A40 378`���" � G
Application Date: g 3`-�l�t ���+5 (������ Tax Map: 0
Amount Paid: 200 � O 3� ��b � Parcel#: �
� ' ������
Receipt #: 1 "12�`�'I �y 6,� _ �
� 170� :1- 1[�..�.�������,��.11 ]H[�t,�.11�:IF�
Application for Services
Services Requested
Improvement Permit (Site Evaluation)
$200.00/$300.00 (if> 600 gpd)
Mobil� Homz Replacement ar Suilding Addition
$150.00 (if site visit required)
Weil Perri►it (New/RepiacemznJRepair)
$3 00.00/$200.00/$75.00
Construction Authorization
(Fee is denendent on the type of
PErmit Revision
$75.00
R�pair of Existing Septic Syster:.
Application: No Charge/ CA $150.00 or $300.00
1) Applicant Infor ation: � •
Name: P-✓���
Address: -
� � ��
2) Name and address of current owner (if different than applicant):
Name:
Address:
Phone (home): 3 �� ^ � S��
(work/cell): ,3� � � � I 3� 9
Phone:
3) P�•operty Description: Lot Size: Subdivision: �Al� 1er�D � r Lot #: O�
Adciress and/or directions to Pro pe r ty: � i� �K'�--5
❑ yes ❑ no Does the site contain any jurisdictional wetlands?
❑ yes 0 no Does the site contain any existing wastewater systems?
❑ yes ❑ no Is any wastewater going to be generated on the site other than domestic sewage?
❑ yes � no Is the site subject to approval by any other public agency?
❑ yes � no Are there any easements or right of ways on this properiy?
(if `yes' is checked, please provide supporting documentation)
4) Proposed Use and Type of Structure:
❑Residential
❑ New Single Family Residence Maximum number of bedrooms: �/ Occupants:
O Expansion of Existing System If expar:sioZ: Current number of be ooms:
❑ Repair to Malfunctioning System Will there be a basement? ❑ yes O no With plumbing fixtures? ❑ yes ❑ no
❑Non-Residential
Type of business:
Maximum number of employees:
Total Square footage o: Build:ng:
Maximum number of seats:
5) Water Supply: � New well ❑ Existing Well ❑ Community Well ❑ Public Water ❑ Spring
Are there any existing welis, springs, or existing waterlines on this property? O yes ❑ no
Please note any known ground water restrictions or sources of contamination:
6) If applying for `Authorization to Consiruct', piease indicate preferred system type(s):
� Conventional ❑ Accepted ❑ Innovative ❑ Alternative ❑ Other ❑ Any
1 cert� that the in, jormation provided above is complete and correct. I also understarid that if the information provided is
inaccurate, the site is subsequently altered, or the intended use changes, ull permits and approvals shall be invalid.
Signature (Owner/ Legal Representative*)
* Supporting documentation required.
Date
Permits are valid for either 60 months or are non-expiring when accompanied by an approved plat.
A completed `Lot Preparation' form must accompany any application requiring a site evaluation.
ri nii s� PPrcnn r'n„nt� F.nvirnnmental Nealth_ 325 S. Mor�an St., Suite (;. Roxhor�_ NC: 27�7:5 (336-�97-179(11
���. sf .���.� ��
---r7=�` � � � � � � Jl
)L�+e��a���,.-,r„ ��-��.Il IE���.Il�]�
Ap�l icant: 5a vn
Address/Location:
Tax NIap: �� Parcel: 3 1�
Subdivision � < ' e c
Phase/SectionlLot # 8'
/ improvement Permit
Permit Valid for: Five Years 1/ Non-expiring
Ty�e of Facility: � Ivew �Addition _ Water Supply: l�� �(
Number of: Bedroo / O upants / Employees / Seats: Projected Daily Flow:�� gal ons/day
Proposed Wastewater Syste : Conven-h�or�a � Type: ,��_
Proposed Repair: � Type: �
Permit C�nditions:
��S.i n'�'Ain_�il �
.-
Authorized StateAgent• Date: S- Z3-1(Q
(X) Owner or Legal Repres ntative: Date: _�2., /• /(�
The issuance of'this permit by the Health Department does not guarantee the issuance of other required permits. It is the responsibility of
the applicandproperty owner to insure that all Person County Planning and Zoning and Building Inspections requirements are met. This
Improvement Permit is subiect to revocation if the site plan, pl.at or the in+e�ded uss changes. The Improve:ne�t i� uot �f:�ct�d
by a cbange in ownership of the property. This per�it was fssusd 'an c�mpl6an�e with t6e provisions o: the Nort6 �arolina �laws
a�:rl Rules for SewaQe Treatment and Disnosal Svstems'(15A NCAC 18A .1900). Neither Person County nor the Environmental
Health Specialist warrants that the septic system will continue to function satisfactorily in the future, or that the water sapply rvill
remain potable.
