HomeMy WebLinkAboutWCOC-09-2022-180471.TIF CATAWBA COUNTY Case# WCOC-09-2022-180471
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4�C t Public Health Department Subdivision DOUGLAS CORNERS
E , `1 Environmental Health Division PIN# 268703241906
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 26
18 2
Site Address: 3822 BANOAK RD,VALE NC 28168
Name on Permit MICHELLE HODGE
Property Size: Acres: 0.68
Directions: Hwy 10,Left on Banoak Rd,Land on Left
WELL CERTIFICATE OF COMPLETION
Permit Number: WELL-04-2022-170270
DATE COMPLETED INSPECTION TYPE STATUS INSPECTOR
08/17/2022 EH Well Grouting No EH Inspection Steven Price
Pursuant to 15A 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 I5A NCAC 02C
.0100. The completed Well Construction Record, as submitted by the licensed well contractor,will serve as
written certification of grout compliance
08/26/2022 EH Well Record Received Approved EH Admin
09/16/2022 EH Well Head Approved Cheyannc Morgan
Mid South Well and Pump(Chad Jullian) 08/17/2022
Well Driller Date Drilled
31d4rt 1117( \
09/16/2022
Authorized State Agent Issuance Date
elm enco: 10/24/2022 09:3I Page 1 of 1
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