WI0300143_GEO THERMAL_20100309

NA MCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue
Governor
-City of Charlotte
Mich~e Haas
·600 East Fourth Street
· Charlotte, FL 28202
Coleen H. Sullins
Director
3/9/2010
Subject: Acknowledgement of Intent to Construct Type 5QW Injection Well System
Permit No. WI0300143
3 725 Ellington
Charlotte, NC 28202
Dear Ms. Michelle Haas:
Dee Freeman
Secretary
In accordance with the application submitted to the Underground Injection Control (UIC) Program that was received on 2/16/2010, the
Aquifer Protection Section (APS) acknowledges your intent to construct a closed-loop geothermal water-only injection well system
for the operation of a ground-source heat pump located at3725 Ellington, Charlotte, Mecklenburg County, NC 28202 . This system is
deemed permitted by rule (North Carolina Administrative Code Title 15A, Subchapter 2C, Section .021 l(u)(2)). However, please
note boreholes shall not connect separate aquifers, which have differences in. water quality (e.g., shallow surficial aquifers, saprolite,
fractured bedrock, etc.) as specified in 15A NCAC 2C .0213(d)(8)(C).
Please notify the Mouresville Regional Office at [phone] at least 48 hours prior to well installation. Additionally, it is
recommended ~t you contact the Mecklenburg 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 yerify compliance with applicable rules.
Thank you for submitting this notification. If you have any questions please call m e at [phone].
Sincerely,
Q~A-~
\ \ t.Y' . Michael Rogers
,._. · Environmental Specialist
GPU-Aquifer Protection Section
cc: Mooresville Regional Office -APS
APS Central Files· Pennit No. WI0300143
Mecklenburg County Health Dept.
Janice Scott (Midsouth Geothcnnal LLC).8275 Tournament Dr Ste 185, Memphis, TN 38125
'"
AQUIFER PROTECTION SECTION
1636 Mail Service Center. Raleigh, North Carolina 27699-1636
. Location: 2728 Capital Boulevard, Raleigh, North Carolina 27604
Phone : [phone] \ FAX 1: 919-715-0588; FAX 2: 91 g.:715-6048 I Customer Selvice: 1-877-623-6748
Internet .www.ncwatergua lilv.org
An Equal Opportunity I Affirmative Action Employer
_ .One
N_flJth Carolina
/\/Oturatlu
Permit Number
Program Category
Ground Water
WI0300143 / Central Files: APS_ SWP_
03/08/10
Permit Tracking Slip
Status
Actfve
Project Type
New Project
Permit Type
Injection Water Only GSHP Well System (50W)
Versfon
1.00
Permit Classification
lndivicfual
Primary Reviewer
michael.rogers
Coastal SW Rule
Permitted Flow
Facilitv
Faclllty Name
City of Charlotte -50W
Location Address
3725 Ellington
Charlotte
Owner
Owner Name
City of Charlotte
Dates/Events
NC 28202
Orig Issue
03/08/10
App· Received Draft Initiated
02/16/10
Reg ulated Activities
Heat Pump Injection
Outfall h!UL i
Waterbody Name
Scheduled
Issuance
Permit Contact Afflllatlon
Major/Minor
Minor
Region
Mooresville
County •
Mecklenburg
f aclllty Contact Affiliation
Owner Type
Government -Municipal
Owner Affiliation
Michelle Haas
600 E 4th St
Charlotte
Publlc Notice Issue
03/08/10
NC
Effective
03/08/10
28202
Expiration
Stream Index Number Current Class Subbasln
02/16/2010 1 1:55 9017489097 MID-SOUTH GEOTHERMAL
NOR1H CAROLINA:
DEPARTMENT OF J:.NVIRONMENT AND NA TUR.AL RESOURCES
NOTIFICATION OF INTENT TO CONSTRUCT A CLOSED-LOOP GEOTHERMAL
WATER,-ONL Y INJECTION WELL SYSTEM
TYPE SOW WELL(S)
ln Accordance With the Provisions orNCAC Titlo 1 SA 02C.0200
Prifa or rype the required informatto11 arzd mail to address on the back page.
