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HomeMy WebLinkAboutWI0800246_GEO THERMAL_20160712Water Resources ENVIRONMENTAL QUALITY Julia Lammert 4816 Wedgefield Drive Wilmington, NC 28409 June 27, 2016 PAT MCCRORY Gvvenwr DONALD R. VAN DER VAART Secretary S. JAY ZIMMERMAN Di r ec/or JUL 122ms water Quality . Subject: Geothermal well sampling results Permit Number WI0800246 ·nsSectiO" Reg\ona\ o1)8181i0 New Hanover County Dear Mrs; Lammert: On May 18, 2016 staff from the Division of Water Resources sampled the influent and effluent from your geothermal heat pump system's wells. The samples were analyzed by the Division's laboratory for coliform, total dissolved solids, metals, nitrates and other inorganic constituents. No exceedances of the State Groundwater Standards were observed. A copy of the lab results are enclosed for your review. Should you have any questions concerning this letter, please feel free to contact me at (910) 796-7215 or by email at geoff.kegley@ncdenr.gov. Enclosure: sample results cc: Shristi Shrestha, DWR Central Office Sincerely, ~~//4F7 Geoff Kegley Water Quality Regional Operations Section Wilmington Regional Office Division of Water Resources, NCDENR State of North Carolina I Department of Environmental Quality I Division of Water Resources 127 Canlinal Drive Ext., Wilmington, NC 28405 919 796 7215 l~t:{O, \ 9 North Ca:rolma D1v1s1on of Water Resources I -----.. - Water Sample Collection & Submittal Form Visit ID: !Tag r Central Laboratory (Water Sciences Section) (opt1onal) ID AC29175 --- ocatJon DescrlP.,tlor WI0800246 T ocation Code Date Received: 5 . ) q . } (Q County: new hanover Collector: G Kegley Priority: Water Matrix Location Type: Time Received: l-DO DWRReglon: W1RO D WROffice: DWR-WQQROS 0Amb1ent OR1ver/Stream 0Lake (b~ed on county) (or agency name) □surface □Estuary Ocanal ~k 0Rout1ne D Storrnwater Received By: River Basin: Date: 5/18/2016 Dcomphance 0Ground □Monitoring Well 0water Suppl~ l..L!'&ate Courier Notes: Geothermal lnJect10n Wells Time: \\:oo :Jefivery Method_ D Hand Delivery Ococ □waste □Effluent Olnfluent □other D Chlorinated D De-chlorinated m Field Sampling 0Grab LJ Composite □Emergency □Blank □Field Blank 0Tnp Blank Temperature Method: Dother 0 Filter Blank ("C) \ .:5 0 Filtered m Field Dissolved analysis Enter"DIS" Sample Depth: □CA Dsolubon D0ther on Arrival: in check-boxes for parameters Collwor's Comments: \ v\ ...(: \ v 0\.,, {-¥~ SDJ11e, e we\\ Microbiology Parameters: MBAS (surfactants) mg/L Metals Parameters: Tm (Sn) µg/L AcIdIty, as CaC03, to pH 4 5/8 3 mg/L 01! and Grease, HEM, Total Recoverat mg/L X Aluminum (Al) µg/L TItamum (Tl) µg/L Alkahrnty, as CaC03, to pH 4 5/8 3 mg/L Phenols, Total Recoverable µg/L X Antimony (Sb) µg/L X Vanadium M µg/L BOD BIochemical Oxygen Demand, 5-day mg/I.. Residue Total (Total So/Jds) mg/L X Arsenic (As) µg/L X Zinc (Zn) µg/L cBOD Carbonaceous BOD, 5-day mg/L Residue Volat1le/F1xed, Total mg/L X Barium (Ba) µg/L X Coliform Fecal MF 1100ml Residue Suspended (Suspended Solle mg/L X Beryllium (Be) µg/L Boron (8), Total µg/L X Coliform Total MF 1100ml Residue VolatIle/Fixed, Suspended mg/L X Cadmium (Cd) µg/L Mercury 1631, low-level ng/L Coliform Tube Fecal 1100ml X TDS -Total Dissolved Solids mg/L X Calcium (Ca) mg/L Coliform Tube Total 1100ml SIlIca mg/L X Chromium (Cr), Total µg/L Organics •Parameters: Specific Conductance, at 25 °C umhos/cm Sulfide mg/L X Cobalt (Co) µg/L Acid HerbIe1des TOC -Total Organic Carbon mg/L Tannin & Llgnm mg/L X Copper (Cu) µg/L Organochlonne Pest1c1des TurbIdrty NTU X Iron (Fe) µg/L Organonitrogen PestIc1des Other Parameters: '' X Lead (Pb) µg/L Organophosphorus Pesticides Wet Chemistry Parameters. pH SU X Lithium (LI) µg/L PCBs (polychlonnated b1phenyIs; Bromide mg/L Hardness, Total as CaC03 -by t1trabo1 mg/L X Magnesium (Mg) mg/L X Chloride mg/L X Manganese (Mn) µg/L Sem1-VolatIle Organics (BNAs) Fluoride mg/L Mercury (Hg) µg/L TPH Diesel Range X Sulfate mg/L Nutrients Parameters: X Molybdenum (Mo} µg/L Chlorophyll a µg/L Ammonia as N (NH3-N) mg/L X Nickel (N1) µg/L Volatile Organics ('JOA) Color ADMI cu X NItrate-N1tnte as N (N03+N02-N) mg/L X Potassium (K) mg/L Color Platinum Cobalt cu Total KJeldahl Nitrogen as N (TKN) mg/L X Selenium (Se) µg/L TPH Gasoline Range COD Chemical Oxygen Demand mg/L Total Phosphorus as P (TP) mg/L X Silver (Ag) µg/L Cyanide, Total mg/L NItnte as N (N02-N) mg/L X Sodium (Na) mg/L Biological: Formaldehyde mg/L Nitrate as N (N03-N calculated) mg/L Strontium (Sr) µg/L Phytoplankton / Algae Hexavalent Chromium (Cr6+) mg/L Orthophosphate as P (P04) mg/L X Thallium (Tl) µg/L LAB COMMENTS ield Parameters(opbona/J Water Temp (°C) pH (s u) Dissolved Oxygen (ppm) ConductIvrty (µmhoslcm) Salinity (ppt) Rev1s1on 2/0612015 AC29175 Loe. Descr.: County: Re.gion: River Basin Emergency COC Yes/No North Carolina Division of Water Resources Water Sciences Section Laborato ry Results WI0800246I Sample ID: AC29175 NEW HANOVER Collector: G KEGLEY VisitlD PO Number# 16G0119 WIRO · Report To WIRO Location ID: WI0800246 Date Received: 05/19/2016 Collect Date: 05/18/2016 priority ROUTINE Time Received: 08:00 Collect Time: 11.;QQ Sample Matrix: GROUNDWATER Labworks Login ID TASCENZ01 Sample Depth Loe. Type: Water SU(!(!lll Delivery Method NC Courier Final Report Date: 6/22/16 Report Print Date: 06/22/2016 Final Re port If this report is labeled preliminary report, the results have not been validated. Do not use for Regulatory purposes. Result/ Units Method Analx':sis CAS# Analyte Name PQL Qualifier Reference Date Validated b¥ LAB Sample temperature at receipt by lab 1.3 "C 5/19/16 MSWIFT MIC Coliform, MF Fecal in liquid 1 B2Q1 CFU/100ml SM 9222 D-1997 5/19/16 ESTAFFORD1 Coliform, MF Total in liquid 1 B2Q1 CFU/100ml SM 9222 B-1997 5/19/16 ESTAFFORD1 NUT NO2+NO3 as N in liquid 0.02 0.02 U mg/Las N EPA 353.2 REV 2 5/20/16 CGREEN WET Bromide 0.4 0.4 U mg/L EPA 300.0 rev2.1 5/19/16 CGREEN Chloride 1.0 78 mg/L EPA 300 .0 rev2.1 5/19/16 CGREEN FILJoride 0.4 0.4 U mg/L EPA 300.0 rev2.1 5/19/16 C.GREEN Sulfate 2.0 6.5 mg/L E.PA300.0 rev2.1 5/19/1.6 CGRE:EN Total Dissolved Solids in liquid 12 305 mg/L SM 2540 C-1997 5/20/16 CGREEN MET 7440-22-4 Ag by ICPMS 1.0 1.0 U ug/L EPA 200.8 Rev5.4 6/13/16 ESTAFFORD1 7429-90-5 Al bylCP 50 50 U ug/L EPA 200.7 Rev4..4 6/2/16 ESTAFFORD1 7440'36-0 Antimony oy ICPMS 10 10 U ug/L EPA 200.8. Rev5.4 6/13/16 ESTAFFORD1 7440-38-2 As by ICPMS 2.0 2.0 U ug/L EPA 200.8 Rev5.4 6/13/11;i ESTAFFORD1 7440-38-3 Baby ICP 10 10 U ug/L EPA'200.7 Rev4.4 6/13/16 ESTAFFORD1 7440-41-7 Bebyl,9P 5.0 5.0 U ug/L EPA200.7 Re.v4.4 6/13/16 ESTAFFORD1 7440-70-2 Ca by ICP 0.10 33 mg/L EPA200.7 Rev4.4 6/2/16 ESTAFFORD1 7440-43-9 Cd bylCPMS 0.50 0.50 U ug/L EPA 200.8 Rev5.4 6/13i16 ESTAFFORD1 7440-48-4 Cobalt by ICP 50 50 U ug/L EPA 200.7 Rev4.4 6/13/16 ESTAFFORD1 7440-47°3 CrbyJCPMS 5.0 5.0U ug/L EPA 200,8 Rev5.4 6/13/16 ESTAFFORD1 7440°50-8 Cu by ICPMS 2.0 2.0 U ug/L EPA 200.a Rev5.4 6/13/1'6 ESTAFFORD1 7439-89-6 Fe by ICP 50 50 u. ug/L EPA 200.7 Rev4.4 6/2/16 ESTAFFORD1 7440-09-7 K by ICP 0.10 6.5 mg/L EPA 200. 7 Rev4.4 6/2/16 ESTAFFORD1 7439°93-2 Li ICP 25 25 U ug/L EPA 200.7 Rev4.4 6/13/16 ESTAFFORD1 7439"95-4 Mg by ICP 0.10 11 mg/L EPA200.7 Rev4.4 6/2/16 ESTAFFORD1 7439-96-5 Mn by ICP 10 10 U ug/L EPA 200.7 Rev4.4 6/2/16 ESTAFFORD1 7439°98-7 Mo by ICPMS 10 10 U ug/L EPA200.8 Rev5.4 6/13/16 ESTAFFORD1 7440-23-5 Na by ICP 0.10 60 mg/L EPA 200.7 Rev4.4 6/2/16 ESTAFFORDi 7440-02-0 Niby IGPMS 2.0 2.0U ug/L EPA200.8 Rev5.4 6/13i16 ESTAFF0R01 7439-92~1 Pb PY ICPMS 2.0 2.0 U ug/L EPA20(Ui Rev5;4 6/13/16 ESTAFFORD1 77S2-49-2 Se by furnace 1.0 1.0 U ug/L EPA 200.9 Rev2.2 6/13/t6 ESTAFF0RD1 WSS Chemistry Laboratory» 1623 Mail Service Center, Raleigh, NC 27.699-1623 (919) 733-3908 "Not Detected" or "U" does not indicate the sample is analyte free but that the ana1yte is not detected at or above the PQL. Page 1 of 2 :NC <D'l¥}c La6oratory Section lJ?§su[ts/Sa.mpfe Comments/Qualifier ©efinitians Sample ID : AC29175 CAS# Analyte Name PQL Result/ Method Analysis Qualifier Units Reference Date Validated by 7440-28-0 Thallium (Tl) ICPMS 2.0 2.0 U ug/L EPA 200.8 Rev5.4 6/13/16 ESTAFFORD1 7440-62-2 V by ICP 10 10 U ug/L EPA 200 .7 Rev4.4 6/13/16 ESTAFFORD1 7440-66-6 Zn by ICPMS 10 10 U ug/L EPA 200 .8 Rev5.4 6/13/16 ESTAFFORD1 WSS Chemistry Laboratory» 1623 Mail Service Center, Raleig_h, NC 27699-1623 (919) 733-3908 "Not Detected" or "U" does not indicate the sample is analyte free but that the analyte is not detected at or above thePQL. Page 2 of 2 1LoC-,O llO North Carolina 1D1v1S1on of Water Resources ,~g € -Visit ID: 1 Water Sample Collection & Submittal Form AC29176 ---Central Laboratory (Water Sciences Sect10n) (optronal) ! ocation Descriptiot WI0800246 E: ocation Code Date Received: S· '9 , ) ~ County: newhanover Collector: G Kegley Priority: Water-Matrix Location Type: DWRRegion: DWROffice: D River/Stream □Lake Time Received: %'-DO (based on county) W1RO (or agency name) DWR-WQQROS □Ambient D Surface □Estuary Ocana, ~ 0Routme Ostormwater Received By: River Basin: Date: 5/18/2016 Dcompllance 0Ground D Monitoring Well 0~ater Suppl} .1:1-istate Couner Delivery Method: Hand Delivery Notes: Geothennal lnJectIon Wells . Time: \\'_\'S Ococ 0Waste □Effluent Olnfluent Oother 0 Chlonnated 0De-chlonnated m Field Sampling 0Grab U compos1te □emergency □Blank □Field Blank 0TnpBlank Temperature Method: D0ther □Filter Blank ("CJ )13 0 FIitered m Field Dissolved analysis Enter "DIS" Sample DeP,th: DOA Dso1ut1on Dother on Arrival: in check-boxes for parameters Collector's Co17!men1S: e-ft \ve ""+ t)i~b ,.-'H> ~ ~ e c:,,-\-;dY\ Microbiology f>.!irameters: MBAS (surfactants) mg/L Metals Parameters: Tm (Sn) µg/L AcIdrty, as CaC03, to pH 4 5/8 3 mg/L 011 and Grease, HEM, Total Recoverat mg/L X Aluminum (AQ µg/L Titanium (Ti) µg/L Alkahnrty, as CaC03, to pH 4 5/8 3 mg/L Phenols, Total Recoverable µg/L X Antimony (Sb) µg/L X Vanadium M µg/L BOD BIochem1cal Oxygen Demand, 5-day mg/L Residue Total (Total Solrds) mg/L X Arsemc(As) µg/L X Zmc(Zn) µg/L cBOD Carbonaceous BOD, 5-day mg/L Residue Volat!le/F1xed, Total mg/L X Banum (Ba) µg/L X Coliform Fecal MF 1100ml Residue Suspended (Suspended Solie mg/L X Beryllium (Be) µg/L Boron (B), Total µg/L X Coliform Total MF 1100ml Residue Volable/FDCed, Suspended mg/L X Cadmium (Cd) µg/L Mercury 1631, low-level ng/L Coliform Tube Fecal 1100ml X TDS-Total Dissolved Solids mg/L X Calcium (Ca) mg/L Colrform Tube Total 1100ml s1I,ca mg/L x, Chromium (Cr), Total µg/L Organics Parameters: . Specific Conductance, at 25 •c umhos/crn Sulfide mg/L X Cobalt (Co) µg/L Acid Herb1c1des TOC -Total Organic Carbon mg/L Tannm & L1grnn mg/L X Copper (Cu) µg/L Organochlorme Pest1c1des TurbIdrty NTU X Iron (Fe) µg/L Organomtrogen Pest1c1des Other Parameters: X Lead (Pb) µg/L Organophosphorus PestIc1des Wet Chemistry Parameters: pH SU X Lithium (Li) µg/L PCBs (polychlonnated bIphenyls; Bromide mg/L Hardness, Total as CaC03 -by t1trallo1 mg/L X Magnesium (Mg) mg/L X Chlon~e mg/L X Manganese (Mn) µg/L Sem1-Volable Organics (BNAs) Fluoride mg/L Mercury (Hg) µg/L TPH Diesel Range X Sulfate mg/L Nutrients Parameters: X Molybdenum (Mo) µg/L Chlorophyll a µg/L Ammonia as N (NH3-N) mg/L X Nickel (NI) µg/L Volatile Organics 0/0A) Color AOMI cu X Nllrate-N,tnte as N (N03+N02-N) mg/L X Potassium (K) mg/L Color Platinum Cobalt cu Total KJeldahl Nitrogen as N (TKN) mg/L X Selenium (Se) µg/L TPH Gasoline Range COD Chemical Oxygen Demand mg/l Total Phosphorus as P (TP) mg/L X SIlver(Ag) µg/L Cyanide, Total -mg/L Nitrite as N (N02-N) mg/L X Sodium (Na) mg/L Biological: Formaldehyde mg/L Nitrate as N (N03-N calculated) mg/L Strontium (Sr) µg/L Phytoplankton / Algae Hexavalent Chromium (Cr6+) mg/L Orthophosphate as P (P04) mg/L X Thallium (Ti) µg/L LAB COMMENTS . 1eld Parameters(optionaQ Water Temp ("C} pH (s u) Dissolved Oxygen (pp!'") Conduct,vrty (µmhos/cm) Salmrty (ppt) Rev1s1on 2/06/2 15 AC29176 North Carolina Division ofWater Resources Water Sciences Sec6on Laborato a Results Loe. Descr.: ~IQ!!0Qi46!; Sample ID: AC29176 County: NEW HANOVER Collector: G KEGLEY VisitlD PO Number# 16G0120 Region: WIRO Report To ~ Location ID: WI0800246E Date Received: 05/19/2016 River Basin Collect Date: 05/18/2016 Priority ROUTINE nme Received: 08:00 Emergency Collect Tirne: ~ Sample Matrix: GROUNQWATER Labworks Login ID TASCENZO1 COG Yes/No Sample Depth Loe. Type: Water Su11[!ll1 Delivery Method NC Courier Final Report Date: 6/22116 Report Print Date: 06/22/2016 Final Re port If this report is labeled preliminary report, the results have not been validated. Do not use for Regulatory purposes. Result/ Units Method Analy:sis CAS# Anal ;i!e Name POL Qualifier Reference Date Validated by: LAB Sample temperature at receipt by lab 1.3 oc 5/19/16 MSWIFT MIC Coliform, MF Fecal in liquid 1 1 B201 CFU/100ml SM 9222 D-1997 5/19/16 ESTAFFORD1 Coliform, MF Total in liquid 84 Q1 CFU/100ml SM 9222 B-1997 5119116 ESTAFFORD1 NUT NO2+NO3 as N in liquid 0.02 0.02 U mg/Las N EPA 353.2 REV 2 5/20/16 CGREEN WET Bromide 0.4 0.4 U mg/L EPA 300.0 rev2.1 5119116 CGREEN Chloride 1.0 79 mg/L EPA300.0 rev2.1 5/19/16 CGREEN Fluoride 0.4 0.4 U mg/L EPA 300.0 rev2.1 5119/16 CGREEN Sulfate 2.0 6.3 mg/L EPA 300.0 rev2.1 5119/16 CGREEN Total Dissolved Solids in liquid 12 305 mgll SM 2540 C-1997 5120/16 CGREEN MET 7440-22-4 Ag by ICPMS 1.0 1.0 U ug/L EPA 200.8 Rev5.4 6113/16 ESTAFFORD1 7429-90-5 Al by ICP 50 78 ug/L EPA 200.7 Rev4.4 612/16 ESTAFFORD1 7440°36-0 Antimony by ICPMS 10 10 U ug/L EPA 200.8 Rev5.4 6113116 ESTAFFORD1 7440-38-2 As by ICPMS 2.0 2.0 U ug/L EPA 200.8 Rev5.4 6/13/16 ESTAFFORD1 7440-38-3 Ba by ICP 10 10 U ug/L EPA200.7 Rev4.4 6/13/16 ESTAFFORD1 7440-41-7 Be by ICP 5.0 5.0 U ug/L EPA 200. 7 Rev4.4 6113/16 ESTAFFORD1 7440-70-2 Ca by ICP 0.10 34 mg/L EPA 200. 