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Home My WebLink AboutWI0800170_GEO THERMAL_20090626Permit Number Program Category Ground Water Permit Type WI0800170 / Central Files: APS_ SWP_ 06/26/09 Permit Tracking Slip Status Active Project Type New Project Injection Water Only GSHP Well System (5QW) Version 1.00 Permit Classification Individual Primary-Reviewer michael.rogers Coastal SW Rule Permitted Flow Facilit Facility Name Building 24 Brunswick Road Location Address Building 24 Brunswick Rd Southport Owner Owner Name Department of the Army Dates/Events NC 28461 Orig Issue 06/26/09 App Received Draft Initiated 06/22/09 Re gulated Activities Heat Pump Injection Waterbody Name Permit Contact Affiliation Major/Minor Minor Region Wilmington County Brunswick Facility Contact Affiliation Owner Type Government -Federal Owner Affiliation Richard P. Lockwood EP Military Ocean Terminal Sunny Point Southport NC 28461 Scheduled Issuance Public Notice Issue Effective 06/26/09 Expiration 06/26/09 Stream Index Number Current Class Subbasin ~A North Carolina Department of Environment and Natural Resources Division of Water Quality Beverly Eaves Perdue Governor Richard Lockwood, P.E. Depai1ment of the Army Military Ocean Terminal, Sunny Point 6280 Sunny Point Road SE Southport, NC 28461 Coleen H. Sullins Director 6/26/2009 Subject: Acknowledgement of Intent to Construct Type 5QW Injection Well System Permit No. WI0800170 Building 24 Bruuswick Rd Southport, NC 28461 Dear Mr. Lockwood: Dee Freeman Secretary In accordance with the application submitted to the Underground Injection Control (UIC) Program that was received on 6/22/2009, 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 Building 24 Brunswick Rd, Southport, Brunswick County, NC 28461. This system is deemed permitted by rule (North Carolina Administrative Code Title 15A, Subchapter 2C, Section .021 l(u)(2)). However, it is recommended that you contact the Brunswick 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. cc: Wilmington Regional Office -APS Sincerely, O~A-~ , ~ ~A Michael Rogers ~ ' Environmental Specialist GPU-Aquifer Protection Section APS Central Files -Permit No. WI0800170 Brunswick County Health Dept. Mike Hadley (Climate Control Heating & Cooling -102 Middle Street, Jacksonville, NC 28546) AQUIFER PROTECTION SECT ION 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: 919-715-60481 Customer Service: 1-877-623-6748 Internet: www.ncwaterguality.org An EqtJal Opportunity\ Afflrmaiive Action Employer No~i.c .. 01u1 aro11na !Vaturall!f NORTH CAROLYNA RECEIVEDi DENR I jV& Ind PmfaCtlry� .Ca�ICII DEVAK 1 MLNi QV hN V11WNMbNI ANO NA 1 UKAL KLNUUKULN (Nt-UtIVISP $ J: NOTIFICATION OF INTENT TO CONSTRUCT A CLOSED -LOOP GEOTHERMAL WATER -ONLY INJECTION WELL SYSTEM: TYPE 5-OW WELL[ S ) In Accordance with the provisions of NCAC Title 15A: 02C.0200, please complete this notification and mail to address on the back page (please Print or T)ne information). DATE: June 09.2009 Well Type Confirmation: Does the proposed system circulate potable water ont, (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 in'ectin 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(5)IAPPLICANT(S) List each Property Owner listed on property deed (if owned by a business or government agency, state name of entity and a representative wlauthority for signatures; Department of the Army (1) Mailing Address: Military Ocean Terminal, Sunny Point, 6280 Sunny Point Road, Southeast City: Southport State: NC Zip Code: 28461 County: Brunswick Home/Office Tele No.: 910-457-8603 Cell No.: Email Address: Ri ch. Lockwood: (-iUS.Armti .Mil Website: (2) Physical Address of Well Site (if different than above): Building 24, Brunswick Road, Sunny Point City: Southport State: NC Zip Code: 28461 County: Brunswick Home/Office Tele No.: 910-457-8603 Cell No.: S. AUTHORIZED AGENT OF OWNER, IF ANY (if the Permit Applicant doe5 not own the subject property, attach a letter from the property owner authorizing Agent to instal and operate UlC well) Company Name: Contact Person: EMAIL Address: Ad, ^.ss: C, State: Zip Code: Off Tele No.. Cell No.: Jc — — -- Website Address of Company, if any: -County- GPUMC 5QW Notification of Intent Form (RCvised 712008) Page I 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: mhadle y@ bizec.rr.com Address: 102 Middle St. RE~EIVEO I DENR I DWQ Aqwfer Protection Section 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 Hadley EMAIL Address: mhadle y@ bizec.rr.com Address: 102 Middle St. JUN 22 2009 City: Jacksonville Office Tele No.: State: NC Zip Code: _28546 __ County:"""O"""n=s=lo"'"'"w"--- 910-353-9040 Cell No.: _910-376-1100_ E. STATUS OF APPLICANT Private: State: Federal: X Municipal: __ Commercial: Native American Lands: F. INJECTION PROCEDURE (briefly describe how the injection well(s) will be used) Closed Loop Geothermal Heat Transfer S vstems G. WELL CONSTRUCTION DATA (1) Proposed date to be constructed: _June -2009 ___ Number of borings: l __ _ 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_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 _O ___ to _250_ (feet) If well has casing, indicate grout depth: from ____ to ____ (feet) GPU/UIC 5QW Notification oflntent Fonn (Revised 7/2008) Page 2 H. 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. I. 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 well(s) 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 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 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 infonnation submitted in this document and all attachments thereto and that, based on my inquiry of those individuals immediately responsible for obtaining said information, 1 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 a]1 related appurtenances in accordance with the approved specie- •ations and co ditions of t ie Permit." 1 Signature of Fro erty Owner/Applicant. If. �iA�ar� ►t - �war� � P'� Prinj o Type Full Name and title LAWW RECEIVED 1 DENR I DWQ Aquifer Prateetiatl See foil JUN 2220 Signature of Property Owner/Applicant Print or Type Full Name and title Signature of Authorized Agent, if any Print or Type Pull Name and title Please return two copies of the completed Application package to: North Carolina DENR-DWQ Aquifer Protection Section-UIC Program 1636 Mail Service Center Raleigh, NC 27699-1636 Telephone (919) 715-6935 OPUMIC 5QW h'ntification of Intent Form (Revised 7/2008) Page 3 26 // I / I _./ / / / / 1 uA Sip �:rreemn! G ranNAm n•Grovn Gehha,will. r ,�• � 13� ai _ r to � 1 1 ® i PI neY Green � .21 KCenerl iH5 A M S P" S 1I o S 41 NBC lwlk. + • ' dr. 4 ] ArndemY �1 Alltryrille,�� Salemhl+rg C�i_'tan r11Fj cowl, CFll�s•`¢hdm :r sCC d •� � chi � 5 El1R L A D •Plgdrnharu 14. 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