HomeMy WebLinkAboutWI0500489_GEO THERMAL_20120228Program Category
Ground Water
Permit Type
WI05004ll9 /
Injection Water Only GSHP Well System (5QW)
Primary Reviewer
eric.g.smith
Coastal SW Rule
Permitted Flow
Facilit
Facility Name
Bryan Stypmann SFR
Location Address
2579 Burton Rd
Durham
Owner
Owner Name
Bryan
NC 27704
Stypmann
Scheduled
Orig Issue
02/28/12
App Received Draft Initiated Issuance
02/16/12
Re g ulated Activities
Heat Pump injection
Private residence, single family
Outfall NULL
Central Files: APS_ SWP_
02/28/12
Permit Tracking Slip
Status
Active
Version
1.00
Project Type
New Project
Permit Classification
Individual
Permit Contact Affiliation
Bryan Stypmann
Owner
5921 Dunbarton Way
Raleigh NC 27613
Major/Minor
Minor
Region
Raleigh
County
Durham
Facility Contact Affiliation
Owner Type
Individual
Owner Affiliation
Bryan Stypmann
Owner
5921 Dunbarton Way
Public Notice Issue
02/28/12
·effective
02/28/12
Expiration
Waterbody Name Stream Index Number Current Class Subbasin
Beverly Eaves Perdue
Governor
Bryan Stypmann
5921 Dunbarton Way
Raleigh, NC 27613
NcD
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Charles Wakiid, P.E. Dee Freeman
Director Secretary
02/28/2012
Subject: Acknowledgement of Intent to Construct Type 5QW Injection Well System
Permit No. WI0500489
2579 Burton Rd.
Durham, NC 27704
Dear Mr. Stypmann:
On 02/16/2012, the Aquifer Protection Section (APS) received notification of your intent to construct a closed -loop water-ont
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 1SA 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 l5A Section 2C Subchapter .0211(u)(2). Additionally, you should contact the Durham 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) 807-6406 or Michael,Ra ers imcdenr.gpv if you,. lave any questions.
cerely,
for Debi W,\tts
Supervi:,
cc: Raleigh Regional Office -APS
APS Central Files - Permit No. W10500489
Durham County Health Dept.
John Boyette (Boyette Well & Septic Inc., 1109 W. Nash St., Wilson, NC 27893)
Chris Barnhill (Raleigh Heating & Air, 2800 Rowland Rd., Raleigh, NC 27615)
AQUIFER PROTECTION SECTION
1636 Mall Service Center, Raleigh, North Carolina 27699-1636
Location: 512 N. Salisbury St., Raleigh, North Carolina 27604
Phone: 919.507-6484 l FAX: 919-607-6496
Internet www.nn aterouafity.orq
An EgveJ Opportunity1A{imiativeAelian Employer
ire
orrhCarolinai
Naturally
Feb 16 2012 3:13PM RALEIGH HEATING AND AIR 9198788519
p.2
i1►.aiw'wf a+�Ss►.1
In Accordance With the Provisions of 15A NCAC 02C .0200
CLOSED -LOOP WATER -ONLY GEOTHERMAL INJECTION WELLS
These welts circulate potable water only as part of a geothermal heating and cooling system.
These wells are 'Itemaued by nik" and do iwt require an individual pant when they are constructed in
fiance with The mien of 13A NCAC 02C .0200 and this Notice is submitted prior to construction.
DATE: 2-6-2012
DWQ)
Print or Type Informs on and Mall ro the ?loddrec.s oar the Losr Page.
, 20_12 PERMIT NO. (to be filled in by
STATUS OF WELL OWNER (choose one)
Non -Gave rnomf' bsoli victual Res a X_ Dominos/Organization
Govetnimeut State Municipal County Federal
B. WELL OWNER - FOrindividual residences, list each owner on property deed. For nil ot6,ers, state nawo of
entity and name of person delegated authority to sign on behalf of the business or agency;
Baran. Stvimaut -
Mailing Address: 5921 i)unbanoti Way -
City: Rpi Stain NC Zip Code: 27613 County. Wake
Day Tole No.: 9199-27O.3726 Cell T a : . Sam�
EMAIL Address: tistypinitiindocrir.conn Fax No: N/A
C. LOCATION OF WELL SITE - Where the injection wells are physically loud:
(I) Parcel Identification Number (PIN) of well site: Comm Ihylw1
(2) Physical Addrena (if different than mailing address): 2579 Burton Rd
City: Dniriiarn
State: tiC Zip Code: . 27704
D, WELL DRILLER INFORMATION
Well Milling Gamier -Wes Name: 10HN BDVETTE JR
NC Well Drilling Contractor Certification No.: 2505
Company Name: BOYE, i-11. WELL & SEPTIC INC.
