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Home My WebLink AboutEHPR-09-2022-42220.TIF CTHIS%� � IS NOT A PERMIT Case# EHPR-09-2022-42220 CATAWBA COUNTY HEALTH DEPARTMENT U (�� PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Ig srr Environmental Health Plan Review-OSWP ABANDONMENT Contractor MORGAN WELL AND PUMP, 1840 BOSTIAN RD,CHINA GROVE NC 28023 C:7049330479 Owner WILLIAM&CHRISTINA SAUNDERS JR,6332 SHERRILLS FORD RD,CATAWBA NC 28609 C:7042887810 NAME TO APPEAR ON PERMIT William & Christina Saunders Jr SITE ADDRESS: 6332 SHERRILLS FORD RD,CATAWBA NC 28609 PIN# 369901378492 NAME of SUBDIVISION: Lot# Section/Block --- PROPERTY SIZE: Square Feet 47,916.00 Acres 1.1 DIRECTIONS: Hwy 150 E,left onto Sherrills Ford Rd,right at Corner of JOe Johnson Rd and Sherrills Ford Rd PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: WATER SUPPLY: Public Water DESCRIBE WORK: well abandonment SITE INFORMATION Do any of the following apply to the property for which this application is applied? If the answer to any of the questions below is"YES",then supporting documentation is required: Does this site contain any jurisdictional wetlands? No Does this site contain any existing wastewater systems? Yes Is any of the wastewater going to be generated on the site other than domestic sewage? No Is the site subject to approval by any other public agency? No Are there any easements or right-of-ways on this property? Yes Property Easements Description: NCCOT/Piedmont Gas, Hickory water/cable APPLICATION FOR: Existing Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: House OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: PROPOSED CONSTRUCTION BASEMENT? Yes BASEMENT FIXTURES? No PLUMBING REQUIRED? EMPLOYEES PER SHIFT: NUMBER OF SHIFTS: TOTAL EMPLOYEES: SEATING CAPACITY: TOTAL FLOOR SPACE(SQ FT): Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: APPLICATION FOR WELL ABANDONMENT ABANDONMENT TYPE: almpplicarion 09/09/2022 09:51 Page 1 of 7 f vs,• CATAWBA COUNTY Case# EHPR-09-2022-42220 • n .1.Iii t• Public Health Department Subdivision . l'� Environmental Health Division PIN# 369901378492 PO Box 389,100-A Southwest Blvd,Newton,NC 28658 Ig s. NAME ON PERMIT: (WILLIAM&CI IRISTINA SAUNDERS JR),6332 SI IERRILLS FORD RD,CATAWBA NC 28609 (William&Christina Saunders J Site Address: 6332 SHERRILLS FORD RD,CATAWBA NC 28609 Property Size: Square Feet 47,916.00 Acres 1.1 Directions: Hwy 150 E,left onto Sherrills Ford Rd,right at Corner of JOe Johnson Rd and Sherrills Ford Rd Completed applications are valid for a period of 2 years.Improvement Permits are valid:with complete site plan=60 months(5 years);with complete plat =without expiration. An Authorization to Construct will remain valid as long as the Improvement Permit is valid.An Authorization to Construct issued for septic repair is valid for 60 months(5 years).Permits may be revoked if the information on this application/site plan changes or if the intended use for the proposed facility changes. Permits may be revoked if site conditions are altered such that they effect permit conditions or installation requirements I have read this application and certify that the information provided herein is true,complete and correct Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible so that a complete site evaluation can b:::::::d,5 . The u the owner of the property or legal agent of the owner. Date: C 1 -'�n �— Signature of Applicant or Agent r If you need further information or assistance please ca 828-465-8270 AREA3 .**+**$**********************.******.*..