WI0800184_GEO THERMAL_20200430

ROY COOPER
Governor
MICHAELS. REGAN
Secretary
S. DANIEL SMITH NORTH CAROLINA
Environmental Quality Director
April 30, 2020
CERTIFIED MAIL# 7018 0040 0001 1449 6917
RETURN RECEIPT REQUESTED
Dana & Douglas Hamerski
1231 Sherman Oaks Dr.
Wilmington, NC 28411
Subject: Notice of Expiration (NOE)
Geothermal Water Return/Open-Loop Injection Well
· Permit No. WI0800184
New Hanover County
Dear Mr. & Mrs. Hamerski:
The Underground Injection Control (UIC) Program of the North Carolina Division of Water
Resources (DWR) is entrusted to protect the groundwater quality and resources of the State of
North Carolina, and is responsible for the regulation of injection well construction and operation
activities within the state. Our records indicate that the above-referenced operating permit for the
geothermal injection well system located on your property at the above referenced address was
issued on July 7, 2015, and expires on June 30, 2020. Per permit conditions and requirements per
15A NCAC 2C .0224(c), the renewal application must be submitted at least 120 calendar days
prior to expiration of the permit if you wish to continue operating the injection well on your
property.
If Your Geothermal Water Return Well is Still Currently Being Used for In jection:
In order to comply with the regulatory requirements listed under North Carolina Administrative
Code (NCAC) Title 15A, Subchapter 2C, Section .0211, you must submit the enclosed renewal
application (Application for a Permit to Construct or Operate Injection Wells -Geothermal
Heating/Cooling Water Return Wells). The form is also available on-line at our website
http://portal.ncdenr.org/web/wq/aps/gwpro/permit-applications.
If Your Geothermal Water Return Well is NO LONGER Being Used for In jection:
If the well is no longer being used for injection, you do not have to renew your permit. Check the
box in Part A of the attached renewal application that you wish to rescind the permit and indicate
the current status of the well (i.e., used as water supply well, irrigation well, inactive, plugged and
abandoned, etc.). Ifit is no longer being used for any purpose, it must be permanently abandoned
according to the regulatory requirements listed under NCAC Title 15A, Subchapter 2C,
North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street I 163b Mail Service Center I Raleigh, North Carolina 27699-1636
919.707.9000
Section .0240. When the well is plugged and abandoned, a well abandonment record (Form GW-
30) must be submitted to our office to certify that the abandonment was properly conducted.
Ii There has been a Change of Ownership of the Pronert►:
If there has been a change of ownership of the property, an "Injection Well Permit
Name/Ownership Change" Form must also be submitted in addition to the renewal application.
This form is not enclosed but can be found at the website listed above. Please submit the applicable
forms to:
Division of Water Resources
11IC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Failure to submit the applicable forms 30 days before the expiration of the permit may result in
the assessment of civil penalties in accordance with North Carolina General Statute 87-94. Thank
you in advance for your cooperation and timely response. If you have any questions, please contact
me by phone at [phone] or by email at shristi.shresthaancdenr..gov.
Regards,
tla
Shristi Shrestha
Hydrogeologist
Division of Water Resources
Water Quality Regional Operations Section
Enclosures
cc: Wilmington- Regional Office — WQROS w/o enclosures
Central Files - Permit No. WI0800184 w/o enclosures

Permit Number
Program Category
Ground Water
Permit Type
WI0800184
Injection Heating/Cooling Water Return Well
Primary Reviewer
michael.rogers
Coastal SWRule
Permitted Flow
Facility
Facility Name
Douglas and Dana Hamerski SFR
Location Address
1231 Sherman Oaks Dr
Wilmington NC
Owner
Owner Name
Douglas
Dates/Events
Orig Issue
5/11/2010
App Received
5/14/2015
Regulated Activities
Heat Pump Injection
Outfall
Waterbody Name
28411
Hamerski
Draft Initiated
Scheduled
Issuance Public Notice
Central Files: APS SWP
7/7/2015
Permit Tracking Slip
Status
Active
Version
2.00
Project Type
Renewal
Permit Classification
Individual
Permit Contact Affiliation
Major/Minor
Minor
Region
Wilmington
County
New Hanover
Facility Contact Affiliation
Owner Type
Individual
Owner Affiliation
Douglas Hamerski
Owner
1231 Sherman Oaks Dr
Wilmington
Issue
7/7/2015
Effective
717/2015
NC 28411
Expiration
6/30/2020
Requested /Received Events
RO staff report requested
RO staff report received
Streamlndex Number Current Class
5/15/15
6/29/15
Subbasin
A~A
North Carolina Department of Environment and Natural Resources
Pat McCrory
Gov,,ernor
Douglas and Dana Hamerski
1231 Sherman Oaks Drive
Wilmington, NC 28411
Re: Issuance of Injection Well Permit
Permit No. WI0800184
July 7, 2015
·Geothermal Heating/Cooling Water Return Well
New Hanover County
Dear Mr. and Mrs. Hamerski;
Donald R. van der Vaart
Secretary
In accordance with your permit renewal application request received May 14, 2015, I am forwarding
Permit No. WI0800184 for the continued operation of geothermal heating/cooling water return
well(s) located at the above referenced address. This permit shall be effective from date of issuance,
until June 30, 2020, and shall be subject to the conditions and limitations stated therein.
Please Note: Samples from the influent and effluent sampling ports of your geothermal well
system were collected on June 24, 2015. Laboratory analytical results will be forwarded to you
when it becomes available.
In order to continue uninterrupted legial use of this well for the stated purpose, you should submit an
application to renew the permit 120 days prior to its expiration date. As indicated in the permit, this
permit is not transferable to any person without prior notice to, and approval by, the Director of the
Division of Water Resources. If you have any questions regarding your permit or the Underground
Injection Control Program please call me at [phone].
Best Regards,
~ .~ ' ~
Michael Rogers, P.G. (N & FL)
Hydro geologist
Division of Water Resources, NCDENR
Water Quality Regional Operations Section
cc: Jim Gregson and Morella Sanchez-King, Wilmington Regional Office
· Central Office File, WI0800184
New Hanover County Environmental Health Department
. 1636 Mail Service Center, Raleigh, North Carolina 27699-1636
Phone: [phone] \ Internet: http://www.ncwater.org
An Equal Opportunity I Affirmative Action Employer -Made in part by recycled paper
·NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVffiONMENT AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE USE OF A WELL FOR INJECTION
In accordance with the provisions of Article 7, Chapter 87; Article 21, Chapter 143; and other applicable
Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Douglas and Dana Hamerski
FOR THE CONTINUED G;PERATION OF 1 (ONE) GEOTHERMAL HEATING/COOLING WATER
RETURN WELL(S), defined in Title 15A North Carolina Administrative Code 02C .0224(a), which will be
used .for the injection of heat pump effluent. The injection well(s) located at 1231 Sherman Oaks Drive,
Wilmington, New Hanover County, NC 28411 will be operated in accordance with the application submitted
May 14, 2015, and conformity with the specifications and supporting data, all of which are filed with the
Department of Environment and Natural Resources and are considered a part of this permit.
This permit is for continued operation of an injection well shall be in compliance with Title 15A North Carolina
Administrative Code 2C .0100 and .0200, and any other Laws, Rules, and Regulations pertaining to well
construction and use;
This permit shall be effective, unless revoked, from the date ·of its issuance until June 30, 2020, and shall be
subject to the specified conditions. and limitations set forth in this permit.
Permit issued this the 7th day of July 2015.
S. Jay Zimmerman, P.G .
. Director, Division of Water Resources
By Authority of the Environmental Management Commission.
Permit #WI0800184 UIC/:5A7
ver. 04/15/2015
Page 1 of5
PART I -PERMIT GENERAL CONDITIONS
1. The Permittee shall comply with all conditions of this permit and with the standards and criteria specified
in Criteria and Standards Applicable to Injection Wells (15A NCAC 2C .0200). Noncompliance with
conditions of this permit constitutes a violation of the North Carolina Well Construction Act and is
grounds for enforcement action as provided for in N.C.G.S. 87-94
2. This permit is effective only with respect to the nature, volume of materials and rate of injection, as
described in the application and other supporting data [15A NCAC 02C .021 l(a)].
3. This permit shall become voidable unless the facility is constructed in accordance with the conditions of
this permit, the approved plans and specifications, and other supporting data [15A NCAC 02C .0211(1)].
4; This permit is not transferable without prior notice and approval. In the event there is a desire for the
facility to change ownership, or there is a name change of the Permittee, a formal permit amendment
request must be submitted, including any supporting materials as may be appropriate, at least 30 days
prior to the date of the change [lSA NCAC 02C .021 l(q)].
5. The issuance of this permit shall not relieve the Permittee of the responsibility of complying with any and
all statutes, rules; regulations, or ordinances, which may be imposed by other local, state, and federal
agencies, which have jurisdiction. Furthermore, the issuance of this permit does not imply that all
regulatory requirements have been met [15A NCAC 02C .0203].
PART II -WELL CONSTRUCTION GENERAL CONDITIONS
1. The well supplying water for the geothermal heating and cooling system shall be constructed m
accordance with the requirements of rule ISA NCAC 02C .0107 except as required in Item #2 below.
2. Any injection weH shall be constructed in accordance with .the requirements of rule 1 SA NCAC 02C
.0107 except that the entire length of the casing shall be grouted in such a way that there is no
interconnection of aquifers or zones having differences in water quality that would result in degradation of
any aquifer or zone. For screened wells, grout shall be emplaced from the top of the gravel pack to the
land surface. For open-end-wells, the casing shall be grouted from the bottom of the casing to the land
surface [ISA NCAC 02C .0224(d)(2),(3)].
3. Bentonite grout shall not be used to seal any water-bearing zone with a chloride concentration equal to or
greater than 1,500 milligrams per liter. In areas where elevated chloride levels are known to exist or are
probable, such as coastal areas, chloride levels shall be verified in the field to determine existing
conditions. [15A NCAC .0225(g)(8)l.
· 4. The injection well system shall be constructed such that a sampling tap or other collection equipment
approved by the Director provides a functional source of water when the system is operational. Such
equipment shall provide the means to collect a water sample immediately after emerging from the water
supply well and immediately prior to injection into the return well [ 15A NCAC 02C .0224( d)( 4)].
5. Each well shall be secured to reasonably insure against unauthorized access and use and shall be sealed
with a watertight cap or well seal as defined in G.S. 87-85(16).
6. Each well shall have permanently affixed an identification plate [15A NCAC 02C .0107(j)(2)].
Permit #WI0800184 UIC/5A7
ver. 04/15/2015
Page 2 of5
7. A completed Well Construction Record (Form GW-1} shall be submitted as described in Part V.5 of this
permit.
PART III-OPERATION AND USE CONDITIONS
1. The Permittee shall comply with the conditions of this permit and properly operate and maintain the
injection facility in compliance with the conditions of this permit and the rules of 15A NCAC 02C .0200,
even if compliance requires a reduction or elimination of the permitted activity [15A NCAC 02C
.021 l(j)].
2. The issuance of this permit shall not relieve the Permittee of the responsibility for damages to surface
water or groundwater resulting from the operation of this facility. In the event that the facility fails to
perform satisfactorily, including the creation of nuisance conditions or failure of the_ injection zone to
adequately assimilate the injected fluid, the Permittee shall take immediate corrective actions that may be
required, such as the repair, modification, or abandonment of the injection facility [15A NCAC 02C
.0206].
PART IV-INSPECTIONS[15A NCAC 02C .021 l(k)J
1. Any duly authorized officer, employee, or representative of the Division of Water Resources (DWR) may,
upon presentation of credentials, enter and inspect any property, premises, or place on or related to the
injection facility at any reasonable time for the purpose ofdetermining compliance with this permit, may
inspect or copy any records that must be maintained under the terms and conditions of this permit, and
may obtain samples of groundwater, surface water, or injection fluids.
2. DWR representatives shall have reasonable access for purposes of inspection, observation, and sampling
associated with injection and any related facilities as provided for in N.C.G.S. 87-90.
3. Provisions shall be made for collecting any necessary samples of the injection facility's activities.
PART V-:-MONITORING AND ~PORTING REQUIREMENTS
1. Records of well construction, repair, or abandonment shall be submitted within 30 days of completion of
such activities. Copies of such records shall be retained on-site and available for inspection [ 1 SA NCAC
02C .0224(f)(2), (4)].
2. Monitoring of any well may be required· to ensure protection ·of the groundwater resources of the State
and compliance with the groundwater quality standards specified in ISA NCAC 02L [15A NCAC 02C
.0224(f)(l)].
3. The Permittee shall report any monitoring or other information that indieates noncompliance with a
specific permit condition, that a contaminant may cause a violation of applicable groundwater quality
standards, or that a malfunction of the injection system may cause the injected fluids to migrate outside
the approved injection zone or area. As specified in rule 15A NCAC 02C .021 l(r), noncompliance
notification shall be as follows:
(A) Oral notification shall be given within 24 hours of the occurrence, or first knowledge of the
occurrence, to the Wilmington Regional Office, telephone number 910-796-7215.
Permit #WI0800184 UIC/5A7
ver. 04/15/2015
Page 3 of5
(B) Written notification shall be made within five days of the occurrence and submitted to the
addresses in Item #5 below.
(C) The written notification shall contain a description of the noncompliance and its cause; the period
of noncompliance, including dates and times; if the noncompliance has not been corrected, the
anticipated time it is expected to continue; and any steps taken or planned to reduce, eliminate, and
prevent reoccurrence of the noncompliance.
4 . The Permittee shall record the number and location of the wells with the register of deeds in the county in
which the facility is located. [15A NCAC 02C .0224(£)(3)].
5. All forms, reports, or monitoring results required by this permit shall be submitted to:
UIC Program Staff
Division of Water Resources
1636 Mail Service Center
Raleigh, NC 27699-1636
and
Water Quality Regional Operations Section
DWR Wilmington Regional Office
127 Cardinal Drive Extension
Wilmington, NC 28405
PART.VI -PERMIT RENEWAL [15A NCAC 02C .0224(c)]
As required by rule an application for permit renewal shall be made at least 120 days prior to the
expiration date of the permit. This permit condition does not apply if the Permittee chooses to
discontinue operation of the well for injection of effluent from the geothermal heating and cooling system
associated with this permit.
PART VII-CHANGE OF WELL STATUS [15A NCAC 02C .0240]
1. Proced'\,lres for temporarily or permanently abandoning a well.are the same as those specified in rule 15A
NCAC 02C .0113. While some of those criteria are given below, the Permittee bears the responsibility of
complying with all applicable regulatory requirements.
2. If a well will no longer be used for any purpose, then it should be permanently abandoned according to
rule 15A NCAC 02C .Ol 13(b) in order to prevent the well from deteriorating and acting as a source or
conduit of contamination, which is prohibited by General Statute 87-88(c).
3. If a well is taken completely out of service temporarily, the Permittee shall install a water-tight cap or well
seal that cannot be removed without the use·ofhand or power tools.
4. When injection operations have ceased at the facility and a well will no longer be used for any purpose,
the Permittee shall permanently abandon that injection well in accordance with the procedures specified in
15A NCAC 02C .Ol 13(b), which include, but are not limited to, the following:
(A) All casing and materials may be removed prior to initiation of abandonment procedures if
such removal will not be responsible for, or contribute to, the contamination of an
underground source of drinking water.
(B) The entire depth of each well shall be sounded before it is sealed to insure freedom from
obstructions that may interfere with sealing operations.
Permit #WI0800184 UIC/5A7
ver. 04/15/2015
Page 4 of5
(C) Each well shall be thoroughly disinfected prior to sealing in accordance with rule 15A
NCAC 02C .01 ll(b)(l)(A),(B), and (C).
(D) Each well shall be completely filled with cement grout, which shall be introduced into the
well through a pipe which extends to the bottom of the well and is raised as the well is
filled.
(E) In those cases when a subsurface cavity has been created as a result of the injection
operations, each well shall be abandoned in such a manner that will prevent the
movement of fluids into or between underground sources of drinking water.
(F) The Permittee shall submit a Well Abandonment Record (Form GW-30) as specified in
15A NCAC 2C .0224(£)(4) within 30 days of completion of abandonment.
5. The written documentation required in Part VII ( 4 )(F) shall be submitted to the addresses specified in Part
V.5 above.
Permit #WI0800J84 UIC/5A7
ver. 04/15/2015
Page 5 of5
Division of Water Resources
Water Quality Regional Operations Section
REGIONAL STAFF REPORT
Date: 6/24/2015 Permittee(s): Douglas and Dana Hamerski
Permit No.: W10800184
To: Michael Rogers County: New Hat MIVFD/DENRIDWR
Project Name: Geothermal Open -Loop Injection Well
Regional Login No: Geoff Ke2le► JUN 2 9 2015
1. GENERAL INFORMATION Water Quality1. This application is (check an that apply):❑ SFR Waste Irrigation System IS]ti1C' Well(s)
❑ New ®Renewal Perms ttg Section
❑ Minor Modification ❑ Major Modification
❑ Surface Irrigation ❑ Reuse ❑ Recycle ❑ High Rate Infiltration ❑ Evaporation/Infiltration Lagoon
LI Land Application of Residuals
❑ Distribution of Residuals
❑ Attachment B included
❑ Surface Disposal
❑ 503 regulated ❑ 503 cxernpt
❑ Closed -loop Groundwater Remediation ® Other Injection Wells (including in situ remediation)
Was a site visit conducted in order to prepare this report? ® Yes or ❑ No,
a. Date of site visit: 6/24/2015
b, Person contacted and contact information: Doug Hamerski anstrutherna usa.net
c. Site visit conducted by: Geoff KecleN,
d. Inspection Report Attached: ❑ Yes or ® No.
2. Is the following information entered into the S1MS record for this application correct?
® Yes or ❑ No. If'no. please complete the following or indicate that it is correct on the current application.
For SFR Treatment Facilities:
a. Location:
b. Driving Directions:
c. USGS Quadrangle Map name and number:
d. Latitude: Longitude: Method Used (GPS, Googlem, etc.);
e. Regulated Activities / Type of Wastes (e.g., subdivision, food processing, municipal wastewater):
For UIC Injection Sites:
Of multiple sites either indicate which sites the information applies to, car. and paste a new section into the
document for each site_ or attach additional pates for each site)
a. Location(s):
b. Driving Directions:
c. USGS Quadrangle Map name and number
d. Latitude: Longitude; Method Used (GPS, GoogleT", etc.); GPS
Af'S-GPiJ Regional Staff Report (Sept 09) Pagel of 4 Pages

