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HomeMy WebLinkAboutWI0800069_GEO THERMAL_19980728GROUNDWATER SECTION July 28, 1998 MEMORANDUM To: Charles Stehman Groundwater Section Wilmington Regional Office From: Mark Pritzl fl-P 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 inj!'!ction well system for a geothermal heat pump system has been filed by Dr. & Mrs. Alex Willis of Emerald Isle North Carolina; a copy of the Notification is enclosed for your files. This injection well system is deemed permitted by rule (NCAC TISA: 2C.21 l(u)2) and no regulatory action is necessary. If you have any questions, please contact me at (919) 715-6166 or Amy Axon at (919) 715-6165. cc: UIC Files WIRO Files Enclosures NORTH CARowNA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DivisioN OF WATER QUALITY A�A NCDENR July 28, 1998 Am ES S. HUNT JR. GOVERNOR Dr. & Mrs. Alex Willis WAYNE MGDEVITT 8703 Qceanview Dr. SECRETARY Emerald Isle, NC 28594 Dear Dr. & Mrs. Alex Willis: A PRESTON HL7WAR4, JR., P.C. In accordance with the notification submitted on your behalf of Climate Control ❑LRELTOR Heating and Cooling Co., Inc. dated July 24, 1998; the Groundwater Section acknowledges your intention to construct closed -loop geothermal water -only 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.421 l(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 contact me at (919) 715 - 6166 or Amy Axon at (919) 715-6165. Sincerely, 144k /3- Mark Pritxl Hydrogeological Technician II Underground Injection Control Program cC: UIC Files WIRO Files GROUNDWATER SECTION P.O BOX 29578. RALUGH, NC 27826-0578 - 2728 CAPITAL BLVO., RALEIGH, NC, 27644 PHONE 819-788-82,21 FAIL 919-715-OSSO AN EQUAL OPPORTUNITY IAFFIRMATIVEACTION EMPLOYER - gt]jn' RECYCLED/10%POST-CONSUMER PAPER NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES NOTIFICATION OF INTENT TO CONSTRUCT A CLOSED -LOOP GEOTHERMAL -WATER -OM INJECTION WELL SYSTEM (GROUND -SOURCE HEAT PUMP) In accordance with the provisions of NCAC Title 15A: 02C.0211 complete notification and mail to address on the back page. This is not the proper form far injection wells to be used in an peen -loop ground -source heat pump system. Do not use this form for systerns-that re -circulate any substances other than w ter below -the ground surface. Type 5QW Wells UD `[C _ DIRECTOR, NORTH CAROLINA DMSION OF WATER QUALITYCO 7-2� DATE: , lg � Please type or print clearly. A. SYSTEM CLASSIFICATION Does the proposed system re -circulate potable 77 water in continuous piping which isolates the fluid from the environment? 0 w - YES If yes, then continue completing this form GW-57 CL. NO _ If no, do not complete this form. A form GW-57 HP (Application For Perrnit To Construct And/Or Use A Well For injection With A Heat Pump System) must be completed. 13. SYSTEM FLUID Will any additives be introduced to the system's subsurface piping, including but not limited to corrosion hihibiton or antifreezes7 YES If yes, do not complete this form. A form GW-57 HP (Application For Permit To Construct And/Or Use A Well For Injection With A Heat Pump System) must be completed. NO If no, then continue completing this form GW-57 CL. C PROPERTY OWNER Name: Dr. f A►-� 1 5 Address: S70-_} •�-Cd Vl ec D r. city: J�t�►r�.CCC ►�" 5��1 Zip code: 2'9�9 '�L County: `A8 Telephone: 2-5-2' - 3 5-af ` 3 GW-57 CL (March 1997) Page I of 4 I D, STATUS OF PROPERTY OWNER Private: A— Federal: State: Public: Coramercink Native American Lands, E. FACILITY (SITE) DATA (Fill out ONLY if the Status of Property Owner is Federal, Stale, Public or Commercial). Name of Business or Facility: Address: City: _ _ _ "Lip code: County: Telephone. _ Contact Person: Staiul,ird Inilu`trial Code(M) which describes Commercial facility: F. HEAT' PUMP CONTRAC'TQR DATA Name: [. . f 1(aAlfrJ / ,� � �9 (6. ,.t% Address: Z .9 X7_ - — - - - City: ASdnly. Ile- �� Zip code: Couiity: CAISA to Telephone: 9c) Coil! act Person. LCI-4 G. WELL USE Will die system well(s) also be used as ttre supply well(s) for your personal consumption? YES NOS' f R. CONSTRUMON DATA (CHECK ONE) EXISTING WELL(S) being proposed for use as a ground -source heat pump welI(s). Provide the information in (1) through (4) below to thn best of your knowledge. Attach a copy of Forin GW-I (Well Coustruction record) if available. PROPOSE WELL(S) to be constructed for use a.