WI0700251_GEO THERMAL_20160208

Rogers, Michael
From:
Sent:
AIIState Geothermal <[e-mail]>
Monday, February 08, 2016 2:22 PM
To: Rogers, Michael
Subject: Re : FW: WI0700251
Received.
Thank you very much.
On Feb 8, 2016 2:17 PM, "Rogers, Michael" <michael.ro 11ers(a)ncdenr.!l ov> wrote:
Let me know you received. Thanks.
-----Original Message-----
From: Michael Rogers [mailto:michael.ro 2.ers @ncdenr.gov]
Sent: Monday, February 08, 20161:36 PM
To: Rogers, Michael <michael.ro !![e-mail]>
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Rogers, Michael
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Rogers, Michael
Monday, February 08, 2016 2:18 PM
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FW: W10700251
20160208133555229.pdf
Let me know you received. Thanks.
Original Message ----
From: Michael Rogers[mailto:[e-mail]]
Sent: Monday, February 08, 2016 1:36 PM
To: Rogers, Michael <[e-mail]>
Subject:
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Scan Date: 02.08.2016 13:35:55 (-0500)
Queries to: [e-mail]
I

Permit Number
Program Category
Ground Water
Permit Type
WI0700251 /
Injection Water Only GSHP Well System (5QW)
Primary Reviewer
eric.g.smith
Coastal SW Rule
Permitted Flow
Facilit
Facility Name
Dan & Danielle Beckius SFR
Location Address .
41174 Ocean View Dr
Avon
Owner
Owner Name
Daniel
Dates/Events
NC
A
27915
Beckius
Scheduled
Orig Issue
10/24/11
App Received Draft Initiated Issuance
10/10/11
Regulated Activities
Heat Pump Injection
Outfall NULL
Central Files: APS_ SWP_
10/24/11
Permit Tracking Slip
Status
Active
Version
1.00
Project Type
New Project
Permit Classification
Individual
Permit Contact Affiliation
Charles C. Menefee
2257 Santa Fe Arch
Virginia Beach VA . 23456
Major/Minor
Minor
Region
Washington
County
Dare
Facility Contact Affiliation
Owner Type
Individual
Owner Affiliation
Daniel A. Beckius
1109 Sophmore Ct
Durham
Public Notice Issue
10/24/11
NC
Effective
10/24/11
27713
Expiration
Waterbody Name Stream Index Number Current Class Subbasin
AlgrA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coteen H. Sullins Dee Freeman
Governor Director Secretary
10/25/2011
Daniel Beckius
Danielle Beckius
1109 Sophmore Court
Durham, NC 27713
Subject: Acknowledgement of Intent to Construct Type SQW Injection Well System
Permit No. W10700251
41174 Oeeanview Drive, Avon. NC 27915
Dear Daniel and Danielle:
On October 10, 2011, the Aquifer Protection Section (APS) received notification of your intent to construct a closed -loop water-onh
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 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 Dare 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 [phone] or Michael.Roeers.dincdenr.gov if you have any questions,
cerely, ixt,4,
for Debra Wa
Supervisor
cc: Washington Regional Office - APS
APS Central Files - Permit No. WI07002S 1
Dare County Health Dept
C & G Well Drilling (Criss Menthe)
R.A. Hoy Heatine & Air (Fred Marklin)
AQUIFER PROTECTION SECTION
1636 Mail Service Canter, Raleigh, North Carolina 27699-1636
Location: 2728 Capital Boulevard, Raleigh. North Carolina27604
Phone: [phone] FAX 1: 919-7 i 5-058B; FAX 2; 919-715-60481 Customer Service:1-877-a"23-674F:
Internet www.ntwaternuaiitv.e o
At+ Ecd�l OpponuMty S tifnrmaiire,..eion Employer
Ndin
orth Carolin a
Naturally

