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Home My WebLink AboutWELL-07-2022-175262.TIF jos catawba county public health June 28, 2024 Dana Overcash 110 Aqua Drive Mooresville, NC 28117 Subject: Notice of Intent to REVOKE the Well Permit for 3543 Jefferson st;PIN:369702873564 Catawba County Permit WELL-07-2022-175262. Dear Dana Overcash: The Environmental Health Division of Catawba County Public Health intends to revoke your Well Permit 30 days from the date of this notice. You must apply for a new Well Permit and meet the requirements of the current laws and rules necessary to obtain a new Well Permit. You have a right to an informal review of this decision.You may request an informal review by the environmental health supervisor at the local health department.You may also request an informal review by the Department of Health and Human Services' Regional Soil Scientist.A request for informal review must be made in writing to the local health department. You also have a right to a formal appeal of this decision.To pursue a formal appeal,you must file a petition for a contested case hearing with the Office of Administrative Hearings, 1711 New Hope Church Rd, Raleigh, NC 27609.You may write the Office of Administrative Hearings, call the office at 984-236- 1850,or get a copy of the petition form from the OAH web site at http://www.oah.nc.gov.The petition for a contested case hearing must be filed in accordance with the provision of General Statutes 130A-24 and 150E-23 and all other applicable provisions of Chapter 150B.General Statute 130A-335(g) provides that your hearing will be held in the county where your property is located. If you wish to pursue a formal appeal,you must file the petition form with the Office of Administrative Hearings WITHIN 30 DAYS OF THE DATE OF THIS LETTER.The date of this letter is June 28,2024. Meeting the 30-day deadline is critical to your formal appeal. If you file a petition for a contested case hearing with the Office of Administrative Hearings,you are required by General Statute 150B-23 to serve a copy of your petition on the Registered Agent for the catawbacountync.gov Environmental Health Catawba County Government Center 25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270 MAKING. LIVING® BETTER. 2\ Department of Health and Human Services:Julie Cronin, Office of General Counsel, Department of Health and Human Services, 2001 Mail Service Center, Raleigh, N.C. 27699-2001. Do not serve the petition on your local health department.Sending a copy of your petition to the local health department will not satisfy the legal requirement in General Statute 150B-23 that you send a copy to the Office of General Counsel, 2001 Mail Service Center, Department of Health and Human Services. R tfully, can Evans, REHS Environmental Health Specialist Catawba County Public Health catawba county public health VOLUNTARY RELINQUISHMENT OF ADMINISTRATIVE APPEAL RIGHTS Date prepared: 6/1212024 Owner(s): DANA OVERCASH Mailing Address: 110 AQUA DR MOORESVILL1,NC 28117 Properly location/site legal description: 3543JI'shhl?RSON ST,SI'll-sRRILLS FORT)NC Pll�d: 369702873564 Improvement Permit(Il') 1MPV-07-2022-275263 Dttle Issued 7/8/2022 Authorization to Construct(AC) AUfI1-07-2022-175264 Date Issued 7/X2022 I,�0.t1G�.L DV'G k ,voluntarily relinquish my rights to pursue a fumed appeal through the North (print full name) Carolina Office of Administrative Hearings pursuant to NC General Statute 130A-24 and 150I3-23 and all other applicable provisions of Chapter f 5Q13 for the above referenced pennit(s)(which includes the Ills and ACs)in order for the authorized agent/loeal health department to issue the applicable permit(new IP and/or AC)for the site. I understand by completing this form that the pennit(s)for a 25%reduction (System description) will be revoked immediately by the authorized agent/local health department. I understand that the local health department's revocation of a permit can be appealed to the North Carolina Office of Administrative Hearings within 30 days ofthe revocation pursuant to the North Carolina Administrative Procedure Act. t understand that in order lhr the local health department to issue another IP and AC that the current 11'and AC must be revoked. I understand Mai the local health department's revocation of an IP or CA is not elTectivc tmtil30 days front the revocation or,if the revocation is appealed,at the time that the Office of Administrative Hearings issues a final decision. I understand that by signing this form and relinquishing my right to appeal the permit revocation at the Office of Administrative Hearings that the local health department's permit revocation will become effective immediately. I