HomeMy WebLinkAboutSAM-04-2023-194321.TIF }1 k 1 (.;'AI OLINA :ttAiR.'...1%1EN"S'OF ENVIRON y 1,N I .A.NE)"tiA U AL RFSO RCe S
'VARIANCE APPLICATION FOR 2C.0100 WELL CONSTRUCTION STANDAR US:
PRIVATE,DRINKING WATER\VE.ILS UNDER iSA NCAC 02C.0300
WATER SUPP'L'Y WELLS UNDER ISA NCAC 02C.0107
tl c„,U3sr irs- s ,wells na'earls d r d 'Pn.atc Dnntang ft'€rtee Welts' a d lncitkltrfy trrrgorto.'.POttstrol.woad Nmo.crcaal ik e11s..
WELLS OTHER THAN WATER SUPPLY UNDER ISA NCAC 02C.0108
LscIttdfng rs cmu'orlrrg Old reCt3very wolfs.
cleerly or type itt Ornscstrura. srrIwarittets will be returned rr,i rc,•om 4?c e.
DATE.' • 2(1 Z3 PERMIT NO.: (t c<rmwleciii by DWQ,DPII)
A. WELL OWNER—For single family residences list the property owner( ), For all others,. list name of the business,
organiatioa,or government agency and person delegated signature authority_
'tilailin Address; ..�.3.J J 1� "� �... .^. w w._.. . �.
City_ State; Zip,Code; (14".T ,. brri
D)ay°Tcle a No„ $. ,$-3(?.2.-94)5' �C+eli +'o.:5_i176
EMAIL Address. Ccrn1' Sc�.. . . ?r_ �3 a iii axNo.:w..,....
B. PHYSICAL.i OCATION OF WEI,.E,SITE
(1) Parcel Identification Nt tuber(Pll\r)of well site, 3155 0 1 t (0
County; .CA iA
(2) Physical Address(If different than mailing address)=.
City State:NC Zip Code:
C. WELL DRILLER iNFORNIATION(i(known)
Well t Tilling Contractor's Name:
NC Wel Drilling Contractor Certification No,: .._._._. _._..—__
Co npar.y Name- _.._�. Contact Person: .._..._. _
City, „ State: Zip Code: County:
Day Tcle No Cell No,:
EMAIL Address; Fax No.;
;;:riaG1A',32V t r€4,r*ed rem uy2€ 1)
13, 1i ASSON FOR VARIANCE R.EQUFS`U Include type of‘.,ell(s)to be coostnieted, rule for winch the variance S
err requested; description of haw the alternate coustrtict'kvu will not endanger human health and welfare r<d ti c
ea,,tct nra:tit and reason why i c isiniction andiur opz:r icia to aceordanec with the standards i$ not technically lily feasible
provides Vc at E.rSeiter protection of the grounth'atce
, rave .
r aty:ot 4 � J��'ata::.vyti. ,... t.
L.
E. ATTACHMENTS--Provide the following information is an-actin-tents to this application-.
t!I A map showing general location of the property (including road names, NC Stan Route Number, distances,
any key<a.ndmarks,etc.)sufficient for finding the well location.
(2) Detailed site map with scale showing location of proposed well relevant to septic system(s), =tas;din
foundations,property lines,water bodies,potential sources ofcontamination,other wells,etc.
(3) Submit a copy of the local well permit application and site evaluation map(if applicable),
(4) Any barer information relevant to flee variance tetluest such asa well construction diagram showing pwpo.sca
atyp>eai construction mati'.riiisitictbo s,
OTHER MINIMUM CONSTRUCTION REQUIREMENTS
.fn t;�t;�r ma's 1 � wells, tr�e,.T.^ss«t of g Srvianco 'Sb's i require that nee l;n, :11 enrs•trretiio'? Y`equinernents titiyonfi a r
specified in ISA NCAC 02C .0107 be met. Minimum additional construction requirements for Coastal Plaid and
Piedmont and Mountain region wells arc referenced on Attachments A and 13 on pages 4 and 5 of this application.
