WI0100153_GEO THERMAL_20120518

Beverly Eaves Perdue
Governor
AW'i:r-
NcDEMR=-
North Caronna-Department of Environment and NaturaLResources
Division..olWater-.Ou_ality_
Char1es Wakild, P. E.
· Director
May 18, 2012
Margaret Samano
2012 Spyglass Lane
New Symma Beach, FL 32169
Subject: Notification of Rule Revisions Affecting
Closed-Loop Geothermal Injection Well Permit Holders
Permit Number: WI0100153
Dear Ms. Samano:
Dee Freeman
Secretary
Our records indicate that you currently hold a permit for a closed-loop geothermal injection well
system. This letter is to inform you that on May 1, 2012, the North Carolina Administrative
Code Title 15A Section 2C .0200 entitled "Well Construction Standards -Criteria and
Standards Applicable Injection Wells" were revised. These revisions affect all permits issued
for injection wells including geothermal wells.
This letter is also to inform you that your closed-loop geothermal injection well(s) have become
"permitted by rule." Therefore, you are no longer required to renew your current permit
and the permit will be valid indefinitely as long as the wells are active and are operated in
accordance with the revised rules referenced above. Please keep in mind that if you abandon
the wells, a record of abandonment must be submitted to the Division of Water Quality. You
may view the revised rules on our website at http://p ortal.ncdenr.org/web/wq/a ps.
If you have any·que·stions regarding your current permit or the rule revisions, please feel free to
contact our underground injection control staff at [phone].
Sincerely,
Eric G. Smith, P .G.
Hydro geologist
cc: UIC Pennit File
AQUIFER PROTECTION SECTION
1636 Mail Seivice Center, Raleigh, North Carolina 27699-1636
Location: 512 N. Salisbury St., Raleigh, North Carolina 27604
Phone: [phone] \ FAX: [phone]
Internet: www.ncwaterouality.org
An Equal Opportunity\ Affirmative Action Employer
Nirth Carolina
JVat11rnllu
Permi t Number WI0100153
Program Category
Ground Water
Permit Type
Injection Mixed Fluid GSHP Well System (SQM)
Primary Reviewer
john.mccray
Coastal SW Rule
Permitted Flow
Facili
Faclllty Name
Margaret M Samano SFR
Location Add ress
Balsam Mtn Preserve Ph4
Sylva
owner
Owner Name
NC
Margaret M
Dates/Events
28779
Samano
Orig Issue
04/28/11
App Received Draft Initiated
04/12/11
Scheduled
Issuance
Central Files : APS_ SWP_
05/05/11
Permit Tracking Slip
Status
Active
Project Type
New Project
Version
1.00
Permit Classlficatlon
Ind ivi dual
Permit Contact Afflllatlon
Larry Wells
Contact Driller Well
258 N Turkey Creek Rd
Leicester NC
Major/Minor
Minor
Region
Asheville
County
Jackson
Faclllty Contact Affiliation
Owner Type
Individua l
Owner Affiliation
Margaret M. Samano
2012 Spyglass Ln
New Smyrna Beach FL
Public Notice Issue
04/28/11
Effective
04/28/11
28748
32169
Expiration
03/31/16
_R_e .... a_u_la--te--d_A_c ___ tl_vi--ti __ es _______________ =R=e=q=ue=s=t=e-=d,.,_/R~e=-=c=e"-iv"--'e=d'-'E=v=e=n=ts=-----------
Heat Pump Injection RO s taff report reciues ted
RO s taff report received
Outfall
Waterbody Name Stream Index Number Current Class
04/19/11
04/21/11
Subbasin
,~A
North Carolina Department of Environment and Natural Resources
Divis ion of Water Quality
Beverly Eaves Perdue
Governo r
Coleen H. Sullins
Director
April 28, 2011
Margaret M . Samano
201 '.:! Spyglass Ln.
New Smyrna Beach, Fl 32169
Ref: Issuance of Injection Well PermitW10100153
Issued to Margaret Samano
Sylva , Jackson County, North Carolina
Dear M s. Samano:
Dee Freeman
Secretary
In accordance with the application received on April 12, 2011 , I am forwarding perm.it number W10100153 for the
construction and operation of a vertical closed-loop geothermal mixed-fluid heat pump injection well system. This
permit shall be effective from the date of issuance until March 31, 2016, and shall be subject to the conditions and
limitations stated therein. Specific attention should be paid to the requirement to protect the well during
construction of the site and structures located at the facility as specified in Part I.5, the requirement to install
well identification tags as 8pecified in Part Il.3, and to submit well construction records as specified in Part
VIl.2. Be sure to read the entire permit to ensure that you are aware of all compliance requirements of the permit
You will need to notify this office at least 48 hours prior to beginning construction and operation of the injection
well system. In order to continue uninterrupted legal use of the injection facility for the stated purpose, you must
submit an application to renew the permit 120 days prior to its expiration date, This permit is not transferable to
any person without prior notice to and approval by the Director of the Division of Water Quality.
