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Home My WebLink AboutWI0500473_GEO THERMAL_20120131Permit Number WI0500473 Program Category Ground Water Permit Type Injection Water Only GSHP Well System (5QW) Primary Reviewer eric.g.smith Coastal SW Rule Permitted Flow Facili Facility Name Theodore & Staci Haggis SFR Location Address 4801 Regalwood Dr Raleigh Owner Owner Name Theodore Dates/Events NC 27613 Haggis Scheduled Orig Issue 01/31/12 App Received Draft Initiated Issuance 11/30/11 Regulated Activities Heat Pump Injection Outfall NULL Central Files: APS_ SWP_ 01/31/.12 Permit Tracking Slip Status Active Project Type New Project Version 1.00 Permit Classification Individual Permit Contact Affiliation Joshua Niles Robertson Driller Well 8228 Kerr Chapel Rd Elon Major/Minor Minor Region Raleigh County Wake Facility Contact Affiliation Owner Type Individual Owner Affiliation Theodore Haggis 4801 Regalwood Dr Raleigh NC NC Public Notice Issue 01/31/12 Effective 01/31/12 27244 27613 Expiration Waterbody Name Stream Index Number Current Class Subbasin NCDENR North Carolina Department of Environment and Natural Resources Division of Water Quality Beverly Eaves Perdue Charles Wakild, P.E. Dee Freeman Governor Director Secretary January 31, 2012 Theodore Haggis Staci Haggis 4801. Reg&wood Drive Raleigh, NC 27613 Subject: Acknowledgement of Intent to Construct Type 5QW Injection Well System Permit No. WI0500473 4801 Regalwood Drive, Raleigh, NC 27613 Dear Mr. & Mrs. Haggis: On 11/30/201 1, the Aquifer Protection Section (APS) received notification of your intent to construct a closed -loop water-onl4 geothermal injection well system for the operation of a ground -source heat pump located at the address referenced above. 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: 1. The injection well system contains only potable water, 2. The injection well system is constructed in accordance with well construction standards specified in North Carolina Administrative Code Title 1SA 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 Wake County Health Department as they may have additional requirements for this type of system. Noncompliance with applicable state, county, or municipal rules and regulations may result in the assessment of civil penalties. Please contact Mike Rogers at (919) 807-6406 or Michaei.Royersluncdenr,gov if you have any questions. S it}rerely, for Debra W Siipervisor cc: Raleigh Regional Office - APS APS Central Files - Permit No. W 10500473 Wal.c County Health Dept. Triad Drillers (Joshua N. Robertson ) All American cleating & Air (Jason Tarter) AQUIFER PROTECTION SECTION 1636 tAaiI Service Center, Raleigh, North Carolina 27699.1636 Location: 512 N. Salisbury St., Raleigh, North Carolina 27604 Phone: 919.807-64641 FAX: 919-807-6496 Internet: www.navaterguality.arq An Equal Opporlturlly t AMffn live Action Employer Nne ortbCarolina Naturally 2011-113 9I 15336423 E'47 utpl2c 919-543-9105 �> Tula Z9:43. srTRIM) ERILk 3364215085 P 1/4 PACE 01/93 NORM CAROLINA bEIYAROMNT OF ENVMONMENE AND NATURAL R SOURCES NO1 CAUON OF 1NTENT TO ERUCT OR OVERATE JNJICIION WALLS Ia Ateccdante Witco. the Provithoss of I SA NCAC MC .420O USED— OP W LTER•AIY _ TECTION Tie walls aircalatepatablo Met vat, es par: ofa gtottiemPlIteetiug Fad coo4n system. Tie wells AperghitA by.mle" amd 40 aot re to ea tt►ddvrdna1 permit w cy are cetastruthad is awailzwe with the rates of 15A NCAC 02C ,02& and this Natice k submitted prior to ecoo zuaion. Prat or T3:p ItOrratian exatoll PI &dew on thg Last Pake DA1 , JL u . Z 1 20,14 alma Nv! itS3041'2i (t0 t F] $y 3wt 4,. ST ATM Or WELL -OWNER (0h oast Naa-GoVertumeotr individaal Residence BussnesslOrgscoization — Government Ste lvlunicipel Co;my _-� Pedxrel l L�+ OWNR'—For iadav dial midenees, enc owner oft rev* dd. For au others, ate mat of Why gg WItIS of pe?astdelegeted �to sign an behalf ofthe bisinessornen: Ma A=4/I C#y: Co /" ,coaniy: Wye ;►ion r- r J .1 UayTda �� 11�a.r �l9'��.