HomeMy WebLinkAboutSAM-06-2023-198849.TIF AVA CG Case# SAM-06-2023-198849
CATAWBA COUNTY HEALTH DEPARTMENT
Environmental Health Section`Q
18 4 2 sM 06/27/2023
WATER SAMPLE FIELD REPORT
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Applicant SONNIE YANG,2882 ZION CHURCp RD,HICKORY NC 28602
C:8288555916 S v a rt c1• f e, �I 5 a@ yyNp; I,C oY►�
Site Address: 2882 ZION CHURCH RD,HICKORY NC 28602
Parcel Number: 361909075277
Driving Directions Hwy 10,turn right on Zion Ch Rd,after you pass the bridge will he the first home on the right
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Sample Collected by: Tw " t• 11l 1 Date/Time Sampled: 0'1//,7/a3 I! Dlr
Sampling Point: 1 ' '-t2A1 k0. ' ()^ S ��CI — 6-E k0ufe
Is well head accessible? Yes No 1/ Reason for inaccessibility H o vy wool C43 if
Well New or Existing? New Existing 1/
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:
rsamfieldreport 06/27/2023 16:41 Page 1 of 2
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Case# SAM-06-2023-198849
CATAWBA COUNTY HEALTH DEPARTMENT
Q 1119 0 `-5(
/8 42 sm Environmental Health Section
06/27/2023
WATER SAMPLE TEST RESULTS
Applicant SONNIE YANG,2882 ZION CHURCH RD,HICKORY NC 28602
C:82885559I6
Site Address: 2882 ZION CHURCH RD,HICKORY NC 28602
Parcel Number: 361909075277
Lab Coliform Analysis Results: Total Coliforms: cacva-cf,Lo Fecal/E.Coli: cova2...nk#
No Collection Date Over 30 hours old
Invalid Results: Excessive turbidity Excessive Chlorine
Lab Accident ____
0/1-
Lab Tech Initials IN
Date/Time Received co.% 11-14r)0 iq30
Date/Time Completed C14/6(0/202 icisi.A.
RECEIVED
i: ,
Environmental Health
rsamfieldreport 06/27/2023 16:41 Page 2 of 2