7 Rev4.4 612/16 ESTAFFORD1 7440-43-9 Cd by ICPMS 0.50 0.50 U ug/L EPA 200.8 Rev5.4 6113116 ESTAFFORD1 7440-48-4 Cobalt by ICP 50 50 U ug/L EPA200.7 Rev4.4 6/13/16 ESTAFFORD1 7440-47°3 Cr by ICPMS 5.0 5.0 U ug/L EPA 200,8 Rev5.4 6113116 ESTAFFORD1 7440-50-8 Cu by ICPMS 2.0 3.0 ug/L EPA 200.8 Rev5.4 6/13/16 ESTAFFORD1 7439-89-6 Fe by ICP 50 50 U ug/L EPA200.7 Rev4.4 612/16 ESTAFFORD1 7440-09-7 Kby ICP 0.10 6.6 mg/L EPA 200. 7 Rev4.4 612/16 ESTAFFORD1 7439-93-2 Li ICP 25 25 U ug/L EPA 200. 7 Rev4.4 6/13116 ESTAFFORD1 7439-95-4 Mg by ICP 0.10 11 mg/L EPA200.7 Rev4.4 6/2116 ESTAFFORD1 7439-96-5 Mn by ICP 10 10 U ug/L EPA 200. 7 Rev4.4 612/16 ESTAFFORD1 7439-98-7 Mo by ICPMS 10 10 U ug/L EPA 200.8 Rev5.4 6113/16 ESTAFFORD1 7440-23-5 Na by ICP 0.10 61 mg/L EPA 200.7 Rev4.4 612/16 ESTAFFORD1 7440-02-0 Ni by ICPMS 2.0 2.0 U ug/L EPA 200.8 Rev5.4 6/13/16 ESTAFFORD1 7439-92-1 Pb by ICPMS 2.0 2.0 U ug/L EPA 200.8 Rev5.4 6/13/16 ESTAFFORD1 7782-49-2 Se by furnace 1.0 1.0 U ug/L EPA 200.9 Rev2.2 6113/16 ESTAFFORD1 WSS Chemistry Laboratory» 1623 Mail Service Center, Raleigh, NC 27699-1623 (919) 733-3908 "Not Detected" or "U" does not indicate the sample is analyte free but that the analyte is not detected at or above the POL Page 1 of 2 NC<~ La6oratorySection !J<§sufts/Sa.mpfe Comme11ts/Quafifier©efinitions Sample ID: AC29176 CAS# Anal vte Name PQL ResulU Method Anal:ilSiS Qualifier Units Reference Date Validated b~ 7440-28-0 Th~ll1um (TIJ ICPMS 2.0 2,0U ug/L EPA 200.8 Rev5.4 6113/16 ESTAFFORD1 7440-€,2-2 Vby ICP 10 10 U ugll !=PA _200.7 Rev4.4 6113/16 ESTAFFORD1 7440-66-6 Zn bylCPMS 10 13 ugll EPA200.8 Rev5.4 6/13116 ESTAFFORD1 WSS Chemistry Laboratory» 1623 Mail Service Center, Raleig_h, NC 27699-1623 (919) 733'3908 "Not Detecled" or "U" d_oes not indicate the sample is analyte free.but that ihe analyte is not detected at or above the POL Page 2cif2 Permit Number Program Category Ground Water Permit Type WI0800246 Injection Heating/Cooling Water Return Well Primary Reviewer shristi.shrestha Coastal SWRule Permitted Flow Facility Facility Name Brent & Julia Lammert SFR Location Address 4816 Wedgefield Dr Wilmington Owner Owner Name Brent Dates/Events NC Troy Orig Issue 7/19/2011 App Received 4/22/2016 Re g ulated Activities Heat Pump Injection Outfall Waterbody Name 28409 Lammert Draft Initiated Scheduled Issuance Public Notice Central Files: APS SWP 5/31/2016 Permit Tracking Slip Status In review Version Project Type Renewal Permit Classification Individual Permit Contact Affiliation Diana Helias PO Box 882 Hampstead NC 28443 Major/Minor Minor Facility Contact Affiliation Owner Type Individual Owner Affiliation Brent Troy Lammert 4816 Wedgefield Dr Wilmington Region Wilmington County New Hanover NC 28409 Issue Effective Expiration Requested /Received Events RO staff report requested RO staff report received Streamlndex Number Current Class 4/28/16 5/26/16 Subbasin PAT MCCRORY Governor DONALD R. VAN DER VAART Water Resources ENVIRONMENTAL QUALITV Brent and Julia Lammert 4816 Wedgefield Drive Wilmington NC 28409 Re: Issuance of Injection Well Permit Permit No. WI0800246 June 2, 2016 Geothermal Heating/Cooling Water Return Well New Hanover County Dear Mr. and Mrs. Lammert: Secretary S. JAY ZIMMERMAN Director In accordance with your permit renewal application received April 22, 2016, I am forwarding Permit No. WI0800246 for the continued operation of geothermal heating/cooling water return well(s) located at the above referenced address. This permit shall be effective from date of issuance until May 31, 2021, ~d shall be subject to the conditions and limitations stated therein. Please Note: • Samples from the influent and effluent sampling ports of your geothermal well system were collected on May 18, 2016. Laboratory analytical results will be forwarded to you when it becomes available. In order to continue uninterrupted legal use of this well for the stated purpose, you should submit an application to renew the permit 120 days prior to its expiration date. As indicated in the permit, this permit is not transferable to any person without prior notice to, and approval by, the Director of the Division of Water Resources. If you have any questions regarding your permit or the Underground Injection Control Program, please call me at (919) 807-6406. Best Regards, Shristi Shrestha Underground Injection Control (UIC) -Hydrogeologist Division of Water Resources, NCDEQ Water Quality Regional Operations Section State of North Caroliua I Environmeutal Quality I Water Resources 161 l Mail service Center I Raleigh, North Carolina 27699-161 l Q 1 Q 707 Q(l(l/1 cc: Jim Gregson-Morella Sanchez-King, Wilmington Regional Office Central Office File, WI0800246 New Hanover County Environmental Health Department Page 2 of2 NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION DEPARTMENT OF ENVIRONMENT AL QUALITY RALEIGH, NORTH CAROLINA PERMIT FOR THE USE OF A WELL FOR INJECTION In accordance with the provisions of Article 7, Chapter 87; Article 21~ Chapter 143; and other applicable Laws, Rules, and Regulations PERMISSION IS HEREBY GRANTED TO Brent and Julia Lammert FOR THE CONTINUED OPERATION OF ONE (1) GEOTHERMAL HEATING/COOLING WATEl RETURN WELL(S), defined in Title 15A North Carolina Administrative Code 02C .0224(a), which will be use for the injection of heat pump effluent. The injection well(s) located at 4816 Wedgefield Drive, Wilmington N< 28409 will be operated in accordance with the application submitted April 22, 2016, and in conformity with th specifications and supporting data all of which are filed with the Department of Environmental Quality and ar, considered a part of this permit. This permit is for continued operation of an injection well shall be in compliance with Title 15A North Carolin; Administrative Code 2C .0100 ·and .0200, and any other Laws, Rules, and Regulations pertaining to wel construction and use. This permit shall be effective, unless revoked, from the date of its issuance until May 31, 2021, and shall bt subject to the specified conditions and limitations set forth in this permit. Permit issued this the 2nd day of June 2016. S. Jay Zimmerman, P.G. Director, Division of Water Resources By Authority of the Environmental Management Commission. Permit #WI0800246 UIC/5A7 Do,....,,., 1 .... cc PART I -PERMIT GENERAL CONDITIONS 1. The Permittee shall comply with all conditions of this permit and with the standards and criteria specifie, in Criteria and Standards Applicable to Injection Wells (15A NCAC 2C .0200). Noncompliance wit] conditions of this permit constitutes a violation of the North Carolina Well Construction Act and is ground for enforcement action as provided for in N.C.G.S. 87-94 2. This permit is effective only with respect to the nature, volume of materials and rate of injection, a: described in the application and other supporting data [15A NCAC 02C .021 l(a)]. 3. This. permit shall become voidable unless the facility is constructed in accordance with the conditions o this permit, the approved plans and specifications, and other s~pporting data [15A NCAC 02C .0211(1)]. 4. This permit is not transferable without prior notice and approval. In the event there is a desire for the facilit~ to change ownership, or there is a name change of the Permittee, a formal permit amendment request mus be submitted, including any supporting materials as may be appropriate, at least 30 days prior to the date o the change [15A NCAC 02C .021 l(q)]. 5. The issuance of this permit shall not relieve the Permittee of the responsibility of complying with any anc all statutes, rules, regulations, or ordinances, which may be imposed by other local, state, and federa agencies, which have jurisdiction. Furthermore, the issuance of this permit does not imply that al regulatory requirements have been met [15A NCAC 02C .0203]. PART II -WELL CONSTRUCTION GENERAL CONDITIONS 1. The well supplying water for the geothermal heating and cooling system shall be constructed in accordanct with the requirements of rule 15A NCAC 02C .0107 except as required in Item #2 below. 2. Any injection well shall be constructed in accordance with the requirements of rule 15A NCAC 02C .01 0~ except that the entire length of the casing shall be grouted in such a way that there is no interconnection o: aquifers or zones having differences in water quality that would result in degradation of any aquifer or zone For screened wells, grout shall be emplaced from the top of the gravel pack to the land surface. For open· end wells, the casing shall be grouted from the bottom of the casing to the land surface [15A NCAC 02( .0224( d)(2), (3 )] . 3. Bentonite grout shall not be used to seal any water-bearing zone with a chloride concentration equal to 01 greater than 1,500 milligrams per liter. In areas where elevated chloride levels are known to exist or art probable, such as coastal areas, chloride levels shall be verified in the field to determine existing conditions [15A NCAC .0225(g)(8)]. 4. The injection well system shall be constructed such that a sampling tap or other collection equipmen approved by the Director provides a functional source of water when the system is operational. Sud equipment shall provide the means to collect a water sample immediately after emerging from the watei supply well and immediately"prior to injection into the return well [15A NCAC 02C .0224(d)(4)]. 5. Each well shall be secured to reasonably insure against unauthorized access and use and shall be sealec with a watertight cap or well seal as defined in G.S. 87-85(16). 6. Each well shall have permanently affixed an identification plate [ 15A NCAC 02C .0107(j)(2)]. Permit #WI0800246 UIC/5A7 · Page2 ofS 7. A completed Well Construction Record (Form GW-1) shall be submitted as described in Part V.5 of tl permit. PART Ill -OPERATION AND USE CONDITIONS 1. The Permittee shall comply with the conditions of this permit and properly operate and maintain t1 irije<;tion facility in compliance with the conditions of this permit and the rules of 15A NCAC 02C .0201 even if compliance requires a reduction or elimination of the permitted activity [15A NCAC 02C .021 l(j) 2. The issuance of this permit shall not relieve the Peimittee of the responsibility for damages to surface watc or groundwater resulting from the operation of this facility. In the event that the facility fails to perfon satisfactorily, including the creation of nuisance conditions or failure of the injection zone to adequate! assimilate the injected fluid, the Permittee · shall take immediate corrective actions that may be require< such as the repair, modification, or abandonment of the injection facility [15A NCAC 02C .0206]. PART IV -INSPECTIONS [15A NCAC 02C .021 l(k)] 1. Any duly authorized officer, employee, or representative of the Division of Water Resources (DWR) ma) upon presentation of credentials, enter and inspect any property, premises, or place on or related to th injection facility at any reasonable time for the purpose of determining compliance with this permit, ma; inspect or copy any records that must be maintained under the terms and conditions of this permit, and ma; obtain samples of groundwater, surface water, or injeqtion fluids. · 2. DWR representatives shall have reasonable access for purposes of inspection, observation, and samplin! associated with injection and ~y related facilities as provided for in N.C.G.S. 87-90. 3. Provisions shall be made for collecting any necessary samples of the injection facility's activities. PART V -MONITORING AND REPORTING REQUIREMENTS 1. Records of well construction, repair, or-abandonment shall be submitted within 30 days of completion of such activities. Copies of such records shall be retained on-site and available for inspection [15A NCAC 02C .0224(f)(2), (4)]. 2. Monitoring of any well may be required to ensure protection of the groundwater resources of the State and compliance with the groundwater quality standards specified in 15A NCAC 02L [15A NCAC 02C .0224(f)(l )]. 3. The Permittee shall report any monitoring or other information that indicates noncompliance with a specific permit condition, that a contaminant may cause a violation of applicable groundwater quality standards, or that a malfunction of the injection system may cause the injected fluids to migrate outside the approved injection zone or area. As specified in rule 15A NCAC 02C .021 l(r), noncompliance notification shall be as follows: (A) Oral notification shall be given within 24 hours of the occurrence, or first knowledge of the occurrence, to the Wilmington Regional Office, telephonenumber910-796-7215. (B) Written notification shall be made within five days of the occurrence and submitted to the addresses in Item #5 below. Permit #WI0800246 UIC/5A7 (C) The written notification shall contain a description of the noncompliance and its cause; the period o noncompliance, including dates and times; if the noncompliance has not been corrected, th , anticipated time it is expected to continue; and any steps taken or planned to reduce, eliminate, an1 prevent reoccurrence of the noncompliance. 4. The Permittee shall record the number and location of the wells with the register of deeds in the county i1 which the facility is located. [15A NCAC 02C .0224(f)(3)]. 5. All forms, reports, or monitoring results required by this permit shall be submitted to: UIC Program Staff Division of Water Resources 1636 Mail Service Center Raleigh, NC 27699-1636 and Water Quality Regional Operations Section DWR Wilmington Regional Office 127 Cardinal Drive Extension (Courier 04-16-33) Wilmington, NC 28405 PART VI-PERMIT RENEWAL [15A NCAC 02C .0224(c)] As required by rule an application for permit renewal shall be made at least 120 days prior to the expiratior date of the permit. This permit condition does not apply if the Permittee chooses to discontinue operatior of the well for injection of effluent from the geothermal heating and cooling system associated with thii permit. PART VII-CHANGE OF WELL STATUS [15A NCAC 02C .0240] 1. Procedures for temporarily or permanently abandoning a well are the same as those specified in rule 15A NCAC 02C .0113. While some of those criteria are given below, the Permittee bears the responsibility oJ complying with all applicable regulatory requirements. 