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Home My WebLink AboutWI0800199_GEO THERMAL_20100623' Permit Number WI0800199 Program Category Ground Water Permit Type Injection Water Only GSHP Well System (5QW) Primary Reviewer michael.rogers Coastal SW Rule Permitted Flow Facilitv Facility Name Wesley Cox SFR Location Address 155 Cedar Point Blvd Cedar Point Owner Owner Name Wesley Dates/Events NC 28584 Cox Orig Issue 06/17/10 App Received Draft Initiated 06/17/10 Reg ulated Activities Heat Pump Inj ection Private re sidence, single fami ly Outfall NULL Scheduled Issuance Central Files: APS_ SWP_ 06/23/10 Permit Tracking Slip Status Active Project Type New Project Version 1.00 Permit Classification Individual Permit Contact Affiliation Gail D. Cox 81609 Alexander Chapel Hill Major/Minor Minor NC Region Wilmington County Carteret Facility Contact Affiliation Owner Type Individual Owner Affiliation Wesley Cox Owner 81609 Alexander Chapel Hill Public Notice Issue 06/17/10 NC Effective 06/17/10 27517 27517 Expiration Waterbody Name Stream Index Number Current Class Subbasin , Beverly Eaves Perdue Governor Wesley Cox Gail Cox 81609 Alexander Chapel Hill, NC 27517 AVA NCDENR North Carolina Department of Environment and Natural Resources Division of Water Quality Coleen H. Sullins Director 6/23/2010 Subject: Acknowledgement oflntent to Construct Type 5QW Injection Well System Permit No. WI0800199 155 Cedar Point Blvd. Cedar Point, NC 28584 Dear Mr. and Mrs. Cox: Dee Freeman Secretary On 06/17/2010, the Aquifer Protection Section (APS) received notification of your intent to construct a closed-loop water-onl v geothermal injection well system for the operation of a ground-source heat pump located at the address referenced above. An individual permit is not required for the construction and operation of this type of geothermal injection well system as long as the following conditions are met: 1. The 1.njection well system contains only potable water, 2. The injection well system is constructed in accordance with well construction standards specified in North Carolina Administrative Code Title 15A Section 2C Subchapter .0213, and 3. The required notification form and associated maps have been completely and accurately submitted. Failure to comply with all of these conditions constitutes a violation of the North Carolina Well Construction Act and North Carolina Administrative Code Title 15A Section 2C Subchapter .021 l(u)(2). Additionally, you should contact the Carteret County Health Department as they may have additional requirements for this type of system. Noncompliance with applicable state, county, or municipal rules and regulations may result in the assessment of civil penalties. Please contact Mike Rogers at (919) 715-6166 or Michael.Ro !!:ers@ncdenr.2ov if you have any questions. cc: Wilmington Regional Office -APS APS Central Files -Pem1it No~ WI0~00! 99 Carteret County Health Dept. ;· gcd)l>l0 forDe~atts Supervisor Jim Cornette (Applied Resource Management, P.C., P.O. Box 882, Hampstead, NC 28443) John White (Carteret Heating and Cooling, 151 Cedar Point Blvd., Cedar Point, NC 28584) 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 I Customer Service: 1-877-623-6748 Internet: www.ncwaterquality.org An Equal Opportunity I Affirma i;ve Action Employer N~ithCarolina /Vatural/!f NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES CNCDENR) NOTIFICATION OF INTENT TO CONSTRUCT A CLOSET] -LOOP GEOTHERMAL WATER -ONLY INJECTION WELL SYSTEM TYPE 5-QW WELL In Accordance with the provisions ofNCAC Title 15A: 02C.0200, please complete this notification and mail to address on the back page (please Print or Type information). DATE: June 14.2010 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_ Nu Do Not complete this form. Complete other UIC application forms for installing either a 5A7 well ❑ en -loop wel I iniectin 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)IAPPLICANT(S) List each Property Owner fisted on property deed. (if owned by a business or government agency, state name of entity and a representative wlauthority for signature): Wesle4 and Gail Cox (1) Mailing Address: 81609 Alexander City: _ Chapel Hill State: NC Zip Code: 27517 County: Chatham Horne/Office Tele No.: 919-604-3913 Cell No.: Email Address: wdoncoxr evahooxom Website: (2) Physical Address of Well Site (if different than above): 155 Cedar Point Blvd City: Cedar Point State: _NC_T Zip Code: 28584 County: Carteret Home/Office Tele No.: 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 U1C well) Company Name. - Contact Person: EMAIL Address: Address: City: State: Zip Code: County: Office Tele No.: Cell No.: R&C61140 i „ENR , r.M Website Address of Company, if any: Aquifer ProL-Mon Sectbrl JUN 1.7 2010 Gf U/UIC 5QW Notification of hAtnt'Form (Revised 8/2008) Page I C. WELL DRILLER INFORMATION Company Name: A pplied Resource Manag ement. P.C. Well Driller Contractor's Name: ~H~. M~ic=h=a=e=---1 =Sa="=e~---------------- NC Contractor Certification No.: 2531-A Contact Person_: ~J~im~C~o~m~e_tt~e __________ =E=MA=-==IL=---A~d=dr~e=ss~:-'J=im=---~A=RM_@ ___ b_e_ll_so_u_th_._n _et __ _ Address: P.O. Box 882 City: Hampstead Zip Code: 28443 County: ---"'-P"""'en=d=e=r ________ _ Office Tele No.: 910-270-2919 Cell No.: 910-512-4890 D. HEAT PUMP CONTRACTOR INFORMATION (if different than driller) Company Name: Carteret Heating and Cooling Contact Person: John White EMAIL Address: john@ carteretheatingandcoolin g.com Address: 151 Cedar Point Blvd City: Cedar Point Zip Code: 28584 County: ------'C=a=rt=e=re""'t _____ _ Office Tele No.: 252-393-7712 Cell No.: 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 system. Water only. grouted along the loo p's entirety . G. WELL CONSTRUCTION DATA (1) Proposed date to be constructed: ___ 6~/2=8=/~l =0 ______ Number of borings: __ 4'----- Approximate depth of each boring (feet): ___ 2~5~0' _____ _ (2) Type of tubing to be used (copper, PVC, etc): __ HD_P_E ____________ _ (3) Well casing. Is the well(s) cased? (check either (a.) Yes!!! (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 Other (specify) _Thermex __ _ (b) Grout placement: Pumping__ Pressure_X _ Other (c) Grout depth of tubing (reference to land surface): from ___ to ___ (feet) If well has casing, indicate grout depth: from ___ to ____ (feet) GPU/UIC 5QW Notification oflntent Fonn (Revised 8/2008) Page 2 06/14/2010 10:49 PAX 919 997 7229 W DON COX INS. 160031003 IL IINJECITON-RELATED EQUIPMENT Attach a diagram showing thw eagioaermg layout or proposed modificatimL of the injecdon equipment and exterior piping/tubing associated with the injectian operation- The manufacturer's brochuum may provide supplementary infounation. I, LOCATION OVWEI L(S) Attach two copies of maps shoving the following information: (1) Include a Site Map fun be drawn) showing_ buildings, properly line-, meace water bodies, potential sources Of groundwater contamination Aud the orientation of and distances between the proposed well(s) and any costing well(5) or waste disposal facilities such as septic tatik:s or drain fields located within 200 feet of the geothermal heat pump well syster3a. label all features clearly and include.a north s_t]w. (2-) The Site Map IImst ghaw the subject property in relation to the mnourtding area by using at least two fixed reference points Rich as roads_ surams, and/or highway intersections. J. CERI`IFICATION Note: This Permit Applicmtion must be signed by ezch person appearing on the recorded legal property deed. 11 hereby certi'y, under penalty of law, that I have personalty examined and am fararaisr with the information Submitted in skis doWMCnt cad all attachments thereto and that, bago-d on my inquiry of those individuals immediately respoanoble for obtaining said information, I believe that she kformation is true. accurate and complete. I am aware tbat their sue significant peaalties, including the passibility of fides and impt'iw=ent, for Submitting f "Or information. I agree to- constiirct, operate, maintain, repssr, And if applicable, abandon the injcotion well and all rclatcd appurtenaaoes is arordance with the approved spec^-ifioad(ms and conditions of the Permit_' Signature of arty (�nmer/Ax plicaut Print or Type Frill Name and titla Signature of Propuly Chun Applicant CT *t( D. C4� Pmt or Type Fall Name xnd title Signanite of Authorized Ageat, if any. -Print or Type Full Name and tide Please rettun two copies of the completed Application pacicage to - North Cantina DENR-DWQ Aquifer krolecti0n Section-UIC Proglrarsl 1636 Mail Service Center Raleigh, NC 27699-I636 Telephone (919) 715-6935 Cr U1= 5QW NoU&Aian of to� Foam Okcviacd MEM) RECEIVED I ❑ENR 1 DWQ page 3 Aquifer Protection Section JUN 1.7 nio 14 -Vr r � ► r, ti Approximate Property Lines Approximate Closed Loop Locations, Spaced 20' apart N Notes: Public water and septic systems are utilized in the area. Existing structure removed from property. Adapted from Google Earth and Beaufort County GIS Map, June 2010. TITLE: SITE MAP FIGURE: died ReSouree Manaiement PG 155 CEDAR POINT BLVD n Box mps eW. I JOB: SCALE: [SATE: DRAWN BY: f [910] 270-2919 Fax 270 2988 Cox NTS I 6/14/ 10 DNH L r' u _3-, • r. j� . 