HomeMy WebLinkAboutWELL-02-2023-188985.TIF 4
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d i Site Address: 2040 BROWN CHAPEL RD CATAWBA NC 28609
I Nam.on Permit: BRYAN 8 KIM LEFEVER
Property Size: Acres 15 42
Directions: Hudson Chapel Rd.Right on Brown Chapel Rd,Lot on Left
Owner/Authorized Representative Acknowledgement of Permit Receipt
XB Li ccrtifl that I am the uwncr or authorized agent(otvncr':c authorization required)representing the owner of
the propert} described above.
Qt.-As the property owner or authorized representative, I have received the above referenced
permit(s)as requested in the application for service RBPR-12-2022-42956,by the following method(s):
Received in Person
Facsimile Transmittal(Return form with signature required)
7 Electronic Image Transmittal/E-mail (Return receipt required)
I - 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 1 SA.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:02/10/2023 ('-----
Owner/Authorized Representative Signature4,___:/
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Date .- - ls_ ) 3
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person sending permit)
Signature 1__ Date/Time 3/61)3
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 yoiPlease ttake a few momentts tto complette our custtomer service survey att
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chpermit 02/10/2023 a 211
Catawba County Environmental Health
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This map/report product was prepared from the Catawba County,NC Geos atial Information Services. Catawba County has made substantial efforts
to ensure the accuracy of location and labeling Information contained on this map or data on this report.Catawba County promotes and recommends
the independent verification of any data contained on this map/report product by the user.The County of Catawba,Its employees,agents,and
personnel,disclaim,and shall not be held liable for any and all damages,loss or liability,whether direct,Indirect or consequential which arises or may
arise from this map/report product or the use thereof by any person or entity.
Copyright 2021 Catawba County NC
02/09/2023
I.Well Contractor Information:
Robert Teague ii.Vt.t r i.R/ONES 1
I HMI I ) I DESCRIrtioN I
2857-AWell Contractor Name i 1 ft. !1.ft, i/
✓ -- —
n. ft. ! 1
'`C Well Contractor Ccrtfication Num114.1
15.OUTER CASING(for multi-cased wells)OR LINER Of appltabk)
FROM : TO j DIAMETER THICKNESS ! MATERIAL j
B &K Well Drilling Inc 1
Company`fiat to a ft. t. I S 118 in. S3R-21 PVC
b 16.INNER CA I5 NG OR TLBING(geothermal closed-loop)
IS� J aS FROM I TO I DIAMETER ( THICKNESS MATERIAL
2.Well Construction Permit rt: 1 LC an apphcahle%ell Cunrrrtrctran per mill rr a C'IC',('onrtM1t PaleI aeons e.etc) ft. f ft. to
3.Well Use(check well use):
ft. I ft. in. 1 }
-
Water Supply Well: 17.SCREEN
aAgrtcultural iKOM TO OSlunicipal'Public fr. ft. DIAMETER SLOT517AE THICKNESS ,MATERIAL
in. {{I
0Geothermal(Heating Cooling Supply) Residential Water Supply(single) ft. ft. in. I
0 lndustnaliCornmercial OResidential Water Supply(shared)
D Irrigation FROM
GROUT (I{
FROM i TO MATERIAL I EMPLACEMENT METHOD&.UfOCNT
Non-Water Supply Well: ft. i ft. 1
0Monitonng DR %•cryi
cco
ft.
ft.
Injection Well: i
Aquifer Recharge �Groundwattx Rcmcdwuon n ft i i
!9.SAND/GRAVEL PACK(If applicable)
Aquifer Storage and Recovery Salinity Barrier FROM 1 TO MATERIAL I EN1PlACEMENT METHOD
Aquifer Test �Stormwater Dratr.age n. i ft.
li
Experimental ntal Technology Subsidence Control R, 1 n.
Geothermal(Closed Loop) Tracer 20.DRILLING LOG(attach additional sheets if necessary)
Geothermal(Heating/Cooling Retum) [Other(explain under?21 Remarks) FROM To Dl.SCRI ION(color,ha ca.wWroek nee.grain du.cm)
^� IH �f� f`' j _,C�
4.Date Well(s)Completed:�j7'd• 'a2 Well LDk 7 Oft. '),(i f. 4A.111 so 5--i )C-.0
rt.
c Well Location: ,� J /
Factht;[Owner Name Facility II>(If appltcabtc) ft. ft.
rt. R.
Physical Address.City.and Zip '
✓ ft. ft.
21.REMARKS
County Parcel Identification No.(PIN)
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(dwell field,one taClong is sufficient) 22.Certificatio
N W 7,,.,. ....4110/ ca-,)2- <, -3
6.ls(are)the well(s)123Permanerir or 0Temporar) SignatiucofC nifcdWci1Co factor Doc
$s signing dui/+'u'm.1 hrreht servile Mat the ne•11tti nai(here/con wucted In accordance
7.Is this a repair to an existing well Yes or No hind,15.4 NCAC OW.0100 or Ill.VCAC 02C.0200 IVelI Construction Standards and that a
If Mu LT repair,fit!oar;mm»n well construction informationy,:..in the nature suet iii thin ramrd hat hero prutiddI la the hill(At lief
repair under 021 remarks section or on the back alibis form '
23.Site diagram or additional well details:
8.For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same You may use the back of this page to pros ide additional well site details or we:i
construction.only I GW'-I is needed. Indicate TOTAL NUMBER of wells construction details. You may also attach additional pages if necessary.
