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Home My WebLink AboutWELL-06-2023-198627.tif • CATAWBA COUNTY Case# WELL-06-2023-198627 t. Public Health Department Subdivision CRESCENT LAND AND TIMBI ,�0 "�C Environmental Health Division PIN# 461 601 07647 1 PO Box 389,25 Government Drive,Newton,NC 28658 LOTH 15 1H. sr Site Address: 8193 DRAKE CT, SHERRILLS FORD NC 28673 Name on Permit: MICHAEL(RODNEY)*BRANTLEY Property Size: Acres 0.71 Directions: Slanting bridge rd turn on Drena,turn on wellbom, turn on Drake t. Owner/Authorized Representative Acknowledgement of Permit Receipt I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of the property described above. As the property owner or authorized representative, I have received the above referenced permit(s)as requested in the application for service RBPR-05-2019-31903,by the following method(s): Received in Person Facsimile Transmittal(Return form with signature required) Electronic Image Transmittal/E-mail (Return receipt required) 'i As the property owner or authorized representative I have reviewed and understand the specific conditions `J of the permit issued, and further understand that all applicable regulatory requirements specified under the North Carolina Laws and Rules for Sewage Treatment and Disposal Systems(15A NCAC 18A.1900), and/or Well Construction Standards(15A NCAC 2C.0100), shall apply to the issuance of this permit and the construction of the wastewater system and/or water supply well permitted. Permit Issue Date: 06/22/2023 Owner/Authorized Representative Signature Date Documentation of Permit(s) Transmittal (permit transmitted by electronic or other means) Permit transmitted by (name of'person sending permit) Signature C„ Date/Time �/� �! 7 j Method: Fax V Email US Mail Other Owner's request to send by the above indicated method of transmittal in lieu of signature We wantt tto hear from youPlease ttake a few momentts tto complette our custtomer service survey aft http://www.surveymonkey.com/s/EHCusttomerService rod t\oy 0. CastAin sector, i ne. ov ehpeouis 06/22/2023 16:34 �$• CATAWBA COUNTY Case# WELL-06-2023-198627 23: .r.i11111k. Public Health Department Subdivision CRESCENT LAND AND TIMBE '" Environmental Health Division PIN# 461601076471 ..,...) PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 15 /84i .. Site Address: 8193 DRAKE CT,SHERRILLS FORD NC 28673 Name on Permit: MICHAEL(RODNEY)*BRANTLEY Property Size: Acres 0.71 Directions: Slanting bridge rd turn on Drena,turn on wellbom,turn on Drake t. WELL REPAIR 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/Rivers 25 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 Adding casing to raise well head to at least 12 inches above ground surface for variance approval. 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 nee+R constructed private drinking water wells are required to be sampled in accordance with the North Carolina Rules Regarding Private Drinking Water Well Testing(I5A 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. fiii2,(„ 06/22/2023 Authorized State Agent Permit Issuance Date 6/22/28 Permit Expiration Date cIq'rnnit 06'22,2023 16:38 RBPK- Os-)or -31903 S193 I ak €,C+, 5hcrr;l\s 1ord vkv \av 30' Riw old We11ov � Exisft well , add 0 0 `0" ` �Kfin . of\ . Q l Qedrocrn 13. 1 Eloust, r ECPalinridd �K S � �G� 9 63' .33' �� NOfMart IIs'Lib' 444$A case ammiWELL-06-2023 T 9862�P Y t �� CATAWBA COUNTY HEALTH DEPARTMENT .<(-) arl ®.' 4 Environmental Health Section /8 4 2 sml 07/05/2023 WATER SAMPLE FIELD REPORT Lien Agent NO LIEN AGENT RliQt1IRED,, F:000000000 Owner MICHAEL(RODNEY)*BRANTLEY,3212 N ALEXANDER ST.CHARLOTTE NC 28205 C:704-361-8358 DBOLAN60lieGMAIL.COM Contractor SAME AS OWNER,. Site Address: 8193 DRAKE CT,SI IERRILLS FORD NC 28673 Name of Subdivision: CRESCENT LAND AND TIMBER CORP Parcel Number: 461601076471 Driving Directions Slanting bridge rd turn on Drena,turn on wellborn,turn on Drake t. Sample Collected by: ,]/wi301 ; -4't Date/Time S,I nip led: 0 7//1/ -3 5 " 30 Sampling Point: a.w-pLZ, Like Is well head accessible? Yes V No Reason for inaccessihilil\ Well New or Existing? New / Existing Type of Well: Drilled ✓ Bored I land 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: rsamfieldreport 07/05/2023 12:02 Page I of 2 (z,,d�i"5e Case it WELL-06-2023-198627 Ii , t Zi CATAWBA COUNTY HEALTH DEPARTMENT 1 v ,�, AIEnvironmental Health Section \U 42 sM 07/05/2023 WATER SAMPLE TEST RESULTS Lien Agent NO LIEN AGENT REQUIRED , F:000000000 Owner MICI[AFT(RODNEY)*I3RAN I'I,IT.Y.3212 N Al l XANDFR S'I'.CIIARLOTTF NC 28205 C:704-361-8358 DROLAN60td1GMAII,.('OM 1D a l l g s R. B. I A r‘ Contractor SAME AS OWNER,, Site Address: 8193 DRAKE CT,SHERRILLS FORD NC 28673 kth 461e 40 r e1�t, Lb\) 1�oh e. Name of Subdivision: CRESCENT LAND AND TIMBER CORP 2�q�' 1 t�S r�IGT'�ahS �l h o� Parcel Number: 461601076471 in!{ II dri'IlB,rs !Isi- fo abov.? ew\.'1\ al6tatResf. Lab Coliform Analysis Results: Total Coliforms: V(e'Cint Fecal/E.Coli: mint I No Collection Date Over 30 hours old Invalid Results: Excessive turbidity Excessive Chlorine I.al-)Accident Lab Tech Initials D'ri Date/Time Received V ' 1I I.Fralill) 14W Date/Time CompleterOV 0)14° 14 Ps a—/'''r— \ 'r-- J U L 1 3 2023 Environmental Haan rsamfieldreport 07/05/2023 12:02 Page 2 of 2 1 J Analytical Results STATESVIII,F, ANALYTICAL Catawba County Public Health � s PO Box 389 Newton, NC 28658 Receive Date: 07/12/2023 Reported: 07/14/2023 For: Michael Brantley 8193 Drake Ct Sherrills Ford NC 28673 Comments: Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst 230712-21-01 Nitrate 06-2023-198627 <1 mg/L 353.2 07/13/2023 CL 230712-21-01 Nitrite 06-2023-198627 <0.1 mg/L 353.2 07/13/2023 CL Respectfully submitted, J"j e&GD,Be J. ?2p ) Melissa Myers �/ NC Cert#440, NCDW Cert#37755, EPA#NC00909 PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 1 of 2 . . ::..:,..*.'4,:t Ssmos S:..,,,,vs,,,J...;,;•:..^.;1.v;•.,-; . 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