•
Division of Water Resources
Water Quality Regional Operations Section
REGIONAL STAFF REPORT
II! INJECTION WELL PERMIT APPLICATION' (Complete these two sections for all systems that use injection
wells, including closed -loop groundwater remediation effluent injection wells, in situ remediation injection wells, and heat
pump injection wells.)
Description of Well(s) and Facilities — New, Renewal, and Modification
l , Type of injection system:
® Heating/cooling water return flow (5A7)
❑ Closed -loop heat pump system (5QM/5QW)
❑ In situ remediation (51)
❑ Closed -loop groundwater remediation effluent injection (51.,/"Non-Discharge")
❑ Other (Spec i fy: )
2. Does system use same well for water source and injection? ❑ Yes ® No
3. Are there any potential pollution sources that may affect injection? ❑ Yes ® No
What is/are the pollution souree(s)? What is the distance of the iniection wellis j from the pollution
sou.rceLs ft.
4. What is the minimum distance of proposed injection wells from the property boundary? 15 ft.
5. Quality of drainage at site: ® Good ❑ Adequate ❑ Poor
6. Flooding potential of site: ®Low ❑ Moderate ❑ High
7. For groundwater remediation systems, is the proposed and/or existing groundwater monitoring program
(number of wells, frequency of monitoring, monitoring parameters, etc.) adequate? ❑ Yes ❑ No. Attach
map of existing monitoring well network if applicable. If No, explain and recommend any changes to the
groundwater monitoring program:
S. Does the map presented represent the actual site (property lines, wells, surface drainage)? ® Yes or ❑ No. If
no or no map, please attach a sketch of the site. Show property boundaries, buildings, wells, potential pollution
sources, roads, approximate scale, and north arrow.
Injection Well Permit Renewal and Modification Only:
1, For heat pump systems, are there any abnormalities in heat pump or injection well operation (e.g. turbid water,
failure to assimilate injected fluid, poor heating/cooling)?
❑ Yes ® No. If des. explain:
2. For closed -loop heat pump systems, has system lost pressure or required make-up fluid since permit issuance
or last inspection? ❑ Yes ❑ No. If des, explain:
3. For renewal or modification of t+_roundwater remediation permits (of am iypel. will
continued/additional/modified injections have an adverse imt?act on migration of the plume or manauement of
the contamination incident? ❑ Yes ❑ No. if 4es. explain:
APS-GPU Regional Staff Repori (Sept 09) Page 2 old Pages

Division of Water Resources
Water Quality Regional Operations Section
REGIONAL STAFF REPORT
4; Drilling Contractor: Name:
Address:
NC Certification number:
Complete and attach NEW Injection Facility Inspection Report, if applicable
V. EVALUATION AND RECOMMENDATIONS
I. Provide any additional narrative regarding your review of the Application:
This review was conducted for a permit renewal request for an open loop underground
injection geothermal well heat pump system for the Hamerski residence. On June 24,
2015, staff visited the home to inspect the well system. Source well water and water
prior to re-injection was sam _pled for Metals, total and fecal coliform, Nitrates, Chloride
and Total Dissolved Solids. Sampling results will be forwarded to the Central Office
when received. System operation has been normal.
2. Attach new Injection Facility Inspection Form, if applicable
3. Do you foresee any problems with issuance/renewal of this permit? 0 Yes r;g] No. If yes, please explain
briefly. __ .
4. List any items that you would like APS Central Office to obtain through an additional information request.
Make sure that you provide a reason for each item:
--~------- -
Item --+----Reason
~----------------------------------~
5. List specific Permit conditions that you recommend to be removed from the permit when issued. Make sure
that you provide a reason for each condition:
----
Condition Reason
6. List specific special conditions or compliance schedules that you recommend to be included in the permit when
issued. Make sure that you provide a reason for each special condition:
APS-GPU Regional Staff Report (Sept 09) Page 3 of 4 Pages
Division of Water Resources
Water Quality Regional Operations Section
REGIONAL STAFF REPORT
Condition Reason
7. Recommendation: ❑ Hold, pending receipt and review of additional information by regional office; ❑ Hold,
pending review of draft permit by regional office; ❑ Issue upon receipt of needed additional information; LE
Issue; ❑ Deny. If deny, please state reasons:
Signature of report Preparers)
1Y,20( s-
Signature of APS regional supervisor:
Date: Q 0'a5,-0/5
ifI ADDITIONAL INFORMATION AND SITE MAP (Sketch of site showinj house and waste irrigation
system. spray or drip field, location of'well(s). and/or other relevant information- SHOW NORTHARROii )
APS-GPU Regional Staff Repot (Sept 09) Page 4 of 4 Pages

j %� Source Well
'I 9.2 1 Sherman Oaks Dr

WATER QUALITY REGIONAL OPERATIONS SECTION
APPLICATION REVIEW RE QUEST FORM
Date: May 15, 2015
To: Jim Gregson/Morella Sanchez-King
From: Michael Rogers, WQROS -Animal Feeding Operations and Groundwater Protection Branch
Telephone: [phone] Fax: [phone] E-Mail: [e-mail]
A. Permit Number: WI0800184
B. Applicant: Douglas and Dana Hamerski
C. Facili tv Name:
D. Application:
Permit Type: Geothermal Heating/Cooling Water Return Well
Project Type: Renewal
E. Comments/Other Information:
D I would like to accompany you on a site visit.
Attached, you will find all information submitted in support of the above-referenced application for your
review, comment, and/or action. Within 30 calendar days, please return a completed W OROS Staff
Report.
When you receive this request form, please write your name and dates in the spaces below, make a copy
of this sheet, and return it to the appropriate Central Office Groundwater Protection Branch contact
person listed above.
RO-WOROSReviewer: __________________ Date: _____ _
COMMENTS:
NOTES:
FORM: WQROS-ARR ver. 092614 Page 1 of 1
ATA
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
May 15. 2015
Douglas and Dana Hamerski
1231 Sherman Oaks Drive
Wilmington, NC 28411
RE: Acknowledgement of Application No. WIOSOO184
Geothermal Heating/Cooling Water Return Well
New Hanover County
Dear Mr_ and Mrs. Hamerski:
Donald R. van der Vaart
Secretary
The Water Quality Regional Operations Section (WQROS) acknowledges receipt of your
permit application and supporting documentation received on May 14, 2015. Your application
package has been assigned the number listed above, and the primary reviewer is Michael Rogers.
Central and Wilmington Regional Office staff will perform a detailed review of the
provided application, and may contact you with a request for additional information. To ensure
maximum efficiency in processing permit applications, the Water Quality Regional Operations
Section (WQROS) requests your assistance in providing a timely and complete response to any
additional information requests.
Please note that processing standard review permit applications may take as long as 60 to
90 days after receipt of a complete application. If you have any questions, please contact
Michael Rogers at [phone] or [e-mail].
ncdenr.gov.
Sincerely,
day-- Debra J. Watts, Supervisor
Animal Feeding Operations & Groundwater
Protection Branch
Division of Water Resources
cc: Wilmington Regional Office, WQROS
Permit File WI0800184
1636 Mail Service Center, Raleigh, North Carolina 27699-1636
Phone: [phone] Internet: htlp://www.ncwater,org
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NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
APPLICATION FOR A PERMIT TO CONSTRUCT OR OPERATE INJECTION WELLS
In Accordance With the Provisions of 15A NCAC 02C ,0224
GEOTHERMAL HEATING/COOLING WATER RETURN WELL(S)
These well(s) inject groundwater directly into the subsurface as part of a geothermal heating and cooling system
CHECK ONE OF THE FOLLOWING:
New Application Renewal* Modification Permit Rescission Request*
*For Permit Renewats or Rescission Request, complete Pates 1 and 4 (signature page) only
Print or Type Information and Mail to the Address on the Last Page. Illegible Applications Will Be Returned As Incomplete.
DATE: V L -. ti 0 .20 I5 PERMIT NO. (leave blank if New Application)
A. CURRENT WELL USE AND OWNERSHIP STATUS (leave Blank if New Application)
I. Current Use of Well
a. Continue to use as Geothermal Well Drinking Water Supply Other Water
Supply
b. Terminate Use: If the well is no longer being used as a geothermal injection well and you wish to
rescind the permit, check the box below. if abandoned, attach a copy of the Well Abandonment
Record (GW-30).
❑ Yes, I wish to rescind the permit
2. Current Ownership Status
Has there been a change of ownership since permit last issued? ❑ YES
If yes, indicate new owner's contact information:
Name(s)
Mailing Address:
City: State: Zip Code:
Day Tele No.: Email Address.:
B. STATUS OF APPLICANT (choose one)
Non -Government: Individual Residence Business/Organization
Government: State Municipal County Federal
County:
C. WELL OWNER(S)IPERMIT APPLICANT — For individual residences, list owner(s) an property deed. For
all others, list name of entity and name cif person delegated authority to sign:
44 .1- 1 /'1
Mailing Address: i 4 e t S
City: State: t ip Code: 1' 1 ` County: Mr3Q I-] a!►tr, rtil
Day Tele No.: L VC! -- S ( -' S l q Cell No.:
EMAIL Address:•ra Fax No.:
Geothermal Water Return Well Permit Application (Ksvaed kir 2M+! sj Page 1

NOTE: In most cases an aerial photograph of the property parcel showing property lures and structures can be
obtained and downloaded from the applicable county GIS website Typically, the property can be searched by
owner name or address. The location of the wells in relation to property boundaries, houses, septic tanks, other
wells, etc. can then be drawn in by hand Also, a `layer' can be selected showing topographic contours or
elevation data
M. CERTIFICATION (to be signed as required below or by that person's authorized agent)
i 5A NC.,' { ; _. ' ! 1 requires that all permit applications shall be signed as follows:
1, 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 municipality or a state, federal, or other public agency_ by either a principal executive
officer or ranking publicly elected official;
4. for all others: by all the personisi listed on the property deed.
If an authorized agent is signing on behalf of the applicant, then supply a letter 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 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. 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."
Signature of Property&$ ner/Applicant
Print or Type Full Name
fv,..17)tc — •
Signature of Property Owner/Applicant
Print or Type Full Name
Signature of Authorized Agent, if any
Print or Type Full Name
Submit two copies of the completed application package to:
Division of Water Resources
Water Quality Regional Operations Section (WQROS)
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone [phone]
Geothermal Water Return Well Permit Application [ . 1
Page 4