2. If a well will no longer be used for any purpose, then it should be permanently abandoned according to rule 15A NCAC 02C .Ol 13(b) in order to prevent the well from deteriorating and acting as a source or condui1 of contamination, which is prohibited by General Statute 87-88( c ). 3. If a well is taken completely out of service temporarily, the Permittee shall install a water-tight cap or well seal that cannot be removed without the use of hand or power tools . 4. When injection operations have ceased at the facility and a well will no longer be used for any purpose, tht: Permittee shall permanently abandon that injection well in accordance with the procedures specified in 15A NCAC 02C .0113(b), which include, but are not limited to, the following: (A) All casing and materials may be removed prior to initiation of abandonment procedures if such removal will not be responsible for, or contribute to, the contamination of an underground source of drinking water. (B) The entire depth of each well shall be sounded before it is sealed to insure freedom from obstructions that may interfere with sealing operations. (C) Each well shall be thoroughly disinfected prior to sealing in accordance with rule 15A NCAC 02C .011 l(b)(l)(A), (B), and (C). Permit #WI0800246 UIC/5A7 Page 4 of5 (D) Each well shall be completely filled with cement grout, which shall be introduced into t well through a pipe which extends to the bottom of the well and is raised as the well filled. (E) In those cases when a subsurface cavity has been created as a result of the injectic operations, each wen shall be ab~doned in such a manner that will prevent the moveme1 of fluids into or between underground sources of drinking water. (F) The Permittee shall submit a Well Abandonment Record (Form GW-30) as specified i 15A NCAC 2C .0224(f)( 4) within 30 days of completion of abandonment. 5. The written documentation required in Part VII (4)(F) shall be submitted to the addresses specified in Par V.5 above. Permit#w,I0800246 UIC/5A7 North Carolina Department of Environmental Quality -Division of Water Resources WQROS REGIONAL STAFF REPORT FOR UIC Program Support Permit No. WI0800246 Date: 5/20/2016 To: Shristi Shrestha Central Office Reviewer County: New Hanover Permittee/ Applicant: Brent and Julia Lammert Facility Name: _________ _ I. GENERAL INFORMATION RECEIVED/NCDEQ/DWR 1. This application is (check all that apply): D New ~ Renewal D Minor Modification D Major Modification MAY 2 6 2016 a. Date oflnspection: 5/18/2016 Water Quality Regional b. Person contacted and contact information: Julia Lammert -julia.lammert@ me.cotPPerations Section c. Site visit conducted by: Geoff Ke gley d. Inspection Report Printed from BIMS attached: D Yes ~ No. e. Physical Address of Site including zip code: 4816 Wed gefield Dr., Wilmington , NC 29409 f. Driving Directions if rural site and/or no physical address: g. Latitude: 34 09 03 .90 N Longitude: 77 53 01.61 Source of Lat/Long & Accuracy (i.e., Google Earth, GPS, etc.):_ Google Earth II. DESCRIPTION OF INJECTION WELL (S ) AND FACILITY 1. Type of injection system: IZ! Geothermal Heating/Cooling Water Return D In situ Groundwater Remediation D Non-Discharge Groundwater Remediation D Other (Specify: ) 2. For Geothermal Water Return Well (s ) onl y a. For existing geothermal system only: Were samples collected from Influent/Effluent sampling ports? IZ! Yes D No. Provide well construction information from well tag: Accuratel y listed in BIMS b. Does existing or proposed system use same well for water source and injection? D Yes IZ! No If No, please provide source/supply well construction info (i.e., depth, date drilled, well contractor, etc.) and attached map and sketch location of supply well in relation to injection well and any other features in Section IV of this Staff Report. 3 . Are there any potential pollution sources that may affect injection? D Yes IZ! No What is/are the pollution source(s)? ________________________ _ What is the distance of the injection well(s) from the pollution source(s)? ___________ _ 4. What is the minimum distance of proposed injection wells from the property boundary? ______ _ 5. Quality of drainage at site: D Good IZ! Adequate D Poor 6. Flooding potential of site: ~ Low D Moderate D High WQROS Staff Report Rev. 4/15/2016 Page I Date: 7. For Groundwater Remediation Injection Systems only, is the proposed and/or existing groundwater monitoring program (number of wells, frequency of monitoring, monitoring parameters, etc.) adequate? ❑ Yes ❑ No. If No, attach map of existing monitoring well network if applicable and recommend any changes to the groundwater -monitoring program. 8. Does the map included in the Application reasonably represent the actual site (property lines, wells, surface drainage)? ® Yes ❑ No. If No, or no map, please attach a sketch of the site. Show property boundaries, buildings, wells, potential pollution sources, roads, approximate scale, and north arrow. g. For Non -Discharge Groundwater Remediation systems only (i.e., permits with WQ prefix): a. Are the treatment facilities adequate for the type of waste and disposal system? ❑ Yes ❑ No ❑ N/A. If No, please explain: b. Are the site conditions (soils, topography, depth to water table, etc) consistent with what was reported by the soil scientist and/or Professional Engineer? ❑ Yes ❑ No ❑ N/A_ If no, please explain; III. EVALUATION AND RECOMMENDATIONS 1. Do you foresee any problems with issuance/renewal of this permit? ❑ Yes ® No. If Yes, explain. _ 2. List any items that you would like WQROS Central Office to obtain through an additional information request. Make sure that you provide a reason for each item; Item Reason 3, List specific special conditions or compliance schedules that you recommend to be included in the permit when issued. Make sure that you provide a reason for each special condition: Condition Reason 4. Recommendation ❑ Deny. If Deny, please state reasons: ❑ Hold pending receipt and review of additional information by Regional Office ❑ Issue upon receipt of needed additional information ® Issue 5. Signature of Report Preparer(s): Signature of WQROS Regional Supervisor: 5/2o /24)1 c s-726/7( WQROS Staff Report Rev. 4/15/2016 Page 2 IV. ADDITIONAL REGIONAL STAFF REVIEW COMMENTS/ATTACHMENTS (Optional I /[Needed) This review was conducted for a permit renewal request for a geothermal injection well heat pump system for the Lammert residence . On May 18, 2016, staff visited the home to inspect the well system . Source well water and water prior to re-injection were sampled for Metals, Total and Fecal Coliform, Nitrates, Chloride, Sulfate and Total Dissolved Solids. Sampling results will be forwarded to the Central Office and owner when received from laboratory. System operation has been normal. WQROS Staff Report Rev. 4/15/2016 Page 3 WATER Q UALITY REGIONAL OPERATIONS SECTION APPLICATION REVIEW RE Q UEST FORM Date: April 28, 2016 To: Jim Gregson-Morella Sanchez King From: Shristi Shrestha, WQROS -Animal Feeding Operations and Groundwater Protection Branch Telephone: 919-807-6406 Fax: (919) 807-6496 E-Mail: Shristi.shrestha@ncdenr.gov Permit Number: WI0800246 A. B. C . Applicant: Brent and Julia Lammert Facility Name: Application: Permit Type: Geothermal Heating/Cooling Water Return Well Project Type: Renewal E. Comments/Other Information: __ I would like to accompany you on a site visit. Attached, you will find all information submitted in support of the above-referenced application for your review, comment, and/or action. Within 30 calendar days, please return a completed W O ROS Staff Report. When you receive this request form, please write your name and dates in the spaces below, make a copy of this sheet, and return it to the appropriate Central Office Groundwater Protection Branch contact person listed above. RO-WO ROS Reviewer: __________________ Date: _____ _ COMMENTS: NOTES: FORM: WQROS-ARR ver. 092614 Page 1 of 1 WATER QUALITY REGIONAL OPERATIONS SECTION APPLICATION REVIEW RE QUEST FORM Date: April 28, 2016 To: Jim Gregson-Morella Sanchez King From: Shristi Shrestha, WQROS -Animal Feeding Operations and Groundwater Protection Branch Telephone: 919-807-6406 Fax: (919) 807-6496 E-Mail: Shristi.shrestha@ncdenr.gov Permit Number: WI0800246 A. Applicant: Brent and Julia Lammert B. Facility Name: C. Application: Permit Type: Geothermal Heating/Cooling Water Return Well Project Type: Renewal E. Comments/Other Information: __ I would like to accompany you on a site visit. Attached, you will find all information submitted in support of the above-referenced application for your review, comment, and/or action. Within 30 calendar days, please return a com pleted WOROS Staff Report. When you receive this request form, please write your name and dates in the spaces below , make a copy of this sheet, and return it to the appropriate Central Office Groundwater Protection Branch contact person listed above. RO-WOROS Reviewer: __________________ Date: _____ _ COMMENTS: NOTES: FORM: WQROS-ARR ver . 092614 Page 1 of 1 PAT MCCRORY Governor DONALD R. VAN DER VAART Secretary Water Resources ENVIRONMENTAL QUALITY S. JAY ZIMMERMAN Brent and Julia Lammert 4816 W edgefield drive Wilmington NC 28409 April 28, 2016 RE: Acknowledgement of Application No. WI0800246 Geothermal Heating/Cooling Water Return Well New Hanover County Dear Mr. & Mrs. Lammert: The Water Quality Regional Operations Section (WQROS) acknowledges receipt of your pennit application and supporting documentation received on April 22, 2016. Your application package has been assigned the number listed above, and the primary reviewer is Shristi Shrestha Central and Wilmington Regional Office staff will perform a detailed review of the provided application, and may contact you with a request for additional information. To ensure maximum efficiency in processing permit applications, the Water Quality Regional Operations Section (WQROS) requests your assistance in providing a timely and complete response to any additional information requests. Please note that processing standard review permit applications may take as long as 60 to 90 days after receipt of a complete application. If you have any questions, please contact Shristi Shrestha at 919-807-6406 or email at Shristi.shrestha@ncdenr.gov. cc: Wilmington Regional Office, WQROS Permit File WI0800246 Sr Debra J. Watts, Supervisor Animal Feeding Operations & Groundwater Protection Branch Division of Water Resources State of North Carolina I Environmental Quality I Water Resources 1611 Mail service Center I Raleigh, North Carolina 27699-1611 919 707 9000 Director NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES APPLICATION FOR A PERMIT TO CONSTRUCT OR OPERATE INJECTION WELLS In Accordance With the Provisions of [ 5A NCAC 02C .0224 GEOTHERMAL HEATING/COOLING WATER RETURN WELL(S) These well(s) inject groundwater directly into the subsurface as part of a geothermal heating and cooling system CHECK ONE OF THE FOLLOWING: New Application Renewal* Modification Permit Rescission Request* *For Permit Renewals or Rescission Request, complete Pages 1 and 4 (signature page) only Print or Type Information and Mail to he Address sn the Last Page, Illegible Applications Will Be Returned As Incomplete. DATE •- 1Q 4-,20 1 l PERMIT NO. 8 cp(leave blank if New Application) 19'72-D 1 Ne_Ay-1 e_vv A. CU ' ENT WELL USE AND OWNERSHIP STATUS (leave Blank if New Application) I. Current Use of Well a. Continue to use as Geothermal Well Drinking Water Supply Other Water Supply b. Terminate Use: If the well is no longer being used as a geothermal inject' to to rescind the permit, check the box below. If abandoned, attach a copy of t Record (GW-30). ❑ Yes, I wish to rescind the permit APR 2 2 2016 Water Quality Regional Operations Section 2. Current Ownership Status Has there been a change of ownership since permit last issued? ❑ YES E NO If yes, indicate new owner's contact information: Name(s) Mailing Address: City: _ _ State: Zip Code: _ _ County: Day Tele No.: _ _ Email Address._ B. STATUS OF APPLICANT (choose one f Non -Government: Individual Residence V Business/Organization Government: State Municipal County Federal C. WELL OWNER(S)IPERMIT APPLICANT - For individual residences, list owner(s) on Property deed. For all others, list name of entity and name of person delegated authority to,sign: -Rlrvt.