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Home My WebLink AboutWI0800167_GEO THERMAL_20090511NA NCDEMR North Carolina Department of Environment and Natural Resources Division of Water Quality Beverly Eaves Perdue Governor George Desrochers P.O. Box 1212 Swansboro, NC 28584 Subject: Permit Rescission UIC Permit No. WT0800167 SQW Geothermal Injection Well Carteret County Dear Mr. Desrochers: Coleen H. Sullins Director May 11, 2009 Dee Freeman Secretary Reference i.s made to your request for rescission of the subject Type 5QW Geothermal Injection Well Permit located at 7003 Ocean Drive, Emerald Isle, NC 28594. Staff from the Wilmington Regional Office has confirmed that this permit is no longer required. Therefore, in accordance with your request, Underground Injection Control (UIC) Permit No. WI0800167 is rescinded, effective immediately. If in the future, you wish to operate a Type SQW geothermal heat pump injection system, you must first submit a Notification oflntent to Construct a 5QW Closed-Loop Geothermal Well. Operating a geothermal heat pump injection system without a valid permit will subject the responsible party to a civil penalty ofup to $1000 per day. If it would be helpful to discuss this matter further, please do not hesitate to call Michael Rogers at (919) 715- 6166. Attachment( s) cc: Wilmington Regional Office -APS APS Central Files -Permit No. WI08001 67 Carteret County Environmental Health Dept. AQUIFER PROTECTION SECTION 1636 Mail Service Center, Raleigh, North Carolina 27699-1636 Location: 2728 Capital Boulevard, Raleigh, North Carolina 27604 Sincerely, Phone: 919-733-3221 \ FAX 1: 919-715-0588; FAX 2: 919-715-6048 \ Customer Service: 1-877-623-6748 Internet: www.ncwaterguality.org An Equal Opportunity I Affirmative Action Employer Ni~carolina JVaturattu Rogers , Michael From: Sent: To: Cc: Subject: Dear Mr. Rogers George Desrochers [geo_sue_desrochers@msn.com) Tuesday, May 05, 2009 5:33 PM Rogers, Michael George Desrochers 5QW Injection Well System Permit No. WI0800167 We have decided not to install a closed-loop geothermal water only injection well system for the operation of a ground-source heat pump at 7003 Ocean Drive, Emerald Isle, NC 28584. Therefore, we will not be using Permit No. WI0800167. Thank you. Sincerely, George Desrochers 1 OCR a-'D cq-� Rogers, Michael From: Charles 5tehman [Charles.Stehman ncmail.net] Sent: Wednesday, April 29, 2009 1:32 PM To: Michael Rogers Subject: August 23, 2004 Attachments: Reynolds Variance.doc Here is the letter I sent after discussing the technique used by the driller. As you will see, you should have been copied on this letter. Let me know if it does not arrive in you office. In my opinion, the mud rotary method the driller proposes to use will protect the Castle Hayne Aquifer. Accordingly to Mr. Hadley, the Derochers decided not to install a system and their application should have been withdrawn. Thus, there is no letter pertaining to their application. Charlie 5tehman (-'J�f (9 g 6.0 - (':�' .-: 1 Permit Number WI0800167 Program Category Ground Water Permit Type Injection Water Only GSHP Well System (5QW) Primary Reviewer michael. rogers Permitted Flow Facilit Facility Name George Desrochers SFR Location Address 7003 Ocean Dr Emerald Isle Owner Owner Name George Dates/Events NC 28594 Desrochers Orig Issue 04/30/09 App Received Draft Initiated 04/09/09 Re g ulated Activities Heat Pump Injection Outfall NULL Scheduled Issuance Central Files: APS_ SWP_ 04/30/09 Permit Tracking Slip Status Active Project Type New Project Version 1.00 Permit Classification Individual Permit Contact Affiliation Mike Hadley 102 Middle St Jacksonville Major/Minor Minor NC Region Wilmington County Carteret Facility Contact Affiliation Owner Type Individual Owner Affiliation George Desrochers PO Box 1212 Swansboro Public Notice Issue 04/30/09 NC Effective 04/30/09 28546 28584 Expiration Waterbody Name Stream Index Number Current Class Subbasin A.VA MCDEMR North Carolina Department of Environment-and Natural Resources Division of Water Quality Beverly Eaves Perdue Governor George Desrochers PO Box 1212 Swansboro, NC 28584 