Please contact me at (919) 715-61 68 or j [e-mail] if you have any questions about your permit.
cc: Landon Davidson, Asheville Regional Office
WI0100153 Permit File
Jackson County Environmental Health Dept.
AQUIFER PROTECitON SECTION
1636 Mall Service Center, Raleigh. North Carolina 27699-1636
Locatlon : 2728 Capital Boulevard , Raleigh, North Carolina 27604
Best Regards,
~£A([C.
Y John McCra7
Phone: [phone] I FAX 1: 919•715-0588; FAX 2: 919 •715-6048 I Customer Service : 1-877-623-6748
Internet: www.ncwaterouality.org
An Equi;I OpportUnlly \ Affirmanve />..coon Employer
~rthCarolina
)Vatural/11
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
Margaret M. Samano
FOR THE CONSTRUCTION AND OPERATION OF 2 TYPE SQM INJECTION WELL(S), defined in Title
15A North Carolina Administrative Code 2C .0209(e)(3)(F), for the purpose of operating a vertical closed loop
geothermal mixed fluid heat pump system. 'Ibis system is located at Balsam Mtn. Preserve Phase 4 Lot #208 ,
Cook House Rd, Sylva, Jackson County, and will be constructed and operated in accordance with the
application received April 12, 2011, and in conformity with the specifications and supporting data submitted, 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 and shall be in compliance with Title 15A of
the North Carolina Administrative Code 2C .0100 and .0200 plus any other applicable Laws, Rules, and
Regulations pertaining to well construction and use.
This permit shall be effective, unless revoked, from the date of its issuance until March 31, 2016, and shall be
subject to the specified conditions and limitations set forth in Parts I through IX hereof.
Permit issued this the 2 7th day of Ap1iJ, 2011.
~)~
\ -Coleen H . Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission.
Permit #WI0100153 UIC/SQM
ver. 03/2010
Page 1 of 5
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 perm.it shall become voidable unless the facility i s 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 not be located in an area generally subject to flooding. Areas that are generally
subject to flooding include those with concave slope, alluvial or colluvial soils, gullies, depressions, and
drainage ways.
S. Each injection well shall be afforded reasonable protection against damage during construction and u se.
PART II -WELL CONSTRUCTION SPECIAL CONDITIONS
1. At least forty-eight ( 48) hours prior to constructing system, the Permittee shall notify the Aquifer
Protection Section's Underground Injection Control (UIC) Program Central Office staff, telephone
number [phone], and the Asheville Regional Office Aquifer Protection Section Staff, tel ephone
number [phone].
2. The location of each of the system manifolds shall be recorded by triangulation from three permanent
features on the site (e.g., building foundation comers) and shown on an updated Site Map. The Permittee
shall retain a copy of this record on site.
3. One well identification tag per grouping or 'cluster' of wells shall be permanently affixed to the heating
and cooling unit or other nearby permanently fixed location in accordance with I SA NCAC 2C .0213(g).
PART ill-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). 1n the event there i s a desire for the facility to change ownership, or there is a
name change of the Permittee, a fonnal 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 o rdinances, which may be impos ed 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.
Per mit #WI0100153 UIC/SQM
ver. 03/2010
Page 2 of 5
PART IV -PERFORMANCE STANDARDS
1. The injection facility shall be effectively maintained and operated at all tiDles so that there is no
contamination of groundwater that 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
ground water 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.
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's Underground Injection Control (UIC)
Program 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 pennit, 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 . Division 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 sball be made for collecting any necessary and appropriate samples associated with the
injection facility activities.
Permit #WI0100153 UIC/SQM
ver. 03/2010
Page 3 of S
PART VII -MONITORING AND REPORTING REQUIREMENTS
1. All required documentation shall be submitted to:
Aquifer Protection Section -UIC Program
DENR -Division of Water Quality
1636 Mail Service Center and
Raleigh, NC 27699-1636
Ph# 919-715-3221
Aquifer Protection Section
Asheville Regional Office
2090 U.S. 70 Highway
Swannanoa., NC 28778
Ph# 828-296-4500
2. A completed Well Construction Record (Form GW-1 ) for each injection well must be submitted to the
Aquifer Protection Section Central Office and the Asheville Regional Office within 30 days of completion
ofwell construction. Copies of the GW-1 fonn(s) shall also be given to thePermittee and retained on site
to be made available for inspection.