Approval of a variance will not be considered in cases where the specified minimum additional construction
requirements cannot be met,
G. SIGNATURES
`�. SAA
r<<r of e ,.m F.esttemilsge fur‘s'rtt CmIttrttett'n ft'.ri alty the well ttrfitarl
hri M Sml
stets or 0 tic Full Name of Pe on flrapon tblc for Well Ccanstrsaettabn
(topically the la ell&titer)
Sling a erCo►anty Eye trtrimental health Speetalisr _:....._.._.
a? 1
Print or Type Full Same of County tine trraitmentol Health Spectattst
G.. 5.! 4rIC i?tl ,�y T T t,toe�`.s a.r Marv! lde p r,ecr }' r th F-o =s
> d. . . �. �.>dn a u mac-;k".-,., €'�T:+L'step.,'4t`,?#$t3f� Q:.{�.1�5°eftc.'�5'c$(.:7 4'{plfj'.T<L` ri•.
en:azni/al Gf information deemed nceassar to make a s eI.rorr on the viviance, may impose conditions en- ;o
derision, and.th aai r:a'pond in writing to the tcg7u ui within 30 dajs' of rcecipf of the variance rS:zgiuesi .t Ba
,,, .:Sat Oed with the dcc#Stoas Of the Director may commence a contested€`inn Ry' ty perito,
:doerihea in :S. 1.01I-lJ within 60(Jays after receipt ofthe decision.
i'% : j
,.. r
North Carolina Please submit this form along with a Well
Department of Health and Human Services Variance Application for an existing
private water supply well.
Division of Public Health
Existing Well Variance Inspection Report
Well Site Location: C, ' 4 L r L 3 ' I /-1.,, y I b
Town,community,subdivision and Lot#)
Address: 6 3 f', I N NC /G 14 w./ County: c, i""^'
City/ST/Zip: G„ t\I c. 7 6 13 Date of SiteVisit: 5 l 2--I / 1,3 C1 I. 5 t i4
Well Construction Well Head Completion
Date of Well Construction: _ Is the well head 12"above land surface YES r NO
If unknown, was it drilled before 1972? YES or NO f.f no, what is the height of the casing: inches
If unknown,was it drilled before 7/1/2008?YES or NO Is there a sanitary well seal? YES r NO
What type of well is it: Is the sanitary well seal in good repair or NO
Drilled ore Hand Dug Jetted Other Are the following items present at the well head?
Does the well have a cement slab? or NO Vent IV J Sample Tap No
Well Tag No Pump Tag N 0
Does the well appear to be grouted?OpEl) or NO
Potential Sources of Contamination?
Does the well currently meet separation requirements with known sources of contamination YES or NO
If no,please provide distances to those it does meet:
Other comments:
Complete below.
Name of person completing this form (please print): S I
4312 District Drive
`; MSC 1918
-}-•fr North Carolina State Laboratoryof Public Health
II �` � Raleigh.NC 27699-1918
idi ••��1 Environmental Sciences http//slph.ncpublichealth.com
Phone: 919-733-7308
� �""` 7 Inorganic Chemistry ry Fax: 919-715-8611
Certificate of Analysis FINAL REPORT
Report to: ENVIRONMENTAL HEALTH Name of System:
CATAWBA COUNTY ENVIRONMENTAL HEALTH Christopher Smith
P O BOX 389 6391 N NC 16 Hwy
NEWTON, NC 28658 Conover, NC 28613
EIN: 566001814EH Delivery: NC Courier
StarLiMS ID: ES230525-0052 Date Collected: 05/24/2023 Time Collected: 09:50 By: Jason Boyd
Date Received: 05/25/2023 Time Received: 08:07
Sample Type: Raw Sampling Point: Outside spigot at well Well Permit No. SAM04-2023-194321
Sample Source: Well water Receipt Temp. : GPS Number:
Profile: Inorganic Chemical+ Metals I
Analyte Test Result Allowable Limit Unit Qualifier(s)
Arsenic <0.001 0.010 mg/L
Barium 0.184 2.0 mg/L
Cadmium <0.0005 0.005 mg/L
Calcium 8 mg/L
Chloride 41.8 250 mg/L
Chromium <0.02 0.10 mg/L
Copper 0.014 1.3 mg/L
Fluoride <0.1 4.00 _ mg/L
Iron <0.06 0.30 mg/L
Lead <0.003 0.015 mg/L
Magnesium 6 mg/L
Manganese 0.015 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 12.8 mg/L
Sulfate <5 250 mg/L
Total Alkalinity 8 mg/L
Total Hardness 48 mg/L
Zinc <0.05 5.0 mg/L
Report Date: 06/06/2023 E,, ` Reported By: _�
ED
RFC
Marc Komlos
J U N 1 2 2023
Environmental Health
Page 1 of 1
;_,„ „..�..,>,= No ROY COOPER • Governor
,."ra . � '',, NC DEPARTMENT OF
> KODY H. KINSLEY • Secretary
A HEALTH AND
,t•
o! HUMAN SERVICES HELEN WOLSTENHOLME • Interim Deputy Secretary for Health
. �._ MARK T. BENTON •Assistant Secretary for Public Health