DA'fE: ___ ~_-_;.)....;;Sc..___, 20JQ
PAGE 02/04
Well Typt Co,ifirmalion: Doos the proposed system circulate potable water only (no additives) in
continuous piping that compietely isolates the fluid from the environment (i.e.
closed-loop)?
Yes~ Continue completing this fonn ,
No __ Do Not complete this form. Complete other UIC application forms for installing
either a 5A7 well ~-loop well iniecting potable water into the aquifer) or a 5QM well (closed-
loop 'well containing additives such es R-22, ethanol, or other ant.ifrce.t\; or coi:rosion inhibitors).
A. PROPERTY OWNER(S)/APPLICANT(S)
List each Property Owner listed on property deed (if owned by a business or government agencyt state name of
entity and a. representative w/authorlty fRr signature):
CN.'--' ~ ~V'tJ.,t-l o+te.
\
{l )
(2) Physical Address of Well Site (if different than above): :?,7 a5 t: lL1 09f ±o ()
City: Ci;\a_ r I o tte.. State:)\)£!.. Zip Code: 2 ~')./) d) County: Meekl:en. lou..r£t
Home/Office Tele No.: ___, Coll No.: -
AUTHOlUZEl> AGENT OF' OWNl:B., IF ANY (if the Permit Applicant does not own the subject property,
attach a letter from the property owne.r authorizing Agent to install and operate UlC well)
CompanyName~---------------------------
Contact Person.~: -------------=E=MA=--IL~A=d...,dre..,.-ss.._: ________ _
Address: _________________ _
City: --· _______ State:_ Zip Code: -----'-· County: ______ _
Office Tele No.: Cell No.:
Website Address of Company, if any: _____________ _
GPU/UlC 5QW Notificalion ofT~t Form (Revised 8/2008)
02/1£/2010' 11:55 9017489097 MID-SOUTH GEOTHERMAL PAGE 03/04
'
c.
D.
W.ELL DRILLER INFORMA115,)~. C
CompanyName: ./0'.) l D$c)(Uh G:e6f+erc. (l.(a_{ \ LU
Well Drllle, Coot,,,ctor', Name: .9\-o~~ J s!2..±-r.e.r
NC Contractor Certification No.: JJO_JiJ: d.~ IB5--A
Contact Person; J Q [\\C ~ Sr mr: EMAILAddressus~u \~~'WtJ(t.l
Addtess:~1S:':Touu~o.M\ln t '1 12.. <S±e• l~ cc:r,
City: t\A.e M f ½ ts Zip Code; -3~ I dis-County: 3''oe. L-At f
Offioa Tele No.: Ci>l-7Y~ -s()qS Cell No.:_-_______ _
HEAT PUMP CONTRACTOR INFORMATION (if different than driller)
Company ~ame:~\\ DSOL}fu C-e&t'\-Q \<...UA.Q \ , \.. L.C ,,
Contact PcI'$on i3"'~\'\.,Q e. &ore: EMAIL Address~$&~ :M-S5X>bu..%e:--\.\..hor1Ut
0 . __ ~ \.c;i.t:-~to11,
Address::c,:;:};]S \ OU.;fJ::\cs,\'\I\Q 'C"\-C-~-~\-e-o p
City: 'i',\-e ~~\,\\,> 'Zip ~e: :th) County: _S=\-'1€. __ u_~~i------
Office Tele No .: 9 D\~\.\~-°1C)Q~ CellNo .: _______ _
,'
E . STATUS OF APPLICANT
F.
