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Home My WebLink AboutWELL-03-2022-167350.TIF Oct 27 22,01:52p p.2 WELL CONSTRUCTION RECORD(GW-11 For Internal Use Only: 1.Well Contractor Information: Kyle C. Shaw 14.WATER ZONES 1- Well Contractor Name �� FROM 10 , DESCRIPTION` 4521-A 'non- u5 rt' i .7,' i I R. n I NC Well Contractor Certatmticn Number 15.OUTER CASING(for multi-cased walls)OR LINER(1 f sip Doable) Advanced Well Drilling, LLC ' FROM TO DIAIIEiER THICKNESS MATERldr. Compcny Name 1 (I. � ft 6 in. Heavy PVC t+ _ lb.IcTERCASIIGOR TUPING(geothermal closed-14mq 2.Well Construction Permit#: LJt? 3��G:�" � �J FROM �o DWusrrst THICI.-r'rss MATERIAL List oll applicabis IR construction pawn's(i.e, WC,County.Steve, Valiance.era) !i ft. tn' a 3.Well Use(check.well use): n et. '" Water Supply Well; 17.SCREEN FROM TO DIAMETER I SLOT SIZE THICKNESS MAIEr AJ. ❑Agricultural ❑MtniicipahPublic it. rt. in. ❑Geetit mal(HeatingiCoclino Supply) MResidential Water Supply(single) - ft. ' R. in ❑lndustrialtConunercial UResidential Water Supply(shares~) IS.GROUT ❑Initiation ❑V/ells> 100.000 GPD -FROM TO , MATERIAL EMPfACEMENr'METHOD&AMOUNT Non-WW'aterSupply Well; D it 17 rL Bentonite Poured ❑Monitoring DRe coveery It. ft- Irliection Well: n. rt. ❑.siquifelr Redtarae OC•roandc ater Remediatiatt 19.5ANDiGRAVEt PACK'(if applicable) ❑Aqui ter Storage and Recovery DSalinityBarrier FROM _ TO MATERIAL E}1PLACEIIETMETHOD ❑Aquifer Test ❑Stornivater Drainage n' ft' ❑Experimenrtal Technology OSubsidence Control rt. h- ❑Geodlennal(Closed Loop) ❑Tracer 20.URILLI G LOG(attach additional sheets if neccssare) FROM TO DESCRIPTION(color.hardness.soil/rock type,gralu sue.etc] ❑Ge❑thermal(He ttingCooling Return) DOdta tax-plain under..=21 Remarks) q 0 it otS ft.r-1/4 1 a.ti. 4.Date Well(s)Completed: 1 -a6 °l,Well HA. '2-5 tt j n' cJOCl ._ Set.Well Location: j ft K. j rL Isar-g a)r-&-7 p-,� GV_I o,+d 3,-1:ir-i e S z c I.e.0.1o.^_ L/y% ft. 5't ibt-61 ci`e�l r'o�\L- FecitittlOeaterNome Facility ID=;ifappiicablc) ft fL •! f 'S\ l- M • It it Physical Address,City,end Zip it ft. (astgtj�(5\ _11.REMAR1s County Parcel Identif:cationNo C13I1) • 5b.Latitude end longitude in deg'eesfminutedseconds or decimal degrees: Orwell field.one lot/long is aual eimt) 22.Certification: 35 . SGu-..5,? � L 6.is(arc)the well(s): ,Permanent or CTempor:ll) Si /479-4'Ll—' 9-R6--(22... g a of Certified 1Ye11 Cortmctor • Due 8t•sigrrfng tiris-farat.I hereby aerri fj•thee the aell(s)lour(ware)constructed in accordance with 7.Is this a repair toan existing well: CYes or Naa 1LI.\•C,ICOK.0100or111?CAC 02C.0200 Ira/Caastrnuion Standards and Mar acopy if this is a repair.fill our brown veil cow:sedan irlorma:ion and explain rho tavure ofrlx of this record has been pr aided to the well oxvier. repair ander 421 rentaris seofon or on the bark gt this ferns. 23.Site diagram or additional sr'el!details: 8.For Geoprobe(DPT or Closed-Loop Geothermal Wells having the sang You may use the bark of this page to provide additional val1 constriction info eorstrueaon,only 1 OW-1 is n dad. Indicate TOTAL\Z 1iBER of galls (add'See Ova in Remarks Box).You may also attach additional pages if necessary. drilled: 24.SUBMITTAL INSTRUCTIONS 9.Total st'ell depth below land surface: 'O (R') Submit this GW-1 within 30 drys of well completion per the Following:• Par rxulripk wefts list nil dcprhs O'c-efferent(example-34+200'artd 2Z1 GO) �i 0 (ft.) 24a. For All Wells: D.-iginal form to Division of Water Resources'(D',1 R). 10.Static water level below top of casing: treater level is above casing.use--6" Information Processing Unit.1617 MSC,Raleigh.NC 27699-16 1 7 11.Borehole diameter. 6 (i ) 24b.For Infection Wells:Copy to DWR Underground Injection Control(11iC) Progran,1636 MSC,Raleigh.NC 27699-1636 12.Well construction method: A. t—Vro'N.{;I 24c.For Water Supply and Open-Loop Geothermal Return Wells:Copy to the (Le.auger,rotary,cable,niece push,etc.) county environmental health department of the county where Ftstalled FOR WATER SUPPLY WELLS ONLY: 24d.For Water Wells produchx,over 100 000 GPD:Copy to DWR,CCPCUA 13a.Yield(gpm) ) b,) Method of test: Air Permit Program,1611 NISC.Raleig ,NC 276g9-f6(1 1313.Disinfection type: HTH Amount: i ) .o ,• . -_...._.. North Carolina Dcpa.-tment o=EnIronrner.tal Quality•Division of Water Resources R-s_?ti,__ i' 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: Joshua Hatcher Sample ID Number: 167350 Location: 3166 E Maiden Rd, Maiden NC 28650 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. N 0 R T H C A R 0 L I N A ,,sAEM', t ; Private Well Information GI and Use Recommendations NC DEPARTMENT OF HEALTH AND HUMAN SERVICES Division of Public Health For Inorganic Chemical Contaminants County: Catawba Name: Joshua Hatcher—3166 E Maiden Rd, Maiden NC 28650 Sample ID#: 1167350 Reviewer: Megen McBride TEST RESULTS AND USE RECOMMENDATIONS I. ® 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 ❑ Lead ❑ Manganese ❑ Mercury ❑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. Z 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 ❑ Fluoride ® Iron ® Manganese pH n Silver ❑ Sulfate ❑ Zinc 6. ❑ a. Sodium levels exceed the U.S. Environmental Protection Agency's(USEPA) Health Advisory level for sodium of 20 mg/l. 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 inoreanic 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.