Ro gers, Michael
From:
Sent:
To:
Subject:
Attachments:
Dana-
Rogers, Michael
Tuesday, May 05, 2015 3:47 PM
'Dana Hamerski'
RE: WI0800184 Hamerski Geothermal Well Permit Renewal
Geothermal Well Permit App_2015_0130.docx
As I mentioned, just complete the first and last pages. You can scan and send back in reply to this email. Thanks.
From: Dana Hamerski [mailto:dlhamerski @g mail.com]
Sent: Monday, May 04, 2015 6:57 PM
To: Rogers, Michael
Subject: RE: WI0800184 Hamerski Geothermal Well Permit Renewal
We showed the letter to Obrien and they said they spoke to you and the permit was only needed when the
project was worked on. We are using the the well for our geothermal heat pump.
On May 4, 2015 4:44 PM, "Rogers, Michael" <michael.ro gers ,ncdem.gov> wrote:
Is the well no longer being used for geothermal injection? What is status? Thanks.
From: Dana Hamerski [mailto:dlhamerski@g mail.com]
Sent: Monday, May 04, 2015 4:17 PM
To: Rogers, Michael
Subject: Re: WI0800184 Hamerski Geothermal Well Permit Renewal
We no longer need tge permit, as the geothermal project is completed. Thank you.
On May 4, 2015 2:45 PM, "Rogers, Michael" <michael.ro gers@ ncdenr.gov> wrote:
Mr. and Mrs. Hamerski-
We sent you a renewal application in February for your geothermal injection well. Do you wish to renew your
geothermal well permit? If so piease complete, sign, and return. You can send back Ill reply to this email if
you wish. If you want to rescind the permit, please check the box on the 1st page and sign. If you have any
questions, please contact me.
Thank you for your cooperation.
1
Michael Rogers, P.G. (NC & FL)
Hydrogeologist
NCDENR-DWR
Water Quality Regional Operations Section
1636 Mail Service Center
Raleigh, NC 27699
Direct No. 919-807-6406
http://portal.ncdenr.org/web/wq/ aps/ gwpro/reporting-forms
NOTE: Per Executive Order No. 150, all e-mails sent to and from this account are subject to the North
Carolina Public Records Law and may be disclosed to third parties.
2
Ro g ers, Michael
From:
Sent:
To:
Rogers, Michael
Monday, May 04, 2015 2:46 PM
'[e-mail]'
Subject:
Attachments:
WI0800184 Hamerski Geothermal Well Permit Renewal
Geothermal Well Permit App_2015_0130.docx
Mr. and Mrs. Hamerski-
We sent you a renewal application in February for your geothermal injection well. Do you wish to renew your
geothermal well permit? If so please complete, sign, and return. You can send back in reply to this email if you wish. If
you want to rescind the permit, please check the box on the 1st page and sign. If you have any questions, please contact
me.
Thank you for your cooperation.
Michael Rogers, P.G. (NC & FL)
Hydrogeologist
NCDENR-DWR
Water Quality Regional Operations Section
1636 Mail Service Center
Raleigh, NC 27699
Direct No. 919-807-6406
http://portal.ncdenr.org/web/wg/aps/gwpro/reporting-forms
NOTE: Per Executive Order No. 150, all e-mails sent to and from this account are subject to the North Carolina Public
Records Law and may be disclosed to third parties.
1
AVA NCDEMR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
February 6, 2015
CERTIFIED MAIL# 7014 1200 0001 3432 8336
RETURN RECEIPT REQUESTED
Douglas and Dana Hamerski
123.1 Sherman Oak Drive
Wilmington, NC 28411
Subject: Notice of Expiration (NOE)
Geothermal Water Return/Open-Loop Injection Well
Permit No. WI0800184
New Hanover County
Dear Mr. and Mrs. Hamerski:
Donald R. van der Vaart
Secretary
The Underground Injection Control (UIC) Program of the North Carolina Division of Water
Resources (DWR) is entrusted to protect the groundwater quality and resources of the State of
North Carolina, and is responsible for the regulation of injection well construction and operation
activities within the state. Our records indicate that the above-referenced operating permit for the
geothermal injection well system located on your property located at the above referenced address
was issued to you on May 17, 2010, and expires on April 30, 2015. Per permit conditions and
requirements per 15A NCAC 2C .0224(c), the renewal application must be submitted at least 120
calendar days prior to expiration of your permit if you wish to continue operating the injection well.
According to our records, your permit renewal application is now past due. Please submit your
application (attached) as soon as possible if you wish to continue using the well for injection.
If Your Geothermal Water Return Well is Still Currentlv Being Used for In jection:
In order to comply with the regulatory requirements listed under North Carolina Administrative
Code (NCAC) Title 15A, Subchapter 2C, Section .0211, you must submit the enclosed renewal
application (Application for a Permit to Construct or Operate Injection Wells -Geothermal
Heating/Cooling Water Return Wells). The form is also available on-line at our website
http://portal.ncdenr.org/web/wq/ aps/ gwpro/permit-applications.
If Your Geothermal Water Return Well is NO LONGER Being Used for In jection:
If the well is no longer being used for injection, you do not have to renew your permit. Check the
box in Part A of the attached renewal application that you wish to rescind the permit and indicate
the current status of the well (i.e., used as water supply well, irrigation well, inactive, plugged and
abandoned, etc.). If it is no longer being used for any purpose, it must be permanently abandoned
according to the regulatory requirements listed under NCAC Title 15A, Subchapter 2C, Section
.0240: When th€ well is-plugged and abandoned, a well abandonment record (Form GW-30) must
be submitted to our office to certify that the abandonment was properly conducted.
1636 Mail Service Center, Raleigh, North Carolina 27699-1636
-Phone: [phone]\ Internet: www.ncdenr.gov
An l:cjual-Opp,ortunity I Affirmative Action Employer -Made in part by recycled paper
Douglas and Dana Hamerski Page2
If There has been a Change of Ownership of the Prope rtv :
If there has been a change of ownership of the property, an "Injection Well Permit
Name/Ownership Change" Form must also be submitted in addition to the renewal application.
This form is not enclosed but can be found at the website listed above. Please submit the applicable
forms to:
Division of Water Resources
UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Failure to submit the applicable forms in a timely manner may result in the assessment of civil
penalties in accordance with North Carolina General Statute 87-94. Thank you in advance for your
cooperation and timely response. If you have any questions, please contact me by phone at (919)
807-6406 or by email at Michael.Ro gers @ncdenr.rw v .
Regards, ~~--
Michael.Rogers, P.G. (NC & FL)
fiydrogeologist
Division of Water Resources
Water Quality Regional Operations Section
Enclosures
cc: Wilmington Regional Office -WQROS w/o enclosures
Central Files -Permit No. WI0800184 w/o enclosures
7014 1200 0001 3432 8336
U.S. Postal Servicerna
CERTFIEP MAILrM RECEIPT
(Domestic Mail Only; No insurance Coverage Provided)
For delivery Information visit our website at www.usps.com9
Return Receipt Fee
(Endorsement Required)
Restricted Delivery Fee
(Endorsement 9e uIred)
Total Postage & Fees
Postmark
Here
Sent To
City Stele.2P+L4 r Ir l r -77c cge4'
SENDER: COMPLETE THIS SECTION
• Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
• Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailplece,
or on the front it space permits.
1. Article Addressed to:
DLzzis ard Lary
kal 4e&-reta .02/Le
hl trnitri02, 126
g4/I
COMPLETE THIS SECTION ON VEL1VERY
Signature
x
S. Received by (Printed Name)
■
El Addressee
C. bate of Lialiy ty—
D. Is delivery address different from item t? 0 Ye
if YES, enter delivery address below: ❑ No
3. Sice Type
edified Malin ❑Priority Mail Express'
© Registered 0 Return Receipt for Merchandise
O Insured Mall 0 Collect on Delivery
4. Restricted Delivery? (Extra Fee)
v Yes
2. Article Number
(Transfer from service label}
7014 1200 0001 3432 8336
PS Form 3811, July 2013 Domestic Return Receipt
1

Permit Number WI0800184
Program Category
Ground Water
Permit Type
..
Injection Heating/Cooling Water Return Well (5A7)
Primary Reviewer
michael .rogers
Coastal SW Rule
Permitted Flow
Facilit
Facility Name
Douglas and Dana Hamerski SFR
Location Address
1231 Sherman Oaks Dr
Wilmington NC 28411
Owner
Owner Name
Douglas Hamerski
Dates/Events
Orig Issue
05/11/10
App Received Draft Initiated
02/04/10
Scheduled
Issuance
Central Files : APS_ SWP_
05/24/10
Permit Tracking Slip
Status
Active
Project Type
New Project
Version
1.00
Permit Classification
Individual
Permit Contact Affiliation
Daina Helias
PO Box 882
Hampstead NC
Major/Minor
Minor
Region
Wilmington
County
New Hanover
Facility Contact Affiliation
Owner Type
Individual
Owner Affiliation
Douglas Hamerski
Owner
1231 Sherman Oaks Dr
Wilmington
Public Notice Issue
05/17/10
NC
Effective
05/17/10
28443
28411
Expiration
04/30/15
_R_e_..g_u_la_t_e_d_A_c_t_iv_i_ti_e_s ________________ .:.cR=e=q=u=e=s=te=d=/-=-R=e=c=e=iv,._,e=d'-=E:..:.v=e.:..:n.:.:ts"-------------
Heat Pump Injection RO staff repo rt requested
Private residence, single family RO _staff report rece ived
Additional information reque sted
Additional information rece ived
Outfall NJLL
Waterbody Name
RO staff report requested
RO staff report received
Stream Index Number Current Class
02/26/10
03/08/10
03/16/10
03/31/10
04/12/10
05/05/10
Subbasin
Permit Number WI0800184
Program Category
Ground Water
Permit Type
Injection Heating/Cooling Water Return Well (5A7)
Primary Reviewer
michael.rogers
Coastal -SW Rule
Permitted Flow
Facilitv
Facility Name
Douglas and Dana Hamerski SFR
Location Address
1231 Sherman Oaks Dr
Wilmington NC 28411
Owner
Owner Name
Douglas Hamerski
Date s/Events
Orig Issue
05/11/10
App Received Draft Initiated
02/04/10
Re ~ulated Activities
Heat Pump Injection
Private residence, single family
Outfall NULL
Scheduled
Issuance
Central Files: APS_ SWP_
05/11/10
Permit Tracking Slip
Status
Active
Project Type
New Project
Version
1.00
Permit Classification
Individual
Permit Contact Affiliation
Daina Helias
PO Box882
Hampstead NC
MajorlMinor
Minor
Region
Wilmington
County
New Hanover
Facility Contact Affiliation
Owner Type
Individual
Owner Affiliation
Douglas Hamerski
Owner
1231 Sherman Oaks Dr
Wilmington NC
Public Notice Issue
05/11/10
Effective
05/11/10
Re g uestedlReceived Events
RO staff report requested
RO staff report received
Additional information requested
Additional information received
RO staff report requested
RO staff report received
28443
28411
Expiration
02/26/10
03/08/10
03/16/10
03/31/10
04/12/10
05/05/10
Waterbody Name Stream Index Number Current Class Subbasin
A7A
NCDENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Division of Water Ouallty
Coleen H. Sullins Dee Freeman
Director Secretary
May 17, 2010
Douglas and Dana Harnerski.
1231 Sherman Oaks Dr,
Wilmington, NC 28411
Re: Issuance of Injection Well Permit
Permit No. WI0800184
Issued to Douglas and Dana Hamerski
New Hanover County
Dear Mr. and Mrs. Hamerski:
In accordance with your application received February 4, 2010, and additional information received March 31,
2010, I am forwarding Permit No. W10800184 for the construction and operation of a 5A7 geothermal
underground injection control (UIC) well heat pump system located at the above referenced address. This
permit shall be effective from the date ofissuance until April 30, 2015, and shall be subject to the conditions
and limitations stated therein.
In order to continue -uninterrupted legal use of this well for the stated purpose, you should submit an application
to renew the permit four months prior to its expiration date. As indicated in the permit, this permit is not
transferable to any person without prior notice to, and approval by, the Director of the Division of Water
Quality, If you have any questions regarding your permit or the Underground Injection Control Program please
call meat [phone].
Best Regards,
Michael Rogers, P.G. (N FL)
Environmental Specialist
cc: Charlie Stehman — Wilmington Regional Office
Central Office File — WI0800184
New .Hanover County Environmental Health Dept.
Attachment(s)
AQUIFER PROTECTION SECTION
1636 Mail Service Center, Raie&ah, North Carolina 27698-1636
Location: 2728 Capital Boulevard, Raleigh, North Carolina 27604
Phan! 919-733-32211 FAX 1: 919-715.0588; FAX 2' 919-715-6048 \ Customer Service;1-677-623-6748
Internet www.ncwateraugh v.Qry
M Equal 0pparlunity L Affirmativt+Anon Employar
One
No Carolina
aturally

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE CONSTRUCTION AND OPERATION OF A WELL FOR INJECTION
In accordance with the provisions of Article 7, Chapter 87; Article 21, Chapter 143, and other applicable
Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Douglas and Dana Namerski
FOR THE CONSTRUCTION AND OPERATION OF A TYPE 5A7 INJECTION WELL, defined in Title 15A
North Carolina Administrative Code 2C .0209(e)(3)(A), which will be used for the injection of heat pump
effluent. This injection well is located at 1231 Sherman Oaks Dr., Wilmington, New Hanover County, NC
28411, and will be constructed and operated in accordance with the application February 4, 2010, and
conformity with the specifications and supporting data received March 31, 2010, all of which are filed with the
Department of Environment and Natural Resources and are considered a part of this permit.
This permit is for Construction and Operation of an injection well shall be in compliance with Title 15A North
Carolina Administrative Code 2C .0100 and .0200, and any other Laws, Rules, and Regulations pertaining to
well construction and use,
This permit shall be effective, unless revoked, from the date of its issuance until April 30, 2015, and shall be
subject to the specified conditions and limitations set forth in Parts 1 through IX hereof.
444%
Permit issued this the day of infix , 2010
al:16r),TrA
Caleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission.
W10800184 t

