HomeMy WebLinkAboutWELL-05-2022-171366.tif 01:1144 CATAWBA COUNTY Case#
4-111liti Public Health Department Subdivision
c s Environmental Health Division PiNN 46f 602577965
1�/0 PO Box 369,25 Government Drive,Newton,NC 28ti58 LOTq 2
faIrSlteAdd►ess: 4496 KISER ISLAND RD,TERRELL NC 28682
Name on Permit: 'NEST HOMES LLC
Property Size: Acres 0.54
Directions: $on NC 16,Eon Hwy 150,approx 7 miles,Right on Kiser Island Rd,Kiser Island Rd to parcel on Left
d� Owner/Authorized Representative Acknowledgement of Permit Receipt
1 I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property described above.
(WAs the property owner or authorized representative,I have received the above referenced
permit(s)as requested in the application for service RBPR-01-2022-39866,by the following method(s):
Received in Person
Facsimile Transmittal(Return form with signature required)
TElectronic Image Transmittal/E-mail (Return receipt required)
As the property owner or authorized representative I have reviewed and understand the specific conditions
of the permit issued, and further understand that all applicable regulatory requirements specified under the
North Carolina Laws and Rules for Sewage Treatment and Disposal Systems(1SA NCAC 18A.1900),
and/or Well Construction Standards(1SA NCAC 2C.0100), shall apply to the issuance of this permit and
the construction of the wastewater system and/or water supply well permitted.
Permit Issue Date: 05/12/2022
Owner/Authorized Representative SignatureAjiat,4-N...--1
Date 511(6/2o9_2,
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by 1 (name of person sending permit)
Signature I _Date/Time hA V))
V
Method: Fax _ ‘ Email US Mail Other
Owner's request to send by the above indicated method of transmittal In lieu of signature
We want tto hear from youPlease ttake a few momentts tto complette our custtomer service survey att
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til a w
e ti ROY COOPER•Governor
's�,. NC DEPARTMENT OF KODY H. KINSLEY• Secretary
Ai HEALTH AND
Q HELEN WOLSTENHOLME • Interim Deputy Secretaryfor Health
,�; HUMAN SERVICES p y
MARK T. BENTON •Assistant Secretary for Public Health
Division of Public Health
Onsite Water Protection Branch
May 9, 2022
Wind and Water Development LLC.
PO Box 3965
Mooresville, SC 28117
Re: Approval No. JMB2629
Private Well Located Less than 50' from Surface Water [Rule 15A NCAC 2C
.0107(a)(2)(Q)]
Property location:
4496 Kiser Island
Terrell, NC 28682
To Whom It May Concern:
On May 4, 2022, the On-site Water Protection Branch received your request for a
variance from the Well Construction standards, Title 15A North Carolina Administrative
Code Subchapter 2C .0100. The request for a variance concerns a proposed water supply
well on the referenced property that will serve a single-family dwelling and part of a lake
on the property will be within fifty feet of the well. The home is on a lot with very
difficult topography.
Specifically, the variance request grants you permission to construct a water supply well
at a distance closer than the fifty-foot setback to a surface water body. Achieving the
fifty-foot setback would be difficult given the challenges of the property.
Based upon information provided by the Catawba County Health Department, and the
property owner, it is my finding that based upon current conditions as the site exist
today (as well as the current proposal for use of the structure) you meet the conditions
necessary for approval of a variance as specified by 15A NCAC .0118 (a) (1) and (2).
On that basis and if the following conditions are met, the requested variance is
approved:
NC DEPARTMENT OF HEALTH AND HUMAN SERVICES • DIVISION OF PUBLIC HEALTH
LOCATION:5605 Six Forks Road,Raleigh, NC 27609
MAILING ADDRESS:1642 Mail Service Center, Raleigh, NC 27699-1642
www.ncdhhs.gov • TEL:919-707-5874 • FAX:919-845-3972
AN EQUAL OPPORTUNITY I AFFIRMATIVE ACTION EMPLOYER
1) The new water supply well shall be constructed of either PVC, steel, or galvanized
metal casing.
2) The well shall be located as far as possible from the structure where, depending upon
where well rig can actually set up, will possibly encroach upon the 50foot setback,
but not be closer than 25feet.
3) A preconstruction meeting shall be required with the Catawba County Health
Department staff to ensure that the maximum possible distances are achieved.
4) The well will be required to have casing installed to a minimum of 50 feet below land
surface or to bedrock, whichever is greater.
5) The well shall be at least one hundred feet from any part of the septic system
including repair area.
6) Grout will be required the entire length of the casing from land surface into bedrock.
7) A drill bit with a diameter of a least one third greater than the diameter of the casing
must be used to drill the cased portion of the well.
8) Grout must be either pumped into place with the use of a tremmie pipe or pressure
method.
9) If a full-length grout is not possible due to site conditions, then a packer-liner
must be installed in the well. The liner must extend at least five feet beyond the
end of the casing and grouted entirely with a neat cement grout.
