The URL can be used to link to this page

Home My WebLink AboutWI0500444_GEO THERMAL_20111027Permit Number Program Category Ground Water Permit Type WI0500444 / Injection Water Only GSHP Well System (5QW) Primary Reviewer eric.g.smith Coastal SW Rule Permitted Flow Facili tv Facility Name Daniel Swart SFR Location Address 6432 Sassafras Ln Raleigh Owner Owner Name Daniel Dates/Events NC 27614 Swart Scheduled Orig Issue App Received Draft Initiated Issuance 10/27/11 10/27/11 Regulated Activities Heat Pump Injection Private residence, single .family Outfall NULL Central Files: APS_ SWP_ 10/27/11 Permit Tracking Slip Status Active Project Type New Project Version 1.00 Permit Classification Individual Permit Contact Affiliation Michelle Swart 6432 Sassafras Ln Raleigh Major/Minor Minor Region Raleigh County Wake Facility Contact Affiliation Owner Type Individual Owner Affiliation Daniel Swart Owner 6432 Sassafras Ln Raleigh NC NC Public Notice Issue 10/27/11 Effective 10/27/11 27614 27614 Expiration Waterbody Name Stream Index Number Current Class Subbasin 4..VA ~CDEMR North Carolina Department of Environment and Natural Resources Division of Water Quality Beverly Eaves Perdue Governor Daniel Swart Michelle Swart 6432 Sassafras Ln. Raleigh, NC 27614 Coleen H. Sullins Director 10/27/2011 Subject: Acknowledgement of Intent to Construct Type 5QW Injection Well System Permit No. WI0500444 6432 Sassafras Ln. Raleigh, NC 27614 Dear Mr. Swart: Dee Freeman Secretary On 10/27/2011, the Aquifer Protection Section (APS) received notification of your intent to construct a closed-loop water-onl v 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: l. 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 .02ll(u)(2). Additionally, you should contact the Wake 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 (919) 715-6166 or Michael.Ro!!ers /m ncdenr,.gQY ():u have any questions. Jincerely, ~G ·~watts cc: Raleigh Regional Office -APS APS Central Files -Permit No. WI05004-L Wake County Health Dept. Supervisor Glen A. Darch (Glen A. Darch Well Drilling LLC, 13109 Bold Run Hill Rd., Wake Forest, NC 27587) Steve Bowman (Bowman Mechanical Services, 145 Technical Ct., Gamer, NC 27529) AQUIFER PROTECTION SECTION 1636 Mail Seivice Center. Raleigh, North Carolina27699-1636 Location: 2728 Capital Boulevard. Raleigh, North Caroiina 27604 Phone: 919-733-3221 \ FAX 1: 919-715-0588; FAX 2: 919-715-6048 \ Customer Service: 1-877-623-6748 Internet: www.ncwateroualitv.o rg An Eq ual Opporiunii f \ A~rmaii ve Action Employer T ... P1!S-1-.c· r ~ ~ 01u1 aro..ma /Vaturall!I NORTH CARO1.IINA 1)EPARTMFSNT OF ENVIRO}NM1FNT AND NATIURALL RESOURCES NOTIFICATION OF INTENT TO CONSTRUCT OR OPERATE INJ•E ON WELLS 509/11/1 CLOSED -LOOP WATER -ONLY GEOTHERMAL INJE'CTION WELLS -mese ells circulate potable water only as part of gcihcrmal heating and cooling worm. !n Acorerdancc W itn the Provisions of 15A NCAC 02C _ 1200 Thew wells are "permitted by rule" and do not squire an individual permit when they any constructed in accordancr with the rules of ] SA N AC O2C .02OO ernd this Name submitted prior to construction. DATE; 1 0' a A. Primr ur Typr Irrformirim and Mail ro the !!r rheas un the Lira Pow. 20 t t PERMIT NO. (to he ROW in by row) RECEIVED / ❑ENR ! DINO Aquifer Protection Section Non•Governmer,t: Individual Residence y Business izatirt _____oOCT 2 7 2011 STATUS OF WELL OWNER (choose 4.100) Govemrncnt: State Municipal County - Federal IL WELL OWNER — For individual residences, list each owner on property deed. For all Whets, Late name rtt enti aid name of petson del ted authority to sign on behalf of the bush d; ior age !� !I+tlBrl tng �#' ddri: r i! �'r' kt� sic, 'kl t � aL.