understand and agree that the revocation ofa permit that takes effect immediately is in my best interest. I understand that by signing this form that I agree that I do not want to appeal the permit revocation. I understand that I ant not required to relinquish my appeal rights but that this is an option available to me so I do not have to wait 30 days for the revocation of the nen it to take effect. Signature of Property Owner. gait/if Cpp. :-) Date Signed: 1_17`2021 NCDHHS/DPH/EHS/OSWP Revised May 2015 * catawbacountync.gov Environmental Health Cotowbo County Government Center 25 Government Drive PO Box 389 I Newton NC 28658 1828.465.8270 MAKING. LIVING. BETTER. r CArAw8A COUNTY tIlLPublic HealthfkplcWnent SubJn coon "," Itt:nvironroemal Health Division F'I Na 369702873564 0 PO Box 389,25 Government tkrve.Newton,NC' 28655 t.1 f to Site Address: 3543 JEFFERSON ST,SHERRILLS FORD NC 28673 Name on Permit: TIMOTHY COLUNS Property Size: Ades 0.94 Directions: NC 16,Left Buffalo Shoals RD.Right onto UM Mountain RD,Letat on Little Mountain RD, Left onto Jefferson ST ,(�/� Owner/Authorized Repreentativc AcknowledgerncnI of 1'ermit Receipt 2[��i ccrtitj that I am the owner or authuriied agent(owner's authoriratitm required)representing the owner of fe the property described above. tAs the property owner or authorized representative.I have received the above referenced permit(s)as requested in the application for service RBPR-04-2022-407332,by the following method(s): Received in Person Facsimile Transmittal(Return farm with signature required) I Electronic Image Transmittal/E-mail (Return receipt required) 4�As the property owner or authorized representative I have reviewed and understand the specific conditions t/( 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(I5A NCAC 18A.1900), and/ur Well Construction Standards(15A 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:07/06/2022 Owner Authorized Representative Signature 'Mt Date 7?Z.9a _... Documentation of Permit(s)Transmittal (permit transmitted by electronic or other means) Permit transmitted by _ frame of person sending permit) Signature _-- E Daterlimc I i 1/4 Z Method: Fax f:mail �`t;s Hail Other Owner's request to send by the above indicated method of transmittal in lieu of signature We wentt tto hear from ywPlease ttake a few mornentts tto complette our custtomer service survey att http://www.surveymonkey.com/s/EHCusttomerService f,I in . I%•W°r310,4. 1'g r,n 07.l '4122 elk 11 I j CATAWBACOUNTYCase# WELL-07-2022-175262 Public Health Department Subdivision Environmental Health Division PIN# 369702873564 PO Box 389,25 Government Drive,Newton,NC 28658 LOT I Site Address: 3543 JEFFERSON ST, SHERRILLS FORD NC 28673 Name on Permit: TIMOTHY COLLINS Property Size: Acres 0.94 Directions: NC 16, Left Buffalo Shoals RD, Right onto Little Mountain RD, Lefet on Little Mountain RD, Left onto Jefferson ST NEW WELL PERMIT VARIANCE WELL See attached state well variance approval for well construction standards and setbacks. PERMIT CONDITIONS Well must be kept minimum: 15'from power lines,25'from building foundations,60'from any part of septic system. Well driller shall contact EHS at(828)851-6547 1 week prior to installation for preconstruction conference. Wells shall be constructed in accordance with state regulations: Article 15A North Carolina Administrative Code Subchapter 2C The well driller must verify all setbacks before drilling the well. If the well driller is unable to maintain the required setbacks,contact Catawba County Environmental Health at 828-465-8270, before drilling the well Casing Height: 12 inches minimum above finished grade All newly constructed private drinking water wells are required to be sampled in accordance with the North Carolina Rules Regarding Private Drinking Water Well Testing(15A NCAC 18A.3800).The fee for this sampling is included in the cost of the well permit.It is the applicant or property owner's responsibility to notify Environmental Health when the well is ready for sampling.Water samples will be drawn from an outside faucet unless otherwise specified.For questions or for more information,please contact Environmental Health. ,Ife............. ice„ E„.„. 08/15/2022 Authorized State Agent Permit Issuance Date 8/15/2027 Permit Expiration Date 08/17/2022 22:58 i �d �F=•.,„, a ROY COOPER • Governor ;'//, �'_�'', NC DEPARTMENT OF , r• KODY H. KINSLEY • Secretary jig HEALTH AND HELEN WOLSTENHOLME • Interim Deputy Secretary for Health � aT HUMAN SERVICES P .,,"' ".