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NORTE CAROLINA
DEAARTIMIT CF ENVIRONMENT AND NATURAL RESOURCES (NC DM)
NOTIIlCATI'ON OF XNTENT TO COMM, A Mffaalla GEC TBEIRIWAL
rascrroN WELL SYSTEM:
Try 5-OW W LLAS)
In Aonisoce witb the gene of NOW Tithe 15A: =MAO, please
ooropleto t1a a aod&atan and wail to adze o;} the Sind; pap (phrase Wig or au t itormat cm),
DATE 5e P.,664.2.� ..
Weli,Type Crn t rmatiols3 tors tho proposed system clreularL potable Inter only (ueadditives) iu
CGalftloall pipttxg the aampletclyr solatce tho fluid $arn ze avvit'onnistlt (Le.
Yes Continue co, l$ rg this tom.
No Co Not complete the tom). Complete other WC application arts for installing
either A well (loop well tgcseing potable wester inttx the ageilisr) !ore. 5 wet Now.
Loop well coUtAilditt A ditiVeS ouch as li 12, ethanol, or der antifreeze or eurroston.irtbfbitoria.
A. PROPERTY 'OW /ALICANT(S)
L#st A PropertyOwno 11eted on property deed (it' owned by a buaineas or gowimxuc n agency, stain name of
entity and a teprosertatiwlauthority for signature*.
-
Mailing Address! . , 9 5ceif
City. p Staten/w'd Zip Code:..2 7 yi C5tmty:,..
Itorne/Office Tale No.: II «- tot 14.01 Coil No.:
]i nag Address: _ W tei ....
(1)
(2) Physical Address of Wel! site (if different than above): 1 J I' 9 caw +r: W of[,
City; Statdc N Zip Code: 2"�� IS .0 t PAW
li€omlpl 5ice Telm No.: �, „ . „ ., .. ::........... -.
AvafoORtZa• AGcN'I' OP OWNER, IF ANY (if the Palk Applicant Ouce aft ovc a tha tobjeot property,
attach a latter from tbs prapatty owner atithorizing Agent to install and operate VIC we 1)
Ccsnny Name:
Contact Per$3nL
Addr :
Cfty steal Zip Cads: UMW: _
OM a TeAs Ne • .� . CeILN12,:
%beta Adtirea3 ofCozzspat:ny, if ram
Cal UNK 5QW MQDtn:ettfart of ens !cm (I MOM
Aquifer Prri r.tiof
OCT 10 2011
Nal

10/10/11 12:25AM
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C, WELL O t x R WOU.ATION
Comp'i yM . te;-Treir ..
Well Driller Cntr11ek"'s Nam ; �
1%7C Centractor Certifoatioe, No 31,433
Canted Pi
Addrrsa: _}� `� c4 "-vi &
ate: ! . 0 y VA _ r vIp Cie: 2ittfee County:
Mee Tele No,: 7 - flO 3 . Coll No,: 7? . ? / J(L-
D, ',SAT YAP CO TX ACTO MVO IM nON (If diftreit then driller)
Comps Nam:
Coot Pernik fil.t.tgrktfri
Addrew . P g . 1)Z or1
City 14 i } s- zip Cock: ?R'$t Gb►uxtY: 00144
Office Tole No.; 14n. - Pdel ` Cell Nu.; �3 Y
E. STATUS OP APPLICANT
Privets: Federal: ,,.:. Commercial:
State: Maicfpel: Netivo Amattc, a Lao&
F INJECTION PROCEDURE (braefy desexibe stow the Injection well(s) will be used,
— 1 r " c- Yam.
WELL. COCONSTRuenorir DATA
(1) hapood ate to bo conetrr 3: t �` ?' ! � !if Number of borings: 5
Approximate depth of each bang eS; ta0
(2) Type of tubing to be utlad (sapper. PVC, etc):
(3) Well ea _ L the well(g) mend? (obcck oidi r (a,) Yu
(A) Y*s _ _ .w. », if yea, then provide rasing informs
Typo: ,..,,...setvenhed l _Meek steel _Auto uthee (specify)
Cssiug depth: Prow - to _ hot (rei'mesrcc to !end surfkoe)
Casing email; to above ground !who
(b) Nn
(4) Or ut bib Oztaterirti mounding well ring and/or pipitxgj:
(a) Get type: Neat Cu _ Bentonitc Other (sI Y
(b) Groot plu merit: Pumping, Primate_ Other
depth of t� (a) &out dap #ag Wrre= to lsrrd gullet); from 0 to __,Q4/c4) (feet)
If wdtl ices mint tg, indicate groat depth: from — to _ — . y. _ ff et)
ovun = mw mo tt e:40 , 6f Went perm atevtred s�aboat
Page 2