G,
Private:
State:
Federal:_
Municipal ; _1._
Commercial:
Native An).erican Lands:_
lNJJi:CTlON l'ROCEDURE (briefly describe how the injection well(s) will be used)
Q.\ D5-e_:tJ co13 -1_~ciJo.l' snu r• \ ,.o;;,.\if Seu re e..
mLL CONSTRUCTION DATA,
(1) Proposed date to be constructed: g_\t1 \IO Number of borings: ----'\ __
Approximate depth of each boring (feet): 360
(l) Type of tubing to be used (copper, PVC, etc): \ 11 t-\t) PE' :V\rd:te.. f ~ f V
(3) Well casing. Is the well(s) cased? (check either (a) Yes~ (b .) No below)
(a) Yes __ if yes, then provide casing .information below
Type: ~vanized steel _black steel__plastic_othet (specify)
Casing depth : From ___ to ___ feet (reference to land surface)
Casing extends to above ground __ .inches
(b) No • ~
( 4) Grout ln1b (matorial surrounding wcll casing and/or piping): <!!J!I
(a) Grout cype: Neat Cement__ Bentonite __j_ Other (specify) ____ --..t'-'"""'i~~l
(b) Grout placement: Pumping...__ l>ressure__ Other__ fi
(c) Grout depth of tubing (reference to land surface): ftom _t =---to 76" (feet) 6-"
If well has casing, indicate grout depth: from ___ to ___ (feet)
GPU/UIC SQW Notification ofintent Form (Rivised 812008)
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02/~6/201~ 11:55 9017489097 MID-SOUTH GE□l
~ ~;,,
,/.e~ 0 ~.Jlifi
To:
Comp;my:
Fax Number.
Pages (inciude. cover):
Dat.c:
From:
6. MidSouth
.-GEOTHERMAL
Specialty Geothermal Well Field Services
FAX LEAD SHEET
Mr. Michael Rogers
NC Dept of Environment & Natural Resource
919-715-0588
4
February 16, 2010
Janice Scott
~: CMPD Test Well -NC DENR 5QW Drilling Pennit
Mr. Rogers,
Attached is the NC DENR permit application a drilling the test well in
Charlotte, NC.
Please do not hesitate to call if you have any questions or require additional
information. My number is (901} 748-9095.
Sincerely,
Janice E. Scott
8275 Tournament Drive Ste. 135 • Memphis, TN ~8125-08S1
Office [phone] • Fax [phone]
Rogers, Michael
From:
Sent:
To:
Janice Scott [e-mail]]
Wednesday, February 17, 201011 :57 AM
Rogers, Michael
Cc:
Subject:
Attachments:
Michael,
Janice Scott
CMPD Site.pdf 2/17/10
CMPD Site.pdf
Attached .is a site layout for the Charlotte-Mecklenburg Police Dept. The
job could produce at most 22 wells . The wells should be 300 ft deep for
grouting.
Let me know if this covers everything or if you need anything else.
Thank you for all your help.
Janice E. Scott
Office Manager
MidSouth Geothermal, LLC
8275 Tournament Dr. Ste. 185
Memphis, TN 38125 -0851
Office [phone]
Fax (90~)748-9097
j scottfn1midsouthgeothermal. com
www .midsouthgeothermal.com
1
'
GA
~CDENR
North Carolina Department of Environment and Natural Reso.urces
Division of Water Qualill'----------~~~!""'"""~
Coleen H. Sullins ~ ~ (G (E a W/ ~ w Beverly Eaves Perdue
Governor
City of Charlotte.
Michelle Haas
600 East Fourth Street
Charlotte, FL 28202
Director LJ
3;912010 MAR l O 3)10
NCDF.NRMRO owa ~ A uifer Protection
Subject: Acknowledgement of Intent to Construct Type 5QW Injection Well System
PermifNo. V..1 0300143
3725 E llington
Charlotte, NC 28202
Dear Ms. Michelle Haas:
Dee Freeman
Secretary
In accordance with the application submitted to the Underground Injection Control (UlC) Program that was received on 2 /16/2010, the
Aquifer Protection Section (APS) acknowledges your intent to construct a closed-loop geothermal water-onh· injection well system
for the operation of a ground-source beat pump located at 3725 Ellington, Charlotte, Mecklenburg County, NC 28202. This system is
deemed pennitted by rule (North Carolina Administrative Code Title 15A, Subchapter 2C, Section .021 l(u)(2)). However, please
note boreholes shall not connect separate aquifers, which have differences in. water quality (e.g., shallow surficial aquifers, saprohte,
fractured·bedrock, etc.) as specified in 15A NCAC 2C .02!3(d)(8)(C).