-1- ] rC) l� Q� nrLYVI'-k_ V + aivul _ �\uSjo� 1) I/%t {—_ LL-Mitilk 1+ Mailing Address: B 1 iZ W ./ i �q j City: Mu_ 1 +'1 State: )Zip Code: � -T " ! County: 16H,, . t.)'ev Day Tele No.: 4 I c s z- 4-1._CQ a� Cell No.: A -- EMAIL Address:, '1 d\ Gt . ) Curtuvrt-& £ Fax No.: �" 1 A tl one,. CD m Geothermal Water Return Well Permit Application (itc, i, c,1 ai i 2(11=) Page 1 (a) For screen and gravel-packed wells, the entire length of casing shall be grouted from the top of the gravel pack to land surface; (b) For open-end wells without screen, the casing shall be grouted from the bottom of the casing to land surface. (3) A sampling tap or other approved collection equipment shall provide a functional source of water during system operation for the collection of water samples immediately after water emerges from the supply well and immediately prior to injection. J. WELL CONSTRUCTION SPECIFICATIONS (1) Specify the number and type of wells to be used for the geothermal heating/cooling system: _____ *EXISTING WELLS ____ PROPOSED WELLS *For existing wells, please attach a copy of the Well Construction Record (Form GW-1) if available. (2) Attach a schematic diagram of each water supply and injection well serving the geothermal heating/cooling system. A single diagram can be used for wells having the same construction specifications as long as the diagram clearly identifies or distinguishes each well from one another. Each diagram shall demonstrate compliance with the well construction requirements specified in Part H above and shall include, at a minimum, the following well construction specifications: (a) Depth of each boring below land surface (b) Well casing and screen type, thickness, and diameter ( c) Casing depth below land surface ( d) Casing height "stickup" above land surface (e) Grout material(s) surrounding casing and depth below land surface Note: bentonite grouts are prohibited for sealing water-bearing zones with 1500 mg/L chloride or greater per 15A NCAC 02C .0107(1)(8 ! (f) Length of well screen or open borehole and depth below land surface (g) Length of sand or gravel packing around well screen and depth below land surface K. OPERATING DATA (1) Injection Rate: Average (daily) gallons per minute (gpm). (2) Injection Volume: Average (daily) gallons per day (gpd). (3) Injection Pressure: Average (daily) pounds/square inch (psi). (4) Injection Temperature: Average (January) ° F, Average (July) __ ° F. L. SITE MAP-As specified in ISA NCAC 02C .0224 (b}(4), attach a site-specific map that is scaled or otherwise accurately indicates distances and orientations of the specified features from the injection well(s). The site map shall include the following: (1) All water supply wells, surface water bodies, and septic systems including drainfield, waste application area, and repair area located within 250 feet of the injection well(s). (2) Any other potential sources of contamination listed in I SA NCAC 02C .0107(a )(2) located within 250 feet of the proposed injection well(s). (3) Property boundaries located within 250 feet of the parcel on which the proposed injection well(s) are to be located. (4) An arrow orienting the site to one of the cardinal directions (north, south, west, or east) Geothermal Water Return Well Permit Application (Revised Jan 2015 ) Page3 D. WELL OPERATOR (if different from well owner) — For individual residences, list owner(s) on property deed_ For all others, list name of entity and name of person delegated authority to sign on behalf of the business or agency; Mailing Address: City: State: Zip Code: County: Day Tele No.: Email Address.: E. LOCATION OF WELL SITE — Where the injection wells are physically located: (1) Parcel Identification Number (PIN) of well site: County: (2) Physical Address (if different than mailing address): City: _ State: NC Zip Code: F WELL DRILLER INFORMATION Well Drilling Contractor's Name: NC Well Drilling Contractor Certification No.; Company Name: Contact Person: Address: EMAIL Address: City: Zip Code: State: County: _ _ Office Tele No.: Cell No.: Fax No.; C. HVAC CONTRACTOR INFORMATION (if different than driller) IIVAC Contractor's Name: NC HVAC Contractor License No.: Company Name: Contact Person: EMAIL Address: Address: City: Zip Code: State: County. Office Tele No.: Cell No.; Fax No.: H. WELL USE Will the injection well(s) also be used as the supply well(S) for the following? (1) The injection operation? YES — _ NO (2) Personal consumption? YES NO 1. WELL CONSTRUCTION REQUIREMENTS — As specified in 5A NCAC 02C .0224(d): (1) (2) The water supply well shall be constructed in accordance with the water supply well requirements of 15 A NCAC 02C .0107, If a separate well is used to inject the heat pump effluent, then the injection well shall be constructed in accordance with the water supply well requirements of I5A NCAC 02C .0107, except that; Geothermal Water Return Well Permit Application [;�. ) Page 2 NOTE: hi most cases an aerial photograph of the property parcel showing property lines and structures can be obtained and downloaded from the applicable county GIS website. Typically, the property can be searched by owner name or address. The location of the wells in relation to properly boundaries, houses, septic tanks, other wells, etc. can then be drawn in by hand. Also, a `layer' can be selected showing topographic contours or elevation data M. CERTIFICATION (to be signed as required below or by that person's authorized agent) 15 A NCAC 42C .021 is e l requires that all permit applications shall be signed as follows: 1, for a corporation: by a responsible corporate officer; 2. for a partnership or sole proprietorship: by a general partner or the proprietor, respectively; 3. for a municipality or a state, federal, or other public agency: by either a principal executive officer or ranking publicly elected official; 4. for all others: by all the person(s) listed on the property deed. If an authorized agent is signing on behalf of the applicant, then supply a letter signed by the applicant that names and authorizes their agent to sign this application on their behalf. "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. 1 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 approved specifications and conditions of the Permit." r r 7 4—nature of Property Owner/Applicant -$ ►�� TE;'( L rim Eg Print or Type Full Name fgnature of Property Owner/Applicant Print or Type Full Name Signature of Authorized Agent, if any Print or Type Full Name Submit two copies of the completed application package to: Division of Water Resources Water Quality Regional Operations Section (WQROS) 1636 Mail Service Center Raleigh, NC 27699-1636 Telephone (919) 807-6464 Geothermal Water Return Weil Permit Application { } Page 4 Permit Number WI0800246 Program Category Ground Water Permit Type Injection Heating/Cooling Water Return Well (5A7) Primary Reviewer michael.rogers Coastal SW Rule Permitted Flow Facilit Facility Name Brent & Julia Lammert SFR Location Address 4816 Wedgefield Dr Wilmington Owner Owner Name Brent Dates/Events NC 28409 Lammert Orig Issue 07/19/11 App Received Draft Initiated 07/25/11 Scheduled Issuance Central Files : APS_ SWP_ 08/24/11 Permit Tracking Slip Status Active Version 1.10 Project Type Major modification Permit Classification Individual Permit Contact Affiliation Diana Helias PO Box 882 Hampstead NC 28443 Major/Minor Minor Region Wilmington County New Hanover Facility Contact Affiliation Owner Type Individual Owner Affiliation Brent Lammert 5045 Whitner Dr Wilmington Public Notice Issue 08/19/11 NC Effective 08/19/11 28409 Expiration 07/31/16 · _R_e-i:i_u_la_t_ed_A_c_ti_v_it_ie_s _______________ Re a uested/Received Events Heat Pump Injection RO staff report requested RO staff report received Outfall NULL Waterb~dy Name Stream Index Number Current Class 08/04/11 08/15/11 Subbasin Permit Number WI0800246 Central Flies: APS SWP 08/17/11 Permit Tracking Slip Program Category Ground Water Status Project Type In review Major modification Permit Type Version Permit Classification Injection Heating/Cooling Water Return Weil (5A7) Individual Primary Reviewer Permit Contact Affiliation michael.rogers Diana Heiias Coastal SW Rule Permitted Flow Facility PO Box 882 Hampstead NC 28443 Facility Name Brent & Julia Lammert SFR Location Address 4816 Wedgefield ©r Wilmington Owner Major/Minor Region Minor Wilmington County New Hanover NC 28409 Facility Contact Affiliation Owner Name Owner Type Individual Brent Lammert Owner Affiliation Brent Lammert ates&Eve ry Orig Issue 07/19/11 App Received Draft initiated 07/25/11 Scheduled issuance 5045 Whitner Dr Wilmington NC 28409 Public Notice Issue Effective Expiration ta\ai 1 1311its Reuulated Activities Heat Pump Injection Outfall NULL RO staff report requested RO staff report received 08/04/11 08/15/11 Waterbody Name Stream Index Number Current Class Subbasin AwA NCDENR North Carolina Department of Environment and Natural Resources Division of Water Quality Beverly Eaves Perdue Goleen H. Sullins Dee Freeman Governor Director Secretary August 19, 2011 Brent and Julia Lammert 5045 Whitner Dr. Wilmington, NC 28409 Re: Issuance of Injection Well Permit Permit No. W10800246 Issued to Brent and Julia Lammert New Hanover County Dear Mr. and Mrs. Lammert: In accordance with your application received July 25, 2011, I am forwarding Permit No. WI0800246 for the construction and operation of a 5A7 geothermal underground injection control (UIC) well heat pump system located at 4816 Wedgefield Dr., Wilmington, New Hanover County, 28409. This permit shall be effective from the date of issuance until July 31, 2016, and shall be subject to the conditions and limitations stated therein. Per Permit Condition Part 11.2, please notify Jim Bushardt with the Wilmington Regional Office (910-796-7215) within 30 days after the well becomes operational in order for water samples can be collected from the geothermal system. In order to continue uninterrupted legal use of this well for the stated purpose, you should submit an application to renew the permit 120 days prior to its expiration date. As indicated in the permit, this permit is not transferable to any person without prior notice to, and approval by, the Director of the Division of Water Quality. If you have any questions regarding your permit or the Underground Injection Control Program please call one at (919) 715-6166. Best Regards, Michael Rogers, P.G. (NC & FL) Environmental Specialist cc: Charlie Stehman, Wilmington Regional Office Central Office File, WI0800246 New Hanover County Environmental Health Dept. AOU[FER PROTECTION SECTION 1636 Maii Servicci Carer, Raleigh, Norlfl Carolina 27699-1636 Location: 2728 Capital Boulevard. Rslelgh. North Carolina 27500 Phone. 919-733-322'I 1 FAX 1: 919-715.0586: FAX 2: 5 i9-715.60481 Customs" 5ervlcs, 1.B77-623:,74Z Internet: www,ncwataraualitv.Qrg NOn`i:h7Caroiina C porum, After anv&ike 4 Fmnioye- • NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES RALEIGH, NORTH CAROLINA PERMIT FOR THE CONSTRUCTION AND OPERATION OF A WELL FOR INJECTION In accordance with the provisions of Article 7, Chapter 87; Article 21, Chapter 143, and other applicable Laws, Rules, and Regulations PERMISSION IS HEREBY GRANTED TO Brent and Julia Lammert FOR THE CONSTRUCTION AND OPERATION OF A TYPE 5A7 INJECTION WELL, defined in Title 15A North Carolina Administrative Code 2C .0209(e)(3)(A), which will be used for the injection of heat pump effluent. This injection well is located at 4816 Wedgefield Dr., Wilmington, New Hanover County, NC 28409, and will be constructed and operated in accordance with the application, July 25, 2011, and conformity with the specifications and supporting data, all of which are filed with the Department of Environment and Natural Resources and are considered a part of this permit. This permit is for Construction and Operation of an injection well shall be in compliance with Title 15A North Carolina Administrative Code 2C .0100 and .0200, and any other Laws, Rules, and Regulations pertaining to well construction and use. This permit shall be effective, unless revoked, from the date of its issuance until July 31, 2016, and shall be subject to the specified conditions and limitations set forth in Parts 1 through IX hereof Permit issued this the le‘ day of �-�-y��� ~, 2011 vv.,. a k...k_z".±› Coleen H. Sullins, Director Division of Water Quality By Authority of the Environmental Management Commission. W10800246 1 PART I -WELL CONSTRUCTION GENERAL CONDITIONS 1. The Pennittee must comply with all conditions of this permit and with the standards and criteria specified in Criteria and Standards Applicable to Injection Wells (15A NCAC 2C .0200). Any noncompliance with conditions of this permit constitutes a violation of the North Carolina Well Construction Act and is grounds for enforcement action as provided for in N.C.G.S. 87-94. 2. This permit shall become voidable unless the facility is constructed in accordance with the conditions of this pennit, the approved plans and specifications, and other supporting data. 3. Each injection well shall not hydraulically connect separate aquifers. 4. Each injection well shall be constructed in such a manner that water from land surface cannot migrate into the gravel pack or well screen. 5. Each injection well shall be secured to reasonably insure against unauthorized access and use. Each well shall be permanently labeled with a warning that it is for injection purposes and the entrance to each well must be sealed with a watertight cap or well seal, as defined in G.S. 87-85(16). 6. Each injection well shall be afforded reasonable protection against damage during construction and use. 7. Each geothermal injection well shall have permanently affixed an identification plate according to 2C .0213(g). 8. A completed Well Construction Record (Form GW-1) must be submitted for each injection well to: Aquifer Protection Section -UIC Staff 1636 Mail Service Center Raleigh, NC 27699-1636 and Aquifer Protection Section -Wilmington Regional Office 127 Cardinal Dr. Extension Wilmington, NC 28405 910-796-7215 GW-ls must be submitted within 30 days of completion of well construction. Copies of the GW-1 form(s) shall be retained on-site and available for inspection. PART II -WELL CONSTRUCTION SPECIAL CONDITIONS 1. At least forty-eight (48) hours prior to constructing each injection well, the Permittee shall notify the Aquifer Protection Section-Underground Injection Control (UIC), Central Office staff, telephone number (919) 715-6166 and the Wilmington Regional Office Aquifer Protection Section (APS) Staff, telephone number 910-796-7215. 2. Within 30 days of injection well completion, Permittee must contact the Wilmington Regional Office APS Staff in order to have samples collected at the source well and injection well. WI080 024ii 2 3. Continued operation of the injection system will be contingent upon the effluent not impacting groundwater quality. The water quality of the effluent cannot be that of a lower quality than the influent, which results in a degrading of water quality of the aquifer. 