1 112'Lbs . ,. ,.„ -" ' ot..ntsinfiction vv.:: ,--- • '.. A.0.-11,1: '..,. , , ...,. i ..., ,',",,7-1e?,,,'4,,,, ,,,, „ % •::''''' '.:.; ' :,,,,,, :'e,"'?,, .' e.-1.' ''..,,,,71 .44 a; i Form Ovi-1: ,, = ,i,orrh.rardlfurfr+arirocupottrokronmcni4Oualiti.;,f)n:lifoonf)..yC'T.lcsourtts, 1, , Eci 7,, ' ..)tscd6.45.10,(It ,,,, ,' A„-; -- : , , i , 1 . . .. WELL- oa- czoaz- lg.Sk7. CATAWBA COUNTY HEALTH DEPARTMENT Environmental Health Section IIPArr WATER SAMPLE FIELD REPORT & TEST RESULTS Owner: RUSSELL DOUGLAS BLAIR AKA RUSSELL DOUGLAS B, GAMBER-RUSSELL DEBORAH ANN AKA RUSSELL DEBORAH A Owner's Address: 18 FARRAGUT DR,KEEDYSVILLE,MD 21756-1362 Phone#&Email: Site Address: 8585 BLUE HERON,TERRELL,NC 28682 Parcel#: 461704537952 Subdivison: (� (, Sample Collected By:D'S P'1 f e ) Date/Time Sampled: l I/63//c /Z:PM ih Sampling Point: IV e. I I L-e414 Is well head accessible? Yes ✓ No Reason for inaccessibility Well New or Existing? New k,,1 Existing Type of Well: Drilled 11 Bored Punch Hand Dug 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 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: W4- Fecal/E.Coli: VP/ IT No Collection Date Over 30 hours old Invalid Results: Excessive turbidity Excessive Chlorine Lab Accident av .� VV � I Lab Tech Initials: Et"' Date/Time Received: t t(°�/25 �5 Date/Time Completed: � I� soma ihmaa N 0 V 5 2025 Environmental Health Analytical Results STATESVILLE ANALYTICAL Catawba County Public Health PO Box 389 Newton, NC 28658 Receive Date: 11/04/2025 Reported: 11/05/2025 For: Douglas B. Russell: 8585 Blue Heron Dr Terrell NC 28682 Comments: Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst 251104-49-01 Nitrate 165878 <1 mg/L 353.2 11/05/2025 CL 251104-49-01 Nitrite 165878 <0.1 mg/L 353.2 11/05/2025 CL Respectfully submitted, �7 y '0.2 LC• G %� 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-nc.com ' • _ NITRATE/NITRITE ANALYSIS . • ttuu:•ggiera2muoaa nthemild for couipt xe eot'ie. 'WATER SYS RIVIIDff: - o �WELL - 0 a �. (GSS 78 County: Catawba Name of Water System: To v..g(a S B. QZ v.sS e.l1 . Sample Type: 0 Entry Poi t gSSpecial/Noon-compliance ��// Location Where Collected: 0.7 a,;7 8Iu. E.rxan 'Pt' TGrr e,ll PMC DSCif2. Facility ID No. 166 S 8tt'1 Sample Point:• W 61 Rta.ot i1 Collection Date li Collection Time Collected By: DvitShar Alt 11(eA.) 11 /03 /2s' . 10: i `t f M tp{c...,6 Q ca,,,..irn muiryArder FhQ Mail Results to(water system representative): CATAWBA COUNTY PUBLIC HEALTH Phone#p:t,(828)465-8270 ENVIRONMENTAL HEALTH Fax#: . (� SZB�465-8276 , PO BOX 389 Responsible Person's email: li EHAdmin@catawbacountync.gov • NEWTON,NC 28658 LABORATORY ID#: 37755 El SAMPLE UNSATISFACTORY 0 RESAMPLE£IEQUIR1tD CONTAM METHOD REQUIRED WI DETECTED - QUANTIFIED . ALLOWABLE CODE CONTAMINANT CODE REPORTING LIMIT (i.e.<R.RL.) RESLZTS" LIMIT 1I I04. n.F...�._.r 0 Nitrate 3532 1.00 mg/L �,/ ----- mg/L, 10.00 ng/L, i1041 Nitrite • 3532 0.10 rng/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: i ANALYSES BEGUN: 1 1/015 /2 7 :`l5 It nq —C 2f sedrua,;mg, ANALYSES COMPLETED: G t /96 /2 6 D:-`�� M I gym tSxavAld etel) �tt nn 51 Certified B Laboratory I.og{�#: -G ��'L'�nQ_`•�t 1 Y: CO."' - COMMENTS: 27e8 5,aboratory shoed Mail Remelt,tot • Public Water Supply Section,Attn:Data Entry,I634 Mail Service Citte;[Weigh,NC 276994634 PO Box 228 • Statesville,NC 28687 • 704/872/4697 Page 2 of 2 ` ; ,' ,, ='a 4312 District Drive % t _�,; North Carolina State Laboratoryof Public Health MSC 1918 � , Raleigh,NC 27699-1918 H `�� 111�� b' ',,�'�iiii _k, Environmental Sciences http://slph.ncpublichealth.com 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 Douglas Blair Russell P O BOX 389 8585 Blue Heron Dr NEWTON,NC 28658 Terrell,NC 28682 EIN:566001814EH Delivery: NC Courier 1 StarLiMS ID: ES251105-0127 Date Collected: 11/03/2025 Time Collected: 12:14 By: Dwight Mikeal Date Received: 11/05/2025 Time Received: 08:37 Sample Type: Raw Sampling Point: Well head Well Permit No. WELL-02-2022-165878 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 24 mg/L Chloride 32.6 250 mg/L Chromium <0.02 0.10 mg/L Copper <0.01 1.3 mg/L Fluoride 0.354 4.00 mg/L Iron <0.06 0.300 mg/L Lead <0.003 0.015 mg/L Magnesium 4 mg/L Manganese 0.019 0.05 mg/L Mercury <0.0004 0.002 mg/L Nickel <0.01 0.1 mg/L pH 7.3 N/A Selenium <0.005 0.05 mg/L Silver <0.01 0.10 mg/L Sodium 11.7 mg/L Sulfate 10.9 250 mg/L Total Alkalinity 44 mg/L Total Hardness 77 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