10)The well must be constructed outside of any road right of way.
The granting of this variance is for the well location only. It in no way relieves the owner
or agent from other requirements of the North Carolina Well Construction Standards
including, but not limited to the requirements in 15A NCAC 2C .0113(b)to repair or to
abandon any well which acts as a source or channel for the migration of contamination.
This approval does not imply sufficient water quality. Further, the approval does not
relieve your responsibility to comply with any other applicable Federal, State, or local
laws or regulations.
If you have any questions regarding this variance, please contact me at(828) 713-3335.
Sincerely,
t. ,,,
John M. Brooks R.E.H.S, MS
2
5/17/22,9:50 AM
WPDT Report
Area of Interest (AOI) Information
Area : 3,134,508.65 ft2
May 17 2022 9:49:25 Eastern Daylight Time
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5/17/22,9:50 AM
4496 Kiser Island Rd
All North Carolina Department of Environmental Quality(NCDEQ)GIS data is expressly provided"AS IS"and"WITH ALL FAULTS".The
NCDEQ makes no warranty of any kind,express or implied,concerning this information,including but not limited to any warranties of
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2/2
• Cis,_, 1,di 417 t+.2,3 111111111111
111.1,1 (•O\STRUCI•ION RECORD (CW-1) Par internal Use Only:
I.Nell Gontr orbit Itrfnrmalion:
Joseph Bailey .A .�.- rI � ;" r'ra
PROM •7D �nrlu'Rlr ion
��� - .
1l i l l t,�su.tr!.x tinnx , +/� h. //_4 rt.3271•A L1IRd1rI {/
IL R.
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\t \)ell I',Wm,tot t mill:alit%LIMNr �tkiie,(j t• tu : •,,.1 ---mot
�13:Offt'�f�trAlfir((7 ""'"TY .
B & K Well Drilling Inc FROM _10 DIAMETER rut Kw-+a MARIM.
A ft. , n. MAIIIIIPIr
L// �OC�2p;� f0l G FROM lu DIAMETER TillCK'YAS MAIFRIA!
2.Well Construction Permit N:� L/ /` 1
/� h, _/�fl. G N In, /
f rJ all dpp6rablr weft e'anctrcn?wire pro „(,Pre.Me,('nanny,.Stair, i urutnre,rk) , /a 7'/ 3 ri
V n. f O. la
{.Well l'sc(check well twit
Water Supply'Well:
FROM to mawIEH sun amfHr NNY.
ls9 61ATFAIAt
Water
()MunicipallPublic ft. ft. in. -__ -
EI(ie,,lhcrnml O!rating Cooling Supply) @Residential Water Supply(single) n. It. In.
,9lndustrwl'Cummctetal ()Residential Water Supply(shared) ' la.GROUT Mt -
Irrigation FROM TToAI I.RIAI, EAIPI.ACF,\1FVl MF:l HUD A AMrtt:ni^,
Non-Willer Supply Well: 0 h. 20 n' Donors Pour `r
0 Monlioring Recovery b h' ,� ft. A'a 40 • l��,S• �
injection Well: ft. n• t/
IqII'Ir
Reharge ()Crroundwntrr RemediaHnn -19, lequila Storage and Recovery ()Salinity13amer FROM 10eothAquifer Tcst (Storrnwatcr r Remc r apcnmcntal Technology ()Subsidence Control h. fl.i uthermal(Closes Loop) ()Tracer 20.DRILLING LOG(attachaddidaasl sheets if oecessan')
FROM 10 D►m-turtin%(color,sardopymnunK►flpasrru__Lya.t-
n(icothemial(Heating/Cooling Return) ❑Other(explain under 421 Remarks) ' It Rd gar/�
/� 1 y� ij
4.Date Well(s)Completed: .1 /S ) Well MN Ld/ p� ''6 It. a 5 ft. '50VA a/J — —'
Sa.Well Locat on: n' h• l.L//¢aJ /I.AJf
-
/ 007I f at. Pottle srft• n. [Tay j...4. ►� r/e3.7.4,•1y'i
Facility/Owner Name Facility il)a(d appllrabk) 45J✓ ft. Ise ft. /li t -
9L k,sef, s1444, IC r0P1I, tic a ti s . ° 1. ,L�` ---
Physi al Address,City,and 7Ip
C4174164 �6 Q 6RO)94 ' 11.REMARKS . •
/. . /7n
County Parcel Idenrdiranon Na(PIN) �. H U_� 'l1 e I I •f�'�i 7'"
Sb.Latitude and longitude in degrees/minutes/seconds or decimal degrees: l?ark 411 Ala,v�:,4•.21.-_ZO71 j)4
(dwell kid.one Lit/long is sufficient) 22.Certification:
N W01 ,
6.is(are)the wells) Permanent or DTemporary Si urco W on ctnr Dar
B. signing r c farm.1 hereby ce that the well(s1 writ(ism)t onsttucted in accordance
7.Is this a repair to an existing well: ()Yes or IDNo with 114 MCA;02C.0100 or 15A NCAC 02C 0200[Feil Construction Standards and that it
If am o a repay,loll out lunowrf well construction to/ormarhm and aydan the natter of Me rope oJrhis record has been provided Zr,the.tell owner.
