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A40 12�� L•� � �` �Y � � � �J � � � �{� ��:�•.�� v�.�,.�1 �E-�[�-.��.D �LIk, Date: __�__/��/�_ Name: 1.. Tax Map:� U Parcel: 12 Address: S�j � 2 (.}►�c�d(2 �(�� l� Re: Bacteriological Test Results Dear Well Owner: Your well water was sampled on �/ ?.t� /�, and tested for both total and fecal coliform bacteria. Your water sample test results are noted below: V No coliform bacteria were detected in the sample. Your well water is safe to use for drinking, cooking, washing dishes, bathing and showering, based on the bacteriological resu[ts only. Total coliform bacteria were detected in the sample. Fecal coliform bacteria were detected in the sample. Total coliform bacteria are naturally found in the soil. Fecal coliform bacteria are associated with animnal and/or human waste. The presence of either total or fecal coliform bacteria in well water may indicate that a new or repaired well was not properly disinfected prior to use, or that contaminated groundwater may be entering the well. IJcolaform bacteria are present in your water sample, the water may not be safe for use. Young children, the elderly, and the individuals with compromised immune systems are especially vulnerable and their physicians should be not�ed of the test results. A well that tests positive or total or ecal coliform bacteria should be properlv disinfected and retested prior to resuminQ normal use. The well may be disinfected using the enclosed disinfection procedure. A well contractor or plumber can assist you if needed. Once the chlorinated water has been thoroughly flushed out of the system, please contact the Health Department to request a re-sample. For additional information, please fee( free to contact Environmental health at 336-597-1790. Our office hours are 8:30 to 5:00, Monday through Friday. Sincerely, �— . u�s�L�►� 1 Environmental Health Specialist Person County Health Department (rev. 4l20/16) Person County Environmental Heaith, 325 S. Morgan St., Suite C, Roxboro, NC 27573, Phone: 336-579-1790, Fax 336-597-7808 North Carolina State Laboratory Public Health Environmental Sciences Microbiology Certificate of Analysis Report To: PERSON CO ENVIRONMENTAL HEALTH 325 S MORGAN STREET ROXBORO, NC 27573 EIN:566000331 EH COURIER #: 02-33-15 StarLiMS Sample ID: ES122116-0090001 � �� ES Microbiology ID: GPS Number: Sample Description: Comment: Name of System: CHRISTINE LONG P.O. Box 28047 4312 District Drive Raleigh, NC 27617-8047 htto://slph.ncaublichealth.com Phone: 919-733-7308 Fax: 919-715-8611 5912 HURDLE MILLS RD ROXBORO, NC 27574 Col lected: 12/20/2016 14:30 Received: 12/21/2016 08:15 Sample Source: Well Sampling Point: Bathroom sink J Smith Angela Heybroek Well Permit Number: A40-12 Environmental Microbiology - Colilert Profile Method: SM 92236 Test Name: Colilert Analyte Test Result Date Total Coliform, Colilert Absent 12/22/2016 E. coli, Colilert Absent 12/22/2016 Report Date: 12/28/2016 Explanations of Coliform Analysis: Reported By: Susan Beaslev / � , If coliform bacteria are Absent, the water is considered safe for drinking purpose. If coliform bacteria are Present, the water is considered unsafe for drinking purpose. Presence of E. coli (bacteria) generally indicates that the water has been contaminated with fecal material. It must be remembered that a water analysis refers only to the sample received and should not be regarded as a complete report on the water supply. �� 'i��' /7 ne daparhnont of hnalth and human services County: Sample ID #: [ . I,. � g r � �� c ' �■ra p� � � f-.., _;- -! •1 (� � i�: a j I ,�"�1 i.," ' �` �.' i'_ f.F.. � d 4 gr„� � t '`', , �,� � - E r<' � f v� � ( F � ,.•E i �,,' i i � � i�'! � � �,r � � , ; � ,...__. E . : � ?�^ 1 ° ! k E E�+ ' "� i�F f� � j•j � � � � �{��' ;�i � ~I I � �� j I } � ^` � ~V �: ��•� ..r�� i' t__ �.� F i i i � � o �',i {�� . i�•Y �.i For Inorganic Chemical Contaminants Name: G r' Reviewer: � � TEST RESULTS AND USE RECONIlVI�NDATIONS 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 onlv. 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 orthe 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 inorFanic chemical results onlv. Barium Cadmium Chromium � Copper � Fluoride � Lead � Iron Mercurv Nitrate/Nitrite Selenium Silver Magnesium Zinc � pH 3. 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 inorPanic chemical results onlv. ❑ b. Levels over 30 mg/1 may pose aesthetic problems such as bad taste, odor, staining of porcelain, etc. 4. 0 Re-sampling is recommended in months. 5. 0 Re-sample for lead and /or copper. Take a f rst draw, 5 minute, and l 5 minute sample inside the house (preferably the kitchen) and if possible a first draw, 5 minute and a 15 minute sample at the well head to determine the source of the lead and/or copper. 6. �The following substance(s) exceeded federal drinking water standards. Your water can be used for drinking, cooking, washing, cleaning, bathing, and showering based on the inorFanic chemical results onlv, 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. Barium Cadmium Chromium � Fluoride � Iron M na eanes Selenium � Silver � pH � Zinc For more information regarding your well water results, please cal! the North Carolina Division of Public Health at 919-707-5900. 0 � North Carolina State Laboratory of Public Health 3�12 D st?ct�Drve Environmental Sciences Raleigh, NC 27611-8047 htta://sloh. ncaublichealth. com Inor anic Chemist Phone: 919-733-7308 g � Fax: 919-715-8611 Certificate of Analysis Report To: Name of System: PERSON CO ENVIRONMENTAL HEALTH CHRISTINE LONG 325 S MORGAN STREET 5912 HURDLE MILLS RD ROXBORO, NC 27573 Courier # 02-33-15 ROXBORO, NC 27574 EIN: 566000331 EH StarLiMS ID: ES122116-0048001 Date Collected: 12/20/16 Time Collected: 2:30 PM Date Received: 12/21/16 Collected By: J Smith Sample Type: Raw Sampling Point: Bathroom sink Well Permit #: A40-12 Sample Source: Well Temp. at Receipt: 3.3 GPS #: Sample Description: Comment: New Well I (Profile) Analyte Result Allowable Limit Unit Qualifier(s) Arsenic < 0 005 0 010 mg/L Barium < 0 1 2.00 mg�� Cadmium < 0 001 0 005 mg/L Calcium 52 mg/L Chloride 33.00 250 mg/L Chromium Copper Fluoride Iron Lead Magnesium S Manganese Mercury N itrate Nitrite pH Selenium Silver � Sodium Sulfate < 0.01 0.11 < 0.20 0.19 < 0.005 12 0.110 < 0.0005 < 1.00 < 0.1 7.4 < 0.005 < 0.05 21.00 0.10 ►r 1.3 m 4.00 m 0.30 m ).015 m 0.05 0.00� 10.0( 1.00 0.05 0.10 250 m m m Total Hardness 180 mg�� Zinc < 0.50 5.00 mg/L Report Date:12/30/2016 Reported By: Deddie .�Konco�' Page 1 of 1