4. The injection well system must be constructed with sampling ports so that system influent and effluent may be sampled. 5. The injection well must be constructed to a depth such that it is injecting water into the same aquifer that a source well, if present, is drawing from. PART III-OPERATION AND USE GENERAL CONDITIONS 1. This permit is effective only with respect to the nature, volume of materials and rate of injection, as described in the application and other supporting data. 2. This permit is not transferable without prior notice to, and approval by, the Director of the Division of Water Quality (Director). In the event there is a desire for the facility to change ownership, or there is a name change of the Permittee, a formal permit amendment request must be submitted to the Director, including any supporting materials as may be appropriate, at least 30 days prior to the date of the change. 3. The issuance of this permit shall not relieve the Permittee of the responsibility of complying with any and all statutes, rules, regulations, or ordinances, which may be imposed by other local, state, and federal agencies, which have jurisdiction. Furthermore, the issuance of this permit does not imply that all regulatory requirements have been met. PART IV-PERFORMANCE STANDARDS 1. The injection facility shall be effectively maintained and operated at all times so that there is no contamination of groundwater which will render it unsatisfactory for normal use. In the event that the facility fails to perform satisfactorily, including the creation of nuisance conditions or failure of the injection zone to adequately assimilate the injected fluid, the Permittee shall take immediate corrective actions including those actions that may be required by the Division of Water Quality such as the repair, modification, or abandonment of the injection facility. 2. The Permittee shall be required to comply with the terms and conditions of this permit even if compliance requires a reduction or elimination of the permitted activity. 3. The issuance of this permit shall not relieve the Permittee of the responsibility for damages to surface or groundwater resulting from the operation of this facility. PART V -OPERATION AND MAINTENANCE REQUIREMENTS 1. The injection facility shall be properly maintained and operated at all times. 2. The Permittee must notify the Division and receive prior written approval from the Director of any planned physical alterations or additions in the permitted facility or activity not specifically authorized by the permit. WI0 80 0246 3 3. At least forty-eight (48) hours prior to the initiation of the operation of the facility for injection, the Permittee must notify by telephone the Aquifer Protection Section-Underground Injection Control (UIC), Central Office staff, telephone number (919) 715-6166 Notification is required so that Division staff can inspect or otherwise review the injection facility and determine if it is in compliance with permit conditions. PART VI -INSPECTIONS 1. Any duly authorized officer, employee, or representative of the Division of Water Quality may, upon presentation of credentials, enter and inspect any property, premises, or place on or related to the injection facility at any reasonable time for the purpose of determining compliance with this permit, may inspect or copy any records that must be maintained under the terms and conditions of this permit, and may obtain samples of groundwater, surface water, or injection fluids. 2. Department representatives shall have reasonable access for purposes of inspection, observation, and sampling associated with injection and any related facilities as provided for in N.C.G.S. 87-90. 3. Provisions shall be made for collecting any necessary and appropriate samples associated with the injection facility activities. PART VII -MONITORING AND REPORTING REQUIREMENTS 1. Any monitoring (including groundwater, surface water, or soil sampling) deemed necessary by the Division of Water Quality to insure surface and ground water protection, will be established and an acceptable sampling reporting schedule shall be followed. · 2. The Permittee shall report by telephone, within 48 hours of the occurrence or first knowledge of the occurrence, to the Wilmington Regional Office, telephone number 910-796-7215, any of the following: (A) Any occurrence at the injection facility that results in any unusual operating circumstances; (B) Any failure due to known or unknown reasons that renders the facility incapable of proper injection operations, such as mechanical or electrical failures; 3. Where the Permittee becomes aware of an omission of any relevant facts in a permit application, or of any incorrect information submitted in said application or in any report to the Director, the relevant and correct facts or information shall be promptly submitted to the Director by the Permittee. 4. In the event that the permitted facility fails to perform satisfactorily, the Permittee shall take such immediate action as may be required by the Director. PART VIII -PERMIT RENEW AL The Permittee shall, at least 120 days prior to the expiration of this permit, request an extension. WI0 80024h 4 PART IX-CHANGE OF WELL STATUS 1. The Permittee shall provide written notification within 15 days of any change of status of an injection well. Such a change would include the discontinued use of a well for injection . If a well is taken completely out of service temporarily, the Permittee must install a sanitary seal. If a well is not to be used for any purpose that well must be permanently abandoned according to 15A NCAC 2C .0213(h)(l), Well Construction Standards. 2. When operations have ceased at the facility and a well will no longer be used for any purpose, the Permittee shall abandon that injection well in accordance with the procedures specified in 15A NCAC 2C .0214, including but not limited to the following: (A) All casing and materials may be removed prior to initiation of abandonment procedures if the Director finds such removal will not be responsible for, or contribute to, the contamination of an underground source of drinking water. (B) The entire depth of each well shall be sounded before it is sealed to insure freedom from obstructions that may interfere with sealing operations. (C) Each well shall be thoroughly disinfected, prior to sealing, if the Director determines that failure to do so could lead to the contamination of an underground source of drinking water. (D) Each well shall be completely filled with cement grout, which shall be introduced into the well through a pipe which extends to the bottom of the well and is raised as the well is filled. (E) In the case of gravel-packed wells in which the casing and screens have not been removed, the casing shall be perforated opposite the gravel pack, at intervals not exceeding 10 feet, and grout injected through the perforations. (F) In those cases when, as a result of the injection operations, a subsurface cavity has been created, each well shall be abandoned in such a manner that will prevent the movement of fluids into or between underground sources of drinking water and in accordance with the terms and conditions of the permit. (G) The Permittee shall submit a Well Abandonment Record (Form GW-30) as specified in 15A NCAC 2C .0213(h)(l) within 30 days of completion of abandonment. 3. The written documentation required in Part IX (1) and (2) (G) shall be submitted to: WI0800246 Aquifer Protection Section-DIC Program DENR-Division of Water Quality 1636 Mail Service Center Raleigh, NC 27699-1636 5 AQUIFER PROTECTION SECTION REGIONAL OFFICE STAFF REPORT To: AQUIFER PROTECTION SECTION CENTRAL OFFICE Central Office Reviewer: Michael Rodgers Application No.: WI0800246 Permittee: Lammert Project Name: same Regional Login No.: lammert.811 County: New Hanover GENERAL INFORMATION 1. This application is (indicate all that apply): X New Renewal Minor Modification Major Modification Surface Irrigation Reuse Recycle Evaporation/Infiltration Lagoon 503 Regulated 503 Exempt Land Application of Residuals Distribution of Residuals High Rate Infiltration Attachment B included Surface Disposal Closed Loop Groundwater Remediation X Other Injection Wells (UIC-5A7) 2. Was a site visit conducted in order to prepare this report? X Yes No a. Date of site visit: 08/10/2011 b. Person contacted and contact information: Julia Lammert 910-622-4002 c. Site visit conducted by: Jim Bushardt d. Inspection report attached: Yes X No (see report summary) 3. Is the following information entered into the BIMS record for this application correct? Yes No If no, please complete the following information or indicate that it is correct on the current application. For Treatment Facilities: a. Location: 4816 Wedgefield Drive, Wilmington, NC b. Driving directions: c. USGS Quadrangle number and map name: Wilmington, NC d. Latitude: 34.09.04 Longitude: 77.53.01 e. Regulated activities/type of wastes: (e.g., subdivision, food processing, municipal wastewater): HVAC injection well RECEIVED / DENR / DWQ AQUIFl=R·PROTt=r.TION SECTION AUG 15 2011 AQUIFER PROTECTION SECTION REGIONAL OFFICE STAFF REPORT For Dis posal Sites: (If multiple sites either indicate which sites the information applies to, copy and paste a new section into the document for each site, or attach additional pages for each site) a . Location(s): b. Driving directions: c. USGS Quadrangle map name and number: d. Latitude: Longitude: NEW AND MAJOR MODIFICATION APPLICATIONS (this section not needed for renewals or minor modifications, skip to next section) . DESCRIPTION OF WASTE (S) AND FACILITIES 1. Please attach a completed rating sheet. Facility classification: 2 . Are the new treatment facilities adequate for the type of waste and disposal system? Yes No N/A If no, please explain: 3. Are the new site conditions (soils, topography, etc.) consistent with what was reported by the soil scientist and/or professional engineer? Yes No NIA If no, please explain : 4. Does the application (maps, plans, etc.) represent the actual site (property lines, wells, surface drainage)? Yes No N/A If no, please explain: 5. Is the proposed residuals management plan adequate and/or acceptable to the Division? Yes No N/A If no, please explain: 6. Are the proposed application rates for the new sites (hydraulic or nutrient) acceptable? Yes No · N/A If no, please explain : 7. Are the new treatment facilities or any new disposal sites located in the 100 year floodplain? Yes No N/A If yes, please attach a map showing the areas of the 100 year floodplain and explain and recommend any mitigative measures/special conditions in Part IV : 8. Are there any buffer conflicts (new treatment facilities or new disposal sites)? Yes No If yes, please attach a map showing conflict areas or attach any new maps you have received from the applicant to be incorporated into the permit: 9 . Is the proposed or existing groundwater monitoring program (number of wells, frequency of monitoring , monitoring parameters, etc.) adequate? Yes No N/A Attach map of monitoring well network if applicable. Indicate review and compliance boundaries. If No, explain and recommend any changes to the groundwater monitoring program. Attach map of existing monitoring well network, if applicable, indicating the review and compliance boundaries. AQUIFER PROTECTION SECTION REGIONAL OFFICE STAFF REPORT 10. For residuals, will seasonal or other restrictions be required? Yes If yes, attach list of sites with seasonal restrictions (Certification B?) No N/A RENEWAL AND MODIFICATION APPLICATIONS (use previous section for new or major modification systems) DESCRIPTION OF WASTE(S) AND FACILITIES 1. Is there an appropriately certified ORC for the facility? Yes No Operator in Responsible Charge: Certificate # : Back-up Operator : Certificate # : 2. Is the design maintenance and operation (e.g. adequate aeration, sludge wasting, sludge storage, effluent storage, etc.) of the treatment facilities adequate for the type of waste and disposal system? Yes No If no, please explain: 3. Are the new site conditions (soils, topography, etc.) maintained appropriately and adequately assimilating the waste? Yes No If no, please explain: 4. Has the site changed in any way that may affect the permit (drainage added, new wells installed inside the compliance boundary, new development, etc.). Yes No If Yes, please explain: 5. Is the residuals management plan adequate and/or acceptable to the Division? Yes No If no, please explain: 6. Are the existing application rates (hydraulic or nutrient) still acceptable? Yes No If no, please explain: 7. Is the existing groundwater monitoring program (number and location of monitoring wells, frequency of monitoring, monitoring parameters, etc.) adequate? Yes No N/A Attach map of existing monitoring well network if Applicable. Indicate review and compliance boundaries. If No, explain and provide recommended changes to the groundwater monitoring program: 8. Will seasonal or other restrictions be required for added sites? Yes If yes, attach list of sites with restrictions (Certification B?) No 9. Are there any buffer conflicts (new treatment facilities or new disposal sites)? N/A Yes No If yes, attach a map showing the conflict areas or attach any new maps you have received from the applicant to be incorporated into the permit: 10. Is the description of the facilities type and/or volume of waste(s) as written in the existing permit correct? Yes No If no, please explain: 11. Were monitoring wells properly constructed and located? Yes No N/A If no, please explain: 12. Has the review of all self-monitoring data been conducted (GW, NDMR, and NDAR as applicable)? Yes No Please summarize any findings from the review: Compliance AQUIFER PROTECTION SECTION REGIONAL OFFICE STAFF REPORT 13. Check all that apply: No compliance issues Notices of violation within the last permit cycle Current enforcement action(s) Currently under SOC Currently under JOC Currently under moratorium If any items are checked, please explain and attach any documents that may help clarify answer/comments (such as NOV, NOD, etc.). 