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HomeMy WebLinkAboutWELL-02-2023-188545.TIF f 4 �� e CATAWBA COUNTY .t. ,Z Public Health Department Subdivision Q ,lut Environmental health Division PIN# 369701093595 1$ w PO Box 389,25 Government Drive,Newton,NC 28658 LOT# Site Address: 6055 LITTLE MOUNTAIN RD, SHERRILLS FORD NC 28673 Name on Permit: *PEDICINO CONSTRUCTION LLC Property Size: Acres 0.97 Directions: Hwy 16 S, Left on Buffalo Sholas, Right Little Mountain Owner/Authorized Representative Acknowledgement of Permit Receipt I certify that 1 am the owner or authorized agent(owner's authorization required)representing the owner of the property described above. YAs the property owner or authorized representative, I have received the above referenced permit(s)as requested in the application for service RBPR-11-2022-42756, by the following method(s): Received in Person /Facsimile Transmittal (Return form with signature required) vi Electronic Image Transmittal/E-mail (Return receipt required) As the property owner or authorized representative I have reviewed 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 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: 02/02/2023 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) el Signature t Date/Time ,y Oh; Method: Fax Y 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 yoiPlease ttake a few momentts tto complette our custtomer service survey att http://www.surveymonkey.com/s/EHCusttomerService �ci.Ctnoecoshmelt�r 3' 1. 6r 6`� ehpennil 02/03/2023 07:52 Y t ft WELL CONSTRUCTION RECORD CW-1 For internal Use Only: ',Well Contractor Information: Robert Teague Well Contractor Name 11 WATER ZONES FROM 70 UkSCRIPTIOA 2857-A (,. y n. INC Weil Cantrscsor Canficat,ort Number ft. n. — B&K Well Drilling Inc IS.OU ER CASLNG(for ma111<ased wells OR LINER f ;-,-, ® TO DIAMETER THICKNESS MATERIAL Company'Name a ft. ft. 6118 In. SOR•11 PVC 2.Well Construction Permit q: • 1 16•INTER CASING OR TUBING feeathermal dewed•Iwp) Lire all applicable well Coi(rucuon EOM TO DIAMETER THICKNESS MATERIAL permnr fee.LTC.County. tale.Variance,et(t It. rt. In. 3.Well Use(check well use): ft. fl, Ia. Water Supply Well: 17,SCREEN pAg icuIrunt1 DMunicipaVPubhc PR011 TO DIAMETER SLOT SIZE THICKsLI< MATERIAL Geothermal(lleatin6Conlin Supply)' ft. n. is B S PP Y) �Residetnial Water Supply(single) ft. ft. Ia Industrial/Commercial Residential Water Supply(shared) I lrri anon la.GROUT1 Non-Water Supply Well: rAOM TO }IA7EAIAL I(lIPI 1CrM[\T MCfHOD4 tMl+l\r h, n Atalitonng ❑R aovcry { Injection Well: ft. n. Aquifer Recharge ❑Groundwater RcmedtaUon ft. fa l 1 —" Aquifer Storage and Rao 19.SAWJGRAVEL PACK applicable) �-s Salini Barrier Aquifer Test FROM To 'IATERfhL 1 EMPLACEMENT NI ETHOD 11 Stormwatcr Drainage rt. It Experimental Technology Q Subsidence Control JGcotltcrmal(Closed Loop) Tracer rt. ft. 10,DRILLING LOG(attach addltland sheds If accessary) Georhermai fliratinpJCoolinp Return) [Other(explain under#21 Remarks) vRoat 10 nrcCRlrno.Irae,,a,ta tav,sx l . 1 rt. a. I.Yea,etc) 1 /t fL 4.Date Well(s)Completed 1^)' ? Well Ma + fa ('J = ` r` ♦ 1' �,Welll Location:}� /' '/1 1, /� r J _ FacdttyfpwnerName Facility ID*(if applK ) ft. r%II 6-6SSLiHit pl6U )14nih j ft. it _ 1 Physical Address,Clip,and Zip r II. rt. l 'a`1` \ 21.REMARKS j County Parcel ldcraificuionho(PIN) I 5b.Latitude and longitude in degreddmiuutesiseconds or decimal degrees: (if well field,one Lonorig a sufficient) 22.Certlfic on:, � tY W �� 1Oe .o �Slrnaue otCcni cd Well Contractor, Itar)the well(s)EDPermanent or OTemporary By aping Out Jon,.I herrht certify-that the.elf/aj an,(writ/r,urn eta l in accordant 7.Ia dais a repair to an esisdng well: Yes or No Nitlt 1SA.NC4C 01C 0100 or ISA.VCAC 02C.0200 Well Cannelton Standmdo and tha'a If Mit 1.1a repair,fill out moan well construction information t d loon the nature of