Coleen H. Sullins Director 4/30/2009 Subject: Acknowledgement of Intent to Construct Type SQW Injection Well System Permit No. WI0800167 7003 Ocean Drive Emerald Isle, NC 28594 Dear Mr. Desrochers: Dee Freeman Secretary In accordance with the application submitted to the Underground Injection Control (UIC) Program that was received on 4/9/09, the Aquifer Protection Section (APS) acknowledges your intent to construct a closed-loop geothermal water-onlv injection well system for the operation of a ground-source heat pump located at 7003 Ocean Drive, Emerald Isle, Carteret County, NC 28594. This system is deemed permitted by rule (North Carolina Administrative Code Title 15A, Subchapter 2C, Section .0211 (u)(2)). However, it is recommended that you contact the Carteret County Health Department, as they may have additional construction Qr permitting requirements for this type of system. If you modify your system at any time, including the addition of antifreeze, corrosion inhibitors, or any other substances to the circulating fluid, you must contact the APS to verify compliance with applicable rules. Thank you for submitting this notification. If you have any questions please call me at (919) 715-6166. Sincerely, o~~ . ~ ~ 0/\. Michael Rogers cc: Wilmington Regional Office -APS '---\. · Environmental Specialist GPU-Aquifer Protection Section APS Central Files -Permit No. WI0800167 Carteret County Health Dept. Mike Hadley (Climate Control Heating & Cooling -102 Middle Street, Jacksonville, NC 28546) AQUIFER PROTECTION SECTION 1636 Mail Service Center, Raleigh, North Carolina 27699-1636 Location : 2728 Capital Boulevard, Raleigh, North Carolina 27604 Phone: 919-733 -3221 I FAX 1: 919-715-0588; FAX 2: 919-715-6048 I Customer Service: 1-<!77-623-6748 Internet: www.ncwaterquality.org An Equal Opportunity I Affirmative Action Employer Nirthcarolina JVaturallll Climate Control Heating and Cooling Company, Inc. 102 Middle Street April 7, 2009 To: North Carolina DENR-DWQ Jacksonville, NC 28S40 910-353-9040 Aquifer Protection Section-UIC Program 1636 Mail Service Center Raleigh, NC 27699-1636 Attn: Mike Rogers RE: Variance Request George Desrochers RE~EIVED I DENR I DWi .Aquif P.r Proter.tion Se t· Q -' CJOO APR 09 2009 Mr. George Desrochers has contracted us to install Geothermal Heat Pumps in his house at 7003 Ocean Drive, Emerald Isle, N.C. We are planning to install a water only vertical closed loop geothermal heat exchanger but we can't get the required 50' clearance from the septic system. We are asking for a variance from the 50' rule to be able to install the vertical loop. We will be using Wyoben-Thermex grout and grouting the entire borehole from the bottom using a piston typed grout pump. There are no known potable water wells in the vicinity and all houses are connected to a public water system. I have enclosed a NC form 5-QW wells, a submittal on Wyoben-Thermex Grout, plot plan, and a site sketch from the Carteret County Health Department. A prompt rely would be greatly appreciated because we would like to complete the project before May 1, 2009. Starting May 2, 2009 the house will be occupied and this work would cause a great inconvenience to the tenants if we are working during their stay. Thank you, IICLJ)~ Michael Hadley, President NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES (NCDENR) NOTIFICATION OF INTENT TO CONSTRUCT A CLOSED-LOOP GEOTHERMAL WATER-ONLY INJECTION WELL SYSTEM: TYPE 5-0 W WELL{S ) cE\VED / oENR I '{VO RE 'f Pro•e-fon Se ,tion A0im er " _,, In Accordance with the provisions of NCAC Title 15A: 02C.0200, please ~PR ()9 1.00 complete this notification and mail to address on the back page (please Print or~ information). DA TE: -----=-A=p"""ril"'""'2=, ..... , ____ __,, 2009 _ Well Type Confirmation : Does the proposed system circulate potable water onl y (no additives) in continuous piping that completely isolates the fluid from the environment (i.e. closed-loo p)? Yes _ x_ Continue completing this form. No ,,.. Do Not complete this form. Complete other UIC application forms for installing either a 5A7 well (open-loop well injecting potable water into