WI0100035_GEO THERMAL_19991022

NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
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DIVISION OF WATER QUALITY
ASHEVILLE REGIONAL OFFICE
GROUNDWATER SECTION
October 22, 1999
MEMORANDUM
TO: Amy Axon, UIC Group
Raleigh Central Office
THROUGH: Laura Kay Dechant, Acting Groundwater Environmental 00_�
Regional Supervisor, Asheville Regional Office
FROM: H.E. Minnick, Hydrogeological -OV
Asheville Regional Office
SUBJECT: Inspection of Geothermal Heat Pump System
Owner -Jim Paschal
Asheville, Buncombe County
On September 23, 1999, I inspected the well borings to be used in the geothermal heat -
pump system installed by Bullman Heating and Air Conditioning for Mr. Jim Paschal.
All of the borings were constructed in compliance with 15A NCAC 2C. 0100, the North
Carolina Well Construction Standards.
Should you have any questions, please feel free to contact me at [phone].
INTERCHANGE BUILDING, 58 WOODFIN PLACE, ASHEVILLE, NC 28801-2414
PHONE [phone] FAX [phone]
AN EQUAL OPPORTUNITY / AFFIRMATIVE ACTION EMPLOYER - 50 Yo RECYCLED/10% POST -CONSUMER PAPER

GROUNDWATER SECTION
October 18, 1999
To: Kay Dechant
Groundwater Section
Asheville Regional Office
From: Mark Pritzl W, [e-mail]
Hydrogeological Technician H
UIC Group
Groundwater Section
Raleigh Central Office
Re: Receipt of Notification for a Closed -Loop Geothermal Water -Only Injection Well
System.
Notification to construct and operate injection wells for a geothermal heat pump system has been
filed by dim Paschal of Asheville, North Carolina and a copy of the Notification is enclosed for
your files. This injection well system is deemed permitted by rule (NCAC T15A: 2C.21 l(u)2)
and no regulatory action is necessary. If you have any questions, please contact me at (919) 715-
6166 or Amy Axon at [phone].
CC: UIC Files
ARo Files
Enclosures

NCDENR.
SAME; 13. HUNT JR.
COORNOR
r.
WAYNE MCDEVITTJim Paschal
SECRETARY% 611 Holt Lane
Asheville, NC 28803
KERR T. STEVENS Dear Mr. Paschal:
DIRECTOR
NORTt :AROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
October 18, 1999
DivisioN OF WATER QUALITY
In accordance with the notification submitted on your behalf by Bullman Heating &
Air dated September 28, 1999; the Groundwater Section acknowledges your intention
to construct closed -loop geothermal water-onl,, injection wells for the operation of a
ground -source heat pump. The system as described in your notification will not
require an injection well permit and is deemed permitted by rule (North Carolina
Administrative Code Title 15A: 2C.0211(u)(2). The Underground Injection Control
Group has added your site to our inventory. If you modify your system, please contact
the Groundwater Section to verify compliance. Thank you for submitting this
notification.
If you have any questions regarding geothermal heat pump wells please feel free to
contact one at [phone] or Amy Axon at [phone].
Sincerely,
AJ_P_:
Mark Pritzl
Hydrogeological Technician 11
Underground Injection Control Program
UIC Files
ARQ Files
GROUNDWATER 89CTION
1 036 MAIL 9ERVICt CXNTER, RALit 19H, NC ;7800.1676 - 2728 CAPITAL, 0LVO„ RALILIaH, NC 47604
PHONE [phone] FAX [phone]
AN EQUAL 0PPORTUN ITY 1 A■FIRMATI VE ACTION EN PLOYRR - 60% RECYCLEOl10% PC ST-CQN9UMItR PAPER

NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
NOTIFICATION OF INTENT TO CONSTRUCT A CLOSED -LOOP
GEOTHERMAL WATER --ONLY INJECTION WELL SYSTEM
(GROUND COUPLED HEAT PUMP)
Type SQW WeIls
In Accordance with the provisions of NCAC Title 15A: 02C.0200
Complete application and mail to address on the back page.
1
This is not the proper form to be used for injection wells in an open -loop geothermal system.
Do not use this form for systems that circulate an. substances other than water.
TO: DIRECTOR, NORTH CAROLINA DIVISION OF WATER QUALITY
DATE: I9_[�.
A. SYSTEM CLASSIFICATION Does the proposed system circulate potable water in continuous
piping that completely isolates the fluid from the environment?
YES If yes, then continue completing this form.
NO If no, do not cam plete this form. Form GW-57 HP, Application For
Permit To Construct AndlOr Use A Well(s) For Injection With A Hear
Pump System, should be completed,
H. SYSTEM FLUID Will any additives be introduced to the system's circulating heat transfer
fluid? This includes, but is not limited to corrosion inhibitors and/or antifreezes.
YES If yes, d❑ not complete this form. Form GW-57 HP, Application For
Permit To Construct And Or Use A Well(s) For Injection With A Heat
Pump System, should be completed.
NO _ If no, then continue completing this form,
C. PROPERTY OWNER
Name:
Address: e L i 0<, _
City: /,77 - _ , , State: At Zip Code: I
County: �. Teiephane: S�2,,x' err y4 T Y ,
D. STATUS OF PROPERTY OWNER 2 zt 177 - 3°3 Z-
Private: Federal: Commercial:
State: Municipal: Native American Lands:
GW-57 CL (May 1998) Page 1 of

