WI0300125_GEO THERMAL_20080929

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North Caronna• Department ot Environment and Natural Resourcea • Division ol Water Quallty~Groundwater Section
1638 Mall Sttvloe Center. Aalelgh, N,O. 27099--1830-,P/Jon,-(9HI) 733-3221
''
WELL CONSTRUCTION REGOFfo· WELL CONTRACTOR: R.A. Simmons ·Drill:Ln~ Co., Inc.
. WELL CONTRACTOR CERTIFICATION#: WC03588
STATE WELL CONSTRUCTION PERMIT#:-w""'r ... 0 .... 30-0-1-2~5----
1. WELL USE (CheckAppllcabl• Box): ResldenUaf D Munlolpal O · Industrial D
Recovery O Heat Pump Water Injection tit Other D If Olher, List Us_e:
Agricultural D Monitoring D
2. WELL LOCATION; (Show sketch of the location below)
Nearest Town: Salisbury Co.unty: __ R_o_w_an ________ _
131 East Fisher St.
{Road Name and Numbers, Community, or Subdlvlalon and Loi No,)
3. OWNER Bill Wagoner ·
Address 131 East Fisher St.
· (Slreel or Roule No.) Salisbury NC 28144
DRILLING LOG
From To
1
1 3
3 12
DEPTH
Fonriallon DelCllpllOl'I
To:e Soil
Clay
Silty material City or Town . _ Stale· Zip Code
4. DATEOR!LLE!O 9/23/08 12 18 Sandy material7water
5. TOTAL DEPTH 300 FT ,;.:s -"18 l,r.--....,•:,4l 41 Caving Sandi materia:
6. CUTTINGS COLLECTED YES O No(IJ I .. 93 Saprolite
7. DOES WELL REPLACE EXISTING WELL? YES n NO{l]
e. STATIC WATER LEVEL. Below Top of Casing: :t1r Fr,
93 105fi, Brown Weathered Rock
10.5 106_, ·'. Granite
CU•••+• U Above Top or CUlnOI
9. TOP OF CASING IS NA FT. Above Land Surface•
106 118 . Brown Weathered Rock
118 121 ...... ,, ?;ranite .,.op ot casing t1nnlnat1d 11/or below land 1urfac1 requlrea • variance In accor,
dance with 15A NCAC 2C ,0118 121 !48 Soft Brown Rock
10. YIELD (gpm): ...!!._ MEITHOD OF TEST ____ _
11. WATER ZO~ES (depth): 5 GPM @ 23 2 FT
... .14.8. 232 Granite
232 23~~ Soft Granite.;,
233 251 Granite
12. CHLORINATION: Type ___ ......_ __ Amount __ _
13. CASING:( ) . Removed
:23 I 23~ · Green Granite
253 jut,;; Gra-qlte·
Oepth ·· Diameter
From_+2 __ To 101,_ Ft. 6. 625
WIii llllclcntll .
or Welg_hllR. Maltlflll
.188 Steel
From To·---Ft •. --· ---
From To---Ft,---
14. GROUT: . . . -:.' .. -.,. . \.
Oepth Material Method::_·;;:-,. ·· .. . . .. • · · LOCATION SKl;J:Q::f
From -300 T~urfac~t, Bentonite Tremie . (Showdlrectlonand:
1
dlatanoefromatleasttwoState
From __ To ___ Ft. Pressure Pumped Roada, orothe~m..P reference points)
15. SCREEN:
Oep1h Diameter
From _ro_Ft_ In.
From-To-Ft,_ In.
from_ To~FL-In.
· 18. SAND/GRAVEL PACK:
Depth Size
SlotSlzi Material
-'"·-----'"·-----~1n, ___ _
Material
From----to---FJ•---------
. From To Ft. ___ ------
(See Attached)
"r.f· .:vclV•.i.. / s:1\if, / ,WQ
l
SEP 2 9 2008
5 GPM
17. REMARKS:: ___ ...,;_ ___ :-....:__ _________ ,____; _________ _
., .. ,. ....
