HomeMy WebLinkAboutWCOC-01-2023-187575.TIF �..:. • CATAWBA COUNTY Case#
WCOC-01-2023-187575
Qti(..,i, Public Health Department Subdivision G C PARK SUB
m, Environmental Health Division PIN# 360804948064
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 17A
/842 w
Site Address: 4025 MILLER DR,NEWTON NC 28658
Name on Permit MARK WILLIAMS
Property Size: Acres: 0.63
Directions: W NC Hwy INC 10,left on Hickory Lincolnton Hwy,right onto Miller Dr,house is on left side
WELL CERTIFICATE OF COMPLETION
Permit Number: WELL-07-2019-119794
DATE COMPLETED INSPECTION TYPE STATUS INSPECTOR
08/08/2019 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
08/29/2019 EH Well Record Received Approved EH Admin
11/23/2022 Ell Well I-lead Approved Randy Ross
HICKORY WELL DRILLING 08/08/2019
Well Driller Date Drilled
At,_ z._ 4,.....,..._
01/13/2023
Authorized State Agent Issuance Date
ehwelleoc 01/30/2023 09:58 Page 1 of 1