PART I -WELL CONSTRUCTION GENERAL CONDITIONS
1. The Permittee must comply with all conditions of this permit and with the standards and criteria specified
in Criteria and Standards Applicable to Injection Wells (15A NCAC 2C .0200). Any noncompliance with
conditions of this permit constitutes a violation of the North Carolina Well Construction Act and is
grounds for enforcement action as provided for in N.C.G.S. 87-94.
2. This permit shall become voidable unless the facility is constructed in accordance with the conditions of
this permit, the approved plans and specifications, and other supporting data.
3. Each injection well shall not hydraulically connect separate aquifers.
4. Each injection well shall be constructed in such a manner that water from land surface cannot migrate into
the gravel pack or well screen.
5. Each injection well shall be secured to reasonably insure against unauthorized access and use. Each well
shall be permanently labeled with a warning that it is for injection purposes and the entrance to each well
must be secured with a locking cap.
6. Each injection well shall be afforded reasonable protection against damage during construction and use.
7. Each geothermal injection well shall have permanently affixed an identification plate according to 2C
.0213(g).
8. A completed Well Construction Record (Form GW-1) must be submitted for each injection well to:
Aquifer Protection Section -UIC Staff
1636 Mail Service Center
Raleigh, NC 27699-1636
and
Aquifer Protection Section-Wilmington Regional Office
127 Cardinal Drive Extension
Wilmington, NC 28405-2845
[phone]
GW-1 s must be submitted within 30 days of completion of well construction. Copies of the GW-1
form(s) shall be retained on-site and available for inspection.
PART II-WELL CONSTRUCTION SPECIAL CONDITIONS
1. At least forty-eight (48) hours prior to constructing each injection well, the Permittee shall notify the
Aquifer Protection Section-Underground Injection Control (UIC), Central Ofijce staff, telephone number
[phone] and the Wilmington Regional Office Aquifer Protection Section (APS) Staff, telephone
number (91 O) 796-7215.
2. Within 30 days of injection well completion, Permittee must contact the Wilmington Regional Office
APS Staff in order to have samples collected at the source well and injection well.
WI0800184 2
3. Continued operation of the injection system will be contingent upon the effluent not impacting
groundwater quality. The water quality of the effluent cannot be that of a lower quality than the influent,
which results in a degrading of water quality of the aquifer.
4. The injection well system must be constructed with sampling ports so that system influent and effluent
may be sampled.
5 . The injection well must be constructed to a depth such that it is injecting water into the same aquifer that
the source well is drawing from .
PART III-OPERATION AND USE GENERAL CONDITIONS
1. This permit is effective only with respect to the nature, volume of materials and rate of injection, as
described in the application and other supporting data.
2. This permit is not transferable without prior notice to, and approval by, the Director of the Division of
Water Quality (Director). In the event there is a desire for the facility to change ownership, or there is a
name change of the Perrnittee, a formal permit amendment request must be submitted to the Director,
including any supporting materials as may be appropriate, at least 30 days prior to the date of the change.
3. The issuance of this permit shall not relieve the Permittee of the responsibility of complying with any and
all statutes, rules, regulations, or ordinances, which may be imposed by other local, state, and federal
agencies, which have jurisdiction. Furthermore, the issuance of this permit does not imply that all
regulatory requirements have been met.
PART IV -PERFORMANCE STANDARDS
1. The injection facility shall be effectively maintained and operated at all times so that there is no
contamination of groundwater which will render it unsatisfactory for normal use. In the event that the
facility fails to perform satisfactorily, including the creation of nuisance conditions or failure of the
injection zone to adequately assimilate the injected fluid, the Permittee shall take immediate corrective
actions including those actions that may be required by the Division of Water Quality such as the repair,
modification, or abandonment of the injection facility.
2. The Permittee shall be required to comply with the terms and conditions of this permit even if compliance
requires a reduction or elimination of the permitted activity.
3. The issuance of this permit shall not relieve the Permittee of the responsibility for damages to surface or
groundwater resulting from the operation of this facility.
PART V -OPERATION AND MAINTENANCE REQUIREMENTS
1. The injection facility shall be properly maintained and operated at all times.
2. The Permittee must notify the Division and receive prior written approval from the Director of any
planned physical alterations or additions in the permitted facility or activity not specifically authorized by
the permit.
WI0800184 3
3. At least forty-eight (48) hours prior to the initiation of the operation of the facility for injection, the
Permittee must notify by telephone the Aquifer Protection Section-Underground Injection Control (UIC),
Central Office staff, telephone number [phone] Notification is required so that Division staff can
inspect or otherwise review the injection facility and determine if it is in compliance with permit
conditions.
PART VI-INSPECTIONS
1. Any duly authorized officer, employee, or representative of the Division of Water Quality may, upon
presentation of credentials, enter and inspect any property, premises, or place on or related to the injection
facility at any reasonable time for the purpose of determining compliance with this permit, may inspect or
copy any records that must be maintained under the terms and conditions of this permit, and may obtain
samples of groundwater, surface water, or injection fluids.
2. Department representatives shall have reasonable access for purposes of inspection, observation, and
sampling associated with injection and any related facilities as provided for in N.C.G.S. 87-90.
3. Provisions shall be made for collecting any necessary and appropriate samples associated with the
injection facility activities.
PART VII-MONITORING AND REPORTING REQUIREMENTS
1. Any monitoring (including groundwater, surface water, or soil sampling) deemed necessary by the
Division of Water Quality. to insure surface and ground water protection, will be established and an
acceptable sampling reporting schedule shall be followed.
2. The Permittee shall report by telephone,· within 48 hours of the occurrence or first knowledge of the
occurrence, to the Wilmington Regional Office, telephone number [phone], any of the following:
(A) Any occurrence at the injection facility that results in any unusual operating circumstances;
(B) Any failure due to known or unknown reasons that renders the facility incapable of proper
injection operations, such as mechanical or electrical failures;
3. Where the Permittee becomes aware of an omission of any relevant facts in a permit application, or of any
incorrect information submitted in said application or in any report to the Director, the relevant and
correct facts or information shall be promptly submitted to the Director by the Permittee.
4. In the event that the permitted facility fails to perform satisfactorily, the Permittee shall take such
immediate action as may be required by the Director.
PART VIII -PERMIT RENEW AL
The Permittee shall, at least 120 days prior to the expiration of this permit, request an extension.
WI0800184 4
PART IX-CHANGE OF WELL STATUS
1. The Pennittee shall provide written notification within 15 days of any change of status of an injection
well. Such a change would include the discontinued use of a well for injection. If a well is taken
completely out of service temporarily, the Pennittee must install a sanitary seal. If a well is not to be used
for any purpose that well must be permanently abandoned according to 15A NCAC 2C .0213(h)(l), Well
Construction Standards.
2. When operations have ceased at the facility and a well will no longer be used for any purpose, the
Pennittee shall abandon that injection well in accordance with the procedures specified in 15A NCAC 2C
.0214, including but not limited to the follpwing:
(A) All casing and materials may be removed prior to initiation of abandonment procedures if
the Director finds such removal will not be responsible for, or contribute to, the
contamination of an underground source of drinking water.
(B) The entire depth of each well shall be sounded before it is sealed to insure freedom from
obstructions that may interfere with sealing operations.
(C) Each well shall be thoroughly disinfected, prior to sealing, if the Director determines that
failure· to do so could lead to the contamination of an underground source of drinking
water.
(D) Each well shall be completely filled with cement grout, which shall be introduced into the
well through a pipe which extends to the bottom of the well and is raised as the well is
filled.
(E) In the case of gravel-packed wells in which the casing and screens have not been
removed, the casing shall be perforated opposite the gravel pack, at intervals not
exceeding 10 feet, and grout injected through the perforations.
(F) In those cases when, as a result of the injection operations, a subsurface cavity has been
created, each well shall be abandoned in such a manner that will prevent the movement of
fluids into or between underground sources of drinking water and in accordance with the
terms and conditions of the permit.
(G) The Permittee shall submit a Well Abandonment Record (Form GW-30) as specified in
15A NCAC 2C .0213(h)(l) within 30 days of completion of abandonment.
3. The written documentation required in Part IX (1) and (2) (G) shall be submitted to:
WI0800184
Aquifer Protection Section~UIC Program
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
5
State of North Carolina 4c. W H i'-is,
Department of Environment Q6
and Natural Resources c I!"%I 1 Ir'11
Division of Water Quality > zj
Beverly Eaves Perdue, Governor
Dee Freeman, Secretary
Coieen Sullins, Director
Division of Water Quality
Aquifer Protection Section
Location: 2728 Capital Blvd.
Raleigh, NC 27604
Mailing Address: 1636 Mail Service Center
Raleigh, N.C. 27699-1636
FAX: [phone]
[phone]
❑ate:i7�/
FAX TO:
FAX NUMBER:
FROM: - 6--6(i'
PHONE:
NO. OF PAGES INCLUDING THIS SHEET:
If you receive this fax by mistake call: Aquifer Protection Section @ 919-733-3221

