HomeMy WebLinkAboutWCOC-03-2023-192130.TIF ,F . CATAWBA COUNTY Case# WCOC-03-2023-192130
1~ .t.ii Public Health Department Subdivision THE SUMMIT AT LAKE NORM
Q "'1 Environmental Health Division P1Nk 470002973310
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 8 I
Site Address: 8175 LONG ISLAND RD,CATAWBA NC 28609
Name on Permit *CORNERSTONE III PROPERTIES INC
Property Size: Acres: 0.95
Directions: Brown Chapel Rd,left on Long island
WELL CERTIFICATE OF COMPLETION
Permit Number: WELL-09-2021-158145
DATE COMPLETED INSPECTION TYPE STATUS INSPECTOR
02/27/2023 EH Well Grouting No EH Inspection Jason Boyd
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
03/13/2023 EH Well Record Received Approved FH Admin
03/23/2023 EH Well head Approved Steven Price
Rowan Well 02/27/2023
Well Driller Date Drilled
,
03/23/2023
Authorized State Agent Issuance Date
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