A26 22A�-��z-�y �-� �6
Application Date: UO
Amount Paid: �DO� � �4 •
Receipt #: 1�� � 3 f��
� � O O 1 . �JG � c
��� S ( ���� �� Tax Map: 14 � �
._..: •' � �f Parcel#: � � A
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�'.nav-na-cnan�ca¢�aa4:m.� )I���ei�.� -4.��
Services
Impr t Permit (Site Evaluation) Perc tcs �-
$200.00 300.00 (if> 600 gpd)
0 Mob' me Replacement or Building Addition
$150.00 (if site visit required)
❑ Wetl Permit (l�iew/Replacement/Repair)
$300.00/$200.00/$75.00
for Services
0 Construction Authorization
(Fee is dependent on the type of
❑ Permit Revision
� Repair of Existing Septic System
Application: No Charge/ CA $150.00 or $300.00
�plicant Information:
Name: �o h n '
Address: .( �
�CZ�P n A� .�'., �7,�j % �%
2) Name and address of current owner (if different than applicant):
Name: �,. /,,,,� S1n AI//dD y�
Address: ����, �m
Phone (home): 33 ��3� x I`t t R
(work/cell): - �- o -
Ca I ( ,
u,)he � �' ��
Phone:
d� ,
i � ���_�b�L
3) Property Description: Lot Size: j.� .�' Subdivision: Lot #:
Address and/or directions to Property: >4 C.t-os� 1'O M S6 S' �T0.c� o„�,�t-► c.� Q�
❑ yes � no Does the site contain any jurisdictional wetlands?
❑ yes (,� 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 property? �b�e.�- �;,� �,
(if `yes' is checked, please provide supporting documentation)
4) Proposed Use and Type of Structure:
�Residential
�1 New Single Family Residence Maximum number of bedrooms: ,,,�_
❑ Expansion of Existing System If expansion: Current number of bedrooms:
❑ Repair to Malfunctioning System Will there be a basement? ❑ yes j5�1 no With plumbing fixtures? ❑ yes [�J no
❑Non-Residential
Type of business:
Maximum number of employees:
Total Squaze footage of Building:
Maximum number of seats:
5) Water Supply: �i1 New well ❑ Existing Well ❑ Community Well ❑ Public Water ❑ Spring
Are there any existing wells, springs, or existing waterlines on this property? ❑ yes � no
J
If applying for `Authorization to Construct', please indicate preferred system type(s):
j� Conventional ❑ Accepted ❑ Innovative ❑ Alternative ❑ Other ❑ Any
I cert� that the information provided above is complete and correct. I also understand that if the information provided is
inaccurate, or if the site is subsequently altered, or the intended use changes, all permits and approvals shall be invalid.
Signatu
Representative*)
documentation required.
�/v�-/y
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.
(10/11) Person County Environmental Health, 325 S. Morgan St., Suite C, Roxboro, NC 27573 (336-597-1790)
���,s� ���.���
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7E�s �-Yn �- � �:���¢�.II. I�3C � �.11�7�
Applicant: � �Haa�c NR�
Address/Location: l�l�� c
��ic�c�sS _,� z� �Sl.?
�
RA �
Improvement Permit
Permit Valid for: Five Years i�_ Non-expiring
Type of Facility: �� i3�C�wt� HouSTc New � Addition _
Number of: Bedrooms 3/ Occupants (v"'�/ Employees / Seats:
Proposed Wastewater System: �i�►c -P�L� a5'?� 'Rkpa�
Proposed Repair: �cc��A �+ a�`�lc �J�
Tag Map: l�a� Parcel: ��l�
Subdivision
Phase/Section/Lot #
-�i
� (�24
V4'ater Supply: P'�►vt��c W cU..
Projected Daily Flow: 3b� gai(ons/day
Type: "�Si G
Type: �_
Permit Conditions: l���ri'�. 5'�� s��ti. c��Sa1V.�1�c.f, w��t�► C�f1R��� �� �. Pc� � � Da,Es„��l�
1�3�1��-t���1 � Pv� x.�1.s�aw;.� �L Ct�vr�^�
Authcrized State Agent: a�R4ac►L 11- Sthc�-1 _ Date:
(X) Owner or Legal Representative: ,� � .� � .-�� � � _ � Date:
�
The issuan�e of this permit by the Healt�h Dep�a�rtment does �t guazantee�the issuance of other required permits. lt is the responsibility of
the applicant/pr�perty owner to insure that all Person County Planning and Zoning and Building Inspections requirements are met. This
Improvement Permit is subject to revocation if the site plan, plat or the intended use changes. The Improvemeni is not affected
by a change in ownership of the property. This permit was issued in compliance with the provisions of the North Carolina `Luws
ruid Rules ibr Se►vag�: Treatment and Disnnsal Svstems'(15A I�iCAC i8A .t9Up). Neither Person County nor the Environmental
Health Speciatist warrants that :he septie system will c�ntinue to fanciion satisfa�torily in the future, or that tbe water supply wi�l
remair �ota�le. _ __ _— _—
Authorization to Construct Wastewater System
See site plan and additional attac`iments �_).
