HomeMy WebLinkAboutWELL-08-2023-202714.TIF rr46, • CATAWBA COUNTY Case# WELL-08-2023-202714
.t.111 Public Health Department Subdivision ROCKING HORSE RIDGE
Environmental Health Division PIN# 367704607282
Notrav PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 9
Site Address: 4286 ANDERSON MOUNTAIN RD, MAIDEN NC 28650
Name on Permit: JAMES KMOSKO
Property Size: Acres 0.64
Directions: Hwy 16 S to Anderson Mtn RD
NEW WELL 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.
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 newly constructed private drinking water wells are required to be sampled in accordance with the North Carolina Rules Regarding Private
Drinking Water Well Testing(15A 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.
e,r 5,4011
08/15/2023
Authorized State Agent Permit Issuance Date
8/15/2028
Permit Expiration Date
Ow nut 08/16/2023 08:13
Catawba County Environmental Health
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,L0Q) WPDT Screening Report
Area of Interest (A01) Information
Area : 3,134,508.67 ft2
Aug 16 2023 8:17:22 Eastern Daylight Time
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(NCDEQ)GIS data is expressly provided"AS IS"and WITH ALL FAULTS'.The NCDEQ
makes no warranty of any kind,express or implied,concerning this information,
including but not limited to any warranties of merchantability or witness for
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(or refrain horn acting)based upon information in the Data without
independently verifying the information and obtaining any necessary
professional advice.Users are solely responsible for ensuring the accuracy,
currency and other qualities of any products derived from or in connection with
the NCDEQ's Data.The Data is collected from various sources and may be
modified over time without notice to improve spatial and attribute accuracy.
The NCDEQ disclaims responsibility for the spatial accuracy and attribution of
GIS features and makes no warranty concerning same.
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9.114a1 well depth Below land surfaces O b (fl.) Zia,)tor MI Web Submit this Conn Within 30 days of completion of well
1•crmulriple xrllr lilt all drpttit pilletrn((erarnpk•1 200'end 4100 construction to tiro following:
• JO,made w•itcr lcyel below top of easing' Z GAD (ft,) Division of Water Rosa wets,Infatniatlmt l'I(wentag Cult,
. Ifxara list1rdoe(W1ng,arc"I" 1617 Mail Se(t•Ice Center,itnlclgti,NC 27699.1617
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Permit#:L? � -1�.�_&Oc9 -
CATAWBA COUNTY HEALTH DEPARTMENT o�Da�lc(
Environmental Health Section
WATER SAMPLE FIELD REPORT & TEST RESULTS
Owner: KMOSKO JAMES
Owner's Address: 4692 ROCKING HORSE DR,MAIDEN,NC 28650-8115
Phone#&Email:
Site Address: 4286 ANDERSON MOUNTAIN RD, MAIDEN, NC 28650
Parcel#: 367704607282
Subdivison:
Driving Directions: A f t
Sample Collected By: �.1 U,�n Re. m o roan Date/Time Sampled: g I Z�/Z ' 1 I; i
Sampling Point: Sarn?1 ! 4- 7 J
Is well head accessible? Yes V No Reason for inaccessibility
Well New or Existing? New ✓ / Existing
Type of Well: Drilled •\/ Bored Punch Hand Dug /
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 in.above finished grade
Well head missing vent
Well head does not have a threadless tap
Well head missing identification plate or pump tag
Wire conduit opening not sealed
Other(Comment) •
Comments:
Lab Coliform Analysis Results: Total Coliforms: Fecal/E.Coli: ataa"U-
No Collection Date Over 30 hours old
Invalid Results: Excessive turbidity Excessive Chlorine
Lab Accident
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Lab Tech Initials: D o��__�' U '�►3� 1- Date/Time Completed: 8$/Z i °6 45 c-ervt.i.
to
AUG 2 9 2024
Environmental Health
Analytical Results <' STATES 'ILLE
ANALYTICAL
Catawba County Public Health
PO Box 389
Newton, NC 28658
Receive Date: 08/28/2024
Reported: 08/30/2024
For: James Kmosko 4286 Anderson Mountain Rd.
