WI0400215_GEO THERMAL_20110907

Permit Number
Program Category
Ground Water
Permit Type
WI0400215 /
Injection Water Only GSHP Well System (5QW)
Primary Reviewer
michael.rogers
Coastal SW Rule
Permitted Flow
Fac ili tv
Facility Name
John Allen SFR
Location Address
820 Country Club
Roaring Gap
Owne r
Owner Name
John
Dates/Eve nts
NC 28668
Allen
Scheduled
Orig Issue
09/07/11
App Received Draft Initiated Issuance
09/07/11
Ret1 ulated Activities
Heat Pump Injection
Private residence, single family
Central Files: APS_ SWP_
09/07/11
Permit Tracking Slip
Status
Active
Project Type
New Project
Version
1.00
Permit Classification
Individual
Permit Contact Affiliation
David J. Brown
1908 Hamptonville
Hamptonville
Major/Minor
Minor
NC
Region
Winston-Salem
County
Alleghany
Facility Contact Affiliation
Owner Type
Individual · ·
Owner Affiliation
John Allen
Owner
PO Box 126
Roaring Gap
Public Notice Issue
09/07/11
NC
Effective
09/07/11
27020
28668
Expiration
Waterbody Name Stream Index Number Current Class Subbasin•
ACT;
�rr►10.wri+
NCDEN'R
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Govemor Director
09/07/2011
John Allen
Lynne Allen
P.O. Box 126
Roaring Gap, NC 28668
Subject: Acknowledgement of Intent to Construct Type 5QW Injection Well Systcm
Permit No. W10400215
820 Country Club
Roaring Gap, NC 28668
Dear Mr. Allen:
Dee Freeman
Secretary
On 09/07/2011, the Aquifcr Protection Section (APS) received notification of your intent to construct a closed -loop water-oril
geothermal injection well system; for the operation of a ground -source heat pump located at the address referenced ahnve. 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,
I . The injection well system contains only potable water,
The injection well system is constructed in accordance with well construction standards specified in worth
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 Alleghany County Health
Department as they may have additional requirements for tiffs type of system. Noncompliance with applicable state, county, or
rmunicipaI rules and regulations may result in the assessment ofeMl penalties.
Please contact Mike Rogers at [phone] or MichaeI.Rooersut:ncdenr.�,ov if you have any questions,
incerely, r �
for eb Watts
Supe 7r
cc: Winston-Salem Regional Office - APS
APS Central Files - Permit No. WI04002 I
Alleghany County Health Dept.
David J. Brown (Yadkin Well Co., Inc.. 1908 Hamptonville Rd., Hamptonville, NC 27020)
Mark Evans (Evans Heating & Cooling, Inc., 2297 Rich Hill Rd., Glade Valley, NC 29627)
AQUIFER PROTECTION SECTION
1636 Maii Service Center, Raleigh, Nor[h Carolina 27699.1636
Location: 2728 Capital Boulevard. Raleigh, No0i Carolina 27604 One
Phone: [phone] FAX t: 919-715.05B8, FAH 27 919-715-CYfJ481 Gustomer Service: 1-977-623-6748 North Carolina
inter,et: www.ncwalemualitv.ora Aatmria,14il
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MESSAGE:
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FOR ALL YOUR WATER NECOW
YADKIN WELL CO.. INC.
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