il
Proposed Wastewater System: �Cc �,�'CEQ w� aSi� � (*)Type � G Design Flow 3�4 _ gaL/day
New � Repair _ Expansion Soil LTt�R: O.� gal_/day/ft2
Type of Facitir,�: 3 ��.pt�qtti ��US� Basement: _ Yes � No
(*) System Types Illb, IIIbg, IY, a�d i�,� r�oe periodic system inspections by the Ferson County Health Department.
Wastewater System Re.quirements
Tank Size: S�ptic Tar►k 1�Q� gal. Pump Tank r gal. Grease Trap � gal.
Drainfield: Total Area i�8� sq. ft. "fotal Length 3�o'C' _ ft. Max. Trench Depth�-l�_ in.
Trench Width 3 ft. iVIin.Soil Cuver � in. Min.Trench Separation �_ ft.
Distribution: Distribution Box / Serial Distributionx / Pressure Manifold
Specifications: _'� �*\s'�tu�-'� M��� 1�-���'(t�� ' QC�t �°�, 33�- S�`I- t'l�'O
Authorizzd State tlgent: 'tr�, �ct4R�e �� A- 5r►ii� Issue Date: S 15 i
Permit Expiration Date: $ 15 19
7'he system permitted is: Conventional /Accept d x/ Alternative / Innovative . I accept the coliditions
and specifications of this permit.
(X) Owner or Legal Representative: � Date: �����_
Person Counry Environmental Health, 325 S. Morgan St, Suite C, Roxboro, NC 27573/ph: 336-597-1790 (rev 5/12)
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.
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I���aa-�������.IL IF���.]L�II�
Tax Map �� Parcel # �
Subdivision
Phase/Section/Lot # N
# of Bedrooms 3
O�eration P�r�it
System Type (From Table Va): Product (IIIg): �Z
Type V& VI Expiration Date: Type V& VI Renewal Date: �
i
This system has been installed in compliance with applicable North Carolina General Statutes, Rules for
Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction
Authorization.
�
(Authorized Agent)
fU�ilCe Lewis
(Licensed Contractor)
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,i�' GAf W I'�'� M i l�C L! W i S Sep'h G
t,�as� ���'o�,�cd �►a� dawls �n
ttnc �iddle o� a l�nt -%� �ew syskW.s
arC. alnsoluk w�act�P�abl�
Scale
PCHD, re . 12/14/12
,.
-
1 r�2 L�n
I�� 3c��`�
.2�5- .3
�,_30�� ,2S
�—/S ��
(Date)
1�-15 -1l�
(Date)
Line Length
1 !3 '
2 3'
3 '
Total 340'
Tax Map: �.� Parcel #: 22A
Septic Tank System Checklist (Type II-I�
Se tic Tank InitiaUDate
State ID & Date: _ _�
Z-1 -
Ca acity: � - � UO
Tee and filter
Baffle
Vent ,/
Riser /�
Outlet boot
Perm. Marker ✓
Distribution
D-box (levels set)
Serial
Pressure Manifold I
LPP
Notes:
System Type: �E?.�
, � , ,� �„ ��
Pump System Checklist
Pum Tank InitiaUDate
tate ID & Date:
Ca ac
Riser 6" 'n.)
NEMA 4X Box
Model:
Piggy back lug
Hard wired
Alarm functioning
Mounted on post
Above grade (12")
Conduit sealed
Pressure Manifold
Number of ta s:
Size and sch:
Contracted Certified Operator (Type IV Systems):
Notes:
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� SITE PLAN
Name����ii �'1P1�� T:x Map #��o Pucel # a��
� Subdivision Section/Lot
l�-1Z.(4cX. /4• Si�� � �
� .Suthorized State Agent Date
i
System compoaents feprueat apprvx3mate contorus only The contraaormusttlag rhe sysrem prior to begiania� rhe instalf�tion m
j iasare tharpmpergnde is maintaine.�:
625
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3248
30249
.',`,� � S`�S�ET''1
Q� x
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' �'0�,��q w� �c;�1p
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Tax Map: ��o
Subdivision:
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��rawn�c-am�a�rnn��ra��.� g��<m.���n
Parcel: aa�4r
WELL PERMIT
(New� Repair_ J
Lot:
Applicant's Name: ���a�( h�i���.