the copy of Mrs record hat been provided to the well owner repair under 021 remarks section or on the bark of thU form 23.Site diagram or additional well details: 8.For GeoprobeiDPT or Closed-Loop Geothermal Wells having the same You may use the back of this page to provide additional well site details ur well construction,only -I is needed, Indicate TOTAL NUMBER of wells construction details. You may also attach additional pages if deeceasary. drilled: _,0 © 1 U MITTAL INSTRUCTIONS 4.Toni well depth below land surface: �1 (k) j4a•for All Wells: Submit this corm within 30 days of completion of well For mi i:pleoribfuraDdepths fdiferenrtuawpir-+4g200 construction to the following AO 10.Stade water level below top of casing: (ft.) Division of Hater Resources,Information Processing Unit, If WIC,loci u short ratng use'•" 6 118 1617\fail Service Center,Raleigh,NC 27699-1617 II.Borehole diameter. (In.) 146.for IniectiuR Wells: In addition to sending Me form to the address in Na IL Well construction method: Air Rotary above.also submit one copy of this form within 30 days of completion of well Ire.auger,rotary.cable,evert push,et...) constnrction to the following Division of Water Resources,Underground Injection Control Program, FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center,Raleigh,NC 27699.1634 13a.Yield(gpm) Method of test:'kr Fit)* 24c.fur Water S4DDIb $Infection Wells: In addition to sending the form to 13b.Disinfection type: Tabs ,� the addresses) above. also submit one copy of this form within 30 days al Amount: completion of well construction to the county health department of the county where constructed. Form GW.I \orth Carolina Dcpanmcrtt of Enstronrncnul Quality-Di.uion of N.atcr Resources Rauod 2-22.2016 Analytical Results STATESVILLE ANALYTICAL 010L1 Catawba County Public Health PO Box 389 Newton, NC 28658 Receive Date: 05/22/2025 Reported: 05/24/2025 For: Logan Anderson: 6055 Little Mountain Rd, Sherrills Ford NC 28673 Comments: Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst 250522-30-01 Nitrate 188545 12.2 mg/L 353.2 05/23/2025 CL 250522-30-01 Nitrite 188545 <0.1 mg/L 353.2 05/23/2025 CL Respectfully submitted, �r yi j. ."( Melissa Myers NC Cert#440, NCDW Cert#37755, EPA#NC00909 PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 1 of 2 122 Court Street Statesville,NC 28677 704-872-4697 www.sa-nc.com PPlTRA E/NrI (UJ ANALYSIS . • WATER SYS ID if: WELL - 0 P- _ a02-3,(5$s y5- County: Catawba Name of Water System: •1-01-� A h.d e.t sorr • Sample Type: 0 Entry Point N Special/Non-compliance Location Where Collected: Co 55 1.- * tiu.trtTa,1, { , SL I is (rel N e ag5 73 Facility ID No. (!!--3 ur'S�{5 Sample Point T or }7 i I Collection Date II Collection Time Collected By: Dw.s1{A 1+1 1 1t cc(l 0 5)g I/ _9 .5 R M (Pl.sPria) WM: (S ifyA'.ta 4 Mail Results to(water system representative): CATAWBA COUNTY PUBLIC HEALTH Phone I:i (828)46548270 ENVIRONMENTAL HEALTH gas#: l(828)465-8276 . ,PO BOX 389 Responsiltle Persou's emall: EHAdrlin@ catawbacountyn c.gov NEWTON,NC 28658 LABORATORY ID 0 37755 . 0 SAMPLE UNSATISFACTORY 0 RESAMPLE REQUIRED METHODREQUIRED NOT DETECTED QUANTIFIED - ALLOWABLE CONTAMODECONTAMINANT CODE REPO_ GL[4fIT (.e ) CODE RESULTS'''. akar 1040 Nitrate 3532 1.00mg/L 12.. Z mg/I 1D.00 g2 l 1041 Nitrite • 3532 0.10 mg/L X --_-- mg/L 1.00- m ilL i Note:If result exceeds allowable limit,the laboratory must fax analytical results to the State on day test Meted. I DATE: TIME; iANALYSES BEGUN:I � / • ._?.3a Z$?✓/ .t=,:rM1 . ANALYSES COMPLETED: �J/ 2 — 3; -5— ,g.,,,,,. Laboratory La 11: �C o ,- &IliiadSy: C . La ry 8 c�c..1 �V COMMENTS: . 