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a LNitCTIO LATED EQUIPMENT
,Atfsat► diagram 4=0i118 the cazgieeetltrg lay►nut er proposed tabdiftenton of the int tetion eigutmcnt sad exterior
plptnet bfng aesbeciated with, the itjention operation, The manufaetwates brochure may provide supptementery
I. LOCATION OF WELL(S)
1.
Much two copies of mops ah owing the following it rmatiom
(1) Include s Site Map (ran be drawn) sttaw€ng: building*, p aperty lines, st race water bodies, potential
sources of groundwater boatemination sad the or*liorl of and dIBthncea bet 03M the proposed wotl() and
any existing woll(s) or waste dispoani Mies such u septic *nip or drain 6: ids located wittne ZQQ loot of
t geatbcnn d feat pump well systeaa. Label all Osatures aloofly and kgb.de a gath,Xvis
The S1te Map mwt show the subject property in relation to the surrounding as ea by using at least twri fixed
nifeteztce paints sucks as rvIda, stems; andior highway intersection',
(2)
J. CUM/CATION
Natal This Permit Application must be signed by ask parson sppeering on the
recorded legal property deed.
"1 hereby codify, under polzaity a£ law, that T have personally examined and am suitor with the information
3Ubmittod in thin document aud all attac unetti t r to aid that, based oti my inquiry of those itutivtdeils
irmosdiatcly responsible tr obtaining said information, t believe that the information a true, ante and oampicte.
azu mans that there are sigftlfieant penaltiet, htoludIg the possibility of foes and imprisonment, for submitting
NA* do X *gee to con truot, oporabc, maintain, repair, and if applicable, s the itaJcctio well awl
.il rotated appurteutioes m ICWdlnsz with dtc Wprovad a+oi bona and acmditfott s of the 3Pelmit."
Signature or Property pwnerlAppfoant
E4ti $
'Friar or Typo Pull Name and title
Siof Property OwtterIApp leant
pr rj 1.44 BatC4K MI
Print or Type Pull ?Ureic end title
—I"',.�3..'�
&stature of Authors Agent, if any
Print or Type Pull Notts* and title
Plesse rem two cotes of the eorrrptets4 Applic*t ai package to
North Carolina DENR DWQ
Aquifer Protection SexHo.UXC Program
m - R ; GY1(�
1636 shiest Service Center �µ
eighs NC 27699.1636 ,IIfe protA-Alr_n Section
Telephoue (919) 77.5-693$ OCT I 0 c01I
7/97g
OPWU C SOW Natllk.tlon of Nom Parris (RAvisad 40.01181
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3200 NORM CROATAN HWY. KILL DEVIL HII 5,. tic 21948
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Parcel Inquiry Results Page 1 of 1
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Parcel Number: 014822028 [ Submit I Print Date: 10/24/2011
Parcel: 014822028
PIN:054905283524
St#: 41174 OCEAN VIEW DR
District: [01 ] AVON
• PARCEL DATA SHEET
• BUILDING PHOTOS
• TAX BILL
• TAX CERTIFICATION
Owner: BECKIUS, DANIELLE M
Owner: BECKIUS, DANIEL A
Address: 1109 SOPHOMORE CT
Subdiv: [K310] KINNAKEET SHORES PHASE 5 DURHAM NC 27713
Lot-Block-Sect: Lot: 28 Blk: Sec: 5
Multiple Lots: -Units: 1
Plat-Cab-Slide: PL: C SL: 36D
Status: ACTIVE
Land Value:
Building Value:
Misc Value:
Gross Real Estate Value:
371,100
577,300
Ownership: PRIMARY
Nature of Ownership: EUX
Deed Bk/Pg: 1837/0464 -7/13/2010
PUSE: [0100] Single Family Residential
48,100 * Values are for the current tax bill period
996,500
********** END OF RECORD********"*
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