HomeMy WebLinkAboutWELL-11-2022-185182.tif C m� CATAWBA COUNTY
(...._-t. Public Health Department Subdivision WESTON
Qam�s Environmental Health Division PINS 266901455525
a�yy PO Box 389,25 Government Drive.Newton.NC 28658 LOTS 14
it■ Y✓
Sits Address: 1827 MESA DR,VALE NC 28168
Name on Permit: 'CLAYTON HOMES OF CONOVER
Property Size: Acres 1.200
Directions: R on NC 10 Hwy W, R on Providence Church Rd, L on Old Shelby Rd, R on 8rittain Rd, L on Mesa Dr
Owner/Authorized Representative Acknowledgement of Permit Receipt
1.IV I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property described above.
t, Yu`- As the property owner or authorized representative,1 have received the above referenced
permit(s)as requested in the application for service RBPR-03-2022-40377,by the following method(s):
Received in Person
_ Facsimile Transmittal(Return form with signature required)
Ni Electronic Image Transmittal/E-mail (Return receipt required)
t As the property owner or authorized representative I have reviewed and understand the specific conditions
r 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(I5A NCAC 18A.1900),
and/or Well Construction Standards(I SA NCAC 2C.0100), shall apply to the issuance of this permit and
the construction of the wastewater system and/or water supply well permitted.
Permit Issue Date: 11/28/2022
i
Owner/Authorized Representative Signature
Date //-cZ - - /
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person sending permit)
Signature E. Date/Time Ii tZ(Iz
Method: Fax i Email US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
We wantt tto hear from yolPlease ttake a few momentts tto complette our custtomer service survey att
http://www.surveymonkey.com/s/EHCusttomerService
MAR t Vauk4 e&U/i /g► 'E,n1
l'I.,h'llllll 1 V
l t/28/2022 16 32
CATAWBA COUNTY Case# WELL-11-2022-185182
�
Public Health Department Subdivision WESTON
d ., 'y Environmental Health Division PIN# 266901455525
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 14
Site Address: 1827 MESA DR,VALE NC 28168
Name on Permit: *CLAYTON HOMES OF CONOVER
Property Size: Acres 1.200
Directions: R on NC 10 Hwy W, R on Providence Church Rd, L on Old Shelby Rd, R on Brittain Rd, L on Mesa Dr
NEW WELL PERMIT
REQUIRED WELL SETBACKS:
Septic Systems and Repair Areas for Single Family Dwellings 50 ft.
Septic Systems and Repair Areas for Businesses and Multi-Family Residences 100 ft.
Underground Storage Tanks 100 ft.
Animal Barns 100 ft.
Lakes/Ponds 50 ft.
Streams/Brooks/Creeks/Rivers 25 ft.
Building Foundations 25 ft.
All Other Sources of Groundwater Contamination 100 ft.
Saprolite Septic Systems and Repair Areas 100 ft.
Septic Systems and Repair Areas to Wells with 2 or more connections 100 ft.
Wells shall be constructed in accordance with state regulations:
Article 15A North Carolina Administrative Code Subchapter 2C
The well driller must verify all setbacks before drilling the well.If the well driller is unable to maintain any of
the above setbacks,contact Catawba County Environmental Health at 828-465-8270,before drilling the well.
Grouting Depth:20 feet minimum
Casing Height: 12 inches minimum above finished grade
All newly constructed private drinking water wells are required to be sampled in accordance with the North Carolina Rules Regarding Private
Drinking Water Well Testing(I5A NCAC I 8A.3800).The fee for this sampling is included in the cost of the well permit.It is the applicant or
property owner's responsibility to notify Environmental Health when the well is ready for sampling.Water samples will be drawn from an
outside faucet unless otherwise specified.For questions or for more information,please contact Environmental Health.
