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Home My WebLink AboutWI0800202_GEO THERMAL_20100716'Permit Number WI0800202 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 98 E First Street Location Address 98 E First St Ocean Isle Beach Owner Owner Name NC Sand Fleas Investment Fund LLC Dates/Events 28469 Central Files: APS_ SWP_ 07/16/10 Permit Tracking Slip Status Active Project Type New Project Version 1.00 Permit Classification Individual Permit Contact Affiliation H Michael Sage Driller Well PO Box 882 Hampstead NC Major/Minor Minor Region Wilmington County Brunswick Facility Contact Affiliation Owner Type Unknown Owner Affiliation James L. Bierman PO Box 6834 Ocean Isle Beach NC 28443 28469 Orig Issue 07/16/10 App Received Draft Initiated Scheduled Issuance Public Notice Issue Effective 07/16/10 Expiration 07/06/10 07/16/10 Re g ulated Activities Heat Pump Injection Outfall l'':JU Waterbody Name Stream Index Number Current Class Subbasin WDER North Carolina Department of Environment and Natural Resources Division of Water Quality Beverly Eaves Perdue Co#een H, Sullins Govemor Director 7/16/2010 Sand ]"leas lnvesttnew Fund LLC Larnes L. Bierman, Manager PO Box 6834 Ocean Isis Beach. NC 28469 Subject: Acknowledgement of Intent to Construct Type 3QW Injection Well System Permit No. W10800202 98 E. Fitt Street, Clean Isie Beach, NC 28469 Dear Mr. Bierman: Dee Freeman Secretary On 71612010, the Aquifer Protection Section (APS) received notification of your intent to construct a closed -loop water-onl,. geothemal 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: The injection well system contains only potable water. The injection well system is constructed in accordance with well construction standards specified in North Carolina Administrative Code Title 1 SA Section 2C Subchapter .0213, and 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 .0211(u)(2). Additionally, you should contact the Brunswick 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•Roeers(umcdenr.sov if you have any questions. Sincerely. CkAJO, A for Debra ❑rats Supervisor cc- Wilmington Regional Office - APS APS Central Files - Permit No. WIV800202 Brunswick County Health Dept. ilpnlied Rc.murne Mgn}t (.3im Cornette. PO Box 882, Hampstead, NC 29443) First Ocean Air (Myase Morgan, 7369 Pir:way Rd, Longwood, NC 28432) AQUIFER PRG_CTION SECTION 1636 Mail service Center, Raleigh. North Caroline. 27699-1636 LomWn: 2728 Capllal Boulevard, Raleigh, Nrsth Carolina 276W. Phone: 919.733-3221 1 FAX t 919.71s4)588, FAX, 2; 919-7I.W48 r. Customer Service- 1-877-623 6748 Internet' WHw-mWater0uality,om An Epriai 4pp7rft y t AirimDilve Am mn Emp Dyer NorthCarotina Natlfr`ally NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL, RESOURCES (NCDENR) NOTWICATION OF INTENT TO CONSTRUCT A CLOSED -LOOP GEOTHERMAL WATER -ONLY INJECTION WELL SYSTEM: TYPE 5- W WELL(S) 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 lvoe information). DATE: July I . 2010 V � 1 crio W �,D a- A. B. WfeR 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 (oven -loop well in�g 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)_ PROPERTY OWNER(S)IAPPLICANT(S) List each Property Owner listed on property deed (if awned by a business or government agency, state name of entity and a representative wlauthority for signature): Sand Fleas Investment Fund. LLC James L Bierman - Manasuer (1) Mailing Address: P.O. Box 6834 City: Ocean Isle Beach State: _NC Zip Code: 28469 County: Brunswick Home/Office Tele No.: 9I0-632-7180 Cell No.: Email Address: JimLBierman1&vahoo.com Website: (2) Physical Address of Well Site (if different than above): 98 E. First Street City: Ocean Isle Beach State: NC_ Zip Code: 