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Home My WebLink AboutSAM-05-2022-172014.TIF • D. REASON FOR VARIANCE REQUEST —Include type of well(s) to be constructed; rule for which the variance is being requested; description of how the alternate construction will not endanger human health and welfare and the environment;and reason why construction and/or operation in accordance with the standards is not technically feasible and/or provides equal or better protection of the groundwater. g•L) c/ cL -front OI h�� r� � Ce 01 l e 4 5 } ne st2-e_ E. ATTACHMENTS—Provide the following information as attachments to this application: (1) A map showing general location of the property (including road names, NC State Route Number, distances, any key landmarks,etc.)sufficient for finding the well location. (2) Detailed site map with scale showing location of proposed well relevant to septic system(s), building foundations,property lines,water bodies,potential sources of contamination,other wells,etc. (3) Submit a copy of the local well permit application and site evaluation map(if applicable). (4) Any other information relevant to the variance request such as a well construction diagram showing proposed well liner or atypical construction materials/methods. F. OTHER MINIMUM CONSTRUCTION REQUIREMENTS For water supply wells, approval of a variance will require that additional construction requirements beyond those specified in 15A NCAC 02C .0107 be met. Minimum additional construction requirements for Coastal Plain and Piedmont and Mountain region wells are referenced on Attachments A and B on pages 4 and 5 of this application. Approval of a variance will not be considered in cases where the specified minimum additional construction requirements cannot be met. G. SIGNATURES L/14402111)1 Signature o >erson Responsible for Well Construction(typically the well driller) Robe ,se nn1er Print dr Type Full Name of Person Responsible for Weil Construction (typically the well driller) • Signora a (County Enviro nental Health Specialist Keesey\lvarik Print or Type 611 Name of County Environmental Health Specialist Per 1 SA IVCAC 02C.0118 the Secretary of the Division of Water Quality or the Division of Public Health may require submittal of information deemed necessary to make a decision on the variance, may impose conditions as part of the decision, and shall respond in writing to the request within 30 days of receipt of the variance request. A variance applicant who is dissatisfied with the decision of the Director may commence a contested case by filing a petition as - described in G.S. 150E-23 within 60 days after receipt of the decision. Form GW-72V Page 2 Revised February 2D13 M7yi ' %54 CATAWBA COUNTY HEALTH DEPARTMENT N° 5 5 5 0 V� Telephone (828)465-8270 TDD (828)465-8200 Imp Fimt. ,th. o Const. Rpr P t. - Opr Print. Sys Type Well Print. Well Rpr Print. Owner/Agent Q illuy'4 US/ 'y Phone 4 - 3/i • Address— 3$$ ,� t2 • iy Subdivision /j i„ i� G - S ction/Biock/Phase Lot# /8 • Lot Sr • Directions. 2 - L Facility House Mobile )( Business Multi-family Other: Tax Map or Pin Number_ Other Zoning Approval# 1 #Bedrooms ;' #Seats #Employees Application Rate i 35 GPD Flow 3eep Hot Tub or Spa yes ty Special Fixtures Basement yes tto� 100% Repair Area es no Basement Plumbing yes �.L� Water Supply- Pnvaate Well Public Semi-Public ******************** *********************************************************,t******************************************* Type of System. Trench x Bed Pump Pump/Panel Panel _LPP Other Septic Tank Size 1000 Pump Tank Size Nitrification Field: Total Square Feet 1030 Depth of Stone i 2 ". Bed Size Trench Width V 1 Total Length of All Trenches19 g g�� Number of Trenches _ Trench Length57 157 iS71,S7 i5'71S']Feet on Center -/ Maximum Trench Depth gip' Distance of Nearest Well So' *DO NOT INSTALL SEPTIC WHEN WET* f *WELL R&CORD REQUIRED AT COMPLETION* *******i3 ***r***********tp 3 • • Topo - Slope CJ T'S ' I Texture add47. 1 i 1 Structure I ` S l' Clay Min. I Soil Wetness --- " ttHi L Soil Depth I)4' " t� ` � '' d ag.Restric Hoz.at-�`' ii6k , �`''L IU .i �151151 Available spac:Mlo $ I ,�l+ ,SI,,,,Ile 0 Overall Class S ' U ►a" Comments 1 ` 5-1 9lacomv÷ i L copobitdt _ s -,tf �S, coup rtttri° iodic— \ taltx £ � pUS�YtLc+tll 1; \\I 'V25, / (0j too { Ql` y J'IQ __yiTh' .,-..