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Home My WebLink AboutWELL-02-2023-189861.TIF I f 11111. ., CATAWBA COUNTY i, Public Health Department Subdivision ;�1. ��,s Env'tronmcrxal Health Division P1Ns\ 370005180160 % 4 PO Bone 319,25 Government Drive,Newton,NC 2b658 LOTH' 1 • Sae Address: 1778 PAIN RD,HICKORY NC 28602 Naar on Permit 'FOURTEES INC Property Wu: Acres 3 okscttorn: Hwy 10,tight onto Zion Ch Rd,left onto Bethel Ch Rd,left onto Sain Rd,property on the left i/ Owner/Authorized Representative Acknowledgement of Permit Receipt W _I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of the property described above. rAs the property owner or authorized representative,I have received the above referenced permit(s)as requested in the application for service RBPR-02-2023-43315,by the following method(s): Received in Person Facsimile Transmittal(Return form with signature required) Z. Electronic Image Transmittal/E-mail (Return receipt required) W-------- AS the property owner to authorized representative 1 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(I5A NCAC 18A.1900), and/or Well Construction Standards(1 SA 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:02/23/2023 Owner/Author'zcd Representative Signatur _ 1 Date_9/IL+ 93 Documentation of Permit(s)Transmittal (permit transmitted by electronic or other means) Permit transmitted by (name of person sending permit) SignatureA E Date/Time , JvJj3_ Method: Fax J 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 yo&Pleese ttake a few momentts tto complette our ctrsttomer service survey att http://www,surveymonkey.tom/s/EHCusttomerServlce btit I a 44v- 'atu. isaii-1 earl eliperm 02L13/2023 14 15 r r V,: ,. CATAWBA COUNTY .t. 2 Public Health Department Subdivision . `� E : 9., nvironmental Health Division PIN#� 370005180160 PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 1 1 Site Address: 1778 SAIN RD, HICKORY NC 28602 Name on Permit: *FOURTEES INC Property Size: Acres 3 Directions: Hwy 10, right onto Zion Ch Rd, left onto Bethel Ch Rd, left onto Sain Rd,property on the left 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. As the property owner or authorized representative, I have received the above referenced \4 permit(s)as requested in the application for service RBPR-02-2023-43315,by the following method(s): Received in Person Facsimile Transmittal (Return form with signature required) J 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: 02/23/2023 Owner/Authorized Representative Signature 9 Date Documentation of Permit(s)Transmittal (permit transmitted by electronic or other means) Permit transmitted by (name of person sending permit) Signature_ L E Date/Time ,'3IN1)3 v / Method: Fax J 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 youPlease ttake a few momentts tto complette our custtomer service survey aft http://www.surveymonkey.com/s/EHCusttomerService iZ r chpermit 02/23/2023 14:25 S 4'(e"e\of-( Catawba County Environmental Health ID, tit: 'NI° \ E� � 4111110* fib c^ �; E S��rrt'1 {''P O • t•••4/ / - itke- • tz., , -..