HomeMy WebLinkAboutWCOC-06-2023-197102.TIF CATAWBA COUNTY Case# WCOC-06-2023-197102
,z Public Health Department Subdivision LUTHER COWANS SHERRILL
4 Environmental Health Division PIN# 462801468655
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 4
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Site Address: 9476 RIVIERA DR.SHERRILLS FORD NC 28673
Name on Permit *MIKE PALMER HOMES, INC.
Property Size: Acres: 0.53
Directions: E.Hwy 10 to Murrays Mill RD South to Sherrills Ford RD,Left on Island Pointe RD,Left on
Riiera DR lot on left
WELL CERTIFICATE OF COMPLETION
Permit Number:WELL-03-2022-168580
DATE COMPLETED INSPECTION TYPE STATUS INSPECTOR
05/25/2022 Ell Well Grouting No EH Inspection Steven Price
Pursuant to I5A 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
06/17/2022 El I Well Record Received Approved EH Admin
12/21/2022 EH Well Head Failed Steven Price
no threadless tap. had spigot with no backliow preventer
05/22/2023 EH Well Head Failed Steven Price
no well tag
06/01/2023 EH Well Head Approved Steven Price
b&k 05/25/2022
Well Driller Date Drilled
06/01/2023
Authorized State Agent Issuance Date
ehneIIcoc 06/01/2023 11:46 Page I of 1
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Parcel: 462801468655, 9476 RIVIERA DR 1in=40ft
SHERRILLS FORD, 28673
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12/27/2022