2008 Laboratury should Mall Results to: . Public Water Supply Section,Attu:Data Fatly,1634 Mail Service Crater,Raleigh,NC 27699-1634 • PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 2 of 2 4d ST�f o 4312 District Drive 1.''' State Laboratory of Public Health MSC 1918 -��- lritic � �� North CarolinaRaleigh,NC 27699-1918 .,,:�� V- Environmental Sciences http://slph.ncpublicheaith.corn ".;`ce m„1r+" 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 Logan Anderson P 0 BOX 389 6055 Little Mountain Rd NEWTON,NC 28658 Sherrills Ford,NC 28673 EIN:566001814EH Delivery: NC Courier StarLiMS ID: ES250523-0009 Date Collected: 05/21/2025 Time Collected: 09:50 By: Dwight Mikeal Date Received: 05/23/2025 Time Received: 08:03 Sample Type: Raw Sampling Point: Well head Well Permit No. WELL-02-2023-188545 Sample Source: New Well Receipt Temp. : GPS Number: Comment: 13.3 mg/L of Nitrate-N was detected in this sample.A follow-up sample collected in a nitrate sampling kit is recommended. Profile:New Well-No Nitrate I Analyte Test Result Allowable Limit Unit Qualifier(s) Arsenic <0.001 0.010 mg/L Barium 0.103 2.0 mg/L Cadmium <0.0005 0.005 mg/L Calcium 11 mg/L Chloride 13.9 250 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 0.056 0.05 mg/L • Mercury <0.0004 0.002 mg/L Nickel <0.01 0.1 mg/L pH 6.1 N/A Selenium <0.005 0.05 mg/L Silver <0.01 0.10 mg/L Sodium 19.4 mg/L Sulfate <5 250 mg/L Total Alkalinity 18 mg/L Total Hardness 46 mg/L Zinc <0.05 5.0 mg/L Report Date: 06/05/2025 RFCEIVED Reported By: 4,./MCI.;;; -"------. Marc Komlos J U N 1 7 2025 Environmental Health I Page 1 of 1 r 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: L ' C" AAde-rs o Sample ID Number: If5&5 I. e. Location: r t4Ie-ON 1' Far.) Reviewer: Jason Boyd 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.) XNo 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. N 0 R T H C A R 0 L I N A 3N04T.i Private Well Information and Use Recommendations NC DEPARTMENT OF HEALTH AND HUMAN SERVICES Division of Public Health For Inorganic Chemical Contaminants County: Catawba Name: Logan Anderson—6055 Little Mountain Rd, Sherrills Ford NC 28673 Sample ID#: 188545 Reviewer: Megen M.Thomas 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 oqv.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 on4v. ❑Arsenic ❑Barium ❑ Cadmium ❑ Chromium ❑ Copper ❑Fluoride ❑Iron ❑Lead ❑ Manganese n 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. 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. ❑ Chloride ❑ Copper ❑Fluoride ❑Iron ®Manganese ®pH ❑ Silver ❑ Sulfate n 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 on*v. ❑b.Your sodium level exceeds 30 mg/l 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. Nitrate, _ 7F-- , ,,.„, v. 1 Nitrite 8� Iti , \\ S j1 PRIVATE WELLS i •..t 5 , f 1 What is nitrate and nitrite? Nitrate and nitrite are nitrogen compounds,with nitrogen, a natural gas,bound to oxygen.Nitrate and nitrite are What level of nitrate and nitrite found in water,air,soil,and rocks deep underground. should I be concerned about? Nitrate and nitrite are used to preserve food,in medical The NC Department of Environmental Quality developed drugs and to produce ammunition and explosives.Nitrate a groundwater standard of 10 milligrams of nitrate per liter is used in most inorganic fertilizers. of water(mg/L)and 1.0 milligram of nitrite per liter of water(mg/L).Ground water standards are developed to How does nitrate and nitrite protect public health.This standard was developed in 2013. get in my private well water? The US Environmental Protection Agency used the same values for public drinking water standards.Public drinking Nitrate and nitrite can enter your private well water from water standards are based on public health protection and erosion of rocks underground and leaching from soil into cost of treatment/testing at large utilities.These standards groundwater.Rain may wash out nitrate and nitrite from were developed in 1992 and validated in 2017. animal waste and nitrogen containing fertilizers at the surface to groundwater. How do I test for nitrate and