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HomeMy WebLinkAboutWELL-08-2023-202784.TIF CATAWBA COUNTY Case# Public Health Department Subdivision PHILLIP MORETZ .. .."1"".-1 , Environmental Health Division PIN# WELL-08 2023 202784 372408799363 PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 13&PT14 Site Address: 3140 43RD AVE NE, HICKORY NC 28601 Name on Permit: RICK HUFFMAN Property Size: Acres 5.95 Directions: Springs Rd to sulfer Springs Rd,go 1 mile on the left after Snow Creek Rd, properyt 1/2 mile on the left 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. 34,e4Y4t 614.1" 08/17/2023 Authorized State Agent Permit Issuance Date 8/17/2028 Permit Expiration Date chprn iil 08/17/2023 08:31 1 Catawba County Environmental Health ft2 -o9 ,�3 - ,1U4c.y well —at - ZOZ3 - 10770 � g (co) rR 0 181 • 41.7Ro o FNF 321 45: .• ovrfhlA1 /o„,- •3140 u- M Y co Q 0 D • /79.9• 200.05 461.73 •. Parcel: 372408799363, 3140 43RD AVE NE 1 in=100ft HICKORY, 28601 This map/report product was prepared from the Catawba County,NC 0eospatlel Informitlon Services. Catawba County has made substantial efforts to ensure the accuracy of location and labeling Information con alned an tills map or date on Ihle import.Catawtut County promotes and recommends the independent vertftcatwn tit any data/unturned art this mall/report product by the user.The County of Catawba,Its employees,agents,and personnel.disclaim,and shad not be held Halite tar any end al damages,loss or liability,whether direct,Indirect or consequential which arises or may arts*horn this map/report product or the use thereof by any parson or entity. Copyright 2023 Catawba County NC 08/17/2023 aM) WPDT Screening Report Area of Interest (AOI) Information Area : 3,134,508.72 ft2 Aug 17 2023 7:40:57 Eastern Daylight Time — ''' I I [ ,--_1 / L._ / 1 n t. I �, E. 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E 7 L I. 5 !- i r.„ .=, I ' .„„.---".2--4;;;., 1:4,514 0.03 0.06 0.12 ml 1 I Parcels(Polygons)- Parcels I i i % ' ti •, •, '1 0 0.05 0.1 0.2km County Boundary Non-System Roads NOT Gt9 Unf1.NC CGW,Alauo, — Non-System — Secondary Route r 3140 43rd Ave NE, Hickory All North Carolina Department of Environmental Quality (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 any particular purpose.The NCDEQ assumes no responsibility or legal liability concerning the Data's accuracy,reliability,completeness,timeliness,or usefulness.The data is not intended to constitute advice nor is it to be used as a substitute for specific advice from a professional.Users should not act (or refrain from 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. Print WELL CONSTRUCTION RECORD (CW-11 . For Internal Use Only: ' I.Well Contractor Informalion: Robert Teague 14.WATER ZONES Well Contractor Herne FROM , TO _DISCRirr10N 2857-A rL n. rt. rt. NC Well Contractor Cemfcation Number IS.OUTER CASING(for maltltued walla)OR LINER(If bit) B&K Well Drilling Inc FROM 1j1.11 DIAMETER THICKNESS MAIERLAL Company Name 0 ft / -D. 6 tr6 la, SOR•2t 1 PVC a o�-�` a(�a 1 y IL INNER CASING OR TUBING(iso termal efaad-i ep) , 2.Well Construction Permit N: FROM To DIAMETER THICKV55 MATERIAL Let all applicable well ruwtrrucrtan pantile(i.e.U1C,Coanry.Stare.Varronrr,etr) f4 ft. In. 3,Well Use(check well use): ft. fr. l —In. Water Supply Well: 17,SCREEN .0AgT7CLLIl11Rl FROM TO DIAMETER SLOT SIZE THICKNLUA SIATI:FOAL QMunicipal/Public ft rt. tn. 3 Geothermal()ieating/Cooling Supply) 0Residential Water Supply(single) IDdustriaUCotmttercial ft ❑Residential Water Supply(shared) h Irrigation FROM GROUT ft. In. TO MATERIAL EMPLACEMENT METHOD A 4MOLNr Non-Water Supply Well: rt. ` rt. RMonaonng Recovery ft. ft. Injection Well: Aquifer Recharge ft. roundwater Remcdietion Aquifer Storage and Recovery Salini Hamer 19.SAND/GRAVEL PACK(1f appakabt.) ry FROM TO MATERIAL EM►tACEMENTMETHOD Aquifer Test ❑StormwsterDrainage n. n. Experimental Technology ft. Control f. R. Geothermal(Closed Loop) ❑Tracer 20.DRILLING LOG(attach addition'meth NaeeassarT) aGeolhelma►(Heating/Cooling Return) FROM DESCRIPTION(Mar. rdww.,ulurvee tyre.seals An,ten) [Other(explain under S2I Remarks) to To I � � i •� 4.Date Well(s)Completed:#(.,2/113`y' Well IDS 7 O rL (.) 1f ( 6 S C c4 'J f (/- -) s�Wed Locadoo: 2,b9 R• 0 S IL ho.c-C.t - 5rr"T"-e- `At. 1{1 L.