3. A copy of the site map updated with manifold locations required in Part 11.2 of this permit shall be
submitted to the Aquifer Protection Section Central Office and the Asheville Regional Office within 30
days of completion of well construction.
4. 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.
5. The Permittee shall report by telephone, within 48 hours of the occurrence or first knowledge of the
occurrence1 to the Asheville Regional Office, telephone number (8 28) 296-4500, 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;
(C) Any loss of refrigerant in the system, regardless of the origin of the loss;
(D) Any-recharging of the refrigerant system.
6 . Where the Pennittee 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.
7. 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 VITI -PERMIT RENEW AL
In order to continue uninterrupted legal use of the injection facility for the stated purpose, the Permittee shall
submit an application to renew the permit 120 days prior to its expiration date.
Permit #WI0100153 UIC/SQM
ver. 03/2010
Page 4 of S
PART IX-CHANGE OF WELL STATUS ,
1. The Permittee 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 Perm.ittee must install a sanitary seal. If a well is not to be used
for any puq,ose, then that well must be permanently abandoned according to ISA NCAC 2C .0213(h)(l).
Notification shall be submitted to the addresses given in Part VII.1 of this permit.
2. When operations have ceased at the facility and a well will no longer be used for any purpose, the
Permittee shall abandon that injection well in apcordance with the procedures specified in 15A NCAC 2C
.0214, including but not limited to, the following:
(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 that 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 bas 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 tbe permit.
(G) The Permittee shall submit a copy of the Well Abandonment Record (Form GW-30) as specified
in 15A NCAC 2C .0213(h)(l) within 30 days of completion of abandonment. Copies shall be
submitted to the addresses given in Part Vll. l of this permit.
Permit #WI0100l53 UIC/SQM
ver. 03/2010
Page 5 of S
Permit Number WI0100153
Program C ategory·
Ground Water
Permit Type
Injection Mixed Fluid GSHP Well System (5QM)
Primary Reviewer
john.mccray
Coastal SW Rule
Permitted Flow
Facili
Faclllty Name
Margaret M Samano SFR
Location Address
Balsam Mtn Preserve Ph4
Sylva
Owner
Owner Name
NC
Margaret M
Dates/Events
28779
Samano
Orig Issue App Recehred Draft Initiated
04/12/11
Scheduled
Issuance
Central Flies: APS_ SWP_
04/28/11
Permit Tracking Slip
Status
In review
Project Type
New Project
Version Permit Classlflcatlon
Individual
Permit Contact AfflllatJon
Larry Wells
Contact Driller Well
258 N Turkey Creek Rd
Leicester NC
Major/Minor
Minor
Region
Asheville
County
Jackson
Facility Contact Afflliatlon
Owner Type
Ind ividual
Owner Afflllation
Margaret M. Samano
2012 Spyglass Ln
New Smyrna Beach FL
Public Notice Issue Effective
28748
32169
Expiration
-'--'R=e .... g=u=la=te;:;..;d:;_:_A=ct=iv..;;..i'""'ti""es=----------------~R=e=g=u=es=t=e=d._./R~e=c=e"-iv..,e=d._E=v=e=n=t=s _________ _
Heat Pump Injection RO staff report requested
RO staff report received
Outfall t~~JLL
Waterbody Name Stream Index Number Current Class
04/19/11
04/21/11
Subbasin
Mccray, John
From : Stepp, Jonathan
Sent:
To:
Thursday, April 21 , 2011 4:08 PM
Mccray, John.
Cc: Davidson, Landon
Subject: RE : ·saM geothermal appl ic ations W I0100152 and 153
John,
I spoke with Larry Wells (certified driller) about these two apP.lications so that I could get a distance between septic
systems and the.proposed geo wells. Mr. Wells indicated.the property in question for permit W I0100153 was going to
be on city water a nd sewer. Th e property associated with pe r mit number 152 will have a septi c system. Mr. Wells
thin ks it will be over 100 feet away from the geo wells, however he has not measured it ... Mr. Wells plans to call me after
measuring so that I can m ark it i n the application.
My recommendation is to proceed with permitting on both of these. Please h ighlight the section in the permi t stati ng
that the wells shall be protected during the construction process.
Thanks ,
Jonathan
Jonathan St epp -Jonathan.Ste pp@ n cd e nr.gov
North Carolina De pt . of Environm,ent and Natura l Resources
Ashevi lle Regio nal Office
Division of Water Quality• Aquif er Pro.tection Section
2090 U.S. 70 Highway
Swannanoa, NC 28778
Te l : 828-296-4500
Fax: [phone]
Notice: E-mail correspondence to and from thi s address may be subject to t he North Ca rolina Public Records Law and
therefore may be d isclosed to third parties.