the aquifer) or a SQM well (closed- loop well containing additives such as R-22, ethanol, or other antifreeze or corrosion inhibitors). A. PROPER1Y OWNER(S)/APPLICANT(S) List each Property Owner listed on property deed (if owned by a business or government agency, state name of entity and a representative w/authority for signature): -=Ge=o=r_,_ge"-'D=-e=sr=o=c=he=r=-s __________ _ (1) Mailing Address 120 Seagate Ln. f t) Sox /Z/l,, Swa-n~ £-D'Yl) / 11/C, zes-B+ , City: Swansboro State: _NC_Zip Code:28584 County: Onslow Home/Office Tele No .: 910-326-5399 Cell No.:703-304-2287 Email Address: Website: --------~=~------------- (2) Physical Address of Well Site (if different than above): 7003 Ocean Dr. City: Emerald Isle State: _NC_Zip Code : 28594 County: Carteret Home/Office Tele No.: -=25=2::...;·3=5c...:4-=-2"-'4-=65=---__ ___,C=e=ll~N-=o=.: _________ _ B. AUTHORIZED AGENT OF OWNER, IF ANY (if the Permit Applicant does not own the subject property, attach a letter from the property owner authorizing Agent to install and operate UIC well) Company Name: ___________________________ _ Contact Person,_: --------------'E=MAIL==-A:..:=-ddr==es=s,_: _________ _ Address: ______________________________ _ City: ________ State: __ Zip Code: ______ County: _______ _ Office Tele No.: Cell No .: Website Address of Company, if any: _____________ _ C. WELL DRILLER INFORMATION Company Name: Coastal Geothermal Well Driller Contractor's Name : Sanford Sweeting NC Contractor Certification No.: NC 2082 Contact Person : Mike Hadley EMAIL Address: mhadley @bizec.rr.com Address : 102 Middle St. City : Jacksonville Zip Code: 28546 County: Onslow Office Tele No.: 910-353-0926 · Cell No.: 910-376-1100 D. HEAT PUMP CONTRACTOR INFORMATION (if different than driller) Company: _Climate Control Heating & Cooling Co., Inc . _____ _ Contact Person: Mike Hadlev EMAIL Address : mhadlev (tv,bizec.rr.com Address: 102 Middle St. City: Jacksonville. NC Zip Code: _28546 __ County:Onslow __ Office Tele No.: __ 910-353-9040 __ Cell No.: _910-376-1100_ E. STATUS OF APPLICANT Private: _x_ State: Federal: Municipal: __ Commercial: Native American Lands: F. INJECTION PROCEDURE (briefly describe how the injection well(s) will be used) Closed Loop Geothermal Heat Transfer Systems G. WELL CONSTRUCTION DATA (1) Proposed date to be constructed: _April -2009 ___ Number of borings: _5 __ _ Approximate depth of each boring (feet): __ 250 _____ _ (2) Type of tubing to be used (copper, PVC, etc): _High Density Polyethylene_X (3) Well casing . Is the well(s) cased? (check either (a.) Yes or (b.) No below) (a) Yes ___ if yes, then provide casing information below Type: __galvanized steel __ black steel_Jlastic __ other (specify) Casing depth: From ---'to ___ feet (reference to land surface) Casing extends to above ground ___ inches (b) No _x __ (4) Grout Info (material surrounding well casing and/or piping): (a) Grout type: Neat Cement__ Bentonite _x_ Other (specify) ______ _ (b) Grout placement: Pumping_X_ Pressure__ Other (c) Grout depth of tubing (reference to land surface): from _o __ to _250_ (feet) If well has casing, indicate grout depth: from ___ to ____ (feet) R. INJECTION -RELATED EQUIPMENT Attach a diagram showing the engineering layout or proposed modification of the injection equipment and exterior piping/tubing associated with the injection operation. The manufacturer's brochure may provide supplementary information. LOCATION OF WELL(S) Attach two copies of maps showing the followiug information: (1) Include a Site Map (can be drawn) showing: buildings, property lines, surface water bodies. potential sources of groundwater contamination and the orientation of and distances between the proposed well(s) and any existing well(s) or waste disposal facilities such as septic tames or drain fields located within 200 feet of the geothermal heat pump well system. Label all features clearly and include a north arrow. (2) The Site Map must show the subject property in relation to the surrounding area by using at least two fixed reference points such as roads, streams, and/or highway intersections. J. CERTIFICATION Note: This Permit