HomeMy WebLinkAboutWCOC-11-2022-184276.TIF •
CATAWBA COUNTY Case# WCOC-1 1-2022-1 84276
144'n Public Health Department Subdivision MOONLITE BAY
R _ Environmental Health Division PlN# 460604843059
tad" PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 52
Site Address: 4955 SURFWOOD DR,SHERRILLS FORD NC 28673
Name on Permit THOMAS NORWOOD
Property Size: Acres: 0.47
Directions: Hwy 150,L on Slanting Bridge,L on Vista View,L on Surfwood,Lot on Left
WELL CERTIFICATE OF COMPLETION
Permit Number:WELL-10-2020-139768
DATE COMPLETED INSPECTION TYPE STATUS INSPECTOR
09/07/2022 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
09/14/2022 EH Well Record Received Approved Ill A:Imin
10/I0/2022 EH Well Head Approved Randy Ross
B&K 09/27/2022
Well Driller Date Drilled
11/11/2022
Authorized State Agent Issuance Date
elmelleo, 11/28/2022 13:31 Page I of I
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