HomeMy WebLinkAboutWELL-6-10-8040.TIF �g CATAWBA COUNTY Case # WELL-6-10-8040
G Public Health Department
Q � 2 Subdivision &
.� Environmental Health Division
v �"< PO Box 389, 100-A Southwest Blvd, Newton, NC 286�8 Lot # �q
tgq2 sM PIN# 278116844043
ApplicanUOwner KENNETH HART
Site Address: 2584 OLD SHELBY RD, HICKORY, NC
Property Size: SF 28.25 ACRES
Directions: I-40 WEST/ EXIT 121; TO AWAY FROM TOWN/ APPROX 2.1 MILES/ ON LF
WELL CERTIFICATE OF COMPLETION
WATER SUPPLY: Well Type: Individual Well
— - - — — - -- — -- - - -- - - - INSPECTIONS
INSPECTION# COMPLETED �NSPECTiON TYPE STATUS INSPECTOR
INSP-60558 09/10/2010 EH Well Grouting Aonroved Megen McBride
INSP-60559 04/08/201 1 EH Well Head Aonroved Megen McBride
INSP-60561 04/08/2011 EH Well Certificate of Completion Apnroved Megen McBride
INSP-60562 11/10/2010 EH Well Record Received Annroved EH Admin
Roy Price 08/28/2010
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 constructed
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 4/8/2011
AUTHORIZED STATE AGENT APPROVAL DATE
04/12/2011 08:37