Maiden NC 28650
Comments:
Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst
240828-23-01 Nitrate 026431 <1 mg/L 353.2 08/29/2024 CL
240828-23-01 Nitrite 026431 <0.1 mg/L 353.2 08/29/2024 CL
Respectfully submitted,
�r p G6gL , ed e
Melissa Myers
NC Cert#440,
NCDW Cert#37755,
EPA#NC00909
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 2
F
STATEB%ILLE
ANAL'i TICAL
I22 Court Street Statesville,NC 28677
704-872-4697 www.sa-nc.com
NITRATE/NITRITE ANALYSIS
Nett:[JI iafo:mia.most be ntpptied fareongiercc credit.
WATER SYSTEM ID if: eer - nt:i)0 - ZWN3) — County: Catawba •
Name of Water System: TAmeS )(M Qct
Sample Type: 0 Entry Point IEl e.pecial/Non-complianc �
Location Where Collected: 4Z({D 4n(Je(san Moltn4-/A;A /L(�, MA(,(Lrl w p[ tp (.S
^
Facility ID No. DZIOL{3)�
Sample Point: mflL rE Collection Date Collection Time
Collected By: C1nQtrtA the /�lor6n .12J/all Z U 1 L:1 , A M
./ (Pleat Pe.0 (t.LVJDrfT) (SpccifyAM or PM)
Mail Results to(water system representative):
CATAWBA COUNTY PUBLIC HEALTH Phone# t (828)465-8270
ENVIRONMENTAL HEALTH Fax#: j(823)465-8276
PO BOX 389 Responsible Person's email:
NEWTON,NC 28658 'EHAdmin@catawbacountync.gov
LABORATORY ID#: 37755 0 SAMPLE UNSATISFACTORY ❑RESAMPLE REQUIRED
COYTAM METHOD REQUIRED NOT DETECTED QUANTIFIED ALLOWABLE
CODE CONTAMINANT CODE REPORTING LIMIT (i.e.<R.R.L.) RFSULTS* LIMIT
(X)
1040 Nitrate 353.2 1.00 mg/L • __u_ mg/L 10.00 mg/l.
1041 Nitrite 353,2 0.10 mg/L ,.a .- _ mg/L 1.00 mg/L
(
*Note:If result exceeds allowable Iimit the laboratory must fax analytical results to the State on day test completed.
DATE: TIME:
ANALYSES BEGUN; 'O$/ 2q / 2 4 I : L B A M
nt�P9t++7. . .—Q «yrAngrr9..
• ANALYSES COMPLETED: Q' / 2-a / 2,1f, 6 : PTM
— t$ttal AN rtM(�
•
2.3 •
Laboratory Lag;#:a ;934)I Certified By: l
COMMENTS:
2003
p.abaratory should Man Results to:
Public Water Supply Section,Ann:Data Entry,1634 Mail Service Center,Raleigh,NC 27699-1634
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 2 of 2
North Carolina Division of Public Health
Occupational and Environmental Epidemiology Branch,Epidemiology Section
BIOLOGICAL ANALYSIS REPORT
Private well water information and recommendations
County: Catawba Name: James Kmosko Sample ID Number: 202714
Location: 4286 Anderson Mountain Rd,Maiden NC 28650 Reviewer:Megen McBride
Initial Sample X Confirmation Sample:
BIOLOGICAL ANALYSIS RESULTS AND RECOMMENDATIONS FOR USES OF YOUR
PRIVATE WELL WATER(These recommendations are based on biological analysis only.)
X No coliform bacteria were found in your well water.Your water can be used for all purposes
including drinking, cooking,washing dishes,bathing and showering.
Total coliform bacteria were detected in your water sample. Total Coliform are a group of related
bacteria that are(with few exceptions)not harmful to humans.A variety of bacteria,parasites,and
viruses,known as pathogens, can potentially cause health problems if humans ingest them.EPA considers
total coliforms a useful indicator of other pathogens for drinking water.Total coliforms are used to
determine the adequacy of water treatment and the integrity of the distribution system
It is recommended that your well water be re-tested to verify that the result is accurate.
