HomeMy WebLinkAboutWCOC-10-2022-181749.TIF .44 . CATAWBA COUNTY Case# WCOC-10-2022-181749
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Public Health Department Subdivision
Environmental Health Division PIN# 461604545490
PO Box 389,25 Government Drive,Newton,NC 28658 LOT#
/842 s.
Site Address: 4835 KISER ISLAND RD,TERRELL NC 28682
Name on Permit JEFFREY LANCASTER
Property Size: Acres: 0.79
Directions: Hwy 150,Rt on Kiser Island,on causeway
WELL CERTIFICATE OF COMPLETION
Permit Number: WELL-11-2020-141932
DATE COMPLETED INSPECTION TYPE STATUS INSPECTOR
05/31/2022 EH Well Grouting No EH Inspection Randy Ross
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 15A NCAC 02C
.0100. The completed Well Construction Record,as submitted by the licensed well contractor,will serve as
written certification of grout compliance
05/31/2022 EH Well Record Received Approved EH Admin
09/07/2022 EH Well Head Approved Randy Ross
# Well no4 drilled as Vafiafce yJe.IL 1-I-via: able {o be Ioc4'fed ou-ISiclt: -}ht 54- f.
kaKe IJ& (er and rne+ all o-+her a frlicaLIe ;'e- backs•
B&K 05/31/2022
Well Driller Date Drilled
,4"-`0"-- -'- Z=5;= --,---
10/05/2022
Authorized State Agent Issuance Date
chwellcoc 10/27/2022 11:53 Page 1 of I
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