WI0800051_GEO THERMAL_19990924

GROUNDWATER SECTION
August 24, 1999
MEMORANDUM
To: Charles Stehman
Groundwater Section
Wilmington Regional Office
From: Mark Pritzl /vJf [e-mail]
Hydrogeological Technician II
UIC Group
Groundwater Section
Raleigh Central Office
Re: Receipt of Notification for a Closed-Loop Geothermal Water-Only Injection Well
System.
Notification to construct and operate an injection well system for a closed-loop geothermal heat
pump system has been filed by John & Diana Aklan of Oak Island, North Carolina and a copy of
the Notification is enclosed for your files. This injection well system is deemed permitted by
rule (NCAC TISA: 2C.2 l l(u)2) and no regulatory action is necessary. If you have any
questions, please contact me at [phone] or Amy Axon at [phone].
cc: UIC Files
Enclosures
��
y.,n
NCDENR
JAMES B. HUNT JR.
GOVERNOR
NORTH . AROLINA DEPARTMENT OF
ENVIRONMENT ANG NATURAL REsouRCE5
August 23, 1999
Diana & John Aklan
97 West Island Drive
WAYNB McDrviiT Oak Island, NC 28465
SECRETARY
Dear Mr. & Mrs. Aklan:
DIVISION OF WATER QUALITY
KKRR T STBVENS In accordance with the notification submitted on your behalf by Climate Control
DIRECTOR Heating & Cooling dated August 23, 1999-9 the Groundwater Section acknowledges
your intention to construct closed-loW geothermal water-onI% injection wells for the
operation of a ground -source heat pump. The system as described in your notification
will not require an injection well permit and is deemed permitted by rule {North
Carolina Administrative Code Title 15A: 2C.4211(u)(2). The Underground Injection
Control Group has added your site to our inventory. If you modify your system,
please contact the Groundwater Section to verify compliance. Thank you for
submitting this notification.
If you have any questions regarding geothermal heat pump wells please feel free to
i contact me at (919) 7I5-6166 or Amy Axon at [phone].
Sincerely,
ma
Mark Pritzl
Hydrogeological Technician II
Underground Injection Control Program
cc: UIC Files
WIRO Files
GROUNDWATER SECTION
1636 MAIL SERVICE CENTER, AALE40k, NC 27699.1630 - 2728 CA/1TAL, 0LVD., RALE1614, HC 2760,
PHONI. 419-7S3-3221 FAX 919-715-O511:
• AN EQUAL OPPORTUNITY I AFFIRMATIVE ACTION EMPLOYER • 50% 11EC YC LED110% POST -CONSUMER PAPER

NORTH CARO: ,INA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
NOTIFICATION OF INTENT TO CONSTRU TA CL - TD-LOOP
GEOTHERMAL WATERY INJECTION WELL SYSTEM
(GROUND COUPLED ,HEAT PUMP) �
to
Type 5QW Wens t�
t►
In Accordance with the provisions o€NCAC Title 15A. 42C.0200 �
C.o;tipiete applicstion and naad to address en the back page.
Is is ru �F tie F"'EF11e:• f03.111 tO laf' used for hijccflon wells in all o ern -to neQtl1flrrt:QI 93'etem.
. of use mis form for s),atems that circulate s m, subatuuces Utter dial water. �
TO: DIRECTOR, NORTH CA.WLINA DIVISION CF WATER QUA'UTY
DATE;
19
A. SYSTEIA CLASSIFICATION Dries the proposed system circulate pota'Me watzr in continurju5
piping that completely isvia+es the fluid from tht: environment`i
YES _ � If yes; then continue completing this farm.
NO If no, ao not complete this fprsn. Fonn OVI-571 . rtpplioc ilon For
Pe)•mit To Con rucf flttdlGr We A Well(s) For .njection Wish A Hl,al
Pump system, should be completed.
E. SYSTEM. FLUID Will any addhives be intratluced to the system's c:rculat_ing I ea, trmisfcr
€lu d7 Thi. includes, but is not limiter! W +:orrosior, inhibitors and/or antifreazes,
YES It yes, tl❑ trot 4GC+I IV Lb Uiib funn. Fours For
Permit To Curtsrriiet AndlOr Ure ,4 Well(s) F'or 4ection With .4 Heat
pullip ,System., should be completed.
NO If no, then euntlnue completing this form.
CC.PROPERT Y OWNER
Marne: ,n a nti I? i a Rkl C"1—
Addmss:
City: DxkState: NS.G dip Code: _
Coun±y: Bru-o % wl QLL i'e1ep5 !1e: 9o - 2 79- 3 50 7,
D. STATUS OF PROPERTY OWNER
Private: , Federal: - Com - rc;el:
State: MOD' icipal: Native Ameri=an Lands:
OW57 CL (May 1998)
pese I of e