E. FACILITY (SITE) DATA
(Fill out ONLY if the Status of Owner is Federal, State, Municipal or Commercial).
Name of Business or Facility:
Address:
City: ___ State: Zip Cade: __ County:
Telephone: Contact Person:
Standard Industrial Code(s), SIC, which describes commercial facility:
F. HEAT PUMP CONTRACTOR DATA
Name:
Address: f G City: _f 1 i ►; State: 1-- 7ip Code-. r Couniv __ : r
Telephone: $ $� ��$ �.Z�G $ Contact Person: -Of d I i_ r," a t.
G. CONSTRUCTION DATA (check one)
EXISTING WELL(S) being proposed for use as a ground -coupled heat pump
well(s). Provide the information in (1) through (4) below to the best of your
knowledge. Attach a copy of Form GW-1 (Weil Construction Record) if available.
PROPOSED WELL(S) to be constructed for use as a ground -coupled heat pump
wells) . Provide the information in (1) through (4) below as PROPOSED
construction specifications, Submit Form GW-1 after construction.
(1) Well Drilling Contractor's Name: i C %%(l CO
NC Driller Registration number: _
Date to be constructed: Number of borings: is
Approximate depth of each boring (feet):
(2) Well casing: Is the well(s) cased?
(a) YES If yes, then provide the casing information below,
Type: Galvanized steel Black steel Plastic Other (specify)
Casing depth: From- to ft. (reference to land surface)
Casing extends above ground inches
(b) NO -)L
(3) Grout (grout the vertical length of the borehole to a minimum depth of 20 feet b.l.s,):
(a) Grout type: Cement Bentonite X- Other (specify)
(b) Grouted surface and grout depth (reference to land surface):
around closed loop piping; from 0 to 300 (feet).
around well casing; from to (feet).
NOTE: Ti-tr- WELL DRILLING CONTRACTOR CAN SUPPLY THE DATA FOR G]Ti-€LR EMST€NG OR
PROPOSED WELLS IF THIS INFORMATION IS UNAVAILABLE BY OTHER MEANS.
GW-57 CL (May 1998) Page 2 of 4

H. INJECTION -RELATED EQUIPMENT
Attach a diagram showing the engineering layout of the injection equipment and exterior piping/tubing
associated with the injection operation. The manufacturer's brochure may provide supplementary
information.
LOCATION OF WELL(S) Attach two maps.
(1) Include a site map (can be drawn) showing: buildings, property lines surface water bodies,
potential sources of groundwater contamination and the orientation of and distances between
the proposed well(s) and any existing well(s) or waste disposal facilities such as septic tanks
or drain fields located within 200 feet of the ground -coupled heat pump well system. Label all
features clearly and include a north arrow.
(2) location map referencing the site to two nearby permanent reference points (such as roads,
streams and highway intersections).
PERMIT LIST: Attach a list of all permits or construction approvals that are related to the site.
Examples include:
(1) Hazardous Waste Management program permits under RCRA
(2) NC Division of Water Quality Non -Discharge permits
(3) Sewage Treatment and Disposal Permits
K. CERTIFICATION
`Y hereby certify, under penalty of law, that I have personally examined and am familiar with the
information submitted in this document and all attachments thereto and that, based on my inquiry of
those individuals immediately responsible for obtaining said information, I believe that the information
is true, accurate and complete. I am aware that there are significant penalties, including the possibility
of fines and imprisonment, for submitting false information. I agree to construct, operate, maintain,
repair, and if applicable, abandon the ground -source heat pump system and all related appurtenances in
accordance with the approved specifications and conditions of the Permit."
tinat of Well Owner or Authorized Agent)
If au prized agent is acting an behalf of the well owner,
please supply a letter signed by the owner
authorizing the above agent,
G W-57 CL (May 1998) Page 3 of 4

L. CONSENT OF PROPERTY OWNER (Owner means any person who holds the fee or other property
rights in the well being constructed. A well is real property and its construction on land rests
ownership in the landowner in the absence of contrary agreement in writing.)
If the property is owned by someone other than the applicant, the property owner hereby consents to
allow the applicant to construct each injection well as outlined in this application and that it shall be
the responsibility of the applicant to ensure that the ground -source heat pump system Is wells)
conforms to the Well Construction Standards (Title 15A NCAC 2C .02Q0)
;ie�(gignrty Owner I DiFferent From Appl'scant}
Please return two copies of the completed Application package to:
UIC Program
Groundwater Section
North Carolina DENR-DWQ
P.O. Box 29578
Raleigh, NC 27626-0578
Telephone [phone]
y4r fty,,f
GW-57 CL (May 1998) Page 4 of 4

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