How can nitrate and nitrite nitrite in my private well? affect my health? Use a certified lab to test your well water for nitrate and nitrite every two years,as part of the inorganic panel Nitrate and nitrite are sources of nitrogen for your body. screen.Contact the private well program at your county Nitrogen is a major part of proteins and deoxyribonucleic health department to assist you with getting your water acid(DNA).However,drinking high levels of nitrate and tested.Pricing of testing varies from county to county. nitrite may cause adverse health effects.You can't smell, taste or see nitrate or nitrite. What if my nitrate and nitrite Drinking high levels of nitrate and nitrite can lead to levels are high? decreased oxygen transport throughout the body. This may cause: If there are infants or pregnant women at the residence,you • Decreased blood pressure can install a treatment system to reduce the levels of nitrate • Increased heart rate and nitrite in your private well.Treatment systems that reduce • Headaches the levels of nitrate and nitrite in your well water include: • Vomiting • Anion exchange • Stomach cramps • Distillation • Reverse osmosis Pregnant women and infants less than six months of age are very sensitive to nitrate and nitrite toxicity. You can also reduce your exposure by using bottled water or connecting to public water supply,if possible. Percent of Private Wells Tested Exceeding State �4 and Federal Standards for Nitrate, 2011-2013 ' i1i1I 4110014-101-114101FAtikAlliiiW&A,4-1 - -111.41k-jalkilrgek.14011.0"417.7/1611 sishittWiliwe Percent of Private Wells Tested Exceeding State 0pg110®®® LP and Federal Standards for Nitrite, 2011-2013 '� r���,V).#44 � q WefigitariPADVOLAIREN101 >25%exceeded health standards Rkil an 10-25%exceeded health standards � � Ell<10%exceeded health standards L0%exceeded health standards tar Insufficient data(<10 wells tested) Where are nitrate and nitrite There you can find: found in NC? • Contacts for your county private well program • Nitrate and nitrite in well water maps Nitrate is found at varying levels(1-97 mg/L)throughout • A guide for selecting a treatment system NC.Less than 1%of wells sampled for nitrate in NC from • Other private well resources 2011 to 2013 exceeded state and federal standards.Yet, You can also call the Private Well and Health Program there are several areas in NC with at least 10%of the wells at 919-707-5900. exceeding state and federal standards.See map for areas with elevated nitrate. Nitrite is found at varying levels(0.1-2.1 mg/L)throughout Where did this information NC.Less than 1%of wells sampled for nitrite in NC from come from? 2011 to 2013 exceeded state and federal standards.Yet, Agency for Toxic Substances&Disease Registry: there are several areas in NC with at least 10%of the wells www.atsdr.cdc.gov/toxfags/tfacts204.pdf exceeding state and federal standards.See map for areas with elevated nitrite. World Health Organization:www.who.int/water sanitation health/dwq/chemicals/nitratenitrite2ndadd.pdf Where can I find more National Sanitation Foundation:www.nsf.org/consumer- reso u rces/what-is-n sf-certification/water-fi lters-treatment- information about nitrate and certification/contaminant-reduction-claims-guide nitrite and my well? Water Quality Association:www.wqa.org/Portals/0/ Visit the NC Division of Public Health's Private Well and Technical/Technical%20Fact%20Sheets/2014 Health Program website:http://epi.publichealth.nc.gov/ NitrateNitrite.pdf oee/programs/wellwater.html. /\a,_ NC Department of Health and Human Services•Division of Public Health•Epidemiology Section•Occupational and Environmental r t ' NCf'f'I Epidemiology Branch•Private Well and Health Program•https://eolpublichealth.nc.gov/oee/orograms/wellwater.html•NCDHHS is an •n Pohhcticl[h N•nhc•ro5. equal opportunity employer and provider.•09/2019