Application must be segued by each person appearing on the recorded legal property deed. "I hereby certify, under penalty of law, that l 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 injection well and all related appurtenances in accordance with the Woved specifiicaticF Itand conditions of the Permit." Z, I REGEIVED t DF-NR r D*Q ggtik4i�; prnt�riinn �et�#!OC'z APR 0 y Signatnre of Property Owner/Applicant Print or Type Full Nance and title Signature of Property Owner/Applicant Print or Type Full Name and title Signature of Authorized Agent, if any Print or Type Full Name and title PIease return two copies of the completed Application package to-. North Carolina DENR-DWQ Aquifer Protection Section-LTIC Program 1636 Mail Service Center Raleigh, NC 27699-1636 Telephone (919) 715-6935 RECEIVED I DENR r UNU Agsiifpr Rrntprtinn sprhon sa ~ LlZ4NfC MUN S saw, APPRM OEM ABAYiIC OQO t� 1) TOTAL LOT ARFA - FIAW Sa Fr. V FLOOD ZWS AS .'XltW JJ PLAT ►IE MOMM Im 4) AEA ' Y.R. jM Pa. v s) P'lFiQl 7SM46 I I ST L,l1F PIE7 i YEOL _ _ _ _ _ _ELIR. f f Uk -E7XS3alE; OW 9W ALE L. -MWAR f amour Srm4CK Li9he- +-jW-Wrr 5vlw POW L L ryi i iiE —4 P �wP� G' t - �Cs fro I'll, ,7.W ,Rr Il.r � 1 i TOTAL PIRG PGSM MrfPMUS SUWACr- i 31?w at. - I? ax s MOMM CLWW M71W ARFA r 70' X 40'' %QOD S.F. ARFA AVTT� C 7 1 M- +(M-MK n AMC�.LM), CO SC IE, PAY /.v 1- �LF. 194CEUA E" - 14D S &, TOTAL. PROPPED CLEARM - 54W A it BLAf iMA! 'E Tl+�'�,;• R r S MV6-34'E S 7`1 3-ew 33,#t' N i 31LO-AB' TO F. P-K Ml CA IN7, DMW DR. B l "ATER OR. R% } C/,L _paii OOMAN m 6 AAZUW DPI L CM4� ALM MEu. 0=57EffiP LAAV O0 PVU] Ylt2M SU9W FM- 1SMWE MAM-10 AIMUM M B1uewater Associates -%WNW CAI AN AGCQROImor. am LOr 13, BL" A. IiLVWWAM MY 7!!E STA404WS AF PREC= FW LARD SiA41E•WW W M WW CARMAK No IMF 7w Cr0m MOM EA 11'3WN OF X=UW Mff OP SAID Mrs a" rwsP., ca"IffSt comm, N.C. o�rr Alan BeU Surveying, P.A. ' doom Cm" pofivr AZYD SWAMM BQ, N.C. 4�5 ALA�,HC11�: (,8d�j--19L9—BI�I Carteret County Health Department SITE SKETCH �� ` �arr•,� � Psrmc�eEcs Current Land O neer, Name '76103 (7crah Dlwee Property Location /(1 e NO (Parcel Identification Number-15 digits) A survey or other plot plan inink (mot pencil) may he used as an attachment to the application. It would need to show shape -of lot; lot dimensions, structure location with dimensions and setbacks, driveway, and proposed or eadstmg septic system and water source location. � . F Permit Number WI0800167 Program Category Ground Water Permit Type Injection Water Only GSHP Well System (5QW) Primary Reviewer michael.rogers Permitted Flow Facilit Facility Name George Desrochers SFR Location Address 7003 Ocean Dr Emerald Isle Owner Owner Name George Dates/Events NC 28594 Desrochers Central Files: APS_ SWP_ 04/30/09 Permit Tracking Slip Status Active Project Type New Project Version 1.00 Permit Classification Individual Permit Contact Affiliation Mike Hadley 102 Middle St Jacksonville I NC Major/Minor Minor Region Wilmington County Carteret · Facility Contact Affiliation Owner Type Individual Owner Affiliation George Desrochers PO Box 1212 Swansboro NC 28546 28584 Orig Issue 04/30/09 App Received Draft Initiated Scheduled Issuance Public Notice Issue 04/30/09 Effective 04/30/09 Expiration 04/09/09 Re g ulated Activities Heat Pump Injection Outfall NULL Waterbody Name Stream Index Number Current Class Subbasin AVA MCDENR North Carolina Department of Environment •and Natural Resources Division of Water Quality Beverly Eaves Perdue Governor George Desrochers PO Box 1212 Swansboro, NC 28584 Coleen H. Sullins Director 4/30/2009 Subject: Acknowledgement of Intent to ConstructType 5QW Injection Well System PermitNo. WI0800167 7003 Ocean Drive Emerald Isle, NC 28594 Dear Mr. Desrochers: Dee Freeman Secretary In accordance with the application submitted to the Underground Injection Control (UIC) Program that was received on 4/9/09, the Aquifer Protection Section (APS) acknowledges your intent to construct a closed-loop geothermal water-only injection well system for the operation of a ground-source heat pump located at 7003 Ocean Drive, Emerald Isle, Carteret County, NC 28594. This system is deemed