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Site Address: 2674 SARDIS CHURCH RD.HICKORY NC 28602
Name on Permit: LANE FULBRIGHT
Property Size: Acres 4 28
Directions: Left off of W NC 10 Hwy onto Sardis Church Rd.3rd lot on left.
Owner/Authorized Representative Acknowledgement of Permit Receipt
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�` I certil} that I ant the oft n s cr or authorized agent tots authorization required)rcprescn(ing the rtcncr Of
{{ the property demerill d abate.
L1 As the property owner or authorized representative.I have received the above referenced
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permit(s)as requested in the application 'Or service RBI'K-IO-2022-42500.by the following method(s):
Received in Person
1 Facsimile Transmittal(Return firm with signature required)
Electronic Image Transmittal- E-mail (Return receipt required)
14.
(..—k"+1s the property owner or authorized representative I have ref iewed and understand the specific conditions
of the permit issued. and further understand that all applicable regulatory requirements specified under the
North Carolina Laws and Rules for Sewage Treatment and Disposal Systems(15A NCAC' I8A.1900),
and/or Well Construction Standards(I5A NCAC 2C .0100), shall apply to the issuance oI'this permit and
the construction ol'the wastewater system and/or water supply well permitted.
Permit Issue Date: 11/22)2022
Owner'Authnrized Representative Signature
Date 1W
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by . . /tutu'ol.person seralipt,l;permit)
CifSignature I)alc''titne iu 5i`1
Method: Fax /Email _US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
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.. ' North Carolina State Laboratoryof Public Health MSC 1918
�'� �i�I-._�,�-� ,,,`i� Raleigh,NC 27699-1918
+,v,‘id , j�1�,`` /' Environmental Sciences http://slph.ncpublichealth.corn
_. Phone: 919-733-7308
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Inorganic Chemistry Fax: 919-715-8611
Certificate of Analysis FINAL REPORT
Report to: ENVIRONMENTAL HEALTH Name of System:
CATAWBA COUNTY ENVIRONMENTAL HEALTH Lane Fuibright
P 0 BOX 389 2674 Sardis Church Rd
NEWTON,NC 28658 Hickory,NC 28602
EIN:566001814EH Delivery: NC Courier
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StarLiMS ID: ES250519-0004 Date Collected: 05/15/2025 Time Collected: 12:17 By: Dwight Mikeal
Date Received: 05/19/2025 Time Received: 07:46
Sample Type: Raw Sampling Point: Well head Well Permit No. WELL-11-2022-185001
Sample Source: New Well Receipt Temp. : GPS Number:
Profile: New Well-No Nitrate I
Analyte Test Result Allowable Limit Unit Qualifiers)
Arsenic <0.001 0.010 mg/L
Barium <0.1 2.0 mg/L
Cadmium <0.0005 0.005 mg/L
Calcium 3 mg/L
Chloride <5 250 mg/L
Chromium <0.02 0.10 mg/L
Copper <0.01 1.3 mg/L
Fluoride <0.1 4.00 mg/L
Iron 0.277 0.300 mg/L
Lead <0.003 0.015 mg/L
Magnesium 2 mg/L
Manganese 0.046 0.05 mg/L
Mercury <0.0004 0.002 mg/L
Nickel <0.01 0.1 mg/L
pH 6.4 N/A
Selenium <0.005 0.05 mg/L
Silver <0.01 0.10 mg/L
Sodium 3.8 mg/L
Sulfate 8.9 250 mg/L
Total Alkalinity 14 mg/L
Total Hardness 16 mg/L
Zinc <0.05 5.0 mg/L
Report Date: 06/04/2025 E Reported By:
RECIVED
Marc Komlos
JUN 1 7 2025
Environmental Health
Page 1 of 1
North Carolina Division of Public Health
Occupational and Environmental Epidemiology Branch,Epidemiology Section
BIOLOGICAL ANALYSIS REPORT
Private well water infoiuiation and recommendations
County: Catawba Name: L r - v I b Sample ID Number: 1 5- 0 V I
Location: 7-1-1 u1 S c.r-J i C1t rc L Reviewer: 0.1 613
Initial Sample )C Confirmation Sample:
BIOLOGICAL ANALYSIS RESULTS AND RECOMMENDATIONS FOR USES OF YOUR
PRIVATE WELL WATER(These recommendations are based on biological analysis only.)