******************************************************************** FEENAME DATE FEE AMOUNT Well Abandonment Fee 09/09/2022 $100.00 TOTAL FEES $100.00 FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) ahapplicao,o 09/09/2022 09:51 Page 2 or catawba county public health Application for Environmental Health Services THIS IS NOT A PERMIT Application is for: El New Construction Existing Facility ❑Improvement Permit ❑Authorization to Construct ❑New Septic ❑ Septic Repair/Malfunction El Septic Relocation ❑ Septic Expansion ❑Existing System Inspection or Reconnection ❑New Well ❑ Replacement Well idWell Abandonment ❑Well Repair Property Address Co co",-0 C TPbaiSJAr , ► i C Z53(001 Acres 1.,o:1 Subdivision 1 Lo Driving Directions to Property 4-1,41 15 ) LE-P T o-'10 s 6 -e_ LL ro o►--, ��r Cam - ol% 40-,Q s N-e-f-f--'u-1-s Fro(-0 Describe work '4 ,-a tack 1 vefl OLi) b a Fi1-. L4,.4 t}t< Y,e 6Li 1lc)ws1 r j .l Applicant Name C•r_45-17 S,ovu Ot(9(ZIS Applicant Address (0• 32 Sik -f-,u-ls roe,, �t cGA .a 0,4, LI C 2 Phone 4ell Phone let _ 2 jep --`� , 10 Owner Name (H(- TU 9 A �- rlkr a-►►-- Q $ t 1 Owner Address (D 3 LASo�') C w 64 C_ Phone Cell Phone Oq- .._ Z j 9 1O Contractor Name 0 1.,1 o eLtrl eIILicense# — ,� C- •Z OContractor Address �,��S 1,A1.a � t� C+�>J ��rr'� t--t � 'Z Phone 101- - ?,3 -04--21.9 Cell Phone Name to Appear on Permit? MOivner ❑Applicant ❑Contractor Who will be the Primary Contact? 'j Owner 0 Applicant ❑Contractor New Construction-Residential Primary Resi•e ■ New Residence ❑ Addition to Residence #of New Bedrooms*t #of Occupants Project Description Structure Dimensions,also specify dimens u,. • decks&porches Basement 0 Yes ❑ No Basement Plumbing \ • IN No Accessory Dwelling #of New Bedrooms*t #of Occupa Structure Dimensions Basement ❑Yes 0 No Basement Plumbing ❑Yes 0 No Accessory Structure(s)Describe tructure(s)Dimensions Plumbing ❑Yes ❑No Describe Plumbing Needed Multi-Family Residence #of Apartments #Bedrooms per Apartment*t Total#Bedrooms in Structure*t • Occupants Structure Dimensions Basement ❑ Yes ❑ No Basement Plumbing ❑Yes 0 No Well Construction/Abandonment/Repair Proposed Well Type ❑ Individual Well 0 Semi-Public Well 0 Community Well Abandonment Type 0 Drilled ❑ Bored ❑ Dug In Unknown Well Repair Requested 0 Yes VI No Describe Will Certified Well Contractor Install Water Line or Electrical Line from Well Head to Pressure Tank?❑Yes prNo catawbacountync.gov Environmental Health Cotowba County Government Center 25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270 MAKING. LIVING. BETTER. Existing Structures on Site Describe 'f2 S-To lei 9JN'k--T Iu Structure Dimensions 3`�" �` � U #of Bedrooms* ' #of Occupants Basement [ Yes 0 No Basement Plumbing ❑ Yes ['No Existing Water Supply ❑ Individual Well 0 Shared Well-Number of Connections ❑ Community Well County/City/Township Water Line Is a public water supply available?** Yes 0 No :rcial ❑Proposed New Construction ❑Existing/Change of Use ❑ Repair Food Service • -• Type #Seats Dining Area(Sq.Ft.) #Employees per Shift #of Shifts Church #of Seats Daycare 0 Yes LI o #of Children #of Employees per Shift #of Shifts Commercial Kitchen ❑ Yes ❑No Residentia • en ❑ Yes ❑No Daycare#of Children _ #of Employees per Shift Shifts Business/Other Specify Type _ Structure Di - ••ns Retail Floor Space #of Employees per Shift #of Shifts Other Information Calculated Design Flow,Commercial t (This value will be determined by EH staff) The Applicant shall notifythe local health department upon submittal of this application if any of the following apply to the property in question. If the answer to any question is"yes",applicant must attach supporting