permitted by rule (North Carolina Administrative Code Title 15A, Subchapter 2C, Section .0211 (u)(2)). However, it is recommended that you contact the Carteret County Health Department, as they may have additional construction or permitting requirements for this type of system. If you modify your system at any time, including the addition of antifreeze, corrosion inhibitors, or any other substances to the circulating fluid, you must contact _the APS to verify compliance with applicable rules. Thank you for submitting this notification. If you have any questions please call me at (919) 715-6166. Sincerely, o~~ . ~ t 0/\. Michael Rogers cc: Wilmington Regiorial Office -APS '-\' -Environmental Specialist GPU-Aquifer Protection Section APS Central Files -Permit No. WI080016 7 Carteret County Health Dept. Mike Hadley (Climate Control Heating & Cooling -102 Middle Street, Jacksonville, NC 28546) AQUIFER PROTECTION SECTION 1636 Mail Service Center, Raleigh, North Carolina 27699-1636 Location: 2728 Capital Boulevard, Raleigh, North Carolina 27604 Phone: 919-733-3221 \ FAX 1: 919-715-0588; FAX 2: 919-715-6048 \ Customer Service: 1-877-623-6748 Internet: www.ncwaterquality.org An Equal Opportunity I Affirmative Action Employer Nirthcarolina )Vatural/11 NCDENR North Carolina Department of Environment and Natural Resources Division of Water Quality Beverly Eaves Perdue Governor Mr. Paul Reynolds 1913 Lewis Circle Raleigh, North Carolina 27608 Coleen H. Sullins Director April 22, 2009 Subject: Variance for Geothermal Well Placement 312 Colony Drive Atlantic Beach, NC Carteret County Dear Mr. Reynolds: Dee Freeman Secretary The Division of Water Quality received your request for a variance to separation requirements for a set of 5QW geothermal wells to be installed at your Emerald Isle property referenced above. Your contractor, Michael Hadley of Climate Control Heating and Cooling Company, Inc. of Jacksonville, North Carolina, requested the variance. The variance is necessary because lot size limitations require that the wells be installed in proximity to an existing septic system - After review you notification documents and drawings, and after discussions with Mr. Hadley about his drilling technique, I am comfortable that the location and construction of the wells in proximity to the septic system will not compromise groundwaters of the state. Therefore, the Division of Water Quality honors your request and gives this variance for construction of the wells as authorized under 15A NCAC 2C.0215. Should you have further questions concerning this matter, please feel free to call me at (91 0) 796-7218. Yo - very truly- - � 1 r Charles F. Stehman, Ph.D., P.G. Environmental Program Supervisor llI cc: Michael Hadley Debra Watts Mike Rogers Wilmington Regional Office ��p nB 127 Cardinal Drive Extension Wilmington, NC 28405 N6LCarohna Phone: 910-796-7215 1 FAX: 910-350-2004 AECEat1� / DENR r? OM a N��■ Internet: yaww ncwater•�ualit .or ajar Proterlion 5mto� F LI Ny An Equal QpportunitylAtlinnatNe Action Employer APR 2 3 2009 CuslomerService 1-877-623-6748 50% RecycledllQ% Post Consumer Paper Climate Control Heating and Cooling Company, Inc. 102 Middle Street Jacksonville, NC 28540 910-353-9040 April 7, 2009 To: North Carolina DENR-DWQ Aquifer Protection Section-UIC Program 1636 Mail Service Center Raleigh, NC 27699-1636 Attn: Mike Rogers RE: Variance Request George Desrochers RE~EIVEO I DENR I DWQ Aqwfer Protection Section APR 09 2009 Mr. George Desrochers has contracted us to install Geothermal Heat Pumps in his house at 7003 Ocean Drive, Emerald Isle, N.C. We are planning to install a water only vertical closed loop geothermal heat exchanger but we can't get the required 50' clearance from the septic system. We are asking for a variance from the 50' rule to be able to install the vertical loop. We will be using Wyoben-Thermex grout and grouting the entire borehole from the bottom using a piston typed grout pump. There are no known potable water wells in the vicinity and all houses are connected to a public water system. I have enclosed a NC form 5-QW wells, a submittal on Wyoben-Thermex