Contact Person; aOHN itHETU
Address: 1109 W- NASH ST
City: WILSON Zip Code: 271393 State: NC County; WILSON
Office Tele No.: 252-237-9355 CeJ No.:252-237-8298
No.252-2(15-099
EMAIL Adds: ihbovatelgeoLcom
GPUIIUIC 5QW tdatificalua (Reviaed.3rti? Yt) )
RECEIVED 02-16 '12 13:51 FOCI- 9198788519 TO- NC DENS P&S
Pap 1
P002/003
Feb 16 2012 3:13PM RALEIGH HEATING AND RIR 9198788516 p.1
Company Name; lta1oigh Heating_AridAir
Contact Prsron: Cris Harehg}.
Address: MO Rowland rd
City: Raleigh Zip Code: MI5_ State: ___NC County: Wake
Office Tole No.: 91.9478-0008 Col Nu.: _919-868-7909 Fax No.,919-87i- &5 19
eAAddreas.eb�rniu�a i�►c_Gam
F. WELL CONSTRUCTION DATA
(1) Number of borings to be constructed*: _3 Depth of each holing (feet): 240-31fl)
* IjrexFsttng water supply wells will be used then pro tde the information to item (4) below.
(2) Type of tubing to be used (steel, PVC, etc):
(3) Well casing. If the walls) will use casing then provide the tne (steel, PVC, etc.), Chigriett', dcoh,
axed catg of casing appod:wing above ground:
(4) Grout (material surrounding well casing and/or piping :
(a) Grout type: Cement & tanite* * i[ _ Other (specify)
'• 13Y echxtrng beaitahite► wart, a vuimot: is hsriy rwpteaiedia 1 SA NC AC 2c .UZ 13(01 XA). which requires a cep typv grout.
(b) Grout depth of tubing (reference to land surface): from 0 to 0 (feet)
If well has casing, indicate grout depth. from _ - - to (feet)
G. WELL LOCATIONS - Maps must be scaled or otherwise accurately indicate distances and orientations of
features located within ION fled of the injection well(s). Lam all features clearly and include a north atrt%
(1)
Attach a situ -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
* Existing or o4en1%ai sources of groundwater contamination
(2) A tech a topographic map ofthe area encoding 114 mile from the injection well Bile that indicates the
facility's location and tho map name.
NOTE Ile most eases, OR aerial pi aftgrwpk eau' property parcel dicpsing property t and srudeerea can be
phials':4 and downloaded from the oppllcable comedy GIS webuire. J»i illy, the property con ha ached by
weer name or address. The &cation vide -40.6 in reJ6QaEurr to property boaruktrsev, homes, septic tombs, other
wear, era roux then be drawn in by Mont Alm a 44per' can be self Owning topographic caawoarrs or
elevation data.
GPINIC'Qil/ Notidmriop O r:wised 3/18/201 I)
RECEIVED 02-16-`12 13:51 FROM- 9198788519
TO- i1C DENR P&5
1 ale 2
P001/002
Feb 16 2012 3:13PM
RALE I GH HEATING AND AIR S 1987885 19
p.3
15A NCAC 02C .0211(b) requires that all permit applications shall be signed as follows
L for a corpeautioa: by a responsible corporate ot3ioer;
2. for a partnership or sole proprietorship: by a general partner or the proprietor, respectively;
3. for tt municipality or a suave, federal, or other public agency: by either a principal executive
officer or ranking publicly elected official;
4. for all others: by the well owner (which mums all persons lisgto the property 4erdi-
I1 aEn authorized agent is signing on behatf of the appticant, her~ supply a letter steed by the
applicant that names and authorizes their west to sign Oil application on their behalf.
"I lwreby certify, uncle* wrathy of law, that 1 have personally marninod 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 die information is true, scud= and
complete. I am aware that there are significant pentitie, including the possibility of fines and im[prisonmei t,
for submitting false information. I agree to cottstxeect, operate, maintain, repair, and if applicable, abandon the
injection well and all related appurtenances in nee thei tcatrnns and enntlitioas of
the Permit."
Submit the complete application package to:
Signature of ftop �vtmerlAppiicrtn
Prixri or Typo H u1 i Name
Signattuc of Property Owner/Applicant
Print or Type Full Name
Signature of Authorized Agent, if any
Print or Type Full Name
DWQ - Aquifer Protection Section
1636 Mail Smite Center
Raleigh, NC 27699-1636
Telep
807- 456 i
[]PtJ/tJI : 50V Notification (Rvinta:1: +1WW1 I )
RECEIVED 02-16-'12 13:51 FROM- 9198788519
TO- NC DEM P&5
Page 3
F003/003
•
TOVItOct—
-,;_.,.4;.l7. •^ r^i. F 'tit::' ::'• • .' Ty -i....