DATE,TIME
FAX NO. /NAME
DURATION
PAGE(S)
RESULT
MODE
TRANSMISSION ,VERIFICATION REPORT
05/08 23:34
919102702988
00:02:17
07
OK
STANDARD
ECM
TIME 05/08/2010 23:37
NAME NCDE&NR/WATER QUAL
FAX [phone]
TEL [phone]
,.
AQUIFER PROTECTION SECTION REGIONAL OFFICE STAFF REPORT
To: AQUIFER PROTECTION SECTION CENTRAL OFFICE
Central Office Reviewer: Mike Rogers
Application No.:
BIMS Permit# WI0800184
Permittee: Doug & Dana Hamerski
Remediation
Project Name: 1231 Sherman Oaks Drive
Regional Login No.: CFS2010 County: New Hanover
GENERAL INFORMATION
1. This application is (indicate all that apply):
XNew Renewal X Minor Modification Major Modification
Surface Irrigation Reuse Recycle
Evaporation/Infiltration Lagoon
503 Regulated 503 Exempt
Land Application of Residuals
Distribution of Residuals
Closed Loop Groundwater Remediation
2. Was a site visit conducted in order to prepare this report? X Yes
a. Date of site visit: March 5, 2010
b. Person contacted and contact information:
c. Site visit conducted by: Charles Stehman
d. Inspection report attached: Yes XNo
~roEIVED I DENR / DWQ
Aquifer Protection Section
MAY 05 2010
High Rate Infiltration
Attachment B included
Surface Disposal
XOther Injection Wells
No
3. Is the following information entered into the BIMS record for this application correct? Yes No
If no, please complete the following information or indicate that itis correct on the current
application.
For Treatment Facilities:
a. Location:
b. Driving directions:
c. USGS Quadrangle number and map name:
d. Latitude: Longitude:
e. Regulated activities/type of wastes: (e.g., subdivision, food processing, municipal
wastewater):
AQUIFER PROTECTION SECTION REGIONAL OFFICE STAFF REPORT
For Disposal Sites:
(If multiple sites either indicate which sites the information applies to, copy and paste a new
section into the document for each site, or attach additional pages for each site)
a. Location(s):
b. Driving directions :
c. USGS Quadrangle map name and number:
d. Latitude: Longitude:
NEW AND MAJOR MODIFICATION APPLICATIONS (this section not needed for renewals
or minor modifications, skip to next section)
DESCRIPTION OF WASTE(S) AND FACILITIES
1. Please attach a completed rating sheet. Facility classification:
2. Are the new treatment facilities adequate for the type of waste and disposal system?
Yes No N/A If no, please explain:
3. Are the new site conditions (soils, topography, etc.) consistent with what was reported by the
soil scientist and/or professional engineer? Yes No N/A
If no, please explain:
4. Does the application (maps, plans, etc .) represent the actual site (property lines, wells,
surface drainage)? Yes No N/A If no, please explain:
5. Is the proposed residuals management plan adequate and/or acceptable to the Division?
Yes No N/A If no, please explain:
6. Are the proposed application rates for the new sites {hydraulic or nutrient) acceptable?
Yes No N/A If no, please explain:
7. Are the new treatment facilities or any new disposal sites located in the 100 year floodplain?
Yes No N/A If yes, please attach a map showing the areas of
the 100 year floodplain and explain and recommend any mitigative measures/special
conditions in Part IV:
8. Are there any buffer conflicts (new treatment facilities or new disposal sites)? Yes No
If yes, please attach a map showing conflict areas or attach any new maps you have
received from the applicant to be incorporated into the permit:
9. Is the proposed or existing groundwater monitoring program (number of wells, frequency of
monitoring, monitoring parameters, etc.) adequate? Yes No N/A Attach
map of monitoring well network if applicable. Indicate review and compliance boundaries.
If No, explain and recommend any changes to the groundwater monitoring program . Attach
map of ex isting monitoring well network, if applicable, indicating the review and
compliance boundaries.
AQUIFER PROTECTION SECTION REGIONAL OFFICE STAFF REPORT
10. For residuals, will seasonal or other restrictions be required? Yes
If yes, attach list of sites with seasonal restrictions (Certification B?)
No N/A
RENEWAL AND MODIFICATION APPLICATIONS (use previous section for new or
major modification systems)
DESCRIPTION OF WASTE(S ) AND FACILITIES
1. Is there an appropriately certified ORC for the facility? Yes No
Operator in Responsible Charge: Certificate # :
Back-up Operator : Certificate # :
2. Is the design maintenance and operation (e.g. adequate aeration, sludge wasting, sludge
storage, effluent storage, etc.) of the treatment facilities adequate for the type of waste
and disposal system? Yes No If no, please explain:
3. Are the new site conditions (soils, topography, etc.) maintained appropriately and
adequately assimilating the waste? Yes No If no, please explain:
4. Has the site changed in any way that may affect the permit (drainage added, new wells
installed inside the compliance boundary, new development, etc.). Yes No
If Yes, please explain:
5. Is the residuals management plan adequate and/or acceptable to the Division?
Yes No If no, please explain:
6. Are the existing application rates (hydraulic or nutrient) still acceptable?
Yes No If no, please explain:
7. Is the existing groundwater monitoring program (number and location of monitoring wells,
frequency of monitoring, monitoring parameters, etc.) adequate?
Yes No N/A Attach map of existing monitoring well network if
Applicable. Indicate review and compliance boundaries. If No, explain and provide
recommended changes to the groundwater monitoring program:
8. Will seasonal or other restrictions be required for added sites? Yes
If yes, attach list of sites with restrictions (Certification B?)
No
9. Are there any buffer conflicts (new treatment facilities or new disposal sites)?
N/A
Yes No If yes, attach a map showing the conflict areas or attach
any new maps you have received from the applicant to be incorporated into the permit:
10. Is the description of the facilities type and/or volume of waste(s) as written in the existing
perm it correct?
Yes No If no, please explain:
11. Were monitoring wells properly constructed and located? Yes No N/A
If no, please explain:
12. Has the review of all self-monitoring data been conducted (GW, NDMR, and NDAR as
applicable)? Yes No Please summarize any findings from the review:
Compliance
AQUIFER PROTECTION SECTION REGIONAL OFFICE STAFF REPORT
13. Check all that apply: No compliance issues
Notices of violation within the last permit cycle
Current enforcement action(s)
Currently under SOC
Currently under JOC
Currently under moratorium
If any items are checked, please explain and attach any documents that may help clarify
answer/comments (such as NOV, NOD, etc.).
14. Have all compliance dates/conditions in the existing permit, SOC, JOC, etc. been
complied with? Yes No N/A If no, please explain:
15. Are there any issues related to compliance/enforcement that should be resolved before
issuing this permit? Yes No If yes, please explain:
INJECTION WELL PERMIT APPLICATIONS (Complete these two sections for all systems that
use injection wells, including closed loop groundwater remediation effluent injection wells, in situ
remediation injection wells, and heat pump injection wells.
Descri ption of well (s ) and Facilities -New, Renewal , and Modification
1. Type of injection system:
X Heating/cooling water return flow (5A7)
Closed-loop heat pump system (5QM/5QW)
In situ remediation (51)
Closed-loop groundwater remediation effluent injection (5L nondischarge)
Other ( specify)
2. Does the system use the same well for water source and injection? Yes X No
3. Are there any pollution sources that may affect injection? Yes X No If yes, what
are the pollutant source(s) and distance(s) from the closest injection well:
4. What is the minimum distance of proposed injection wells from the property boundary?
85 FEET
5. Quality of drainage at the site: X Good
6. Flooding potential of site: XLow
Adequate
Moderate
Poor
High
7. For groundwater remediation systems, is the proposed and/or existing groundwater
monitoring program (number of wells, frequency of monitoring, monitoring parameters,
etc.) adequate? Yes No Attach map of monitoring well network if
applicable. If no, explain and recommend any changes to the monitoring program.
8. Does the map presented represent the actual site (property lines, wells, surface
drainage)? Yes No If no, or no map, please attach a map of the site
showing property boundaries, buildings, wells, potential pollution sources, roads,
approximate scale, and north arrow.
AQUIFER PROTECTION SECTION REGIONAL OFFICE STAFF REPORT
Injection Well Permit Renewal And Modification Onl y :
1. For heat pump systems, are there any abnormalities in the heat pump or injection well
operation (e.g. turbid water, failure to assimilate injected fluid, poor heating/cooling)?
Yes XNo If yes, please explain:
2. For closed loop heat pump systems, has the system lost pressure or required make-up
fluid since permit issuance or last inspection? Yes No If yes, please
explain:
3. For renewal or modification of groundwater remediation permits, will
continued/additional/modified injections have an adverse impact on migration of the
plume or management of the contamination incident? Yes No If yes,
please explain:
4. Drilling contractor: Name
Address
Certification Number
5. Complete and attach well construction data sheet:
EVALUATION AND RECOMMENDATIONS
1. Provide any additional narrative regarding your review of the application. Originally the
applicant proposed that this heat pump system would use two existing water
supply wells situated on the 1231 Sherman Oaks Drive Property. The applicant
proposes to use a 190 foot well which was recently constructed to withdraw water
from the Pee Dee Aquifer. The applicant proposes to inject the spent water into
the second well which is completed in the Castle Hayne Aquifer, 130 feet below
land's surface. This older well is of unknown age, but probably was built sometime
around 1994 when the land ownership was transferred from a developer to the first
homeowner.
Because the Division was unwilling to permit a configuration where water from one
aquifer would be injected into a different aquifer, it requested that the permit
application be modified to have the injection side well set in the 190 foot aquifer.
In response the permit application was modified by the applicant to propose
construction of a third well extending into the PeeDee Aquifer, which would be
used for the injection side of the system. This configuration is acceptable to the
Division.
2. Attach well construction data sheet, as needed information is available. Not needed.
3. Do you foresee any problems with issuance/renewal of this permit? Yes X No
If yes, please explain:
4. List any items that you would like the APS Central Office to obtain through additional
information request. Please provide a reason with each item.
5. List specific permit conditions that you recommend to by removed from the permit when
issued. Please provide a reason for each recommendation.
6. List specific special conditions or compliance schedules that you recommend to be
included in the permit when issued. Please provide a reason for each recommendation.
8. Recommendation:
Issue X
Hold pending receipt and review of additional information ;
Deny If denied, please state reasons See Above
Signature of report preparer: _____________________ _
Signature of APS regional supervisor : __________________ _
Date: __________ _
ADDITIONAL REGIONAL STAFF REVIEW ITEMS
Ro gers, Michael
From: Stehman, Charles
Sent:
To:
Wednesday, May 05, 2010 4:01 PM
Rogers, Michael
Subject:
Attachments:
Hamerski Injection Well Modified.Rpt.docx
Hamerski Injection Well Modified.Rpt.docx
Here is theHamerski staff report. It was prepared and supposedly sent on the same day I received the modified
application. However, I cannot find record of any transmission to you. So, lets try it again.
cfs
Charles F. Stehman, Ph.D.,P.G.
Enviromnental Program Supervisor III
NC Division of Wate1· Qualtiy, Aquifer Protection Section
Wilmington Regional Office, 127 Cardinal Drive Extension
Wilmington,North Carobna 28405
phone: [phone], fax: [phone]
DISCLAIMER: Per Executive Order No. 150, all e-mails sent to and from this account are subject to the North Carolina
Public Records Law and may be disclosed to third parties.
1
Rog ers,. Michael
From:
Sent:
To:
Cc:
Diana Helias [[e-mail]]
Tuesday, April 13, 2010 2:32 PM
Rogers, Michael; Slusser, Thomas
Stehman, Charles
Subject:
Attachments:
Re: Hamerski Permit# WI0800184
WI 0800184 Hamerski.pdf
Dear Sirs,
After a meeting today with Dr. Hamerski, he asked that we move the location of the new proposed Injection well. Please
see the attached map for the new location (well# 3). Please let me know if you have any questions.
Diana Helias
Project Coordinator
Applied Resource Management, P.C.
www.ARM-PC.com
ARM's Waterworks
www. Water Works Wells.com
910.270.2919
910.270.2988 Fax
P.O. Box 882
Hampstead, North Carolina 28443
---Original Message ----
From: Ro gers , Michael
To: Slusser. Thomas ; Diana Helias
Cc: Stehman . Charles
Sent: Monday, April 12, 2010 1 :44 PM
Subject: RE: Hamerski Permit# WI0800184
Charlie-
Attached is a revised SA7 application for the above . This is in response to the add info we sent March 16, 2010. Please
review and submit a revised staff report with your recommendations.
Thanks
Michael Rogers, P.G. (NC & FL)
Environmental Specialist
NC Div of Water Quality-Aquifer Protection Section (APS)
1636 Mail Service Center
Raleigh ; NC 27699-1636
Direct Line [phone]; Fax [phone] (put to my attn on cover letter)
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties
From: Slusser, Thomas
Sent: Thursday, April 08, 2010 5:27 PM
1
To: Diana Helias
Cc: Stehman, Charles; Rogers, Michael
Subject: RE: Hamerski Permit# WI0800184
Greetings Diana,
Looks like Mike received a rP-vised application on March 31, 2010. I am not sure if our regional office staff, copied on
this email, needed to do any follow-up or provide additional comments. Mike had a note on the package that indicated
he wants to review it when he returns to the office on Monday.
Maybe Charlie Stehman can provide some additional information from the regional office perspective. Otherwise, Mike
will respond when he returns on Monday
I hope this heips. Take care,
~rhornas.
F mf:it! Cl'ril'Spu;;:c,-;ct fu md !rum 1h.':: addrass fi7c :' ve s1,~1icl t,, fiw !.':.Ttil D,rJ:trii:! Plhii; i?t'n1;Js Law and ms; be disdosei io thi"!J r:a, fies
From: Diana Helias [mailto:[e-mail]]
Sent: Thursday, April 08, 2010 4:24 PM
To: Slusser, Thomas
Subject: Hamerski Permit# WI0800184
Thomas,
Can you please let me know the status of permit# W 10800184 for the Hamerski Residence at 1231 Sherman Oaks Drive
in Wilmington. I sent in a revision as per the request of Michael Rogers on or about March. 27th.
Thanks,
Diana Helias
Project Coordinator
Applied Resource Management, P .C.
www.ARM-PC.com
ARM's Waterworks
w ww. W ater Works Wells.com
910 .270.2919
910.270.2988 Fax
P.O. Box 882
Hampstead, North Carolina 28443
2
3
• 1
I
5-,� V6,14
h
ermara Gak 0
rise
1
f
. � i°. LAI Suiv.
___ _
Approximate Property Lines
Approximate Building Perimeter
Existing 130' Well
Existing 190' Well to be used as Source Well
Proposed 190' Well to be used as Injection Well
Ir. 47
i d'lo
N
AA
Notes:
1. Subject property and surrounding area are serviced by public sewer and water.
2. Well #1 is an existing well, time of drilling unknown, that is approximately 12' from the building.
3, Well #2 was drilled on 1122/10.
Adapted from Google Earth and New Hanover County GIS Map, January 2010.
70cplied 1ZeSOurce Management PC
O. Box 882, Hampstead, NG 28443
9101 270-2919 FAX [phone]
I TITLE: REVISED SITE MAP
1231 SHERMAN OAKS DRIVE
JOB: SCALE: DATE: DRAWN BY:
Hamerski As Shown 4/13/10 DNH
FIGURE:
1

Ro gers, Michael
From:
Sent:
To:
Cc:
Rogers, Michael
Monday, April 12, 2010 1 :44 PM
Slusser, Thomas; Diana Helias
Stehman, Charles
Subject:
Attachments:
RE: Hamerski Permit # W 10800184
Hamerski.pdf
Charlie-
Attached is a revised 5A7 application for the above. This is in response to the add info we sent March 16, 2010. Please
review and submit a revised staff report with your recommendations.
Thanks
Michael Rogers, P.G. (NC & FL)
Environmental Specialist
NC Div of Water Quality-Aquifer Protection Section (APS)
1636 Mail Service Center
Raleigh, NC 27699-1636
Direct Line [phone]; Fax [phone] (put to my attn on cover letter)
E-mail correspondence to and from this address may be subject to the No1th Carolina Public Records Law and may be disclosed to third parties
From: Slusser, Thomas
Sent: Thursday, April 08, 2010 5:27 PM
To: Diana Helias
Cc: Stehman, Charles; Rogers, Michael
Subject: RE: Hamerski Permit# WI0800184
Greetings Diana,
Looks like Mike receive'd a revised application on March 31, 2010. : am not sure if our regional office staff, copied on
this email, needed to do any follow-up or provide additional comments. Mike had a note on the package that indicated
he wants to review it when he returns to the office on Monday.
Maybe Charlie Stehman can provide some additional information from the regional office perspective. Otherwise, Mike
will respond when he returns on Monday.
I hope this helps. Take care,
~Thomas.
rmaii r:orrespor,de!l::e to Bfld from this E:!dress may be subject to ti?P liorth Caro/ir,a Pub& Records Law afld may be disclosed to thirdparties.
From: Diana Helias [mailto:[e-mail]]
Sent: Thursday, April 08, 2010 4:24 PM
To: Slusser, Thomas
Subject: Hamerski Permit # WI0800184
Thomas,
Can you please let me know the status of permit# W 10800184 for the Hamerski Residence at 1231 Sherman Oaks Drive
in Wilmington. I sent in a revision as per the request of Michael Rogers on or about March 27th.
1
Thanks,
Diana Helias
Project Coordinator
Applied Resource Management, P .C.
www.ARM-PC.com
ARM's Waterworks
Vvrww.WaterWorksWells.com
910.270.2919
910.270.2988 Fax
P.O. Box 882
Hampstead, North Carolina 28443
2
NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES (NCDENR) m '„c.
rr fl
APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR
INJECTION WITH A GEOTHERMAL, HEAT PUMP SYSTEM FOR:
TYPE 5-A7 OPEN -LOOP WELL(S1
New Permit Application Renewal X Modification (check one)
DATE: March 25.2010
PERMIT NO.: WI 0800184
(leave blank if NEW permit application)
A. PROPERTY OWNER(S)/PERMIT APPLICANT(S)
List Each Property Owner listed on property deed (if owned by a business or government agency, state name
of Entity and a Representative w/authority for signature): Douglas and Dana Hamerski
(1) Mailing Address: 1231 Sherman Oaks Drive
City: Wilmington State: NC Zip Code:28411 County: New Hanover
HomelOfflce Tele No.: 910-794-9829 Cell No.: 910-431-6621
Fax No. EMAIL Address: anstrutherri-z usa.net
(2) Physical Address of Site of Well(s) (if different than above):
City: State: Zip Code: County:
Home/Office Tele No.:
Fax No. _
Cell No.:
EMAIL Address:
B. AUTHORIZED AGENT OF OWNER, IF ANY [attach a letter from the property owner authorizing the
Contractor/Agent (driller, heat pump contractor or other type of contractor/agent) to install and operate
UIC well]
Company Name:
Contact Person: EMAIL Address:
Address:
City: State: Zip Code: County:
Office Tele No._ Fax No. Ce11 No..
Website Address of Company, if any:
C. WELL DRILLER INFORMATION
Company Narne: Applied Resource Management. P.C.
Welt Drilling Contractor's Name: H. Michael Sane
NC Contractor Certification No.:
2531 A Contact Person: James Comette
GPINUIC 5A7 Well Pernat Application (Rev. August 2009) Page 1 of 4

