HomeMy WebLinkAboutWCOC-07-2022-175681.TIF ,*• • CATAWBA COUNTY Case# WCOC-07-2022-175681
. IR Public Health Department Subdivision
y Environmental Health Division PIN# 461904840503
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# I
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Site Address: 9343 AZALEA RD,SHERRILLS FORD NC 28673
Name on Permit JOSEPH O'ROURKE
Property Size: Acres: 1
Directions: Newton Hwy 10 to Murrys Mill RD Left onto Sherrills Ford RD Left onto Mollys Backbone RD
;Right onto Azalea RD,Property is located on the right in 2.4 miles
WELL CERTIFICATE OF COMPLETION
Permit Number:WELL-12-2021-162947
DATE COMPLETED INSPECTION TYPE STATUS INSPECTOR
06/06/2022 EH Well Grouting No EH Inspection Steen Price
were not ready at time they had scheduled for inspection and wound up self certifying.
Pursuant to 15A NCAC 02C.0305(1)1 This well grouting was certified by the licensed
well contractor who is therefore liable and responsible for its compliance with the rules of I5A NCAC 02C
.0100. The completed Well Construction Record,as submitted by the licensed well contractor, will serve as
written certification of grout compliance
06/13/2022 EH Well Record Received Approved EH Admin
07/05/2022 EH Well Head Approved Robbie Phelps
•
b&k 06/06/2022
Well Driller Date Drilled
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07/13/2022
Authorized State Agent Issuance Date
el.wellc,,c 07/14/2022 08:46 Page I of I
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