-, a ground -source lrcat punip well(s). Provide the information in (1) tfrr-ough (4) below as PROPOSED construction specifications. Submit Form GW-1 after construction. GW-57 CL (Mardi 1997) Page 2 of 4 NOTE: I (1) Well Drilling Contractor's Name: C-./im4,fe-~N1'-n:,/ Jl f, r-C/'/ ~ • :J: Jc.- NC Driller Registration number: _--1-/-----"'{e"'-----'3=---=3~-------- (2) Date to be constructed: -r--9f" ., ..t.t,, Approximate depth of each boring: __ ~ _____ _ Number of borings: _ __,f'~-- (3) Well casing: Is the well(s) cased? (a) YES If yes, then provide casing information below. Casing type: Galvm1ized steel_ Black steel_ Plastic_ Other (specify) ________ _ Casing depth: from'---__ to ___ ft (reference to land surface) (b) N) (4) Grout (material surrounding well casing and/or piping): (a) Grout type: Cement_._; BentoniteX; Other (specify) _____ _ (b) Grouted surface and grout depth (reference to land surface): .K_ around closed-loop piping; from O to f-2e ft. _ around well casing; from ___ to ___ ft. nrn WELL DRILLING CQ:t\T'fRACTOR CAN SUPPLY THE DAT.A FOR EITHER EXISTING OR PROPOSED WELLS IF THIS INFORMATION IS UNAVAILABLE BY OTHER MEANS. H. LOCATION OFWELL(S) Attach two maps. (1) a site map (can be drawn) showing the orientation of and distances between the proposed well(s) and any existing well(s) cir waste disposal facilities such as septic tanks or drain fields located within 200 feet of the ground-source heat pump well system. (2) a location map referencing the site to a labeled road intersection. GW-57 CL (March 1997) Page 3 of 4 I. CERTIFICATION "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 immediately responsible for obtaining said information, I believe that the information is true, accurate and complete. I am aware that there are significant penalties, including the possibility of fines and imprisonment, for submitting false information. I agree to construct, operate, maintain, repair, and if applicable, abandon the ground-source heat pump system well(s) and all related appurtenances in accordance with Title 15A NCAC Subchapter 2C Section .0200." r «1r=w~-~ (Signature of Owner or Author1zed Agent) Please supply a letter signed by the owner authorizing tlze above agent, if authorized agent is signer. J. CONSENT OF PROPERTY OWNER (Owner means any person who holds the fee or other property rights in the well being constrncted. A well is real prope1ty and its construction on land rests ownership in the land owner in the absence of contrary agreement in writing.) If the property is owned by sorneoue·other than the operator, the property owner hereby consents to allow the operator to constrnct a ground-source heat pump system as outlined in this notification and that it shall be the responsibility of the operator to ensure that the ground-source heat pump system's well(s) confo1m to the Well Construction Standards (Title 15A NCAC Subchapter 2C .0200) GW-57 CL (March 1997) (Signature of Property Owner if Different From System Operator) Please return the completed Notification package to: UIC Program Groundwater Section North Carolina DEHNR-DWQ P.O. Box 29578 Raleigh, NC 27626-0578 (telephone: 919-715-6165) Page 4of 4 &P� -r MI-5 41,�c tolvi . r41 -rD sGv"s L Ord