52a7 ElQ:ORI r ,w
.•Vd
'4's'i, O.
n
i
I
TOO@i 113M aumou 9560MM yva 9£:9i L00Z/CO/Z0
02/04/2007 18:04 FAX 2522930955
BOYETTt WELL 4 001
Z� ? i Qc1x lr-v Pelf
OrAILk6,VN � z 770 �
JippZt
46'1-
kro-ak-
poo\
),-
NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
NOTIFICATION OF INTENT TO CONSTRUCT OR OPERATE INJECTION WELLS
In Accordance With the Provisions of 15A NCAC 02C .0200
CLOSED -LOOP WATER -ONLY GEOTHERMAL INJECTION WELLS
These wells circulate potable water only as part of a geothermal healing and cooling system.
These wells are "permitted by rule" and do not require an individual permit when they are constructed in
accordance with the rules of .15A NCAC 02C .0200 and this Notice is submitted prior to construction.
DATE: 2-8-20I2
DWQ)
Print or Type Information and Afail to the Address on the Last Page.
20 12 PERMIT NO. Y.. (to be filled in by
A. STATUS OF WELL OWNER (choose one)
Non -Government: Individual Residence X Business/Organization
Government:
State _ Municipal _ _ County Federal
B. WELL OWNER — For individual residences, list each owner on property deed. For all others, state name of
entity and name of person delegated authority to sign on behalf of the business or agency:
Bran Stypmanu
Mailing Address: 5921 funbarton Way
City: Role .g State: NC Zip Code: _ 27613 County: Wake
Day Tele No.: 919-270-3726 Cell N9.: _Same
EMAIL Address: bsh omaruth nc.rr.com Fax No.: NIA
C. LOCATION OF WELL SITE — Where the injection wells are physically located:
(1) Parcel Identification Number (PIN) of well site: County_ Durham
(2) Physical Address (if different than mailing address): 2579 Burton Rd
City: Durham _ State: 1,_C Zip Code: 27704
D. WELL DRILLER INFORMATION
Well Drilling Contractor's Name: JOHN l3OYETCE JR
NC Well Drilling Contractor Certification No.: 2505
Company Name: 13OYETTE WELL & SEPTIC INC.
Contact Person: JOHN BOYETTE EMAIL Address: jhbo• cttel d col. corn
Address: 1109 W. NASH ST
City: WILSON Zip Code: 27893 State: NC County: WILSON
Office Tele No.: 252-237-9355 Cell No.:252-237-8298 _ Fax No.252-205-0992.
GPu, which requiren a =meat type rout.
(b) Grout depth of tubing (reference to land surface)- from _ to (feet)
if well has casing, indicate grout depth: from to - - - - (feet)
G. WELL LOCATIONS — Maps must be scaled or otherwise accurately indicate distances and orientations of
features located within 1000 feet of the injection well(s). Label all features clearly and include a north arrow
(1)
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
Existing or potential sources of groundwater contamination
(2) Attach a topographic map of the area extending 114 mile from the injection well site that indicates the
facility's location and the [clap name.
NOTE: In most cases, an aerial photograph of the property parcel sho ing property lines and structures can he
obtained and do oloaded from the applicable county GIS ►.febrile Typically, the property can be searched by
owner name or address. The locution of the wells in relation to property boundaries, houses, septic tanks, other
3csells, eta can then be drawn in by hand Also, a layer' can he selected shelving topographic contours or
elevation data_
OPU/U[C SEW Notification (Re►istd 3II F,l2t! i i.) Page 2
II. CERTIFICATION (to be signed as required below or by that persons authorized agent)
15A NCAC 02C _021 l(b) requires that all permit applications shall be signed as follows:
t. for a corporation: by a responsible corporate officer,
2. for a partnership or sole proprietorship: by a general partner or the proprietor, respectively;
3. for a inuni:cipality or a state, federal, or other public agency: by either a principal executive
officer or ranking publicly elected official;
4, for all others: by the well owner (which means all persons lifted on the property_dee )
If en authorized agent is signing on behalf of the applicant, then supply a Fetter signed by the
applicant that names and authorizes their agent to sign this application on their behalf.
"I hereby certify, under penalty of law, that I have personally examinedand 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
injection well and all related appurtenances in accorderre t thee, ifications and conditions of
the Permit."
Signature of !'rope. wner/Applic au
Print or Type FullName
vszes■.,
Signature of Property Owner/Applicant
Print or Type Full Name
Signature of Authorized Agent, if any
Print or Type Full Name
Submit the complete application package to:
DWQ - Aquifer Protection Section
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephon
iJ7- 63e I
GPUJUIC 5QW Notification (Rcvised 3/I snot!) 1'sgc I