3719Vt 1477(
11/28/2022
Authorized State Agent Permit Issuance Date
11/28/2027
Permit Expiration Date
ehpennit 11/28/2022 16:32
ebt -I J-)0))-4t5I 2_
Catawba County Environmental Health
VJI✓L - I I -?OLZ- I S51 3
:\.1,
I
I I
I I
Icr-
I
Sc) El 4 I 'p 1827
�5 50 \57
I
I
�� �O 3gr�B I
_ C� I
$ I I
I l
lao .less 16 6J I I
I pt"� I
I got' Weilani0 I R
345.4e I }, 1x 466,10,4C/
I
I
I
CC
I I o
g m 1841 w
I 145.49
it—
I I
I 1
I I
4.54
Parcel:266901454499, 1835 MESA DR VALE, 1in=50ft
28168
erae ty. pa
I • mordrepon ca'u&d location aced��ICatawba
o n y NC .oip mapoor tea on ic Services. Catawba County Ms made substantial efforts
to ensure bef tq port Catawba County promotes and reconvnends
Vra Indepardent wrlflraUon d any data contained on this maplrepon product by Via user.The County of Catawba,Its amployeas,agents,and
pareortrxl,disclaim and shall not be Mid liable tot any and all damages,lost or liability,whether direct.Indirect or consequential which alias or may
'prism from Ws map/report produd or 1M usa thereof by any person or entity.
Copynght 2021 Catawba Carly NC
0926 2022
,_,FQ WPDT Report
Area of Interest (AOI) Information
Area : 3,134,508.59 ft2
Nov 28 2022 16:34:49 Eastern Standard Time
It h5 " .
•
}•. ,a' is ' ''-
'�: '' •''f' '�' r law _
till,. , r
' #' - ' ''!
.r.,,• r r,r. ..fir • ' .hit
.'a
. , ', ii 4plivibi., '
i r
' (i ,`''
'7te 10
li0 �rY♦ t. , C
rL 11 r A �i * f rY.
r 6T
_ t , ,„,/ - t.e ...t/ lik
it
;.15, p ,
. 4 V ,t �4 1
1.1‘
T; ,ti 1 ii/11
z
./ . . .
1:4,514
� i Parcels(Polygons)-Parcel Ro1ected Route ..I 0.03 0 C 0 12 m
I 1 1 5 ti i ti 1 1
Non-Syslem Roads — Other State Agency Route 0 005 0.t 0.21on
— Federal Route — Seconder/Route
-- Non-Systern Primary Roads
Other System Roads — Iolerstate WW1 c.s Unu.Nc CO .0 Naar.E>,C n.,.ng Msra coarreoi,
6.0..1 Norm ranyna 001 d ophnSvcohkaa,4lK15We.En.NEIE
— Ramps,Rest/vette.Non Mamhne — LIS Rate a nn,n.sal.rwa,n cn,7'.C.okq,.t o-M uenxv,+r 0205 EPA lies
„s Gen.,m.eru Usoa
— NC Route
1827 Mesa Dr,Vale
All North Carolina Department of Environmental Quality(NCDEQ)GIS data is expressly provided"AS IS"and"WITH ALL FAULTS".The
NCDEQ makes no warranty of any kind,express or implied,concerning this information, including but not limited to any warranties of
merchantability or witness for any particular purpose.The NCDEQ assumes no responsibility or legal liability concerning the Data's accuracy,
reliability,completeness,timeliness,or usefulness.The data is not intended to constitute advice nor is it to be used as a substitute for specific
advice from a professional. Users should not act(or refrain from acting)based upon information in the Data without independently verifying
the information and obtaining any necessary professional advice. Users are solely responsible for ensuring the accuracy,currency and other
qualities of any products derived from or in connection with the NCDEQ's Data.The Data is collected from various sources and may be
modified over time without notice to improve spatial andattribute accuracy.The NCDEQ disclaims responsibility for the spatial accuracy and
attribution of GIS features and makes no warranty concerning same.
Wau .)/-)0D-ItS!g1-
\J\I6u-- !I-wu- 1%5B3
Catawba County Environmental Health
1
14 1I I
A
I I
I
I I
I
114?? \.�' - v I
. >
I
I
l.
‘ :
So' t
.�4 ....
