HomeMy WebLinkAboutWI0100100_Complete File - Historical_20220311 Is I
NCDENR
North Carolina Department of Environmen tHFal, R8—S-81:1F688
Division of Water Quality RECEIVED
Beverly Eaves Perdue Coleen H.Sullins Dee Freeman
Governor Director Secretary
June 29, 2010 1UN 25 2G19
Stephen and Jayne Cluggish Asheville Regional Office
3101 Churchill Rd. Aquifer Protection
Raleigh,NC 27607
Subject: Issuance of Injection Well Permit
Permit No.W10100100
Issued to Stephen and Jayne Cluggish
Buncombe County
Dear Mr. and Mrs. Cluggish:
In accordance with your application received June 2,2010,I am forwarding Permit No.WI0100100 for
the construction and operation of a vertical closed-loop geothermal mixed-fluid heat pump injection well
system to be located at 21 Snow Shoe Dr.,Asheville,NC 28803. This permit shall be effective from the
date of issuance until May 31,2015,and shall be subject to the conditions and limitations stated therein.
Please pay special attention to Part 11.1 of the permit. At least forty-eight(48)hours prior to
constructing system,the Permittee shall notify the Aquifer Protection Section's Underground Injection
Control(UIC)Program Central Office staff,telephone number(919) 715-6166, and Jonathan Stepp with
the Asheville Regional Office Aquifer Protection Section Staff,telephone number(828)296-4500
Additionally,per Part VEL2 of the permit, submit copies of the Well Construction Completion form
(GW-I,)within 30 calendar days of completion of installation of geothermal well(s).
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 me at(919)715-6166.
Sincerely,
Michael Rogers,P.G. &FL)
Environmental Specialist
cc: Landon Davidson—Asheville Regional Office
Central Office File—WI0100100
Buncombe County Environmental Health Dept.
Attachment(s)
AQUIFER PROTECTION SECTION
1636 Mail Service Center,Raleigh,North Carolina 27699-1636
Locaton:2728 Capital Boulevard,Raleigh,North Carolina 27604 One
Phone:919-733-3221 1 FAX i s 919-715-05a8:FAX 2:919-715&048\Customer Service:1.877-623-6748 North Carolina
Internet www.navatemuaHN.orn (� C room
An Equal Oppommny t AHinnanve Action Employer Naturall
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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
Stephen and Jayne Cluggish
FOR THE CONSTRUCTION AND OPERATION OF 4 TYPE 5QM INJECTION WELL(S), defined in Title
15A North Carolina Administrative Code 2C .0209(e)(3)(F), for the purpose of operating a vertical closed loop
geothermal mixed fluid heat pump system. This system is located at 21 Snow Shoe Dr., Asheville, Buncombe
County, NC 28803, and will be constructed and operated in accordance with the application received June 2,
2010, and in 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 and shall be in compliance with Title 15A of
the North Carolina Administrative Code 2C .0100 and .0200 plus any other applicable Laws, Rules, and
Regulations pertaining to well construction and use.
This permit shall be effective, unless revoked, from the date of its issuance until May 31, 2015, and shall be
subject to the specified conditions and limitations set forth in Parts I through IX hereof.
Permit issued this the 29th day of June 2010.
f Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission.
Permit WI0100100 UIC/5QM Page 1 of 5
ver.03/2010
PART I-WELL CONSTRUCTION GENERAL CONDITIONS
1. The Permittee 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 permit, the approved plans and specifications, and other supporting data.
3. Each injection well shall not hydraulically connect separate aquifers.
4. Each injection well shall not be located in an area generally subject to flooding. Areas that are generally
subject to flooding include those with concave slope, alluvial or colluvial soils, gullies, depressions, and
drainage ways.
5. Each injection well shall be afforded reasonable protection against damage during construction and use.
PART II—WELL CONSTRUCTION SPECIAL CONDITIONS
I. At least forty-eight (48) hours prior to constructing system, the Permittee shall notify the Aquifer
Protection Section's Underground Injection Control (UIC) Program Central Office staff, telephone
number (919) 715-6166, and Jonathan Stepp with the Asheville Regional Office Aquifer Protection
Section Staff, telephone number (828) 296-4500.
2. The location of each of the system manifolds shall be recorded by triangulation from three permanent
features on the site (e.g., building foundation corners) and shown on an updated Site Map. The Permittee
shall retain a copy of this record on site.
3. One well identification tag per grouping or `cluster' of wells shall be permanently affixed to the heating
and cooling unit or other nearby permanently fixed location in accordance with 15A NCAC 2C .0213(g).
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.
Permit W10100100 UIC/5QM Page 2 of 5
ver.03/2010
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 that 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
ground water 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.
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's Underground Injection Control (UIC)
Program 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. Division 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.