14. Have all compliance dates/conditions in the existing permit, SOC, JOC, etc. been complied with? Yes No N/A If no, please explain: 15. Are there any issues related to compliance/enforcement that should be resolved before issuing this permit? Yes No If yes, please explain: INJECTION WELL PERMIT APPLICATIONS (Complete these two sections for all systems that use injection wells, including closed loop groundwater remediation effluent injection wells, in situ remediation injection wells, and heat pump injection wells. Descri ption of well(s ) and Facilities -New, Renewal , and Modification 1. Type of injection system: X Heating/cooling water return flow (5A7) Closed-loop heat pump system (5QM/5QW) In situ remediation (51) Closed-loop groundwater remediation effluent injection (5L nondischarge) Other (specify) 2. Does the system use the same well for water source and injection? Yes X No 3. Are there any pollution sources that may affect injection? Yes X No If yes, what are the pollutant source(s) and distance(s) from the closest injection well: proposed well is 135 ft from sanitary sewer and 25 ft from house foundation. 4. What is the minimum distance of proposed injection wells from the property boundary? Approx 10 ft 5. Quality of drainage at the site: Good XAdequate Poor 6. Flooding potential of site: X Low Moderate High Back yard location has topography and well head area should not impound stormwater. 7. For groundwater remediation systems, is the proposed and/or existing groundwater monitoring program (number of wells, frequency of monitoring, monitoring parameters, etc.) adequate? Yes No Attach map of monitoring well network if applicable. If no, explain ·and recommend any changes to the monitoring program.n/a AQUIFER PROTECTION SECTION REGIONAL OFFICE STAFF REPORT 8. Does the map presented represent the actual site (property lines, wells, surface drainage)? Yes X No lfno, or no map, please attach a map of the site showing property boundaries, buildings, wells, potential pollution sources, roads, approximate scale, and north arrow. No topographic map provided, but visual observation shows adequate drainage capability around proposed injection well head. In jection Well Permit Renewal And Modification Onl y : 1. For heat pump systems, are there any abnormalities in the heat pump or injection well operation (e.g. turbid water, failure to assimilate injected fluid, poor heating/cooling)? Yes No If yes, please explain: 2. For closed loop heat pump systems, has the system lost pressure or required make-up fluid since permit issuance or last inspection? Yes No If yes, please explain: 3. For renewal or modification of groundwater remediation permits, will continued/additional/modified injections have an adverse impact on migration of the plume or management of the contamination incident? Yes No If yes, please explain: 4. Drilling contractor: Name Address Certification Number 5. Complete and attach well construction data sheet: EVALUATION AND RECOMMENDATIONS 1. Provide any additional narrative regarding your review of the application. This report is being prepared based upon an application to install an injection well to support a water to air heat pump system. The existing supply well was installed 3/15/11 into the Pee Dee (confined) aquifer approximately 215 ft BLS. The well has a concrete apron and is grouted to an undetermined depth. There are no buffer issues with this existing supply well or for the proposed injection well. The applicant will install an injection well into the Pee Dee ( confined) aquifer, approximately 155 ft BLS. The proposed well location has changed. An updated site map is enclosed. 2. Attach well construction data sheet, as needed information is available. N/A 3. Do you foresee any problems with issuance/renewal of this permit? Yes X No If yes, please explain: 4. List any items that you would like the APS Central Office to obtain through additional information request. Please provide a reason with each item. None 5. List specific permit conditions that you recommend to by removed from the permit when issued. Please provide a reason for each recommendation. None AQUIFER PROTECTION SECTION REGIONAL OFFICE STAFF REPORT 6. List specific special conditions or compliance schedules that you recommend to be included in the permit when issued. Please provide a reason for each recommendation. None 7. Recommendation: Hold, pending receipt and review of additional information by the regional office; Hold, pending review of draft permit by the regional office; X Issue Deny If denied, please state reasons Signature of report preparer y►- �� �-r�'� Signature of APS regional supervisor: } lr7 /3 44r . Fofa_ Ct .4es q-etulw Date: f3'Az/.// ADDITIONAL REGIONAL STAFF REVIEW ITEMS Jb:lammertweli.811 Cc: Wilmington APS Files Central Office APS Files SURVEY R1411tRaYESt DEED BOOR 4683. PAGE 433 AMP BOOK PACE 349 PIO: RO7179-005-024-000 1. THIS PROPERTY DOES NOT LIE WITHIN A SPECL4L FLOOD HAZARD AREA. ALP PANEL No.: 372O313400J MAP PANEL a4TE APRIL J, 2006 zone 7r• 2, CORNERS ARE MARKED AS NOTED ON AMP. 3 ALL DISTANCES ARE HOW. FIELD MEASUREALINTS. 4. AREA COMPUTED BY THE COORDINATE METH= i —.. — 3 NEIGHBOR'S FENCE L07 234 — x --- t DUSTING RESIDENCE crmersrr_ FRONT = 25- SIDE = 70' REAR a 20' m 7D' UTILITY FASkAIEM T0 1i,-y7 r N 64 —End ATnit PTOF CURVE air 2 AS SHOW' IN MAP BOOK 36 PAGE 349. -e LE'GEN&: • NIS7NCVC IRONIRON �ROO) • SIR (SET IRON ROD) U EXISTING' CONTROL MONUMENT PROPERTY LINE — -- — TIELINE — — - — EASEMENT UNE — K — FENCE LINE HIDDEN VALLEY — SEC770N 2 MAP 5X. 19, PG, 74 Tr* MANAGE EErASSEMENT. J59O S ; Fs Mar LINE :2 0' PROPOSED SfDEWALK WA7E34 itgETER EVSTING 57DNE Rea SETBACK Da — i S 7 05 72T 700.G0 (CHORO) Ae7Il15 = 2e2250' WF.I'DDEFI'LD DRIVE 45 PUBLIC R7CHT OF WAY sftOiseiezt SITE FR71717 YAP (A.Ts) STORAGE BUILDING IS 0,53' ACROSS LINE AT Dill' POINT NE7G7&13OR $ FENCE JSi7NG RESIDENCE T7,7e copy hos been transmitted through electronic media and shall not he used as a certified document, This document was originally issued and sealed by Manley O. Carr, PLS PROPOSED SITE PLAN NC LLcerrse Na. L-2580 on FOR March fa 2071. CENTERLINE CURVE DATA RADIUS = 2800.00" DELTA = 917'76` BRENT T. LAMMERT and wife, JULIA M. LAMMERT OF LOT 235 - SECTION 2 - WEDGEFOELD AT CROSSWINDS SOUTH Il7LMING70N TOWNSHIP — NEW HANOVER COUNTY — NORTH CARDUNA SCALE 7" = 30' DATE: MARCH 8, 2017 30 0 30 60 1 INCH = 30 FEET 1, Manley D. Carr, PLS certify that this plat was drown under my eapervision from on actual field survey made under my supervision from informollon as noted hereon; that the boundaries not surveyed are clearly Fndlcaled as dashed tines; that the ratio of precision as calculated us 1:10,000+ and Is correct to the best of my knowledge and belkf, Vilifies* my original Signature, License Number and Seal this day of . AD, 201 i. Manley D. Can; PLS NC Licenser No. L-2580 Existing Pumping Well * Proposed Injection Well 90 MANGEY 0. CARR, PLS ROOT H. GOBLET & ASSOCIATES. PA LAND SL1RVEYORS — LAND PLANNERS 317 E. MVRd1Y ST. / P.O BOX 733 WALLACE, NOR17I CAROLINA 28466 NC CORPORATE LICENSE No. C-7167 910-285-42T0 Emark rhgwalffemborgmail.com F7LE No.: 71790524 AQUIFER PROTECTION SECTION APPLICATION REVIEW REQUEST FORM Date: Aueust 4 . 2011 To: D Landon Davidson, ARO-APS □ Art Barnhardt, FRO-AP~ 0 Andrew Pitner, MRO-APS 0 Jay Zimmerman, RRO-APS From: Michael Ro 11ers Groundwater Protection Unit Telephone: (919) 715-6166 E-Mail: Michael.Ro gers@ncmail.net A. Permit Number: WI 0800246 B. Owner: Brent and Julia Lammert. C. Facility/Ope:ration; _._: _._ [gl Proposed D Existing D. Application: 0 David May, W aRO-APS J:gj Charlie Stehman, WiRO-APS □ Sherri Knight, W-SRO-APS Fax: (919) 715-0588 D Facility D Operation 1. Permit Type: D Animal D SFR-Surface Irrigation □ Reuse D H-R Infiltration D Recycle D I/E Lagoon D GW Remediation (ND) [gj UIC -5A 7 Well For Residuals: D Land App. 0 503 0 D&M D 503 Exempt D Surface Disposal □ Animal 2. Project Type: [g) New [gj Major Mod. D Minor Mod. D Renewal D Renewal w/Mod. E. Comments/Other Information: D NOTE: This site originally submitted as 5QW. However, they filled out the wrong form as this is an open loop geothermal system. Attached, you will find all information submitted in support of the above-referenced application for your review, comment, and/or action. Within, please take the following actions: J:gj Return a Completed APSARR Form and attach laboratory analytical results, if applicable. D Attach Well Construction Data Sheet. D Attach Attachment B for Certification by the LAPCU. D Issue an Attachment B Certification from the RO.* * Remember that you will be responsible for coordinating site visits and reviews, as well as additional information requests with other RO-APS representatives in order to prepare a complete Attachment B for certification. Refer to the RPP SOP for additional detail. When you receive this request form , please write your name and dates in the spaces below, make a copy of this sheet, and return it to the appropriate Central Office-Aquifer Protection Section contact person listed above. RO-APS Reviewer: Date: ------ FORM: APSARR 07/06 Page I of I RA NCDENR North Carolina Department of Environment and Natural Resources Divis ion of Water Quality Beverly Eaves Perdue Governor Coleen H. Sullins Director August 2, 2011 Brent Lammert Julia Lammert 5045 Whitner Dr. Wilmington, NC 28409 Subject: Acknowledgement of Application No. WI0800246 Brent & Julia Lammert SFR Injection Heating/Cooling Water Return Well ( 5A 7) New Hanover Dear Mr. Lammert: Dee Freeman Secretary The Aquifer Protection Section of the Division of Water Quality (Division) acknowledges receipt of your permit application and supporting materials on 07/25/2011. This application package has been assigned the number listed above and will be reviewed by Michael Rogers. The reviewer will perform a detailed review and contact you with a request for additional information if necessary. To ensure the maximum efficiency in processing permit applications, the Division requests your assistance in providing a timely and complete response to any additional information requests. Please be aware thatthe Division's Regional Office, copied below, must provide recommendations prior to final action by the Division. Please also note at this time, processing permit applications can take as long as 60 -90 days after receipt of a complete application. If you have any questions, please contact Michael Rogers at 919-715-6166, or via e-mail at Michael.rogers@ncdenr.gov. If the reviewer is unavailable, you may leave a message, and they will respond promptly. Also note that the Division has reorganized. To review our new organizational chart, go to http://h2o.enr.state.nc.us/docurnents/dwg or!'!chart.pdf. PLEASE REFER TO THE ABOVE APPLICATION NUMBER WHEN MAKING INQUIRIES ON THIS PROJECT . Sincj ely, D r\ 01J'iL-A ~WLU for Debra~atts Supervisor cc: Wilmington Regional Office, Aquifer _Protection Section Diana Helias (ARM's WaterWorks, P .O. Box 882 , Hampstead, NC 28443) Permit-A.i,plication-Fi-le· WGI080014ti AQUIFER PROTECTIOt; SECTION 1636 Mail Service Center, Raieigh, North Carolina 27699-163f. Lo:ation: 272B Capital Boulevard, Raieigh, r·;ort h Caroiina 2760, Phone: 919-733-3221 \ FAX 1: 919-715-0588: FAX 2: 919-715-6048 \ Customer Service 1-877-623-5748 lniernet: www.ncwaterauali tv.oro An Equal Opport~a it:: \ f,~•'T12.iive Acm:1 En,~1 01•,_- None . C 1. ortn· aroma J\'Jaturallt/ NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES APPLICATION FOR A PERMIT TO CONSTRUCT OR OPERATE INJECTION WELLS In Accordance With the Provisions of 15A NCAC 02C .0200 OPEN-LOOP GEOTHERMAL INJECTION WELLS These wells discharge groundwater directly into the subsurface as part of a geothermal heating and cooling system (check one) X-New Application ___ Renewal* Modification * For renewals complete Parts A-C and the signature page. Print or Type Information and Mail to the Address on the Last Page. Illegible Applications Will Be Returned As Incomplete . DATE: June 22 20 11 PERMIT NO. _W_I 0_8_0_02_4_6 _____ (leave blank ifNew Application) A. STATUS OF APPLICANT (choose one) Non-Government: Individual Residence X Business/Organization __ Government: State Municipal __ County__ Federal REG_EIVEO / DENR I DWQ Aquifer Protection Section JUL 26 2011 B. PERMIT APPLICANT -For individual residences, list each owner on property deed. For all others, state name of entity and name of person delegated authority to sign on behalf of the business or agency: Brent & Julia Lammert Mailing Address: 5045 Whitner Drive City: Wilmington State: NC Zip Code:_2_8_4_0 _9 ____ County: New Hanover Day Tele No.: 910_:-~22-4002 Cell No.: EMAIL Address: _____________ ~F~ax~N~o=.:c._ _________ .,, ___ _ C. LOCATION OF WELL SITE-Where the injection wells are physically located: (1) Parcel Identification Number (PIN) of well site: R07119-005-024-000 County: New Han. (2) Physical Address (if different than mailing address): 4816 Wedqefield Drive City: Wilmington State: _NC Zip Code: ... 2=8~4~0~9 _____ _ D. WELL DRILLER INFORMATION Well Drilling Contractor's Name: ~H~. ~M~i~c~h=a~e~I_S~a"--"-"g--'-e ________________ _ NC Well Drilling Contractor Certification No.: ~2=5~3~1~A...a..... ________________ _ Company Name: ARM'S Waterworks Contact Person: Diana Helias Address: PO Box 882 EMAIL Address: Diana@wateiworksdrilling.com City: Ham pstead Zip Code: 28443 State: NC County: ~P~e~n=de=r~----- Office Tele No.: 910-270-2919 Cell No.: Fax No.: 910-270-2988 -------- GPU/UIC 5A7 Permit Application (Revised 3/18/2011) Page 1 E. HEAT PUMP CONTRACTOR INFORMATION (if different than driller) F. G. CompanyName:_T_B_D ___________________________ _ Contact Person,.,_: ______________ _.::E:.:.,MA=I"'-"L'""'Ao.