Division of Public Health
Onsite Water Protection Branch
May 26, 2023
Christopher Marcus Smith
6391 N NC Hwy 16
Conover, NC 28613
Re: Approval No. JMB3034
Private Well Located Less than 25' from Building Perimeter [Rule 15A NCAC 2C
.0107(a)(2)(P)]
Property location:
6391 N NC Hwy 16
Conover, NC 28613
Dear Mr. Smith:
On May 25, 2023, the On-site Water Protection Branch received your request for a
variance from the Well Construction standards, Title 15A North Carolina Administrative
Code Subchapter 2C .0100. The request for the variance concerns a water supply well on
the referenced property. A structure is proposed to be within twenty-five feet of the well.
Specifically, the variance request grants you permission to use a water supply well at a
distance closer than the twenty-five-foot setback to a building perimeter. Achieving the
twenty-five-foot setback would be difficult given the challenges of the property.
Based upon information provided by you, and the Catawba County Health
Department, it is my finding that based upon current conditions as the site exist today
(as well as the current proposal for use of the structure) you meet the conditions
necessary for approval of a variance as specified by 15A NCAC .0118 (a) (1) and (2).
On that basis and if the following conditions are met, the requested variance is
approved:
NC DEPARTMENT OF HEALTH AND HUMAN SERVICES • DIVISION OF PUBLIC HEALTH
LOCATION:5605 Six Forks Road,Raleigh,NC 27609
MAILING ADDRESS:1642 Mail Service Center,Raleigh,NC 27699-1642
www.ncdhhs.gov • TEL:919-707-5874 • FAX:919-845-3972
AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER
1) The well/wellhead shall meet all current 2C. 0100 standards, including but not limited
to being properly grouted,terminated at least 12" above land surface, properly
sealed, and having a thread-less sample tap etc.
2) The well shall be sampled for the same parameters required of a newly constructed
well. If samples indicate contamination, further repairs or treatment will be necessary.
3) No potential sources of groundwater contamination shall be stored near the wellhead.
4) No termite treatment shall be applied to the structure within twenty-five feet of the
well unless alternative methods are approved by Catawba County Health Department.
The granting of this variance is for the well location only. It in no way relieves the owner
or agent from other requirements of the North Carolina Well Construction Standards
including, but not limited to the requirements in 15A NCAC 2C .0113(b) to repair or to
abandon any well which acts as a source or channel for the migration of contamination.
This approval does not imply sufficient water quality. Further,the approval does not
relieve your responsibility to comply with any other applicable Federal, State, or local
laws or regulations.
If you have any questions regarding this variance, please contact me at (828) 713-3335.
Sincerely,
John M. Brooks R.E.I-I.S, MS
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: Christopher Smith Sample ID Number: 194321
Location: 6391 N NC 16 Hwy, Conover NC 28613 Reviewer: Megen McBride
Initial Sample X Confirmation Sample:
BIOLOGICAL ANALYSIS RESULTS ANI) RECOMMENDATIONS FOR USES OF YOUR
PRIVATE WELL WATER(These recommendations are based on biological analysis only.)
X 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 arc 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
4-7 1,71'
.. � Private Well Information
and Use Recommendations
NC DEPARTMENT OF
HEALTH AND HUMAN SERVICES
Division of Public Health For Inorganic Chemical Contaminants
County: Catawba Name: Christopher Smith—6391 N NC 16 Hwy, Conover NC 28613
Sample ID#: 194321 Reviewer: Megen McBride
TEST RESULTS AND USE RECOMMENDATIONS
I. ® 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 on(v. 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 I lealth 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). I lowever, it may be used for
washing, cleaning, bathing and showering based on the inorganic chemical results only.