Company Website: WWW.arm-pc .com Email Address:
Address: ------=-P-"-'.O""'.:...:B=o=xa...8=8=2=----------------------------
City: Hampstead Zip Code: 28443 County: ------=-P=en=d=e=r _____ _
Office Tele No.: 910-270-2919 Fax No. 910-270-2988 Cell No. ---------
D. HEAT PUMP CONTRACTOR INFORMATION (if different than Driller)
Company Name: ___ O=--''B=r=ie=n~S=e=rv-'-'i=c-=-e--=C:...:o=m=p=an=y......_ _______ _
Contact Person: ____ N--"=at=e~C~arr~--------
Company Website: WWW.obrienservice.com Email Address: Nate@ obrien service.com
Address: 3308 Enterp rise Drive
City: Wilmington Zip Code: 28405 County: --~N_e~w_H_an_o~v~e~r ___ _
Office Tele No.: 910-799-6611 Fax No. ________ Cell No. ________ _
E. STATUS OF APPLICANT
Private: _x_
State:
Federal:
Municipal: __
Commercial:
Native American Lands:
F. INJECTION PROCEDURE (briefly describe how the injection well(s) will be used)
Passive infiltration of well water use for geothermal heat exchange
G. WELL USE Will the injection well(s) also be used as the supply well(s) for the following?
(1)
(2)
The injection operation?
Personal consumption?
YES ___ _
YES ___ _
NO~X~_
NO --=-X~--
H. WELL CONSTRUCTION DATA (Ski p to Section I if this is a Permit RENEWAL)
surface)
X PROPOSED Well(s) to be constructed for use as an injection well. Provide the data in (1)
through (7) belo'Y as PR9/OSED cRnstructi~specifications. Submit Form GW-1 after
construction. ( "4'tl l -i;J"!, o-tl ti~ "ft. ~ )
X EXISTING Well(s) being proposed for use as an injection well. Provide the data in (1) through
(7) below to the best of your lmowledi e. Attach ~ copy of Form GW-1 (Well Construction
Record) if available. (wtll -:t! 2-M fl'.1 l)('.J.. ~ )
(I) Date to be constructed: ASAP Nurl'!b er of borings: __ l __ _
Approximate depth of each boring ( feet): _ _,.1=9~0_' __ _
(2) Well casing. Is the well(s) cased? (check either (a.) YES Q! (b.) NO below)
(a) YES X If yes, then provide the casing information below.
Type: Galvanized steel __ Black steel __ Plastic X Other (specify) ______ _
Casing thickness: SCH40 diameter (inches): 4" depth: from O to 160' ft. (reference to land
Casing extends above ground ---=1=2_" ___ inches
(b) NO
(3) Grout (material surrounding well casing and/or piping):
(a) Grout type: Cement _x__ Bentonite* Other (specify) _______ _
(b) Grouted surface and grout depth (reference to land surface):
GPU/UIC 5A7 Well Permit Application (Rev. August 2009) Page 2 of4
I.
___ Around closed-loop piping; from ____ to ___ (feet).
__ X __ Around well casing; from _O ___ to 20 (feet).
*By selecting bentonite grout, a variance is requested to ISA NCAC 2C .0213(d)(l)(A) that
requires a cement type grout.
(4) Well(s) Screen Information, if any
Depth of Screen: From 160' to 190' feet below land surface
(5) N.C. State Regulations (Title 15A NCAC 2C .0200) require the Permittee to make prov1s10ns for
monitoring wellhead water quality and processes. A faucet on both Influent (groundwater entering heat
pump) and Effluent (water being injected back into the well) lines is required. Will there be a faucet on:
(a) Influent line? Yes X No__ (b) Effluent line? Yes X No __
(6) Source Well Construction Information (if the water source well is a different well than the injection well)
Attach a copy of Form GW-1 (Well Construction Record). If Form GW-1 is not available, provide the
following data:
NOTE:
Groundwater Source. -From what depth, formation, and type of rock/sediment units will the groundwater
be withdrawn? (e.g. granite, limestone, sand, etc.)
Depth: 190' Formation: Pee Dee Rock/sediment unit: Sandstone
THE WELL DRILLING OR HEAT PUMP CONTRACTOR CAN SUPPLY THE DATA FOR EITHER EXISTING OR
PROPOSED WELLS IF THIS INFORMATION IS UNAVAILABLE BY OTHER MEANS.
OPERATING DATA
(1) Injection rate: Average ( daily) <15 gallons per minute (gpm).
(2) Injection Volume: Average ( daily) <21.600 gallons per day (gpd).
(3) Injection Pressure: Average (daily) <15 pounds/square inch (psi).
(4) Injection Temperature: Average (January) 60 ° F, Average (July) 65 o F.
J. INJECTION-RELATED EQUIPMENT
Attach a diagram showing a schematic or cross-section of the well construction (i.e., the total depth, casing,
location/extent of grout, stickup, location of influent/effluent sampling ports, etc.). If this is a modification, show
the engineering layout or proposed modification of the injection equipment and exterior piping/tubing associated
with the injection operation. The manufacturer's brochure may provide supplementary information.
K. LOCATION OFWELL(S)
Attach two copies of documents showing information mentioned below.
(1) A site map (can be drawn) showing: House(s)/Building(s), 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 1000 feet of
the geothermal heat pump well system. Label all features clearly and include a north arrow.
(2) A topographic map of the area extending 1/4 mile from the property boundaries and
indicate the facility's location and the map name.
(3) A property deed or tax record (can be obtained from your county GIS website) showing present property
ownership.
NOTE: In most cases, an aerial photograph of the property parcel showing property lines and structures can be
obtained and downloaded from the applicable County GIS website. Typically, the property can be searched by owner
name or address. The location of the wells in relation to property boundaries, houses, septic tanks, other wells, etc.
can then be drawn in by hand. Also, a 'layer' can be selected showing topographic contours or elevation data.
GPU/UIC 5A 7 Well Permit Application (Rev. August 2009) Page 3 of4
L. CERTIFICATION
Note: This Permit Application must be signed by Each person appearing an the
recorded legal property deed.
"I 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 injection well and
all related appurtenances in accordance with the approved specifictions and conditions of the Permit,"
Signature of Propert "Owner/Applicant
?r?16'r5�C,
Print or Type Full Name
Signature of Property Owner/Applicant
1.--V-A JY RA S 14r
Print or Type Full Name
Signature of Authorized Agent, if any
Print or Type Full Name
Please return two copies of the completed Application package to:
North Carolina DENR-DWQ
Aquifer Protection Section
UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone [phone]
CiPUIiJIC 5A7 Well Permit Application (Rev. August 2009) Page 4 of 4

1. WELL CONTRACTOR:
NONRESIDENTIAL WELT, CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- t ivtsion gf Writer Quality
WELL CONTRACTOR CERTIFICATION #
Well Contractor (Individual) Name
Applied Resource Management. P.C.
Well Contractor Company Name
257 Transfer Station Rd.
Street Address
Hampstead
City or Town
(910 ) 270-2919
Area code Phone number
2. WELL INFORMATION:
NC 28443
State Zip Code
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT (itap
SITE WELL ID Cif applicable) r a 1 • . (e.
3. WELL USE (Check One Box) Monitoring Li Municipa&P •tic p
Industrial/Commercial ° Agricultural ❑ Recovery 0 Injection 0
Irrigation Other d(list use) Heat DUITTD
DATE DRILLED 1 /22/10
4. WELL LOCATION:
1231 Sherman Oaks Drive
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: Wilmington COUNTY New Han.
TOPOGRAPHIC 1 LAND SETTING: (check appropriate box)
°Slope °Valley 'Flat ❑Ridge ❑Other
LATITUDE 34 ° 17 24.DD00 " DMS OR OD
LONGITUDE 77 50 ' 46.0000 " DMS OR DD
Latitudeilongitude source: 3PS Qfopographic map
(location of well must be shown on a USGS topo wrap andaftached to
this form if not using OPS)
5. FACILITY (Name of the business where the well is located.)
Facility Name Facility ID# (if applicable)
Street Address
City or Town State Zip Code
❑oiinlas Hamerski
Contact Name
1231 Sht?.rman Oaks nrive
Mafiing Address
Wilmington NC 28411
City or Town State Zip Code
010 't 794-9829
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 1 g0'
b. DOES WELL REPLACE EXISTING WELL?
c. WATER LEVEL Below Top of Casing: 2G
(Use "+" if Above Top of Casing)
YES ❑ NO r f
FT.
d. TOP OF CASING IS —1.5 FT. Above Land Surface'
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118_
e. YIELD (gpm): 50 METHOD OF TEST Airlift
f. DISINFECTION: Type HTH Amount 30f/410%
g. WATER ZONES (depth):
Tap Bottom Top Bottom _
Top Bottom Top Bottom
Top Bottom
7, CASING: Depth
Top 0 Bottom 160
Top Bottom
Top Bottom
Top Bottom
Thickness/
Diameter Weight MVlaterial
Ft. sch4 PVC
Ft.
Ft.
B. GROUT: Depth Material
Top 0 Bottom 20 Ft. Grout
Top Bottom Ft.
Top Bottom Ft.
Method
Tremmie
9. SCREEN: Depth Diameter Slot Size Material
Top 160 Bottom 190 Ft. 4 in, .010 in. Grout
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 150 Bottom 190 FL Coarse Sand
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom
0' 1 30'
30' 1 60'
60' _ / 130'
130' / 140'
140' 1 150'
150' / 190'
1
1
12. REMARKS:
Formation Description
Medium grained sand
Coarse sand
Limestone
Mud_rock
Pee Dee cl$v
Sandstone
DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CON .UCTION STANDARDS. AND THAT A COPY OF THIS
R HD HAS BEEN PROVI A TQ.riIE WELL OWNER.
SIGNATURE OF CERTIFIED ELL C NQA TQR DATE
J. 1/22/10
Donald H. Cumminos
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30 days of completion to: Division of Water Quality - information Processing,
1 C17 Mall Service Center, Raleigh, NC 27699-161, Phone : [phone]
Form GW-1 b
Rev. 2/09

NA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue
Governor
Douglas and Dana Hamerski
1231 Sherman Oaks Dr.
Wilmington, NC 28411
Re: Additional Information Request
Coleen H. Sullins
Director
March 16, 2010
Injection Well Permit Application WI0800184
New Hanover County
Dear Mr. and Mrs. Hammerski:
Dee Freeman
Secretary
After reviewing the referenced permit application and conducting a site inspection our staff identified an item
that needs clarification and/or additional information.
The permit application cannot be approved as submitted. The proposed injection well (Well #1) will be
injecting water into a shallower, separate aquifer from the existing source well (Well #2). The injection well is
completed in the Castle Hayne aquifer at 130 feet below land surface and the source well is completed in the
Pee Dee aquifer at 190 feet. In order to approve a permit for a geothermal injection well, you must resubmit the
application with either: (a.) a new proposed well to be completed in the deeper Pee Dee aquifer at
approximately the same depth as the source well at approximately 190 feet; or (b.) the existing proposed
injection well must be re-drilled (overreamed) and completed in the deeper, Pee Dee aquifer.
Additionally, if any of these options are selected, the injection well, must be grouted the entire length of the
casing in order to prevent injected water migrating up outside the well casing to land surface.
Please submit your responses with any corrected text pages/figures for insertion into the previously submitted
UIC Application within 30 calendar days of receipt of this letter. If you have any questions regarding your
permit please call me at [phone] or email me at Michael.Ro [e-mail].
Thank you for your cooperation.
Best Regards,
Michael Rogers, P.G. (NC & FL)
Environmental Specialist
cc: Charles Stehman-Wilmington Regional Office
Central Office File-WI0800184
New Hanover County Environmental Health Department
Page 1 of2 Pages
r.
Existing 190' Well to be used as Source Well
Approximate Properly Lines
Approximate Building Perimeter
Existing 1 30' Well
3 Proposed 1 90' Well to be used as injection Well
Notes:
1. Subject property and surrounding area are serviced by public sewer and water.
2. Well #1 is an existing well, time of drilling unknown, that is approximately 12' from the building,
3. Well #2 was drilled on 1/22/10.
Adapted from Google Earth and New Hanover County GIS Map, January 2010.
7O1\---.
.plied Resource IvIanagerient PC
P.O. Box 882. Hampstead, NC 28443
19101 270-2919 FAX [phone]
TULE' REVISED SITE MAP
1231 SHERMAN OAKS DRIVE
JOB: SCALE: !DATE: DRAWN BY:
Hamerski As Shown 4/13/10 DNH
FIGURE:
1

QV-
3
Notes:
1. Subject proper /: nd surrounding area are serviced by public sewer and water.
2. Well #1 is an =I isting well, time of drilling unknown, that is approximately 12' from the • uilding.
3. Well #2 wa ::rifled on 1 /22110.
pie •d
age5'GeoY.cgOI Survz.v
/ME
Approximate Property Lin _ E
Approximate Building ' P_meter
Existing 130' Well
Existing 190' Well t■ •e used as Source Well
Proposed 190 , II to be used as Injection Well
N
Adapted fro Google Earth and New Hanover County GIS Map, January 2010.
1 TITLE: SITE MAP FIGURE:
ppplied Resource Mara ement PC 1 1231 SHERMAN OAKS DRIVE
PO. Box 882, Hampstead, NC 28443 JOB: SCALE: I DATE: DRAWN BY:1
(9101270-2919 FAX [phone] Hamerski As Shown 3125/09 I DNH