--.1 filter Required !� t� \ 0 y Riser required when b; Mgt tank is more than 6 �''`'dw"'a r f4o _.. inches deep. **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION** *Improvement Permit has no expiration date and is transferable, but may be revoked if site plans or intended use changes for the proposed facility An Authorization to Construct is valid for (5) five years from date issued and is not transferable. Well Permit valid for 5 years provided site conditions do not change. Well location, installation, and protection must meet state and local regulations,and must be inspected and approved by a representative of the Catawba County Health Department before any portion of the installation is put into use. The siting of the well by the Health Department staff is to provide protection from kno possible sources of contamination. No volume of water is guaranteed at any siA4 the Health Department. Permit Date . 2 //` EHS cat I Owner/Agent i Septic ank I By . a AI GL41 Date EHS ? r Well Installed By ell out. 'pro Date Well Head Approval Date . - . Date Sample Cbllected Date of Results Result El - White-Office Blue-Building Inspection Operation Permit Yellow Owner/Agent Green-Bui i g In ion uth iz ti Construct -.:: North CarolinaPlease submit this form along with a Well Department of Health and Human Services Variance Application for an existing Division of Public Health private water supply well. Well Site Location: g°tilnWVOe4 4 reS; P/,‘asc' -7 i-c'7 (Town,earmunihy,suhdh'isiun is 11 n$ tr Address '3 3 66 terra woo 44. CourttV: C—e0Vi...d c City/ST/Zip: Air w u N 2 6 Sq Date of SiteVisit_ 51,2((�,7-- Well Construction Well Head Completion Date of Well Construction: _4N / evil Is the well head 12"above land surface? YES If unknown, was it drilled hefure 1972? Y ES or 6) If no, what is the height of the casing: 6 inches If unknown, was it drilled before 7/1/2008? 'E: or No Is there a sanitary well seal? YI S )r NO What type of well is it: Is the sanitary well seal in good repai Y '.' or NO Drilled Bore Hand Dug Jetted Other Are the following items present at the well head? YES the well have a cement slab? YES or NO Vent / Sample p Tap _.. Well Tag ✓ Pump Tag Does the well appear to he grouted? YEL or NO Potential Sources of Contamination? Does the well currently meet separation requirements with known sources of contamination? YES ( NO If no, please provide distances to those it does meet: I 1 -10 ex)s--ti75. .(lrc t 1-/ij , v \ b' rep Atce . "1 ' - hotAst . Other comments: ('ontplete below. l Name of person completing this time (please print): /'" I ell:`' ArLivi,S Catawba County Environmental Health 170.26 135.02 133.11 0000120 0101910 010191 _ \ re) •3366 •3352 •3374 r \_ ''l _I, 0101910 * 0000120 * tx,t4,rs We 1 85.39 70.49 133.06 68.04 BENDWOOD RD 18.06 129,03 144.33 I 1 Parcel: 371007693858, 3366 BENDWOOD RD 1 in=40ft NEWTON, 28658 This map/report product was prepared from the Catawba County,NC Geospatial Information Services. Catawba County has made substantial efforts 1 to ensure the accuracy of location and labeling information contained on this map or data on this report.Catawba County promotes and recommends the independent verification of any data contained on this map/report product by the user.The County of Catawba,its employees,agents,and personnel,disclaim,and shall not be held liable for any and all damages,loss or liability,whether direct,indirect or consequential which arises or may arise from this map/report product or the use thereof by any person or entity. Copyright 2021 Catawba County NC 05/26/2022 Analytical Results -/ c STATE SVIL.I.F 1' ANALYTICAL Catawba County Public Health PO Box 389 Newton, NC 28658 Receive Date: 05/27/2022 Reported: 05/31/2022 For: 05-2022-172014: Bennster Comments: Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst 220527-08-01 Nitrate 172014 <1 mg/L 3532 05/27/2022 CL 220527-08-01 Nitrite 172014 <0 1 mg/L 3532 05/27/2022 CL Respectfully submitted, Melissa Myers NC Cert#440, NCDW Cert#37755, EPA#NC00909 PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 1 of 2 . STATESY(LLE .44' ANALYTICAL Ads 122 Court Street Statesville,NC 28677 704-872-4697 www.sa-nc.cof 'NITRATE/NITRITE ANALYSIS Note:Aa Infeernation run be supplied for compliance edit. WATER SYSTEM ID#: O S -2-6iA- - I7.2.O1a County: Catawba Name of Water System: f}Pii 1 p„d /'03y geoe r')'' Sample Type: 0 Entry Point Cll-pecial/Non-compliance Location Where Collected: 3366 Ark,cJweckl QIrf A/ -bhl CVO ,2 S'bs-p Facility ID No. t'2 O)14 P tip•-.