Grout, plot plan, and a site sketch from the Carteret County Health Department. A prompt rely would be greatly appreciated because we would like to complete the project before May 1, 2009. Starting May 2, 2009 the house will be occupied and this work would cause a great inconvenience to the tenants if we are working during their stay. Thank you, ltt;Lf~ Michael Hadley, President NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES (NCDENR) NOTIFICATION OF INTENT TO CONSTRUCT A CLOSED-LOOP GEOTHERMAL WATER-ONLY INJECTION WELL SYSTEM: TYPE 5-0 W WELL (S) In Accordance with the provisions ofNCAC Title 15A: 02C.0200, please RECE\VEO / o~NR de .:~ Aquifer Protection APR 09 200 complete this notification and mail to address on the back page (please Print or~ information). DA TE: ___ A_p_ri~l 2=,~·----~· 2009 _ Well Type Confirmation: Does the proposed system circulate potable water only (no additives) in continuous piping that completely isolates the fluid from the environment (i.e. closed-loop)? Yes _ x_ Continue completing this form. No __ Do Not complete this form. Complete other UIC application forms for installing either a 5A7 well (open-loop well injecting potable water into the aquifer) or a 5QM well (closed- loop well containing additives such as R-22, ethanol. or other antifreeze or corrosion inhibitors). A. PROPERTY OWNER(S)/APPLICANT(S) List each Property Owner listed on property deed (if owned by a business or government agency, state name of entity and a representative w/authority for signature): ~Ge~o~r-ge~D_e=s~ro~c~her~s __________ _ (1) Mailing Address 120 Seagate Ln. Po Bex /Zll, l S'evan~ borO / }1/C,,, z13s-e+ > City: Swansboro State: _NC_Zip Code:28584 County: Onslow Home/Office Tele No.: 910-326-5399 Cell No.:703-304-2287 Email Address: Website: ---------'-'-====-------------- (2) Physical Address of Well Site (if different than above): 7003 Ocean Dr. City: Emerald Isle State: _NC_ Zip Code: 28594 County: Carteret Home/Office Tele No.: 252-354-2465 Cell No.: B. AUTHORIZED AGENT OF OWNER, IF ANY (if the Permit Applicant does not own the subject property, attach a letter from the property owner authorizing Agent to install and operate UIC well) Company Name: ___________________________ _ Contact Person: EMAIL Address: ""-----------------===-==="'------------ Address: ______________________________ _ City: ________ State: __ Zip Code: ______ County: _______ _ Office Tele No.: Cell No.: Website Address of Company, if any: _____________ _ C. WELL DRILLER INFORMATION Company Name: Coastal Geothermal Well Driller Contractor's Name: Sanford Sweeting NC Contractor Certification No.: NC 2082 Contact Person: Mike Hadley EMAIL Address: mhadlev@ biz.ec.rr.com Address: 102 Middle St. City : Jacksonville Zip Code: 28546 County: Onslow Office Tele No.: 910-353-0926 Cell No.: 910-376-1100 D. HEAT PUMP CONTRACTOR INFORMATION (if different than driller) Company: _ Climate Control Heating & Cooling Co., Inc. _____ _ Contact Person: Mike Hadlev EMAIL Address: mhadley@ bizec.rr.com Address: 102 Middle St. City: Jacksonville, NC Zip Code: _28546 __ County:Onslow __ Office Tele No.: __ 910-353-9040 __ Cell No.: _910-376-1100_ E. STATUS OF APPLICANT Private: X Federal: Commercial: State: Municipal: __ Native American Lands: F. INJECTION PROCEDURE (briefly describe how the injection well(s) will be used) Closed Loo p Geothermal Heat Transfer Systems G. WELL CONSTRUCTION DATA (1) Proposed date to be constructed: _April -2009 ___ Number of borings: _5 __ _ Approximate depth of each boring (feet): __ 250 _____ _ (2) Type of tubing to be used (copper, PVC, etc): _High Density Polyethylene_X (3) Well casing. Is the well(s) cased? (check either (a.) Yes m: (b.) No below) (a) Yes ___ if yes, then provide casing information below Type: __galvanized steel __ black steel__plastic __ other (specify) Casing depth: From ___ to ----'feet (reference to land surface) Casing extends to above ground inches --- (b) No _x __ ( 4) Grout Info (material surrounding well casing and/or piping): (a) Grout type: Neat Cement__ Bentonite _x_ Other (specify) ______ _ (b) Grout placement: Pumping_ X_ Pressure__ Other __ (c) Grout depth of tubing (reference to land surface): from _0 __ to _250_ (feet) If welf has casing, indicate grout depth: from ___ to ____ (feet) H. INRCTION-RELATED EQUIPMENT Attach a diagram showing the engineering layout or proposed modification of the injection equipment and exterior piping/tubing associated with the injection operation. The manufacturer's brochure may provide supplementary information. 