documentation. ❑Yes ji No Does the site contain any jurisdictional wetlands? VI Yes 'p No Does the site contain any existing wastewater systems? ❑Yes No Is any wastewater going to be generated on the site other than domestic sewage? ❑Yes f4No Is the site subject to approval by any other public agency? (� r ISYYes 0 No Are there any easements or right of ways on this property? Describe 1...1c. I T Et u T y,.ta If applying for an Improvement Permit or Authorization to Construct,Please Indicate Desired Syste Type(s): (systems can be ranked in order of your preference) s9 rY-ul C.VU- ❑Accepted 0 Alternative CI Conventional 0 Innovative 0 Other 0 Any I *Any room that will be intended for sleeping at the time of construction or for future consideration should be noted as a bedroom and counted on all applications.The number of bedrooms will be confirmed by rooms identified on floor plans as a bedroom at the time of building permit issuance. This may prevent the need for septic system expansion in the future. t If structure is plumbed but has no bedrooms,calculated design flow will be determined by EH Staff. ** If No,a well permit must be issued with the Authorization to Construct. RETRIP TO THE PROPERTY AND/OR SYSTEM REDESIGN WILL INCUR AN ADDITIONAL CHARGE(SEE FEE SCHEDULE) Completed applications are valid for a period of 2 years. Improvement Permits are valid:with complete site plan=60 months(5 years): with complete plat=without expiration. An Authorization to Construct will remain valid as long as the Improvement Permit is valid.An Authorization to Construct,issued for septic repair is valid for 60 months(5 years).Permits may be revoked if the information on this application/site plan changes or if the intended use for the proposed facility changes.Permits may be revoked if site conditions are altered such that they effect permit conditions or installation requirements. I have read this application and certify that the information provided herein is true,complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible so that a complete site evaluation can be performed. The undersigned is the owner of the property o ent of tebwner. Q Signature of Owner or Legal Agent Date -4/ I /2 2 Printed Name of Owner or Legal Agent `}1 j+u AC1 L+q l'�s� . S 'PR- o9 Aoli-N$Li3 -21 - ....1 , . ••,. . Catawba County Environmental Health . . - ' ."4 • . 11 0. . SI •- .... . gttolt... - „ : . •..- 4",..,.! .."...., ,-,,.. ..' -• e. .: : - , .. , - 4' . .. * IIDJ .. ,t.' • .,. .. i , . .- , - • t • • .... . ... - .. 4 . IS: I 1 V • • :. . . • : , ...i 1:s. 71 .....• • %1 . i 4,I V° - ' ' . - .• • . .. . . 'I i . .. _ I. 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This inopmport productive,jaiianid earn els catreibe Coviint#MC.Oekspailst WormilibilLnilarg. combs cg:attes rases subphyla)snorts ID&weft ocesmoi or know doshopindintorwsiden pinso Oil Iris mop or do%on MPG&COW* presidia end ralue the Independent iddritisillonand shottilbadde now wiroami:11.11nti isiggrePertA..........idera.to Lir Mr um MI county olL.. .Ceirstg.Ns employs's.swift,iiii•—•••• .! Psr"nnlition:griairs4lespoS proa•wit,US.%sisal a**IV P•TiOn-ratiti. • dr"' .10 whiohillile$Of may ... Copyright 7021 Wawa r•tams.Imr• Scanned with CamScanner t • V P: 04).t CATAWBA COUNTY•,..