� MARK T. BENTON •Assistant Secretary for Public Health Division of Public Health Onsite Water Protection Branch August 12, 2022 Tim Collins Dana Overcash 151 Capital Ave#3213 Mooresville,NC 28117 Re: Approval No. JMB2724 Private Well Located Less Than 100' from a Septic System [Rule 15A NCAC 2C .0107(a)(2)(C)] Property location: 3543 Jefferson St Sherrill's Ford, NC 28673 Dear Mr. Collins and Ms. Overcash: On August 11, 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. The closest septic system is more than fifty feet away from the proposed well, but closer than the required one hundred feet. The well is to serve two or more homes. Specifically, the variance grants you permission to construct a water supply well at a distance closer than the one-hundred-foot setback to a septic system. Achieving the one- hundred-foot setback would be difficult given the challenges of the property. Based upon information provided by 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/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 any septic system or repair area, depending upon where the well rig can actually set up, will possibly encroach upon the 100foot setback, but no closer than 60feet. 3) A pre-construction meeting with the Catawba County Health Department staff is required 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 and 10 feet into bedrock. If bedrock is encountered at a depth greater than 50feet, then casing must extend 10 feet into bedrock. 5) Grout will be required the entire length of the casing from land surface into bedrock. 6) 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. 7) Grout must be either pumped into place with the use of a tremmie pipe or pressure method. 8) 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. 9) Any improperly located or constructed wells or wells no longer in use, shall be properly abandoned in accordance with the Well Construction Standards. 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.E.H.S, MS 2 z. I Site Plan SFo s r r ,G- ,I1OkJU/ir ,,f e ) 5 ,13 j a..Y t-iL r s 0 /1 .S 5 h r 5 Y r ,q_ y r:=.,,,-, -`\ mPy - 7 _ 2Z _ I-? 5- 2..4, 3 �, It F.: �-t- - 7 Z 2 — 17 s i 6 z norm ..i ��r`'——'dw a°"'wow, • ' ' 4 j "'P.a....14;7..............:. • • ............ .4.4z,. I • 1 `�� .\..'.'..::; : :::::P.PBPS'(Vert:y;::: ::3824.sq tt =: s: 4ea agg. +` It/Me,. /a \4a�Kttee. 23%Rd❑ctlon ole ;Bedroo as - :6276zsq :: :�� N*5... \\.\\ ''' -iocrOteebe rompovsd y Existing Septic `ST 81 ': System to be $CZ _ Q Q s Abandoned ,. 30 •.Ace.o ,hip k ``/ 36. 0 \ ex0poh • ' 0 Tii. Op lr �. g ....... — ilits, Wooden stake egond: (represents front • Soil Eveluatlon Locatl• Jefferson St right comer of 'Y MN house envelope) <all other values), eopey ...,. Ae Type Wood'take Is at BO'from front right %/I Initial Area prop.corner and 30' WM Repek Area from edge of rAit Potential Well Area right of way. t. '- ' S z wz h ,yz. s'�-: � yaaa4-a,`,.a ,.,at -x, ai,..f' ,': wM'u's u d . ;,. aS• :Cri i. ' _4-�r� ,, ' , a 4 BezTy 9 ", .s " :; .mpa .1i m ., w x #IL'4 " . .3, . 7', ' z ti ?t , . y�° , as �£ ..#.,.. Scanned with CamScanner WPDT Report Area of Interest (AO1) Information Area : 3,134,508.76 ft2 Jul 8 2022 8:50:12 Eastern Daylight Time', \,,,,',.0,,`\ \ ,..,,,V ,,,, i / , 7,----.1 w , y0 1: f y,---.. Tommy. ,�Sherrill Rd- T" ,. .-� t. r._ �I Mrs .r,,,. ! -_____I r 11,--- Il t � ' � � I t "_"" i ff 1 -r .MtR ! 1 s l-1 .� " y 11 e } )yob t - ;:'N r` ,r i I --. . NN /, i 4 1:4,514 ........... Parcels(Polygonal•Parcels. PrtseGtet4 Route 0 003 006 0 12 nu 1 1 5 ti 't Non.Syatem Roam — Other StateApericy Route 0 006. 0.1 0.2 rem "" Federal Route — Secondary Route Non-System Prunary Roads' Other System Roads Interstate cu.riM....4 UM.cr„r.nw:..wrrr rr:,.mr Sk0e,w Nd!n crw«. COT 46 S7wnAenedrq, Ohms.. 6%. NFAf Go.a, S,Mr.L'iiW, — Ramps,Rest Areas,Nort.MelMme — US Route dwTrl.vopti,..4EmNAS.1.wos.DIA.N s VS Caw.Duress USDA INCODT G.S u.r.Srwwza ES n+ea DS crac.s.NGA NASA NC Route 3543 Jefferson St Sherrills Ford NC 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 merchantability or witness for any particular purpose.The NCDEQ assumes no responsibility or legal liability concerning the Data's accuracy, reliability,completeness,timeliness,or usefulness.The data is not intended to constitute advice nor is it to be used as a substitute for specific advice from a professional.Users should not act(or refrain from acting)based upon information in the Data without independently verifying the information and obtaining any necessary professional advice. Users are solely responsible for ensuring the accuracy,currency and other qualities of any products derived from or in connection with the NCDEQ's Data.The Data is collected from various sources and may be modified over time without notice to improve spatial andattribute accuracy.The NCDEQ disclaims responsibility for the spatial accuracy and attribution of GIS features and makes no warranty concerning same.