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AIUort Harkey
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D. REASON FOR VARIANCE REQUEST—include type of well(s) to be constructed; rule for which the variance is
being requested; description of how the alternate construction will not endanger human health and welfare and the
environment;and reason why construction and/or operation in accordance with the standards is not technically feasible
and/or provides equal or better protection of the groundwater.
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E. ATTACHMENTS—Provide the following information as attachments to this application:
(1) A map showing general location of the property (including road names, NC State Route Number, distances,
any key landmarks,etc.)sufficient for finding the well location.
(2) Detailed site map with scale showing location of proposed well relevant to septic system(s), building
foundations,property lines,water bodies,potential sources of contamination,other wells,etc.
(3) Submit a copy of the local well permit application and site evaluation map(if applicable).
(4) Any other information relevant to the variance request such as a well construction diagram showing proposed
well liner or atypical construction materials/methods.
F. OTHER MINIl1•I JM CONSTRUCTION REQUIREMENTS
For water supply wells, approval of a variance will require that additional construction requirements beyond those
specified in 15A NCAC 02C .0107 be mct. Minimum additional construction requirements for Coastal Plain and
Piedmont and Mountain region wells are referenced on Attachments A and B on pages 4 and 5 of this application.
Approval of a variance will not be considered in cases where the specified minimum additional construction
requirements cannot be met.
G. SIGNATURES
Signature of Person Responsible fur WeU Construction(typically the well driller)
Print or Type Full Name of Person Responsible for Well Construction
(typically the well driller)
4,1,1A A/—
Signature of County1 Efnvironmental Health Specialist
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Print or Type Full Name of County Environmental Health Specialist
Per 15A NCAC 02C.0118 the Secretary of the Division of Water Quality or the Division of Public Health may require
stibnniaal of information deemed necessary to make a decision on the variance, may Impose conditions as part of the
decision, and shall respond in writing to the request within 30 days of receipt of the variance request. A variance
applicant who is dissatisfied with the decision of the Director may commence a contested case by filing a petition as •
described in G.S. 150B-23 within 60 days after receipt of the decision.
Form GW-22V Page 2 Revised February 2013
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Parcel: 461604634563, 4897 KISER ISLAND RD 1 in=40ft
TERRELL, 28682
This map/report product was prepared from the Catawba County,NC Geospatial Information Services. Catawba County has made substantial efforts
to ensure the accuracy of location and labeling information contained on this map or data on this report.Catawba County promotes and recommends
the independent verification of any data contained on this map/report product by the user,The County of Catawba,its employees,agents,and
personnel,disclaim,and shall not be held liable for any and all damages,loss or liability,whether direct,Indirect or consequential which arises or may
arise from this map/report product or the use thereof by any person or entity.
Copyright 2023 Catawba County NC
09/27/2023
Julia English
From: Brooks,John M <john.brooks@dhhs.nc.gov>
Sent: Friday, September 29, 2023 11:09 AM
To: Robert Phelps
Cc: Julia English
Subject: [External] 4897 Kiser Island Rd
Attachments: HarkeyVarianceCatawba_Approval_JM B3189.doc
This is an external email. Please be cautious before clicking any links or attachments. If you have
questions about this email, please send them to suspiciousemailcatawbacountync.gov
Robbie,
I left in the house setback encroachment just in case.
John Brooks, REHS, MS
Environmental Health Regional Specialist
Division of Public Health, On-Site Water Protection Branch
N.C. Department of Health and Human Services
5605 Six Forks Road
1632 Mail Service Center
Raleigh, NC 27699-1632
Phone: 828-713-3335
John.Brooks@dhhs.nc.gov
http://ehs.ncpublichealth.com/oswp/
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
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Unauthorized disclosure of juvenile,health,legally privileged,or otherwise confidential information,including confidential information relating to an ongoing State
procurement effort,is prohibited by law. If you have received this e-mail in error,please notify the sender immediately and delete all records of this e-mail.
Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed to third parties by an authorized State
official.Unauthorized disclosure of juvenile,health,legally privileged,or otherwise confidential information,including confidential information relating to an ongoing
State procurement effort,is prohibited by law. If you have received this email in error,please notify the sender immediately and delete all records of this email.
1
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10. ROY COOPER • Governor
'
� NC DEPARTMENT OF KODY H. KINSLEY • Secretary
�� '-- ''er,
4 HEALTH AND
" HUMAN SERVICES HELEN WOLSTENHOLME • Interim Deputy Secretary for Health
• " �� MARK T. BENTON •Assistant Secretary for Public Health
F� VY
Division of Public Health
Onsite Water Protection Branch
September 29, 2023
Albert Harkey
1585 Amity Hill Rd
Cleveland,NC 27013
Re: Approval No. JMB3189
Private Well Located Less than 25' from Building Perimeter and Located Less than 50'
from Surface Water [Rule 15A NCAC 2C .0107(a)(2)(P)(Q)]
Property location:
4897 Kiser Island Rd
Terrell,NC 28682
Dear Mr. Harkey:
On September 27, 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 and surface water on
the property will be within fifty 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 and at a
distance closer than the fifty-foot setback to a surface water body. Achieving the twenty-
five-foot and fifty-foot setbacks 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 l Ofeet.
3) The well shall be located as far as possible from the surface water where, depending
upon where well rig can actually set up, will possibly encroach upon the 50foot
setback, but not be closer than 30feet.
4) A preconstruction meeting shall be required with the Catawba County Health
Department staff to ensure that the maximum possible distances are achieved.
5) The well will be required to have casing installed to a minimum of 50 feet below land
surface or to bedrock, whichever is greater.
6) The well shall be at least fifty feet from any part of the septic system including repair
area.
7) Grout will be required the entire length of the casing from land surface into bedrock.
8) 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.
9) Grout must be either pumped into place with the use of a tremmie pipe or pressure
method.
10)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.
11)The well must be constructed outside of any road right of way.
12)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