WI0700148_GEO THERMAL_20091019

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MCD~EM-R
North Carolina Department of Environment and Natural Resources
Division of Wat er Qualit y
Beve rly Eaves Perdue
Governo r
Matt B rentjens
Liz B rentj en
21 8 C ountry C lub Drive
E denton, NC 2 79 32
Coleen H. Sullins
Directo r
10 /19/2009
Subject: Acknowledgement of Intent to Construct Type 5QW Injection Well System
Permit No. WI0700148
2 18 C ountry C lub Drive
Edenton, NC 27 932
Dear Mr. & Mrs.Brentjens:
Dee Freeman
Secretary
In accordance with the application submitted to the Underground Injection Control (UIC) Program that was received on
10/14/2009, the Aquifer Protection Section (APS) acknowledges your intent to construct a closed-loop geothermal water-
only injection well system for the operation of a ground-source heat pump located at 218 Country Club Drive, Edenton,
Chowan County, NC 27932'. This system is deemed permitted by rule (North Carolina Administrative Code Title 15A,
Subchapter 2C, Section ,0211 (u)(2)).
However, it is recommended that you contact the Chowan County Health Department, as they may have additional
construction or permitting requirements for this type of system. If you modify your system at any time, including the
addition of antifreeze, corrosion inhibitors, or any other substances to the circulating fluid, you must contact the APS to
verify compliance with applicable rules.
Thank you for submitting this notification. If you have any questions please call me at [phone].
cc: W ashinbTl:on Regional Office -APS
Sincerely,
o~~ ' D • 0--Michael Rogers
--Y,--Environmental Spec1ahst
GPU-Aquifer Protection Section
APS Central Files -Permit No. \VI0700 l 4~
Chowan County Health Dept.
Jeff Stagg (.T.A. Stage Energy Enterprises, Inc -636 Benefit Road, Chesapeake, VA 23322)
Hal Nystrom (Atlantic Shores -3500 Robs Dr.. Suffolk, VA 23434)
/1,QUIFER PROTECTION SECTION
1636 Mail Service Cente;, 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.ncwatergualitv .org
A:i Eq:Jal Opr.ortJn;t:• \ Affirmai;ve Action Employer
NonehC . ort arohna
,Naturaf/11
Permi' Number W10700148
Program Category
Ground Water
Permit Type
Injection Water Only GSHP Well Systern (50W )
Primary Reviewer
michael,rogers
Coastal SW Rule
Permitted Flow
Facility
Central Files: APS SWP
10/19/09
Permit Tracking Slip
Status
Project Type
Active
New Project
Version
Permit Classification
1.00
Individual
Permit Contact Affiliation
Facility Name MajorfMinor Region
Matt & Liz Brentjens SFR Minor Washington
Location Address County
218 Country Club Dr Chowan
Edenton NC 27932 Facility Contact Affiliation
Owner
Owner Name Owner Type
Individual
Matt Brentjens Owner Affiliation
Matt Brentjens
218 Country Club Dr
Edenton
Dates/Events
Scheduled
brig Issue App Received Draft Initiated Issuance
10/19/09 10/14/09
Reciulated Activities
Heat Pump Injectian
Outtall
NC 27932
Public Notice Issue Effective Expiration
10/19/09 10/19/09
Waterbody Name Stream Index Number
Current Class Subbasin

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DVARTMEtrT OF �ROhtMEI� I ANi3 l�tA-ruyl kL FCEMURCES (NCi7EM)
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Yes Continue cdalplceps this furl.
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.Oct 14 09 11,15a Jeffrey A. Stagg
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�, n Address 218 Country Club Dr
�-+ Edenton, NC 27932
3$
757-421-2108 a.5
RECEIVED i N24A
AquWer Pralef tian ,'don
OCT 14
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