The URL can be used to link to this page

Home My WebLink AboutWI0500487_GEO THERMAL_20120221Permit Number Program Category Ground Water Permit Type WI0500487 Injection Water Only GSHP Well System (5QW) Primary Reviewer eric.g.smith Coastal SW Rule Permitted Flow Facilit Facility Name Markus & Ilka Schalkamp SFR Location Address 1705 Everett Ridge Ct Wake Forest Owner Owner Name Markus Dat&s/Evenfa NC 27587 Schalkamp Scheduled Orig Issue 02/21/12 App Received Draft Initiated Issuance 02/20/12 Regulated Activities Heat Pump Injection Central Pifes: APS_· SWP_ 02/21/12 Permit Tracking Slip Status Active Project Type New Project Version 1.00 Permit Classification Individual Permit Contact Affiliation Glen A Darch 13109 Bold Run Hill Rd Wake Forest Major/Minor Minor Region Raleigh County Wake Facility Contact Affiliation Owner Type Individual Owner Affiliation Markus Schalkamp 1213 Fairview Club Dr Wake Forest NC NC Public Notice Issue 02/21/12 Effective 02/21/12 27587 27587 Expiration Waterbody Name Stream Index Number Current Class Subbasin Beverly Eaves Perdue Governor Markus Schalainp llka Schaiamp 1213 Fairview Club Drive Wake Forest, NC 27587 AVIMA MrrlIFINIP Division of Water Quality Charles Wakild, P.E. Dee Freeman Director Secretary February 21, 2012 Subject Acknowledgement of Intent to Construct Type 5QW Injection Well System Permit No. WI0500487 1705 Everett Ridge Court, Wake Forest, NC 27587 llear. lvir. uc Mrs. SGtiai.i,np: On February 20, 2012, the Aquifer Protection Section (APS) received notification of your intent to construct a closed -loop water -only 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 condition, 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 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 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 eun ut. Mike Rogers at (919}'80 7-6 Foci of Mid lael.Rogers@uesseur.41), if you have any questions. Cc: Raleigh Regional Office - APS APS Central Piles - Permit No. W 10500487 Wake County Health Dept. Glen A Darch Well Drilling, LLC (Glen Darch) Bowman Mechanical Services, Inc (Steve Bowman) Location: 512 N. Sulishiny St, Raleiyii, Worth caroilzFa 27504 Phone: 9194307.6464 l FAX 919407-6490 lntemeE www.navalemusrriv.orq An Equal LFp primEtj Airrmaaiive Action Employer Sincerely, faebra V Supervisor NOne Carolina attraili 'r NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES NOTIFICATION OF INTENT TO CONSTRUCT OR OPERATE INJECTION WELLS In Accordance With the Provisions of 15A NCAC 02C .0200 CLOSED -LOOP WATER -ONLY GEOTHERMAL INJECTION WELLS These wells circulate potable water only as part of a geothermal beating and coaling system_ These wells are `permitted by rule" and do not requires an individual permit when they are constructed in accordance with the rules of 15A NCAC 02C .0200 and this Notice is submitted prior to construction. DATE: Print or Type information and Mail to the Ad��d'ess on the Last Page. r . 20 PERMIT NO. V�s. �] _ _'-Fr�] -7 (to be filled in by DWQ) A. STATUS OF WELL OWNER (choose one) Non -Government: Individual Residence X . Business/Organization Government: State Municipal County Federal B. WELL OWNER - For individual residences, list each owner on property deed. For all others, state name of entity and name of person delegated authority to sign on behalf of the business or agency: AO u sc.� L }cecrzy law Cc 44 Litarnip Mailing Address: +f �13 r-�['L ► 6/0 6 Prf City: k)c[ "%QreC# State:/l/e Zip Code: 1 LI County: 4 4T l e Day Tele No.: 1/9- 7 1Y -6$ql cell No.: 9►9 7 � 91 EMAIL AddAddress:Anarkfie r 5a 4r: ram. cvarr Fax No.: C. LOCATION OF WELL SITE - Where the injection wells are physically located: - (1) Parcel Identification Number (PIN) of well site: (81f .C31 Jq -.37 7 4/ County: r,j (2) Physical Address (if different than mailing address): 170 5 EL. re_s___4 d i qp C 4' City: —Lie k e la r .e s State: NC Zip Code: 27 5 g7— - D. WELL DRILLER INFORMATION / ]II Well Drilling Contractor's Name: L _ r/e P1 _ - r O�`�c_ It Mid-. ; /..; L L C NC Well Drilling Contractor Certification No.:3,, `9va �` A Company Name: L /-eA A,12y' v4 !!"'e!'%1 �� , // / e Contact Person: atn 4 IJ 7 EMAIL Address: ' <. it iv 1,,v1i' - 6) 0 o J Can Address: 13/¢! & / un hid/ A(I city: G' Ire -)re Si Zip Code: 2.--7) State: A/C County: tijk- e Office Tele No.: r'`r 0 551 a 39 Cell No.: 079' r'i zt -WV Fax No.: (' & cc(- 3 0. ' OPU,TJIC SQW Notification(Revised 3/18t20 11) Page 1 E. HEAT PUMP CONTRACTOR INFORMATION (if different than driller) Company Name: 8tJt.vmtJ." /Yleclio,'\I~✓ <; ervFce.J I.A. C Contact Person: ~-f e It'~ Bo-iv"Y.., EMAIL Address: bt1&v'"'"""c(J ecl11,J'Vc./@ Je/&i,v/J. "el Address: /'Ir 'li:::c l"', chi C ,L City: Carne.,,.-Zip Code: 7-7<..c_. 'J State: /1-C County: _M_i::r_A_-e--e-=------ Oftice Tele No.: (2,1 ) 77Z-"l-75°Cj CellNo.: _______ FaxNo.: (>!.') 7 79-9zfJy F. WELL CONSTRUCTION DATA (1) Number of borings to be constructed•: ~-2--Depth of each boring (feet): -~ 3 7 5 • If existing water supply wells will be used then provide the information in item (4) below. (2) Type of tubing to be used (steel, PVC, etc): _j/.