Authorization to Construct Wastewater �ystem
See site plan and additional attachments (�
Propose astewater System: (J,�nvevt�lnv►a � (*)Tyge � D�sign Flow �j� gal./day
New � Repair Expansion So:l LTAR: ..3 gai./dsy/ft=
TypE of �acility: '� ' Sasemenc: _ Yes No
(*) System Types IIIb, IIIBg, IV, and V, require p�riodic system inspections by the Person Counry Health Department.
Wastewate* System �Requireme�ts
Tank Size: Septic T�ik f t Gtib gal. Purr,p Tank -' gal.
Drainfield: Total Arza � sq. ft. Total Length �33 ft.
Trench Width �_ ft. Min.Soil Cover �( _ in.
Distribution: Distribution Box �/ Serial Distribution �/rPressure Manifolc
Specifications:
Grease Trap �— gal.
Max. Trench Depth Zl/ in.
o.C.
Min.Trench Separation _� ft.
�
Authorized State Agent�C � Issue Date: �''-Z3-/(,
Permit Expiration Date: 8-23-2/
The system permitted is: Conventional ✓/Accepted / Alternative / Innovative . I accept the conditions
and specifications of this permit.
(X) Owner or Legal Representative: Date: /2-l-1 CD
Person County. Environmental Health, 325 � tLiorgcn St, Suite C, Roxboro, NC 27573/ph: 336-597-1790 (rev 5/12)
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7G��a-�� � ���.11 1L--3L��.Il�11�
STTE PI�3N
Name �� �*+ �i Tax Map #,�Q. Parcel # 3 7�
Subdivision cC Section/Lot# ft�'f
� ��.5-- 03
tluthorized tate Agent Date
System components represent approxrmam contovrs only. 7Tie conrracmrmusttlag t6e system prior m bee nni a,u thelnstall�tioa to
iasure th�t propergrade is mzinrained.
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SITE PLAN
Name �� �i � ' Taa ::bllap #t,�Q., Parcel # 3 %
Subdivisioa G Section/Lor# .
�Z3 _ I(p
A orized 3tate Ageat Date .
System compoaeats ieplrseat nppmvmatr eoamrus only. T3e caamcmrmusttlag tde system pdot m begiaaiag t6e iase7B�troa m
insurr thatpropergrade Is mtinmraed .
�`Fla4 ����r Wakrslte� Pf�+�
Scale: � �� � �� �
�—►� �`� I Sus�_
��� � � BR
��
-�' �33' Conve��o�a�
V 2�" �eN� ��
_.;�-6ox o� ser,al
�I�s+r�buhd� o�� -��
c�-��c Y�^A�n�x�i` �Ha�
Ienq�,� Iin�S
,1
PCF3D, rev. 69/12/Ol
i�i r � r�) ( � /�\ � '
T.�.. l��i.... A � I n D......ol .{{ �-f n
' ` � �' � � �-' �- � � � # of Bedrooms �{
��da���„-„-„ ����.Il I�ZL��.Il�11�..
Applicant:
Location:
3
E�a�"iil%y ��i`�iYil�
System Type (From Table Va): Product (IIIg): Cl,ar►�.b�r
Type V& VI Expiration Date: Type V& VI Renewal Date: �,�
This system has been installed in compliance with applicable North Carolina General Statutes, Rules for
Sewage T'reatment and I)isgosal, and all comsiations of the Imprcvemeat P�rmi� a�d Construction
Au��ori�a�icn.
� �
(A thorized Agent)
M► L �ewis
(Licensed Contractor)
� - �an�5 5ctn��
Scale ►���__
PCHD, :ev. 1"14/12
he.����' �.� �� a� ci�ar��aer
I Z-!�(-!lo
(Date)
12-��!!c.
(Date)
Line Len n
1 '
Z e�
�
o'
Total y pp'
Tax Map: �i � Parcel #: 3�_
s em ec is ype II=I ys em ype:
Notes•
Pump System Checklist
Contracted Certified Operator (Type IV Systems):
Notes:
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]E�.�.����m���.Il ]HC��Il�]E�
Tax Map: � D Parcel: _3�8
Subdivision: �)a K Q�'
WELL,PERMIT
(New� Repair_)
Lot: gS
Applicant'sName: �w,►v�� I�aw%in5
Mailing Address: -,�S � rd le
ox ro . �k. 27 5� �
Phone Numbers: �t�N- ZS�Z 5�8- zr2.9
Permit Conditions:
1.) See attached site plan for proposed well docation.