XNo coliformbacteria were found in your well water. Your water can be used for all purposes
including drinking, cooking, washing dishes,bathing and showering.
Total coliformb acteria were detected in your water sample. Total Coliform are a group of related
bacteria that are (with few exceptions)not harmful to humans.A variety of bacteria,parasites, and
viruses,known as pathogens,can potentially cause health problems if humans ingest them.EPA considers
total coliforms a useful indicator of other pathogens for drinking water. Total coliforms are used to
determine the adequacy of water treatment and the integrity of the distribution system
It is recommended that your well water be re-tested to verify that the result is accurate.
Fecal coliform bacteria were detected in the sample. Do not use the water for drinking,
cooking,washing dishes,bathing or showering.
If the re-test shows contamination by bacteria contact your local health department for assistance. There
may be a problem with the construction of the well,the groundwater source,or operation of the well. The
well needs to be inspected by the local health department or a local well contractor to determine the
problem with the well and to give guidance on how to correct the problem.
•
Your well water was tested for biological contaminants(total coliform and fecal coliform bacteria). The
results were evaluated using the federal drinking water standards.
Drinking water may contain substances that can occurnaturally in water or can be introduced into water
from man-made sources.Total colifolluzbacteria are found in soil and fecal conform bacteria are found in
animal and human waste.Total coliform or fecal coliform bacteria in well water indicate that the well
may have structural problems or that the well was not properly disinfected. •
If you have been drinking the well water and are pregnant,nursing,have a child in the household under 5
years of age,orimmuno compromised (such as an individual with AIDS, cancer, hepatitis, dialysis or
surgical procedures) inform your physician of these results at your next visit.
If the contamination continues,you should investigate the possibility of drilling a new well or installing a
. point-of-entry disinfection unit which can use chlorine,ultraviolet HEX or ozone.
For further information please contact your county health depai Linent or the Occupational and
Environmental Epidemiology Branch at 919-707-5900.
N 0 R T H C A R 0 L I N A
ATE Private Well Information
,..v
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and Use Recommendations
NC DEPARTMENT OF
HEALTH AND HUMAN SERVICES
Division of Public Health For Inorganic Chemical Contaminants
County: Catawba Name/Address: G�• j� {1 11x a ens r Z6-1 S< <
Sample ID#: $5 D 0 I Reviewer: Jason Boyd
TEST RESULTS AND USE RECOMMENDATIONS
1. M Your well water meets federal drinking water standards for inorganic chemicals.Your water can be used for
drinking,cooking,washing, cleaning, bathing, and showering based on the inorganic chemical results only.You may
have other water sampling results that are not taken into account in this report.
2. ❑ The following substance(s)exceeded federal drinking water standards or the North Carolina 2L calculated health
levels. The North Carolina Division of Public Health recommends that your well water not be used for drinking and
cooking,unless you install a water treatment system to remove the circled substance(s).However, it may be used for
washing, cleaning,bathing and showering based on the inorganic chemical results only.
❑ Arsenic n Barium ❑ Cadmium n Chromium ❑ Copper n Fluoride n Iron
❑Lead n Manganese ❑ Mercury ❑Nickel ❑Nitrate/Nitrite n Selenium n Silver
❑ Zinc
3.❑While your lead levels do not exceed federal or state standards,the North Carolina Division of Public Health has
concerns with any detection of lead. Should you have any questions please contact the NC Private Well and Health
Program at(919) 707-5900.
4. n Re-sample for lead and/or copper. Take a first draw and 30-second flush sample inside the house (preferably the
kitchen sink)and a first draw and 4 minutes flush sample at the wellhead to determine the source of lead and/or copper.
5.X The following substance(s)exceeded aesthetic drinking water standards. Your water can be used for drinking,
cooking,washing,cleaning, bathing,and showering based on the inorganic chemical results only,but aesthetic problems
such as bad taste, odor, staining of porcelain, etc.may occur.You may want to install a household water treatment system
to address aesthetic problems.
n Chloride n Copper ❑Fluoride n Iron n Manganese
1StpH ❑ Silver ❑ Sulfate n Zinc
6. n a. Sodium levels exceed the U.S.Environmental Protection Agency's(USEPA)Health Advisory level for sodium of
20 mg/1.The North Carolina Division of Public Health recommends that only individuals on no or low sodium-restricted
diets not use this water for drinking or cooking. It may be used for washing, cleaning,bathing,and showering based on
the inorganic chemical results only.
n b.Your sodium level exceeds 30 mg/1 and may pose aesthetic issues such as bad taste, odor, staining of porcelain, etc.