� -72/ir EMAIL Adthees.±ho 5 T C. LOCATION Or WELL SITE — When to iaje wets are pbeaI]y 10 ed (I) Pored IdeodicatioO Number (Par) of well sip 4,38047,ebeg County: te4Ale Q) Pbytieel Address (if di:T=1111S= mean, asldiess) City - Stir NC z p Cow A. WELL DPSLER VOIORMATION! j tNcl; Driti as C ons Nam: , r E�- • ;S�y Y g NC Well Drilling Comaraor,Cenifloadoo No.: 214- CmpatyNerne: T';--I Dirr!ems !, os:tactPetsor, p t{q 1i' iA Adds: 71Ci r1LP e Address: Cie Xem aye I "pkiii/465, or an Zip Cod _ Sty: ic, :- tse) Offlot ieleNo,:- / Cei[No.: -4-4"'S x3 ck-S —' - - 'wit/1)1CNotazdata 3r18r201y Ptypt 900/ Z00'a t595# HJIMY NISI sgtra 59t0t926 6 9E:90 900Z16H/TI 2011-111g?sitAii8 a9: 41 321.Etp! 2c 94 3 91��` » 3364215085 P 2/4 PACE 02/0-2 E. BEAT PUMP CONTRACTOR TriVORMATION (if &ti ro tia driiftm) COMIClr Nate: i3J r 6i; 1"e4i,n� Ad caw:act Perseo:_ qtsv i - r•t-tf , Address• „w.,, A,ddeer. ILhl'}_14A-ItC,: .PaI(C -Dr. City: t_Aktr5V Code:- of-7 SW= AP.otrzar tA)0 L OfSce Tele to.: Fi 1973P--[acF z >vell Mo.: q114 • 74 i — 571.4 NC No.;1I q - 7 92. &'52-y WELL CONSTRUCTION DATk (i) Number ofbar to be eon: .1 Depth ores& boric oeet) Z _ ° Msaing w w wia be used Ow provide Mg (4) berm (2) Type oftulssttgto be usaid (steel, PVC. etc): 1J PF ptts (3) Wdl Deft If t wen(s) sri{tLupe casitkg then provide ide the iym (seed, PIC, errs), drat and extozct of rasing appeen above ground: ,QOJ)_e (4) Gtotrt (material surrounding well cam =d m r ag): (a Gro n pe= cement Sac crate*' — Other(spa y) "Hy s Moultatizeisz.= i rrd y repack to 15ANCAC2 . 3(FXiXA�, w a Comtottype gXtHst () rrotrt dtptla g n (rderen to LIM e): � _ If well has casing indicate rpm emu to (fed) WELL t On —;ems must be scaled or'odierwise sixsztaleiy irecticaiz distar=sas4 gx1eaiatiots of feiraze.sioe2aed within i000 het orthe in ec ticia well(s). La1xl air p �] i i zde a as h &tow. (1) AMC.11a s spec asap Mb& the Loc :opt oftheMowing: Proposed injection wells t S di * Property ioutavries Surfirre viztarbeelibb • Water stpaly wets * Sept tat sad assq stay Criseion sites, dmen'•Ia1ds, or repair areas ' Ex or pawl warms of wourofeea= off,' (!) Ate a tapemap of the 8 ceding 114 m1 a ii.ora `1te izjettion well site that indicts the facilities loca#cta and the Ir ap name. NOM' Pe moat dross, en saki rapb of ihePtoPaly pO'shim* property tows and sires Om odd and dorwiroaded fry toqpticzablit minty GAS' wrist& Typal, eke proem eax be secachel by owner atwaro or cddre= The location epic walk: ix rye tp property hmratladxs,aa sviic tanks, arm' ate, war than b drawn da by Irmsd 4L41o. a Toyer' cam sakeaad sponging topographic contours yr elevation caraNnC SW Vitas MivbaelM81201) Nig 2 goo/ 200'd V5854 lit x ]d�I NNI SAVG 59IOt98615 9£=90 8OO /5d/ T ? 11-11::�i i i4809:41 335421.3Etpl2c 919-543-9105 » TR AD TRiLLFRs 3364Z15085 P 3/4 FAGS 83i n H. C'EPAYEICATION Oa be signed as requited below or by that pe son's authorf agent) t5A NCAC 02C .021100 retpri es dist ail permit applications cha t be sigoaclas sFlaovs: 1, for a etspan eiols: by e. respon.sible torporte 0E04; 2_ for a partnership or sole propretoratip: by a gel partner or the pr°Pneios-, respootivelr. 3. for a municipality or a sze, * or odic public ageriey: by either a print pal exgeutire officer or ranking public* el d official; 4, for all others: byte well owner (fin mesas nersopikkgen die ue_ deed). If an sathorized wilt is signing on bald of the pp * bran sappy a 1tr sped by the appti nt that names and autories their aged to lien this appricadea astheir behalf. hereby , under het' of law, that I have persansliy �d madair With the juke:P.3nort submitted. it: this went and an asaeil, its taw) ate that, based en my inquiry of those zrzdividuis Immediately resporalle for aging said intatmation„ I beLZeve that the information is 1xue, accurate and opiete. Tam aware that them are sigriftenzit penalties, intit,dhzg the possibility of furs and :asp: &)ittueat, for sabpaitiar§tabx info on. I agree to con not operate, maktaiss, repair, and if applicable, Anion the injaetiou well and all related qpurtetumeesis aroanane with the waved spec cations mad co icons of the Pewit" 6tto t the complete 2pglication pee to: /L—J a• Sign2r12e ofWoty •: Ili �n AFFi1CaiT 48(0.