2.) All applicable SYate and County regulations governing construction and setbacks apply.
3.) Permits expire 5 years from the date of issue..
4.) Issuance of a permit does not guarantee a potable water supply
Other CondiHons/Comments:
Permit issued
(�Tew Well:
EHS/Date
Location: 35 12 - i y��(�
Grouting: sat.F c<r • ' 1z-�z.-tcc
Well Log: 35 12-i 3-1 �,
Well Tag: S
Pump Tag:
Air Vent: -(y-( l�
Hose Bib:
Casing Height:
Concrete Slab:
�
Date: _ �- 23 -� l�
Certificate of Completion
DI.iner:
EHS/Date
Well Driller: �ar„y{ft
Pump Installer: .
Approved by:
Additional Comments:
Date Sample Collected:
EHS:
Person County Environmental Health
325 S. Morgan St.,Suite C
R.,,,ti�.� Nf �7577
Depth:
Grout:
DAbandonment:
Date:
Method/Materials:
License #:
License #:
Date: _�/2-/4-/!0
Date Results Mailed:
Phone:336-597-1790 Fax:336-597-7808
„i�ci,�
Dec 12 16 03:13p Barnette Well Drillinglnc
�
WELL CONS'I�LUCTION RECQRD
This fo[tn can bc uscd farsiogle ar mttiaPfe vclls
I. Wd Contrattpr infotman�:
�
a'f+sN j G � �� �:r f�
Wdl Co�or Ctnmc
� 3 76 � �
re w�i c�� c��w�. r���
Barn�'tt� Well Oriliing, Inc.
�N� � � �
L wdr eoastrvUion Permi't#:
�s� aJl appl�robJe neR eansuuctfon permit (�.� Carny. 5/a1G Vartmrc�e, aG)
3, Wc31 Usr (eF�cc4 wen use�
W�ser SnPP�3' �i e.tL-
OAgFia�fima] ❑MunicipaUPttblic-
pGsothcrmal (IicatingJCoding Supply) t9R�idrnval Water Sapplp {singlc)
QlndusviallCammtrcial OR�esiduitial Wa[crSupPlY iSf�a:ed)
iJ06-WA►CT'
DAqn�Fr Reoh�e �Gcouoclvratc Remediation
�Aqnifec Stnrage and Rerovag OSalinitp Bairiu'
❑AquiferTo-t QStocmwatcrihaimaga
O�cpuimrn[alTcchnotogy flSubsidrnctConuoi
l�C�.itOtl7QlIS81 tCiOSGd LOOp� LTi[aCG
336-598-9275 p.1
Fw lotemal Uu ONLY=
ta:wa�xzo�s.
e�sox o��noa
� �rc �/O �' iA��+ l
� OUiERG15[NG Grudu�cmed-wdls ORL�iER' ifa lirafiie
FROM iV D[4Tt6ZFA TH[QCiVFS'9 MA'{'PltUl.
a$ c� � � s�. 3'Q 2 z. � t/G
16�:It8YCcuCA.SFRGOR�I'UH2NG 'thdrmalc[me�Iuo . � -
fltQFf 1'O DiAMiZfR TiRCl10ESS NAiFAL1L
. ,t. �. �- -
fr. !i. �-
� 17 SC UMEI'ER SLOTS{Z2 TFI[CiQVFSS AfATERtAL
RROM 'fO
tt f6 in.
[L iL iA
�s.c�aaur . : , - :
fR0111 TO litATER7AL FMPLACE7Hffi:fMEiHOD&AMOUM'
E7
cu
Q �t' � a' �ne�.
(t ft
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':Ig_.�ii:�l�`iZAi�i.�PA�'.�K If . . •Cd�1iC - . - . . � . -. �� �. . .. _ � .
�7tp�S TO PfATER7AL ' � . ii[PLICflHFN[ tKCI'HO�
tr. k
it t�
:26.�DSWGIDIG"[AG sitacL�addz6enal�ataeebifae�t= .� - •.- � ..,.
