WI0100639_Aqueous Closed Loop Geothermal Well Construction Application_20220108

WI0100639
E.
REQUIRED MAPS, PLANS, AND SPECIFICATIONS
A site maps must be submitted. It must be scaled or otherwise accurately indicate distances (in feet)
and orientations of features located within 250 feet of the injection well(s). Label all features clearly
and include a north arrow. Attach the site -specific map showing die wells in relation to the locations of
the following:
(1)
(2)
• Buildings
• Property bouArie<��ti
• Surface Nvater bodiejs,'if any
Water supply wells, if any
• Septic systems and associated spray irrigation sites,
drain fields, or repair areas, if any
• Existing or potential sources of groundwater
contamination, if any
Plans and specifications of the surface and subsurface construction details of the well system.
NOTE: In most cases, an aerial photograph and/or plat map 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 and fields, and other wells, etc. can then be drawn in by hand. Also, a 'laver' can be selected showing
topographic contours or elevation data.
F. TYPES AND CONCENTRATIONS OF ADDITIVES - List any additives that will be used and their
concentrations. NOTE: Only injectants approved by the NC Division of Public Health, Department of Health
and Human Services can be injected. Approved injectants can be found online at
http://deq.nc.gov/about/divisions/water-resources/water-resources-nennits/wastewater-branch/ground-water-
protection/ground-water-approved-iniectants. All other substances must be reviewed by the DHHS prior to use.
G. WELL DRILLER INFORMATION
Well Drilling Contractor's Name:
Clint Babbitt
NC-3556-A
NC Well Drilling Contractor Certification No.:
Company Name: AAA Sweetwater Well
City: Swannanoa
Day Tele No.. 828.298.1117 EMAIL Address: u?ke \PaAti�111
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Contact Person: ( \111- to
State: NC zip Code:287'?`�ounty: Buncombe
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Cell No.:
Fax No,:
H. HEAT PUMP CO RACTOR INFORMATION
Company Name._ V'. t(.C' n t„ 1- en$4
Contact Person 0 4 49k Hen ee 1MAlI. A(ldress, .1aStnki f•-• t�pA41(-
Address: 10 a4 f l s , t-
City: S(,. t/i Zip Code• tg $O 9 State: 1V (I County:
Office Tele No.: SLS (7 56-7-4°Coll No.:SZSe7(Z'7`1$$
Closed -Loop Geothermal Well Notification Rev. 3-1-2016
Fax No.: g28 -65$' I c)o
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I. PROTECTION — Provide a brief description of how any (a.) water supply wells. (b.) surface water bodies, or
(e.) septic systems and associated spray irrigation sites, drain fields, or repair areas within 250 feet of the
proposed injection wells will be protected during construction of the wells:
J. VARIANCE — Pursuant to 15A NCAC 02C .0241 the Director of the Division of Water Resources may grant
a variance from applicable well construction or operation standards provided that:
(1) Use of the well(s) will not endanger human health and welfare or the groundwater; and
(2) That construction or operation in accordance with the standards is not technically feasible or the
proposed construction provides equal or better protection of the groundwater.
Any variance request should accompany submittal of this notification to expedite evaluation of the request.
The variance request form can be accessed online at httns://ncdenr.s3.amazonaws.com/s3fs-
public/Water%200uality/Aquifer%20Protection/GPU/GeothennalVarianceRequestFonnFillablc-
20130805.pdf
SIGNATURES — The following section is to be completed as required below or by that person's authorized
agent. 15A NCAC 02C .0211(e) requires signatures as follows:
(a) for a corporation: by a responsible corporate officer;
(b) for a partnership or sole proprietorship: by a general partner or the proprietor, respectively;
(c) for a municipality or a state, federal, or other public agency: by either a principal executive
officer or ranking publicly elected official;
(d) for all others: by the well owner;
(e) for any other person authorized to act on behalf of the applicant: documentation shall be
submitted with the notification that clearly identifies the person, grants them signature
authority, and is signed and dated by the applicant.
"7 hereby certify, under penalty of lmv, that I have personally examined and am familiar with the information
submitted in this document and all attachments thereto and that, based on my inquiiy of those individuals
immediately responsible for obtaining said information, I believe that the information is true, accurate and
complete. I am aware that there are significant penalties, including the possibility offines and imprisonment,
for submitting false information. 1 agree to construct, operate, maintain, repair, and if applicable, abandon the
injection well and all relal/j 1 appurtenances in accordance with the 15A NCAC 02C 0200 Rules."
Signature of Property Owner/Applicant
iz "le l/ jo\tr..5
Por Type Full Name
re of Authorized Agent, if any
,yJ&V croY1h 5 r -�-
Print or Type Full Name
Closed -Loop Geothermal Well Notification Rev. 3-1-2016 Page 3

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Laverty, Brett
From:sweetwaterwell <[e-mail]>
Sent:Thursday, January 13, 2022 10:09 AM
To:Laverty, Brett
Subject:RE: [External] Geothermal Application: R. Johnson
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to 
Report Spam. 

Ok, sorry about that. Thanks!

Sent from my U.S.Cellular© Smartphone

-------- Original message --------
From: "Laverty, Brett" <[e-mail]>
Date: 1/13/22 10:04 AM (GMT-05:00)
To: sweetwaterwell <[e-mail]>
Subject: RE: [External] Geothermal Application: R. Johnson

Danielle,

The geothermal well construction permit number for the subject site is WI0100639. Please send me a copy of the GW1 
well construction records when complete. 

I also need you to improve your site maps or I may begin returning the applications as incomplete. For example, the 
current site map has set back distances but no labels. On all homes, I need you to identify the septic or sewer/collection 
system lines. If applicable I would also like to see a water supply well location. On older homes, I need for you to identify 
any under or above ground fuel tanks. 

Let me know if you have any questions.

Brett Laverty

Brett Laverty