repair under n11 remarks section or on the bock ofthis form 23.Site diagram or additional well details:
6.For Geuprobe/DPT or Closed-Loop Geothermal Wells having the same You may use the back of this page toprovide additional well site details or well
construction details. You
construction,only l GW-I is needed. Indicate TOTAL NUMBER of wells may also attach additional pages if necessary'.
drilled.' --_____ .---..__....__._.___ SIIU ll"I1'AL INSTRI.J IO%S
r
9.'1'otal well depth below land surface: J0,C le,•) 24a. For All Welt): Submit this form within 30 days of completion of well
tor multiple wells list all depths if dtl/i•renr?esample.3rdt200'and 1(4,,100 construction to the following:
10.Static water level below top of casing:40 (ft.) Division of Water Resources,Information Processing Unit,
If,me,Jere!is above rasing We"•" 1617 Mall Service Center,Raleigh.NC 27699-1617
11.Borehole diameter: 6 1/8 (in.) 24b. For Infection Wells: in addition to sending the form to the address in 24a
� above,also submit one copy of this form within 30 days of completion of well
12.Well construction method: flai construction to the following
(r c auger,rotary,cable,dnect push.etc)
Division of Water Resources,Underground Injection Control Program,
FOR WATER SUPPLY WELLSpO�NLY: 1636 Mall Service Center,Raleigh,NC 27699-1636
13a.Yield(gpm) /060/ Method of test: Airlift 24e.For Water Sootily Sr Iniecilot Wells: In addition to sending the form to
Me adl)(ess(es) above, also submit one copy of this form within 30 days of
Chlor Tabs 1 1!2 Tubs completion of well construction to the count health de arUrient of the
13h.Disinfection type: Amount: P p county
where constructed.
Form c;w.l North Carolina Department of Ftnironmcnlal()twiny•Division of Water Resources Revuod a 22-2016 •
i
,, ` ; ASTATf 4312 District Drive
i,t1lj if i :_ '',, North Carolina State Laboratoryof Public Health MSC 1918
Raleigh,NC 2769 9-1 9 1 8
\ Ii fN Vci Environmental Sciences http://slph.ncpublichealth.corn
S,,}c" *,"` Phone: 919-733-7308
Inorganic Chemistry Fax: 919-715-8611
Certificate of Analysis FINAL REPORT
Report to: ENVIRONMENTAL HEALTH Name of System:
CATAWBA COUNTY ENVIRONMENTAL HEALTH Scott&Karen Stull
P 0 BOX 389 4496 Kiser Island
NEWTON,NC 28658 Terrell,NC 28682
EIN:566001814EH Delivery: NC Courier
StarLiMS ID: ES240626-0065 Date Collected: 06/25/2024 Time Collected: 11:22 By: Dwight Mikeal
Date Received: 06/26/2024 Time Received: 08:06
Sample Type: Raw Sampling Point: Sample tap on well head Well Permit No. WELL-05-2022-171366
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 6 mg/L
Chloride <5 250 mg/L
Chromium <0.02 0.10 mg/L
Copper <0.01 1.3 mg/L
Fluoride 0.103 4.00 mg/L
Iron <0.06 0.300 mg/L
Lead <0.003 0.015 mg/L
Magnesium 2 mg/L
Manganese <0.005 0.05 mg/L
Mercury <0.0004 0.002 mg/L
Nickel <0.01 0.1 mg/L
pH 7.1 N/A
Selenium <0.005 0.05 mg/L
Silver <0.01 0.10 mg/L
Sodium 7.1 mg/L
Sulfate <5 250 mg/L
Total Alkalinity 33 mg/L
Total Hardness 26 mg/L
Zinc <0.05 5.0 mg/L
Report Date: 07/12/2024 RECEIVED Reported By: .".".." ~
1 Marc Komlos
JUL 1 8 2024
Environmental Health
Page 1 of 1
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: Scott Stull Sample ID Number: 171366
Location: 4496 Kiser Island Rd,Terrell NC 28682 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 depai talent 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
d wR�EaNO Private Well Information
44° v0' and Use Recommendations
NC DEPARTMENT OF
HEALTH AND HUMAN SERVICES
Division of Public Health For Inorganic Chemical Contaminants
County: Catawba Name: Scott Stull—4496 Kiser Island Rd,Terrell NC 28682
Sample ID#: 171366 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 n Cadmium ❑ Chromium ❑ Copper ❑Fluoride ❑Iron
n Lead n Manganese ❑Mercury ❑Nickel n 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.
❑ Chloride n Copper ❑Fluoride n Iron n Manganese
❑ pH ❑ Silver n 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 inorganic chemical results only.
n b.Your sodium level exceeds 30 mg/1 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.