FRO?1 '[Q P�R'lIOF oGtrarde 'a.Wevek �.. . .ase,�-.
n m /l� � r+� , F.a_.P.� �■ Ri O�
a. nareStie[us) Comp[aeea: /Z /Z�J'.Gwetl7n# �'�'C� 9�' 72 �
59. W eil Lolntiou: �1
S�Ar�xr.y �'/f�r�-3 �C �N 3 'i'� O� ��''
�ausi�r c�z r�:�svm�c�f���t�
vf�i i Q i��� � -f-1 en�s' /e.5i �4V �
YEt�rfiesl A�dtiss, Ciq, md Zip
�p �2-s�,�c% ,�?8
C�� Pucct [daui6ud� Na [F'lt�
SL.Iatitude and I.angitnde in dcgmsfrniantes/sseond�ot' decimal degrees
��.,,en s�a, «�� ��s u ".�a� �c)
36„ zf �2� x?9 D tZ8 w
6. is (arc) thewell(s�t8�ermanent or �7'empoMr�`
7_'(s 26iyy �epnir tp sa �stSogweU: OYGc oc SiPI�
If�JiLr !s a repalr,fi!! ow.Enowr+.rcl! awuucJion tiyfarara+lmraad rsglain rJrc nw+ac nfelrr
repelr urtdar �`Z L ra.nrkt tt+ctlen or on dmbac$ q/d�tsform.
B.Tiu�aberofseilscoastcucteda l
!•br�w67ple ta{Jecra"on or �mrrwtarer styr�nly x'lls OIYLYriih d+e sm+re eawsDrucf+o�+. 3'O� �
stdimfr mrc fwru.
9_ Totai �di deplL 6elax Iand snrfac� __ I� d (ftJ
I'�or crultlpfe wr!!t llsi aAdeF�hs ij�arem (�'8��" 3�ZOQ' mai 7QI00�
IO_ Stati c�water levd bdow top of t�sind. Z S {ft) pi�� °f �ater Qaaiip', InCormasfoa ProcnsioE Uait,
1617 ,17s�7 5u?ite Ccntex, R�lefg6,1\C Z7699-I67 7
ffwaterlercf isebm�e case+& urr "}'
` 2db. �or Icri�crion Wcl[s: in addiCion to sending �e facm to the addesss in24a
IL Borehaled'umeter_ c Ca-) ��,� �� ���� a enpy of Chis farm witkein 30 days oi caenp�w� of wcll
1Z weA construation metLod: �, !� O� T"� �� _ cons�ucrion to the fauocvin�
(Lm aug�. sot�'. tlbte, d'ueapush, ek.) Divisio� otR'atrr QuRIkSe Uudergraund IajeeIIoa Contrnl i'ragram,
iG36 htail Service Ceute , Italeieb, PIC 27699-ib36
�OR WA'CER SLiPPLI' �EI.iS OA1I-Y:
fS ��� o� �� g�pyyp2p mjAtttg 1At For �ater Suoniv � 7nlecdne Wdtr. Tn addition to sa�dir+gthe farm to
I3z Yidd (gpm) the a3dres(es) atwv�, also sahmit one copy of this furin c4�thm 3Q day�s of
c�pictiun af wd! constrnchao co [he raemfy hcilth depamnent oF the caunty
13b.n�iinrcutoatyr�- tiTkt ,��t 9/2 Cu�_ ,���or�ccrad.
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eaevc,•., . . .. -. . .
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22. Certiricativa:
��r,�=�.._ �. p-�.. 1 z-- fz ��
S�aCuc of CcitiS�d WdI Coalrac9or B'�'
BY slgn'^S iFisJbrrx. I fxrY6y eesrify de� rGr wrlf(s) x�ar Ik'�1 m+v�nrrad in ocearrlaau _
xith !yf 1YGiC 02C.DI40 or 1SA NCdC OZC.OYflD �e11 CoRSlrnason Sra+da+dsend [har o
aopy ofrhls reciondherbemprovtded un ths .pelt o+rner.
Z3. S'ite dia�ram ar addiHaaal weli detail�
Yon may �su � 6ack o£th�s page In prwidc a�dditional tuelf sitc dclails or wdl
coisOrucfion de� You aiay s�sa sttach edditionel pa_cs if nccessary.
SUBMi7'TAL 1T1SiUC170N5
?ria, For AlI Wdls Submit this fotia wifhin 30 days of carnpletian of vvef I
conshudion to thc'fullowin�
Fwm Caii�7
Nwsla Cyoli� D��"t ofEavitw�+sa[ and Nsaral Ra�ou=ors—Division ot�Yater Q�dUY
8ev:scd Iaa.3a1 i
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iL.:rl 7i`il'ar i� u• � rrn Ir�"11 a:i �[�1 �:,izi. ��r K:.+�L t�L ��
Date: �/�S /�
Name: oa C�Q�e�c,�. Tax Map:,�l � Parcel:�
Address: e,
�d 2�
Re: Bacteriological Test Results
Dear Well Owner:
Your well water was sampled on �/ 2�/�, and tested for both total and fecal coliform bacteria.