(.1 Cuss# OP_12 2021-Ib3132 t.ilk Public Health Department Subdivision • Environmental health Division PIN# 369901378492 PO Box 789,25 C;overnmem Drive,Newton,NC 28658 L0°F Site Address: 6332 SHERRILLS FORD RD, CATAWBA NC 28609j[� nr} �� Name on Permit WILLIAM& CHRISTINA SAUNDERS JR D LJ'`I pt N 4-13 Property Size: Acres 1.09 Directions: Hwy 150 E Left Sherrils Ford Rd on Right at Corner Joe Johnson Road and Sherrils ford rd Operation Permit Permit Category: Expansion/.e`DC4iori Wastewater Flow: 480 g.p.d. Type of Facility: Primary Residence- Basement? Yes Basement Plumbing? No Bedrooms: 4 Water Supply: Private Well Maximum Occupants: 8 System Type: IIIG-OTHER NON-CONY TRENCH SYSTEMS Description: 25%REDUCTION System Code: IQ4PS System Code Description: Infiltrator Quick 4 Plus Standard Types V and VI systems expire in 5 years. Owner must contact Environmental Health 6 months prior to expiration for permit renewal. System Installation Comments: STB 760 Shoaf Tank 4x100'trenches IQ4PS PERMIT CONDITIONS: 1.All maintenance, monitoring &performance requirements shall be in accordance with 15 A NCAC 18.1900, Rule.1961 2. Operation&Maintenance Specifics: Subsurface system operator required? Yes_ No X_ — 0 c > This system has been installed in compliance with applicable NC General Statutes,Rules for Sewage Treatment and Disposal. Russell Williams#3137 12/22/2021 System Installer Installation Date dt— 1/ 12/22/2021 Authorized State Agent Permit Issuance Date Form f V'p m,,r 12/29/2021 13.58 A0040 `432Siciato=217 v 7 Catawba County Environmental. Health 7 il .4 4 Q. .4. ....... : • '. .. . ,•/4* ..'4 ,*/ I_ ' • • ' . ' . . ' ' ' a A a. ao .... ' : . :•'., . . . • 4 ..... ,41114 i)it ,:. C 1 .s lq- 4 . ''' 1 -1 .t a ''.: . ... • . , '0 ) IA • i. 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Catawba Cottnty has made su annual.11,,....- This maPirePall---- and labeitna infonnotlon conlMned on title map Or data on thls reixut.Catawba County promotes anbd mom----rrif,""""„r',., to ensure The accuracy of location the indisPenti....4ani vabflilultilan date*ordained on this map/report ptodurd by the user.The County of Catawba its amok...—. ------8 Inot be hekf liable for any end all damages.loss ce liability.terhether dIrict,Indirect ' • "—"'-"..NrIa.and avissinownmlfrom'elsre rnea"pirsandpottshaproduct ot•the use thereof by any porsort or entity.. • Couvrlah1 2021 Catravhs numbs Ihr or consequential wmn arlseS or may Scanned with CamScanner �$A • CATAWBA COUNTY 100A SOUTHWEST BLVD NEWTON, NORTI I CAROLINA 28658 RECEIPT V Friday,September 9,2022 18 42 sM www.catawbacountync.gov PAYOR: Saunders Jr,William&Christina PAYMENTS TRANSACTION NUMBER: TRC-46884028-09-09-2022 PAYMENT DATE: 09/09/2022 PAYMENT TYPE: Credit Card INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 09-22-411922 110-580200-663000 Well Abandonment Fee $100.00 .. TOTAL PAYMENTS: $100.00 EHPR-09-2022-42220 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 6332 SIIERRILLS FORD RD,CATAWBA NC 28609 Owner WILLIAM&CI-IRISTINA SAUNDERS JR,6332 SHERRILLS FORD RD,CATAWBA NC 28609 C:7042887810 **NO PEOPLESOFT ACCOUNT ASSIGNED** Contractor MORGAN WELL AND PUMP, 1840 BOSTIAN RD,CHINA GROVE NC 28023 C:7049330479 receipt 09/09/2022 09:50 Page 1 of 1 NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES VARIANCE APPLICATION FOR 2C.0100 WELL CONSTRUCTION STANDARDS: PRIVATE DRINKING WATER WELLS UNDER 15A NCAC 02C.0300 WATER SUPPLY WELLS UNDER 15A NCAC 02C.0107 All water supply wells not considered"Private Drinking Water Wells"and including irrigation,industrial,and commercial wells. WELLS OTHER THAN WATER SUPPLY UNDER 15A NCAC 02C.0108 Including monitoring and recovery.wells. Print clearly or type information. Illegible submittals will be returned as incomplete. ' DATE: t I• , 20 22 PERMIT NO.: (to be completed by DWQ/DPH) A. WELL OWNER-For single family residences list the property owner(s). For all others,list name of the business, organization,or government agency pad person delegated signature authority: W I LLIxtvl L, SAUNQ9R.5 r ..1 g. . a n ' , 1 mB, il e ki 0�f () Mailing Address: (o 3 re- �1�`"Apl LA-5 ro 1� 1` ,0 A2N-O City: CATA>o-1 A State: NC Zip Codc:2 Qf 1 County: G IA N It2A- Day Tele No.: —101- - 2vo _ vb i o cell No.: loci- '-1,6cat, - 12D 10 EMAIL Address:CSi S53 --it.grha.k.00.