··:···
131 e. fisher st, salisbury. nc. -Google Maps
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Address 131 E Fisher St
Salisbury, NC 28144
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Page 1 of 1
Get Google Maps on your phone g Tl!llt:theword "GMAPS•to 466453
~
http://maps.google.com/maps?f=q&hl=en&geocode=&q= 131 +e. +fisher+st, +salisbury. +nc.... 9/25/2008
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Coleen H. Sullins Director
Division of Water Quality
September 16, 2008
Bill Wagoner
Fisher Street Theater
131 E. F isher Street
Salisbury, NC 28144
Subject: Revised Aclmowledgement of Intent to Construct Type 5QW Injection Well System
Permit No. Wl0300125
131 E. Fisher Street
Salisbury, NC 28144
Dear Mr. Wagoner:
In accordance with the revised Notification of Intent submitted to the Underground Injection Control
(UIC) Program that was received on September 15 , 2008, the Aquifer Protection Section (APS)
aclmowledges your intent to construct a closed-loop geothermal water-onlv injection well system for the
operation of a ground-source heat pump located at the above referenc.ed address . This system is deemed
permitted by rule (North Carolina Administrative Code Title 15A, Subchapter 2C , Section .021 l(u)(2)).
The permit bas been revised to reflect Richard Simmons Drilling Co., Inc. as the-driller for this
project (NC Certification #3588).
However, it is recommended that you contact the Rowan County Health Department, as they may have
additional construction or permitting requirements for this type of system. If you modify your system at
any time, ·including the addition of antifreeze. corrosion inhibitors, or any other substances to the
circulating fluid, you must contact the APS to verify compliance with applicable rules.
Thank you for submitting this notification. If you have any questions please call me at [phone].
Sincerely,
.~ /'~~
Michael Rogers / ·
cc: Mooresville Regional Office -APS w/attachments
Environmental Specialist
GPU-Aquifer Protection Section
APS Central Files -Permit No. WI0300115 w/attachments
Rowan County Environmental Health Dept. w/attachme.nts
Stephan Brooks -Richard Simmons Drilling Co., fuc. (sent via.fax and US.P.S.) w/ou.t attachments
City of Salisbury w/out attachments
Aquifer Protection Section
lnternet: www.ncwaterouality.org
1636 Mail Service Center
Location: 2728 Capital Boulevard
An Equal Opportunity/Affirmative Action Employer-50% Recycied/10% Post Consumer Paper
Raleigh. NC27699-1636
Raleigh, NC 27604
'Telephone:
Fax l :
Fax2:
Customer Service:
1Jf§;;));a
[phone]
(919) 7 I 5-0588
[phone]
(8 77) 623-6748
DRILLING
Richard S tm,,,ons
!)rilling Co .. Inc.
6() Drill Rig Drive
Buchanan, VA . 24066
p, (540) 2 54-2289
F . (5 40) 2 54--1 2 68
FAX TRANSMITTAL -S pages (including tbi8 p age)
September 15, 2008
TO:
RE:
FROM:
Notice of Intent -Geothermal Test Well -Salbbury, NC.
Stephen B.-ook.,
As di scusse.d last week the attached fonn is being submitted by Simmons Drilling after the
previou s drilling contractor failed to perform the work. All infonnation remains the same with
the e~on oftne drilling con.trac tor.
If possible, we ask that ''Acknowle,dgement o f Intent to Construct" be faxed to us at (540-254-
1268) so we may expedite our services for the c l ient.
If y ou have any questions, I can be reached at (540 ) 2 54-2289.
Thank you,
Stephen Brooks
Geothermal Manager
SE.P 15 2008
7046377891 WAGGER CONST
N0{(.UI CUOUNA
DBPAR.TMBNT OP BNVIll(l)NMBNT. AND NA'llJRAL .RBSOURaiS
NOTIFICATION OF . TO CONSTRUCT A CLQRQ-LQQr
GEOTIIERMAL WAD R ~NLX INJECrION WELL SYSTEM
(GRO~ Cfl)UPLED BEAT PUMP)
!
I
Ty),e5QWWe
I
.111 A.ca.._. wJtb Cbl.. pi!oflllw .of'NCAC nlil lSA; 02CJ>200
lic:ldal!.-.tMJto.wr..oa•beakpap..
I •
ftkl1!1f11dlie,.....1ona••11teic1for-ill~welklaaa9Ptl:ieep 1•tll__,.,._.