Your water sample test results are noted below:
t/ 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 results only.
Total coliform bacteria were detected in the sample.
Fecal coliform bacteria were detected in the saraple.
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. If coliform 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 notified of the test results.
A well that tests positive for total or fecal coli%rm bacteria should be properly disinfected and retested
prior to resumin�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 feel free to contact Environmental health at 336-597-1790. Our office
hours are 8:30 to 5:00, Monday through Friday.
Sincerely,
i
k`�
Environmental Health Specialist
Person County Health Department
(rev. 4/20/l6)
Person County Environmental Health, 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: ES012617-0143001
� ������� ������ (�� ����� ����� ����� ����� ����� ���� ������ ����� ����� ����� ����� ����� ����� ���� ����
ES Microbiology ID:
GPS Number:
Sample Description:
Comment:
Name of System:
SAMMY HAWKINS
116 HENSLEY AVE.
ROXBORO, NC 27574
Collected: 01 /25/2017 14:00
Received: 01/26/2017 08:32
Sample Source: New Well
Sampling Point: well head
P.O. Box 28047
4312 District Drive
Raleigh, NC 27611-8047
htta://slph.ncaublichealth.com
Phone: 919-733-7308
Fax: 919-715-8611
J. Smith
Angela Heybroek
Well Permit Number:
A40-378
Environmental Microbiology - Colilert Profile Method: SM 9223B
Test Name: Colilert
Analyte Test Result Date
Total Coliform, Colilert Absent 01/27/2017
E. coli, Colilert Absent 01/27/2017
Report Date: 01/27/2017
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.
��
�����
nc deparFmQnt
of health and
human services
County: .,,�
Sample ID #:
i '" F �� t p` E
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r'-.��_. . i�� , r=i f } �,,..�,-� �. ^ � � ;��i �'' "�'{ f/5 ;I� E � t.� F i �•.•. �
I', K ¢ '/.� � _,1` F._: '• .� ' `'`�. t` r t E•/ 6 i @ � •..�' � � �. s �,, s `.... i � �.�
� � For lnorganic Chemica! Contaminants
Reviewer: �
� � TEST RESULTS AND USE RECOMIVVI�NDATIONS
1. 0 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 inorPanic 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 we l l water not be use d for drin king an d
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 inoreanic chemical results onlv.
Arsenic Barium Cadmium � Chromium ( Copper � Fluoride � Lead � Iron
iV(a es 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 inorganic chemical results onlv.
❑ b. Levels over 30 mg/1 may pose aesthetic problems such as bad taste, odor, staining of porcelain, etc.
4. � Re-sampling is recommended in months.
5. ❑ Re-sample for lead and /or copper. Take a first draw, 5 minute, and 15 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. 0 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 inorQanic 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
ManEanese Selenium Silver � pH
For more information regarding your wel! water results, please ca[l the North Carolina Division of Public Health at 919-707-5900.
Report To:
North Carolina State Laboratory of Public Health 3�12 D�stnct�Drve
Environmental Sciences Raleigh, NC 27611-8047
htto://slah.ncqubiichealth.com
Inorganic Chemistry Phone: 919-733-7308
Fax: 919-715-8611
Certificate of Analysis
PERSON CO ENVIRONMENTAL HEALTH
325 S MORGAN STREET
Name of System:
SAMMY HAWKINS
116 HENSLEY AVE
ROXBORO, NC 27573 Courier # 02-33-15 ROXBORO, NC 27574
EIN: 566000331 EH
StarLiMS ID: ES012617-0099001 Date Collected: 01/25/17 Time Collected: 2:00 PM
Date Received: 01/26/17 Collected By: J Smith
Sample Type: Raw Sampling Point: Well head Well Permit #: A40-378
Sample Source: New Well Temp. at Receipt: 3.2 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/L
Cadmium < 0.001 0.005 mg/L
Chromium
Copper
Fluoride
s Iron
Lead
Maqnesium
< 5.00
< 0.01
< 0.05
< 0.20
0.76
< 0.005
< 1_0
0.10 m
1.3 m
4.00 m
0.30 m
).015 m
P Manganese 0.320 0.05 mgi�
Mercury < 0.0005 0.002 mg/L
Nitrate < 1.00 10.00 mg/L
Nitrite < 0.1 1.00 mg/L
lenium
<
;r < 0.05
um 7.80
Sulfate
13
0.05
250
Total Alkalinity 65 mg/L
Total Hardness 66 mg/L
Zinc < 0.50 5.00 mg/L
Report Date:02/07/2017
Page 1 of 1
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