Please notify the Mooresville Regional Office at [phone] at least 48 hours prior to well installation. Additionally, it is
recommended that you contact the Mecklenbw-g County Health Department, as they may have additional construction or pennitting
requirements for this type of system. If you modify yow-system at any lime, 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,
O~A-~
cc: Mooresville Regional Office -APS
APS Central Files -Permit No. WI0300143
Mccklenbur_g County Health Dept
Michael Rogers
Environmental Specialist
GPU-Aquifer Protection Section
Jamee Sco_tt (Midsouth Geothermal LLC) 8275 Tournament Dr Ste 185, Memphis, TN 38125
AQUIFER PROTECTION SECTION
1636 Mai l Service Center. Raleigh , North Carolina 27699-1636
location: 2728 Capital Boulevard, Ratelgh, North Carolina 27604
Phone: 919,733-3221 I FAX 1: 919-715-0588: FAX 2: 919:715-6048 •, Customer Service: 1-877-623-6748
Internet: www.ncwaterguality.org
AA Equal Opporruni1y I Affirmative Action Employe,
RECEIVED I DENR I DWQ
Aquifer Protadlon Section
JUL 19 2010
0 ~1-.c lin No1u1 aro · a
;Natura/lg
Permit Number WJ0300143
Program Category
Ground Water
Permit Type
Injection Water Only GSHP Well System (SOW )
Primary Reviewer
michael.rogers
Coastal SW Rule
Permitted Flow
Facllitv
Facility Name
City of Charlotte -5QW
Location Address
3725 Ellington
Charlotte
Owner
Owner Name
City of Charlotte
Dates/Events
NC 28202
Orig Issue
03/08/10
App Received Draft Initiated
02/16/10
Reaul ated Activities
Heat Pump Injection
Outfall NULL
Scheduled
Issuance
Central Flies: APS_ SWP_
03/08/10
Permit Tracking Slip
Status
Active
Version
1.00
Project Type
New Project
Permit Classification
Individual
PermitContactAffiltii'm';'!D v-,-r.~-© ~ D w ~ rm
LAR 1 O 3lll I.!!)
NC:f DF.NR.MRO
DWQ - A ulfer Protection
Major/Minor
Minor
Region
Mooresville
County
Mecklenburg
Facility Contact Affil iation
Owner Type
Government~ Municipal
Owner Affi l iation
Michelle Haas
600 E 4th St
C~arlotte
Public Notice Issue
03/08/10
NC
Effectrve
03/08/10
28202
Expiration
Waterbody Name Stream Index Number Current Class SUbbHTn
02/1E/201 0 11:55 9017 489097 MID-SOUTH GEOTHERMAL
NORTH CAROLINA
DEPARTh.ffiNT OF :ENVIRONMENT AND NATURAL RESOURCES
NOTIFICATION OF INTENT TO CONSTRUCT A CLOSED-LOOP GEOTHERMAL
WATER-ONLY INJECTION WELL SYSTEM
TYPE SQW WELL{S)
In Accordance Wjth the Provisions ofNCAC Title 15A 02C.0200
fr int or rype the required i,iformat£on and mail to address on the back page.
20J..Q_
PAGE '62/0 4
Well Type Confirmation: Does the propo~ed system circulate potable water onlv (no additives) in
continuous piping that completely isolates the fluid from the environment (i.e.
closed-loo p)?
Yes~ Continue completing this fonn.
No ___ Do Not complete this form . Complete other UIC application foims for installing
either a 5A7 well (open-loop well iniecting potable water into the aquifer) or a SQM well (closed.
loop well C-Ontaining additives such as R-22, ethauol, or other antifreeze or corrosion inhibltors).
