HomeMy WebLinkAboutWELL-04-2023-194163.TIF e, CxrA%'BA ccn N rV
.t.11 Public I lealth Department Subdivision
Environmental I lealth Division PINK 361601482661
PO Box 389,25 Government Drive,Newton,N(' 28h58 LUl K A
Site Address: 5840 HICKORY LINCOLNTON HWY, LINCOLNTON NC 28092
Name on Permit: TERRY REINHARDT
Property Size: Acres 2.08
Directions: End of Blackburn Bridge, Left on Hky-Lincolnton, Property on left tree farm
Owner/Authorized Representative Acknowledgement of Permit Receipt
X /1I ccrttf'that I am the owner or authorized agent(owner's authorization required)representing the owner of
theltiv escrihed above.
/ .
1 As -property owner or authorized representative, I have received the above referenced
permit(s)as requested in the application for service RBI'14-03-2023-43786, by the following method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
JElectronic Image Transmittal/E-mail (Return receipt required)
i
yit
II As e property owner or authorized representative I have reviewed and understand the specific conditions
ohthe 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 perintted.
Permit Issue Date: 04/21/2023 / I
Owner/Authorized Representative Signature _ •
_
/ ! Date J S ;/Q I ).5 ._.
Documentation of permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person sending permit)
Signature_ 1-1 cox" Date/Time
Method: FaxEmail US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
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CATAWBA COUNTY Case# WELL-04-2023-194163
a( Public Health Department Subdivision
Q ''3 Environmental Health Division PIN# 361601482661
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# A
/8_42 w
Site Address: 5840 HICKORY LINCOLNTON HWY, LINCOLNTON NC 28092
Name on Permit: TERRY REINHARDT
Property Size: Acres 2.08
Directions: End of Blackburn Bridge, Left on Hky-Lincolnton, Property on left tree farm
NEW WELL PERMIT
REQUIRED WELL SETBACKS:
Septic Systems and Repair Areas for Single Family Dwellings 50 ft.
Septic Systems and Repair Areas for Businesses and Multi-Family Residences 100 ft.
Underground Storage Tanks 100 ft.
Animal Barns 100 ft.
Lakes/Ponds 50 ft.
Streams/Brooks/Creeks/Rivers 25 ft.
Building Foundations 25 ft.
All Other Sources of Groundwater Contamination 100 ft.
Saprolite Septic Systems and Repair Areas 100 ft.
Septic Systems and Repair Areas to Wells with 2 or more connections 100 ft.
Wells shall be constructed in accordance with state regulations:
Article 15A North Carolina Administrative Code Subchapter 2C
The well driller must verify all setbacks before drilling the well.If the well driller is unable to maintain any of
the above setbacks,contact Catawba County Environmental Health at 828-465-8270,before drilling the well.
Grouting Depth:20 feet minimum
Casing Height: 12 inches minimum above finished grade
All newly constructed private drinking water wells are required to be sampled in accordance with the North Carolina Rules Regarding Private
Drinking Water Well Testing(15A NCAC I8A.3800).The fee for this sampling is included in the cost of the well permit.It is the applicant or
property owner's responsibility to notify Environmental Health when the well is ready for sampling.Water samples will be drawn from an
outside faucet unless otherwise specified For questions or for more information,please contact Environmental Health.
allif"%t 1117( \
04/21/2023
Authorized State Agent Permit Issuance Date
4/21/2028
Permit Expiration Date
ehpeimit 04/242023 14:59
Catawba County Environmental Health
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Parcel: 361601482661, 5840 HICKORY 1in=40ft
LINCOLNTON HWY LINCOLNTON, 28092
This map/report product was prepared from the Catawba County,NC Geospatial Information Services. Catawba County has made substantial efforts
to ensure the accuracy of location and labeling Information contained on this map or date 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 2023 Catawba County NC
04/21/2023
riE0 WPDT Screening Report
Area of Interest (AOI) Information
Area : 3,134,508.72 ft2
Apr 21 2023 15:04:14 Eastern Daylight Time
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Famed tPuynorul•Parces Proieded Route ) 009 006 0 12 rm
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C' County Boundary. — Other State Agn+1cy Route 0 0.06 0.1 0 2 km
Non-System Roads — Sews:Ian P.otAe
Feder el Route Pommy Roads
Nco System Irderstere w-.;.n c-Sum uw,
Otter System Roads — 115 Route
— Ramps,Rest Areas,Non-MA eU e — NC Route
5840 Hickory Lincolnton Hwy, Lincolnton
All North Carolina Department of Environmental Quality
(NCDEQ)GIS data is expressly provided"AS IS"and"WITH ALL FAULTS".The NCDEQ
makes no warranty of any kind,express or implied,concerning this Information.