- I . ti a7its PrintccType Full Name otPTopc ► owrfA� PiatarTypePvil Name Side ofAuthorized Agent, if arty Plit or Type Pull Name DWQ . Arita c Pretedion Section 1636 m. Service Center fib, SC 27699-1636 Telephone (919) 733-322 GPUMIC 5QW *r yfcatxss, (Revises 5iI 41 i f raae 3 9O / £OC'd 1'5954 H�Ia Wu NNI SATI 59 Ot92616 95:90 9OOZ/5ZITY ti DEC-17-200e 1S:10 From: — OUNtY HEALTH DPPAKI Mi=.N t Au Priu 7w Vasa 60 006.046A 3 Project * 040Jq Tax Map No. c ,3 Pemei Na. rate Zoning Township 1..res); r fP ()wnerIcontactor; 4 +:i5- L^ cation/Addrese: (_14'5 I 2J f14-•- r )41 (L) SL'DdiN364311 Nang!r '" { f'5� a �•`: 'i Preliminary Lrjaert 1 ssl fl:**" Ag- #$- To:Fax Seruer P.P/2 tit P-NU #C W inl.x= Odi t r_v;+s+t r 1+.01 F 11CvIr��- FACI++ DATE IlvsuWwce t/16-1mpravement Permit _ f~ WeH Parrott rlo. C19502 ❑permlan gait I I Dare. rx. � �1 1 L i .4Q g) as - x. s.srt. # 190 / z Welton or floss No. � Lot Fined sassiagsperasetione Repair [ Original Permit No Garbage Disposal Unit Yes [ 1 NO [Li"' House [ Mobile Home [ ) Burins [ 1 No. at Bedroom Lot Area _ a -6"3 Size of Tank _LPSO Comments: - - - >-4- Dow - Weil individual [ bdc [ I Public [i New ( tY Replacement is Repair [ Fee Paid: Yes C011strucapr7 CarrfpganCp Site Approved We Head Approved Grousing Approved Doe Impedednfisrian I:rjtial Sasrolo: _ j42-7Cam_ Dote: 9 -2 ?-9j - • Re -Sample in I ice: " Fie-Sarrixa t2 Elite: Re -chlorination as required [ j Yes [ I No • Feees viereii rose rrp All ovarian payable to: Wales county Flefil ti Department Y1/1.:ee F+fo [ 4 Nitrification Lino �t C 3 1F t70 b4- IL - - pepth of stone: 12- ( Max Depth of Trenches: 33 in. ^� Riser and Battle Required [ 4--"" Pun Requkod [ sir Parma void if not in corn d{8nce with zoning regulations .r Permits rttay+ 'te le an :... or in : .. - • use attanged Layout oy: Final + Yes Required Stab i rt t 7 Chlorinated [ [ Fles{uired Certificate [ 3 [ 1 Variance (Plcptain) [ ] I l WCHD I.a Arlixedirck756 1 1,0i 1 Sample Weeded I [ 1 1Ne� lnsthilad Byt C - p .}. 5 Dais System RnitliZed Sanuis itan�^�� This rayon is based In part an inforrnat[on provided by the Flvrrrsowrier- or hiarner paprosentatrvo in ha apgaloason automaton rar line permit, The sanitarian is riot responsible for talsa or misleading information contained in ilia application. The sanitarian Is also not rosPonvible far consoled Conditions on to property of for statements in this report that may have mauled from false or misleading statemar is provided io him in the application. Neither Waite Corrnly n0i'the sanitarian warrants that the Septic tank system wit continue to function saber only in she tuturo or that the waster supply will remain potable. DOPY TO HEALTH DEPARTMENT a 32.PIT VIA 9OO/ t00'd t6eSr H�J I8 I�CtI NNI SPEC G910T9136I6 Li::90 e00a/6z/ T 50 100 203 Feet Oik Real E late TO Map Name 0830521033 0161831 088004 Ovmer HAWS. THEODORE P 8 STAC1 F Nla ii�q Mt1ress 1 4601 REGALW000 DR MaiirgAddress 2 RA1,EiQH NG 27613.7042 Mailing Address 3 Deed Book 13387 Lti6ad POge 0672 Deed Data IMAM Deeded Acreage 253 ASsleesed Building 5271.170.00 Value Assessed Land Value $106,000.00 T.Au Assessed Value S377,170.00 slang Class Property Pe rlpiugl • 1NbMNDUAL L0132 HUNTER HILLS SE4A BM1987-107 Heated Area 7:31 Site Addre4E 4801 REGALWOOD DR CFtr TOwns7tp LEESViLL.E Year Built 1984 r �- TOte1 S1de Prim S255.000.00 Sale Date 12/27/1094 Type and Use #ngie Pam¢y Design Stylt Conventional Land Class RESIDENCE-c 10 ACRES -HOME SITE CIO Parcel Number 223-00000-0136 r WAKE COUNTY 900/ 500'd 56B5# HJI3'IVU NISI ma S9Z0I98616 LE:90 200E/EZItt 900/ 900'd t69G# FEITIVS NNE SAVG 59101996T6 9E:90 2002/5?/TI