[p City: 1L State: kg... Zip Code: " 7f / e j County: Day Tele No., _ Z. 7674 �� Cell N{n.: ` I `� Y � f S `f" EMAIL Add: �� : + i t n [` 4 > 5 e Ll�[Fa�s'_�_ C. LOCATION OF WELL SITE - Where the injection wells arc physically located: r 1) Pal -pet ldrntifcation Number (PIN) of well site: 18080 080 77161 County: 44/4' 4-- (2) Physical Address cif different than mailing addres0: City: State: NC Zip Code: - _ WELL DRILLER INFORMATION Well E rillir►g Cool/motor's Name: P-e n A fict..--c / �e/l L.,74 4 C NC Well Drilling Contractor Certification No.: 3 900 -4 I 4 pc,,- CI Gve ) «LII + c- �'�e ,. I EMAIL_ Address: . �e%�.1; gG��Co�-K, Ems. t�l i1 /ed Zip Code; Z 7� % State AteCouuty: We -r 59s9 Cell Nu.: 6-/_9) yz7-99 3/ _ Fax No,; Company Name. Cent Peen Address: 13/0 9 49 id City: Wa/e ICoee ,L Oaf 'tcc Tcle No.: 6B.) 5-51' HEAT PUMP CONTRACTOR INFORMATION (if different than driUer) Company Name: l3uw.mAA /¥1 ec{p_J .. ~c ~f-1 Conract Person~ S'~ ~""-"--EMAIL Address: B~w,.,,,,,. ~~, 4,.,,/./@JJrr;,~ • ,1fi!/ Address: 1¥~ iec/4,.,~ C/ City: . (2w-a e.,.---Zip Code: 2,2£ 2-9 State; NC. County: _c_~ __ ,,,L, .... C::'-· ____ _ Office Tele No.: §!,) 77z-l.7r'J ·. Celt No.; //,) Fax No.:~) 77?-~'l.9f/ F. WELL CONSTRUCTION DATA ( 1) Number of bodngs to be constructed•: '-/ Depth of each boring (feet): __ z._t_O ___ _ * If existing water .vupply wells will be used then provide the informati'on in item (4) belOM (2) Type of tubing to be used (stee], PVC, etc): -....:./J;L..._ 'l~P. __ 'IE-=--· _________ _ (3) W•eU casing. If the weU(s) will use casing then provide them {steel, PVC. etc.), diameJer. ~ and extent of casing appearing above ground: ----~----------- ( 4) Grout (material surrounding weJl casing and/or piping): (a.) Grout type: Cement__ Bentonite•• J<. Other (specif)·) ________ _ 0 By selecting bentonite 8f'OUl, a verianoe is heteby requested to I SA NCAC 2C .02 l.3(d)( 1 )(A). whicluequin:s a cement type grout. (b) Grout depth of tubing (reference to land surface): from .s;tc to 2,,{(j (feet) If we!l has casing~ indicate grout depth: from ___ to--~-(feet) G. WELL LOCATIONS -Maps must be scaled ,or otherwise accurately indicate distances and orie.ntations of features Jocated within 1000 feet of the injection weU(s). Label all feat~ clearly and include a north arrow. (J) Attach a site-specific map showing the locations of the following: * Proposed injection wells • Buildings • Property boundaries • Surface water bodies • Water supply wells • Septic tanks and associated spray irrigation sites. drain fields. or repair areas * Exi$ting or potential sources of groundwater contamination (2) Attach a topographic map of the area extending 1/4 mile from the injection well site that indicates the facility's location and the rnap name. NOTE: In most casa, t1n aerial photograpll of the propaty parcel slrowing propt!rty lines and stractura Cflft be obtained and dow11"1ath,I from tit~ IIJlp/kdk COll1'ty GI$ wdnilL lyplcolly, di, propaty co be ,nrc/,d by ow,ur nome or fNldras. llie loutil1n of die wdls in ttlldlon to pf'OJH!'I, bolltularla, l,o,ua• uptk ,,,.ts, otl,r, wdb~ •c. ct111 then be dn,wn in by llfllUI. Also. • •layer' CM be ulectd •howhrg t~lc contoMr.t 01 df!'Wllion data. R. CERTIFICATION (to be signed as required Mow or by that person ° s authorized agent) 15A NCAC 02C .021l(b) requires that all permit applications shall be signed as follows: I, for a corporation: by a responsible etrrparate officer, 2. for a. partnership c it soli; proprietorship: by a general partner or the proprietor, respectively; 3, for a municipality or a state, feral, or otter public agency: by either a principal executive officer or ranking publicly elected official:, 4. for all others_ by the well turner (which mews all persons 14444 on the pra rt demd 1, If an atatha►rired agent Ls signing on behalf of the applicant, then