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Home My WebLink AboutWELL-05-2022-171352.tif WELL CONSTRUCTION RECORD(GW-IOnly: Print Form; For Internal Use 1.Well Contractor Information: Joseph Bailey 14.WATERZONES • Well Contractor Name F'R097,.tr TOIIFSCRIPTION ' 3271-A aI • 24/7fL /fu e►1 ,4-s Zoe_ft. ft. NC Well Contractor Certification Number 15.OUTER CASING(fur multi-cased wells)OR LINER(if ap licable) B&K Well Drilling Inc FROM '10 DIAMETER THICKNESS MaTERIAI. Company Name 2.Well Construction Permit#: we/ ft. /!y4 ft. !_. In. 0 e41 �, qt„, /( `Qb,,., O�v' /ea lb.INNER CASING OR TUBING(geothermal closed-loop) ((r'-wvYCC(•• JI FROM TO DIAMETER THICKNESS MATERIAL List all applicable well construction pet-BTUs(i.e.WC,County,State,Variance,etc.) ft. ft. In. 3.Well Use(check well use): ft. ft. in. Water Supply Well: 17.SCREEN 0AgriCUltural FROM TO DIAMETER SLOT SIZE THICKNESS MATERIAL QMunicipal/Public ft. ft. in. Geothermal(Heating/Cooling Supply) nResidential Water Supply(single) ft. ft. in. 0IndustriaUCofmnercial OResidential Water Supply(shared) 18.GROUT ',Irrigation FROM TO MATERIAL EMPLACEMENT METHOD&AMOUNT Non-Water Supply Well: 0 rt. 20 ft. senora Pour Monitoring 0Recovery ft. ft. Injection Well: uifer Rechargeft. ft. A q g DGroundwatcr Rcntediation Aquifer Storage and Recovery19.SAND/GRAVEL PACK(if applicable) QSalinity Barrier FROM _TO MATERIAL EMPLACEMENT METHOD Aquifer Test Experimental Technology QStormwater Drainage ft. ft.Subsidence Control II. ft. Geothermal(Closed Loop) O Tracer 20.DRILLING LOG(attach additional sheets if necessary), Geothermal(Heating/Coolin Return) FROM TO DESCRIPTION(color,hardness,soil/rock type,grate tie,,etc.) $ Other(explain under'#21 Remarks) to 4.Date Well(s)Completed: /�a Well ID# / �� f t �a ft. t �� 1 a f`• 345�. /3 rt o,' 5a.Wellll Location: 1/fL 1, 'ft. re f/ov 5 j.i/ s,, Aft-+! Homo LU h/ i,672 `Ju-ft• 5,75 f' a- t,y'la 'fid J Facility/Owner Name Facility 1D#(if pplicable) f"(tt. /2y ft. `J--'- `� /� �54,..► 3�I3 Tritc-l?un Li✓ te4den,Afc.Gsa ITTa�t• 30 - a-11J c Physical Address,City,(it and Zip / f' ft. ft. Cfr.w1)/ CO, jG��00 /�1 J /07 21.REMARKS . Courtly Parcel Identification No.(I'IN) 5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees: Orwell field,one Iat/long is sufficient) 22.Certification: N W / 6.Is(are)the well(s)0Permanent or Temporary Sig Lire of C ifed wtt(Contractor I/ OW B. signing this Jorm,1 hereby ccrti Thal the well(s)am(were)constructed in accordance'7.Is this a repair to an existing well: [Yes or IZINo with 15,4 NCAC 02C.0100 or 15A NCAC 02C.0200 Well Construction Standards and that a If this is a repair,fill out known well construction information and explain the nature of the copy alibis record has been provided to the well owner. repair under#21 remarks section or on the back of this form. 23.Site diagram or additional well details: You may use the back of this page to provide additional well site details or well 8.For Geoprohe/DPT or Closed-Loop Geothermal Wells having the same construction details. You may also attach additional pages if necessary. construction,only I GW-I is needed. Indicate TOTAL NUMBER of wells drilled:' .345, SUBMITTAL INSTRUCTIONS 9.Total well depth below land surface: (ft.) 24a. For All Wells: Submit this form within 30 days of completion of well For multiple wells list all depths if different(example-3@ri200'and 2C 100) construction to the following: 10,Static water level below top of casing: 40 If water level is above casing,use"+„ (ft.) Division of Water Resources,Information Processing Unit, 1617 Mail Service Center,Raleigh,NC 27699-1617 11.Borehole diameter: 6 1/8 (in.) 24h. For Injection Wells: In addition to sending the form to the address in 24a 12.Well construction method: J? 7'9/ above,also submit one copy of this fort within 30 days of completion of well (i.e.auger,rotary,cable,direct push,etc.) construction to the following: FOR WATER SUPPLY WELLS