U
E. FACIL.TT`I (SITE) DATA
(F11t Qot UNLY )f the st'attl5 ar 0Wllzi, is Federal, State, Municipal nr Commercial).
F
G.
Name, of $iis'i=s or Facility:
Address:
City; State, Zip Cade: Counq': ,.
Trlepho-.-e. _ _ Contact Person.
Standard Imiustriai C'ode(s), $1C: M)irib describes commercial facility:
HEAT F JJMP CO N, 7tRACTOR DATA
A'ame u3lmat ��Trrsl tieatinr. '�ool'ni Cb" Inc.- ---- -
Address: ?C-'�-�;e�rreex—'7 r t �& Z _41 e—
�T
41ty: T SUe:I __ Zip Code: 7R ,L.A CCU,-Ity: . n" Z1 rju
Teleplicne: g Y + - — Contact Person: M r_h.."! 1-i:,_ i. —
C014STRUC T ION b lTA (c;ieck one)
CX;STIiN'G WELLjS) bung proposed for use 2s a ground-coup;ed he$- primp
wel!(s). Previdc the in brttW;on in (1) through (d) below to the ;pest of pur
knowledge. Attach a copy of Faun GW- I (Weil Construction .Record) if miiabl;.
PROPOSED WELL(S) to ice constrvcted fer use as a ground-ccupled !test purnp
welgs) , Provide the information in t;l) through (4�) be!ovv ns PROPOSED
c:onsrructiott specificadoGs, Submit Forrn GW-f after cans -auction.
( !) Well Dialling C:oatractor's Namf-
'.SIC Driller Rogistratiou number. 1633
Date to be cvn::tructe': 4,&4- Number of borings:
Approximate deF Ili of each hari4(feet)
2-01D
(i!} Well c�ts;�ig: Is laic welt(s) clsed? NO
() 1'FS If yes, then provide the casing nformatloo below.
Type: Ga!vanized s-v"i BIaok 3teeI pla$tbfi Gthcr rspcoity)_
Casing depth: From to_ ft. (reference to laird surftte)
Casing extends above ground Inches
(b) NO
out tt 1c. vt1licai lena.rh of tl�e borahoIe to a rni; !mum depth of 20 feet b.
(a) Gr- t:t ry Fe; Cement Bet7tonile -Y— other
f i�} G.outed SUrface zrid grout delidi �reforence to land surface):
araurt�f Gl[rse[i :❑vp piping; f nm �}_ to -0 (fUt).
vovild wel! casing; from to {feet}.
NOT& T11e WELL L)RILL114G CONTRAC TOR CAN 5VP7 .Y T11C t:ATfl roc. FlTwrr: �3xrsYiNo ov
PA.I.` OMD WCL LS IF 11(IS MFOIW ,MON I WAVA[LAl3LC 9Y DTH`•R MriANS
t,W-17 CL �;V!ky 1994] Page 2 of 4