\ 11 y- 1t'hClr1 ft. rt. Facility/Owner Name Facility ID*(ifepplicable) rt. 3 \U c %Al ii. KNIt, 1\14 41 c.i r) rt. f. Physical Address,City,and Zip L.�• .c �e-.. 21.REMARKS County Parcel identification No.(PIN) 5b.Ladtude and longitude In degrees/minutes/seconds or decimal degrees: (ifwell field one laVbng is sufficient) 22 Certifcatio N W 4� ,Z !3 Z t 6.Is(are)the well(s)0Permanent or Tempos Signature ofCcni3 ficdZVell Co for pa ry By.tiring this form.l kereby eerily'Mar the%rWe)nu:(were)emutruered errs plionce 7.Is this a repair to an existing well: 0Yes or No evh 15A NCAC 01C.0100 or 1SA h'CAC 02C.0100 Well Consrrac Ion Sea rdr and rhar a !fait is a repair,fill out known well canrrructian information and ain the narwe of the CTrpy of thin record Se,Men pmyided la the evil owner• repair under 521 remark:lecNon or on the ban*of this form. 23.She diagram or additional well details: 8.For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same You may use the back of this page to provide additional well site details or well • construction,only GW-1 is needed. Indicate TOTAL NUMBER of wells construction details. You may also attach additional pages if necessary. drilled: . SUBMITTAL INSTRUCTIONS 9.Total /J well depth below land surface: `�!05 M.) 24a. For All Weill: Submit this form within 30 days of completion of well for awlllple wile la,all depths!fd ffereru(example-3@@100'and 13100') construction to the following; 10.Static water level below top of casing:40 (ft.) Division of Water Resources,Information Processing Unit, (/venter kwrl u above casing,use"' ' 7. 1617 Mall Service Center,Raleigh,NC 27699-1617 II.Borehole diameter: 6 1/8 (In.) 24b.For Inicetion We)II: In addition to sending the form to the address in 24a 12 Well rnnstrucdoa method: Air Rotary above,also submit one copy of this form within 30 days of completion of well (i..,auger,rotary,cable,direct push,etc.) construction to the following: Division of Water Resources,Underground Injection Control Program, FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center,Raleigh,NC 27699-1636 13a.Yield(gpm) /0 Method of test: Air Flow 24e.for Water Sunoly& lnlection Well}: In addition to sending the form to Chbr Tatra the addressfes) above, also submit one copy of this form within 30 days of 13b.Dldnfection type: Amount: t to tb. completion of well construction to the county health department of the county where constructed. Form GW-1 North Carolina D epanmcnt ofEnvironmenlal Quality•Division of Water Resources Revised 2 L 2016 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: Is, r c.k. f(v fvv-^ Sample ID Number: 3-0 2"MI Location: 9)I y ° t1 flue— J\f r } t-1 4.1cc y 'Zzs6 a I Reviewer: Jason Boyd 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.) 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 colifonn or fecal colifonn 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 immunocomprornised(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. 1 N 0 R T H C A R 0 L I N A `War STATt 3"°�� Private Well Information L as ;o•, and Use Recommendations NC DEPARTMENT OF HEALTH AND HUMAN SERVICES Division of Public Health For Inorganic Chemical Contaminants County: Catawba Name/Address: P2 tE 1K v-P R 4' i s (-13 r) iq v a- f ,1 k a - Sample ID#: _© .-7 tq Reviewer: Jason Boyd TEST RESULTS AND USE RECOMMENDATIONS 1. Your well water meets federal drinking water standards for inorganic chemicals. Your water can be used for dr nking,cooking,washing, cleaning,bathing, and showering based on the inorganic chemical results only.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. n Arsenic n Barium n Cadmium n Chromium n Copper n Fluoride ❑ Iron ❑Lead n Manganese n Mercury n Nickel n Nitrate/Nitrite n Selenium n Silver n 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 n Fluoride n Iron ❑ Manganese ❑ pH ❑ Silver n Sulfate n Zinc 6. ❑ a. Sodium levels exceed the U.S. Environmental Protection Agency's (USEPA)Health Advisory level for sodium of 20 mg/1. 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 only. ❑ b.Your sodium level exceeds 30 mg/I and may pose aesthetic issues such as bad taste, odor, staining of porcelain, etc. 7. ❑Re-sampling is recommended in months,to reinvestigate . 1 i For more information regarding your well water results,please call the North Carolina Division of Public Health at 919-707-5900.