WI0100170_GEO THERMAL_20110912

Permit Number W10100170
Program Category
Ground Water
Permit Type
Injection Water Only GSHP Well System (50W)
Primary Reviewer
michael.rogers
Coastal SW Rule
Permitted Flow
Central Files: APS SWP
09/12/11
Permit Tracking Slip
Status
Project Type
Active
New Project
Version
Permit Classification
1.00
Individual
Permit Contact
Affiliation
Lon Dillard
Driller Well
PO Box 580
Blairsville
GA 30514
Facility
Facility Name Major/Minor Region
Western Carolina University 5OW Minor Asheville
Location Address County
554 Central Dr Jackson
CulloWhee NC 28723 Facility Contact Affiliation
wne
Owner Name Owner Type
State of North Carolina Government - State
A Owner Affiliation
Joe Walker
Western Carolina University
U2iaSlFV2nES Cullowhee NC 28723
Scheduled
Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
09/12/11 09/07/11 09/12/11 09/12/11
Regulated Activities
Heat Pump Injection
University/College
Outfall
Waterbody Name
Stream Index Number Current Class Subbesin

4;-7A
MCDEMR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
09/13/2011
,Toe Walker, PE
Western Carolina University
3476 Cullowhee Rd.
Cullowhee, NC 28723
Subject: Acknowledgement of Intent to Construct Type SQW Injection Well System
Permit No. WI010D170
554 Central Dr.
Cullowhee, NC 28723
Dear Mr. Walker:
Dee Freeman
Secretary
On 09/07/2011, the Aquifer Protection Section (APS) received notification of your intent to construct a closed -loop water-onl%
geothermal injection well system For the operation of a ground -source heat pump located at the address referenced above. An
individual permit is not required for the construction and operation of this type of geothermal injection well system as long as the
following conditions are met:
The injection well system contains only potable water,
The injection well system is constructed in accordance with well construction standards specified in North
Carolina Administrative Code Title 15A Section 2C Subchapter .0213, and
3. The required notification form and associated maps have been completely and accurately submitted,
Failure to comply with all of these conditions constitutes a violation of the North Carolina Well Construction Act and North Carolina
Administrative Code Title 15A Section 2C Subchapter .0211(u)(2). Additionally, you should contact the Jackson 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 [phone] or Michael.Roversfa ncdenr.eov if you have any questions.
5ihcer�ely, '
for Debrra Watts
Supervisor
cc: Asheville Regional Office - APS
APS Cent; al Files - Pennit No. WI0100170
Jackson County Health Dept.
Lon Dillard (Byers Well Drilling, Inc., P.O. Box 580, Blairsville, GA 30514)
Anthony Barnette (W.E. Bolton, P.O. Box 8609, Asheville, NC 28114)
AWIFER PROTECTION SECTION
1636 Mail Service Center, Raleigh, Norlh Carolina 27699.1636
Location: 2728 Capital Boulevard, Raleigh, North Carolina 27$64 ne
Phone: [phone] l FAX 1- 919.71W588; FAX 2: 919-71M0481 Customer Service: 1-B77-623-6748 1, w7 h Carc lria
Internet: ► %w.ric atamuaKv.or1
an Egaa! Opporwity; Atri maliv., AOcrr Emolover Nat
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NORTH CAROLINA D13PARTMEN7' OF 1 NMONMENT AND NM URAL 1113SOURMS
NOTIVICA"ON OF IWMT TO CONSTRUCT OR OPESATE 1NnCTXON'VVI"
In Aecwdmree With die Provislefm of 15A NCAC 02C .MD
CLO M1,0OP M ATER-ONLY GEOTHERMAL INJECTION WELLS
Tltese %volts clmulate potable water mly Qo perk of a g oommal Ise ting and cooling sy*m,
These wells are "permidod by rule" and do not require an Individual permit Men they are constructed hz
geeaordanoc with die rules of I SA NCAC = ,0200 sod this Notlm is sabulitlad prior to eonmruction.
1'KW ar 7}" 10ronarfan andU411 to tiro Addrrm our 1ho krear Paga.
DATE: Aagust 22, 2011 PZRMrr NO, (Do be filled In by DWQ)
A. 8TATUS OF It1+E1t,Y. OWNER (choose one)
Non-Goverm lent: Individual Residence.__.— HusiaesslOrgartizatlon
Government: State x Municipal Cmaty Fodtxal
a 'WEII.L, OWNER — For individual maideocos. list ugh owner on pro" deed. For all otbam state tannic of
entity Ed mama of pmon delegated authority to slgn on behalf of the business or agaacy:
'1'hE Rmte of Nor7h Carolina through Western Carolinm ihdvar&
Mailing Address: 3476 Old Cupowlwa►+
City. Cullawheo_ Slater NC Zip Cade: 28723 County: Jackson
Day Tole No.: [phone] ... Coll No., NA _
EMAIL Addr+em: [e-mail],edu_ _ FaxM l929)227-7198
C LOCATIOK OF WELL SrM — Where the lgacti m wells arc physically located:
(1) Parcel Identification Nurnbw(P1N) dwell site:_ 7559-23-1452 County:
(2) Physical Address (if difiururt than mailipg address):
_, ral Dri e
City: _ Ctllrotivhee State; dip Coda: , 28723
D. WELL DRILLER INFORMATION
Well Drilling ContrWAW's Name: Awm Well Drilling in
NC Well DiiU4 c3untrwtorCamication No.: 3131 r
Coo;pay Name- H s iIII
Cont"t Pea U 1 EMAIL As: IdIl
Address: POE x 586 w
CiV i 21p Code: 30514 State: C' A CouWy: j2ft
Office Tele No.: [phone] _ Cell No,: _(706) 78I.4582 Fix Np - _ NA
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F.