including but not limited to any warranties of merchantability or witness for
any particular purpose,The NCDEQ assumes no responsibility or legal liability
concerning the Data's accuracy,reliability,completeness,timeliness,or
usefulness.The data is not intended to constitute advice nor is it to be used
as a substitute for specific advice from a professional.Users should not act
(or refrain from acting)based upon information in the Data without
independently verifying the information and obtaining any necessary
professional advice.Users are solely responsible for ensuring the accuracy,
currency and other qualities of any products derived from or in connection with
the NCDEQ's Data.The Data is collected from various sources and may be
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The NCDEQ disclaims responsibility for the spatial accuracy and attribution of
GIS features and makes no warranty concerning same.
Print Form
WELL CONSTRUCTION RECORD(C;W-1) For internal list Only:
I.Well Contractor Information:
Robert Teague 14.WATER ZONES
Well Contractor Name
FROM TO OCSCRIrI ION
2857-A 4 G Ott. 1. 7 r. 9,
Ct
ft. ft.
NC Well Contractor Certification Number
8&K Well DrillingInc5.OUTER CASING(for taald-cased wd OR LINER if a b►e
nc FRON ; TO DIAMETER `J THICKNESS MATERIAL
Company Name 0 iI. i3 a n- a its In• SOD-21 PVC
��- I ` 16 INNER CASING OR TUBING(geothermal eksid Iaap)
2.Well Construction Permit p l FROM _ TO ' DIAMETER THICKNESS MATERIAL
ail all applicable well rwtsowetion peinrrn fi e.WC.County, ate fanenrr.eft) ft. rt. in.
3.Well Use(check well use): ft. I ft. In.
Water Supply Well: II.SCREEN
OAgTcui Ural FROM TO D[AMFttp _SLOT MGE rHICKyEa MATERIAL
�MunihpalPubhI H. it. M.
Geothermal(Heating Cooling Supply) IDRcsident:al Water Supply(singlet —1
r]lnduscnaLCottunactal ORestdenral\P rt. ft. I in, I I
� ater Supply(shared)
L 1 irm Ration 1R.GRblfr
FROM TO MATERIAL CM PLACEMENT!METHOD d AMOUNT
Non-Water Supply Weil: R. rt.
Monitoring _ _
Recovery
Injection Well:
❑ 4. D.
Aquifer Recharge Groundwater Rcntcdia[Ion fe.r k.
Aquifer Storage and Recovery 19.SAND/GRAVEL PACK(It applicable)
�SalingyBamer FROM To M MATERIAL [MIIACEM[YTMETHOD __
Aquifer Teel n. ft.
❑Stormwater Drainage
Experimental Technology Subsidence Control rt. It.
❑Geoth arm al(Closed loop)
OTractt 20.DRI LLLYG LOG(attach addldonal sheets If aeotaliary)
Geothermal(Heatin¢/Coolin);Return) Other(explain under 021 Remarks) FRo" TO it&SCRI►T ION(foist.as no,pdarora t.pa pair oakNt)
•
4.Date Well(s)Completed: '' ell IDN i 1% - ."5 J L �L 5 "-P I _
Sss Well Location:
1► ,3 l .�.C)tAr J . A- S 44- ,
Y ` rrV Name
n ' 'o'L' ft. ft.
Facility/Ow Name Facility IDa(ifapplicable) _i ft. rt ��u
L �ft. ft. I
/P-hysical Address,City,and tip ft ft.