28469 County: Brunswick Home/Office Tele No.: 91"32-7182 Cell No.: 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.: RECEIVED ! OENR 1 DVV Q Website Address of Company, if any: fifer Prnten#lon 5gctivrt GPU/k)IC 5QW Notification of Intent Form (Revised 8/2008) JUL 06 20in Page 1 C. WELL DRILLER INFORMATION Company Name: A pp lied Resource Management, P.C. Well Driller Contractor's Name: _H_. M_ic_h_a_el_S_a~g~e ________________ _ NC Contractor Certification No.: -----=2=5=--3-"---I---=--A=------------------------ Contact Person: Jim Cornette EMAIL Address: Jim ARM@ bellsouth.net Address: -----=-P"""'.O"-'.--=B"'"'o""'"x=-8=8=2'--_________________________ _ City: Ham pstead 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: ___ F=-1=-·rs=t"""'O"""'c'""e=an~A=ir'------------------------- EMAIL Address: Contact Person: M vase Morgan Address: 7369 Pirewav Road City: Longwood Zip Code: 28452 County: ----=B=--=ru--==ns=w__,__,i=ck=------------ Office Tele No.: 910-287-3494 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 loo p geothermal svstem. Water onl y. grouted alon g the loo p's entirety. G. WELL CONSTRUCTION DATA (I) Proposed date to be constructed: ___ 7/_9_/l_0 _____ Number of borings: __ 8 __ _ Approximate depth of each boring (feet): ___ =22=5'-'----- (2) Type of tubing to be used (copper, PVC, etc): _HOPE ____________ _ (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) (b) (c) Grout type: Neat Cement __ Bentonite Other (specify) _Thermex __ _ Grout placement: Pumping__ Pressure X Other Grout depth of tubing (reference to land surface): from __ 0 __ to 225 (feet) If well has casing, indicate grout depth: from ____ to ____ (feet) GPU/UIC 5QW Notification of Intent Form (Revised 8/2008) Page 2 06/30/2010 13:51 FAX 7042160139 FRECISIOIdTE1i U001 H. INJECTI0N-RELATi® FQUiPMENT Attach a diagram showing the engkieeri ug layout or proposed modification of the injection equipment and eamerior ptingltubing associsaed with the injectaift operation_ The manufacer's brochure nmy provide supplementary informatiom. I. LOCATION OF %Ta."S) Attach two .dies of maps showing the following information; (1) Made a Site Map (can be dmawa.) showing, buildings, property Tines, surface water bodies, potmdal sources of groundwater contamination and the orientation of and distances between the proposed well(s) acid any existing well(s) or waste disponI facilities such as septic teaks or &-ain fields located within 200 feet of the geothemmal heat pump well system. label all features clearly artd incfu� g north amw. (2) The Site Map must show the subject prop=V !A relation to the sutrouading area by using at least two fixed reference points such as roads, streams, and/or highway indermctiow. J. C 11T.EFICATIG Note; This Permit Application mast be sighed by gash persam appmAng an the recorded iepi property deed. 'I hereby certify, under penalty of law, that l have personally examined and am familiar whit the intortaatitm submitted in this document and all attachments thereto and that, based on my inquiry of those individuals immediately responsible for obWning said information, I believe that the information is true, accurate and complete. I am aware that theca are slgni'ficant penalties, including the possibility of ffm and imprisonment, for subrnittiug false infotmati nz. I agree to construct, operate, Maintain, =pair, and if applicable, abandon the injection well and all related appurtenan es in awArdimce with the agrvved speciocador�d conditions of the Permit" w ur Tj pe ktull Name and 5igatze of Pmpc* Owner/Applicsn[ Pratt or Type Full Name and title Sigpature of AW=rIzed Agea, if my Print or Type Full Name card title Please return two copies ofthe completed Application package to: North Carolina DENR-DWQ Aquifer Protection Section-UIC Frogram 1636 Mail Service Center Raleigh, NC 17699-1636 Telephone (919) 715.6935 OPU/U[C 5Qw NoaQ;n = of I mt Form, (krvisad 8 ON) �� Q�V� � 1 D�Ni� 1 Pw3 roreckio� 5�� Approximate Property Lines Approximate New Structure Location Approximate Closed Loop Locations N s 1 Notes: 1. Subject property and surrounding area are currently serviced by public water and sewer. 