Lr In �� J� _uli rt�lyl t
JIIM47E '"NT OL
�
H. INJECTION -RELATED EQUIPME:+T
Attach adiagrunr showing the wngintt:a`ing lay nui of tile injection equipment ead exmi for pspinpJtubing
assockted with the injection eperalloo. Th-. manufacturer's brcchure ttAy pro vide sapplernentaty
information.
i. LOCATION OF WELL(S) Attach two Wraps.
InCludo a SitR rl:gp (CAM be drawnl Showing,. buildings, property iinea surface rater boJles,
potent -'al sources of grotzndwatea- contamination atuf the orientation of and distances between
the proposed well(s) gnu any existing well(s) or waste disposal facilities Such as septic tanks
or drain fields located within 200 feet of the ground-Goitpled hce. punap well system. babel all
features clear;y and include a ncirlit arrow,
(2) location Wrap referencing the site to two cea.rby permanent reference pro nts (Such as roads,
streams and highway intersections),
3. PERNUT LIST: Attach a list of permits or construction approvals that are reIaked to tite site.
Zxamples incltida;
(1) Hazardc,ls Vfasre Managoment program permits under RCRA
(t) NC Dwision of Water Quality Non -Discharge permits
jJ) Sewage Treatinent and Disposal Pernti:s
K. CERTIFICAVON
"I here%=y certify, u11der per+aity of law. that I have personally examined and am fami!iar with the
m`brm0oa se.bminee in this document and all attachmenIA thereto nold that, based on rns inquiry of
those individuals imroediately respooslbie for obtaining said i r. formatl c n, I Lie]ieve that tLe iiuortnation
is true, ace3,rate and coin plete. 1 am aware that there are significant penalties, ittciudsng iite posslbi!ity
of fines ar-A iniprisc�nmeny for sul aiming False information. I agree to construes, operate, maintain,
nmir, and if applicable, abandon the ground-sourw meat pump system and all related appurtenances In
accordance with tree approved speeffications at - condi cis of the Permh.'
(St tore of Well Owner or Authorized Agent)
�fau►�torFxer� agent is acting on behalfof T1v well owner
please supply a letter sigrsd by the otv rw
authorizing the above agent.
C,W-57 C1_ (msy 1998) Page � of a

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Jun 21 99 11:55a
M.D. Geddings
910-278-7117
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Jun 21 99 ll:55a
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Jun 21 99 11:54a M.D. Geddines
11-h.17.1999 10:33fihl HED L RECORDS
910-278-7117
1`40.071 P.2
P.2
NOIC1 H CARQL[NA
DEPA- ItTMEN F OV t; '0IRONMENT AND XXZ Uf. (L RESOURCES
NOTMCATLON OF Its'" Er'YT TO CONSM'C'�'�A CLOSED -LOOP
GEOTHERMAL 3LA-1 -ONLY ZNJECT+I_01= � WELL SYSTEM
(GROUN 1) E:0tPLE'D i#E*T N .,WP}
.hype SOW Wells
A
r
In Accordance w n the provisions of NCAC TRIG 151 GZCv W
Complete appl aVan and mail to address Qn ti a tel.: k page.
'F'lsisirs ttet t#te pr-opev €ornkta bs =4 for it ee1toa ue11&.ltL An 1,Fr tisetoAl system.
ilia Flo! uaB tills fort" for xs "'SC'lts 111111 Cirellirtle 1111Y.Su L)7 II -:.Ice! Wig watsr•
TO: DIRECTOR, NORTH CARO I, IN A V VI51 ON OF VA'TE:Z i; 11ALCTY
a
Lo
DATE # 4_
n .
� FA
A. SYSTEM ELASS1fJ:F.ik'CION Ffnca t11L` j11Q1)D5Ct1 system sirs : ! able vlraFer i{l caniirletous
a`r
piping that completely isolaiv; t1v fluid from the enairorim-!W
YE5 _ lf-yt•: Ilia7l Continue ct►Irlplcting rt is f rni.
`�
_,__
.. ►'r
ND #€ax ►lo-n�atrtsrripklrr !lsf ` Ord CIS-57 �Ik�,.�pplicarlo:a Far
Prrm t To Con,ut7+ct 4rrellOr Use. ! P: 70) For Injection With A !-Teal
z
,*w;x( 4azu1, should be complate-1,
B. SYSTEM FLUID Will -my i0ditivea be intioduc*d to th r system's circulating hoat trsinsfer
fititd7 This iticiudt,% trut is m t lR rrited to cofroi itlrr ittlrtlrii; m : adlor artti!'racsts,
r
YES if y.•:. d-� not complete this-ronn. ror - . GW-57 HP, Application Far
Ptl'r' +? �:r EemlYl'HrF ,4Filp0> Uae .; FvA1(s) . Fw, iFo idt'ia A lit: v!
Ats,y 5)venr, shoilld bo compiettd.
AIO If iin thr, rt continue wmpleting tl,:.s + I.r m.
C. PROPERTY OWNER
Name: d L f4m
City' _ State: Zip Cod I.:
_ _
Ct}tltiiy: r f �C}_:,.: -
LL &TAYU&Of PRDRM TY U %VNf;k
prirrtte.- A 1'sCl: I al: Commercial
State.: miu. ieirld. Nnti►+e A:mei :an Lands.,
G W-S7 CL (mar 1991)
Pais t of 4
4•
LTTL-BLZ-a1t3 •B•W e411611 66 91 unr
I