❑ Arsenic ❑ Barium ❑ Cadmium ❑ Chromium ❑ Copper ❑ Fluoride ❑ Iron
❑ Lead ❑ Manganese ❑ Mercury ❑Nickel ❑Nitrate/Nitrite ❑ Selenium n Silver
❑Zinc
3.❑ While your lead levels do not exceed federal or state standards, the North Carolina Division of Public I-lealth 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. "fake 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(v, 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 Chloride n Copper _ ❑ Fluoride n Iron El 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/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 on(v.
❑ 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 gf Public Health at 919-707-5900.
pH, Total
Alkalinity &
WELLSPRIVATE
Al 0
.10
What are pH and total alkalinity?
pH is a measurement of the acidity or basicness of
water.Water with a pH less than 7 is acidic.Water
that has a pH greater than 7 is basic.Water the has a
pH of 7 is neutral,neither acidic nor basic.
•
Total alkalinity is a measurement of the capacity for ._.,
water to resist changes in pH. ' •
What affects the pH level acceptable range for pH.This standard was developed
and total alkalinity in to prevent metallic or sour taste,slippery feel,and pipe
my private well water? corrosion.There are no health-based standards for pH.
pH levels and total alkalinity depend on the amount The US Environmental Protection Agency or
of minerals like carbonate,bicarbonate,and NC Department of Environmental Quality have not
hydroxide in groundwater. developed standards for total alkalinity.
How can pH and total How do I test for pH and total
alkalinity affect my health? alkalinity in my private well?
High and low levels of pH can cause gastrointestinal Use a certified lab or buy test kits at your local home
problems.Low pH (less than 4)can cause skin and improvement store to test for pH and total alkalinity
eye irritation.High pH (greater than 10)can cause in your well water.Contact the private well program
hair damage.High and low pH can cause corrosion at your county health department to assist you with
which may cause more harmful contaminants to getting your water tested.Pricing of testing varies
enter groundwater. from county to county.
Alkalinity cannot impact your health.
What if my water is acidic
What level of pH and total or alkaline?
alkalinity should I be If you are concerned about the taste of your
concerned about? well water,you can install a treatment system to
The US Environmental Protection Agency or neutralize the acidity or alkalinity of your private well.
NC Department of Environmental Quality developed A neutralizer is a treatment system that can reduce
an aesthetic standard for pH of 6.5 to 8.5 being an the acidity or alkalinity of your well water.
Percent of Private Wells Tested
Outside of State and Federal Guidelines for
pH, 2011-2013
•
■ 1101011111.
40p .411
>75%outside guidance range --- Y
- 50.1-75%outside guidance range
-25.1-50%outside guidance range /
<25%outside guidance range
0%outside guidance range
Insufficient data(<10 wells tested) du—
What are the pH and total Where did this information
alkalinity levels in NC? come from?
The pH of private well water varies across NC US Environmental Protection Agency:www.epa.
(3.2-11.6),see map for areas with pH outside qov/sites/production/files/2015-09/documents/
of guidance range(6.5-8.5). 2009 03 13 estuaries monitor chapl 1.pdf
Total alkalinity of private well water varies across and https://safewater.zendesk.com/hc/en-us/
NC ranging from 0 1,020 mg/L. articles/211406048-What-is-the-difference-between-
pH-and-alkalinity-
Where can I find more World Health Organization:www.who.int/water
information about pH, total sanitation health/dwq/chemicals/ph revised 2007
alkalinity and my well? clean version.pdf
Water Quality Association:www.wga.org/learn-
Visitthe NC Division of Public Health's Private Well about-water/perceptible-issues/corrosion/acidity-
and Health Program website:http://epi.publichealth. low-ph-
nc.gov/oee/programs/wellwater.html.
There you can find:
• Contacts for your county private well program
• pH and Total alkalinity in well water maps
• A guide for selecting a treatment system
• Other private well resources
You can also call the Private Well and Health Program
at 919-707-5900.
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