�5 ;, II! 61e27
6 •
I
! I IIII
�y- . 04,
a t— '`y0 I
1 vo 1 0
34e I a I
I
e1841 I
oi 1 15.49 a
1 1
1 1
,00 ,,, I
64.54
Parcel:266901454499, 1835 MESA DR VALE, 11n=50R
28168
I
• 7Ne rhrpbeport product wee plan e*from the Canal County.NC Geospail information Series.Cara'County made subsoentld efforts
to Kam vne eoou sa of Wean art Isbeanq I mstion congaed on tide mop or date on thts read.Catawba promotes end recommends
p»independent verification of sny date contained on Its mephead product by Me user.The County of Catawba.Ms emproyses.scants.and
and ahafi not be Mid fiat*lea any and km demepas,l or Maly.whether direct.intact or oonwpueroW which anises or may
pews*, fromlro il*Ma report product or the use fftareof by ape hl 1 Cetera'County NC
09125R022
FROM FAX NO. May. 25 2013 08:15PM P1
V++
,,!. -t
iVA; . l i I,::= S'I '�%TL9L w
4 za �, 1:LL CONSTRUCTION RI?C:t�P.0
�1 North Carolina I ept- cnt of Environment
and Nar�rrJ R=ael:rres•Div;sior,of Water
WELL CONTRt.CTOR CERTIFICATION'0 , al?y
1.WELD.CONTRACTOR:
TONY R DAVIS P. R ZONES
Vvell contraetor ftndiv:dt:al}Name —"� Top 8otiam i C�' r
DAVIS W Top Bquoa
.I BORING Top Bottom —.._
we i Co!ttractor Cmrt an - ..-•—. Too_______ Top -•._._.aott„rr,
1481 LAkRY DAVIS ROAD Botlom,_,•„_ T��`Bottom
5rzetAddr�g 7, C N Depth Thickhead '
p Diameter Weight Material •
L�AW''b Top SWOT,/ t.2k 1_.� exit
C!'�mrTmwn stale 28090 Topes`yottarn Cement
276 3434 •
zip Coda To
Bottom — e--
Area Code Fhona n<wrrr -•'- t•"'"
2.WELL INFORMATION: 8. GROUT: De* Material
Top ° Bo9om 20 Method
tNE'L±COt+tSTn{JCTIOIYPERM!T;C Ft Concrete Truck
WELL CONSTRUCTION
PERMITS{'da rm,,a, Top Bottom`- PL —`�
SITE WELL ID ki 0.g! riJe�•.. . w Top Bottom_�.. �..�.�_
3.WELL USE(Ch i ie AppGcet�e • 8. SCREEN: Depth Diameter Slot Size
Sox): Rasldentta:Water Su Mate_
2 9ply Ton,-8oftom_ Ft _��• in. _� � .
CAS DRILLr� � — -
Top�.`Bottom,. FL In. In,TIME COMPLETD l,!70_ AM n Top Bottom -
Ft,.,In. in.
d.WELL �N 10.SAND/GRAVEL PACK:
41 .1 C . _ —
1 2 CpJ I 7cp...41, Bottom �7F ytaterial
- �f Gravel
(free:Na,�e.11L•!;t3e��.rour�,,Subdvsn!t,Lot 1;>�.,� To Bottom Ft�^ ..—
TOPOORApHiC J I..4ND S"?TNG: Top Ft.
`S!e rJ t' �¢ t-e�k apar�p:e':box)
citidge 0Other. 11.DRILLING LOG
LATrr UDE _4.. t r•DIMS OR 3 X70op 00 T_P Eoi!a.T Formation D86Crptior.
LCNGlTLJDE 4 7+► �OMS OR 7X.
LadeJlo ip,de sa 'oe: r G7opogmphJa map `/,..�� _'"�„"�•�-�� ...
ilewan of we!!l must be shown en a USGS tope map ardatterxtar/to �.1
rhts fan rfnot using GPS) —..