1 l ` � . I Subject Property Note: Adopted from Google Earth Map, June 2010. TITLE: OVERALL SITE MAP FIGURE: lied Kosource Marla ement f C --- 155 CEDAR POINT BLV❑ ❑mpg ea ! JOB: SCALE: DATE: DRAWN M3 At4id] 270 29}9 FAX 27�-2988 Cox AsShown 6/14/10 DNN Approximate Property Lines Approximate Closed Loop Locations, Spaced 20` apart Notes: Public water and septic systems are utilized in the area. Existing structure removed from property. Adapted from Google Earth and Beaufort County GIS Map, June 2010. TITLE: SITE MAP FIGURE: At lied Resource Management PG 155 CEDAR POINT BLVD JOB: SCALE: DATE: DRAWN BY: 910) 270-2919 FAX 270-2988 Cox NTS 6/14/ 10 DNH 2 Subject Property Note: Adapted from Google Earth Map, June 2010. TITLE: OVERALL SITE MAP FIGURE. lied Reeource Management PC 155 CEDAR POINT BLVD Box mps ea Job: SCALE: ; DATE: DRAWN BY: �9�0� ��o �� Fax 7�a 2�as Cox As Shown ! 6/14/1 Q DNH 3 WATERWORKS ... July 1, 2010 Post Office Box 882 Hampstead, NC 28443 (91 OJ 270-2919 Fax (91 OJ 270-2988 NCDENR, Aquifer Protection Section Attn: Mr. Michael Rogers 1636 Mail Service Center Raleigh, North Carolina 27699-1636 RE: Permit# WI 0800199 Cox Residence 155 Cedar Point Blvd. Dear Mr. Rogers, - I am enclosing some revised drawings for the above referenced permit. The owner requested that we drill an additional 250' Geothermal Loop for their HVAC unit. Figure 1 is a Revised Site Map that shows the addition of the fifth loop, as well as a change to the location of the septic tank and pump tank. Figure 2 is a Revised Site Map that has the correct property outlined and the additional loop marked. Please update the file and let me know if any further information or forms are needed. Sincerely, @~~ Diana Helias Project Coordinator RECEIVED I DENR / DWQ Aquifer Protection Section JUL 08 2010 it I k LIN. �• i 204 . Approximate Property Lines Approximate Closed Loop Locations, Spaced 20' apart Approximate Additional Closed Loop Location Notes: Public water and septic systems are utilized in the area. Existing structure removed from property. Adapted from Google Earth and Beaufort County GIS Map, June 2010 N Revisions: Correct property lines are outlined Additional Geothermal Loop has been added TITLE: REVISED SITE MAP FIGURE: „lied }�e�our�e Mana,emerr� Fc _ _ 155 CEDAR POINT BLVD7 FU x 682, HOMPSteW, NC 2b443 JOB: SCALE; DATE; DRAWN BY: 19701 270-2919 FAX 270-2988 Cox NTS 711110 DNH 2 A pia al ty�p,�laN p.Itr� NnME N�K' �, i� VjZ Ski UW 8 A ' � ;s sD gd. ig F� r ❑ 4 .4 Al Approximate Closed Loop Locations Notes: - Public water and septic systems are utilized in the area. - Adapted from Municipal Engineering Services Company Map " �o�� 5 G 3 dated January 6, 2010. 9 'f G ME: SITE MAP FIGURE: 155 CEDAR POINT BLVD JOB: SCALE: DATE: DRAWN BY: Cox 1" = 1& 6/14/10 DNH A(lied Kroouree Management 11C P , Box 8 ampsiead, NC 28443 910) 270-2919 FAX 270-2988 i Z d .1 A 1FG ,5 V g.4jr 2 A PRO ��yDAT1p� P ILA HQMp MAx' �. C2 CDR ?A A. E t gUE 4,1 ray F G Approximate Closed Loop Locations Notes: - Public water and septic systems are utilized in the area. - Adapted from Municipal Engineering Services Company Map dated January 6. 2010. 2N, 2. 2 TITLE: SITE MAP FIGURE. 155 CEDAR POINT SLVD JOB; SCALE: DATE: DRAWN BY. Cox 1" = 15' 6/14/10 DNH 7kL;lied Resource Mana ement PG ,P,0- Box 2, Ham 8443 910) 270-2919 FAX 270-2988 1., 2• g,4A- P. 21 PIL� HbM2 X� 2' L2 g�R MA 2.4 �►� •4 r play ID lag $�`� f& - S ' aI� .9o• . �d G' " ° 1 � -4L F G ❑ l 3 ,1 k F I. 2 IK 4 98 �. b a Approximate New Septic Tank Q~ and Pump Tank Loccation FG 4.9 �' Approximate Existing Closed Loop Locations tr 3. nG. p Approximate Additional Closed Loop Location Revisions: Additional Geothermal Loop has been added, Septic Tank and Pump Tank relocated Notes: - Public wafer and septic systems are utilized in the area. - Adapted from Municipal Engineering Services Company Map dated January 6, 2010. TITLE: REVISED SITE MAP FIGURE: 155 CEDAR POINT BLVD JOB: SCALE: DATE: DRAWN BY: Cox 1 " = 15` 711110 DNH ;��:lied �e5ource Mana.:ement F'� ox 882, Hampstead N 28443 (41 p� 27D-2414 FAx 27Q-2988