Doaotw ... toawre.-..-..t1111t~-m..,_,,ew:4F!h•-,w .
I
TO: DJkBCTOR. NOJl'l'll C.AaOLINA D~ OP WA TBR QUAUTY
A,
B.
C.
D.
.DAT£: J\llf 16,lOOI l
I
SYSTEM CLASSJIIICATION Does die~~ circulade potable~ ill ooadauou,
ptpinctbat c.ompletety ..._ dMi fluid~ tht enviromnent?
l
YES X · tf:vm, dttD oootmuejcrmp~dt.11 fi:nm.
i
NO _1f~ do llrOt oomp,.. '1m finl. PC!ffll G'W-57HP,App1Je«Jo,, For
PDWIII To Co,,u,v;t MtllC>r Un.A ,,dl(I) Jro,, IJflet:.'IJolt ~A 8-
,-,, ~ lboald b.l~
I
SYSTBM PU1lD Will-., ~jbe in1roducod to 11w ,,.,_,. oirouJ;tfas bllttnmficr
floid? Tbb includiia, but ii not Jimihld ro oorro,ion inhibtton lftdtor ~
YllS ___ lf~ do not camp'j this tbaa. Porm G'W'-S7 HP, App/icdoft For
l'fflllit To~ ~at-UH .4. 'lfd/(1) For l,;.:tfon "'1lr A Ila
hwf,6),Mn.lbou.ldMOQlllplaled. .
NO I traa,1beocoadaue~1411dQetbiaform.
~OWNER i
Name: C Ir L,~ !
San: NC zl,, Code: ZS /If .us.i...J,~:_IU._-+:~----T~•1t4-i;D,Sl.11>
!
STAlUS OF PR0!1Dl'JY OWNBI.
i Fcdc:ral: _ i Col:nmerciaJ: _
Munlcipal:_x_ ! N'ldve~,Lmda:
!
i
08/24 /2008 15:5 3 704 6377891 WAGONER CONST PAGE. 02
a. roe (&n'H) DA.f A
Name: M~1'£=R.. 4··nia-eT clftiA'r~
~~~:;;, !.~;!_~; ~W-JW!a.~ J½,Akl
F. HEAT PUMP CONDACTOR DATA
G. CONSTllU'CnON DATA (cbeck one)
____ EXISTING WELL(8) being proposed rot use aa a (P.'!:Jlmckouplcd Mat pmnp
~ll(t), Provim the iuformalion in (J) dlJouaJ,. (-4<) botow to tbe bolt of your
lcnewled&e-Amch a copy of Form GW-1 (Well CoNtnsctioo ~ if nallable.
X PROPOSBD WELL(S} to be constniotcid tor use as• ground-c,,oupled beat pamp
"11(1). ~ the informatioa m (1) through (4) below a PROPOSED
~OD spec:ific:atloos, Sabal~~ Form GW-1 af\ior ~ction..
(1) w.n DrWiag c~·• Nqe: &~~~~4-S 1),,./!::. '-, N ti, a~., ~;.1,.
I
NC~ Cc1iuc:aJ:i0111JU1Dbr. ,k,L C._D ~:rA.t.:.. --------
Dam to be comtruatl!ld: St,, f' .t:>I Number of'boriop: _l ---Approdmall, depth of each borins(feet):_300' _________ _
(l) Woll casins; Js the weU(1) cuc:d?
(a) YES_ lfyes, ttM:n JJ")Ylde U... cuta1 information below.
Type: Ga1\'dfzed .&1eel_Black·.-1 __ Pluti0_ Other (specify), ____ _
c.ing depth: Pn:m __ ao ___ ft:. (fflference to land susf&co)
Cadu1 ex1Dada ebove pJUCl ___ mcbta
(b)NO__..,X.,__ __ _
(3) Grout {srollt 1h11 verticaJ length of tbc borehole to a mJoimwn deptll of20 r-t b.l..s.};
<•> Orouttype: eanent_Bentanite _x_:_ Other (spcoffy) _____ _
(t,) Oroutad SUl'&ice aod aroat deJQ (re~ to land surface):
_L uoond cio.d loop piping; ~ ...L co ..J!L (=«).
_ mound well cuing; fnxn _to_ (feet).