6. OWNER -��
Owner `4''�Q/���,�_ "-T•
Address
Q A -
i . —
/ ��
CO), own / - .•�
vs a
Zip Code '.4-___--
.A.earode Phone nntnoer 1
I.WELL DETAILS: i2. REMARKS:
a ; ..12. ...,,. ...r
TOTAL DEPTNs4
•
b. DOES WELL REPLACE EXISTING WeLLT _
YES NO _.._
c. WATER LEVEL 39Iow lop atCes I DC HEREBY CEFcTIFY TF;A F+! Wz A E CONSTRU }.l L flue r�i—AFT. : ACCDRDA.NCE TT ,S
a.a�Above` f�-n.•� +MTH i 5A VCAC?C,
-op Casing) STANDARDS.ANC THAT A COPY WELL CONSTRUCTION NASJN _.
d• TOP OF CASING IS "` PR VI 9 TO THE Lar OF This RECORD rrq.S BEEN
"Top of Above Land 3u-tax LL OWNER.
i /21_6'ze
a variancepofzes in erm:terminated
#tlor below with !and=face may regain
e. YIELD(gpm): IftTi.109 OF TEST ' SIONA CERTIFIED I LL CONTRACTOR— DATE ATE
t. DJSINFECTION:- O TONY R DAVIS l7Rt
FRINiEDNAM'OF :•.- s- C 1..77Rur TsA`v Nam' L `-
Sub mltwithin 30 days of completion tat Division of Water T' wEL�
1 S17 Mali Service Center,Raleigh.NC 27699.161,Poore:(S1 Qualify. information Processing,
sysa;-s o PonnGW;a
Rev.2/09 ,
North Carolina Division of Public Health
Occupational and Environmental Epidemiology Branch, Epidemiology Section
BIOLOGICAL ANALYSIS REPORT
Private well water information and recommendations
County: Catawba Name: Brittany Stone Sample ID Number: 185182
Location:1827 Mesa Dr, Vale NC 28168 Reviewer: Bryan Forsee
Initial Sample X Confirmation Sample:
BIOLOGICAL ANALYSIS RESULTS AND RECOMMENDATIONS FOR USES OF YOUR
PRIVATE WELL WATER(These recommendations are based on biological analysis only.)
No coliform bacteria were found in your well water. Your water can be used for all purposes
including drinking, cooking,washing dishes, bathing and showering.
X Total coliform bacteria 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 occur naturally in water or can be introduced into water
from man-made sources.Total coliform bacteria are found in soil and fecal coliform 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, or immunocompromised(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 light, or ozone.
For further information please contact your county health department or the Occupational and
Environmental Epidemiology Branch at 919-707-5900.
4111.11111.
•
Total Coliform
Bacteria, E. coli & 110
PRIVATE WELLS
a
' �.
a. it
What are total coliform bacteria
and E. coli? .a .�
, i
Total coliform bacteria are a group of microorganisms found
in soil and surface water.Total coliform bacteria water tests
look at all coliform bacteria in water.This includes fecal
coliform bacteria,which are a group of bacteria found in the
intestines and feces of animals and humans.
E.coli or Escherichia coli is a type of fecal coliform bacteria.
There are many strains of E.coli. When should I be concerned
about coliform bacteria or E. coli?
How does coliform bacteria and You should be concerned if coliform bacteria or E.coli are
E. coli get in my private well water? present in your well water.
Rain may wash coliform bacteria or E.coli from soil on The NC Department of Environmental Quality
the surface to groundwater.Coliform bacteria or E.coli developed a groundwater standard of 1 colony of
can also enter your water if your private well is poorly coliform bacteria in 100 milliliters of water(colonies/
constructed,cracked or unsealed. mL).Ground water standards are developed to protect
public health.This standard was developed in 2013.
How can coliform bacteria The US Environmental Protection Agency requires
follow up testing and treatment when coliform bacteria
Or E. coli affect my health? or E.toll is found in any public water supply system across
Most coliform bacteria and E.coli strains will not make you the country.Public drinking water guidance are based on
sick.The presence of some types of coliform bacteria in the public health protection and cost of treatment/testing at
water signal the presence of feces or sewage waste. Feces large utilities.These rules were established in 1989 and
and sewage wastes are usually the source of the disease- updated in 2014.
causing organisms.
Total coliform bacteria and E.coli water tests are used as How do I test for total coliform
indicators for the presence of disease-causing organisms. bacteria or E. coli in my
The following are some disease-causing organisms or
pathogens that could be present in your water: private well?
• Bacteria that cause diarrhea and vomiting, Use a certified lab to test your well water for coliform
• Protozoa that cause dysentery, bacteria and E.coli every year.Contact the private well
• Viruses that cause polio and hepatitis,and program at your county health department to assist you
• Helminths,such as roundworms and tapeworms, with getting your water tested.Pricing of testing varies
that cause chronic diarrhea. from county to county.