Mailing Address: �&1 SAr��'t H�u.. Ri�
R�� . �c. dn5'1►}
Phone Numbers: 33b- 3� - 1y13 �b- �W -�5�
Location of Property:
Permit Conditions:
1.) See attached site plan for proposed well location.
2.) All applicable State and County regulations governing construction and setbacks apply.
3.) Permits expire S years from the date of issue.
4.) Issuance of a permit does not guarantee a potable water supply
Other Conditions/Comments: �s.v� �sr tY�c �D �c �� t%�sr_ `Y �ao �� �o`�"^
a.� scer` c�ren�s
Permit issued by: �C.�R1c�1. A . ��cb1
Certificate of Completion
�1ew Well:
HS/Date
Location: - � 3"� �
Grouting: - �3-� �p
Well Log:
Well Tag: SS
Pump Tag:
Air Vent: O-S'��
Hose Bib: �
Casing Height:
Concrete Slab:
Weil Driller: / RY`"'G4"'r`
Pump Installer: St 1
Approved by: ,��
�
Additional Comments:
Date: 8 � i
OL.iner:
EHS/Date
Depth:
Grout:
DAbandonment:
Date:
Method/Materials:
License #:
License #:
Date: �e-S'-1C�
Date Sample Collected: / Date Results Mailed:
EHS:
Person County Environmental Health
325 S. Morgan St.,Suite C Phone: 336-597-1790 Fax: 336-597-7808
Roxboro, NC 27573 11/26/13
WELL CONSTRUCTION REGORD
This fam tan bc �uod for sic�lc ar multiple wctls
l. Wdl Contr�ctor [nforma6oa: �
�J C.L�-
�De�.%y��, � � K ��/ 7/
Wtll Conirador Nunt
� 3 7� �
NC Well Contractoc Cuti6cacion t�[umber
Sarnette Well Driliing, Inc.
Couquuy Name
2. Wdl Constraction Pcrraitt(: // � �
Lis( a/! appllatbls wae!( cvnstruuron permils (i.o_ Cmmry. Slor� {�ariaece, etc.)
3: w�u ux ��a�� w�i. d5s�:
w,r�s�,p�y wd�:
on�i«,ta�at aMu�icipavei►�t�c.
aGeothumal (HeatinglCooling SuPP�Y) zsida�al. Water SaPP�Y �5�81e)
�Indu�triaVCommacial O.Rcsideatial Water Supply (shazed)
Supply Wdt:
QAquifcr Red�argc OFicdindwate� Reniediation
❑Aquifer SWrage and Rocovcry OSalinity Bartia
❑Aquifcr Test �Siormwatett [huivage
�E�erimeatat Tcchnology �Subsidence Controt
�Getathetm2l(Clused C.00p) O'[Yacer
QGootheimal (Heatine/CaalinQ Relum) OOthex(ei�iain ondu#2I P
4. Date Wett�s) Complcted: �Z- " Wd1.ID# ���
sa. Vveu Locahua:
7�����y �i��� .
FacititplQwHCr Natnt FauliCp ID� (ifsppliplilc)
✓
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Pirysial Addccss. Cic}'. and ZiP �
��e �S D.v Z 2'
Couucy Pmccl idcatifiwrioallo. (F'ft�
Fa (dnual Uu ONLY_
-`td'. W,(TF.R�7.ANFS<� . . . . - � . . . . . � . .
�za« �v� �
Z 6 S-rt 276 rc
iS.U�(1'C�RCASING tart¢eltwf
p7tq1( 1'O DCAMI
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l� WNER CASiIVG:�[t�'IVBING:
p80M ' TO OI�MI
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k �
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�(t tt
EOUT - :'i. >;;_ ...;;: :>::
TQ
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ft fc
ft ft
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rt n
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Tfi(CIQ'IiSS MATERL�L � ��.,.
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7F[QRQESS 6lATF:tiAL:.�.,.
in
io_
u
F�'e �A V K�
56. Lahiude and Longifnde m degrteslQuuptes/st�oods � dtdmaf degraS. �„ C� fic�Hae:
(�fwtp �eid, anc Iallong is saEficicat) � r— �
36 %-3 6o Q ���- o� f z 9 W �-���....��_�- 7- / z�/�
Si�ofCusified Wd1 Caouattor D�.