HEAT PUMP COIF tRACI'OIt INFORKATION Of difFcrcntthan driller)
CempaayTYrune :.
Contact Person; Arvk6onw far v►s-ri 1 EMAM Address:
Addrmas:116cl F-L*t. tUW.,gftQ ra-,%r] E7. x 4 1QC9 CIS L Ar
City: a t r a _ Zip Code: Te LEA- state: vLcountyr i54Arht~o+&W
t]fPioe't'ele No.:� f+i-1� 3- 3�Zj Cdl No.: 5 i6.a7. M Fax bh: S2q• 2s r - 2 i +el 4,
WELL CONSTRUCTION aA fA
(1) Number of boring lobe c9nstruc1ed*: 100 Depth of each bo6ag (feet): 430 feet
• I/eXlstll8 wwde Apply tmffs Ivill 4 and then provide the Wormailim in its'" (4) blow.
(2) Type of tubing to be need {sleet, PVC, e(c): HOF
(3) Weli easing, if the wall(s) will use casing dm provide the die (steel, PVC, etc.),
and extent of cash4 appearing above ground: NA
(4) t mt. (material surrounding well easing urtdlor piping,}:
(s) Orout typo: Cement Bertkonits" Other (specify) "Chermally Enhanced Bentonlie
"By seled[GrtB bmaWls Votk a v; rV ea is Mwbr nq=ted is 1 5—AREAC 2C .4213(4(1)W, ►rtttt;b Nolaa ccmad (Ypo FWL
(b) Grout depth of tubhrg (reference to land surlbae): 11am Q to 450 (feet)
If viall has casing, indicate grout depth. from to (feet)
G. WELL LOCATIONS -Maps must be sealed or othrnvlse acmVely indic4ft distawoo and orientations of
features located ►vithin 1000 fact of the injectlon wall(s). Label ll l a north a1mw,
(1) Attsolr a site-apeatfic map ahosving the tvactiorls of tfle follo%ving;
0 proposed injection walls 4 Rrllldings a Property bmuidades
* surface wader hodlyd * Water supply wells
e Sapdo teltka and associated spy irrigation sites, "I fiWda. or repair area
+ M&ting Of p8tUdaI Sources of glrourtdwater cwnmmination
(2) Attuh a tnpagxaphir: nVP Of the stets aartertding 1/4 mite from the lnjw(I= wail site that ladicaks tha
facility's Iow0on and the map nem&.
NOM M MON rums, and aerlml photograph q(Ifte properV pvr&W Moues pnWe V lima and struca m carp of
abtalned and dowmlaudtedfrneet the appllcmbTa owur(v GIS loeb & 7jplaal(, *e preoparly cram be saeardrad by
otoner mwioc ur nrldrrrss The law ffim of Ou ueelh in rakfien to prope* baurrderjer, kat iwx, xr#c fnm4s, otrker
trr4r, 00: am then be draws Im by kwral. Also, a lkyer' cam be sekmd Slaalvtrrg a"rQhjo cCrlwty or
rkmilon dakr.
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EL CERTIFICATION (to be signed as requited below or by that persoa's authrimed ageott) i
Y7
1 SA NCAC 02C .0211 (b) requires that all permit applications shall be signed as follows:
1. ror a corporation: by a reapouible corporate officer,
2. far a partnership or sato proprictorAip: by a general partner or the proprietor, respactively;
3, for a mualclpallty at a state, federal, or other public agency: by 9ithav a principal executive rc". '0
oiiG M or ns king pntblkJy elected official;
4. fur all others: by the wall owner (mddgb M)gMix Ifi yMMS Naiad on U propi deed].
If an antharixed agent Is signbig on behalf of the applicant, then supply a letter signed by the
applicant that us aves and authorises their agent to sign this spinitcatiou an their behaf.
"I hmby Willy, Wrdar penalty of law. that I have persornaliy mndined and am ihmiliar with me information
submitted In this dommmt and all attad ments thereto and that, based an my inquiry of those individuals
irnnnediately responsible for obtaining said information, I believe that the intimation is we, acotrate coil
complete. I an aware the them are sipitieant pensltles, including the passibility of fines and imprisonment,
for xubmitting false lalbavAtion. l agree to sou not, Oparaw, maintaln, repair, and if applicable, abandon the
lrOotion well rind all related appurMnances In accordance with the approved specifications and conditions of
the Permit."
0..' 42-�
Sight of Property 0%"wdAppUc14
Joe walker, PH
Associate VC Nacllttios Manehement
Prism or Type Full Now
Slgiaatum of Property Ownw/Appl leant
Print or Type Full shame
Signature: ofAuthoriged I4gxyt� if any
Print or Type Full Name
Submit the mnplete application package to;
DWQ - Aquifer Protection Section
1636 Mali Service Center
Ralclgk, NC 27699-1636
Ttdcphone ('919) 733-3221
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