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
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