supply a letter signed by the applicant that names and authorizes their aft to sign this application on their behalf. . i hereby certify, under penalty of law, that r have personally examined and am familiar with the inforniatior submitted in this document and all attachments thereto and that. wed an rny inquiry of those individuals immediately responsible for obtaining said infontation. f believe that the information is true, aleurate and complete_ 1 am aware that there are significant penalties, including the :possibility of fines and imprisonment, for submitting fain information. 1 agree to construct, operate, maintain, repair, and if applicable, abandon the injection well and all related appurtenances in accordance with the approved specifications and conditions of the Permit. 11. tare cif Propaert)r )wner1fApplicar1t. L.- -3-7.„ g Print or Type Full Name r- .3 Signature of Property Owner/Applicant C 1 p Rrint or Type Full Marne Submit the complete application package to: Signature of Authorized Agent, if any Print or Type Full Name Q - Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 276' T1636 RECEIVED 1 DENR / pW Aquifer Protection Section OCT 2 7 2011 Telephone (91)) 733-3221 tcQ ?a 0 50 100 200 Feet new Value PIN 180007716i Real Estate ID 0212620 Map Name 180001 Owner SWART. DANIEL J & MICHELLE V Mailing Address 1 6432 SASSAFRAS LN Mailing Address 2 RALEIGH NC 27614-9210 Mailing Address 3 Deed Book 07056 Deed Page 0026 Deed Date 5/31/1996 Deeded Acreage 410 Assessed Building $416.667.00 Value Assessed Land Value $160.000.00 Total Assessed Value $595.667.00 Billing Glass INDIVIDUAL Property Description LO4 UPPER FORTY ESTATES SUB BM-1994-1801 Heated Area 3886 Site Address 6432 SASSAFRAS LN City Township BARTONS CREEK Year Built 1998 Total Sale Price S0.00 Sale Date Type and Lisa Single Family Design Style Conventional Land Class ~ RESIDENCE -a 10 ACRES -HOME SITE Old Parcel Number 212-00000-0000 WAKE COUNTY NtM1111 i_MiOLITlf1 Any damn to dtrplp raidaappro raltARatliaeke &pi*, for uptk ammo aad wogs, reprdetti aarpeeb1 dab addllfeae irdlar acwaory waetelrot.AppYeutfanepoodbU for protothc aOporifwaoftie teptle mine,makarm awl wens(KATdamage dn'fasr er+ceitaAliew4►alll�eflad Rolm. Approved Rolm try Dd. t pf 0/01 App Wake CaartyDept etafgaviswuaaWlDenim Water end Waste err Section 0 60 t00 20a Feet PIN 122007716/ Rail E1.141e ID 021262O Map NAIT0 160001 Owe r SIN ART. DAME. J A 1AICHELLE V 51all00 Adtyeaa 1 6432 SASSAFRAS • W litsft Anvil RALEIGH NC 276144210 uatroo AOows 3 Awn axe 1/?57e :wC P.ye OVA DOW ❑at. a31.11i. L1te9a0 +L•zayn 4 Te Aws=m4 &Malt 2416.667100 V&IN A62661K1 LYIQV.LW 6160,000.00 TAM Aapyare0 Yew $536.667 00 1114n0C1wc ❑4[HV10L1AL Prcperl pp agi0n 1.O1 UPPER FORTY ESTATES SUB 01.11294.1601 Heeled Area 3266 Sib Agorae. ee32 SASSAFRAS LN City TOrAiep BART0NS GREETS YAW LEA ISM Tehl6 alAPrice 20.00 Sib Data Type and Um Single Famly D4520 SI* Caml/wIlar l Lead Gala RESIDENCE-. 10 ACRE 3.1100E SITE Cd Puiialknew/ 212-00000-0000 WAKE COUNTY 0 400 800 1600 Feet Field Value PIN 1800077161 Real Estate ID 0212620 Map Name 184001 Owner SWART, DANIEL J & MIOHELLE V Mailing Address 1 6432 SASSAFRAS LN Mailing Address 2 RALEIGH NC 27614-9210 Mailing Address 3 Deed Book 07056 Deed Page 0025 Deed Date 6/31/1996 Deeded Acreage 4.10 Assessed Building $416,667,00 Value Assessed Land Value $180,000.00 Total Assessed Value $596,667.00 Billing Class INDIVIDUAL Property Descriplion L04 UPPER FORTY ESTATES SUB 8M011994.1801 Heated Area 3886 Site Address 6432 SASSAFRAS LN City Township BARTONS CREEK Year Built 1998 Total Sale Price $0.00 Sale Dale Type and Use Single Family Design Style Conventional Land Glass RESIDENCE-r 10 ACRES -HOME SITE Old Parcel Number 212-00000.000❑ WAKE COUNTY - ONI i, �:ANIILINh