HomeMy WebLinkAboutWELL-12-2022-185680.TIF FA
CATAWBACOUNTY Casey WELL-12-2022-185680
w•
Public Health Department Subdivision ROCKING HORSE RIDGE
< ,. `-'1 Environmental Health Division PIN# 367704607190
84 PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 8
2 w
Site Address: 4298 ANDERSON MOUNTAIN RD, MAIDEN NC 28650
Name on Permit: ANDREW HAYES CONSTRUCTION
Property Size: Acres 0.64
Directions: West on 150 through intersection of Buisness 16 for 200'turn right onto E Maiden Rd. Go 3/4 mile turn right
onto Anderson Mtn Rd
Owner/Authorized Representative Acknowledgement of Permit Receipt
_I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property described above.
f _ As the property owner or authorized representative, I have received the above referenced
permit(s)as requested in the application for service RBPR-09-2022-42284,by the following method(s):
Received in Person
_ Facsimile Transmittal (Return form with signature required)
Electronic Image Transmittal/E-mail (Return receipt required)
r, 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(15A NCAC 18A.1900),
and/or Well Construction Standards(15A 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: 12/06/2022
Owner/Authorized Representative Signature
'� Date
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person sending permit)
Signature le Date/Time ) • I b it Z
Method: Fax 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
SCO II si\erite mac 4ettn
/if
chpermit 12/07/2022 12:08
Catawba County Environmental Health
,Qm_og jc,17-III.y
pY-ll-Z.Z7-11154.
Qum- IJ 7071- l8y�f3
.4286
110.00 g
8
tn2-32 5, MI
11
ioo
7. rAil `�`r
ti
t7m �� .Sja il
0
VL IZ, /6)
c 110.00 r •4298 -t
5Z ' - %aN Lit.
z Y, aPity
274 24
lb
• to'
•4308
60 uP
0
r-
I
Parcel: 367704607190, 4298 ANDERSON 1in=40fi
MOUNTAIN RD MAIDEN, 28650
This mapheport product was prepared from the Catawba County,NC Geospatlal Information Services. Catawba County has made substantial efforts
to ensure the accuracy of location and labeling Information contalnod on thla map or data on this roport.Catawba County promotes end recommends
the independent verification of any data contained on this map/report product by the user.Tho County of Catawba.its employees,agents.and
personnel,disclaim,and shall not be held'labia for any and al damagos,loss or liability,whether direct,Indirect or consequential which arises or may
arise from this map/report product or the use thereof by any
Copyrightn 2021r Ceatawba County NC
11/11/2022
1.., 1„n.,n,li l S. ,,,1
{.Ne1Vt\•nnr,his Into 0ulhlnt _ ._ _ . _ ..
1411111II11►\IS i lei,,roil,n�. , - -
,i.\�tly`h tl:rltl\ 11:,Isl III
Nri%',.r..,tr\, r -;�i 1� �„ rs� It S•rr,�r/ /rf4Tv e :dire. -_
r.s+� I I1 "
Nit'N ra t anh..tot kseitiNtioott\.end.•, I t-I1% I I It t.\.1\I:poi Nudt1 e.s1.I w,ih/118 hl�tl R(Il ri't'1w`IIt11 r u1,1 __._•,
IN,"1
111 IN 1t1111N 11111 A.l..
R s.h well 11n11013 111t: n. � n I r•:•• 1"
hrralal eloerll haopl . N.,
.••.•4„..\,•„ to 1\NFN I',MINI:tIN 1'1'NINI' nn1 Aal ss
Lid.
111 •� l � t mom � PI on 11 N """-""���
lit
\\cif l\as.tlshn,all\11ua♦ s '�• +" l II, I!. ._.».
1\AI l'te it 1+1vk M ell 0.0:
— .. ._ _ . .......
_._.. 17.�I'nlfN sill!.In 1nuh.Is tltuNltl
...I:Wi__._.— plat,,ent.
N alty ut itiht \1 r11: INs1tt u+
u• u1
! +dnutll D\t.•„,.,l.s'lllhll: n.
�! '• 1,1
.rwha,ttal%Hosts tg l',odntg Sop,h 1 0I::.;,S:nhal 1 :11,v St.pph 01141lr) n, n. _. __
t.e.:dcuhal llalr!\Iq,i1(t(•h:ai,ll IAGR/Ih1' I.IrI t1 Itn\I‘It Mints*iltiN\I_
�♦fu.htAl1'a111nAVC1aI Q' ttll Nl tl
1Nettl 11+
il•,r• _ ._ 11 11. 711 II' 11y1..1 tAYv 1+uJ 1•..,..
\,,n u.Irl hgi,i�s 1\rig: ` —
�Rsarl
s� s I u, n.