From: Davidson, Landon
Sent: Tuesday, April 19, 201110:41 AM
To: Stepp, Jonathan
Subject: FW: SQM geothermal applications
G:l ,mdo,n D,lvid!ion , P .G.'
t ,,:C'f Ml C;J.,j;i-;11 ~•, .... -.t .l'v u. ffl",
,,quit1.·1 r r:,t_-:t::i11 !.::ti Jn
fl-::~l 'J(l'.'I ,1r: ~up::IVb::Jt
:-.~h-"'1 L llsg,,m~I Otti ••
;, '.)~, U.!.l+,., .• ,
! \ .. _,;-on.:·n!,)~'. fl...(. 2.'SIS
f'"h.: S1S i::•~ • :J3
r :· : •
e
r
1
web page: http://h2o.enr.stote.nc.us{oqw.html
This e-mail contofns o public record which is subject to disclosure to third
parties and the pub/le pursuant North Carolina '.s Pub/le Records Low. N. C.
Gen. Stat. §132-1, et seq. This e-mail may contain materials prepared
during or Tn ontlclpotion of o /ego/ proceeding os port of preparation for that
/ego/ proceeding, in which case third party or public access to it is subject to
N.C. Gen, Stat. §132-1 .9 and may be denied until the conclusion of the legal
proceeding, Including the completion of of/ appeals and post-judgment
proceedings, or, in the case where no /ego/ proceeding hos been commenced,
upon the expiration of o/1 applicable statutes of limitations and periods of
repose,
From: Mccray, John
Sent: Tuesday, April 19, 2011 10:3S AM
To: Davidson, Landon
Subject: SQM geothermal applications
Mr. Davidson,
Attached you will find two applications for new SQM geothermal systems. Application WI0100152 for a system in
Jackson County and WI0100153 also for a system in Jackson County. Please let me know how your office wants to
proceed with review and issuance.
Best Regards,
John McCray
2
RA NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue
Governor
Coleen H. Sullins
Director
April 15, 2011
Margaret M Samano SFR
_ 2012 S1)yglass Lane
-New Smyrna Beach, FL 32169"
Subject, Acknowledgement of Application No W10100153
Margaret M Samano SFR
Injection Mixed Fluid GSHP Well System (SQM)
Jackson
Dear Ms. Samano :
Dee Freeman
Secretary
The Aquifer Protection Section oftbe Division of Water Quality (Division) acknowledges receipt of your penrut applfoat1on and
supporting materials on April 12, 2011. This application package bas been assigned the number listed above and will be reviewed by
John McCray.
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 pennit applications, the Division requests your assistance in providing a timely and complete
response to any additional mformation requests. , ,
Please be aware that the Div ision's Regional Office , copied below, must provide recomrnendati9ns prior to final action by the
Division. Please also note at this time , processing permit applications can take as Jong as 60 -90 days after receipt of a complete
application. · ·
If you have any questions, please contact John McCray at 919-715-6168, or via e-mail at [e-mail]. If the reviewer i.s
unavailable, you may leave a message, and they wiU respond promptly.
PLEASE REFER TO THE ABOVE APPLICATION NUMBER WHEN MAKING INQUIRIES ON THIS PROJECT.
Sincerely,
()~~ ~
for Debra J. Watts
Supervisor
cc: Asheville Regional Office, Aquifer Protection St::ction
Appalachian Well Drillipng (Larry Wells)
Haywood Hearing & Air Co ndition ing, Inc (David Moody)
Permi ~Apil_!ication File WIOJ 00153
AQUIFER PROTECTION SECTI ON
1636 Mall Service Center. Raleial1 . North Carolina 27699-1636
Loca11on: 2728 Capita l Bou1evald , Raleigh , North Carolina 27604
Phone: [phone] \ FAX t 919-715-0588 ; FAX 2: 919-715-6048 I Cus1omer Service ; 1-Sn-523-6748
Internet: www.ncwateroualitv.org
Eou,.f Oppor1Uni1• Afmma tlvl! a.er.on EIT;ptove:
Nirthcarolina
;Naturall!f
Permit Number WI0100153
Program Category
Ground Water
Permit Type
Injection Mixed Fluid GSHP Well System (SOM)
Primary Reviewer
john.mccray
-Coastal SW Rule
Permitted Flow
Facili
Facility Name
Margaret M Samano SFR
Location Address
Balsam Mtn Preserve Ph4
Sylva
Owner
Owner Name
NC
Margaret M
Dates/Events
28779
Samano
Orig Issue App Rece ived Draft In itiated
04/12/11
Re QuJated Activities
Outfall Nt ,: .