Permit WI0100100 UIC/5QM Page 3 of 5
ver.03/2010
PART VII—MONITORING AND REPORTING REQUIREMENTS
1. All required documentation shall be submitted to:
Aquifer Protection Section—UIC Program Aquifer Protection Section
DENR—Division of Water Quality Asheville Regional Office
1636 Mail Service Center and 2090 US Highway 70
Raleigh,NC 27699-1636 Swannanoa,NC 28778
Ph# 919-715-3221 (828) 296-4500
2. A completed Well Construction Record (Form GW-1) for each injection well must be submitted to the
Aquifer Protection Section Central Office and the Asheville Regional Office within 30 days of completion
of well construction. Copies of the GW-1 form(s) shall also be given to the Permittee and retained on site
to be made available for inspection.
3. A copy of the site-map updated with manifold locations required in Part II.2 of this permit shall be
submitted to the Aquifer Protection Section Central Office and the Asheville Regional Office within 30
days of completion of well construction.
4. 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.
5. The Permittee shall report by telephone, within 48 hours of the occurrence or first knowledge of the
occurrence,to the Asheville Regional Office, telephone number(828) 296-4500 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;
(C) Any loss of refrigerant in the system,regardless of the origin of the loss;
(D) Any recharging of the refrigerant system.
6. 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.
7. 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 RENEWAL
In order to continue uninterrupted legal use of the injection facility for the stated purpose, the Permittee shall
submit an application to renew the permit 120 days prior to its expiration date.
Permit W10100100 UIC/5QM Page 4 of 5
ver.03/2010
\:
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, then that well must be permanently abandoned according to 15A NCAC 2C .0213(h)(1).
Notification shall be submitted to the addresses given in Part VII.1 of this permit.
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 that 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 copy of the Well Abandonment Record (Form GW-30) as specified
in 15A NCAC 2C .0213(h)(1) within 30 days of completion of abandonment. Copies shall be
submitted to the addresses given in Part VI1.1 of this permit.
Permit WI0100100 UIC/5QM Page 5 of 5
ver.03/2010
A
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
June 15,2010
Stephen Cluggish
Jayne Cluggish
3101 Churchill Rd.
Raleigh,NC 27607
Subject: Acknowledgement of Application No.WI0100100
Stephen Cluggish SFR
Injection Mixed Fluid GSHP Well system(5QM)
Buncombe
Dear Mr.and Mrs.Cluggish:
The Aquifer Protection Section of the Division of Water Quality(Division)acknowledges receipt of your permit application and
supporting materials on June 2,2010.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 that the 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@ncdem.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 httni/lh2c'enr.state.ne.us/documents/dwq orechart.odf.
PLEASE REFER TO THE ABOVE APPLICATION NUMBER WHEN MAKING INQUIRIES ON THIS PROJECT.
Sinc ely`/�
for DebraJ.Watts:`)I
Supervisor
cc: Asheville Regional Office,Aquifer Protection Section
Von Plemmons(Clearwater Well Drilling,P.O.Box 71,Hot Springs,NC 28743)
Duane Gentry(Gentry Heating Inc., 100 Buckeye Access Rd., Swannanoa,NC 28778)
Permit Application File WI0100100
AQUIFER PROTECTION SECTION
1636 Mail Service Center,Raleigh,North Cam5na 27699-1636
Location:2728 Capital Boulevard,Raleigh,North Carolina 27604 '
Phone:919-733-32211 FAX 1:919-715-0588;FAX 2919-715.6048 I customer Service:l-877-623.6748; the
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NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES(NCDENR)
APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELLS)FOR
INJECTION WITH A GEOTHERMAL HEAT PUMP SYSTEM FOR:
TYPE 50M WELL(S) I
New Permit Application OR Renewal (check one)
DATE: - 19 20&
PERMIT NO. (leave blank WNEW permit application)
A. PROPERTY OWNER(SYAPPLICANT(S)
List each Property Owner listed on property deed(if owned by a business or government agency,state name of
entity and a representative w/authority forsignature): !F Y i3Hr=0 CL LLGL71 S 4
(1) Mailing Address: 3 I O I C•f 1LLP�' I I ILL eAAb
City: Q RLC-t Gt 1-I State: NC Zip Code: .77UD-7 County:
Home/Office Tele No.: q/A- 2&q- 044 D Cell No.:
EMAIL Address:50-0 1u--V
(2) Physical Address of Site(if different than above): .Z I slJDl t) SN 0C-7 -73P-1 VE
City:_Asw-dlr t >r State: Zip Code::2!&!?)3 County:guk=mBE.
Home/Office Tele No.:`7 J -ZL09 - OcFyC) Cell No•
/ EMAIL AddressG(IBED0sidcytl-Ict_Qxrc►,t�-e r }
B. - (AUTHORIZED AGENT O OWNE ANY(if the Permit Applicant does not own the subject property,
attach a letter from the property owner authorizing Agent to install and operate UIC well)
Company Name:
Contact Person_ EMAIL Address:
Address: _
City: -__- State:—Zip Code: County:
Office Tele No.: —•----------- — Cell No.__.- -
Website Address of Company, ifany:...........
