HomeMy WebLinkAboutWCOC-06-2022-173437.TIF CATAWBA COUNTY Case# WCOC-06-2022-173437
Public Health Department Subdivision 0 R HICKS ESTATES
Q Environmental Health Division PIN# 368601479671
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# PT 3
/g 2
Site Address: 5507 BUCKS GARAGE RD,MAIDEN NC 28650
Name on Permit *LKN CUSTOM HOMES
Property Size: Acres: 1.83
Directions: Hwy 150 East,left on Hwy I6B,left on Bucks Garage,lot on left
WELL CERTIFICATE OF COMPLETION
Permit Number: WELL-01-2021-143932
DATE COMPLETED INSPECTION TYPE STATUS INSPECTOR
05/06/2021 EH Well Grouting No EH Inspection Randy Ross
Pursuant to 1SA NCAC 02C .0305(b) This well grouting was certified by the licensed
well contractor who is therefore liable and responsible for its compliance with the rules of 15 A NCAC 02C
.0100. The completed Well Construction Record,as submitted by the licensed well contractor,will serve as
written certification of grout compliance
05/21/2021 EH Well Record Received Approved EH Admin
06/08/2022 EH Well Head Approved Steven Price
advanced 05/06/2022
Well Driller Date Drilled
06/09/2022
Authorized State Agent Issuance Date
chuc9!a, 06/15/2022 13:01 Page 1 of 1