Scheduled
Issuance
Central Flies: APS_ SWP_
04/15/11
Permit Tracking Slip
Status
In review
Project Type
New Proj ect
Version Permit C lassification
Individual
Permit Contact.Affiliation
Larry Wells
Contact Driller Well
258 N .Turkey Creek Rd
Leicester NC
Major/Minor
Minor
Region
Asheville
County
Jackson
Facility Contact Affiliation
Owner Type
Individual
Owner Affiliation
Margaret M . Samano
2012 Spyglass Ln
New Smyrna Beach
Public Notice Issue Effective
28748
32169
Expiration
Waterbody Name Stream Index Number Current Class Subbasln
Jackson County, NC Detailed Tax Parcels Report
111------'_:;;_,_·~ ..t .. I
WARNING: THlSIS NOT A SURVEY!* This I
map Is prepared for Inventory of real property
within Jackson County. It Is compiled from
recorded deeds, plats, and public data
records. Users of this map are hereby notified
that the aforementioned public Information
•sources should be consulted for verification.
:Jackson County or any County representative
· !assumes no legal responsibility for the
,contents of this map.
Listed To: SAMANO, MARGARET M
Listed To 2:
_....__ -
Physical Address: LT 208 PH 4 BALSAM MTN PRESERV
Tax District: LT 208 PH 4 BALSAM MTN PRES ERV
Account Number: 85862
PIN : 7672-64-6854
Malling Addressl: 2012 SPYGLASS LN
Mailing Address2:
City State: NEW SMYRNA BEACH FL
Zip Code: 32169
Deed Reference: 1818/565
Deed Date: 2009-09-08 00:00:00.0
Sales Price: $0.00
Assessed Acreage : 1.83
Township: SCOTTS CREEK
Map Sheet: 7672.00
Neighborhood: BALSAM MTN PRESERVE
Building Value: $434,710.00
Land Value: $520,000.00
Tot al Val ue: $954,710.00
Wednesday, April 27, 2011
I
s ;J
'<.5 397~ /J .... .
83 . JO li> 'l..8~ ..J
J..l"ie/ wooj
t). ';l.
AVA
NCDENR
North Carol in a Department of Environment and Na tural Resources
Division of Water Quality
Beverly Eaves Perdue
Governor
Coleen H. Sullins
Director
April 15, 2 011
Margaret M Samano SFR
_ 2012 Spyglass Lane
New Smyrna, Beach . FL 3216tt
Subject: Acknowledgement of Application No . Wl0100153
Margaret M Samano SFR
Injection Mixed Fluid GSHP Well System (SQM)
Jackson
Dear Ms . Samano :
Dee Freeman
Secretary
The Aquifer Protection Section of the Division of Water Quality (Division) acknowledges receipt o f your perm.it application and
supporting materials on April 12, 201 1. This application package has been assigned the number listed above and will be reviewed by
John McCray.
The reviewer will perform a detailed review and contact you with'a request for additional inform ation if nec essary. To ensure the
maximum efficiency in processing permit applications, the Division requests your assistance. in providing a timeJ y and complete
resp onse to an y additional infonnation requests. ,
Please be aware that the Division's Regional Office, copied below, must provide recommendations prior to final action by the
Div ision. Please also note at this time, processing permit applications can take as long as 60 -90 days after receipt of a complete
~~ . .
If you have any questions , please contact John McCray at 919-715-6168, or via e-mail [e-mail] v. If the reviewer is
unavailable, you may leave a message, and they will respond promptly.
PLEASE REFER TO THE ABOVE APPLICATION NUMBER WHEN MAKING INQUIRIES ON THIS PROJECT.
Sincerely,
OldA ~
f or Debra J .'Watts
Supervisor
cc: Asheville Regional Office. Aquifer Protection Section
Appalachian Well Drillipng (Larry Wells)
H a ywoo d H eating & Air Con d itioning, lnc (David M oody)
Permit Application F ile WI0100 153
AQUIFER PROTECTION SECTION
1636 Mall Servlre Canter, Raleigh. Nortlt Carolina 27699-1636
Loca!Jan. 2728 Capital Bouievard, Raleigh, North Carolina 27604
Phone 91:l -733-3221 \ FAX I'. 919-715-0588 : FAX 2: 91S-715-6048 \ CUSlome; 5erv1ce: 1-i!n -623-6748
lmemet: ffliW .ncwaterouallty.oro
An Eoua. Opporru M• Afu!lllauve /\<:~on Employ•·
N°1lS.i.c . lin 01u1 aro . a
;Natura/Ly
I
t I
I
REC_EIVED / DENR; DWQ
Aquifer ProtACtion Section
"'-lOir!·ttt.-1\Rm,"' m:P-\Rrw·,·: rn t·!'..:\"IJ{n"!\,;\li.'\:l.\'\D'--\n ·R-\t RL,o:xu·~ APR .2 2011
Aff"U<.· ..\ TIOS FOR A PlR-'lll TO C'O!\STJtl.('1.0.lt OJ'F.tU.1'£ l:"t.Jt(:TIO~ \\'fLl .. ,
"Ir t,n•nrc.un.:l· \\ .i1i1 ~Ri: l"r<"\'l '-ll •n.; o! l :-,\ "\l _,\C o.::c .0'.!011
DA Tl'.-~~i,. ?Ill l ..