Percent of Private Wells Tested alliallbnlealliplOWAP ",
With Detection of E. coli, 2011-2013 ��"� ���`� �' - . t, 4
VIII.1-Y5Ftili It4-11.1" O.
L ti I I.N 1.°26 Id 6 I 4;I 51 I ki I 44 14 I I 1*- 4 7' .4 I 1'1 r''
ill
of
allimpileA
,..00000
vit
Percent of Private Wells Tested With 4�� 71 NAL -.Ti,
Detection of Total Coliform, 2011-2013 lik �, .-rr �milii �;JIM 5� lir
- >50%with detection j —Vatwont
�cif oftr
- 25.1.50%with detection .4w _ r
ij
<25%with detection
0%with detection lt,
Insufficient data(<10 wells tested)
What if total coliform bacteria Where can I find more
or E. coli levels are present? information about total coliform
Shock chlorination is a method to remove bacteria bacteria, E. coli and my well?
contamination in private wells.If contamination persist Visit the NC Division of Public Health's Private Well and
you can install a treatment system to reduce the levels Health Program website:http://epi.publichealth.nc.gov/
of bacteria in your private well.Treatment systems that oee/programs/wellwater.html.
reduce the level of bacteria in your well water include:
• Ultraviolet(UV)filtration treatment system There you can find:
• Contacts for your county private well program
You can also reduce your exposure by using bottled water • Total coliform bacteria or E.coli in well water maps
or connecting to public water supply,if possible. • A guide for selecting a treatment system
• Other private well resources
Where are total coliform bacteria You can also call the Private Well and Health Program
and E. coli found in NC? at 919-707-5900.
Coliform bacteria are detected throughout NC.About 26%
of wells sampled for microbial contamination in NC from Where did this information come
2011 to 2013 tested positive for coliform bacteria.Yet, from?
there are several areas in NC with at least 50%of wells with
coliform bacteria present.See map for areas with high Centers for Disease Control and Prevention:www.cdc.gov/
coliform bacteria detections. healthywater/drinking/private/wells/disease/e coli.htmt
E.coli is detected throughout NC.About 2%of wells Environmental Protection Agency:httos://safewater.
sampled for microbial contamination in NC from 2011 to zendesk.com/hc/en-us/sections/203309158-E-coli-0157-H7-
2013 tested positive for E.coli.Yet,there are several areas National Sanitation Foundation:www.nsf.org/consumer-
in NC with at least 25%of wells with E.coli present.See resources/water-auality/water-filters-testing-treatment/
map for areas with high E.coli detections. contaminant-reduction-claims-guide
"• NC Department of Health and Human Services•Division of Public Health•Epidemiology Section•Occupational and Environmental
4 ^f pi
d, r; _ � Epidemiology Branch•Private Well and Health Program•httgs:!/eni,Dublichealth,ncgov/oee/nr2grams/wellwater.htm(•NCDHHS is an
f �� North Carolina equal opportunity employer and provider.•09/2019
Publ,,Health
N 0 R T H C A R 0 L I N A
Private Well Information
and Use Recommendations
NC DEPARTMENT OF
HEALTH AND HUMAN SERVICES
Division of Public Health For Inorganic Chemical Contaminants
County: Catawba Name: Brittany Stone-1827 Mesa Dr, Vale NC 28168
Sample ID#: 185182 Reviewer: Bryan Forsee
TEST RESULTS AND USE RECOMMENDATIONS
l. ® 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. El 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.
El Arsenic ❑ Barium El Cadmium El Chromium n Copper El Fluoride ❑ Iron
El Lead El Manganese El Mercury ❑Nickel ❑Nitrate/Nitrite ❑ Selenium ❑ 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. ❑ 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. ❑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.
El Chloride ❑ Copper ❑ Fluoride ❑ Iron ❑ Manganese
❑ pH El Silver n Sulfate El Zinc
6. ❑ 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.
❑ b. Your sodium level exceeds 30 mg/I and may pose aesthetic issues such as bad taste,odor, staining of porcelain,etc.
7. El 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.