HomeMy WebLinkAboutWELL-07-2022-176608.TIF • CATAWBA COUNTY Case# WELL-07-2022-176608
II1Public Health Department Subdivision FRED ALLEY EST
C i ` Environmental Health Division PIN# 378004820351
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 12
lg.2 5w
Site Address: 5824 ALLEY RD,CATAWBA NC 28609
Name on Permit: HURST BUILD INC
Property Size: Acres 0.63
Directions: Turn left off of Sherrills Ford Rd onto Alley Rd.2nd lot on left
NEW WELL PERMIT
REQUIRED WELL SETBACKS:
Septic Systems and Repair Areas for Single Family Dwellings 50 ft.
Septic Systems and Repair Areas for Businesses and Multi-Family Residences 100 ft.
Underground Storage Tanks 100 ft.
Animal Barns 100 ft.
Lakes/Ponds 50 ft.
Streams/Brooks/Creeks/Rivers 25 ft.
Building Foundations 25 ft.
All Other Sources of Groundwater Contamination 100 ft.
Saprolite Septic Systems and Repair Areas 100 ft.
Septic Systems and Repair Areas to Wells with 2 or more connections 100 ft.
Wells shall be constructed in accordance with state regulations:
Article I5A 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 any of
the above setbacks,contact Catawba County Environmental Health at 828-465-8270,before drilling the well.
Grouting Depth:20 feet minimum
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(I5A 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.
07/29/2022
Authorized State Agent Permit Issuance Date
7/29/2027
Permit Expiration Date
ehpennil 07/29/2022 13:51
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Parcel: 378004820351, 5824 ALLEY RD 1 in=40ft
CATAWBA, 28609
This map/report product was prepared from the Catawba County,NC Geospatlai Information Services. Catawba County has made substantial efforts
to ensure the accuracy of location and labeling information contained on this map or data on this report Catawba Opunty promotes and recommends
the Independent vertficatlon of any data contained on this map/report product by the user.The County of Catawba,Its employees,agents,and
personnel,dlsdaim,and shall not be held liable for any and all damages,loss or liability,whether di-ect,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
07/29/2022
I
cpWPDT Report
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Area of Interest(A01) Information
Area : 3,134,508.67 ft2
Jul 29 2022 8:07:19 Eastern Daylight Time
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All North Carolina Department of Environmental Quality(NCDEQ)GIS data is expressly provided"AS IS"and"WITH ALL FAULTS".The
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WELL CONSTRUCTION RECORD(GW 1) For Internal Use Only:
I.Well Contractor Information:
Kyle C. Shaw
14.WATER ZONES
Wall Contractor Name
FRO,I( TO I DESCRIPTION j
t 4521-A 135 n (`H S ft. 207 CC1
fa n
NC Well Contractor Co-di-motion Number
Advanced Well Drilling, LLC IS.OUTER CASING(for multi-cased wells)OR LINER(Ifnppl1ob1e)
FROM TO DIAlle.1ER l THICKNESS I MATERIAL
Company Name 0 (t t• it 6 in. I Heavy I PVC
) 16.INNER CASING OR TUBING(geothermal closed-loop)
2.Well Construction Permit#: 7/r%/-'---7.. aP 2..2•`1'7 e FROM TO I DIAMETER I THICKNESS I M t.TERLIL
List all pplicable call cotntnic/!on permits(i c.WC.Count.Stare.t•iuiatce P/C) ft IL I in. I
3.Well Use(check well use): ft. n I to I
I
Water Supply Well: 17.SCREEN
DAg[iCnlhlral FROM I TO DIAMETER SLOT SIZE I THICKNESS I MATERIAL
❑\lunicipal/Public rt. ft In. I I
❑Geothermal(Heating/Cooling Supply) °Residential Water Supply(single)
ft it in. I I
❑Industrial/Commercial ❑Residential Water Supply(shared)
DIrtiswtion lit GROUT
Dot°ells>100.000 GPD FROM I TO I :MATERIAL I EMPLACEMENT METHOD.eAMOUNT
\on:Water Supply Well: V ft I It Bentonite i Poured jarigis
°Monitoring °Recoveery
Injection Well: - ft. I ft.