Fecal coliform bacteria were detected in the sample.Do not use the water for drinking,
cooking,washing dishes,bathing or showering.
If the re-test shows contamination by bacteria contact your local health department for assistance. There
may be a problem with the construction of the well,the groundwater source,or operation of the well.The
well needs to be inspected by the local health department or a local well contractor to determine the
problem with the well and to give guidance on how to correct the problem.
Your well water was tested for biological contaminants(total coliform and fecal coliform bacteria).The
results were evaluated using the federal drinking water standards.
Drinking water may contain substances that can occur naturally in water or can be introduced into water
from man-made sources.Total coliform bacteria are found in soil and fecal coliform bacteria are found in
animal and human waste.Total coliform or fecal coliform bacteria in well water indicate that the well
may have structural problems or that the well was not properly disinfected.
If you have been drinking the well water and are pregnant,nursing,have a child in the household under 5
years of age, or immunocompromised(such as an individual with AIDS, cancer,hepatitis, dialysis or
surgical procedures)inform your physician of these results at your next visit.
If the contamination continues,you should investigate the possibility of drilling a new well or installing a
point-of-entry disinfection unit which can use chlorine,ultraviolet light, or ozone.
For further information please contact your county health department or the Occupational and
Environmental Epidemiology Branch at 919-707-5900.
N 0 R T H C A R 0 L I N A
ti�.f �rr"b,'yl Private Well Information
and Use Recommendations
NC DEPARTMENT OF
HEALTH AND HUMAN SERVICES t
Division of Public Health For Inorganic Chemical Contaminants
County: Catawba Name: James Kmosko—4286 Anderson Mountain Rd,Maiden NC 28650
Sample ID#: 202714 Reviewer: Megen McBride .
TEST RESULTS AND USE RECOMMENDATIONS
1. ®Your well water meets federal drinking water standards for inorganic chemicals.Your water can be used for
drinking, cooking,washing, cleaning,bathing, and showering based on the inorganic chemical results on.v.You may
have other water sampling results that are not taken into account in this report.
2. ❑ The following substance(s)exceeded federal drinking water standards or the North Carolina 2L calculated health
levels.The North Carolina Division of Public Health recommends that your well water not be used for drinking and
cooking,unless you install a water treatment system to remove the circled substance(s).However,it may be used for
washing, cleaning,bathing and showering based on the inorganic chemical results only.
❑Arsenic n Barium ❑ Cadmium n Chromium ❑ Copper n Fluoride n Iron
❑Lead n Manganese ❑Mercury n Nickel ❑Nitrate/Nitrite n Selenium n Silver
❑Zinc
3.❑ While your lead levels do not exceed federal or state standards,the North Carolina Division of Public Health has
concerns with any detection of lead. Should you have any questions please contact the NC Private Well and Health
Program at(919)707-5900.
4. ❑ Re-sample for lead and/or copper. Take a first draw and 30-second flush sample inside the house (preferably the
kitchen sink)and a first draw and 4 minutes flush sample at the wellhead to determine the source of lead and/or copper.
5. ® The following substance(s)exceeded aesthetic drinking water standards. Your water can be used for drinking,
cooking,washing, cleaning,bathing,and showering based on the inorganic chemical results only,but aesthetic problems
such as bad taste, odor, staining of porcelain, etc.may occur.You may want to install a household water treatment system
to address aesthetic problems.
❑ Chloride ❑ Copper ❑ Fluoride ® Iron ❑ Manganese
❑pH ❑ Silver n Sulfate ❑ Zinc
6. n a. Sodium levels exceed the U.S.Environmental Protection Agency's(USEPA)Health Advisory level for sodium of
20 mg/l.The North Carolina Division of Public Health recommends that only individuals on no or low sodium-restricted
diets not use this water for drinking or cooking. It may be used for washing, cleaning,bathing, and showering based on
the inorganic chemical results onto.
❑ b.Your sodium level exceeds 30 mg/1 and may pose aesthetic issues such as bad taste, odor, staining of porcelain, etc.
7. n Re-sampling is recommended in months,to reinvestigate .
For more information regarding your well water results,please call the North Carolina Division of Public Health at 919-707-5900.