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Home My WebLink AboutWI0100136_GEO THERMAL_20110106R Central Files: APS SWP 01 /06111 Permit Number WI0100136 �' Permit Tracking Slip Program Category Status Project Type Ground Water Active New Project Permit Type Version Permit Classification Injection Water Only GSHP Well System (5QW) 1.00 Individual Primary Reviewer michael.rogers Coastal SW Rule Permitted Flow Facility Name Ridgefield Investments LLC Location Address 300 Ridgefield Ct Asheville NC 28806 Owner Permit Contact Affiliation Steven Deweese Driller Well PO Box 5411 Asheville NC 28813 Major/Minor Region Minor Asheville County Buncombe Facility Contact Affiliation Owner Name Owner Type Ridgefield Investments LLC Unknown Owner Affiliation Charles Archerd PO Box 5411 Asheville NC 28813 Dates/Events Scheduled Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration 01/06/11 12/02/10 01/06/11 01/06/11 Regulated Activities Heat Pump Injection Outfall N"J, 1. Waterbody Name Stream Index Number Current Class Subbasin r NCDE:NR North Carolina Department of Environment and Natural Resources Division of Water Quality Beverly Eaves Perdue Coieen H. Sullins laovemor Director 116Q011 Ridgolield lnvrsnnmiits LLC C harics Archerd Pit Box 5411 Ashevillc, NC 2,4913 Subject: Acknowledgement of Intent to Construct Type SQW Injection Well System Permit No. W10100136 - 300 Ridgefield Court. Asheville. NC 28806 Dear Mr. Archerd: Dee Freeman Secretary On 121212010, the Aquifer Protection Section (APS) received notification of your intent to construct a closed -loop water-oni■ geothermal injection well system for the operation of a ground -source heat pump located at the address referenced above. An individual permit is not required for the construction and operation of this type of geothermal iniection well system as long as the fallowing conditions are met: 1. The injection well system contains only potable water, 2. The injection well system is constructed in'accordance with well construction standards specified in North Carolina Administrative Code Title ISA Section 2C Subchapter .0213, and 3. The required notification form and associated maps have been completely and accurately submitted. Failure to comply with all of these conditions constitutes a violation of the North Carolina Well Construction Act and North Carolina Administrative Code Title 15A Section 2C Subchapter .0211(u)(2), Additionally, you should contact the Buncombe County Health Department as they may have additional requirements for this type of system. Noncompliance with applicable state, county, or municipal rules and regulations may result in the assessment of civil penalties. Please contact Mike Rogers at (919) 715-6166 or Michael,Ro,-,ersiatncdenr.l_,ov if you have any questions. Sincerely. iny' Debra Watts 5uperyisor cc. Ashe�ihv Regional Office - APS APS Central Files - Permit Nn. W1IMY'1 6 l3unconibc Counry Health DepT. GeoTherm Loop Services, Inc [Stave 1)eWecsc - PC) Box 5411. Asheville., NC :S81 ,j 6entrt, ,`!eating, luu- {I}urn:ie Gentry — 100 liuckeye C'civt .kcciss Risad. Swanatl0d- 'VC' 28 17k1� AQUIFER PP.r�)'ECTiON 3EG 10N 1t,36 Mail Service Lenler, Ralegli, N o ft Carp+^a 276u9-1636 a at{on 272" CapuaI aot)levard- Raleigh North LaFDirn8 2750 Phcoic , 19-733-322 11 FAX 1 914-7 1�-05K, F 4 X 919-71,�-60481Gustrn7e- S?Nit_ 1 67'-623-6'4� IntemEt yM.nctiyateMua4ttv.om An Equal Rpmnunila r Alfirrnakivs 4cwn E oVoVcr Uri r N nr[h Carc}1a n Lt V11� 1�� NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES NOTIFICATION OF INTENT TO CONSTRUCT A CLOSED -LOOP GEOTHERMAL WATER ONLY INJECTION WELL SYSTEM TYPE 5OW WELLS) In Accordance With the Provisions of NCAC Title 15A 02C.0200 Print or type the required information and mail to address on the back page. DATE: December 1, , 2010 �R � �Q N I -J Wen Type Conferniation: Does the proposed system circulate potable water only (no additives) in continuous piping that completely isolates the fluid from the environment (i.e, closed -loop)? Yes X Continue completing this form. No Do Not complete this form. Complete other UIC application forms for installing either a 5A7 well Conan -loop well iniecting potable water into the aquifer) or a 5QM well (closed - loop well containing additives such as R-22, ethanol, or other antifret= or corrosion inhibitors). A. PROPERTY OWNER(S)IAPPLICANT(S) List each Property Owner listed on property deed (if owned by a business or government agency, state name of entity and a representative wlauthority for signature): Ridgefield Investments, LLC (1) Mailing Address: PO Box 5411 City: Asheville State: NC Zip Code.28813 County: Buncombe Home/Office Tele No.: 828-277-2772 Cell No.: NA Email Address: ca(marcherdheIll.com Website: na (2) Physical Address of Well Site (if different than above): 300 Ridgefield Court City: Asheville State: NC Zip Code: 28806 County: Buncombe Home/Office Tele No.: 828-277-2772 Cell No.: NA B. AUTHORIZED AGENT OF OWNER, IF ANY (if the Permit Applicant does not own the subject property, attach a letter from the property owner authorizing Agent to install and operate UIC well) Company Name: Contact Person: EMAIL Address: Address: City: State: Zip Code: County: Office Tele No.: Cell No.: Website Address of Company, if any: GPUNIC 5QW Notification of Intent Form (Revised 8/2008) Page 1 C. E. F. WELL DRILLER INFORMATION Company Name:, GeoTherm Loop Services, Inc. Well Driller Contractor's Name: Edward Barker Jordon NC Contractor Certification No.: 3172 Contact Person: Steve DeWeese, Vice President EMAIL Address: steveoruteothermservices,com Address: PO Box 5411 City: Asheville Zip Code: 28813 County: Buncombe Office Tele No.: 828-277-7009 Cell No.: 828-712-1689 HEAT PUMP CONTRACTOR INFORMATION (if different than driller) Company Name: Gentry Heating. Inc. Contact Person: Duane Gentry _ _ ENIAIL Address: duaneggentrvheatinginc.com Address: 100 Buckeye Cove Access Road City: Swamnoa. NC Zip Code: 28778 County: Buncombe Office TeleNo.: 828-274-2520 Cell No.: 828-552-1421 STATUS OF APPLICANT Private: Federal: Commercial: X State: Municipal: Native American Lands: INJECTION PROCEDURE (briefly describe how the injection well(s) wilt be used) Closed loops for ground source heat exchanger 1410000�►�1AW8111MlffTil+3110J7IJEN tC1 (1) Proposed date to he constructed: 12/6/10 to 1/31/11 Number of borings: 28 Approximate depth of each boring (feet): 200' (2) Type of tubing to be used (copper, PVC, etc): HDPE (3) Well casing. Is the well(s) cased"? (check either (a,) Yes or (b.) No below) (a) Yes if yes, then provide casing information below Type: galvanized steel black steellastic other (specify) Casing depth: From to feet (reference to land surface) Casing extends to above ground inches (b) No X (4) Grout Info (material surrounding well casing and/or piping): (a) Grout type: Neat Cement Bentonite X Other (specify) (b) Grout placement: Pumping X Pressure Other (c) Grout depth of tubing (reference to land surface): from 0' to 200' (feet) If well has casing, indicate grout depth: from to (feet) GPUAJIC 5QW Notification of intent. Form (Revised MOO&) Page 2 H. INJECTION -RELATED EQUIPMENT Attach a diagram showing 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. I. LOCATION OF WELL(S) Attach two copies of maps showing the following information: (1) include a Site Map (can be drawn) showing: buildings, 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 withrn 200 feet of the geothermal heat pump well system. Label all features clearly and include a north arrow. (2) The Site Map must show the subject property in relation to the surrounding area by using at least two fixed reference points such as roads, streams, and/or highway intersections. J. CERTIFICATION Note: This Permit Application must be 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 app cl_Aotio is and c ions f Permit." ignature of Property _ wrier/Applicant Charles W. Archerd, Manayer Print or Type Full Name and title Signature of Property Owner/Applicant Print or Type Full Name and title Signature of Authorized Agent, if any m M Print or Type Full Name and title Please retttrn two copies of the completed Application package to: n rn North Carolina DENR-DWQ _ c' v Aquifer Protection Section-VIC Program $ 1636 Mail Service Center Raleigh, NC 27699-1636 Telephone (919) 733-3221 GPUMC 5QW Notification of Intent Form (Revised 9/2008) Page 3 E., + Ay I, 1 I �na.a n I cM �to�,sa-j "—`. �.�� •wa¢�irnwv�w ��J'YV�(� ��.wW ..... •.�r+re•� —._� . �..�r ecrew McAsr ;sso�u�sg� , P ;RIDGEFIELD INvESTMENTS, LLC AAe 4, 300 RMCEFIELD COURT' r ' ll In • + `, �`'r;, � _ � � 11 _ 1}1 _ f to ;' .•may a,m,,.,su•deerayu sir.nr �� „`'`. *,: w "' ...,�,...,. —. r•",.:�w.