RA
MCDEMR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue
Governor
Douglas and Dana Hamerski
1231 Sherman Oaks Dr.
Wilmington, NC 28411
Re: Additional Information Request
Coleen H. Sullins
Director
March 16, 2010
Injection Well Permit Application WI0800184
New Hanover County·
Dear Mr. and Mrs. Hammerski:
Dee Freeman
Secretary
After reviewing the_ referenced permit application and conducting a site inspection our staff identified an item
that needs clarification and/or additional information. · · "
The permit application cannot be approved as submitted. The proposed injection well (Well #1) will be
injecting water into a shallower, separate aquifer from the existing source well (Well #2). The injection well is
completed in the Castle Hayne aquifer at 130 feet below land surface and the source well is completed in the
Pee Dee aquifer at 190 feet. In order to approve a permit for a geothermal injection well, you must resubmit the
application with either: (a.) a new proposed well to be completed in the deeper Pee Dee aquifer at
approximately the same depth as the source well at approximately 190 feet; or (b.) the existing proposed
injection well must be re-drilled (overreamed) and completed iri the deeper, Pee Dee aquifer.
Additionally; if any of these options are selected, the injection well, must be grouted the entire length of the
casing in order to prevent injected water migrating up outside the well casing to land surface.
Please submit your responses with any corrected text pages/figures for insertion into the previously submitted
UIC Application within 30 calendar days of receipt of this letter. If you have any questions regarding your
permit please call me at [phone] or email me at Michael.Ro2:ers rw ncdenr.oov.
Thank you for your cooperation.
Best Regards,
~12r---
Michael Rogers, P.G. (NC & FL)
Environmental Specialist
cc: Charles Stehman-Wilmington Regional Office
Central Office File -WI0800184
New Hanover County Environmental Health Department
Page I of 2 Pages
RECEIVED
AOUJFr:RPRo,!,_DENR I DWQ ,,-r.r,ONSEf!
MAR O 8 20l!J. TION
AQUIFER PROTECTION SECTION REGIONAL OFFICE STAFF REPORT
To: AQUIFER PROTECTION SECTION CENTRAL OFFICE ci£·1~<f/!ii
Central Office Reviewer: Mike Rogers
Application No.:
BIMS Permit # WI0S00XXX
Permittee: Doug & Dana Hamerski
Remediation
Project Name: 1231 Sherman Oaks Drive
Regional Login No.: CFS2010
GENERAL INFORMATION
County: New Hanover
1. This application is (indicate all that apply):
XNew Renewal Minor Modification Major Modification
Surface Irrigation Reuse Recycle
Evaporation/Infiltration Lagoon
503 Regulated 503 Exempt
Land Application of Residuals
Distribution of Residuals
Closed Loop Groundwater Remediation
2 . Was a site visit conducted in order to prepare this report? X Yes
a. Date of site visit: March 5, 2010
b. Person contacted and contact information :
c. Site visit conducted by: Charles Stehman
d. Inspection report attached: Yes XNo
High Rate Infiltration
Attachment 8 included
Surface Disposal
XOther Injection Wells
No
3. Is the following information entered into the SIMS record for this application correct? Yes No
If no, please complete the following information or indicate that it is correct on the current
application .
For Treatment Facilities:
a. Location :
b. Driving directions:
c. USGS Quadrangle number and map name:
d. Latitude : Longitude :
e. Regulated activities/type of wastes : (e.g ., subdivision, food processing, municipal
wastewater):
..
AQUIFER PROTECTION SECTION REGIONAL OFFICE STAFF REPORT
For Dis posal Sites:
(If multiple sites either indicate which sites the information applies to , copy and paste a new
section into the document for each site , or attach additional pages for each site)
a. Location(s):
b. Driving directions:
c. USGS Quadrangle map name and number:
d. Latitude : Longitude:
NEW AND MAJOR MODIFICATION APPLICATIONS (this section not needed for renewals
or minor modifications, skip to next section)
DESCRIPTION OF WASTE (S ) AND FACILITIES
1. Please attach a completed rating sheet. Facility classification :
2 . Are the new treatment facilities adequate for the type of waste and disposal system?
Yes No N/A If no, please explain:
3. Are the new site conditions (soils, topography, etc .) consistent with what was reported by the
soil scientist and/or professional engineer? Yes No N/A
If no, please explain :
4. Does the application (maps, plans, etc.) represent the actual site (property lines, wells,
surface drainage)? Yes No N/A If no, please explain:
5. Is the proposed residuals management plan adequate and/or acceptable to the Division?
Yes No N/A If no, please explain :
6. Are the proposed application rates for the new sites (hydraulic or nutrient) acceptable?
Yes No N/A If no, please explain:
7. Are the new treatment facilities or any new disposal sites located in the 100 year floodplain?
Yes No N/A If yes , please attach a map showing the areas of
the 100 year floodplain and explain and recommend any mitigative measures/special
conditions in Part IV:
8. Are there any buffer conflicts (new treatment facilities or new disposal sites)? Yes No
If yes, please attach a map showing conflict areas or attach any new maps you have
received from the applicant to be incorporated into the permit:
9. Is the proposed or existing groundwater monitoring program (number of wells, frequency of
monitoring , monitoring parameters , etc.) adequate? Yes No N/A Attach
map of monitoring well network if applicable. Indicate review and compliance boundaries .
If No, explain and recommend any changes to the groundwater monitoring program. Attach
map of existing monitoring well network, if applicable, indicating the review arid
compliance boundaries .
AQUIFER PROTECTION SECTION REGIONAL OFFICE STAFF REPORT
10. For residuals , will seasonal or other restrictions be required? Yes
If yes, attach list of sites with seasonal restrictions (Certification B?)
No N/A
RENEWAL AND MODIFICATION APPLICATIONS (use previous section for new or
major modification systems)
DESCRIPTION OF WASTE(S ) AND FACILITIES
1. Is there an appropriately certified ORC for the facility? Yes No
Operator in Responsible Charge : Certificate # :
Back-up Operator : Certificate # :
2. Is the design maintenance and operation (e.g . adequate aeration, sludge wasting, sludge
storage, effluent storage, etc.) of the treatment facilities adequate for the type of waste
and disposal system? Yes No If no , please explain :
3. Are the new site conditions (soils, topography, etc.) maintained appropriately and
adequately assimilating the waste? Yes No If no, please explain:
4 . Has the site changed in any way that may affect the permit (drainage added, new wells
i nstalled inside the compliance boundary, new development, etc.). Yes No
If Yes, please explain:
5. Is the residuals management plan adequate and/or acceptable to the Division?
Yes No If no, please explain:
6. Are the existing application rates (hydraulic or nutrient) still acceptable?
Yes No If no, please explain:
7 . Is the existing groundwater monitoring program (number and location of monitoring wells,
frequency of monitoring, mon itoring parameters, etc.) adequate?
Yes No N/A Attach map of existing monitoring well network if
Applicable. Indicate review and compliance boundaries. If No , explain and provide
recommended changes to the groundwater monitoring program:
8. Will seasonal or other restrictions be required for added sites? Yes
If yes , attach list of sites with restrictions (Certification B?)
No
9. Are there any buffer conflicts (new treatment facilities or new disposal sites)?
N/A
Yes · No If yes, attach a map showing the conflict areas or attach
any new maps you have received from the applicant to be incorporated into the permit:
10. Is the description of the facilities type and/or volume of waste(s) as written in the existing
permit correct?
Yes No If no, please explain:
11 . Were monitoring wells properly constructed and located? Yes No NIA
If no , please explain:
12. Has the review of all self-monitoring data been conducted (GW, NDMR, and NDAR as
applicable)? Yes No Please summarize any findings from the review:
Compliance
AQUIFER PROTECTION SECTION REGIONAL OFFICE STAFF REPORT
13. Check all that apply: No compliance issues
Notices of violation within the last permit cycle
Current enforcement action(s)
Currently under SOC
Currently under JOC
Currently under moratorium
If any items are checked, please explain and attach any documents that may help clarify
answer/comments (such as NOV, NOD, etc.).
14. Have all compliance dates/conditions in the existing permit, SOC, JOC, etc. been
complied with? Yes No N/A If no, please explain:
15. Are there any issues related to compliance/enforcement that should be resolved before
issuing this permit? Yes No If yes, please explain:
INJECTION WELL PERMIT APPLICATIONS (Complete these two sections for all systems that
use injection wells, including closed loop groundwater remediation effluent injection wells, in situ
remediation injection wells, and heat pump injection wells.
Descri ption of well{s ) and Facilities -New, Renewal , and Modification
1. Type of injection system:
X Heating/cooling water return flow (5A7)
Closed -loop heat pump system (5QM/5QW)
In situ remediation (51)
Closed-loop groundwater remediation effluent injection (5L nondischarge)
Other (specify)
2. Does the system use the same well for water source and injection? Yes X No
3. Are there any pollution sources that may affect injection? Yes . X No If yes, what
are the pollutant source(s) and distance(s) from the closest injection well :
4 . What is the minimum distance of proposed injection wells from the property boundary?
85 FEET
5. Quality of drainage at the site: X Good
6. Flooding potential of site: XLow
Adequate
Moderate
Poor
High
7. For groundwater remediation systems, is the proposed and/or existing groundwater
monitoring program (number of wells, frequency of monitoring, monitoring parameters,
etc.) adequate? Yes No Attach map of monitoring well network if
applicable . If no, explain and recommend any changes to the monitoring program .
8. Does the map presented represent the actual site (property lines, wells, surface
drainage)? Yes No If no , or no map, please attach a map of the site
showing property boundaries, buildings , wells, potential pollution sources, roads,
approximate scale, and north arrow.
AQUIFER PROTECTION SECTION REGIONAL OFFICE STAFF REPORT
In jection Well Permit Renewal And Modification Onl y:
1. For heat pump systems, are there any abnormalities in the heat pump or injection well
operation (e .g. turbid water, failure to assimilate injected fluid, poor heating/cooling)?
Yes No If yes, please explain:
2. For closed loop heat pump systems, has the system lost pressure or required make-up
fluid since permit issuance or last inspection? Yes No If yes, please
explain:
3. For renewal or modification of groundwater remediation permits, will
continued/additional/modified injections have an adverse impact on migration of the
plume or management of the contamination incident? Yes No If yes,
please explain:
4. Drilling contractor: Name
Address
Certification Number
5. Complete and attach well construction data sheet:
EVALUATION AND RECOMMENDATIONS
1. Provide any additional narrative regarding your review of the application. This
proposed heat pump system would use two existing water supply wells situated on
the 1231 Sherman Oaks Drive Property. The applicant proposes to use a 190 foot
well which was recently constructed to withdraw water from the Pee Dee Aquifer.
The applicant proposes to inject the spent water into the second well which is
completed in the Castle Hayne Aquifer, 130 feet below land's surface. This older
well is of unknown age, but probably was built sometime around 1994 when the
land ownership was transferred from a developer to the first home owner.
Presumably the Castle Hayne well was originally constructed for water supply.
This well ls situated at a location which is only 12 feet from the existing house
foundation. As such, this well would have been non compliant with rules in force
in the 1994, which required at least a 25 foot setback from foundations. The more
recently constructed PeeDee well is compliant with well construction rules.
The current injection well rules do not impose a foundation set back for 5A7 wells
and they only require 20 feet of grout. Both these conditions need to be amended
in future rule revisions. If a permit is issued for the system as proposed by the
applicant, it should have a condition requiring the Castle Hayne well be over-
reamed to the Castle Hayne surface an grouted the full length of the existing
casing.
2. Attach well construction data sheet, as needed information is available . Not needed.
3. Do you foresee any problems with issuance/renewal of this permit? X Yes No
If yes, please explain:
4. List any items that you would like the APS Central Office to obtain through additional
information request. Please provide a reason with each item.
5. List specific permit conditions that you recommend to by removed from the permit when
issued. Please provide a reason for each recommendation. See item #1 above, third
paragraph.
6. List specific special conditions or compliance schedules that you recommend to be
included in the permit when issued . Please provide a reason for each recommendation .
8. Recommendation:
Hold pending receipt and review of additional information concerning owners
intent regarding the modification of the Castle Hayne well; OR Deny .
Deny If denied, please state reasons See Above
Signature of report preparer: ____ Vp __ 4_._.._~.-c..-~-· __________ _
Signature of APS regional supervisor: Oc)_ , ~
Date: D 3 /t:::>r5;// D
(
ADDITIONAL REGIONAL STAFF REVIEW ITEMS
Rog ers, Michael
From:
Sent:
To:
Subject:
Mike,
Diana Helias [[e-mail]]
Friday, February 26, 2010 3:43 PM
Rogers, Michael
Hamerski Property
To clarify and answer your questions regarding this permit, on the drawing Well #1 is the pre-existing well and would be
used as the Injection well. Well #2 is the newer well that we drilled and would be used as the Source well.
Also, on the permit application, the 190' well is the Source well (#2) and the 133' well is the Injection well (#1 ).
Sorry about the confusion. Let me know if you have any more questions.
Thanks,
Diana Helias
Project Coordinator
Applied Resource Management, P.C.
www.ARM-PC.com
ARM's Waterworks
www.WaterWorksWells.com
910.270.2919
910 .270.2988 Fax
P.O. Box 882
Hampstead, North Carolina 28443
1
A~A s,,;;~J,;.
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue
Governor
Coleen H. Sullins
Douglas Hamerski
Dana Hamerski
1231 Sherman Oaks Drive
Wilmington, NC 28411
Subject: Acknowledgement of Application No. WI0800184
Douglas Hamerski SFR
Injection Heating/Cooling Water Return Well (5A 7)
New Hanover
Dear Mr. and Mrs. Hamerski:
Director
February 24, 2010
Dee Freeman
Secretary
The Aquifer Protection Section of the Division of Water Quality (Division) acknowledges receipt of your permit application and
supporting materials on February 4, 2010. This application package has been assigned the number listed above and will be reviewed
by Michael Rogers.
The reviewer will perform a detailed review and contact you with a request for additional information if necessary. To ensure the
maximum efficiency in processing permit applications, the Division requests your assistance in providing a timely and complete
response to any additional information requests.
Please be aware that the Division's Regional Office, copied below, must provide recommendations prior to final action by the
Division. Please also note at this time, processing permit applications can take as long as 60 -90 days after receipt of a complete
application.
If you have any questions , please contact Michael Rogers at 919-715-6166, or via e-mail at [e-mail]. If the
reviewer is unavailable, you may leave a message, and they will respond promptly. Also note that the Division has reorganized. To
review our new organizational chart, go to httr ://h20.enr.state.nc.us/documents/dw9 ornchart.pdf.
PLEASE REFER TO THE ABOVE APPLICATION NUMBER WHEN MAKING INQUIRIES ON THIS PROJECT .
_:2f~~D
for Debra ~atts
Supervisor
cc: Wilmington Regional Office, Aquifer Protection Section
James Cornette (Applied Resource Management, P .C., P.O. Box 882 , Hampstead, NC 28443)
Nate Carr (O'Brien Service Company, 3308 Enterprise Dr., Wilmington, NC 28405)
Penn it Applicatfon Fiie WIOSU IJ l S-1
AQUIFER PROTECTION SECTION
1636 Mail Service Center, Raleigh , North Carolina 27699-1636
Location : 2728 Capita l Boulevard, Raleigh, Nort:1 Carolina 27604
Phone : [phone] FAX 1: 919-715-0588; FAX 2: 919-715-6048 \ Customer Service: 1-877-623-6748
Internet: www.ncwaterouali 11·.o rn
An Eq1ol Opportunity\ Affirmative Action Employer
Dne 1 C . N ort 1 arohna
Jvatural/11
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Beverly Eaves Perdue, Governor
Dee Freeman, Secretary
Coleen Sullins, Director
Division of Water Quality
Aquifer Protection Section
Location: 2728 Capital Blvd.
Raleigh, NC 27604
Mailing Address: 1636 Mail Service Center
Raleigh, N.C. 27699-1636
FAX: [phone]
[phone]
Date: r i /
FAX TO: i.•
tr,
FROM: , ce
PHONE:
FAX NUMBER:
NO. OF PAGES INCLUDING THIS SHEET:
/?
se‘,-0
eo v#4tz 0 s c/p, (:vw-e*0) --/xe ce
Es-
r
If you receive this fax by mistake call: Aquifer Protection Section @ 919-733-3221