l"ERl\'IIT '\O, ~ \ OQJ53_11_c;1\i: hlani.. 1 l:\it>µ :\pphcatio11 1
c.. our l Llkr I
B. PERMIT APPLl(:A~l -I •11 111d i,1(j u:s t r.,:,;idl.'.'nc~·!>. ibl .~1 .. uwnl.'.'t ,,H profl1.,rt,\ J~~J frn :1II 11rli>r:.,
,t.1tr.: ~me. n( er.ti!~· ,md na•H~ o · ~r-.nn ·J~;lci:,11cd·,iw11ori1~ ,1,, -,i:.:n •t>n h-.!n:.il 1: l fill• hu!-1h~...,~ ·..:,r 3gl.'.'n.,:
. \111n;ard M. ~mano
\!jiJing A<ldt~,~· lOl) ~!l-\~la.._, Ln .
Cit~; -~!-'°" ~mHna ~::td,;
Cm,n~:
Du,, 1 r,;!c 1'1c,.: l~O":',ti.__1J..,51iJ7
{'l\!ll.fl.~ddi"C<i.,· ,:n/a
, ! I J>an:r;l IOCLl!ifi.:.iti , 1 l\t;mhc· (!'{1\ J ol. wd!_~II<': , i6"'.2#fa9!4 C,111nt:,:. ~on __ _
1 "', F;t1y~ii.:.:il Add;;.::,,, r dit!i.~..:n fn&nrn:1ii •i•!1 ,WJrc~sl: ·-Ra!sum. Man, P~n•l' Pb.JJ.oti/ WK fool.
. ffolL"4.: .H.m1.d
tl. \\ f.lL tnULLER f1' .. 0R'\-1A'J 10!\
\\, dl l>rillm~ l i )niracll•r·, 1';111~~~ I.am· \\•t>l~
'\.C \~•el! -UnHin1,t l '(mtta;:t"· ~ .:!!1ltlalJ<11 , ,,, ..
l r•mp;m~ '-am-:. .~I
~utna.:t ·1•e~o11:_ :) \l,.~_
:\Jdrl!S~ -l ',0 fu•~--,.._
{. •t~: Lc1Co:1-)c: __ Ii\• ( ~,Ji.:
nrn(L'(dcl\. ;~'li.,· ,.,,:::;, ------
., ' \
t Ho n I
I\
t: ffJ'.,\l' Pt'\1P.t"0!"1l'RA{10tflNFOR'\1AHO'-H ,.l;'kr.:.u•1t~11, 1 ~•
( ,,mpl.Ul~, ~;imc;l lill .~l(ld · lkarm!..! A.A ,r ~ pmlnio11111::,. I ~;.; 1
,\dLtt'c:!>,-. J :?~" \,-,lk\· i~n:tLi,,. ~ l P .(!_J}o\. .:,-
Cit)· \\';n ni:i-~ ilk• -(ip (. ,xk: '28"8t-
~ Grntn m1:l1;:rial &11rr(luntEn.'. \\d; c-asitH.: anu nr11ini11J.!I
la1 .<,routt~l~ (t?mcm ____ H1!11ltlf1ll,:: ,m~r p1.it~
• , 'r .. k t:111~ he'f01Ufl:• !:!\1,U:. l \;,jfl..311\..: t , n~r\·t--, ts:..tu,"1,;;J 1,1 I.;') " ' '"'f Ir \',~li.;l,·1,·
(h1 <..,row u~,,u, ~ir .1un1ug, rdc:rcncc ;c, l:it11.I '-llrt:u:~· ,. •wn
1t \\ d I ha:-~s,;m~. inc:iic:nc ~~,,nl <leptn-frou , ( fc.•e1 I
(,. WELL l.OC'ATIO~~-Map~ mu~,· he :-~ak(I nr 01hc-n, i~ .iccur:ill.'.i~ ui:ti~:tt: d1~t:m..:,• :,nJ tltJcnt~tion, i
.teanm:.~ 1,•.;ate<l \\ ithi11 1(100 te\lt ut t.lu.: 1mcct1cm wc\11.-.1. Lal'li;LJII 1·c:11u(ll.d~<1ri, ·;ind im l ti(ti: :i nr>tl!.LJ...,
• Prc1pm,L:u l_"JC.:lllm \\db
•. ~i1'.'l;:l>!l' \.\ :Ht•: hf'ldi~•, . ·-
• ·HuiiJ1tf'.,.•
, .\\•;)1~:" !-t1ppl\ "l'II-
' ~l!f"ltl tanb.= ;md ;l,.-.o.:i .. tcd ,rm: crrig,n.o:·1 !IL',. d: Jin fidd• or ~pn11 urc ,
L,i~tin~ or tl()IC"Mial ~ou!".:it, ,r ~l't)UIIJ\\:tlc · ..-~mt..11 . \