- 60 \- Oi :0 \,(' ,11,„:'‘,*>\ . ii „ - rt \ �i �b l Sale /-?s, �\ ,,AerGee----hr" /pta�r~ R120' i ti <: :;7. . gg PR-02- .2023 -u331 l MPS- I 0-20a-0_ 114O,291 W I,L-- oz- 2023 _ l gq q4 i • Parcel: 370005180160, 1778 SAIN RD 1 in=80ft HICKORY, 28602 This map/report product was prepared from tho Catawba County,NC Guos utlul Information Sorvlcos. Catawba County has made substantial efforts to ensure the accuracy of location and labeling Information contained on lido map or data on this report.Catawba County promotos and recommends the independent verticabon of any data contained on this nrq+repo,t product by the user.The County of Catawba,Its employoos,agents.and Personnel,disclaim.and shell not be held Noble for any and 011 Nobility.whether droll.tndirod or consequential whsch arises or may arse from this deport product or the use thereof by any popwp t or20 w1 1.Coawba County NC 02/22/2023 S'44C-\•,`( Catawba County Environmental Health E.. C\S. \fib ,-N—/ � (NI G i Stpf f -i 1 J �' `E r I,,,D �'^n r r � 43 cep '� r M u , 7 ``S� › ` \�3 Dr N. 913i7\ ,j_r\y,. e. / '. �� Sg c a, gy Tnir p ' / Bit Pe v'fai / !I 4/riC/ !', O , c �'l\ tr P3., , Lc°-r?y-. ! spa UU Pe- 02- .2023-4331s- IMPV- I0 -,Zoo- 1140zgl A(ATli -0 - 2..0.23.- 1Sgys-9 UV I.I-- 0 - t)23 _ Jgggb) • Parcel: 370005180160, 1778 SAIN RD 1 in=80ft HICKORY, 28602 This map/report product was prepared from the Catawba County.NC Geospnlial information Services. Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this mop or data on this report.Catawba County promotes and recommends the independent verification of any data contained on this mop/report product by the user.The County of Catawba,its employees,agents,and personnel,disclaim,and shall not be held liable for any and olt damages,toss 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 02/22/2023 - Case# WELL-02-2023-189861 CATAWBA COUNTY HEALTH DEPARTMENT „ -. • .1 Environmental Health Section !in1$t}Z SM 08/27/2025 WATER SAMPLE TEST RESULTS Applicant *FOURTEES INC,PO BOX 2429,DENVER NC 28037- B:(704)361-3130C:7043611987 BUILDTHELAKE@GMAIL.COM Owner AUDRA&KEVIN SMITH, 1714 8TH STREET DRAFT 203,HICKORY NC 28601 C:704-361-1987 ; is .�<-�` , n `` Contractor *FOURTEES INC,PO BOX 2429,DENVER NC 28037- B:(704)361-3130C:7043611987 BUILDTHELAKE@GMAIL.COM Site Address: 1778 SAIN RD,HICKORY NC 28602 Parcel Number: 370005180160 i'tr; . ��j • _ iZ!, t Lab Coliform Analysis Results: Total Coliforms: Fecal/E.Coli: a. 4_ No Collection Date Over 30 hours old Invalid Results: Excessive turbidity Excessive Chlorine Lab Accident �o Lab Tech Initials E•CAU— Date/Time Received 0112812025 15°e Date/Time Completed 07/Z /2.025 .rtk• RECEIVED S E P 2 2025 Environmental Health rsamfieldreport 08/27/2025 15:55 Page 2 of 2 (OACo Case# WELL-02-2023-189861 CATAWBA COUNTY HEALTH DEPARTMENT kiiPA , Environmental Health Section I$42 sM Le-4 08/27/2025 WATER SAMPLE FIELD REPORT Applicant *FOURTEES INC,PO BOX 2429,DENVER NC 28037- B:(704)361-3130C:7043611987 BUILDTHELAKE@GMAIL.COM Owner AUDRA&(KEVIN S TH)1714 8TH STREET DR APT 203,HICKORY NC 28601 C.7013611911 a 18 -5��-a,84q Contractor *FOURTEES INC,PO BOX 2429,DENVER NC 28037- B:(704)361-3130C:7043611987 BUILDTHELAKE@GMAIL.COM Site Address: 1778 SAIN RD,HICKORY NC 28602 Parcel Number: 370005180160 Driving Directions Hwy 10,right'onto Zion Ch Rd,left onto Bethel Ch Rd,left onto Sain Rd,property/ on the left Sample Collected by: PW 1 s�k. �1 Date/Time Sampled: 0 P/ t 17I2 r 0:3OA M Sampling Point: 1A/t✓ ,\ Y u' ' ttl Is well head accessible? Yes d No Reason for inaccessibility Well New or Existing? New Existing Type of Well: Drilled ✓ Bored Hand Dug Punch Does well meet adequate construction standards from what can be observed: 1/Yes No Items of non-compliance: Evidence of improper grouting or no grouting Well does not meet a required setback(comment) Improperly constructed sanitary well seal