` Q.iA 4 _21.REMARKS
County Parcel Identification No.(PIN)
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,ore hit/tong u sufficient)
22.Certification:
N
6.fa(are)the well(1)4DPermanent or QTemporary Signature o Cern icd w Contractor Date
Si Ugning this farm.1 hereby cernft thin the i.e77u/Nat Isere)tonsil-soled in accordance
7.Is this a repair to an existing well: Yes or No 14 WI 13J NCAC 02C.0100 or 134 NC.+C 02C• 0100[Veil Construction Standards and thata
lfthis is et repair,fill our known well coniirucRnn information and plum the nature of Me tape of thct record hat',e'en provided car the se/l oKnrr
repair under t 21 remarks section or on the back of this 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 provide additional well site details or well
construction,only 1 GW-I is needed. Indicate TOTAL NUMBER of wells construction details. You may also attach additional pages if necessary.
drilled:
S SUBMITTAL INSTRUCTIONS
9.Total well depth ow land surface: J (a-) 24a. For All 31'elI Submit this formwithin
Far nudnp/e wells lest all depths if different/eraniple-3''r.200'and 2gI00•i t' 30 days of completion of well
construction to the following:
10.Stade water level below top of casing: 40 (ft.) Division of Water Resources,Information Processing Unit,
If never level is shove casing.use"+-" 1617.tilall Service Center,Raleigh,NC 27699.1617
II.Borehole diameter: 6 1/8 (In.)
24b. For Injection Wsllt: In addition to sending the form to the address in 24a
12.Well construction method: Air Rotary above.also submit one copy of this form within 30 days of completion of well
(To at construction to the following:
Aar.nobly,cable,direct push etc)
Division of Water Resources,L:nderground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mall Service Center,Raleigh,NC 27699-1636
13a.Yield(gpm) Method of test: Ar Flow 24c. For Water Suaoh 5,4 Injection VLells: In addition to sending the form to
Chloe Tabs ,[2 ens the addresses) above. also submit one copy of this form within 30 days of
13b.Disinfection type: Amount: coinpletion of well construction to the county health department of the county
where constructed.
Funs G W l North Carolina Depanment of En.ironmentai Quality.Dr,pion or Water Resources
Rc+,ecd 2.22-2016
Analytical Results � STATESYILLE
1 ANALYTICAL
Catawba County Public Health
PO Box 389
Newton, NC 28658
Receive Date: 05/22/2025
Reported: 05/24/2025
For: Terry Reinhardt: 5840 Hickory Lincolnton Hwy,
Lincolnton NC 28650
Comments:
Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst
250522-35-01 Nitrate 194163 3.49 mg/L 353.2 05/23/2025 CL
250522-35-01 Nitrite 194163 <0.1 mg/L 353.2 05/23/2025 CL
Respectfully submitted,
Y-7;det.7474- ,,Le
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.ccm - - '
NITRATEJNITRUE ANALYSIS
tiotc ,Cfourcaka=-,ber4piic:fceaus raze au:.
•
WATER SYSTEM M#:14 E LL - 0Li. - aci3- LggIG3 County: Catawba •
Name of Water System: fe CC,.) jZe i„As.,k .
Sample Type: El Entry Point ��,gqleSpeci diNon-compliance
Location Where Collected: 5-1'Jl'� T! !-C160n4 Linco1rfo,•. {Iwy F LjAcolt,- r piC 2g)cS'O
Facility ID No. 1yy�}Y 1 6
Sample Point 1 et F II Collection Date 11 Collection Time
Collected By: pv✓f j L+ riA t ),-ca.1 • O$'i l i 5 - _ 1:Y.-3 P M
1e 1 (t.yADDtrY) t5,_fyAtt mat)
MaI1 Results to(water system representative):
CA i AW BA COUNTY PUBLIC HEALTH Phone 4:i(828)465-8270
ENVIRONMENTAL HEALTH • Fax#: I(82 )465-8276
,PO BOX 389 Responsible Femsan's ulna$:
•EHAdmin@catawbacountync.gov
NEWTON,NC 28658
LABORATORY ID#: 37755 . El SAMPLE UNSATISFACTORY 0 RESAMPLE REQUi'2t ED
METHOD REQUIRED NOT DETECTED QUANTEIED • ALLOWABLE '
CONTAM CONTAMINANT CODE REPORTING WIT (.c.<R.RL) L
CODE • (R.RL) (X) RESID.TS*
ar
I 1040 ' Nitrate 3532 1.00 mg/L ❑ 3-_a_ mg/L 10.00 mgii.