\~ All<1r11 _:: f('•l"ographii: mir <'i the arl":i ,;\tc11ci1n_:.: 4.m1 .-Jrn111 ;Ii: n f~ •. 111•. "~ ,,,11, 111a:-111J1L.lll' th\
I01.'111f_\ • ' l(kair{IH ;,1.i thnnar 11:ln'L
\'OT/;: ,,, 1,nij'f ni.,e\, 1111 iur,al plw,,,,:raplt ol tltt' pn,p1ttt,1· fXJ"L'c!l ~ltttn'iltJ: pr,,pi:r~• /,;n.-:,, ,mti ~l/'41,11.u~•, um
(1/,f(,titted (lfli( 1lm,·nJ11,urc'1I jrnn~ '"'"' <lflf'I"'""''" ,.,,,111~,-\II,\ H·cbsiJ,·. 1y,ui:ull1. 11,,. pmper:t ( llll /IL' \t'IJt('/1~11 ,~,
111i"llt'r ,,amt'"' ~uJdrcs.,. Th4• lflc~i(lfl uf 1/11: it•dl, m r~·1111um ,,, pr1tfJL>rli lu,umhltfe.~. itmne,, .,,pi;, .timh. o,l1t•1
H·dJ.\, t:/c.·. t'iµ1 '!"" be• ,lru..,.,, ii, In hu11J. •UH,, ,.u 'lcwe,· t·un l,c ,el< -,~u .\lw .. ·i11;.: u,p11:,:raph1c ,·,;111Qt1f\ 41r
t•h~'QtJ,,i1 do,"•
: I
l S,\ NCAC 02C .O~ ti (b) ft:CJ~ lha:S all PlfflJ,rt iq,phcatio1lS :,ball ,~ signed as ibllO\IIS:.
. fut a G')~ by f. n,.spons ibie ~e .offii.et;
2. for. a ,annc:fdiip or sole_ proprietm'!bil,-by a p:n.1!r~J pa,U)er-or tone proprietor. ~vtly;
3. for-a inunicipa)hy Of' &.•llltC. ~1. (J1 otim publk-~: by c11ther a pri:~oal . e:xec~vt
officer <Jr raiooos pu1tli~}y ~lected i,fficW~:
4 f°()t alt Olhcr$· -~· the well OWllf:t twi>j~~ ;\!l P:·~'al'l$i)! ~ J..1uh.
U u avdtoriatd agegt it 1ipbit, o~ beialf of t&t appf..icaat. · tbea ,a.ppty . a lctld' a-ipc.6. \,'y tilt
appl~ tilat,Ulllts ancf a.b~riza, tlacir aptit lO sip tbi8 •PJ)ticatio:a 0A lbeu-btdaaK.
,..1 ~by~ •. lD'ldet ,enalW (tn1v.·, CUf' l havt 'persenal_l~ CMD1Dled ~ ant f.i.Diiliar Wftl\ t.be mfomwtu;m
Sllbttutted. ii" 1bis das:u:unt ~ all ~ tntmo Qd 1bit baei:l on 111, inqUIJ"v' of d'loo.e · indwidnal,
>m~y ffSpOn&ibk for c:,biam~ u.i4 ~01t.. J bc:lio've that t~e i~ i~ iruc1·~ 811(1
c;ompletc. r lln\.~ 11w tbl,rc ~~tgni(~c:a&l'I pr:nUtas, mi:L~ .me pos~ibi~ of lines wid i~s~
.fi;,r aubmitllng 'false inwmian~ T ~ to OOUIJIKI.. cpenot, m&al'lmn, n::peu • .aml i~-~~l,)[c:,;~bWk,iHht
injection wtli c'4 ill rc:laa,d ~~ i."i ~ w,lb ·h applOYed S'llllt-rfiotncm -1t1 ~ri00$ ~
t!v Jfermlt ..
Subznit _t,iro ~ uf 1k wmpletc:d appl~<m p.-c~ te-.
J>WQ • Aquifer ProlcdlOJI Sfftion
.l 636 Mail 6avt(t Ceatet
-----... ◄-.. -t •
· 8akigb, NC 27699,.1'36
'hlea,llon~ (919.) 7J3..3?2l
I
\
......... 9 --•• .,
\
' .,.