1. LOCATION OF WELL(S) Attach two copies of maps showing the following information: (1) Include a Site Map (can be drawn) showing: buildings, property lines, surface water bodies, potential sources of groundwater contamination and the orientation of and distances between the proposed well(s) and any existing wells) or waste disposal facilities such as septic tanks or drain fields located within 200 feet of the geothermal heat pump well system. Label all features clearly and include a north arrow. (2) The Site Map must show the subject property in relation to the surrowiding area by using at least two fixed reference points such as roads, streams, and/or highway intersections- J. CERTIFICATION Note: This Permit Application must be signed by each person appearing on the recorded legal property deed. "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 injection well and all related appurtenances in accordance with the a� oved specificatid '. and conditions of the Permit," REGlrllllr0 I DERR J 4*0 Agt1il1 P"Apchfln SP.r� APR 09 Z009 Signature of Property Owner/Applicant Prat or Type Full Name and title Signature of Property Owner/Applicant Print or Type Full Name and title Signature of Authorized Agent, if any Print or Type Full Name and title Please return two copies of the compacted .Application package to: North Carolina DENR-DWQ Aquifer Protection Section-U11C Program 1636 Mail Service Center Raleigh, NC 27699-1636 Telephone (919) 715-6935 RECEIVED ► DE R r UM Aglaar P•nipr min 5prlion A7LL HC OCEAN WH IAVP IST LAW 02ERK MM----- EJ i r � r i r I r I r I yr k n r S r r � r I I t r r rf�r arm I rr (,�rCfi Z)F - - C.16 Loep E sm mw rb NW 14 orptmw C/L y . (50 LAMTV 8 ,83.6:ialfl aUMM OCEW vimrrr sIP mm TO Sr" 1) TOTAL LOT AREA - 21AW SO: FT. e} fLQW ZOWS ASS Off M PEAT REb'OMEW r9M3 U AM: FRB. 23. PG 91 3) POW 5323 Else 46 W. F-M-EXWI C em RCIO A% L-M MALM 6ULDA G SETRArx LIAF +-AI0Mv0AA:4d5v7w POW 1� TOTAL PROPO M .VW/(IXXJU 3AMFA : Ww S.F. - lr sx ff POCIW LLEARiIV 11OM AREA • is' X 40' - JAW SLF MEEK ARFA AW #4VA D), CANCRM-99W - I'M 9f MMC.[AWOM - rev S.FP. Tp771r_ P3.3x EA S 314�534� .31 4'AM CA W. OCEM _ S T�.i3F9Y 3s£O8' Tp f. PEA' 7 - ---- - DR. B MLE'M'ATER'M E A-X IML C4 WT. OCEAN DR. & AZLW OR b L?W& AL NV M4 RM7FRM LAW s-r-ua I lunw- JVOUNAA?XW SULTRY Fr . SLW%'M YM REP T" `AS r► 3UR r-- Bluewater Associates MMMW PdbM 11 AV ACCOVMNW M W VC STAIR OM OF Pft4tn E FM LAMP 8f11gWY M4 X AWTH CARDLAM, 1w1r-w LOT 13, MOCr A, JU.t1F A"W RAY AND IMT C191C1M ,• . +rr nukv at, ir1m QF' EMMU7& Au OF SAAX 0 L WM= QAi rWW., CARDS'!' COUII M, N.C. M" Bell Su"e plug, P.A. CIVAR PONT IMM � rya SWAB, N.C. MWF84 mm Current Land Ownees Name •7&103 (5� carr Property Location I/. 6,1 b�R 6Y. 1�_ /0f Carteret County HtMth Department SM SKETCH S-3q.30vo778z1.Z6000 Pin# Parcel Ideatificauon Number-15 digits) A A0Us e 951 ¢3'1 Pa•'� 9 U I I7` �r �► � �� DENR I oV�O Aq+ark v.nlar�'q"Oft A PR 0 9 2003 A survey or other plot plan in,n k (not pencf.) May be used as an attachment to the application., it would need to show shape of lot, lot dimensions, structure location with dimensions and setbacks, driveway, and proposed or exLrdng septic system and water source location_ osr Owper.