1 1041 Nitrite - 3532 0.10 mg/I, ( mg/L. IAO mg/L
*Note:If result exceeds allowable limit,the laboratory must fax analytical results to the State on day test comgIeted.
DATE: TIME:
i ANALYSES BEGUN: 5/ 23 / 25 : _-Z.' o ¢ AM,)
i tap'A�n
ANALYSES COMPLETED: b/23 / 2S �_•3�R A,Iv,
l •
t ..:aarrx) .
•
Laboratory Log i:act - 35'01 Certified By: -
COMMENTS: -
aceS '
Laboratory should MO Results to: .
Public Weier5upply Seetlau,Ann:Data.Eaty,1634 Malt Seryicc Center,Rakish,NC 27649-1634
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 2 of 2
r- ,_ _.
4312 District Drive
'1- Ar i,j,_ 'f North Carolina State Laboratory of Public Health Raleigh,MSC 11NC 27699-1918
fa r�
1 , ���\` Environmental Sciences http://slph.ncpublichealth.corn
�_ 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 Terry Reinhardt
P 0 BOX 389 5840 Hickory Lincolnton HWY
NEWTON,NC 28658 Lincolnton,NC 28092
EIN:566001814EH Delivery: NC Courier
StarLiMS ID: ES250523-0016 Date Collected: 05/21/2025 Time Collected: 13:43 By: Dwight Mikeal
Date Received: 05/23/2025 Time Received: 08:04
Sample Type: Raw Sampling Point: Well head Well Permit No. WELL-04-2023-194163
Sample Source: New Well Receipt Temp. : GPS Number:
Profile:New Well-No Nitrate I
Analyte Test Result Allowable Limit Unit Qualifier(s)
Arsenic <0.001 0.010 mg/L
Barium <0.1 2.0 mg/L
Cadmium <0.0005 0.005 mg/L
Calcium 25 mg/L
Chloride 10.7 250 mg/L
Chromium <0.02 0.10 mg/L
Copper <0.01 1.3 mg/L
Fluoride <0.1 4.00 mg/L
Iron 0.100 0.300 mg/L
Lead <0.003 0.015 mg/L
Magnesium 6 mg/L
Manganese. <0.005 0.05 mg/L
Mercury <0.0004 0.002 mg/L
Nickel <0.01 0.1 mg/L
pH 7.5 N/A
Selenium <0.005 0.05 mg/L
Silver <0.01 0.10 mg/L
Sodium 8.4 mg/L
Sulfate <5 250 mg/L
Total Alkalinity 76 mg/L
Total Hardness 88 mg/L
Zinc <0.05 5.0 mg/L
Report Date: 06/05/2025 Reported By: dr4nr.142 ----"---.4'
RECRVED
Marc Komlos
J U N 1 7 2025
Environmental Health
1
Page 1 of 1
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: T- INC.,if Sample ID Number: I"04 163
Location: S(64(0 u«:li.e*y k i f'4 b.- j}w/ L v_N Reviewer: Jason Boyd
Initial Sample >( Confirmation Sample:
BIOLOGICAL ANALYSIS RESULTS AND RECOMMENDATIONS FOR USES OF YOUR
PRIVATE WELL WATER(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.
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 depai tinent 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
Private Well Information
1
\-:, ,,,p'l j•;
„....„..,;, and Use Recommendations
NC DEPARTMENT OF
HEALTH AND HUMAN SERVICES
Division of Public Health For Inorganic Chemical Contaminants
County: Catawba Name/Address: -
l -r.y I -i'0,4-4-r 5 t9014,„U.,y Lt^�.i.,,io,.. 1'L
Sample ID#: i 9i.( (k, i Reviewer: Jason Boyd
TEST RESULTS AND USE RECOMMENDATIONS
1. Your well water meets federal drinking water standards for inorganic chemicals.Your water can be used for
dr. king,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.
❑ Arsenic n Barium ❑ Cadmium ❑ Chromium ❑ Copper ❑Fluoride ❑ Iron
❑ Lead ❑ Manganese ❑ Mercury ❑Nickel ❑Nitrate/Nitrite n Selenium n 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 on*, 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.
❑ Chloride ❑ Copper ❑ 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/1. 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*.
❑ b.Your sodium level exceeds 30 mg/1 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.