C STATUS OF APPLICANT
Private: Federal. irmnrareial
- RECEIVED/DENR IDWQ
State:_ Municipal: Native American Lands:_• ._ AQNIFFR'PP0TFCTInN SECTION
JUN 0 2 ZU10
i
D. WELL DRILLER INFORMATION
Company Name: 0J-r--y"JmL /.1,a(._ -pPJLLWIlC
Well Drilling Contractor's Name: \IDfL) JLE7tlJ1wKis
NC Contractor Certification No.: J/IA
Contact Person:01..) -PIEtAU0&)S EMAIL Address: IfVUJrtLk r 7()0 /a n/,ChAl
Address: -P.D . Bak rI
City: —43M U(',, G Zip Code:2- 43 County: M"1151)0
Office Tele No.: A-622- 9 2,41 Ce11 No.: 4,74 - C Pj -(OSZLn
E. HEAT PUMP CONTRACTOR INFORMATION(If different than driller)
Company Name:
Contact Person: )uA r: &tararRU EMAIL Address•(11.1ayyOO ADn4-y a4irl� im
Address:
�D �✓ILP1t"z Ao 6SS &Ab �� J�Dn
City: 5lyWA1Ah7n/b - Zip Code: County: 8LL000m6j!;
Office Tele No.: SIX- 2212 -,l Cell No.: 192,9 Z- AMI
F. INJECTION PROCEDURE (briefly describe how the injection well(s)will be used)
ILLD5r=D Lr)oY ClPltlit 1lTID►J
G. WELL CONSTRUCTION DATA(Skip to Section H If this is a Permit RENEWALI
(1) Proposed date to be constructed: !j-2 7- 10 Number of borings:
Approximate depth of each boring(feet):
(2) Chemical additives to be used in closed-loop system(only those chemicals indicated have been approved):
R-22 propylene glycol ethanol other(other additives will
need prior approval by NCDENR before use)
(3) Type oftubing to be used(copper,PVC,etc): 29 340-R
(4) Well casing. Is the well(s)rased?(check either(a.)YES or(b.)NO below)
(a) YES if yes,then provide casing information such as tie(steel,PVC,plastic,etc.),diameter,
depth,and extent of casing appearing above ground:
(b) NO
(5) Grout(material surrounding well casing and/or piping):
(a) Grout type: Cement Bentonite Other(speci&.)
(b) Grout depth of tubing(reference to land surface): from V. to 2-1 a (feetI
t(well has casing. indiMV gram depth: Irom h (feet]
H. INJEM. ON-RELATF•D EQUIPMENT
Attach a diagram showing the engineering layout or proposed modification of the injection equipment and exterior
piping/tubing associated with the injection operation. The manufacturer's brochure may provide supplementary
information.
L LOCATION OF WELL(S)
Attach two copies ormops showing the following information:
(1) Include a site map(can be drawn)showing: buildings,property lines,surface water bodies,potential sources,
of groundwater contamination and the orientation or and dislances between the proposed well(s)and any
existing well(s)or waste disposal facilities such as septic tanks or drain fields looted within 1000 feet of the
geothermal heat pump well system. label all features clearly and include a north arrow.
(2) Include a topographic map of the area extending one mile from the property boundaries and
indicate the facility's location and the map name.
J. POTABLE WATER WELL(S)
Are there any potable water well(s)on the subject property or adjacent properties? _YES—NO
If Yes,than indicate location an attached map(s).
1C CERTIFICATION
Note:This Permit Application must be signed by each person appearing on the recorded legal property deed.
"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 therclo and that, baud on my inquiry of those individuals
immediately responsible for obtaining said information,)believe Thal the information is true,accurate and complete.
•1 am aware that there are significant penalties,including the possibility of fires and imprisonment,for submitting
false information. 1 agree to construct,operate,maintain,repair,and if applicable,abandon the injection well and
all related appurtenances in accordance with/thee approved specifications end conditions of the Pemdt"
Signature of Property Owner/Applicant
-7r F q NE 1.1 lL1]/61 st.1
Print or Type Full Nmnc
gnats ofproperryOwner/Ap 'i rC r\
1 yAr. e. Gt vme,4
Print or Type Full No
Signature of Authorized Agent,if any
Print or Type Full Name
Please return two copies of the completed Application package to:
North Carolina IDENR-DWQ
Aquifer Protection Section
UIC Program RECEIVED/DENR/DVV
1636 Mail Service Center AQUIFER pRnTFfTInt4 S1 11
Raleigh,NC 27699-1636 Tm
AN 0 2 2010
Telephone(919)7154935
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