�P—Pull ant Signature lla. THE RM-E X G ROUT' NSF CalSue 1c ' N SFIANS4 b0 THERM -EX GROUT`u is an engineered system for use as backfill material in earth. -coupled heat pump systems. its elevated thermal conductivity and low permeability allow for excellent heat exchange while protecting groundwater supplies. THERM -EX GROUT should be pumped using a positive displacement pump capable of generating pressures in excess of 300 psi. Developed using high swelling Wyoming Bentonite, this new generation of grouting material offers efficient installation of closed -loop geothermal heat pump systems, MAT ERIAL S PECIFIC ATIONS : Thermal Conductivity: .93 Btullur-ft-017 1.05 Btu/hr-ft-°F Permeabi lity : 2 x 10 6 x 10 Solid Content: 64 % 67 % Slurry Weight: 13.6 lbs/gal 14.4 the/gal Slurry Volume/Batch: 29 gals 36 gals APPLICATION RATE: APPROXIMATE VOLUMES FO R GRO UT Drilled Hole Dia. Loop Inside Dia. Anlr. Vol. (cu.ft.lfL) Anlr. Vol. (gal. ft.) 4 3/4 0.08 0.57 4.5 3/4 0.10 0.74 5 3/ 0.13 0.94 5.5 3/4 0.15 1.15 6 3/4 0.19 1.39 5 1 0,12 0.88 55 1 0.15 1.10 6 1 0.18 1.33 The combination of fresh water, THERM -EX GROUT"` and silica sand constitute "the system" for backfilling geothermal loops. Use locally available dry silica sand. For best results, use sand ranging in sire from 30 mesh to 70 mesh (AFS GFN particle size classification 38 to 50), Mix as follows: .93 Biulhr-ft- F 1.05 Rtu hr--ft- F Water 17 gal 20 gal THERM -EX GROUT 1 — 50 Ib bag 1 — 50 lb bag Silica Sand 200 lb 3001b Add the THERM -EX GROUT' to the water while agitating Mix for approximately one minute, then add the sand. Agitate until the sand is uniformly dispersed and pump into place using a tremie line. For best results, place the tremie line near the bottom of the loop and pump into place. Providing local regulations allow, slowly extracting the lrernie line as you come up the hole reduces purrp pressure, aids the grout in setting quicker, and reduces the opportunity for formation damage. To increase work time for deep sets, y ou may add TH1NZ-1TO to the make-up water. Addition rates may vary, but generally 2 ounces to make-up wateryields the desired results. THERM -EX GROffm is packaged in 50 pound bags. WYO-BEN, INC. P.G. Box 1979 Blllings, Montana 69103 Intornet: wwwwyobvn.00rA snwil@?wyoben.00m 800-648 7006 ar(406) 662-6361 THERM —EX GROUT'M PLUS NSF C�AedW NSFIANSI BO THERM -EX GROUT PLUS is an engineered system for use as backfill material in earth -coupled heat pump systems. Its elevated thermal conductivity and low eermeability allow for excellent heat exchange while protecting groundwater supplies. THERM -EX GROUT PLUS should be pumped using a positive displacement pump capable of generat ing p ressures in excess of 300 psi, Developed using high swelling Wy oming Bentonite, this new generation of grouting material offers efficient installation of closed -loop geothermal heat pump systems. MATERIAL S PECIFICATIONS: Thermal Conductivity: 1.13 Btu/hr-ft-OF 1.2 Btulhr-ft °F Permeability: 6 x 10-8 6 x 10 Solid Content: 69 % 71 % Slurry Wei0it: 14.1 lbslgal 15.2lbs/gal Slurry Volume/Batch: 41 gals 41.5 gals APPLICATION RATE: APPROXIMATE VOLUMES FOR GROUT Drilled Hole Dia, Loop Inside Dia. Anlr. Vol. (cu.ft.Jft.) Anlr. Vol. (gal. ft.) 4 3/< 0.08 0.57 4.5 % 0.10 0.74 5 % 0.13 0.94 5.5 3/4 0.15 1.15 6 3/4 0.19 1.39 5 1 1 0.12 0.88 5.5 1 0.15 1.10 6 1 L 0.18 1.33 The combination of fresh water, THERM -EX GROUTT` PL US and silica sand constitute "the system" far backfilling geothermal loops. Use locally available dry silica sand. For hest resuhs, use sand ranging in size from. 30 mesh to 70 mesh (AFS GFN particle size classification 38 to 50). Mix as follows: 1.13 Btuthr--ft-"IT 1.2 Btulhr--tit- F Water 21 gal 22 gal THERM -EX GROUT' PLUS I — 50 lb bag 1 — 50 lb bag Silica Sand 350 lb 400 lb Add the THERM -EX GROUT` PLUS to the water while agitating Mix for approximately one minute, then add the sand. Agitate until the sand is uniformly dispersed and pump into place using a tremie line. For best results, place the tremie line near the bottom of the loop and pump into place. Providing local regulations allow, slowly extracting the tremie line as y ou come up the hole reduces pump pressure, aids the grout in setting quicker, and reduces the opportunity for formation damage. To increase work time for deep sets, y ou may add THINZ-ITt to the rrak-e-up water. Addition rates may vary, but generally 2 ounces to make-up wateryields the desired results - THERM -EX GROUT"` PLUS is packaged in 50 pound bags. WYO-BEN, INC. P.O. Box 1979 Billings, Montana 69103 Internet: www.wyobon.coW. orriail@wyoban.com 800-648 T006 or (406) 652-6391