u• I f ID quifer Recharge °Groundwater Ramedia[ioa
❑Aquifer Storage and Recovery DSalittity Barrier I0.SAND/GRAVEL PACK(ifappltuable)
FROM I TO I MATERIAL EMPLACESI I METHOD
❑Aquifer Test DStonmnaferDrainage It. } ft
°Experimental Technology °Subsidence Control ft I! IL
DOcothemial(Closed Loop) °Tracer 20.DRILLING LOG launch additional sheets If neeetsary
FROM I TO I DESCRIPTION(color.lewdness.iolewdness.soil/reek type.Raft size.tie)
❑Geothetntal(Healing/Cooling Return) Daher(exidain under=21 Remelts)
^�f i 0 r" -7S ' ID. GId.,f
4.Date Well e7'•o�,
s)Completed: -ac Well um ft 11RD ft S 7 e(
5a.Well Location: 62f0).t)a,Cmryr‘ut'4..t ris) rt. I ray it }RSV
Q
Tfyrts t ic-1IA 13t..i1 126 ft- I ZQS it NSA Gc'cek T.o(1
�Faacclity/t/RnerName p } �` ,Facciillity 1124 f applicable) ft I ft.
-(?0 t li`ni a, Gov"aj- k -- �.Y40 1 ft. 1 rt.
Physical Address,City,Mad Zip ft. ft.
C.0,.-E.t.jba.., 21.REyIARRS
County Parcel Identification No.(PIN) -
Sb.Latitude and longitude In degrees/minutes/seconds or decimal degrees:
(if well field,one Lit/long is sufficient)
22.Certification:
35-‘ 7`f9 N. - c1 06.0 0 cl' --\ r -as
tt , ./.sir ./,.-' 5-.sei
6.Is(arc).the well(s): nPermanent or °Temporaty Sign^:c of Certified Well Contractor Date
3rsigninr rhirjornt I hereby cerrjli•that the well was Nara)cansrrueted in accordance with
7.Is this a repair to an existing well: GYes or L°No IS.d.ACAC 02C.0100 or 1 S.A NCiC 02C.0200 IWWeIl Construction Standards and thaty coat'
IP his Is a repair,,Jill antlataurt cell cronurrnad0lt iny-amuatiart and explain the manure of the
of this record has been provided ra the urA entree.
repair tinder 2!rentar •section oran.tlte hack ofthirjornu.
7.3.Site diagram or additional well details:
3.For Gcoprobe/DPT or Closed-Loop Geothermal Wells Itaving.the same You may use the back of this page to provide additional well construction info
construction,only 1.Gt�-1 is needed. indicate TOTALNU BER of wells (add'See Over'in Remarks Bee).You rue also attach additional pages if necessary.
drilled:
24.SUBMITTAL INSTRUCTIONS
9-Total well depth below land sutfnce: aus
For nnrltiple%rens list all dept1'.s(1forent(evant -S:a•200'and 2 lw'1 (ff•)
���� Submit this GW-1 within 30 days of well completion per the following:
10.Static water level below top of unsing: 4..) ft 24a. For All Wells: Original form to Division of Water Resources (lJWR).
Ijunterlcnrl is above casing.rasa ( ) Information Processing Unit 1617MSC,Raleigh,NC 27699-1617
11.BorehoIc diameter: Om) 24b.For Infection Wells:Copy to DWR.Underground Injection Control(IUC)
Program;1636 MSC.Raleigh.NC 27699-1636
12.Well construction method: s1 1n
(Le.auger,rotary,cable,direct push.etc.) 1 lac ForWater Supply and Open-Loop Geothermal Return Wells:Copy to the
county environmental health department of the county where installed
FOR WATER SUPPLY WELLS ONLY:
24d.For Water Wells producing over 100,000 GPD:Copy to DWR,.CCPCUA
13a.1 Yield(gptn) `, tvir--� Method of test: Air + Permit Program 1611 MSC,Raleigh,NC 27699-1611
13b.Disinfection type: V HTH Amount: I lhs I
-y_`'`-1 `:c:a Carolina Department ofErvirorr..cnto!Quality-Division of Water Resources . -.