2. Geothermal well locations are approximate and will be a minimum of 20' apart. 3. Structure shown on the aerial photograph has been destroyed and ❑ new structure is being built. Adapted from Brunswick County GIS Map, July 2010. TITLE: SITE MAP FIGURE; ❑ ;Hed Resource M Ma. ement i'C 98_E_ FIRST STREET, OCEAN ISLE BEACH Box d82, Hampste00, NC 2844:3JOB; SCALE: DATE: DRAWN BY: (910) 270.2939 FAX 270 2988 Bierman 1 " = 45' 711110 DNH Approximate Property Lines Approximate New Structure Location Approximate Closed Loop Locations N r Notes: 1. Subject property and surrounding area are currently serviced by public water and sewer. 2. Geothermal well locations are approximate and will be a minimum of 20' apart. 3. Structure shown on the aerial photograph has been destroyed and a new structure is being built. Adapted from Brunswick County GIS Map, .July 2010. TITLE: SITE MAP FIGURE: lied K-oource Maria emerit pC 98 E, FIRST STREET,_ OCEAN ISLE BEACH Box 662, Hampstead, NU 2U443JOB: SCALE: 1DATE: DRAWN BY: (7i 910) 270-2919 FAX 270.2988 Bierman 1 " _ 45' 711110 DNH Brunswick County, NC Parcel plumber 25BA O 13 160633620 Plat Date V$1,440 POO I so Account Number 1 Land Value PIN 107518315243 Building Vakie Owner SAND FLEAS INVESTMENTS FUND L.LC Other Value 1$2,130 I$0 $1,442 ,130 Owner AddressI %JAMES L BIERMAN Deferred Value Owner Address 2 PO BOX 6834 Total Taxabb Value Crty State OCEAN ISLE BEACH NC Heated Sq Ft Year Built Zip 28470 Bedrooms r 6006 Legal Description L-15+PT 14 B-11 S-B OIS PL-31179 Full Baths Parcel Street Number 98 Stories Parcel Street E. FIRST Ext. Wall I Street Type ST Ext. Wall 2 Street D r Nergiftrhood Subdivision Municrp * OCEAN ISLE BEACH Deed Book 1126 Fire Tax DLstrwt OCEAN ISLE Head Page 0116 Township SHALLOTTE Deed Bate 11129A997 jAcrea6w Sale Price so Plat Book Plat Page Disclaimer: Map and parcel data are believed to be accurate, but accuracy is not Map Scale guaranteed. This is not a legal document and should not be substituted for a title search, 1 inch = 90 feet appraisal, survey, or for zoning verification. htto:lleis.brunsco.netlt3rintPreview.astax?Pn'ntat)tData Brunswick Counts-NCIO101trueifaise.. 71112010 Bruns-wi& County, NC Parcel N amber Account Number P& 25SA1013 j Plat Da to Lana Valise _ $1,440 Q00 $0 $2,130 $0 160633620 107518315243 Building Wade Owner SAND FLEAS INVESTMENTS FUND LLC Other Value Owner Address I % JAMES L BIERMAN Deferred Valise Owner Address 2 city S#ate zip PO BOX 6834 OCEAN ISLE BEACH NC 28470 Total Taxable Value bleated Sq Ft Year Bui# Bedrooms $1,442 ,139 F 6005 LegalDescri#ion L-15+PT 14 B-1 i S-B OI B PL 3/179 Full Baths Parcel Street Number 98 Stories Parcel Street E FIRST EWt Wall I Street Tyre ST Ext. Wail 2 Street Dk Neighborhood Subdivisian 11128 MunicipalW OCEAN ISLE BEACH Geed Book Fire Tax District OCEAN ISLE Deed Page 6116 11MA997 Township SHALLOTTE Deed date acreage Plat Book Sale Prive Disclaimer- Map and parcel data are believed to be accurate, but accuracy is not Map Scale guaranteed. This is not a legal document and should not be substituted for a title search, 1 inch = 9� feet appraisal, survey, or for zoning verification. httr):f/cis.brunsco-neVnn'ntPreview-asux?PrintOt>tData=Brunswick County. NCI 010itruelfalse--- 71112010