A, PROPERTY OWNER(S)/APPLlCANT(S)
Ust each Property Oyvner listed on property deed (if owned by a business or government agency, state name of
entity and a representative w/authority fyr signature):
t-w ~ ~ Q,~':lLt I o:tl-c
\
(l)
(:2) Physical Address of Well Site (if different than above): ~7 '.J.. 5 L. LL) t". at i-0 ('\
C{ty: Q.'\G:. ( j £) t+e.. State:t0(!., Zip Code: ~ li?J.Q d:) CoW1ty:(Y)-e.e kl.en k:)Uf't
Home/Office Tele No,; ___.. Cell No.: -
B. AUTHORlZED AGENT OF OWNER, IF ANY (if the Penn.it Applicant does !:!Of own the subject property,
attach a letter froro the property owner authorizing Agent to install 81).d operate UlC well)
Company Name : ___________________________ _
ContactPerson . .,_: _____________ ::,,:.EMA==IL"'-'-'A=d=dre=ss=a...: _________ _
Address: __________________ _
Cilf. _________ State: __ ZipCode : ______ County: ______ _
Office Tele No.: Cell No.:
Website Address of Company. if any: _____________ _
GPU/UIC 5QW Notification oflnten.t Form (Revised 8/2008)
0C/15/201B 11:55 9017489097 MID-SOUTH GEOTHERMAL PAGE 03/04
c.
E.
F,
G.
WELL »RILLER INFORMATIP N c
Company Name: t1Y\ I D>cxAh Gec¼+>e.fc. (µa._{ \ L~
Well Driller Contra'.tor''.Name Sk&:~ \ SQ::i__:t.e.r
NC Contractor Certification No.: _____Q{:j~ bl IB 5 A
Contact Person:J Q f\\ C '2.-S,r t:, IT EMAIL Ad&ess;tS~ \ ~,yzM,wr ~{ ·
Address: ~~ S:'::tou U\OJ\'l~r+ s /2.. 'S+e' l~ '-._j CCM
City: I\Ae M f V\\ ,s z~ Code ; '38: I Al s-County: S,he u'=sl(
OfficeTeleNo.: cpj-r4g -q6qS CellNo.:_-______ _
HEAT PUMP CONTRACTOR INFORMATION (if different than driller)
CompanyName:t"v\\ t:DDL}-½t:\ b-e,6\{'),QQ..uA.Q\, \_.l C,,.,
Contact rerso110Ct.. \\\(' e.. Sc-:cs=rr: EMA.IL Address:-;s &2~ ½\'µ>t}. ~c::.,.,,..\\.11\-01'\Ul
0 ._-~ ~, ..... ~. L Q ~ f':"tOl'l "') Address:p)';.J,'::, \ C)l.>...~'.':,(t)'\W ,,-,-~. ~~ \.C>~
City: ~~ 'M..?,\,\\_S -Zip C~e: :::n0 County: ._$;_Y'i€. __ u._~_l------
Office Tele No.: 9 D\ ::i '-\ ~ ·°J \)Cl':::> Cell No.: _______ _
STATUS OF APPLlCANT
Ptivate: _.
State:~
Federal:
Municipal: 'j.,
Commercial:
Native American Lands:
INJEC'l'ION PROCEDURE (briefly describe bow the irtjection well(s) will be. used)
C!.\ t;-SR ~~=z Ls!' cl·lw SI ,, I c:,. \ I=-~ Seu rl "'
WELL CONSTRUCTION DATA
(1) Proposed date to be constructed: G..\ l I \ l O Number of borings: --"\ __
Approximate depth of ea.ch boring (feet): 3()0
(2) typeoftubingto be used (~pper, PVC, etc): \ I\ \-\t) p e :v\os\::LQ,, f ~f -V
(3) Well casing. Is the well(s) cased? (check either (a.) Yes fil'. (b.) No below)
(a) Yes ___ if yes, then provide casing information below
TYPe: __galvanized steel __ black steel__plastic_other (specify)
Casing depth: From ___ to ___ feet (referenc e to land surface)
Casing extends to above ground ___ inches
(b) No Y-..