~l)_,P_c _________ _ (3) Well casing. If the well(s) will use casing then provide the~ (steel, PVC, etc.). diameter,~ and extent of casing appearing above ground: _______________ _ {4) Grout (material surrounding well casing and/or piping): (a) Grout type: Cement__ Bentonite .. k. Other {specify) ______ _ •• By selecting bentonite grout, a varianoc is hcn:byn:quesl.l:d to ISA NCAC 2C .0213(d){lXA), which rcquin:s a cement type grout. {b) Grout depth of tubing (reference to land surface): from >'r"C to ~ (feet) If well has casing, indicate grout depth: from ___ to s 7 ? (feet) G. WELL LOCATIONS-Maps must be scaled or otherwise accurately indicate distances and orientations of features located within 1000 feet of the injection well(s). Label all features clearly and include a north arrow. (1) Attach a site-specific map showing the locations of the following: • Proposed injection wells • Bull~ • Property boundaries • Surface water bodies • Water supply wells • Septic tanks and associated spray irrigation sites, drain fields, or repair areas • Existing or potential sources of groundwater contamination (2) Attach a topographic map of 1he area extending 1/4 mile from the injection well site that indicates the facility's location and the map name. NOTE: In most cases, an «eritd photograph of the property parcel showing property Jina and struetures can be obtained and downloaded from the applkable COll1lly GIS website. Typically, the property can be sf!lll'Ched by owner name or atldras. The location of the wells In re/Jdton to property boundaries, houses, septk tanks, other wells, etc. ca dim be drawn In by hand. Also, a 'layer' ca be se1et:led showing topographic contours or devatlon daltl.. GPU/UIC SQW Notification (Rmsed 3/18/2011) Page2 H. CERTIFICATION (to be signed as required below or by that person's authorized agent) 15A NCAC 02C .0211(b) requires that all permit applications shall be signed as follows: I. for a corporation by a responsible corporate offiicer, 2. for a partnership or sole proprietorship: by a general partner or the proprietor, respectively; 3. for a municipality or a state, federal, or other public agency: by either a principal executive officer or ranking publicly elected official; 4_ for all others: by the well owner ( which means all persons listed on the property deed). If an authorized agent is signing on behalf of the applicant, then supply a letter signed by the applicant that names and authorizes their agent to sign this application on their behalf. "I hereby certify, under penalty of law, that I have personally examined and am familiar with the information submitted in this document and all attachments thereto and that, based on my inquiry of those individuals imtnediately responsible for obtaining said information, I believe that the information is true, accurate and complete. [ am aware that there are significant penalties, including the possibility of fines and imprisonment, for submitting false information. 1 agree to construct, operate, maintain, repair, and if applicable, abandon the injection well and all related appurtenances in accordance with the approved specifications and conditions of the Permit" Signature of Property Owp plicant ll +gSRSata1}cr»re Print or Type Full Name ature-oft perty Owner/Applicant �Llc iL_liaerne_ Print or Type Futi Name Signature of Authorized Agent, if any Print or Type Full Name Submit the complete application package to: DWQ - Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636 Telephone (919) 733-3221 GP UILr1C 5QW Notification (& vised 31182011) Page 3 r l Vr 41 r United States of America PC7Ao Aule S N 86 25' 35" E P. H. 2006 ; 4632 0.5 Lot 34 , s ' fF°''"` 5 a e# 54p/,( s'# poic44. II o- 70• Building Footprint Driveway Sidewalks Steps Garage Other Other Total allowed impervious coverage Total area of impervious coverage Total square footage of lot e 'Prey Noo S 89 29' 37' W sqs Permanent Open Space CURVE Ci RADIUS 50.0000' ARC LENGTH 49.1439' CHORD LENGTH 47.1895` CHORD BEARING N0308`59'W DELTA ANGLE 56'18'53" 4; Being Lot 33 Kenwood Reserve Sub'd. Phase 2 Survey Far: Site Plan for pin #1811193774: 0 400 800 Fd0 Lake 1600 Feet IJ $�S --Wilkartashina-E"ri f'OTter Gte°x Wildhurst'Cn--- I o\ 1 I'l �. BentRcl to II ?....S Q. r ci cri'----------- s :Ilk f_ Iv** PIN 1811193774 ReaI Estate ID 0347979 Map Name 181101 Owner SCHALKAMP, MARKUS A & ILKA Mailing Address 1 1213 FAIRVIEW CLUB DR Mailing Address 2 WAKE FOREST NC 27587-4234 Mailing Address 3 Deed Book 1397B Deed Page 0826 Deed Data 6121/2010 Deeded Acreage 0.97 Assessed Building Value S0,00 Assessed Land Value $170,000.00 Total Assessed Value S170,000.00 Billing Class INDIVIDUAL Property Description LO33 KENWOOD RESERVE PH2 BM2006-01632 Heated Area Sile Address 1705 EVERETT RIDGE CT City Township NEW LIGHT Year Built 0 Total Sale Price $0.00 Sale Data Type and Use Design Style Land Class VACANT Old Parcel Number 188— WAKE COUNTY