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HomeMy WebLinkAboutWELL-08-2023-202163.tif • CATAWBA COUNTY iCase# WELL 08-2023 202163 -t. Public health Department Subdivision , , Environmental Health Division PIN# 460703430652 PO Box 389,25 Government Drive,Newton,NC 28658 LOT# tw Site Address: 7462 GABRIEL ST, SHERRILLS FORD NC 28673 Name on Permit: JEFFREY HALLMAN Property Size: Acres 0.53 Directions: NC 16, left onto Buffalo Shoals Rd, right onto Little Mountain Rd, left onto Gabriel St, property on the right REPLACEMENT WELL PERMIT VARIANCE WELL See attached state well variance approval for well construction standards and setbacks. Wells shall be constructed in accordance with state regulations: Article I 5A 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 the required setbacks,contact Catawba County Environmental Health at 828-465-8270, before drilling the well Casing Height: 12 inches minimum above finished grade All newly constructed private drinking water wells are required to he sampled in accordance with the North Carolina Rules Regarding Private Drinking Water Well Testing(I5A NCAC I8A.38001.The tee 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. 414A fillbcl 08/08/2023 Authorized State Agent Permit Issuance Date 8/8/2028 Permit Expiration Date chpcmait 08/08/2023 15;59 �v9ll� a�' Zvz5- 2o2J 6 '3 Catawba County Environmental Health AP See i%C e 6. t'k, Ergs ipppop5.86 ?gg 85 cc s c hitior, 8 r `prt, ri 16 il I'l � I a 430 • 29.E • , ,.:........7 1 heel .itS‘-fn. \. • . *7483 S . • Parcel: 460703430652, 7482 GABRIEL ST 11n=40ft SHERRILLS FORD, 28673 This map/report product was prepared from the Catawba C ,NC Caosp�al information 8ecvfoss. Catawba has made substantial efforts to ensure the sodomy of location and labeling Mvrmatlon n k ed on Pie map or data on this report Catawba Ca promotes and recommends the independent vMMloation of any data contained on this maplrapod product by the user.The County of Catawba,Ms employees, and personnel,disclaim and shall not be held liable for any and al damages,loss or liability,whether direct,indirect or oonsequenbat which arises or may arise from this map/report product or the use thereof by any person or entMy. Copyright 2023 Catawba County NC 08/01/2023 s c STATF q -"W. � ti ROY COOPER • Governor I y` NC DEPARTMENT OF KODY H. KINSLEY • Secretary w p HEALTH AND ;' : , HUMAN SERVICES HELEN WOLSTENHOLME • Interim Deputy Secretary for Health MARK T. BENTON •Assistant Secretary for Public Health Division of Public Health Onsite Water Protection Branch August 8, 2023 Jeffrey Hallman 7462 Gabriel St Sherrill's Ford,NC 28673 Re: Approval No. JMB3127 Private Well Located Less than 25' from Building Perimeter [Rule 15A NCAC 2C .0107(a)(2)(P)] Property location: 7462 Gariel St Sherrill's Ford,NC 28673 Dear Mr. Hallman: On August 4, 2023, the On-site Water Protection Branch received your request for a variance from the Well Construction standards, Title 15A North Carolina Administrative Code Subchapter 2C .0100. The request for a variance concerns a proposed water supply well on the referenced property that will serve a single-family dwelling and part of a structure on the property will be within twenty-five feet of the well. The home is on a lot with very difficult topography. Specifically, the variance request grants you permission to construct a water supply well at a distance closer than the twenty-five-foot setback to a building perimeter. Achieving the twenty-five-foot setback would be difficult given the challenges of the property. Based upon information provided by the Catawba County Health Department, and the property owner, it is my finding that based upon current conditions as the site exist today(as well as the current proposal for use of the structure) you meet the conditions necessary for approval of a variance as specified by 15A NCAC .0118 (a) (1) and(2). On that basis and if the following conditions are met, the requested variance is approved: NC DEPARTMENT OF HEALTH AND HUMAN SERVICES • DIVISION OF PUBLIC HEALTH LOCATION:5605 Six Forks Road,Raleigh,NC 27609 MAILING ADDRESS:1642 Mail Service Center, Raleigh, NC 27699-1642 www.ncdhhs.gov • TEL:919-707-5874 • FAX:919-845-3972 AN EQUAL OPPORTUNITY!AFFIRMATIVE ACTION EMPLOYER 1) The new water supply well shall be constructed of either PVC, steel, or galvanized metal casing. 2) The well shall be located as far as possible from the structure where, depending upon where well rig can actually set up, will possibly encroach upon the 25foot setback, but not be closer than 10feet. 3) A preconstruction meeting shall be required with the Catawba County Health Department staff to ensure that the maximum possible distances are achieved. 4) The well will be required to have casing installed to a minimum of 43 feet below land surface or to bedrock, whichever is greater. 5) The well shall be at least fifty feet from any part of the septic system including repair area. 6) Grout will be required the entire length of the casing from land surface into bedrock. 7) A drill bit with a diameter of at least one third greater than the diameter of the casing must be used to drill the cased portion of the well. 8) Grout must be either pumped into place with the use of a tremmie pipe or pressure method. 