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Home My WebLink AboutSAM-11-2022-185247.TIF SBA ce Case# SA M-1 1-2022-1 85247 (-75: AR 2, CATAWBA COUNTY HEALTH DEPARTMENT Environmental Health Section 18 2 5M 11/29/2022 WATER SAMPLE APPLICATION pplicant ANGELUS CHANG,4770 NORTH ST,CONOVER NC 28613 I-I:828-238-0920 eal t 1 rcStt! fc p -__ehhôo. loon Site Address: 4770 NORTH ST, CONOVER NC 28613 SELECTED SAMPLES Bacterial Name of Subdivision: Lead Parcel Number: 375418402904 Lot: Block: Specific Directions Description: Bacteria and Lead only samples Reason for Sample: Refinance Type of Well Is the well on this same property? Yes Is outside spigot available to collect sample? Yes Is power on'? Yes Has well been tested before? •Yes Results Does the plumbing come out the top of the well through a sanitary well seal? Yes Does the well ever become cloudy or has there ever been a problem with taste and/or odor? No Explain Does the well top extend twelve(12)inches above the ground or well slab? Yes The well is in: Front Does this well supply water to more than one home? No Water samples will be drawn from an outside faucet unless otherwise specified. Please note that all water samples are taken during one visit. The processing laboratories have different protocols and timeframes for reporting results; therefore,you may receive several different reports concerning your water sample. Fo uestimns or more into • ion. please contact Catawba County Environmental Health at(828)465-8270. Date /7/7- -t Signature or ner or Blake Perkins FEE DESCRIPTION DATE FEE AMOUNT Bacteriological Sample Fee 11/29/2022 $58.00 Lead Sample Fee 11/29/2022 $99.00 TOTAL FEES $157.00 rsamapplication 11/29/2022 Page 1 of 1 (.4":: ) catawba county public health Water Sample Application rit g' r f1t_p,,� >"� L I`1 o I2Z ' 2 3 C. 0520 Sample Requested By - �{ f hq t �S Home Phone Property Address 61770 /V Business Phone Mailing Address fl7O ' ° 5 �DY10�- /t/C 2 6 Driving Directions p\ Se.J tik.o11- \C7(,c,i,6r.._ Kn/1• cbhdv/`�`. Sample Requested: Bacteriological ./lnorganic Chemical Other '` ,aof Sample reason: '1/201...Srt k 'v . cr Type of Well: Drilled Bored Dug Other Is the well on this same property? Yes v No PLEASE NOTE: Sample will be taken at the well head. If well head is not accessible, sample will be taken from a spigot on outside of home, unless otherwise specified: . Is outside spigot available to collect sample? Yes iz"+ No Is power on? Yes 1 No Has well been tested before? Yes No Unknown Results Does the plumbing come out the top of the well through a sanitary well seal? Yes VrNo Unknown Does the water ever become cloudy or has there ever been a problem with taste or odor? Yes No " Explain _ Does the well top extend 12 inches above the ground or well slab? Yes No Unknown The well is located in front V rear left side right side of the house. Does well sup ly water to more than one home? Yes No _ __ Date /f 24 Z Z Signature of Owner or/Age L catawbacountync.gov Environmental Health Catawba County Government Center 25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270 MAKING. LIVING. BETTER. 4'A.4-41111Mik.. CATAWBA COUNTY � "Cy y 100A SOUTHWEST BLVD ��1' ` a NEWTON,NORTH CAROLINA 28658 RECEIPT `44 i l PHONE: 828.465.8399 71—. Tuesday,November 29,2022 1 www.catawbacountync.gov PAYOR: Chang,Angelus PAYMENTS TRANSACTION NUMBER: TRC-522181 S 1-29-11-2022 PAYMENT DATE: 11/29/2022 PAYMENT TYPE: Credit Card 298029379 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 11-22-415258 110-580200-663000 Bacteriological Sample Fee $58.00 11-22-415258 110-580200-663000 Lead Sample Fee $99.00 TOTAL PAYMENTS: S157.00 SAM-11-2022-185247 CASE TYPE: Water Sample WORK CLASS: Multiple Different Samples SITE ADDRESS: 4770 NORTH ST,CONOVER NC 28613 Applicant ANGELUS CHANG,4770 NORTH ST,CONOVER NC 28613 H:828-238-0920 **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 11/29/2022 14:50 Page 1 of I �d ,,a 4312 District Drive 1:'' North Carolina State of Public Health MSC,s,8 i { Laboratory Raleigh,NC 27699-1918 1111� ��.,��'91l' . '� Environmental Sciences httpa/slph.ncpublichealth.com - Phone: 919-733-7308`°°"": '-~' Inorganic Chemistry ry Fax: 919-715-8611 Certificate of Analysis FINAL REPORT Report to: ENVIRONMENTAL HEALTH Name of System: CATAWBA COUNTY ENVIRONMENTAL HEALTH Angelus Chang P 0 BOX 389 4770 North St NEWTON, NC 28658 Conover, NC 28613 EIN: 566001814EH Delivery: NC Courier StarLiMS ID: ES221202-0011 Date Collected: 11/30/2022 Time Collected: 12:45 By: Blake Perkins Date Received: 12/02/2022 Time Received: 07:49 Sample Type: Raw Sampling Point: Threaded tap Well Permit No. SAM-11-2022-185247 Sample Source: Well water Receipt Temp. : GPS Number: Profile: Lead Analyte Test Result Allowable Limit Unit Qualifier(s) Lead <0.003 0.015 mg/L Report Date: 01/03/2023 Reported By: Marc Komlos RECEIVED JAN 1 7 23 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 information and recommendations County: Catawba Name: Angelus Chang Sample ID Number: 185247 Location: 4770 North St,Conover NC 28613 Reviewer: Megen McBride 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.) X 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. 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.