7. ❑Re-sampling is recommended in months,to reinvestigate
For more information regarding your well water results,please call the North Carolina Division of Public Health at 919-707-5900.
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What are pH and total alkalinity? i ' ,II
pH is a measurement of the acidity or basicness of
water.Water with a pH less than 7 is acidic.Water f °' ( a
that has a pH greater than 7 is basic.Water the has a
pH of 7 is neutral,neither acidic nor basic.
Total alkalinity is a measurement of the capacity for -1 v
water to resist changes in pH. `--, - 7" ::_
What affects the pH level acceptable range for pH.This standard was developed
and total alkalinity in to prevent metallic or sour taste,slippery feel,and pipe
my private well water? corrosion.There are no health-based standards for pH.
pH levels and total alkalinity depend on the amount The US Environmental Protection Agency or
of minerals like carbonate,bicarbonate,and NC Department of Environmental Quality have not
hydroxide in groundwater. developed standards for total alkalinity.
How can pH and total How do I test for pH and total
alkalinity affect my health? alkalinity in my private well?
High and low levels of pH can cause gastrointestinal Use a certified lab or buy test kits at your local home
problems.Low pH (less than 4)can cause skin and improvement store to test for pH and total alkalinity
eye irritation.High pH(greater than 10)can cause in your well water.Contact the private well program
hair damage.High and low pH can cause corrosion at your county health department to assist you with
which may cause more harmful contaminants to getting your water tested.Pricing of testing varies
enter groundwater. from county to county.
Alkalinity cannot impact your health.
What if my water is acidic
What level of pH and total or alkaline?
alkalinity should I be If you are concerned about the taste of your
concerned about? well water,you can install a treatment system to
The US Environmental Protection Agency or neutralize the acidity or alkalinity of your private well.
NC Department of Environmental Quality developed A neutralizer is a treatment system that can reduce
an aesthetic standard for pH of 6.5 to 8.5 being an the acidity or alkalinity of your well water.
Percent of Private Wells Tested
Outside of State and Federal Guidelines for
pH, 2011-2013
lie
411011MINIEtlir-mil 1111Werfalkilir
10_
MILVILATIMMAllip
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"nr � L I>75%outside guidance range A 50.1-75%outside guidance range rrll I
MI 25.1-50%outside guidance range
<25%outside guidance range
Il 0%outside guidance range 1 —
T Insufficient data(<10 wells tested)
What are the pH and total Where did this information
alkalinity levels in NC? come from?
The pH of private well water varies across NC US Environmental Protection Agency:www.epa.
(3.2-11.6),see map for areas with pH outside gov/sites/production/files/2015-09/documents/
of guidance range(6.5-8.5). 2009 03 13 estuaries monitor chap11.pdf
Total alkalinity of private well water varies across and https://safewater.zendesk.com/hc/en-us/
NC ranging from 0-1,020 mg/L. articles/211406048-What-is-the-difference-between-
pH-and-alkalinity-
Where can I find more World Health Organization:www.who.int/water
information about pH, total sanitation health/dwq/chemicals/ph revised 2007
clean version.pdf
alkalinity and my well?
Water Quality Association:www.wga.org/learn-
Visitthe NC Division of Public Health's Private Well about-water/perceptible-issues/corrosion/acidity-
and Health Program website:http://epi.publichealth. low-ph-
nc.gov/oee/programs/wellwater.html.
There you can find:
• Contacts for your county private well program
• pH and Total alkalinity in well water maps
• A guide for selecting a treatment system
• Other private well resources
You can also call the Private Well and Health Program
at 919-707-5900.
NC Department of Health and Human Services•Division of Public Health•Epidemiology Section•Occupational and Environmental
g„v�' y a ON I I Epidemiology Branch•Private Well and Health Program•https://eoi.oublichealth.nc.00v/oee/programs/wellwater.html.NCDHHS is an
�,:° Notlpcaom1 equal opportunity employer and provider..09/2019
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