RECEIVED 1 DENR 1 Dy►A�
Aquifer Protection Section
NORTH CAROLINA �$ 4 ����
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES (NCO
\PPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR
INJECTION WITH A GEOTHERMAL HEAT PUMP SYSTEM FOR:
TYPE 5-A7 OPEN -LOOP WELL(S)
X Ne Permit Application Renewal Modification (check ne)
DATE: Januao, 30. 2010
PERMIT NO.: WI (leave blank if NEW permit application)
A. PROPERTY OWNER(S)3 :RMIT APPLICANT(S)
List Each Property Owner liste .n property deed (if owned by a business o 'overnment agency, state name
of Entity and a Representative r /authority for signature): Dou as and Dana Hamerski
(I) Mailing Address: 1231 Sh man Oaks Drive
City; Wilmington S : te: _NC Zi Code:28411 County: New Hanover
Home/Office Tele No.: 910-794-9829
Fax No.
CeII No.: 910-43 1 -6621
IL Address: anstruther(a usa.net
(2) Physical Address of Site of Well(s) (if erent an above):
City: ate: Zip 'ode: County:
Home/Office Tele No.:
Fax No.
EMAIL Addre
Cell No.:
B. AUTHORIZED AGENT OF 1 VNER, IF ANY [attach a letter from 7e property owner authorizing the
Contractor/Agent (driller seat pump contractor or other type of contra 'tor/agent) to install and operate
WC well]
Company Name:
Contact Person: EMAIL Address:
Address:
City: State: Zip Code: County:
Office Tel 1 o.: Fax No. Cell No.:
Websit= Address of Company, if any:
C. W LL DRILLER INFORMATION
Company Name: Applied Resource Manaecment. P.C.
Well Drilling Contractor's Name: H. Michael Sate
NC Contractor Certification No.: 2531 A Contact Person: James Cornette
GPit/UIC 5A7 Well Permit Application (Rev. August 2009)
Page 1 of 4

Company Website: www.ann-pc .com Email A ddress :
Address: -----=-P"""'.O"'"'.-=B"'"'o=x=-8"'"'8=2'----------------------------
City: Ham pstead Zip Code: 28443 County: --~Pe~n_d_er _____ _
Office Tele No.: 910-270-2919 Fax No. 910-270-2988 Cell No. ________ _
D. HEAT PUMP CONTRACTOR INFORMATION (if different than Driller)
Company Name: ___ O-=--''B=r=ie=n=-S"'"e=rv-'-1=· c-=-e -=C-=o=m=p=an=--y _______ _
Contact Person: --~N~at=e-=C~a=rr'---------
Company Website: www.obrienservice.com Email Address: Nate@obrien service.com
Address: ----=-33=0=8=-E=n=t=e:..,:rp=n=·s-=-e -=D=r"--'iv..::ce _______________________ _
City: Wilmington Zip Code: 28405 County: ------"-N"'"'e'"""w'--H=an=o=--v-=e-=--r ___ _
Office Tele No.: 910-799-6611 Fax No. Cell No.
E. STATUS OF APPLICANT
Private: ____x_
State:
Federal:
Municipal: __
------------------
Commercial:
Native American Lands:
F. INJECTION PROCEDURE (briefly describe how the injection well(s) will be used)
Passive infiltration of well water use for geothennal heat exchange
G. WELL USE Will the injection well(s) also be used as the supply well(s) for the following?
(1)
(2)
The injection operation?
Personal consumption?
YES ___ _
YES ___ _
NO -"""X""----
NO X ----
H. WELL CONSTRUCTION DATA (Ski p to Section I if this is a Permit RENEWAL)
PROPOSED Well(s) to be constructed for use as an injection well. Provide the data in (1)
through (7) below as PROPOSED construction specifications. Submit Form GW-1 after
construction.
(1)
(2)
X EXISTING Well(s) being proposed for use as an injection well. Provide the data in (I) through
(7) below to the best of your knowledge. Attach a copy of Form GW-1 (Well Construction
Record) if available.
Date to be constructed: Wells are existing Number of borings: __ 2 __ _
Approximate depth of each boring (feet): 190' & 133'
Well casing. Is the well(s) cased? (check either (a.) YES m: (b.) NO below)
(a) YES X If yes, then provide the casing infonnation below.
Type: Galvanized steel __ Black steel __ Plastic X Other (specify) ______ _
Casing thickness: SCH40 diameter (inches): 4" depth: from _O __ to 160' & 68' ft.
(reference to land surface)
Casing extends above ground _____ 1=2_" -=-&~0~'-' __ inches
(b) NO
(3) Grout (material surrounding well casing and/or piping):
(a) Grout type: Cement _X__ Bentonite* Other (specify) _______ _
(b) Grouted surface and grout depth (reference to land surface):
GPU/UIC 5A7 Well Permit Application (Rev. August 2009) Page 2 of4
I.
___ Around closed-loop piping; from ____ to ___ (feet).
X Around well casing; from ___..0 __ to 20 (feet).
*By selecting bentonite grout, a variance is requested to ISA NCAC 2C .0213(d)(l)(A) that
requires a cement type grout.
(4) Well(s) Screen Information, if any
Depth of Screen: From 160' to 190' feet below land surface
(5) N.C. State Regulations (Title ISA NCAC 2C .0200) require the Permittee to make prov1s1ons for
monitoring wellhead water quality and processes. A faucet on both Influent (groundwater entering heat
pump) and Effluent (water being injected back into the well) lines is required. Will there be a faucet on:
(a) Influent line? Yes X No (b) Effluent line? Yes X No __
(6) Source Well Construction Information (if the water source well is a different well than the injection well)
Attach a copy of Form GW-1 (Well Construction Record). If Form GW-1 is not available, provide the
following data:
NOTE:
Groundwater Source. From what depth, formation, and type of rock/sediment units will the groundwater
be withdrawn? (e.g. granite, limestone, sand, etc.)
Depth: 190' Formation: Pee Dee Rock/sediment unit: Sandstone
THE WELL DRILLING OR HEAT PUMP CONTRACTOR CAN SUPPLY THE DATA FOR EITHER EXISTING OR
PROPOSED WELLS IF THIS INFORMATION IS UNAVAILABLE BY OTHER MEANS.
OPERATING DATA
(I) Injection rate: Average (daily) <15 gallons per minute (gpm).
(2) Injection Volume: Average ( daily) <21.600 gallons per day (gpd).
(3) Injection Pressure: Average (daily) <15 pounds/square inch (psi).
(4) Injection Temperature: Average (January) 60 ° F, Average (July) 65 o F.
J. INJECTION-RELATED EQUIPMENT
Attach a diagram showing a schematic or cross-section of the well construction (i.e., the total depth, casing,
location/extent of grout, stickup, location of influent/effluent sampling ports, etc.). If this is a modification, show
the engineering layout or proposed modification of the injection equipment and exterior piping/tubing associated
with the injection operation. The manufacturer's brochure may provide supplementary information.
K. LOCATION OF WELL(S)
Attach two copies of documents showing information mentioned below.
(I) A site map (can be drawn) showing: House(s)/Building(s), 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 1000 feet of
the geothermal heat pump well system. Label all features clearly and include a north arrow .
(2) A topographic map of the area extending 1/4 mile from the property boundaries and
indicate the facility's location and the map name.
(3) A property deed or tax record (can be obtained from your county GIS website) showing present property
ownership.
NOTE: In most cases, an aerial photograph of the property parcel showing property lines and structures can be
obtained and downloaded from the applicable County GIS website. Typically, the property can be searched by owner
name or address. The location of the wells in relation to property boundaries, houses, septic tanks, other wells, etc.
can then be drawn in by hand. Also, a 'layer' can be selected showing topographic contours or elevation data.
GPU/VIC 5A 7 Well Permit Application (Rev. August 2009) Page 3 of4
L. CERTIFICATION
Note: This Permit Application mast he signed by Each person appearing on the
recorded legal property deed.
"I 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 injection well and
all related appurtenances in accordance with the approved specifications and conditions of the Permit."
.s1/4
Signature of Property Owner/Applicant
Print or Type Full Name
f*rt
Signature of Property Owner/Applicant
Print or Type Full Name
Signature of Authorized Agent, if any
Print or Type Full Name
Please return two copies of the completed Application package to:
North Carolina DENR-DWQ
Aquifer Protection Section
MC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone [phone]
GPU/ IIC 5A7 Well Permit Application (Rev. August 2009) Page 4 of 4

NON RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION #
1. WELL CONTRACTOR:
Well Contractor (Individual) Name
Applied Resource Management, P.G.
Well Contractor Company Name
257 Transfer Station Rd.
Street Address
Hampstead NC 28443
City or Town State Zip Code
(910 ) 270-2919
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(1 applicable)
SITE WELL ID #(#applicable)
3. WELL USE (Check One Box) Monitoring 0 Municipal/Public ❑
Industrial/Commercial ❑ Agricultural p Recovery ❑ Injection II
lrrigationlj Other (list use Heat I3Ump
DATE DRILLED 1/22/10
4. WELL LOCATION:
1231 Sherman Oaks Drive
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: Wilmington COUNTY New Han.
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
0 Slope ❑Valley 'Fiat ❑Ridge a Other
LATITUDE 34 " 17 24.0000 " DMS OR DD
LONGITUDE 77 ° 50 ' 46.00 0 DMS OR DO
Latitudeflongitude source: 'PPS Qropographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
Facility Name Facility ID# (If applicable)
Street Address
City or Town
Douglas Hamerski
Contact Name
1231 Sherman Oaks Drive
State
Zip Code
Mailing Address
Wilminaton
City or Town
NC 78411
State Zlp Code
( 910 ) 794-9829
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 190'
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
c. WATER LEVEL Below Top of Casing 26 FT.
(Use "+° if Above Top of Casing)
d. TOP OF CASING IS ---1 5 FT. Above Land Surface"
'Top of casing terminated atlor below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpmy: 50 METHOD OF TEST Airlift
I. DISINFECTION: Type HTH
g. WATER ZONES (depth):
Top Bottom Top Bottom
Top Bottom Top Bottom
Top Bottom Top Bottom
7. CASING: Depth Diameter
Amount 3na10%
Thick ness/
Weight Material
Top 0 Bottom 160 Ft. 4" sch40 _PVC
Top Bottom Ft.
Top Bottom Ft.
8. GROUT: Depth Material Method
Top 0 Bottom 20 Ft. Grout Tremmie
Top Bottom Ft.
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 160 Bottom 190 Ft. 4 in. .010 in. Grout_
Top Bottom Ft. in. in.
Top Bottom Ft. In. in.
10. SAND/GRAVEL PACK:
Depth
Top 150 Bottom 190 Ft.
Size Material
Coarse Sand
Top Bottom FI.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom
0' / 30'
30' /60'
60' / 130'
1.39` 1140'
140' / 150'
/ 190'
I
1
1
1
1
12. REMARKS:
Formation Description
Medium drained sand
Coarse sand
Limestone
Mud rock
Pee Dee clay
Sandstone
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
/SA NCAC 2C, WELL CONSTUCTtON STANDARDS, AND THAT A COPY OF THIS
RE ORO HAS BEEN PROVIE .D T E WELL OWNER
•sJ.�► � 1/22110
SIGNATURE OF CERTIFIED WELL CO ACTDR
DATE
Donald H. Cummings
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30 days of completion to: Division of Water Quality - Information Processing,
1617 Mail Service Center, Raleigh, NC 27699-161, Phone : [phone]
Form GW-lb
Rev 2/09

- Approximate Property Lines
Approximate Building Perimeter
Approximate Well Locations
Notes:
1. Subject property and surrounding area are serviced by public sewer and water.
2. Well #1 is an existing well, time of drilling unknown, that is approximately 12' from the building.
3. Well #2 was drilled on 1/22/10.
Adapted from Google Earth and New Hanover County GIS Map, January 2010.
TITLE: SITE MAP
76c lied I�e�ource Mana ement f C1231 SHERMAN OAKS DRIVE
� Box 882. Hampstead, NC 28443 JOB: SCALE: DATE: DRAWN BY:
910] 270-2919 FAX [phone] Hamerski As Shown 1/23/09 DNH
FIGURE:
1

N
li
Approximate Building Perimeter
Approximate Well Locations
Notes:
1. Subject property and surrounding area are serviced by public sewer and water.
2. Weil #1 is an existing well, time of drilling unknown, that is approximately 12' from the building.
3. Well #2 was drilled on 1/22/10.
Adapted from Google Earth and New Hanover County GIS Map, January 2010.
TITLE: EXISTING WELL MAP
76\-.
nylied Resource Management FC 1231 SHERMAN OAKS DRIVE
P.O. Box 882, Hampstead, NC 28443 JOB: SCALE: DATE: DRAWN BY:
[phone] FAX [phone] Hamerski As Shown 1123/09 DNH
FIGURE:
2

ATA
NCDENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Douglas and Dana Hamerski
1 231 Sherman Oaks Dr.
Wilmington, NC 2841 1
Division of Water Quality
Coieen H. Sullins Dee Freeman
Director Secretary
March 16. 2010
Re: Additional Information Request
Injection Well Permit Application W10800184
New Hanover County
Dear Mr. and Mrs. Hammersli:
After reviewing the referenced permit application and conducting a site inspection our staff identified an item
that needs clarification and/or additional information.
The permit application cannot be approved as submitted. The proposed injection well (Well #1) will be
injecting water into a shallower, separate aquifer from the existing source well (Well #2). The injection well is
completed in the Castle Hayne aquifer at 130 feet below land surface and the source well is completed in the
Pee Dee aquifer at 190 feet. In order to approve a permit for a geothermal injection well, you must resubmit the
application with either: (a.) a new proposed well to be completed in the deeper Pee Dee aquifer at
approximately the same depth as the source well at approximately 190 feet; or (b.) the existing proposed
injection well must be re -drilled (overreamed) and completed in the deeper, Pee Dee aquifer.
Additionally, if any of these options are selected, the injection well, must be grouted the entire length of the
casing in order to prevent injected water migrating up outside the well casing to land surface.
Please submit your responses with any corrected text pages/figures for insertion into the previously submitted
UIC Application within 30 calendar days of receipt of this letter. If you have any questions regarding your
permit please call me at [phone] or email me at Michael.Ro!ers il,ncdenr.gov.
Thank you for your cooperation.
Best Regards,
Michael Rogers, P.G. (NC & FL)
Environmental Specialist
Cc:
Charles Stehman—Wilmington Regional Office
Central Office File — WI0800184
New Hanover County Environmental Health Department
Paget of 2 Pages