GoMAPS -Jackson County ·NC Pub-H e .Access
·1
. ' .
\'
n •~ \.R\.l'\,(i T!ll~ <;; '\1'IT , S.l 'R \"JV!••
1 lw, mar ·, r rcp.tn: i kr ;lu; rt\\'c:m,,1-.. ,,,t 1:~af 11mp~l'l> tuua.! ,1 ttllU} till', Jtm!-tl 1ctior, .
.i.,Q 1l> .. ,,mpilo:d' from n.:.:orJi:J dc,1,b. pla_t'... a nd •1hcr pi.ml,, re.;c,r.J, .u,.,; 1bt.! l.sc:-r,.
~h.:. :u;w :m:· hcrcb~ n-,\w,:u u,a. me ,awtc1nc·111ionr;\l rm11h,., p· 11n al) in1Pn11:mu11 .\<lltrL·,;,
nourd o: ,;;, n~uhi;d l1ir -·,,cn t1ca1, ''i ff Uit m 1nrm:it1 un ... 11n1J·1 r.:oJ ntt ih, ma:, Th,
1!.lll'},.lfl marfl'tli: f"lll,JJI:: a,,0111 .. nl' r.:l!.l T ·~;,p:,~it~-k~ I ' 11 " rn.,ti
nc!d , t.ri·
8 ,.......... ' I r-t:
I
u.:-;;.da: fo .!IH '
I •
l .
i
\"l \.
t .
I
f=.;
I I
l
l ,..
I I l
. J . (
'!t j ~ ~
I
-,
.. _.. .... :. ~
~-~ .... ,.
..
}( v
.:,
--
--.... --
......, -
~ ..;~ ~--=!
r f ~ ) :~
.
·-·
-... -.. ...
...
.,..
,. -...
.. ...
.. -,, ,. , ..
/ ., ,, . .,
,
,.
,
I .;
I ,.
j .,
~ . I .. , ,,.
. . ..
~
J .. ' ., --
I
.,
., .. .
... j• >L '°'
~ "; ~
~o-MAPS ~-Jack so n County NC Public-Access
--~
t ' \ ,;,,: ... :,
~ 't \,-"
... .:,. ' • . -:.:llj,
••? ... _ ~ -.11 •2~3 /j4 1 !..:. ~~ .. _
\\ \J~NIM i lfllt..,1~ 1'ini~, ,,a·it \'l~Y!· ..
{11;,. '1 1r i .-, l'r,·p•u ' fol th e f!!\t flt. t~ i•f rc,il 1,1,ipt·ti~ f<•tm,I ,,,,11111 rliH_imi,1H 1i,1tl. '.tn~l l \;1)111rild I tlf\T i cn•i,hJ
l,•,·:!x pl.it ,. ilti:l111hu 1't1htk l('l,"'<.•11h .\•111 d:tlii, I i.~L'I .; t\l H1i--1i1:1r '.11,· heh:h~ 11,•:1M11 lbi!I the .d1•\~•111t'itli11J1~•a pi 11• it
J !11 'tn 111t;,q1wti', ·,, ~i•tt• · l'' ~h,111!,l fie :'(lrl'-lllit: I t,., \ .-rd1i.'-nk,n c,to,r i•tt<•111,;i ,i;11 t',,111:liocif ·•ti thi, tpa(,· I h,•
< VI\ l'lil 1npri11i ..... ,,p:i!l\ ~ , .. 1111 < ·,1 ,i lq!ll H ,r,( n:ihlli1~ f,;; th• i1,l11ti1 iii0-ii ;,1111i11l•1f "I,;. 111 I
8
LJ
I 1
·{i ~. ,,~
Rogers, Michael
From:
Sent:
To:
Subject:
Attachments:
lphillips9898@aol .com
Tuesday, April 12, 2011 7:02 AM
Rogers, Michael
Fwd: Permit 7 pages
Larry~Samano_0_April_ 11_2011.jpg; Larry_Samano_ 1_April_ 11 _2011.jpg ; Larry_Samano_2
_April_ 11_2011 .jpg; Larry_Saman o_3_April_ 11_2011.jpg; Larry_Samano_ 4_April_ 11_
2011.jpg; Larry_Samano_S_April_ 11_2011 .jpg; Larry_Samano_6_April_ 11_2011.jpg
Hope this one is right. Thanks [phone]
-----Original Message-----
From: Carolyn Parrott <2 parrotts@g mail.com >
To: Larry Phillips <[e-mail]>
Sent: Mon, Apr 11, 2011 4:46 pm
Subject: Permit 7 pages