Well head not term at>=12"above finished grade Well head missing vent Well head does not have a threadless tap Well missing identification plate or pump tag Wire conduit opening not sealed Other(comment) Comment: rsamfieldreport 08/27/2025 15:55 Page 1 of 2 Analytical Results STATESVILLE ANALYTICAL Catawba County Public Health PO Box 389 Newton, NC 28658 Receive Date: 08/29/2025 Reported: 09/02/2025 For: Kevin Smith: 1778 Sain Rd, Hickory, NC 28602 Comments: Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst 250829-05-01 Nitrate 189861 <1 mg/L 353.2 08/29/2025 CL 250829-05-01 Nitrite 189861 <0.1 mg/L 353.2 08/29/2025 CL Respectfully submitted, 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 704-872-497 www.sa-nc.com . ' .NITRATE/NITRATE ANALYSIS . tmrlliaa=r2cazz+tbes�;udsa,r—sx,—*cr . WAT SYSTE if: WE'LL—Ua-Aga —ri sac/ County Casa ►ba Name of Water System: IC e•1 fin 5re%;-131 Sample Type: ❑Entry Point KSpecial/Non-compliance Location Where Collected: 1778 SR.t'n ", RtCdcot t A/C a.Q601. Facility ID No. 1 g 9 g!?/ Sample Point: Wt./l E'er II Collection Date 1 Collection Time Collected By: Pe.r Sli,+ fil lkee..) • i7 d'ja it'1 d3•' - I a :.90 A M - Muse?ich ta/matrry s rAb:rt=sq Mail Results to(water system representative): • CATAWBA COUNTY PUBLIC HEALTH Phone t:i (828)465-8270 ENVIRONMENTAL HEALTH Fax#: L(828)465-8276 • , PO BOX 389 Rer onstb el'erson's email: . •EHAdmin@catawbacountync.gou NEWTON,NC 28658 LABORATORY ID#: 37755 • ❑SAMPLE UNSATISFACTORY 0 RESAMPLE REQUIRED • REQUIRED �ODETEC QUANTIF2D CONTAM IYO _ ALLOWABL E jjj s CODE CONTAMINANT CODE REPORTLNOIaTIT (Le.<R.R.L) (RILL) ( RESULTS MITT a a 1 i 1040 ' Nitrate 3532 1.00 mg/L _ . mg/L 10.00 mg/L 1041 Nitrite • 3532 0.10 mg/L e ,_— mg/L 1.00 mg/L *Note:If result exceeds allowable limit the laboratory must fax analytical result to the State on day test completed. DATE: TIME: • 1] .. �/2 ANALYSES BEGUN: O$/ 6. : b.:02- f" N ANALYSES COr,4PLETED: OS/ ZGI /IS OCi, ` —M 2��u�n aar7,aar.<rxl Laboratory Log II:A501'2! 05.0I Certified By: _ • - V COMMENTS: . 2008 . Laboratory Aorta Nan Results to: . Public Water Supply Sc.tion,Atte Data Entry,1634 Mail Service Ceate,Rafeiob,NC27699-1634 vim.nan H*!/M PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 2 of 2 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: I4-e—v 5 -.L. Sample ID Number: 18 9 s(.1 Location: I -1 1 5 ^ 4 :Llama r 7 Reviewer: Jason Boyd Initial Sample >C 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 40, 4 Private Well Information ¢, . Atv 44000* and Use Recommendations NC DEPARTMENT OF HEALTH AND HUMAN SERVICES Division of Public Health For Inorganic Chemical Contaminants County: Catawba Name: Ke r Smi-{-. - il?$ Sal n Ra, —11C4ory Sample ID#: ( 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 only.You may have other water sampling results that are not taken into account in this report. 2. El 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. El Arsenic ❑Barium El Cadmium ❑ Chromium ❑ Copper El Fluoride El Iron El Lead ❑Manganese ❑Mercury ❑Nickel El Nitrate/Nitrite El 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. 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. El Chloride El Copper El Fluoride ❑Iron ❑Manganese ❑ pH ❑ 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 only. ❑ b.Your sodium level exceeds 30 mg/1 and may pose aesthetic issues such as bad taste, odor, staining of porcelain, etc. 7. El 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.