-=d=dr=e""'ss"-'-: ___________ _ Address:---------------------------------- City: __________ Zip Code: ____ State: __ County : _________ _ Office Tele No.: Cell No.: _________ =-F=ax=-=-N=o=.: ______ _ WELL USE Will the injection well(s) also be used as the supply well(s) for the following? (1) The injection operation? YES ____ NO _X __ _ (2) Personal consumption? YES ____ NO ~X __ _ WELL CONSTRUCTION DATA (1) (2) _X ___ PROPOSED Well(s) to be constructed for use as an injection well. Provide the data in (1) through (6) below as PROPOSED construction specifications . Submit Form GW-1 after construction. ____ EXISTING Well(s) being proposed for use as an injection well . Provide the data in (1) through (6) below to the best of your knowledge. Attach a copy of the Well Construction Record (Form GW-1) if available. Well Construction Date: 8/10/11 Number of borings: 1 ---- Depth of each boring (feet):_2_1_5 _____ _ Well casing type: Galvanized steel Black steel Plastic X Other (specify) ______ _ --1:vc- Casing thickness (in.): sch4 0 Diameter (in.):.£____ . I ' , Well depth: from:~ •S to: 155 feet below land surface Casing exte~~~ above ground < 18 inches (3) Grout material surrounding well casing: (a) Grout type: Cement__x___ Bentonite• X__ Other (specify) ______ _ *By selecfihg 'bentonite grout, a variance is hereby requested to ISA NCAC 2C .0213( d)(l )(A), which requires a cement type grout. (b) Depth of grout around well casing (relative to land surface): from ~O~ __ to 34 feet (4) Well Screen or Open Borehole depth (relative to land surface): from 155 to 215 feet (5) N.C. State Regulations (Title 15A NCAC 2C .0200) require the Permittee to make provisions for monitoring wellhead processes . A faucet on both Influent (groundwater entering heat pump) and Effluent (water being injected back into the well) lines is required. Is there a faucet on: (a) Influent line? Yes_X __ No__ (b) Effluent line? Yes X No (6) Source Well Construction Information. If the water source well is a different well than the injection well, attach a copy of the well construction record {Form GW-1). If Form GW-1 is not available, provide the following data: ~ ~d Wtll ll.a..LD<"l\ Q.c-s"'Vr()ly vvef ( i·n,fu From what depth, formation, and type of rock/sediment units will the groundwater be withdrawn? (e.g. granite, limestone, sand, etc.) Depth: 215' Formation: Pee Dee Rock/sediment unit: Sandstone NOTE: THE WELL DRILLING OR HEAT PUMP CONTRACTOR CAN HELP SUPPLY THE DATA IF THIS INFORMATION IS OTHERWISE UNAVAILABLE. GPU/UIC 5A7 Permit Application (Revised 3/18/2011) Page2 H. OPERATINGDATA (1) (2) (3) (4) Injection Rate: Injection Volume: Injection Pressure: Injection Temperature: Average (daily) <15 gallons per minute (gpm). Average (daily) <21.soo gallons per day (gpd). Average (daily) <15 pounds/square inch (psi). Average (January) 60 ° F, Average (July) 65 ° F. I. WELL LOCATIONS -Maps must be scaled or otherwise accurately indicate distances and orientations of features located within 1000 feet of the injection well(s). Label all features clearly and include a north arrow. (1) Attach a site-specific map showing the locations of the following: * Proposed injection wells * Buildings * Property boundaries * Surface water bodies * Water supply wells * Septic tanks and associated spray irrigation sites, drain fields, or repair areas * Existing or potential sources of groundwater contamination (2) Attach a topographic map of the area extending 1/4 mile from the injection well site that indicates the facility's location and the map name. NOTE: In most cases, an aerial photograph of the property parcel showing property lines and structures can be obtained and downloaded from the applicable county GIS website. Typically, the property can be searched by owner name or address. The location of the wells in relation to property boundaries, houses, septic tanks, other wells, etc. can then be drawn in by hand. Also, a 'layer' can be selected showing topographic contours or elevation data. GPU/UIC SA 7 Permit Application (Revised 3/18/2011) Page3 3. CERTIFICATION (to be signed as required below or by that person's authorized agent) 15A b4CAC 02C .021 1(b) requires that all permit applications shall be signed as follows: 1, for a corporation: by a responsible corporate officer; 2. for a partnership or sole proprietorship: by a general partner or the proprietor, respectively; 3. for a municipality or a state, federal, or other publie agency: by either a principal executive officer or ranking publicly elected official; 4, for all others: by the well owner (which means all persons listed on the propert. deed). If an authorized agent is signing on behalf of the applicant, then supply a letter signed by the applicant that names and authorizes their agent to sign this application on their behalf. "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 responsble for obtaining said information, t believe that the information is true, accurate and complete. 1 am aware that there are significant penalties, including the possibility of fines and imprisonment, for submitting false information. ; agree to construct, operate, maintain, repar.ir, and if applicable, abandon the injection well and all related appurtenances in accordance with the approv1 specifications and conditions of the Permit." gnature re of lrroperty Owner=/Applicant Print or Type Full Name Sis� saJric of Property Owner/Applicant� L/,4 I1 La r1 rM oft - Print or Type Full Name Signature of Authorized Agent, if any Print or Type FuH Name Submit two copies of the completed application package to: DWQ - Aquifer Protection Section 1 636 Mail Service Center Raleigh, NC 27699-1636 Telephone (919) 733-3221 RECEIVED 1 ❑ENR l C}WC Aquifer Protection Section JUL 26 2011 (}PUIUIC 5A7 Permit Application (Revised 3/18f201 1)Pap 4 NON ONRESIDENTIAL WELL CONSTRUCTION RECORD North Carolina Department of Environment and Natural Resources- Division of Water Quality WELL CONTRACTOR CERTIFICATION # 2412 A 1. WELL CONTRACTOR: Donald H. Cummings Well Contractor (Individual) Name Applied Resource Manaaement P.C. Well Contractor Company Name 257 Transfer Station Rd. Street Address Hamizstead Nc 28443 City or Town State Zip Code (910 j 270-2919 Area code Phone number 2. WELL INFORMATION: WELL CONSTRUCTION PERMIT# OTHER ASSOCIATED PERMITit(Ifappricabia) SITE WELL ID tt(ii epp5cabie) 3. WELL USE (Check One Box) Monitoring 0 Municipal/Public u Industrial/Commercial 0 Agricultural u Recovery 0 injection C] trrigationi' other et(list use) Geothermal $upp[ y DATE DRILLED 3 1 1 1,2b11 4. WELL LOCATION: 4816 Wedaeield Drive (Veal Name, Numbers, Commurity, Subdivision, Lot Ne., Pamet, Zip Code) art,: Wilminaton couriry New Han. TOPOGRAPHIC 1 LAND SETTING: (check appropriate box) QSlope 0Valley elat ❑Ridge ❑Other LATITUDE 34 ° B ' 3-n000 OMS OR DD LONGITUDE 77 " DMS OR DO Latitude/longitude source: IR PS 17ropographnc map (location of well rust be shown on a USGS topo map andetacFred to this form if not using GP$) 5. FACILITY [Name of the business where the well Is located.) Facility Name Facility ID* (€f applicable) Street Address City or Town State Julia &Brent I amrriprt Contact Name 4816 Wedoefald Drive Zip Code Marling Address Wilminaton NC 2R40,Q City or Town State Zip Code 910 ) 622-41)02 Area coda Phone number 6, WELL DETAILS: a. TOTAL DEPTH: 215' b. DOES WELL REPLACE EXISTING WELL? YES E7 NO pI c. WATER LEVEL Below Top of Casing: 28 FT. (Use "t' if Above Top of Casing) d. TOP OF CASING 15 1 5 FT. Above Land Surface' "fop of casing terminated at/or below land surface may require a variance in accordance with 15A NCAC 2C .0118- e. YIELD (gpm): 80 METHOD OF TEST Airlift f. DISINFECTION: Type„ HTH Amount 3a@10% g. WATER ZONES (depth): Top Bottom Top Bottom Top Bottom Top, Bottom Top Bottom Top Bottom Thickness, Depth Diameter Weight Material Bottom 155 Ft. 4" sch40 PVC Topes_ Bottom 80 Ft. 6' sch40 PVC Ft. _ 7. CASING: Top 0 Top_ Bottom 8. GROUT: Depth Top 0 Bottom 30 Top 30 Bottom 34 Material Ft. Qrout Ft. Bentonite Top Bottom Ft. Method Tremmie Tremmie 9. SCREEN: Depth Diameter Slat Size Material Top 155 Bottom 215 Ft- 4 in. ,010 in. PVC Top Bottom Ft. in. in. Top Bottom FL in. in. 10. SAND/GRAVEL PACK: Depth Top 151 Bottom 215 Ft, Top Bottom FL Top Bottom Ft. 11. DRILLING LOG Top Bottom 0/s' 9' / 2T 27' ► 4T 47' / 60' 60' _I125' 125' 1 150' 150' 1 220' i 220' 1280' 12. REMARKS: Size Material r Formation Description Sand CIaY Sand, clayey sand Clay Limestone Clay/ mud rock Sand wI sandstone Iens@s at 160'and180' ylav I DO HEREBY CERTIFY THAT THIS WELL WA$ CONSTRUCTED IN ACCORDANCE WrrH ISA NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS REC..•HAS BEEN P-■VI.:. ►TH- LLOWNER. SIGNA * • E OF CERTIFI D * U. CON ' • R DA Donald H. Cummings PRINTED NAME OF PERSON CONSTRUCTING THE WELL Submit within 30 days of completion to: Division of Water Quality - Information Processing, 1617 Mail Service Center, Raleigh, NC 27699-161, Phone : (919) 807-6300 Form GW-lb Rev. 2/09 New Hanover County Page 1 of 1 New HaRo r Profile Sales Residential Commercial Mix. Improvements Permits Land Values 4 riWliural SlceIch Full Legal Exemptions Sub-parcel(s) Info Original Parcel Info f Parcel Map PARID:R07119-DOS-024-000 LAMMERT ERENT T JULIA M AeriOIS t - n Layers a bZ I CONTACT US [ HELP Tax ;•io:re y :2xp:3;rer a Deo:ls:iP me Home Property Records Owner Address Parcel ID Advanced EE 41316 WEDGEFTELD DR -4 Last GIS Data Update: aJan-2010 CURRENT RECORD 1of1 1 Return to Search Results Data Copyright New Hanover County [Disclaimer] [Privacy Policy] Last Updated: 27 Jun 2011 Site Design Copyright 1999-2006 Akanda Group LLC. All rights reserved. http:lletax.nhcgov.comfForms/MapDatalet.aspx?sIndex=0&idx=1 &LMparent=20 7/7/2011 ,New Hanover County PARID: R07119·005·024·000 LAMMERT BRENT T JUUA M Parcel AIIID Address Unit City Zip Code Neighborhood Class Land Use Code living Units Acres Zoning Legal Legal Description Tax District Owners Owner City State Country Zip Page 1 of 1 4816 WEDGEFIELD DR 313408.77 .7921 .000 4816 WEDGEFIELD DR WILMINGTON 5822 RES-Residential 958-Unused Land 0 R-15-RESIDENTIAL DISTRICT LOT 235R WEDGEFIELD AT CROSSWINDS SOUTH FD LAMMERT BRENT T JULIA M WILMINGTON NC 28409 THE DATA IS FROM 2011 http://etax.nhcgov.com/Forms/PrintDatalet.aspx?pin=R07119-005-024-000&gsp=PROFILE... 7/7/2011 , I i 8�c Address 4816 Wedgefield Dr 1 '- Wilmington, NC 28409 IG. Gough• Mapson ycxr phow ,t' Text the word " APS'ta466453 0- err 0hrV �7 Tro.1 rT�S.F r � fy Fi svmi{Irr -1Fh330 or ram. VP yJ fl rfr Arlo. Hijpctle CEOSSLvials ej'. f 418 fw 47 'eoinTAfry nr 1gra`ira':' 426 9. viluatts x�. 2ti Cr Fox:; O❑c' telap data 42011 Goggle SVRVEY ONCE.• DEED GOOK 4683, PAGE 433 MAP BOOK . 6 PACE 349 PIO: R07119-005-024-000 NOTES- 7, rH15 PROPERTY DOES Nor UE WITHIN A SPECIAL FLOOD 1-1AZ4R0 AREA. MAP PANEL No.: 3720313400d MAP PANEL DATE APRIL 3, 2006 ZONE- X" 2. CORNERS ARE MARKED AS NOTED ON MAP. 3 ALL DISTANCES ARE HORIZ FIELD MEASUREMENTS. 4. AREA COMPUTED BY THE COORDINATE METHOD. LEGEND: O E1P(EXISTINC IRON PIPE) • E?R (IX1S11NC IRON ROD) • 51R (SET IRON ROD) ❑ EXIS77NG CONTROL MONUMENT PROPERTY LINE — — — — TIE LINE — • — EASEMENT LINE -- x FENCE LINE HIDDEN VALLEY — SECTION 2 MAP BK. 19, PG. 74 N 77.08'02'W 700, 40' WOOD FENCE 1 ❑' UnciTY & DRAINAGE EASEMENT NEIGNAOR S FENCE LOT 234 --- x x EXISTING RESIDENCE SETBACKS; FRONT = 25' SIDE = 70' REAR = 20' • cn AREA = 15,909 S.F.± r14crc Li - - - --- AROPOSED PATO PROPOSED RESIDENCE 72.0 L — — PROPOSED SIDEWALK I VATER ,ucYera 01 ti vrcBvrTY .AP (N Ls) STORAGE BUILDING IS 0.5J' ACROSS OT" LINE AT THIS POINT ---� STOR. UNIT EXISTING STONE FIRE RING PROPOSED DRIVEWAY SETBACK LINE' POSSIBLE SEWER CONNECJION LOT 236 L x 12.3' N 19-12'70T { EXISTING RESIDENCE r47V PFnncT / 141,7 NONRESIDENTIAL WELL CONSTRUCTION RECORD North Carolina Department of Environment and Natural Resources- Division of Water Quality WELL CONTRACTOR CERTIFICATION # 2412 A 1. WELL CONTRACTOR: PQnald H. Cummings Well Contractor (Individual) Name Aoolied Resource Management. P.C. Weil Contractor Company Name 257 Transfer Station Rd. Street Address H?mvsteed NC 2a443 City or Town State Tap Code (910 ) 270-2919 Area code Phone number 2. WELL INFORMATION: WELL CONSTRUCTION PERMIT# OTHER ASSOCIATED PERMIT#{if applicable} SITE WELL ID #(if applicable) 3. WELL USE (Check One Box) Monitoring ID MunlcipaVPublic ❑ Industrial/Commercial 0 Agricultural D Recovery D injection D lrrtgationit( Other'tllst use) Geothermal smepl y DATE DRILLED 3 l 15 ID2tr1 IE 4. WELL LOCATION: 4816 Wedoefield Drive (Street Name. Numbers, Community, Subdlvtsion, Lot No., parcel, Tip Code) CITY: Wilmington couNTY New Han. TOPOGRAPHIC 1 LAND SETTING: (check appropriate boxy ©Slope D Valley elat Li Ridge D Other LATITUDE 34 ° 9 ' 3.0009 " DMS OR LONGITUDE 77 ' 1. - DMS OR DD DD Latitude/longitude source: 3PS Qropographic map Ocean of well must be shown on a USGS topo map andaftached to Ibis form rfnot using GPS) B. FACILJTY (Name of the business where the well is located.) Facility Name Facility IDrk (if applicable) Street Address City or Town State Julia & Brant I ammert Contact Name 4816 WI?dnefeld Drive .T.ip Code Mailing Address Wilmington N.0 2}1.40ct City or Town State Zip Code ( 910 ) 522-4002 Area code Phone number 6. WELL DETAILS: a. TOTAL DEPTH: 215' b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO c. WATER LEVEL Below Top of Casing: 28 FT. (Use'+" it Above Top of Casing) d. TOP OF CASING IS 1.5 FT. Above Land Surface' 'Top of casing terminated at/or below land surface may require a variance In accordance with 15A NCAC 2C .0118. e. YIELD (ppml: 80 METHOD OF TEST Airlift t. DISINFECTION: Type HMI Amount 21Q1f% g. WATER ZONES (depthr Top Bottom Top Bottom Top Bottum Top Bottom Top Bottom Top Bottom Thickness/ 7. CASING: Depth Diameter Weight Material Top 0 Bottom 155 Ft. 4° _ sch40 PVC Top 0 Bottom 80 Ft_ � Sdi4Q PVC Top Bottom Ft. S. GROUT. Depth Material Method Tap 0 _ Bottom 30 FL Grout Tremrpie Top 30 _ Bottom 34 Ft. Bentonite Tremmie. Top Bottom Ft. 9. SCREEN: Depth Diameter 51ot Size Material Top 155 bottom 215 Ft. 4 in. .010 in. PVC Top Bottom Ft. in. in. Top Bottom Ft in. In. 10_ SAND/GRAVEL PACK Depth Top 151 Bottom 215 Top Bottom Size Material Ft. Coarse Sand Ft. Top Bottom Ft. 11. DRILLING LOG Top Bottom Formation Description 0' 19' Sand 9_I2T clay 27' 1 47' Sand/ clavey sand 47' ! 