�"Ls (are) tht Wtli(sj: �tPE�maneut. or OTempoCai7 �y sfgntng ihtr fvnn. ! Awieby cnr�y dat rho *eU(`s) wo+ (Here) conrirrraed br araoerdancb
� � vilh fSfi111G(e 01C A190 or lif NCdC OIG.Q2Q0 fPcll C.onsriuctlon. SYa�idmiir;ae� tluila
7. is t6is s rspur to au ezisting,.wdh OXes oc B1Qo mPY9�%�'�* �eoonilbas bce� pmrtded a d+e vetf vweer.
!f �di Lr u rrpolr, frd om�brorw+�we(I cwrstrt�iion t, jaawaa, mrdrrpla;n nc� narurt�ojd,e 23. 5'itE� dirgtfw ar �cdditioaalwd! dNails: � � �
rspair+wider �II n� surir+n ur o� ihc. buui afPubi�'orm.
You may use 8ie lrack of tbis (sai�c ta pfrividc: aGilitional well. sito dZtails vr well
&: Nnmber oPwdls eonstcvcfed: � �n�ion ddai'ls. Yon may aLso.attach addi6baal pages if neaGssa,iy.
for mvl[ipie injeetion or iron-�wrer ary��ly wr.lLt ONLYwi�h �he smrte eoe�ow. y�u am SURMTI"fAL IN5'['UGTIONS
subinnnnejorm.
9.TatsC�ve.�ldb(►tL btlowlaudtutiaee: �b �� (jtJ 24a. For Ail W�dL� Su6mif this &uta within 30 days of aompktibti of wdl
�Forsadtipfawellslista!ldePrhsifd�'e+u+t(esOniP►e-3Q200'cndlC�lO(!') . cdtishudionfbfhefo(iowittg:
10. Stafie w'atcr terel bdovr top of casing. Z_S (ft) ��n o£R'ata"Q°'�'t}., Inform�aoo Pro�eg uni4
Ijx�orerlepel.fs obove �ao:&r� �ae "+- 1617 MalSecvi« Center,Rateigk,lhC �7699-1b17
11. Borehok diaiuoter. � {'w:) Z46. For Ioiectioi V1rd[s: in iddition to saiding the foim to the addtcsc in 24a
/� �/� p p abovc, also stil»ait a cvgy of das foad witf►iii30 days of completion of aielt
12. Wen cooslruction methad: rJ / rC i� O�� O� � ��iari t0 tlie followai�
�'ic au8x, iotuY. cable; d¢xt push, dc.)
Uivisiou af Witer Qualily, Uadecg�oa¢d.Injection Cuetro! E'rognm,
FOR.WATER SIJPPLY WELIS ONI.Y- 163G M�u1.Serviae CSenter, Rategh, N+C 27fi99-1636
`Z . Blown20 minute 24c �or�YrtcY.Saohlv �c Iniection �Vdls. in additian to sending ihe fori�► w
13a. Yidd (gpmj. Methqd efta� �� ����� �4 ��}�ih one cqry of. this foiin itritbin 30 days of
13b. Disinfection typ�c HTH ,�mo�� 112 Cup �p�;«� � �,c �aua�«, � � «,�►c� ��; a���c � c�� �ty
,�«r corist�cxca.
Fam GW-t
Nwth CaroGna Dcpxtmrn4afFnvirmmeat aod Naoal Rewa�ocs-Dirisim of WalerQusiity
Rcviscd Jaa: 2013
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I -C�a�n�on�auvra��a��.Il IE���.1l�l�a
Date: i / L l / l?
Name: ��_y Tax Map:�� Parcel:�/�.
Address: /,�� a� ,.,���i�� �,
� � - �3C:��� Z �
Re: Bacteriological Test Results
Dear Well Owner:
You� well water was sampled on /Z /�l�[,�, and tested for both total and fecal coliform bacteria.
Your water sample test results are noted below:
�` 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 bacteri�logical results only.
Total coliform bacteria were detected in the sample.
Fecal coliform bacteria were detected in the sample.
'!'ota! c�liform bacteria are naturally found in the soil. Fecnl coliform, ba�ter�a a.re assQ�iated :v:th
animnal a.nd/or human wasie. The presence of sither t�ta: o: feeal colifo;tn 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 :tot be safe for use. Young children, the elderly, and the individuals with compromised immune
sysaems are especially vulnerable and their physicians should be not�ed of the test results.
