HomeMy WebLinkAboutWELL-05-2023-195794.TIF I t
CATAWBA COUNTY Case# WELL-05-2023-195794
�'�� Subdivision MORNINGSIDE HEIGHTS SUP
Public Health Department
' PIN# 374019606161
d Environmental Health Division
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 11-18&47-54
1842 .
Site Address: 1674 MORNINGSIDE DR, NEWTON NC 28658
Name on Permit: *CONSTANTINO CARBALLO
Property Size: Acres 1.56
Directions: NC 16 Bus to S NC 16 Hwy Right onto Debra Drive left onto morning side home is on the right
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/Rivers25 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.
PERMIT CONDITIONS
*WATER LINE MUST BE RUN ON FRONT SIDE OF HOME
*NOT ENOUGH ROOM BETWEEN SEPTIC AND HOME TO RUN WATER LINE ON LOWER SIDE OF HOME
*WATER LINE LOCATION MUST BE APPROVED BY EHS BEFORE WELL CAN BE FINALED
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 18A.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.
05/16/2023
Authorized State Agent Permit Issuance Date
5/16/2028
Permit Expiration Date
ehpennit 05/16/2023 09:16
Catawba County Environmental Health
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Parcel: 374019606161, 1674 MORNINGSIDE DR 1in=50ft
NEWTON, 28658
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 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 2023 Catawba County NC
05/16/2023
6/2/23, 12:06 PM about:blank
(9, WPDT Screening Report
Area of Interest (AOI) Information
Area : 3,134,508.76 ft2
Jun 2 2023 12:05:40 Eastern Daylight Time
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6/2/23, 12:06 PM about:blank
1674 Morningside Dr
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I Pont form
WELL CONSTRUCTION RECORD(CW-l1 for Internal Use Only
1.Well Contractor Information.
Robert Teague I4.WATER ZONIIS
mom to DiRatirnON —
*cis Con ter Vatae ) 1( 5 n•7-4)D ft iZ 6� Ii-+ ..._ ,
2857-A ft. ft.
NC well Contractor Cem!katmtn Number It.OMER CASING(far mild eased wells)OR LINER at apelfabk]
B&K Well Dolling Inc mum Tq 1 DIAMEtiR WNICKOESS MATERIAL
D n• L/5 ft. li,,e in, soR.21 we
Cody Name
^+N IL INNER CASING OR'RISING(p.tbsrau_d dRIAltiaap)
2.Well Construction Penult 9:�A01. //_ ICI S,�)) mom 10 DIAsILtEn TiticKNUSS MATERIAL
tut alllgvhcas/r ore coammtneaprram'a r UK:Cowin.Stair i'rrlidf nr,of h H. In.
3.\Neil t se(check well toe): R. n. M.
\\Ater Supply Well: 17.SCREEN
�•-� FROM TO DIAMETER SLOT SIZE THICKNESS NIATtRtAL
I--1 4xTcu:turai 0M(tnutpaliPubllc ft. ft. ter.
C]`�nothetmal(Heats Cootie Supply) Residential Watet Supply(single)
rag Cooling uPPY 0 upP>' & fc ft. in. }
0 ndustria)Commer=WResidential Water Supply(shared)
III.GROUTn TIQansn FROM TO MATERIAI, 1 EM PLACEMEN METHOD&SMOI.1T
Non-Water Supply Well: n, i IL ;
'Monitoring ORnos'e ft. n. I
Injection\Nall:
Aaurfcr Recharge �Groundwatcr Rcmediaiion rt. ft. f
19.SAND/GRAVEL PACK(if applicable)
13 Aquifer Storage and Recovery []Salinity Barrier FRost I TO I MATERIAL EMPLACEMENT METHOD
C]Aoulfer Test DStormwater Drainage f ft.
C3!.yrnmcnatTechnology [Subsidence Control ft. ft.
C7 Geothermal(Closed Loop) 0 Tracer 29.DRILLL\C LOG launch additioaal Anti if ailoaaaf2? ra )
C)i
ritOM TO T niS a
CRIPT ION(color.hardens.stAtr ►n or
pa. e
mothennai(Heating,Coolliing Return) Other(explain under A21 Remarks) rt. �� ��C�ti
4.Date ell(s)Completedh -S.. Well LDa 5 1165
bS ft..
()�- jj i e
Sa.Well Location: ? c ) n. 6$ n- hc2.e`r) 3 co- /ZFt/k
R. R. i
Faciltry tJtnaa Nan= Pectins Ito Of applicabtel
R. ft.
1LiLI PAN 7' r111iny5 ;Cc (oat � � R.
ni Phca:Aailresa,On.and ztp
C , is`_ h)C` 21.REMARKS
County Pared Identification No IPIN)
Sb.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(ewe field,ors:al long is sufficiem) 22.Certification:
N W ! j
b.'starel the ss rill s)�Permanent or Temporary Stout nftca,ftedt►cliC nc.or Date
b'i swing:hi him I irrrrfii(1K0 Mar tar.r/1rt)eat/eri maw-wine w arawtfta.
7.Is this a repair to an rusting tscil: pl rs or P\o mink/Sec 3C.ICO2C won or 13.1.\'C.COK 0200 tsi/iCansmwcnoa Standards and?bpi
O'tA:a ct a,r'_- : ... , .-Sint i nrotriic.,w c y',,s,,:rn,s«nJ tp/lil fAr etarr..f:nr c.qn a:Ali re:urrl Aar frets pn„-,:!,-.!r,!Ile..el'a wee.
spier air.•: •r-_•.•,a ,oicm:lw back et Maj farms
23.Site diagram or additional tsrll details:
S.For Geoprobe DPT or Closed-Loop Geothermal Wells hosing the same You rr y we the back of tf., :.1 se to provide additional well site details or well
trottsuuenon,only I GN_I is needed. Indicate TOTAL NUMBER of wells construction devils You n>a:also attach additional pages if necessary
drilled. 1 St ONO TTAL INSTRUCTIONS
9.Total wen depth below laid surface: 3 U -5 (ft.) 24a.for All Wells: Submit this form within 30 days of completion of wet!.
Fer wr/rip'e Seas lot ail dep tt 1diferent trratnple.3g200'and 24/001 construction to the following
10.Static water level below top of cuing:40 (ft.) Dis)slon of Water Resources,Information Processing)'nit.
((etaaer ktri e.IArne cosset:oast.• 1617 Alai,Service Center,Raleigh.NC 27699-1617
I I.Borehole diameter: 6 118 (in.) 24b.For Injection Wells: In addition to sr;ding the form to the address in 24a
Air Rotary above.also aubmit one cops of this fnnr within 30 days of completion of well
12 N ell construction method: construction to the follow in
, a a.ari.rutart,.able.direct push etc 1
Division of\tAter Resources,1ndrrground Injection Control Program.
FOR w ATER SI PPla'WELLS ONLY: I616 lail Service Center.Raleigh.NC 27o99.lo3o
13a.1 jell ti Pnq ) \lrthod of test: Air Flow 24c.for \\ate: Suppy cic Injection Wells: In addition to sending the form to
the address(es) above. also submit one copy of this form sstthin 30 days of
l36 Disinter Elton tope: i,itlor Tabs Amount: I u'2t°s completion of well construction to the county health department of the county
where constructed
f cr,,-w \orih Carolina Ds-po rrcm of Fr,Ito::mccu'Q.a,r*..,0:,s'o,of Warcr R.-soartr► Roaiet 2.22-2,21a