^-1 Fax No.: B. PHYSICAL LOCATION OF WELL SITE (1) Parcel Identification Number(PIN)of well site: ,(.-OCk 1 G 3-7 b41 1 L County: Cto.TA4--4 /1.-- (2) Physical Address(if different than mailing address): City: State:NC Zip Code: C. WELL DRILLER INFORMATION(if known) Well Drilling Contractor's Name: �tt-P-1t5 nb W..1 NC Well Drilling Contractor Certification No.: Cg‘'. S-i L Company Name: of-Cj 44-L II LL.L c: PU PI P Contact Person: City:G 1'-1'. Yei State: NC Zip Code '2J County: lo4 ''1 Day Tele No.: 104- - 3 - O 1-11 Cell No.: EMAIL Address: II Fax No.: Form GW-22V Page 1 Revised February 2013 D. REASON FOR VARIANCE REQUEST- Include t5pe 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. for-- tal,l Ili ?��Ep -T v(�.M Qot,! It�liu tfi Q7�10- 1 ufriit�' NI. i 5P` I4C1k1C� o2C :0 I '� (�ELL Ls.P2o,Wdea l t"16t-i i). I1-t p iiioLA to hcccc��pa�-tC ki-14 7 - STot.t4 pa a-p IS 140 j �E�i 4 as IttE o 15 LocAsTFD _t Ir+OE 1*4 3R tt� dcc�sS s /A I� U�l i�Ep 6440 ib+e- CoNc zt?jE ,atitto 6 +tIL c 4, it> 1)0,9_ 1AL`'[ fiI L> E- o LL (5N iJo Irvt"1 ie. --T ne)ve.° .LL �lF J--ltZlrAl� 06,-4D P.(24 +l tr+tb'5-- v bes ltirt�� SE�vr�� E. ATTACHMENTS-Provide the following information as attachments to this application: -I t- r1 N`-"W • (I)k 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)1- 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 t'.tose 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 13 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 Signature of l'ersun Responsible for well Construction(typically the well driller) C~its I t�r� I . � l'rint or Type Full Nam of Person Responsible for Well Construction (typically the well 41)41 Signature of County Environmental Health Specialist Robb .a P I Ps Print or Type Full Name of County Environmental Health Specialist Per 15A 1slC.4C 02C.0118 the Secretary of the Division of IVater 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 dates 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-22V Page 2 Revised Febtnuy 2t}13 . %SFR•• Cr9-404(-.Vita ..:0, • Catawba County Environmental Health - -fl 4 .: -. :' i! ' • . , • • • • ' * 61.t • ' - : . . . -.,• ' _• r A! •. A.,. ,... . . .. . . ... - : : - - 7..., • , . . ...,, ., „..:: .i• , . ...,-.k.• . :,,,F.:- ...,!,.... .:.?: " • r., • .. e, : • - .. ..T(' ,. .• a' .1'" et ..•t.... Pr' : • . -J . ., •i, ..'; .. • •AS . ... - . . .:: , ..f -/N., 4. ,.. k '1'...,/,: st •,' •fri • - • ''.•:' • .. . - :•- 4 '.' ' ••-•it i !I. I : .* 't : . . : ,. . :. • 11 .t' ...• ..... An . .1 .0 i ,:: :, . t .-, i 4 , - - •r a i title' , : :". ' ' lie .. * .; • 1 • • • AV"I f 4 q L Q - . ,. . -.- %h." 4 lkoilit .-.4...4.: i • „, -3— - , • 4:' i - 1 '71 : - '•. _ -,,i . . I : . 1 -. ' A-,', •• -'71 ', . . 1. 0 ' 1.°4- •": • • .-- ••_ ...`L ' ' ' . ;414 '-; .ic , .../ Jr• --, . . -I 1. • lit • • '..4.,..i 1 fte -- •, . ; : t,, :: .- • • . , _,... ..i_. . • ii • - 40.X ) '., '. . -: ';': :"4-7 it. , . F if 40111111111P ,":1' . i- .- ; I ••- • 4rlizsi 4 , , . , . :.,, . ... r . . 1 • , * , • , . •.. . . - • ,!. :• . •:: .- : • • • - . • . .. 1 . . • ." .. • lb •*•. • . - -iii;- :: 4,::.• . . •. • • • .. . • • .I*0-41Z36920,1*784112.wag StIOROW.8.FORD 1.4.50it - RarATONRAf,28609 . Op $-;4•44... -024440.4 :i 7th:-.