A well tha! tests positive or to!�l er ecal coliform bacteyia shcula� be p; �perly disi,nfzcted and retested
prior to resuming normal use. The well may be disinrected using the enclosed disinfection procedure. A
well contractor or plumber can assist you if needed. Once the chlorinated water has been thoroughly
flushed oat of the system, please contact the Healih 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,
Environmental Health Specia(ist
Perscn County Health Depafiment
(rev. 4/20/16)
Person Ceur.ty En;�iror,mea!al Health, 325 S. Morga� St., Suite �, Roxboro, NC 27573, Phon::: 3;6-579-I i40, Fax 336-597-7R08
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: ES122016-0084001
� ������� ������ ��� ����� ����� ����� ����� ����� ���� ������ ����� ����� ����� ����� ����� ����� ���� ���)
ES Microbiology ID:
GPS Number:
Sample Description:
Comment:
Name of System:
JOHNNY NAPIER
P.O. Box 28047
4312 District Drive
Raleigh, NC 27611-8047
http://slph.ncpublichealth.com
Phone: 919-733-7308
Fax: 919-715-8611
620 JACK HAMBRICK RD.
ROXBORO, NC 27574
Collected: 12/19/2016 11:30
Received: 12/20/2016 08:26
Sample Source: New Well
Sampling Point: outside tap
H. Kelly
Susan Beasley
Well Permit Number:
A26-22A
Environmental Microbiology - Colilert Profile Method: SM 9223B
Test Name: Colilert
Analyte Test Result Date
Total Coliform, Colilert Absent 1ti21/2016
E. coli, Colilert Absent 12/21/2016
Report Date: 12/21/2016
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.
��
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nc department
of heaith and
human services
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county: � G ,.�
Sample [D #: �� —�
For lnorganic Ghemical Contaminants
Name: d" Ni n� 1�i t�
Reviewer: . � Z�
TEST RESULTS AND USE RECOMMENDATIONS
I.❑ Your well water meets federal drinking water standards for inorganic cliemica[s. Your water can be used for
drinking, cooking, washing, cleaning, bathing, and showering based on the inor�anic chemical resu[ts 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 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
wasliing, cleaning, bathing and showering based on the inorQanic cliemical resu[ts onlv.
Arsenic � Barium � Cadmium � Chromium � Copper � Fluoride � Lead � Iron
Manganese Mercury 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/I. 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 iiinrQnnic c/remical results onlv.
❑ b. Levels over 30 mg/I 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 I S minute sample inside the house (preferably
the kitchen) and if possible a first draw, 5 minute and a I S 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 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 �(�ro� � Magnesium
Manganese Selenium Silver pH Zinc
For ��:ore infnrmation regarding your we!/ water results, please call the Nort/e Carolina Division of Public Health at 919-707-5900.
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Report To: H. KELLY
North Carolina State Laboratory of Public Health
Enviranmenta! Sciences
Inorganic Chemistry
Certificate of Analysis
PERSON CO ENVIRONMENTAL HEALTH
325 S MORGAN STREET
Name of System:
JOHNNY NAPIER
P.O. Bax 28047
4312 DisVict Drive
Raleigh, NC 27611-8047
htto: Nsl ph. ncou bl ich ealth. com
Phone: 919-733-7308
Fax: 919-715-8611
620 JACK HAMBRICK RD
ROXBORO, NC 27573 Courier # 02-33-15 ROXBORO, NC 27574
EIN: 566000331 EH
StarLiMS ID: ES122016-0021001
Sample Type: Raw
Sample Source: New Well
Date Collected: 12/19/16
Date Received: 12/20/16
Sampling Point: Outside tap
Temp. at Receipt: 4.0
Time Collected: 11:30 AM
Collected By: H Kelly
Well Permit #: A26-22A
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
Calcium 1 mg/L
Chloride < 5 00 250 mg/L
Chromium < 0 01 0.10 mg/L
Copper < 0 05 1.3 mg/L
FI� �aride < 0 20 4.00 mg/L
0.30
Lead < 0 005 0.015 mgi�
Magnesium < 1 0 mg/L
Manganese < 0 03 0.05 mg/L
Mercury < 0 0005 0.002 mg/L
Nitrate 1 00 10.00 mg/L
Nitrite < 0 1 1.00 mg/L
pH 6.4 N/A
Selenium < 0 005 0.05 mg/L
Silver < 0 05 0.10 mg/L
Sodium 7 50 mg/L
Sulfate < 5 00 250 mg/L
Total Alkalinity 15 mg/L
Total Hardness < 7 � mg/L
Zinc < 0.50 5.00 mq/L
Report Date: 12/29/2016
Page 1 of 1
Reported By: Deddfe.�toncol
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