NO'I'$: 111B W1!U.. CRIWNO ~ CAN SUPPLY natl>ATA FOR B'l'ffl1!1lmasnNG O!;t
PR.Ol'OSISD WIIU.$1' fflJ8 INJIOkMA'ffON 1$ VNA V AIUJJta DY OJ'HPJl MJW,JS,
OW-57.CL (Jan, 2000)
....
?.'
U1 w
08/24/2008 15:53 7846377e9l WAGONER CONST PAGE 04
L, CONSQIT OF PROPmlTY OWNER (Owner means an;y person who hoJds the fee or othet propmy
rights in tbe wall boing comtrucuwJ. A -11 is roaJ propeny and its CQlllttUctioll on land rem awnenbip in
1be I~ in lbe ablencc of CClllltnry agreematt in writing.)
If the ll'oparty is owned by someoae otherthu 1be applicant, tht property owner herebycooaents to
allow die appticaatt to comb'uCt ll!IICh bdecdon wett as out:liDcd iD Ibis application. and that it shall be die
~ ()f1he applicant to c:1111n tr.at the ground-source beat pump S}'Sblln°a well(,) 1.:011fonr.s to
UICI Well~ s.ndatdt (fide lSA NCAC 2C .0200)
OW..$'1 CL
Pleue ntum t,ro «,pi~ of ahe oompleted Appliadicla package to:
UICProeram
Grvaactwaeei-Seetion
Nordl Carolina DENR•DWQ
1636 Mail Service Center
Ralei~ NC 2769',.1636
Telepholle [phone]
(Jm, 2000) .,._e 4 af ,4
Michael F. Easley, Governor
William G. Ross Jr .• Secretary
NoJth Carolina Department of Environment and Notuml Resources
Coleen H. Sullins Director
Division of Water Quality
September l 6~ 2008
Bill Wagoner
Fisher Street Theater
1'31 E. Fisher Street
Salisbury, NC 28144
Subject: Revised Acknowledgement of Intent to Construct Type SQW Injection Well System
Permit No. WI0300125
131 E. Fisher Street
Salisbury, NC 28144
Dear Mr. Wagoner:
In accordance with the revised Notification of Intent submitted to the Underground Injection Control
(UIC) Program that was received on September 15, 2008, the Aquifer Protection Section (APS)
acknowledges your intent to construct a closed-loop geothermal water-onlv injection well system for the
operation of a ground-source beat pump located at the above referenced address. This system is deemed
pennitted by rule (North Carolina Administrative Code Title lSA, Subcbapter 2C, Section .021 l{u)(2)).
The permit bas been revised to reflect Richard Simmons Drilling Co., Inc. as the driller for this
project (NC Certification #3588).
However, it is recommended that you contact the Rowan County Health Department, as they may have
additional construction or permitting requirements for this type of system. If you modify your system at
any time, including the addition of antifreeze, corrosion inhibitors. or any other substances to the
circulating fluid , you must contact the APS to verify compliance with applicable rules.
Thank you for submitting this notification. If you have any questions please call me at [phone],
Sincerely,
~/4-ry~
Micbae1 Rogers /
cc: Mooresville Regional Office -APS w/attachments
Environmental Specialist
GPU~Aquifer Protection Section
APS Central Files -Permit No. WI0300125 w/at.tachments
Rowiµi County Environmental Health Dept. w/attachments
Stephan Brooks -Richard Simmons Drilling Co., Inc. (sent via fax and U.S.P.S.) w/out attachments
City of Salisbury w/out attachments
Aquifer Protection Section
ln1emet: www.ncw!!lergualitv .om
1636 Mail Service Center
Location: 2728 Capital Boulevard
An Equal Opportunity/Affirmative Action Employer-50% Recycled/10% Post Consumer Paper
Raleigh, NC 27699-1636
Raleigh.. NC 27604
Telephone:
Fax I:
Fax2:
Customer Service:
N.?JtbCarolirul
/\lllfllfllll!f
[phone]
(919) 715--0588
[phone]
[phone]
I "TRANSMISSION VERIFICATION REPORT
09/16 10 :20
915402541268
00 :00:37
01
DK
STANDARD
ECM
TIME 09/16/2008 10:21