(4) Grout Info (material surrounding well casing and/or piping):
(a) Grout type: Neat Cement___ Bentonite _j_
(b) Grout placement: Pumping__ Pressure __
(c) Grout depth of tubing (reference to land surface): from
<ff ..
Other (specify) ~ ---~...,.F~I ~" w
Other__ I
,;--to 7 c[j (feet)
lf well has casing, indicate gro\lt depth: from ___ to ____ (feet)
GPU/UIC 5QW Notification of Intent Form (Revised 812008) Page2
02/~5/2018 11:55 9017489097 MID-SOUTH GEOTHERMAL PAGE 0i./04
B. m.tEC110N-RE.LATm iQoma.NT
Affal:ll a~~ The qfne.1di:lg !a,yQv.t Qt' p,oposea n:xodl.fie.ation of the ~ec:tioll equi~ and. exterior
~:' aaodated ~ the jq)e(ijan opc:ratiOl). Tbo m~, ~ may prowic &upt,lemema?y
i ~nos or~)
Attacll e.t-o copies of m~ showing ttu: ron~ infom.e.tfott!
O) tn..lude as~ Map (eat1 tie dnl~ sbowl%ig; buildi%l$5. property 11nea, $~ ~ bodi~ ~
~ of ground~ ~t8t11Jnation lbd the oricnti:tian of 3llod ~es between tbe proposed well(s) «D4
any aicti.ag Vt'e.11(1) ar ~ diapci,11 ~uss Sw:l\ as 5ef't~ ~ or dta1n. 'fi~ds ~ 'l\lithh\ 200 k or
the ~al heat~ wl S)'ctem. ~I all~ elaaey Rad ipolud,e •:run:9) gw.
(l) 11:le Stte Map must sbr;Tw tbe subject~~ in !d&iiotl tlO lhe ~ IUea by lllltll at least two ~
,e.fcn.nce Poinli sual1. uroam, ~ and/or highway mmsect!om;.
J, C!JlTmcAtlON
Noc. '.['Ilk V..UA.pp~ man be •td ·t>, !!Sil Pffl• appezruta 01. the
. reootded ltgal proptrt:Y cited.
."1 he(w)y cenify. under r,enaltr of law, that I hive ~ c:uminCIJ and am familiar with ~ inil:mnctlon
sub!lrttted in 1bi& d~ md ~ 8tiacbmen1$ then.to an4 that. ~ on my iQquiry of ~~ ~
· iznntedl=ty rqpou'ble !Qr ot,,tainmg sai4 ~on, l beliwe 1bet tbe iDfoTm.atlon iS 11'1U:, 11CC&Zr81a 111d complett-.
l am trWQre that there are tlgnifi~t pdlalti.a, mehad!ng tho poosfbUi.ty of ruxis and ~, for submittulg'
1a1st infim:nciati. l asree 10 coo.suuct, oi,caq, mainU!.o., ~, and If app~te, ebandon the u,,iection ~11 IDd
ilJ1 idad ~ in ~wi'Cl tbt approw:d spctlfioclG and~ oftbePemrlt,"
ll'UC--:h;~ · 8 Q.£1.4-/p1 C..1fy.z,f(harl~
Siplture of Prt.,pmty O'Maer/Applicartt
01 IC.~ tie f:lao..s I Sr, ?r~♦.,e,f /1bJ1¢q?r
'Prim or fype Full Name and lnlt ' .J ·
Si~ of~ Agent. if flSJY
l'riat Ol" Type F\111 Name and titl1
?tisase rel.um two oop"9 Qf ttw ~l~ Appliccion paelcap t.o:
Nortlt Cuolbaa.J>INR.·D'WQ
.i\.ft~ Fa ometiou Section-UIC Pl'Ogl'IIDl
lUf Mails.rw=eCeat.r
Ralet~NC 27699-1'36
Telaplu,n•(919)~21
GPU/OIC :.QW Nollicadioo c(1aid J<n1, ~ WOI)
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