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Home My WebLink AboutWELL-02-2022-166413.TIF %NIL!.CONSTRUCTION RECORD(GW-1l For Internal Use Only 1.W ell Contractor Information: Alfred Kiesling Sr , 14.WATER Z:P. FROtl l TO 1 DINCRITTION Well Co,.rrarep tian.r 2670-A G. n. I/0J rt.J fi'1 h/I L c -i 5 tic WcII Corn.ctet Cem ca:.on Nurrx 15.(/ITERCLSING tfar:mattimed Ve1>s)OR LINEAR( MATERIAL B & K Well Drilling Inc FROM TO I DIAMETER I THICN•ESS Company Same '0 ft. 'I b 5 f(. I61/4 to. IsDR-21 PVC /�n / / t le rkNER CASING OR TESL G(geothermal da+edawp) 2.Well Construeaon Permit!: Lf-1 6��- f 61, / 3 ...cr.. r0 1 D14u!►:n TwCkseSS I �1A1eN14L ft. , rt. I in. I LW a:l appl.e:Ne well.otunxaon gee ens r _7C Ca,o n Starr t e crow r.. 1 ft. R I. is. 3.Well Use(check well use): L Water Supply Well: I O't Fin:TO I DIAMETER cLorsltE r T'NI('K�(SS 1'M CURIAL G.Atrlcuitual CYfunlcipal?ublrt.. a. R. I in. Ir CGeothetm:I(Heating'Coohng Supply► 24dential Watt Supply(single' ft. , R. ! to I ; C Ind uscia1VCo ntmerc:al CRes:dennal War Supply(eased) IR GROUT. 1 Clrngaton : ellS>100.000GPD FROM TO —MATERIAL EtlPL'sCE•tE.�T MCTFtvDa VI(lV�'1 Non-Water Supple Wed: 0 h- 20 ft' Bentonite Pour , C\lotvtonng 7Rnotcry ft. l ft. l Injection well: ll j CAqutfee Recharge D(iroundwatet Remedtarion ft.I fr. 19.54'B.GRav'EL PACK fifatrembk) EMPLACEMENT MFT„(a CAquifer Storage and Recovery °Salnnty Barney Foam TO I MATERIAL CAquifer Tat OStotmwaree Drainage ft. I ft. CExpenmemal Technology :Subsidence Control ft. I ft. °Geothermal(Closed Loop) :Tracer ZS.OR1LLINGLOG(sLachadattw.tgleebll«refl■nJ COtotbermal(Hering/Cooling Return) Other(explain under=21 Remarks) FROM I TO DESCRIPTION tiler.brdnr�ae.J.rock rope-.rm no.ere r ov, 4.Date Well(s)Compktedr: !//6,02 Z ve1l 1Da 5-ft. 2 j) ft. h/4.Ki s'it-` 0 R. 1 5 ft. �r�cn SP i' .62r1`-ia.Well Location:E l.� - I„YJ L L c .r� ff. 15- n� mi(1J' (m i Facil,ty,On.,erName Fzcd.nl'):I,fzp;'•eat,le‘ I ft. ft. r I ft. I k Phvvrc.;Andress.CT,and Z,p ft. 36 9 epy7J.241 I l`-sl.xfllUtRES co.„ Pucci Idcto c,a wn No IPINI 1 Sb.Ladtude and longitude in degrees;minatessecunds or decimal degrees: I t— I,f s.cl1...cid.on.latlong iv saic,cnt' 22.Certification: �je g N 6.Is(are)thewelks): nPermaoent or CTemponrs ef du Comrataor Due B,arras 1.7.,corn?l hrrel".terntt that rhr..r/ifA/.411(I 0.arsrtnrrf:r ar VIVTIC n r<.a' 7.Is his a repair to an esisliug well; :Yes or ....:No '(4VC.+l:0:C.010Cor11.4NCACO2C.0200ire nrr..cwSrar_zris and Our acum ;f.sus:r ar pew fill an,kno..rhellrntrrtnn lieu.w'arntarrnn and.riot'rho norure.a:rn. ..frhrr rrenrd Fey he wpo tfind rn the.r/I owner. ' "air tenth":2/remarks soma.a-on the back of ens form 23.Site diagram or additional well details: S.For Geoprobe/DPT or Closed-Loop Geothermal Wells hating the same You may use the back of this page to provide additional well construction info consmncron.only I GW-1 is needed. Indicate TOTAL NUMBER of wells (add'See Os?in Remarks Bo.).You may also attach additional pages if neca..ary drilled: j _ 24.SUBMITTAL INSTRUCTIONS 9.Total well depth below land surface: d OS' (ft•) Fw muinp,r•rib tut nil deyd iif u ,bffetrar f.rampffe-i;e�00 and_'rc l rNl') Submit this GW-1 within 30 days of well eampktion per the following: 10.Static water level below top of using:40 24a. For All Wells: Onvn Resources al form to Division of Water Resoues (OW RI. Ift.) Information Processing Unit.1617 MSC.Raleigh.NC 27E00.1617 If unfe lewd is at,v,r cnrmF use IL.Borehole diameter:6 1/8 tin) 24b.For laiection Wells:Copy to DWTL Underground Imecuon Centro:ail Prom-am.1636 MSC.Rateig.NC 27o99-16:4o 12.Well construction method:Air Rotary 24c.For Water Supply and Open-Loop Geothermal Return Wells•ion to:h. Ire.nufer rotary.cable,drat push.etc I county em):onmeoul health department of the county where Installed FOR WATER SUPPLY WELLS ONLY: _____, 24d.For hater Wells producing user 100.000 GPO:Cops t:•"ts d,CC'C.( 13a.Yield(rpm) l a2 Air Lift Permit Pro,nam,Int I\fx.Raleigh.NC'-n.•4Intl �lrrhnd of test' 13b.Disinfection type:Chlor. Tabs Amount: I 1 1/2 Lbs form GA-I '.or:t('aroltna Depanlncnt at Win.:tonawr:u:Qaahr. .,..,ions..!Si a...II.....,,. ft....A;..-,.. 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 Townsend Sample ID Number: 166413 Location: 3195 Timber Run Ln, Maiden NC 28650 Reviewer: Bryan Forsee 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. lithe 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 `dn sure"<:tio,Ito Private Well Information and Use Recommendations NC DEPARTMENT OF HEALTH AND HUMAN SERVICES Division of Public Health For Inorganic Chemical Contaminants County: Catawba Name: 1 Michael Townsend-3195 Timber Run Ln, Maiden NC 28650 Sample ID#: 166413 Reviewer: Bryan Forsee TEST RESULTS AND USE RECOMMENDATIONS l. ® 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. ❑ 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 jnoruanic chemical results ou(r. El Arsenic El Barium n Cadmium El Chromium ❑ Copper El Fluoride ❑ Iron El Lead ❑ Manganese ❑ Mercury El Nickel ❑Nitrate/Nitrite El Selenium El Silver El 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. ❑ Chloride ❑ Copper El Fluoride El Iron ❑ Manganese ❑ pH El Silver ❑ Sulfate El Zinc 6. ❑ 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 North Carolina Division of Public Health at 919-707-5900.