WI0700087_Staff Report_20201209

DocuSign Envelope ID: 9AF66A3A-CA6A-45B6-831A-557B55E8400B
AQUIFER PROTECTION SECTION - GROUNDWATER PROTECTION UNIT
REGIONAL STAFF REPORT
Date: 12/9/20 Permittee(s): Ashton Lewis Lumber
Permit No.: WI0700087
To: APS Central Office County: Gates
Central Office Reviewer: Shristi ShresthaProject Name: Ini. Heating/Cooling Return Well
Regional Login No:
L GENERAL INFORMATION
1. This application is (check all that apply): ❑ SFR Waste Irrigation System ® UIC Well(s)
❑ New ® Renewal
❑ Minor Modification ❑ Major Modification
❑ Surface Irrigation ❑ Reuse ❑ Recycle ❑ High Rate Infiltration ❑ Evaporation/Infiltration Lagoon
❑ Land Application of Residuals ❑ Attachment B included ❑ 503 regulated ❑ 503 exempt
❑ Distribution of Residuals ❑ Surface Disposal
❑ Closed -loop Groundwater Remediation ® Other Injection Wells (including in situ remediation)
Was a site visit conducted in order to prepare this report? ® Yes or ❑ No.
a. Date of site visit: 12/9/20
b. Person contacted and contact information: Michael Lancaster
c. Site visit conducted by: R. Sipe
d. Inspection Report Attached: ® Yes or ❑ No.
2. Is the following information entered into the BIMS record for this application correct?
® Yes or ❑ No. If no, please complete the following or indicate that it is correct on the current application.
For SFR Treatment Facilities:
a. Location: NA
b. Driving Directions:
c. USGS Quadrangle Map name and number:
d. Latitude: Longitude: Method Used (GPS, GoogleTM, etc.);
e. Regulated Activities / Type of Wastes (e.g., subdivision, food processing, municipal wastewater):
For UIC Injection Sites:
(If multiple sites either indicate which sites the information applies to, copy and paste a new section into the
document for each site, or attach additional pages for each site)
a. Location(s): no change since last permit was issued.
b. Driving Directions:
c. USGS Quadrangle Map name and number:
d. Latitude: Longitude: Method Used (GPS, GoogleTM, etc.);
APS-GPU Regional Staff Report (Sept 09) Page 1 of 4 Pages

DocuSign Envelope ID: 9AF66A3A-CA6A-45B6-831A-557B55E8400B
AQUIFER PROTECTION SECTION - GROUNDWATER PROTECTION UNIT
REGIONAL STAFF REPORT
IV. INJECTION WELL PERMIT APPLICATIONS (Complete these two sections for all systems that use injection
wells, including closed -loop groundwater remediation effluent injection wells, in situ remediation injection wells, and heat
pump injection wells.)
Description of Well(s) and Facilities — New, Renewal, and Modification
1. Type of injection system:
® Heating/cooling water return flow (5A7)
❑ Closed -loop heat pump system (5QM/5QW)
❑ In situ remediation (51)
❑ Closed -loop groundwater remediation effluent injection (5L/"Non-Discharge")
❑ Other (Specify:
2. Does system use same well for water source and injection? ® Yes ❑ No
Note: The system is constructed so that the two wells may be used for supply and injection interchangeably.
3. Are there any potential pollution sources that may affect injection? ❑ Yes ® No
What is/are the pollution source(s)? . What is the distance of the injection well(s) from the pollution
source(s)? ft.
4. What is the minimum distance of proposed injection wells from the property boundary? N/A,
5. Quality of drainage at site: ❑ Good ® Adequate ❑ Poor
6. Flooding potential of site: ® Low ❑ Moderate ❑ High
7. For groundwater remediation systems, is the proposed and/or existing groundwater monitoring program
(number of wells, frequency of monitoring, monitoring parameters, etc.) adequate? ❑ Yes ❑ No. Attach
map of existing monitoring well network if applicable. If No, explain and recommend any changes to the
groundwater monitoring program: NA
8. Does the map presented represent the actual site (property lines, wells, surface drainage)? ® Yes or ❑ No. If
no or no map, please attach a sketch of the site. Show property boundaries, buildings, wells, potential pollution
sources, roads, approximate scale, and north arrow. See attached man
Injection Well Permit Renewal and Modification Only:
1. For heat pump systems, are there any abnormalities in heat pump or injection well operation (e.g. turbid water,
failure to assimilate injected fluid, poor heating/cooling)?
❑ Yes ® No. If yes, plain:
2. For closed -loop heat pump systems, has system lost pressure or required make-up fluid since permit issuance
or last inspection? ❑ Yes ❑ No. If , explain: NA
3. For renewal or modification of groundwater remediation permits (of any bvpe), will
continued/additional/modified injections have an adverse impact on migration of the plume or management of
the contamination incident? ❑ Yes ❑ No. If yes, plain: NA
APS-GPU Regional Staff Report (Sept 09) Page 2 of 4 Pages

DocuSign Envelope ID: 9AF66A3A-CA6A-45B6-831A-557B55E8400B
AQUIFER PROTECTION SECTION - GROUNDWATER PROTECTION UNIT
REGIONAL STAFF REPORT
4. Drilling Contractor: Name: Bobby Harrell - Magette Well and Pump Co.. Inc.
Address: 2341 US 13 South
Ahoskie, NC 27910
NC Certification number: 2936-A
5. Complete and attach NEW Injection Facility Inspection Report, if applicable
V. EVALUATIONAND RECOMMENDATIONS
1. Provide any additional narrative regarding your review of the Application: WaRO has no issues with renewal
of this permit.
2. Attach new Injection Facility Inspection Form, if applicable
3. Do you foresee any problems with issuance/renewal of this permit? ❑ Yes ® No. If yes, please explain
briefly.
4. List any items that you would like APS Central Office to obtain through an additional information request.
Make sure that you provide a reason for each item:
Item Reason
5. List specific Permit conditions that you recommend to be removed from the permit when issued. Make sure
that you provide a reason for each condition:
Condition Reason
6. List specific special conditions or compliance schedules that you recommend to be included in the permit when
issued. Make sure that you provide a reason for each special condition:
Condition Reason
APS-GPU Regional Staff Report (Sept 09) Page 3 of 4 Pages

DocuSign Envelope ID: 9AF66A3A-CA6A-45B6-831A-557B55E8400B
AQUIFER PROTECTION SECTION - GROUNDWATER PROTECTION UNIT
REGIONAL STAFF REPORT
7. Recommendation: ❑ Hold, pending receipt and review of additional information by regional office; ❑ Hold,
pending review of draft permit by regional office; ❑ Issue upon receipt of needed additional information;
Issue; ❑ Deny. If deny, please state reasons:
8. Signature of report Preparer(s): 444 RA"V� 54c
Signature of APS regional supervisor: 'low T "
Date: 12/10/2020
VI ADDITIONAL INFORMATIONAND SITE MAP (Sketch of site showink house and waste irriffation
system, spray or drip field, location of well(s), and/or other relevant information- SHOWNORTHARROi)
Both inj., and supply wells appear to be in good condition consistent with findings of prior inspections
and operating adequately. No samples were collected from the wells due to sample submittal
restrictions at the DWR Central Lab. Samples may be collected at a later date when these restrictions are
lifted.
APS-GPU Regional Staff Report (Sept 09) Page 4 of 4 Pages