9) If a full-length grout is not possible due to site conditions,then a packer-liner must be installed in the well. The liner must extend at least five feet beyond the end of the casing and grouted entirely with a neat cement grout. 10)The well must be constructed outside of any road right of way. 11)A grout inspection must be performed by the Catawba County Health Department. The granting of this variance is for the well location only. It in no way relieves the owner or agent from other requirements of the North Carolina Well Construction Standards including, but not limited to the requirements in 15A NCAC 2C .0113(b)to repair or to abandon any well which acts as a source or channel for the migration of contamination. This approval does not imply sufficient water quality. Further, the approval does not relieve your responsibility to comply with any other applicable Federal, State, or local laws or regulations. If you have any questions regarding this variance, please contact me at(828) 713-3335. Sincerely, John M. Brooks R.E.H.S, MS 2 Print Form WELL CONSTRUCTION RECORD (GW-I) For Internal Use Only: 1.Well Contractor Information: Robert league 14.WATER ZONES Well Contractor Name FROM 'I'O DESCRIPTION 2857-A /4/Bp-LSO ft. 3� 6.p/�p+'�.„ NC Well Contractor Certification Number7� �. ft a C) 1 /yJ 15.OUTER CASING{for multi-caw wee OR LINER(if ap Ncable) B & K Well Drilling Inc FROM TO//��� DIAMETER THICKNESS MATERIAL Company Name 6 It. S`J ft' 8„8 in' SDR-21 PVC h 16.INNER CASING OR TUBING(geothermal closed-loop) 2.Well Construction Permit#: `'�j\ ..3 — �'A',-? FROM TO DIAMETER THICKNESS MATERIAL List all applicable well construction permits(Le.U/C.County,State. Variance,etc.) O ft. Go ft. // in. f i/�V'' v 3.Well Use(check well use): ft, ft, in. Water Supply Well: i7,SCREEN • FROM TO DIAMETER SLOT"SIZE THICKNESS MATERIAL ©Agri eultural Municipal/Public al/Public Q P ft. ft. in. °Geothermal(Heating Cooling Supply) Residential Water Supply(single) . ft. ft. in. °Industrial/Cornmercial °Res idential Water Supply(shared) 15.GROUT ',Irrigation FROM TO 1TERIAL EMPLACEMENT METHOD&AMOUNT Non-Water Supply Well: 0 ft. AMR G ` �� 0 Monitoring °Recovery ft. ft. )'t infection Well: uifcr Recharge ft. ft. A 9 6 °Groundwater Rcrnediation °Aquifer Storage and Recovery19.SAND/GRAVEL PACK(if applicable) °Salinity Barrier FROM TO MATERI.AI. EMPLACEMENT METHOD °Aquifer Test °Stormwater Drainage ft. ft. c)Experimental Technology °Subsidence Control ft. ft. °Geothermal(Closed Loop) °Tracer 20.DRILLING LOG(attach additional sheets if necessary) �Geothetmal(Heating/Cooling Return) Other(explain under 421 Remarks) FROM 'ro DESCRI TIOK(color. dne,a.a ivrocIt type,grain aixe,eta.) t't.▪ R, t r l 4.Date Well(s)Completetq..I)'". 3 Well ID# ft. �W f1. Cx n) �' ? (, 0 I1 5a.Well Location: 7 r. Sf.• S rt. ncr .,c‘ l / tJ Facility/Owner Na c Facility iD*(if applicable) it. ft. 74/ r- 00be,l 1 , ,Sherri IIs)071 it. it. Physical Address,City,and Zip ft. ft. CaAr)41)190, 21.REMARKS County Parcel Identification No.(PIN) Sb.Latitude and longitude in degrees/minutes/seconds or decimal degrees: (if well field,one lot/long is sufficient) 2 2. N W ..z,,i f_ _ 9- )ram cZ_3 6.Is(arc)the well(s)0Permanent or °Temporary rc ofC — Date By signing this loin, 1 herein'ceriJi'that the wilful teat(were)c'anstrucied in accordance '61 7.Is this a repair to an existing well: Yes or o with 15.E NCAC 02C.oloo or/S:I','CAC USC.0200 feel!Construction Standards and that n If this is a repair,fill out known well cnn.cv'uc'i in "nation n c Clain the nature of the copy of this rrwrd has been provided to the u'e//owner. repair under#21 remarks section or on the boo(of this form. 23.Site diagram or additional well details: You may use the back of this page to provide additional well site details or well 8.For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same construction details. You may also attach additional pages if necessary. construction,only I GW-I is needed. Indicate TOTAL NUMBER of wells drilled: c—• SUBMITTAL INSTRUCTIONS 9.Total well dep below land surface: --� (ft.) 24a. For All Wells: Submit this form within 30 days of completion of well For multiple we/Ls list all depths if different(example- 'w?00'and?@u 100'1 construction to the following: 40 10.Static water level below top of casing: ft. If Kates letet is above casing,use"- ( ) Division of Water Resources,Information Processing Unit, 6 1/8 1617 Mail Service Center,Raleigh,NC 27699-1617 11.Borehole diameter: (In.) 24b. For Injection Vvells: In addition to sending the form to the address in 24a 12.Well construction method: Air Rotary above,also submit one copy of this fort within 30 days of completion of well (i.e.auger,rotary,cable,direct push.etc.) construction to the following: FOR WATER SUPPLY WELLS ONLY: Division of Water Resources,Underground Injection Control Program, 1636 Mail Service Center,Raleigh.NC 27699-1636 r 13a.Yield(gpm) 1 l7 Method of test: Air Flow 24c. For Water Supply & Injection Wells: In addition to sending the form to Chloe Tabs 112 Lbs the address(cs) above. also submit one copy of this form within 30 days of In.Disinfection type: Amount; completion of well construction to the county health department of the county where constructed. Form CW-I North Carolina Department of Environmental Revised 2-22-2616 Quality-Division of Writer Resources