\„unto,,ill ._•_ .__ .—___ _
In 1.,:,Gt Kechathv ❑tlnvuldwst:t R:111\I14tnrl trahk? .-__.
W,a\\Rt.N Al Vt.r.al'k(1l y,p► I1111111tu.1,11 Inun
�Vlluult Il,tlnel INatl III_ _% palmist _
\�uatl SwrlCeantR�attls --- -- —..
1 alto lr>t ❑�hvumatct l>amua�r
n. n.
( l:ti•rtu:ortdal Tlvhtwol ps 13SnMAle11,a t'om1a1 n A. ___• r
•,y�sl:ttlulll'6vsAl1A'}'1 011A'n Imnit1111\:1.11(=lruar11.01siwi!1tl k'15iI.I .11f .t,.lno:I.gr.tiod� M�+•!
, I mini is)
•..whclnul HMO •l'.vhn•Renmtl •thlur rs d.ul1 n1t.1.v r'1 Rrnullsl n• —I a_��- f 50i-
'}QQ as-
4,Date WellislCompleted: 0. -!^J_ \1 ell Itsa.C� f Q d. r n, fedI 'a..f,f�Jl
_a rs cW� 7/nt•, 77 i sh.IJre��_5s d,V.S ..
Spa.\1 ri111w atian: p 1Q L (j i!_��. y1/4.lr{✓/ifr-,11 f> ,c4 1
.$ rtlrf i ..�L[n. � ekk...? - "4 h n• [� s.j �.c�
ta.`,htylM,v1\,tuv ,�.� I IoidNi 11 :awls:A.4.1 S r/O._ (�Jy''�;��.-..
41 ccJ J!c /77 1?;�4r_Jde..�c-SiS 70_1E
n, c"_ i/�lKrl/»r_ci.e r /�csc �. .
1'hyss:a:a,t.ars.,tl:s,am!:tr "-'-- -
1'A„VI LkCl1111UAi1.V1ICa teI\1
Sh.I alimde add longitude is slegles,nlinatr..n„nd.or Ii1`itual iI I'( : -- __-- .-
11t wet:t+t1.t is,...41 1.•rf n s6111s tel I1 ::.(C1ldlralion' / //
,i/_
;op 11e OI t•r lied Iii t'O1111a.1 4 VIJW
el.Noel lhenellplfll'rnuanedl or E3rcngooul?
, ,,g,LV::(u/.Hoot 11e•e6..Yea Ilia(OW rrttisl rue brag.1N.:. ..fa I.Av,vd.w.Y
A 7is'ii It•tl:t'PI111 iv?'.I.\t'it"J:t'P:e;•N tit Con.r'..'n,"..1,.f_r.+.s aa.i t(at.1
T.
Is I a r/•lair au(aiming vial:M \ea or Q\o r1:,.1,,.":i-..nv.J U.Crew r.•..(AI A,A.wets.,ewer
:au u a a era.'.F::Obi
i l..,rw Ht.::.,.yrta•:1..r,t 1.'�1•Y.,•e.+wl r4r_..tM a+.r�r•v 14
1 •let.h I 'H .Vii...%A.N to..N Ow M r.„+a+hums :1.Site diagram or additional vial derails:
'I ear nl.l?u.r Ihr Rwl of this op't,,ptasate ae1ddlt'su1 wall site details or well
S.For GroludM hpl or Is Closed-1.oap t:tvthI i and\1 this list mg I esi is :,•tlsuu:urn%kladi \'t,u IlIa?•also.ut,1:h J.l busNwl pages it ncc.7.xaua'.
t\rt.tnAYurt•,v1'% I(111'-1 is tteede i huh:ate il'll'Al NUNIIII R of wells
dulled __ —_ i :11.\11y:111..L5ititCClll\$
I lI
d,l'otal teU depth h D
helot land sulfate: f �r2 (� 1;
.1 3�a, 1,i..111�►SJj.: Snhlnu Ons tiolnt wnlnn 1l1.lads of completion at wrh
.,�....:,,^:r err:.:07 a.:I(.•vU1 .1,;1.••n t
l iata.p.e ,.,t' and:.,C1111 i011NIl1:UOt1 A,the h,Ilottuli1:
10,Stine toter iesel helot Lop of casing: $ll (Ill Itis islon 1'f N ales Ret tune%,lnlurmation 1'Is+eetsing I'nit,
,s„r•1-.,rtr,... %'.5 V....$ ►.e.• I617 Mail Sets lee(inter.Raleigh,NC 37o44•Ial7
11.hold osle dlauteler: 6 118 (In.) a1 Fs!_lujcr{ism%%ells: In aol.hi to.ea,hut,the ti rnl to the aatI 1s ill :-Ia
Rotary s1,0ar•pals,whnnl am io11'a1 this fotnl %OM till.Iris of c.•lui,lctl.at of wAl
IL 11 ell oust,tic lion Illethiol: iallst&N:l1a11 to the folio%nil;
lie uq:e.nra1,...Ile.4 1,e.l 1•..h,ci:1
Ills 1Mou of N ulel Rew+dl trt,I Wet pound Injrcii ou Control hogs am.
