HomeMy WebLinkAboutWCOC-05-2023-196048.tif `. CATAWBA COUNTY Case# WCOC-05-2023-196048
II( Public Health Department Subdivision MOUNTAIN CREEK RIDGE
Environmental Health Division PIN# 369803206692
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 25
Site Address: 3229 CREEK BEND CT,SHERRILLS FORD NC 28673
Name on Permit *CORNERSTONE III PROPERTIES INC
Property Size: Acres: 0.79
Directions: Little Mountain Rd,right on Mountan Creek left on Creek Bend,
WELL CERTIFICATE OF COMPLETION
Permit Number:WELL-01-2022-163670
DATE COMPLETED INSPECTION TYPE STATUS INSPECTOR
02/14/2023 EH Well Grouting No EH Inspection Robbie Phelps
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
03/16/2023 EH Well Head Approved Robbie Phelps
05/16/2023 EH Well Record Received Approved EH Admin
Advance 02/I4/2023
Well Driller Date Drilled
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05/16/2023
Authorized State Agent Issuance Date
diwdlouc 05/18/2023 10:12 Page 1 of 1
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ASSOCIATES P A ? n r} C✓rttiti k 6,244 Ct
"The LSS Evaluation is being submitted pursuant to and meets the requirements of
SL 2018-114 Section 11.(c)." 0 - o S -1oa3 - i 6 7
Soil Descriptions
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PIN or Tax Map # 369803206692 Lot # Lot 25 l