-�=�_— Sample Point: :in, CK wc111tPOl.1 :I I Collection I)ate�1 Collection Time Collected By: to L-e, Pv Mem Prim) (MMVDDrrf) (Specify MI or PM) Mail Results to(water system representativ ): CATAWBA COUNTY PUBLIC HEALTH 828 465-8270 Phoneth ) ENVIRONMENTAL HEALTH F8x#: (828)465-8276 PO BOX 389 Respaosible Person'semail: NEWTON,NC 28658 EHAdminecatawbacountync.gov LABORATORY II)#: 37755 0 SAMPLE UNSATISFACTORY 0 RESAMPLE REQUIRED j CgNTAM METHOD REQUIRED NQj DETECTED f CODE CONTAMINANT REPORTING t.LMLTUANTIFIED ALLOWABLE li CODE (i.e.c R.R.RRL.) �ii(-..,Ati (R.R.L.) (X) RESULTS LIMIT 11 !I 1040 Nitrate � - 353.2�W'� 1.00 mg/L� _ ——- • y 10.00 mg/L1 1041 Nitrite 353.2 0.10 mg/L .t IL---- — — —— me. 1.00 mg/L�� 'Note:If result exceeds allowable li ,the laboratory must fax analytical results to the State on day test completed. DATE :E: TIME: ANALYSES BEGUN: 05, 11 /22 ` ?J: 30 s M 1 p Is,wit,iix r eM,., Z ANALYSES COMPLETED: Q 5/ Z / Z ` (, : 0 3 Pvl 1.. M. BP.Ifff tM ere Laboratory Log,1: 21Z 45i[ 7. EW Certified By: COMMENTS: 2008 • Rendes tot Public Water Supply Section,Attn: a tory should M Data Entry, 634j ail Service Center,Raleigh,NC 27699.1634 i Fair 919.715.6637 PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 2 of 2 „STATED.” (,-,:k ,„ tip ROY COOPER • Governor 4 ,¢ �'A, NC DEPARTMENT OF KODY H. KINSLEY • Secretary rs t ir HEALTH AND HELEN WOLSTENHOLME • Interim Deputy Secretary for Health .! HUMAN SERVICES .,-... ii! MARK T. BENTON •Assistant Secretary for Public Health Division of Public Health Onsite Water Protection Branch June 1, 2022 Roby and April Bennster 3366 Bendwood Rd Newton, NC 28658 Re: Approval No. JMB2655 Private Well Located Less than 25' from Building Perimeter [Rule 15A NCAC 2C .0107(a)(2)(P)] Property location: 3366 Bendwood Rd Newton, NC 28658 Dear Mr. and Mrs. Bennster: On May 26, 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 the variance concerns a water supply well on the referenced property. A structure is proposed to be within twenty-five feet of the well. Specifically, the variance request grants you permission to use a water supply well at a distance closer than the twenty-five-foot setback to a building perimeter. Achieving the twenty-five-foot setback would be difficult given the challenges of the property. Based upon information provided by you, Catawba County Health Department 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/AFFIRMATIVE ACTION EMPLOYER 1) The well/wellhead shall meet all current 2C. 0100 standards, including but not limited to being properly grouted,terminated at least 12" above land surface,properly sealed, and having a thread-less sample tap etc. 2) The well shall be sampled for the same parameters required of a newly constructed well. If samples indicate contamination, further repairs or treatment will be necessary. 3) No potential sources of groundwater contamination shall be stored near the well-head. 4) No termite treatment shall be applied to the structure within twenty-five feet of the well unless alternative methods are approved by Catawba County Health Department. 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, John M. Brooks R.F.1I.S, MS 2 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: April Haynes Sample ID Number: 172014 Location: 3366 Bendwood Rd,Newton NC 28658 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 `a�sT�4"°4� Private Well Information t is/ -id,„ „4, . and Use Recommendations NC DEPARTMENT OF HEALTH AND HUMAN SERVICES Division of Public Health For Inorganic Chemical Contaminants County: Catawba Name: April Haynes—3366 Bendwood Rd,Newton NC 28658 Sample ID#: 172014 Reviewer: Megen McBride TEST RESULTS AND USE RECOMMENDATIONS 1. 10 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 on(v. ❑ Arsenic ❑ Barium ❑ Cadmium ❑ Chromium ❑ Copper n 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. ❑ 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 on(v, 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 E 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 inorganic chemical results on(v. ❑ 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.