ONLY: Division of Water Resources,Underground Injection Control Program, 1636 Mail Service Center,Raleigh,NC 27699-1636 13a.Yield(gpm) I Gp/il Method of test: Airlift 24c. Supply& Injection Wells: In addition to sending the rm Chlor Tabs 1 1/2 Tabs the aForddressWateres) above, also submit one copy of this form within 30 daysfo ofto 13b.Disinfection type: Amount: completion of well construction to the county health department of the county where constructed. Form GW-1 North Carolina Department of Environmental P Quality-Division of Water Resources Revised 2-22-2016 catawba county public health Memorandum July 31, 2025 To: Mr. & Mrs. Ayscue From: Megen McBride, Environmental Health Administrator Re: Well Samples Required. Permit: WELL-05-2022-171352 Site Address: 3213 Timber Run Ln, Maiden NC 28650 Since July 1st, 2008, the North Carolina Department of Health and Human Services requires all private drinking water wells be sampled for bacteria, nitrate, nitrite, pH, and a number of naturally occurring inorganic minerals. Our office has made several attempts to contact you to schedule the water sample collection and have been unable to reach you. Please contact our office so that we can schedule a time,at your convenience,to collect the required samples. The fees normally charged for these samples were included in the cost of your well permit, so there is no additional charge for this service. The samples will be taken from an outside source.The sample test results will be sent to you when they are received by our office. Typical process time is 6-8 weeks. You may reach our office at (828) 465-8270, or by e-mail at EHAdmin@CatawbaCountyNC.gov catawbacountync.gov Environmental Health Catawba County Government Center 25 Government Drive PO Box 389 Newton NC 28658 ( 828.465.8270 MAKING. LIVING. BETTER. ,.' 4 4312 District Drive MSC`+-i ` ', North Carolina State Laboratory of Public Health Raleigh,NC 27699-1918 °'�if�{�� >;1'`1 Environmental Sciences http://slph.ncpublichealth.com *v: „ * 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 Dustin &Kyndra Ayscue P O BOX 389 3213 Timber Run Ln NEWTON,NC 28658 Maiden,NC 28650 I 1 EIN:566001814EH Delivery: NC Courier StarLiMS ID: ES250822-0014 Date Collected: 08/20/2025 Time Collected: 12:21 By: Dwight Mikeal Date Received: 08/22/2025 Time Received: 07:52 Sample Type: Raw Sampling Point: Well head Well Permit No. WELL-05-2022-171352 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 22 mg/L Chloride <5 250 mg/L Chromium <0.02 0.10 mg/L Copper 0.012 1.3 mg/L Fluoride <0.1 4.00 mg/L Iron <0.06 0.300 mg/L Lead <0.003 0.015 mg/L Magnesium 11 mg/L Manganese <0.005 0.05 mg/L Mercury <0.0004 0.002 mg/L Nickel <0.01 0.1 mg/L pH 7.7 N/A Selenium <0.005 0.05 mg/L Silver <0.01 0.10 mg/L Sodium 4.6 mg/L Sulfate 7.8 250 mg/L Total Alkalinity 95 mg/L Total Hardness 100 mg/L Zinc <0.05 5.0 mg/L Report Date: 09/05/2025 Reported By: 4''-s4r S E P 1 2 2025 Marc Komlos 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: 0 ?+ A y 5(u t- Sample ID Number: 17 I 1 L Location: 3 Tl r Reviewer: Jason Boyd 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.) 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" O' L I N 77 A 1 Sij �O Private Well Information Qi; ... a• 3 2. , . and Use Recommendations NC DEPARTMENT OF HEALTH AND HUMAN SERVICES Division of Public Health For Inorganic Chemical Contaminants County: Catawba Name/Address: • tip st, Ays ',.,i0... 32-13 7'► bc-r. 12 A 61e.idLA Sample ID#: )7 1 31 7 Reviewer: Jason Boyd 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 n Copper n Fluoride ❑Iron ❑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. n 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. -- - —C-hler-i-de==❑-C-mapper_ —❑-Fluor do - ❑- -on - - ❑ 'IManganesc ❑ 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/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/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.