-.414 th• 16,3 • • ..... • .... rirox_i_,,wiPhIPialm 4scarvia,,,,,,„,11Dmio. .1.""liddH„,,,d.k.rAlitcd.opii,“mji=ti..8131ailitpridue by gm,""wlitItnu-olitgweas.coslar— casla=t2Y.it. hin""g"nulds.„,..."6"1111"nmmurend,„„ i . ,,......imppiz.„--F-cd.---tom dhdolvizmowt.„d eadmind bg;1,7.brznilityrszy pmemexii km.,,,,,_fohlay ii.hilhow Qua,Mita or carteiwomid iiiiii—i',1;;;; Scanned with CamScanner k lit‘.,--i 1 n E-1-IT * 2 : p ' A,it-flo s 1-i. ri_rp Photos of Water Well under Sherrills Ford Road house in Catawba, North Carolina • .. 5'i t wn '4 f. ^Y .Ay :k • t \ - y 4• �} Y�! ' ;I:- . i. ir View of water well and water well access under house in crawlspace area • � - .• � .... • .' 4.'.t'''M1 ,i. • • k • ,�^:,,`l, v, \ i., 0 , -:' 1 ':blt . 1. View of debris in water well pr�r\t-1 n Es i CIF G' ! O 1 4 E.r-" .+ 6vek I t ' I p a/r1 k i'old P ��.. r I 11`61[- 1 `F Photos of Water Well under Sherrills Ford Road house in Catawba,North Carolina Y r ;!/ +A. 3H . a�j +' . !fir L✓+ �, 3 _ I f. f i� ' L 11 • `Y} 1 ♦. \ > f ti `, Closeup view of water well debris STATE y,„ or ROY COOPER • Governor N s, NC DEPARTMENT OF • _ HEALTH AND MANDY COHEN, MD, MPH • Secretary fi HUMAN SERVICES MARK T. BENTON •Assistant Secretary for Public Health Division of Public Health Onsite Water Protection Branch October 5, 2022 William Saunders Jr. and Christina Saunders 6332 Sherrill's Ford Rd Catawba, NC 28609 Re: Approval No. JMB2778 Private Well Not Free From Obstructions Prior to Abandonment [Rule 15A NCAC 2C .0113(b)(2)] Property location: 6332 Sherrill's Ford Rd Catawba, NC 28609 Dear Mr. and Mrs. Saunders, On October 4,2022, a variance request was submitted for the above referenced property from the Well Construction standards, Title 15A North Carolina Administrative Code Subchapter 2C .0100. The variance request is regarding abandonment of a water supply well at the above referenced property. Specifically, the variance you request would grant you permission to abandon a bored water supply well without it being sounded and clear of obstructions. The well has been filled with cinderblock and concrete pieces and is located in the crawl space of the house. Based upon information provided by the Catawba County Health Department and, it is my finding that you meet the conditions necessary for approval of a variance as specified by 15A NCAC 2C .0118 (a) (1) and (2). On that basis and provided that the well is to be abandoned as follows, the requested variance is approved: 1) The well shall be filled with a cement grout material from the material to the land surface. 2) An abandonment permit shall be obtained from the Catawba County Ilealth Department, and they shall be notified prior to the abandonment so that they will have the opportunity to inspect the abandonment procedure. NC DEPARTMENT OF HEALTH AND HUMAN SERVICES•DIVISION OF PUBLIC HEALTH LOCATION:5605 SIX FORKS RD,RALEIGH NC 27609 MAILING ADDRESS: 1632 MAIL SERVICE CENTER,RALEIGH NC 27699-1632 www.ncdhhs.gov•TEL:919-707-5854•FAX:919-845-3972 AN EQUAL OPPORTUNITY!AFFIRMATIVE ACTION EMPLOYER The approval of this variance does not affect any of the other requirements or limitations of the Well Construction Standards, or to your responsibility to comply with any other applicable Federal, State, or local laws or regulations. This variance is for this project only. If you are dissatisfied with this decision, you may commence a contested case by filing a petition under G.S. 150B-23 within sixty(60)days of your receipt this decision. Should you have any questions, please call me at(828) 713-3335. Sincerely, John M. Brooks R.E.H.S, MS 2