dolled: SUBMITTAL INSTRCCTIOXS
9.Total well depth below land surface: 1 (IL) 24a. For All Wells: Submit this form within 30 days of completion of well
For multiple wells list all depths ifdifferent re+ample-5l 200 cord 2,E Win construction to the following:
10.Static water lot'beluw top of casing: 40 (ft.) Ditision of W ater Resources.Information Processing Unit,
!f»ater:c.c. .iho,r:wins we"- • 1617 Mail Ser+ice Center,Raleigh,NC 27699-1617
11.Borehole diameter: 6 1/8 (In.) 24b. For Injection Wells: In addition to sending the form to the address in 24a
Air Rotary abotc. also submit one copy of this form within 30 clays of completion of well
12.Well construction method: construction to the following:
It e.auger,rotary,cable,direct push.etc l
Disislon of Water Resources,Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center.Raleigh.NC 27699-1636
13a.Yield(gpm) 6,6 Method of test: Air Flow 24c. For Water Supplt B. Injection Wells: In addition to sending the form to
the address(es) above. also submit one cop) of this form within 30 days of
Chloe Tabs 2 L� completion of well construction to the corm health of the corm
13b.Disinfection type: Amount. 4 departmentty
where constructed.
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: `/�'� �°' /'Z r
h Sample ID Number: lg� �t S
Location: 'oqv {`j,Av,aln Reviewer: Jason Boyd
Initial Sample X Confirmation Sample:
BIOLOGICAL ANALYSIS RESULTS AND RECOMMENDATIONS FOR USES OF YOUR
PRIVATE WELL WAl'l R(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.
XTotal colifonn 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 colifonn 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 colifonn and fecal colifonn 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 iinmunocomprornised(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.
�•(0��, t+��n� ,
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_. 1.. '� vt.�^Fe�itrtSi:. t '.. A.,..l_aa y`a.�.?.s..+.1.r.. ..a T 3,= ..^ti.� '-� �Y,.x : r �isF + f..l-.•t e.. �>•.tl '�._.r s'f
r~TRZ Homan, ? ivae Well Infor ,
vers4`\4V\F
and Use Rectrathendations
NC DEPARTMENT OF
HEALTH AND HUMAN SERVICES
Division of Public Health For Inorganic Chemical Cont•� i i masts
tt' .,..s -s Ir�t�' �i�a�
County: Catawba Name/Address: 0rycn r La LipBrav,.n �.lna � Ra Gdf.. �ay
Sample ID#: j g l;7$S Reviewer: Jason Boyd
{WIR is 9 � , e�.�r �t e� 17 1*-4. r i•, t °� 4414. *
p°'tf't`- +t'd,wl$ M*50.4T'"`f.5ir �� s°• '.=e'1;-'.J:.1�� • y� y'i1't{,2 ,ram �R6�.�f i. '.+«
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 only.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 only.
n Arsenic n Barium n Cadmium n Chromium ❑ Copper n Fluoride n Iron
n Lead n Manganese ❑Mercury Nickel n Nitrate/Nitrite n Selenium n Silver
n Zinc
3. n 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 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.
n C�lrlflride -R—G pper =0 Flu°ors c - =1 Iangan-ese- — _
❑pH n Silver ❑ Sulfate n Zinc
6. n a. Sodium levels exceed the U.S.Environmental Protection Agency's(USEPA)Health Advisory level for sodium of
20 mg/I. 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.
n b.Your sodium level exceeds 30 mg/I 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.
I
L-.7.--. -..._______ . _ .
Total Coliform
Bacteria, E. coli & r
,,. . am._
PRIVATE WELLS
I g .s
What are total coliform bacteria ; ,1,3
and E. coli? °�r ��,
Total coliform bacteria are a groupof microorganisms found _ 7 r 4
lir
in soil and surface waterTotal coliform bacteria water tests i y
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 heaith.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.coli 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 private well?
pathogens that could be present in your water:
• 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 �
With Detection of E. coli, 2011-2013 4 �� n�� !Ily ,
NVAITICEMINWASP7- --4117.a
OVZONAVAFAN NittAW411
vamp
*01'
Percent of Private Wells Tested With 4 4111MO T G� l�"-�►
fia'i . ice ■` `�
tilk
Detection of Total Coliform, 2011-2013 .^410,0� ff
hsr,..rN-tw4"�24 ae6T ' ,
O4wviot
50%with detections -� i
- 25.1-50%with detection "' 10 a=
<25%with detection
`..dr-A
0%with detection
I
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/wellwatechtml.
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.coil 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.html
E.toll is detected throughout NC.About 2%of wells Environmental Protection Agency:https://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.coil.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-quality/water-filters-testing-treatment/
map for areas with high E.coli detections. contaminant-reduction-claims-guide
,"; w NC Department of Health and Human Services•Division of Public Health•Epidemiology Section•Occupational and Environmental
r` NCI Epidemiology Branch•Private Well and Health Program•https://epi.oublichealth.nc. ov/oee/pro rams/wellwatechtml•NCDHHS is an
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NP°Llmlth°Hnic IlC,ohe° equal opportunity employer and provider.•09/2019