60Clav fib, 1 125' limestone 125' / 150' Clay/ mud rock 150' / 220' Sand wI sandstone lenses at 1 160' and 180' 220' 1 280' Cl2ty r 12. REMARKS: I CO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 1.5A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RE D HAS BEEN - • • ,, + TH L OWNER. Donald H Cummings PRINTED NAME OF PERSON CONSTRUCTING THE WELL Submit within 30 days of completion to: Division of Water Quality - Information Processing, 1617 Mail Service Center, Raleigh, NC 27699-161, Phone : (919) 807-6300 Form OW -lb Rev. 2/09 Post Office Box 882 Hampstead, NC 28443 (91 OJ 270-2919 Fax (91 OJ 270-2988 July 20, 2011 NCDENR, DWQ, UIC Section Mr. Michael Rogers 1636 Mail Service Center Raleigh, North Carolina 27699-1636 Re.: File# WI 0800246 ,.. Dear Mr. Rogers, Please find enclosed, a corrected permit application for the above referenced file number for the property located at 4816 Wedgefield Drive in Wilmington. As discussed this project will be an open-loop system. If you have any questions, or require any further information, please do not hesitate to contact me. Thank you, @~~ Diana Helias Project Coordinator Cc: Dr. Charles Stehman -WiRO w/ encls. Clean Water. It's What We Do Best! RE~EIVED I DENR I DWQ Aquifer Protection Section JUL 26 2011 �-1--to ruL 08 2011 NORTH CAROLINA DFPA TMENT OF ENVIRONMENT AND NATURAL RESOURCES NOTIFICATION OF -INTENT TO CONSTRUCT OR OPERATE INJECTION WELLS In Accordance With the Provisions of I5A NCAC 02C .0200 CL9SfD-LOOP WATER -ONLY GEOTHERMAL INJECTION WELLS F," These wells circulate potable water only as part of a geothermal heating and cooling system. These wells are "`rewnitted by rule" and do not require an individual permit when they are constructed in accordance with the rules of I5A NCAC 02C .0200 and this Notice is submitted prior to construction. Print or Type Information and Mail to the Address on the Last Page_ DATE: June 22 20 11 PERMIT IYO.L01Ca9+ (to be filled in by DWQ) A. STATUS OF WELL OWNER (choose one) Non -Government: Individual Residence x Business/Organization Government: State Municipal County Federal B. WELL OWNER — For individual residences, list each owner on property deed. For all others, state name of entity and name of person delegated authority to sign on behalf of the business or agency- Brent & Julia Lammed Mailing Address: 5045 Whitner Drive City: Wilmington Day Tele No.: 910-622-4002 State: NC Zip Code: 28409 Cell No.: County: New Hanover EMAIL Address: Fax No.: C. LOCATION OF WELL SITE — Where the injection wells are physically located: (I) Parcel Identification Number (PIN) of well site: R07119-005-024-000 County: New Hanover (2) Physical Address (if different than mailing address): 4816 Wedgefield Drive City: Wilmington D. WELL DRILLER INFORMATION Well Drilling Contractor's Name: H. Michael Sage NC Well Drilling Contractor Certification No.: 2531A Company Name: ARM's WaterWorks Contact Person: Diana Hellas State: NC Zip Code: 28409 EMAIL Address: diana_arm@belisouth,net Address: PO Box 882 City: Hampstead Zip Code: 28443 State: NC County: Pender Office Tele No.: 910-270-2919 CeIl No,: Fax No.: 910-270-2988 GPL.ili11C 5QW Notification (Revised 3/1812011) Page 1 E. HEAT PUMP CONTRACTOR INFORMATION (if different than driller) Company Name:_T_B_D ______________________________ _ Contact Person.~: ________________ E_MA __ IL_A_d~d~r~es_s_: ___________ _ Address: __________________________________ _ City: __________ Zip Code: _____ State: __ County: _________ _ Office Tele No.: Cell No.: _________ =-F=ax.=...Nc....=.o,.,_.: ______ _ F. WELL CONSTRUCTION DATA (1) Number of borings to be constructed*: 1 Depth of each boring (feet):_2 _15_' ______ _ * If existing water supply wells will be used then provide the information in item (4) below. (2) Type of tubing to be used (steel, PVC, etc): _N_/_A ______________ _ (3) Well casing. If the well(s) will use casing then provide the~ (steel, PVC, etc.), diameter. depth, and extent of casing appearing above ground: 4" SCH40 PVC, 155' depth (4) Grout (material surrounding well casing and/or piping): (a) Grout type: Cement~ Bentonite** 'i._ Other (specify) •• By selecting bentonite grout, a variance is hereby requested to !SA NCAC 2C .0213(d)(l)(A)-, w-h-ic-h-re_q_m_·re_s _a -ce_m_e-nt-ty-pe grout. (b) Grout depth of tubing (reference to land surface): from ___ to ___ (feet) If well has casing, indicate grout 1 deppi: from O to 34 (feet) , ':>e.L tt-He..~ \JJ~\\ rei..oid f6i ~'le ,s HJ ~ulf if\ ft> G. WELL LOCATIONS-Maps must be scaled or otherwise accurately indicate distances and orientations of features located within 1000 feet of the injection well(s). Label all features clearly and include a north arrow. (1) Attach a site-specific map showing the locations of the following: * Proposed injection wells * Buildings * Property boundaries * Surface water bodies * Water supply wells * Septic tanks and associated spray irrigation sites, drain fields , or repair areas * Existing or potential sources of groundwater contamination (2) Attach a topographic map of the area extending 1/4 mile from the injection well site that indicates the facility's location and the map name. NOTE: In most cases, an aerial photograph of the property parcel showing property lines and structures can be obtained and downloaded from the applicable county GIS website. Typically, the property can be searched by owner name or address. The location of the wells in relation to property boundaries, houses, septic tanks, other wells, etc. can then be drawn in by hand. Also, a 'layer' can be selected showing topographic contours or elevation data. GPU/UIC SQW Notification (Revised 3/18/2011) Page 2 3. CERTIFICATION (to be signed as required below or by that person's authorized agent) 15A NCAC 02C .021 1(b) requires that all permit applications shall be signed as follows: 1. for a corporation: by a responsible corporate officer; 2. for a partnership or sole proprietorship: by a general partner or the proprietor, respectively; 3_ for a municipality or a state, federal, or other public agency: by either a principal executive officer or ranking publicly elected official; 4. for all others: by the well owner (whi. h means all persons listed on the 2roiler1A deed 1. If an authorized agent is signing on behalf of the applicant, then supply a letter signed by the applicant that names and authorizes their agent to sign this application on their behalf. "1 hereby certify, under penalty of law, that 1 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, f believe that the information is true, accurate and complete. 1 am aware that there are significant penalties, including the possibility of fines and imprisonment, for submitting false information. t agree to construct, operate, maintain, rep:iir, and if applicable, abandon the injection well and all related appurtenances in accordance with the ape ovii specifications and conditions of the Permit." JUL OS'aft signature of roperty Ownei/Applicant 477 Print or Type Full Name A f 7)eit st /-61(--/Fhz-- sit.9,de of Property OwnerfApplicant Print or Type Full Name Signature of Authorized Agent, if any Print or Type Full Name Submit two copies of the completed application package to: DWQ - Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636 Telephone (919) 733-3221 ❑PUiUIC 5A7 Permit Application (Revised 3/18/2011) Page 4 New Hanover County Page 1 of 1 New Hanover County Profile Sates Reselenrial Commercial Vise improverrrents Permits Land Values Agricultural Sketch Full Legal Exemptions Sub-pareel(si info °norms Pares Into ► Parnel Map PARID: R07119-005-024-000 LAMMERT BRENT T JULIA M Aerials f`- g Layers ■ �L{) I CO TACT US I HELP lHC Tax Norne a key!vrer o' ❑ vds H:a.:a Home Property Records Owner Address Parcel ID Advanced 4816 WEDGEFIELD DR Last GIS Data Update: 4-Jan-2010 CURRENT RECORD 1W1 I Return to Search Results) Data Copyright New Hanover County [Disclaimer] [Privacy Polity] Last Updated: 27 ]un 2011 Site Design Copyright 1999-2006 Akanda Group LLC. All rights reserved. http:lletax.nhcgov.00m/Forms/MapDatalet.aspx?sIndex=0&idx=1 &LMparent=20 7/7/2011 New Hanover County PARID: R07119-005-024-000 LAMMERT BRENT T JULIA M Parcel Alt ID Address Unit City Zip Code Neighborhood Class Land Use Code Living Units Acres Zoning Legal Legal Description Tax District Owners Owner City State Country Zip Page 1 of 1 4816 WEDGEFIELD DR 313408. 77. 7921 .000 4816 WEDGEFIELD DR WILMINGTON 5822 RES-Residential 958-Unused Land 0 R-15-RESIDENTIAL DISTRICT LOT 235R WEDGEFIELD AT CROSSWINDS SOUTH FD LAMMERT BRENT T JULIA M WILMINGTON NC 28409 THE DATA IS FROM 2011 http://etax.nhcgov.com/Forms/PrintDatalet.aspx?pin=R07119-005-024-000&gsp=PROFILE... 7/7/2011 `-'� Address 4816 Wedgefield Dr ma N' Wilmington, NC 28409 F sailrierg.Or illedgIIPrerd Dr, 1 tee?Cirjorilr fM13ps o►i yuur phone Text the word r3M+1PS' To466453 %— AtIo "(Carr 7r,g Cron% -this 5 lr'1, �i't,+ Ibis f% k. rZI f1. U. a ig 01. 04 �rrf3s Ft,x4/1 =Yr FOMaDDLY aR 031:, dea @2011 Google ArsA NCDEHR North Carolina Department of Environment and Natural Resources Division of Water Quality Beverly Eaves Perdue Coieen H. Sullins Dee Freeman Governor Director Secretary 711911011 Brent Lainmen Julia Lammers 5045 Whimer Drive Wilmington, NC 28409 Subject: Acknowledgement of Intent to Construct Type 5QW Injection Well System Permit No. WI0800246 4816 Vu edgcfield Drive. Wilmington, NC 28409 Dear Mr. & Mrs. La unert: On July 5, 2011, the Aquifer Protection Section (APS) received notification of your intent to construct a closed -loop water-onh 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 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 15A Section 2C Subchapter .0213, and 3. The required notification form and associated maps have been completely and accurately submitted. Failure to comply with an of these conditions constitutes a violation of the North Carolina Well Construction Ac and North Carolina Administrative Code Title 15A Section 2C Subchapter .0211(u)(2). Additionally, you should contact the New Hanover 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 1Vliehael.Roeermlcuncdenr.eov if you have any questions. Sincerel}, O frr Debra Waa.; Supervisor cc: Wilmington Regienal Office - APS APS Central Files - ?emit No. W10800246 T' ew Hanover County Health Dept. ARM'c Wat,-rvmriks (Diana Helias) iOS.IFFER ?RG1T_OTION SECTION 1636 Mail Serve Center, FaleiiF. Werth Carolina 27$9'-16i6 Lozeii r,: 272E1 ( Oni isnulevare. Faiewr, 4'tonr. Waroiina 276Da Foam 914,73'3-32?+ \ r`F,,: 1 e S•715-o53f3: =AY, 2 9tg-715-604£! \ Customer SSEIVIOE: 1877-fi�3-a75 • Interne;. www.ntwaterair iitv.oro A:: Eed01 GSxvtur.r , Aftrmahw? HC:A1, cmDi4VE- A Cln: Noi thCarolina SURVEY R iC GEED 8OOK 4683, PAGE 433 MAP BOOK 36, PAGE J49 PIO: R07119-005-024-000 NOTES: 1. THIS PROPERTY DOES NOT LIE WITHIN A SPECIAL FLOOD HAZARD AREA. MAP PANEL Na.: 3720313400J MAP PANEL DATE: APRIL 3. 2006 ZONE X" 2. CORNERS ARE MARKED AS NOTED ON MAP. 3. ALL DISTANCES ARE HQRIZ. FIELD MEASUREMENTS 4. AREA COMPUTED BY 77-HE COORDINATE 1401400. LEGEND: o EJP(EX/STING' IRON PIPE) • EIR (EXISTING IRON ROD) • SIR (SET IRON ROO) ❑ EXISTING CONTROL MONUMENT PROPERTY LINE ---- RELINE — — EASEMENT LINE x FENCE LINE HIDDEN VALLEY — SECITON 2 MAP BIG'. 19, PG. 74 N 71 'u8'OZ "W 100.00' WOOD FENCE 10' UI71,dPr' & DRAINAGE EASEMENT ^� NEIGHBOR'S FENCE LOT 234 — x EXISTING RESIDENCE SETBACKS: FRONT = 25'� SIDE = 10' REAR = 20' ti 2 Cri N_ AREA = 15,909 S.F.± sl Z PACK LINE +I PROPOSED PATIO PROPOSED RESIDENCE It.O' L _ ._ PROPOSED. SIDEWALK — — WATER 10' LITlLITY EASEMENTf__ METER TIE ���v 1ti��7 N ��3�34 r r ECM AT THE PT OF CURVE ; 2 AS SHOWN IN MAP BOOK 36, PAGE 349. EXISTING STONE FIRE RING SETBACK IJNE\ 63 POSSIBLE SEWER CONNEc'! oN PROPOSED DRIVEWAY J VICINITY MAP (N.Z3) STORAGE BUILDING 15 0.53' ACROSS OT' LINE AT THIS POINT 5� 71.05 22 E 100.0o'(CHORO) PAOIU5 = 2822.50' WEDGEFIELD DRIVE 45' PUBLIC RIGHT OF WAY NEIGHBOR'S FENCE x T2.J' a rH 79'12'1 ? E LOT 236 EX/S7TNG RESIDENCE --=CAW PEDAVAL This copy has been transmitted through electronic media and shall not be used as a certified document. This document was ariginally issued and sealed by Manley D. Carr, PLS, NC License No. L-2580 on FOR March 10 2011 BRENT T. LAMMERT and wife, JULIA M. LAMMERT CENTERLINE CURVE DATA RADIUS = 2800.00' DELTA = 9'17'16" PROPOSED SITE PLAN OF LOT 235 — SECTION 2 — WEDGEFIELD AT CROSSWINDS SOUTH WILMINGTON TOWNSHIP — NEW 1-WNOVER COUNTY — NOFRTN CAROLINA SCALE: 1" = 30' DATE• MARCH 6, 2011 30 f 0 30 60 90 1000Radius Subject Properly Irrigation Well Stormwater Pond Notes: 1. Subject property serviced by public sewer and water. 2. Adapted from Google Earth and New Hanover County GIS Map, June 2011. • 76c.plded Resource Manaiement PC PO. Box 882, Hampstead, NC 28443 910) 270-2919 FAX 270-2988 TITLE: SURROUNDING SITE MAP 4816 WEDGEFIELD DRIVE JOB: SCALE: DATE: DRAWN BY: Lammert As Shown 6/5/1 1 DNH FIGURE: Subject Property Irrigation Well Stormwater Pond N Notes: 1. Subject property serviced by public sewer and water. 2. Adapted from Google Earth and New Hanover County GIS Map, June 2011. i A( ppriied Resource Manalemer�t PC PO. Box 882, Hampstead, NC 28443 910) 270-2919 FAX 270-2988 SURROUNDING SITE MAP 4816 WEDGEF1ELD DRIVE JOB: SCALE: DATE: DRAWN BY: Lammert As Shown 6/5/11 DNH TITLE: FIGURE: 1