1UR 11.tr1:R SI l'PI-\ 111'I IN 1►\I\: IA►a Mail Set tier(-enter.Raklgh,NC 3'6s64-16.16
14.'I aid wpm) f
!del \Iclhwi of use AA"lift •li.14.1 N.111e(iupld3--si ytl1er'u.1111 T: 10.I.1.1lh.w to Se0.hns the tom h•
the .At.lte.•.tra altar. .thee, submit ow Cop% .N thlx team tuhin 10 doles of
Ch6M 1.Iha ''t'1•'1•• cs•uylcn.'n o1 wcll:.'n.tn0'uan 10 the counts health.kl utnuut of the taunts
t?R l►wuflti'u,,u n pc; __'
t hele:o1Ntltit led
1 rr .,t1.1
bout%1 ai.•h,u I,clv.•,rc At.,11-,o uvnu,cl,:a10.-0.1t lit I, I:,01 NA15I R:..,w,:. RCtl.it ::-:PIS•
6 o 4312 District Drive
NYi U,s
sl'
!4s '''' North Carolina State Laboratory of Public Health MSC 1918
a /i'i 9 699-1918
1�����T,``\� �% Raleigh,NC 27
;°'� ��: Environmental Sciences http://slph.ncpublichealth.corn
. "'*A .�
�'��.���� Phone: 919-733-7308
- --, Inorganic Chemistry Fax: 919-715-8611
Certificate of Analysis FINAL REPORT
•
Report to: ENVIRONMENTAL HEALTH Name of System:
CATAWBA COUNTY ENVIRONMENTAL HEALTH Ryan Schutz
P 0 BOX 389 4298 Anderson Mtn Rd
NEWTON,NC 28658 Maiden,NC 28650
EIN:566001814EH Delivery: NC Courier
StarLiMS ID: ES240619-0067 Date Collected: 06/17/2024 Time Collected: 10:54 By: Dwight Mikeal
Date Received: 06/19/2024 Time Received: 08:12
Sample Type: Raw Sampling Point: Threaded tap on well head Well Permit No. WELL-12-2022-185680
Sample Source: New Well Receipt Temp. : GPS Number:
Profile:New Well-No Nitrate I
Analyte Test Result Allowable Limit Unit Qualifier(s)
Arsenic 0.004 0.010 mg/L
Barium <0.1 2.0 mg/L
Cadmium <0.0005 0.005 mg/L
Calcium 29 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 <0.06 0.300 mg/L
Lead <0.003 0.015 mg/L
Magnesium 5 mg/L
Manganese 0.005 0.05 mg/L
Mercury <0.0004 0.002 mg/L
Nickel <0.01 0.1 mg/L
pH 8.3 N/A
Selenium <0.005 0.05 mg/L
Silver <0.01 0.10 mg/L
Sodium 4.4 mg/L
Sulfate 7.6 250 mg/L
Total Alkalinity 94 mg/L
Total Hardness 95 mg/L
Zinc <0.05 5.0 mg/L
Report Date: 07/08/2024 RECEIVED Reported By:
Marc Komlos
J U L 1 5 2024
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: Ryan Schutz Sample ID Number: 185680
Location: 4298 Anderson Mountain Rd,Maiden NC 28650 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 depai talent 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.
N 0 R T H C A R 0 L I N A
<�Y`{� °ti Private Well Information
and Use Recommendations
NC DEPARTMENT OF
HEALTH AND HUMAN SERVICES
Division of Public Health For Inorganic Chemical Contaminants
County: Catawba Name: Ryan Schutz—4298 Anderson Mountain Rd,Maiden NC 2865
Sample ID#: 185680 Reviewer: Megen McBride
TEST RESULTS AND USE RECOMMENDATIONS
1. ®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 o0v.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 oniv.
❑Arsenic ❑Barium n Cadmium ❑ Chromium n Copper n Fluoride ❑Iron
n Lead ❑Manganese ❑ Mercury ❑Nickel n 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. ❑ 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. n 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 ogv,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 El.Copper ❑Fluoride ❑Iron ❑Manganese
❑pH n Silver ❑ Sulfate ❑ Zinc
6. ❑ a. Sodium levels exceed the U.S.Environmental Protection Agency's(USEPA)Health Advisory level for sodium of
20 mg/l.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 onv.
❑ 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.