WI0400170_GEO THERMAL_20110112

Permit Number
Program Category
Ground Water
Permit Type
WI0400170 /
Injection Water Only GSHP Well System (5QW)
Primary Reviewer
michael.rogers
Coastal SW Rule
Permitted Flow
Facilitv
Facility Name
Jeff Hendley SFR
Location Address
236 Harrison Ln
Boone
Owner
Owner Name
Jeff
Dates/Events
NC 28607
Hendley
Orig Issue
01/13/11
App Received Draft Initiated
12/10/10
Re g ulated Activities
Heat Pump Injection
Private residence, single family
Outfall t-,\JU .
Scheduled
Issuance
Central Files: APS_ SWP_
01/13/11
Permit Tracking Slip
Status
Active
Project Type
New Project
Version
1.00
Permit Classification
Individual
Permit Contact Affiliation
Libbi Hendley
236 Harrison Ln
Boone
Major/Minor
Minor
NC
Region
Winston-Salem
County
Watauga
Facility Contact Affiliation
Owner Type
Individual
Owner Affiliation
Jeff Hendley
Owner
236 Harrison Ln
Boone
Public Notice Issue
01/13/11
NC
Effective
01/13/11
28607
28607
Expiration
Waterbody Name Stream Index Number Current Class Subbasin
•~A ~iii.~
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue
Governor
Jeff Hendley
Libbi Hendley
23 6 Harrison Ln.
Boone, NC 28607
Coleen H. Sullins
Director
01/13/2011
Subject: Acknowledgement oflntent to Construct Type 5QW Injection Well System
Permit No. WI0400170
.236 Harrison Ln.
Boone, NC 28607
Dear Mr. and Mrs.· Hendley:
Dee Freeman
Secretary
On 12/10/2010, the Aquifer Protection Section (APS) received notification of your intent to construct a closed-loop water-onlv
geothermal injection well system for the operation of a ground-source heat pump located at the address referenced above. An
individual permit is not required for the construction and operation of this type of geothermal injection well system as long as the
following conditions are met:
1. The injection well system contains only potable water,
2. The injection well system is constructed in accordance with well construction standards specified in North
Carolina Administrative Code Title 15A Section 2C Subchapter .0213, and
3. The required notification form and associated maps have been completely and accurately submitted.
Failure to comply with all of these conditions constitutes a violation of the North Carolina Well Construction Act and North Carolina
Administrative Code Title 15A Section 2C Subchapter .0211(u)(2). Additionally, you should contact the Watauga County Health
Department as they may have additional requirements for this type of system. Noncompliance with applicable state, county, or
municipal rules and regulations may result in the assessment of civil penalties.
Please contact Mike Rogers at [phone] or Michael.Ro~:v~=;tions.
forDebraQ
cc: Winston-Salem Regional Office -APS
APS Central Files -Permit No . WI0400170
Watauga County Health Dept.
Supervisor
David J. Brown (Yadkin Well Co., Inc., 1908.Hamptonville Rd., Hamptonville, NC 27020)
Winston Petrey (Mountaineer Heating & Cooling, P.O. Box 1905, Boone, NC 28607)
AQUIFER PROTECTION SECTION
1636 Mail Service Center, Raleigh, North Carolina 27699-1636
Location: 2728.Capital Boulevard, Raleigh. North Carolina 27604
Phone: [phone] \ FAX 1: 919-715-0588; FAX 2: 919-715-6048 \ Customer Service: 1-877-623-6748
Internet www.ncwaterguality.oro
An Equal Opportunity Affi,mative Action Employer
None .. C 1. ort11 aro. 1.na ;Vaturalltt ,,,
Dec.. 4, 20.10 6:10PM YADKIN WELL
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HAMPTOMVILLE. NC 27070
DAVID J. BROWN, VICE PRES,
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NOTMCATION OFWMNT TO CONSTRUCT A
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No Duo Nat coeaplew this ftm CQv49ctr otbat MC appfiartionfonme fos im"4
eider a SA7 well ( lop well jAjWU potable wa to WW dw agei 5w) ar a 5QM won (closed-
loW woR coomicing a g' a so* ss R,-A olanal, or other aaa[reee or owrodon ialublUrs).
A. YROMTY OW,N>MMAPYI.ICANTM
jbt MhWup w" Ow= fiW4 as Fop wW deed CxCvwnrA by abwita w Cc gmeaAMUN-Ut , saftsome.cf.
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(2) Physical Addtees of Wolf Site (if difnraat tba ebm);
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B. 4UMMUZ, AGENT Old' OWNER, IF ANY (if the PermitApocm dog it the ubject"oW,
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Well Alec CantracGoa's Neiaa:
14c Councw CardAmdm No.. 2572- A _ 3Q36 A 354$.- A
Ate: 1908 HenqA=vft _
City: H anvills NC, Zip Code: 27028 Court: Ya
Office Tcka No 336463-WO _u CaUNa: 33S-374-9V6
A MIAT POW CONTRACTOR MFORMATXON if dt*rem ffixa drMer)
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Pri rm. `�_ 'pedaral. commeraiaL
Sift• Niicipak: Nero EAmmicaa Lauds:
F_ YfiTMMON MOCYMUAE Oriefy Abe kem the iseiivn weR(s) vM be ► sed)
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G. 'WELL CDNSTRUCTION DATA
(l) rmposed dWm to be caoastactrad,: 2 - 10 Nvubea ofb : .2
Appm=ztv &T6 of each b (JM): 10
(2) Type of tabing w bs t (c{►ppeor, pvc, etr,y PIE 5 �- •
0) W@U cadW Is the well(s) cmW? (dock aithor (a-) Tes 2E (b) No Wow)
(a) Yes below
Type: --p1vaked steed black spat_ - —phrd atm (specify)
CVAMS dew From to £eet (zefmmm to lead m aca)
Casing vmmW to aba" ground iachcs
(b) No �K sttrjf
(4) Gro%t Its (Moo lsl MUndbg wall c 8 snVor plpiag}: ��y t" l dL� nc 2
(a) Or= type: bleat Cetnt Eexsmafm _otbex (apm&)
(b) caw pit: Fumpil � Prmm Otbcr
(tr) emu' daA o£t*iss (re[tam to lead =Am). from �L[a m 3 (f"*
if wel! bps catlnL itdicats grout daptb: from m {tit)
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No.64561�'P. 4- 1
H. OUICTION-Vx"dTM SQUIMENT
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tine gsodiu mai had pm* VWH syslum Labol all clewbr land
(I) 1-he siia map =at sibow the avbjwt km "ty inra'W'ati to the smrmAag em by '&jag at low two ftud
r throw poiav such as roads, sums, isbdlar fiu pmw kft"atiaas.
.T (;jmTm ATION
Plus: This I%I'mft App&sdaa OIL" be sigma by!!PA Perna appearY&Z all the
recorded lepl P " ty dcsd.
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