HomeMy WebLinkAboutWELL-11-10-12619.TIF � CATAWBA COUNTY Case # WELL-11-10-12619
Q . G Public Health Department Subdivision
H � TIMOTHY BOB SHOOK ET
y Environmental Health Division
v 'S' PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Lot # 3
8 S� PIN# 375501264299
Applicant/Owner Timothy Bob Shook
Site Address: 64(16 N NC 16 HWY, Conover, NC
Property Size: SF 6.017 ACRES
Directions: Hwy 16 North - Pass 2nd end of Riverbend Rd then 2nd drive on right in back of field
VVEL,L, CEI�'TIFICA'TE OF COMP�E'TION
!�/ATER SUPPLY: �llell Type:
INSPEC'I'IONS
INSPECTION# COMPLETED INSPECTION TYPE STATUS INSPECTOR
INSP-145799 OS/18/2011 EH Well Head Annroved Megen McBride
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INSP-99364 11/10/2010 EH Well Grouting Annroved with notes Megen McBride
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At well grouting, owner Mr. Shook was present. (He was also present at the time the well:was drilled) '
The Duke Power right of way was not marked. I asked him if he knew where the boundary.of the right�of
way was. He stated he did, that Duke Power had marked the boundary for him last spring, however the �•-
marking was not still visible. He showed me the locafion that Duke Power marked and stated that''�the well
was at least 40 ft. from the edge of the right of way. I told him thaf at this point.he is responsible for .
_ _ representing the right of way boundary accurately to me. He again stated that he was sure ; of its location.
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INSP-99365 OS/17/2011 EH Well Head Failed � Megen McBride
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missing pump tag and threadless tap
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� INSP-99367 OS/18/20l 1 EH Well Certificate of Completion Annroved Megen McBride
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IN 11/10/2010 EH Well Record Received Annroved EH Admin
DONALD RUSSELL 11/09/2010
WELL DRILLER DATE DRILLED
Well permits are valid for 5 years from the date of issuance and are subject to suspension and/or revocation fro non-compliance with
appropriate state and local rules and regulations, or if false information was given in order to obtain a permit. Wells shall be conshucted
in accordance with all state and local regulations and rules. The Well Completion Report must be submitted to the Health Deparhnent
within 30 days upon completion of a well.
Megen McBride 5/18/2011
AUTHORIZED STATE AGENT APPROVAL DATE
OS/18/2011 11:44