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HomeMy WebLinkAboutWI0800220_GEO THERMAL_20110106Permit Number Program Category Ground Water Permit Type WI0800220 / Injection Water Only GSHP Well System (5QW) Primary Reviewer michael. rogers Coastal SW Rule Permitted Flow Facilitv Facility Name BEQ Hadnot Pt Location Address Beq Hadnot Pt P-1104 P-1193 Camp Lejeune NC Owner Owner Name McB Camp Lejeune Dates/Events 28547 Orig Issue 01/06/11 App Received Draft Initiated 12/02/10 Re ~ulated Activities Heat Pu mp Injection Outfall ' I Scheduled Issuance Central Files : APS_ SWP_ 01/06/11 Permit Tracking Slip Status Active Project Type New Project Version 1.00 Permit Classification Individual Permit Contact Affiliation Mike Hadley Driller Well 102 Middle St Jacksonville NC Major/Minor Minor Region Wilmington County Onslow Facility Contact Affiliation Owner Type Government -Federal Owner Affiliation Carl H. Baker Deputy Officer Public Works Building 1005 Camp Lejeune Public Notice Issue 01/06/11 NC Effective 01/06/11 28546 28547 Expiration Waterbody Name Stream Index Number Current Class Subbasln t....R CDENR North Carolina Department of Environmem and Natural ResourcAs Division of Water Quality Beverly Eaves Perdue Goleen H. Sufiins Governor Gimctor 11(,' 201 11 Carl Baker — Deputy Public Works Director Mr,B C.amli Leietlne BuiIdin_ 1005 Michael Road MCD Camp Leieune.. NC28547 Subject: Acknowledgement of Intent to Construct Type SQW Infection Well System Permit No. W10900220 BEQ Hadnot Pt. P• 1 104 P-1 193. N1 1CB Camp Lejeunc. NC29';47 Dear )4;-. bake; Gee l=reeman Secretary On 12117J2010, the Aquifer Protection Section (APS) received notification of your intent to construct a closed -loop water-onl- 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 ❑f this type ❑f geothermal injection well system as long as the following conditions are met: I. The injection well system contains onty potable water, 2. The injection well system is constructed in accordance with well construction standaMs 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 .0211(u)(2). Additionally, you should contact the Onslnw 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.Roeersiamcdcnr.yov if you have any questions. Sincerely, owfl kir Debra H atts 5wper<�:.n� cc- N'ilmingion Regional Office- APS APS Central Files -Permit No. Wlt 9002i20 Onsiriw C'ounta irlealtu ❑cpartnicw Coastal Gmthemial {Mik;: Hadley - 102 Middle. St_.lacicsonville. NC 283 t6y A01;IFER FPOTFU1014 SECTION 1fU Mail aenmc Center . &aiogh. Wen Cadhe 27B9 -1636 Lwation; 2128 Gaml 8oui-vard. kalotgh, North Carniina 27W plwne 916.723--3221 � FAX t: �1715r588: 50V, 2 gi9'1S-66481 Usmer SarvrE- 1-8r,-&K 9748 In!eFnet. www-nrwatempalitv.arc >.r et;al01VW%Jnhv �Afhr. mtveArV,4 -En, ftcT ,One Noil h( r arofi3:a NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES (NCDENR) NOTI17ICATION OF INTENT TO CONSTRUCT A CL0k13-L-Q0P GEOTHERMAL WATER -ONLY INJECTION WE' 'YSTEM: TYPE 5-OW WELLt In Accordance with the provisions of NCAC Title 15A: +. .. '00, please complete this notification and mail to address on the back page (please Print or Type information). DATE: Nov.23.2010 Lc<� Well Type ConfxrnmWon: 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 UTC application forms for installing either a 5A7 well (open -loop well in�Iecting 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 listed on property deed (if owned by a business or government agency, state name of entity and a representative wlauthority for signatures; MCB Camp Lejeune ATTN: Carl H. Baker, Deputy Public Works Officer (1) Mailing Address: Building 1005 Michael Road City: MCB Camp Lejeune State: NC_ Zip Code: 28547 County: Onslow Home/Office Tele No.: 9I0-451-2213 Cell No.: Email Address: cart.h.bake1?44usmc.mil (2) Physical Address of Well Site (if different than above): BEQ Hadnot Pt. P-1104 P-1193 City: _ MCB Camp Lejeune State: NC Zip Code: 28547 County: Onsiow Home/Office Tele No.: 910-451-2213 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: Gt' UIC 5QW Notification of Intent Farm (Revised 7/2008) Page t 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:_N/A _____________________ _ Contact Person=-: -----------=E=MA~=IL~A=d=dr~e=ss==---------- Address: ________________ _ City: ___________ S_ta_te_: __ Zip Code: _____ County: ______ _ Office Tele No.: Cell No.: ___________ _ 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 Loo p Geothermal Heat Transfer Systems G. WELL CONSTRUCTION DATA (1) Proposed date to be constructed: Dec/2010 thru June 201 l ____ Number of borings: _198 Approximate depth of each boring (feet):_350' _____ _ (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) Grouttype: NeatCement__ Bentonite_x_ Other(specify) ______ _ (b) Grout placement: Pumping_X_ Pressure__ Other (c) Grout depth of tubing (reference to land surface): from _O ___ to _350_ (feet) If well has casing, indicate grout depth: from ___ to ____ (feet) GPU/UIC 5QW Notification of Intent Form (Revised 7/2008) Page2 H. INJECTION -RELATED EQU PMEN 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. L 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 retarded legal property deed. "1 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. t ant aware that there are significant penalties, including the possibility of fines and imprisonment, for submitting false information. I agree to construct, operate, i!)r ntain, repair, and if applicable, abandon the injection well and all related appurtenances in accordance with the mppi oved s cations and conditions of the Permit." 'Sig afore of etty Owner/Applicant Carl Baker, Deputy Public Works Officer Print or Type Full Name and title Signature of Property Owner/Applicant T Print or Type Fuil Name and title Signature of Authorized Agent, if any Print or Type Ful i Name and title M Please return two copies of the completed Application package to: tZ:7 m North Carolina DENR-DWQ � ZI a Aquifer Protection Section -[)IC Program c 1636 Mail Service Centerrn Raleigh, NC 27699-1636 Telephone (919) 715-6935 CZ GPU/UtC 5QW Notification of Intent Form (Revised 7/2008) Page 3 Bing Maps Page 1 of 1 Print this page in a more readable format: Click Print next to the lower -left oormr of the map. �^''FFii Jl� �L Vef Srf SIL Id <%n '- PF Sft &tis9inia Darya Ds Cst � OC a Business, address, or landmark B Business, address, or landmark Add to route http://www.bing.com/maps/default:aspx?wip--2&►--Z&rtV-&FORM=MSNH 12/1/2014 g M 0 � rl 1 r 1JJ' ! rl =r.INOD i� .1 P «OPO En- �'a' I .I HTITS_, I�.Ii{ _ - - k 1 ar{}y�I;J� lllllJ,Illillll:ll11111111111111`J--T- -�- U _ -- Z -T-' -c--r=T� -�^_ rye � � -k.- � a. -1 -� _ � •i ? �`` � � 1� � 1 . � �■�`���� �� 1 i r f llllllllllillllllFill 1� �i A I I I t III . r � I i ■ 1 I ■ I f . t � I .■ 1 1 . 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