HomeMy WebLinkAboutSAM-06-2023-198255.tif Case# SAM-06-2023-198255
CATAWBA COUNTY HEALTH DEPARTMENT
() ,,G, Environmental Health Section C.-'�,c10 Ca
1$4`7, sM 06/16/2023
WATER SAMPLE FIELD REPORT
Owner TAMMY LAWRENCE,3709 DEAL RD,CLAREMONT NC 28610
C:8284681115
Site Address: 3709 DEAL RD,CLAREMONT NC 28610
Parcel Number. 376304602196
Driving Directions N Lookoutk St,road name changes to Bunker Hill School Rd,left onto Deal Rd
Sample Collected by: .)14•,5ti I IL Clr_,1 DatelTime Sampled: o6/141/ t 35
Ah
Sampling Point: S'p1 � O r Si Dtr weU S kezt
Is well head accessible? Yes / No _ /Reason for inaccessibility
Well New or Existing? New Existing v
Type of Well: Drilled ✓ Bored Hand Dug Punch
Does well meet adequate construction standards from what can be observed: ✓ Yes No
Items of non-compliance: Evidence of improper grouting or no grouting
Well does not meet a required setback(comment)
Improperly constructed sanitary well seal
Well head not term at>= 12"above finished grade
Well head missing vent
Well head does not have a threadless tap
Well missing identification plate or pump tag
Wire conduit opening not sealed
Other(comment)
Comment:
rsamlicldrepoit 06/16,2023 12'11 Page 1 of2
$w• Cased SAM-06-2023-198255
F " CATAWBA COUNTY HEALTH DEPARTMENT
`, Environmental Health Section
lg 2 SM 06/16/2023
WATER SAMPLE TEST RESULTS
Owner TAMMY LAWRENCE,3709 DEAL RD,CLAREMONT NC 28610
C:8284681115
Site Address: 3709 DEAL RD,CLAREMONT NC 28610
Parcel Number: 376304602196
Lab Coliform Analysis Results: Total Coliforms: ifin+ Fecal/E.Coli: U 1:G 1
No Collection Date Over 30 hours old
Invalid Results: Excessive turbidity Excessive Chlorine
Lab Accident
Lab Tech Initials Date/Time Received OD• L\'9 `l'/ti Date/Time CompletedO(O ` LW
RECEIVED
J U N 2 1 2023
Environmental Health
rsainficldreport 06/16/2023 12:11