� ,ram.. Tf ICAO saTd, RIDGEFIELD INVESTMENTS, LLC ssoesAr€s, A_ " 300 RIDGEFI.ELD COURT " NORTH CAROLINA DEPARTMENT OF ENVIRONMENT ARID NATURAL RESOURCES NOTIRCAT10N OF INTENT TO CONSTRUCT A CLOSED -LOOP GEOTHERMAL WATER -ONLY INJECTION WELL SYSTEM TYPE 5QW WELL(S) In Accordance With the Provisions ofNCAC Title 15A 02C,0200 Print or type the requited information and retail to address on the back page. DATE: December 1. , 2010 Well Type Confirmation: Does the proposed system circulate potable water only (no additives) in continuous piping that completely isolates the fluid from the environment (i.e. closed -loop)? Yes X Continue compietmg this form. No Do Not complete this form. Complete other L]IC application forms for installing either a 5A7 well (open -loop well injecting potable water into the aquifer) or a 5QM well (closed - loop well containing additives such as R-22, ethanol, or other antifreeze or corrosion inhibitors). A. PROPERTY OV4'NER(S)1APPLICANT(S) List each Property Owner listed on property deed (if owned by a business or government agency, state name of entity and a representative wlauthority for signature): Ridgefield Investments, LLC (1) Mailing Address: PO Box 5411 City. Asheville Stare: NC Zip Code.288I3 County: Buncombe Home/Office Tele No.; 828-277-2772 Cell No.: NA Email Address: cakbarcherdbell.com Website: na (2) Pbysical Address of Well Site (if different than above): 300 Ridgefield Court City. Asheville State: NC Zip Code: 28806 County: Buncombe Home/Office Tele No.: 828-277-2772 Cell No_: NA B. AUTHORIZED AGENT OF OWNER, tF ANY (if the Permit Applicant does not own the subject progeny, attach a letter from the property owner authorizing Agent to install and operate UIC well) Company Name: Contact Person: EMAIL, Address: Address: City: State: Zip Code: Crninty: Office Tele No.: Cell No.: Website Address of Company, if any: GPU1 IC 5QW Notification of Intent Form (Revised 8/2008) Page I C. D. E. F. G. WELL DRILLER INFORMATION Company Name:, GeoTherm Loop Services, Inc. Well Driller Contractor's Name: Edward Barker Jordon NC Contractor Certification No.: 3172 Contact Person: Steve DeWeese. Vice President EMAIL Address:_ steve(a geothermservices.com Address: PO Box 5411 City: Asheville Zip Code: 28813 County: Buncombe Office Tele No.: 828-277-7009 Cell No.: 828-712-1689 BEAT PUMP CONTRACTOR INFORMATION (it different than drliler) Company Name:Gentry Heating, Inc. Contact Person: Duane Gentry EMAIL Address: duanaa.gentryheatinxinc.com Address: 100 Buckeye Cove Access Road City: Swan um NC Zip Code: 28778 County: Buncombe Office Tele No.: 828-274-2520 Cell No.: 828-552-1421 STATUS OF APPLICANT Private: Federal: - State: Municipal: Commercial: X Native American Lands: ViJECTION PROCEDURL, (briefly describe how the injection well(s) will be used) Closed loops f�'round soume_heat exchanger WELL CONSTRUCTION DATA (1) Proposed date to be constructed: I2/6/10 to 1 /31 / 11 Number of borings: 28 Approximate depth of each boring (feet): 200' (2) Type of tubing to be used (copper, PVC, etc): _ HDPE (3) Well casing. Is the well(s) cased? (check either (a.) Yes or (b.) No below) (a) Yes if yes, then provide casing information below Type: galvanized steel black steel_ plsstic other (specify) Casing depth: From to feet (reference to land surface) Casing extends to above ground inches (b) No X (4) Grout Info (material surrounding well casing and/or piping): (a) Grout type: Neat Cement Bentonite X Other (specify) (b) Grout placement: Pumping X Pressure Other (c) Grout depth of tubing (reference to land surface): from 0' to 200' (feet) If well has casing, indicate grout depth: from to (feet) GPUIMC 5Qw Notification of Intent Farm (Revised 8/2008) Page 2 H. INJECTION -RELATED EQUIPMENT Attach a diagram showing 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. 1. LOCATION OF WELL(S) Attach two copies of maps showing the following information: (1) Include a Site Map (can be drawn) showing: buildings, 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 200 feet of the geothermal heat pump well system. Label all features clearly and include a north arrow, (2) The Site Map must show the subject property in relation to the surrounding area by using at least two filed reference points such as roads, streams, and/or highway intersections. J. CERTIFICATION Note. This Permit Application must be 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 appr cifications and ipndi n/6f the Permit." Signature of Property Owner/Applicant Charles W. Archerd, Manager Print or Type Full Name and title Signature of Property Owner/Applicant Print or Type Full Name and title Signature of Authorized Agent, if any Print or Type Full Name and title 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 (919) 733-3221 QPU/WC 5QW Notification of tment Form [Revised 8/2008) Page 3 0M« I I . I i Jt t '• �a ii�•:.wiF s rrr 1r fr �i l� II r�iar;agn txse-� #li6itl.A i�..�� a..••••:•r...wwr wai• . P3� ..wa S hkLl Assm'E s*,P.A, � t RIUG E IELD INVESTMENTS, LLC _- 300 R., xIncMELD cOtrkr • i C'°'Bp RIDGEFI.ELD INVESTMENTS, LLe 1= D.. Ssoc� Ads. 6': 300 RIDGCFIELD COURT • a ,p" i