WI0700458_Staff Report_20220714

DocuSign Envelope ID: 15E08DC2-008D-4E59-8F5E-BFED7BCE3681
North Carolina Department of Environmental Quality - Division of Water Resources
WQROS REGIONAL STAFF REPORT FOR
UIC Program Support
Permit No._WI0700458_
Date: _7/13/22_ County: _Beaufort _
To: _Michael Rogers_ Permittee/Applicant: _Kevin & Denise Mayer_
Central Office Reviewer Michael RogersFacility Name: _Kevin & Denise Mayer Return Well_
L GENERAL INFORMATION
1. This application is (check all that apply): ❑ New ® Renewal
❑ Minor Modification ❑ Major Modification
a. Date of Inspection: 713/22
b. Person contacted and contact information: Kevin Mayer (252 945-5921
c. Site visit conducted by: R. Sipe
d. Inspection Report Printed from BIMS attached: ® Yes n No.
e. Physical Address of Site including zip code: No change since last inspection
f. Driving Directions if rural site and/or no physical address: No change since last inspection
g. Latitude: Longitude: NA No change since last inspection
Source of Lat/Long & Accuracy (i.e., Google Earth, GPS, etc.):
IL DESCRIPTION OF INJECTION WELL(S) AND FACILITY
1. Type of injection system:
Z Geothermal Heating/Cooling Water Return
n In situ Groundwater Remediation
n Non -Discharge Groundwater Remediation
❑ Other (Specify: )
2. For Geothermal Water Return Well(s) only
a. For existing geothermal system only:
Were samples collected from Influent/Effluent sampling ports? ® Yes n No.
Provide well construction information from well tag: See attached GW-1
b. Does existing or proposed system use same well for water source and injection'? n Yes
® 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? n Yes Z 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: n Good ® Adequate ❑ Poor
6. Flooding potential of site: ® Low ❑ Moderate ❑ High
WQROS Staff Report Rev. 4/15/2016 Page 1

DocuSign Envelope ID: 15E08DC2-008D-4E59-8F5E-BFED7BCE3681
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? n Yes n 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)? n Yes n 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. (See attached Map)
9. 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? n Yes n No n 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
n Deny. If Deny, please state reasons:
n Hold pending receipt and review of additional information by Regional Office
n Issue upon receipt of needed additional information
® Issue
5. Signature of Report Preparer(s): D,Vti 'f•d+y 5;isL
Signature of WQROS Regional Supervisor: ga4L4 T 4
Date: 7/13/2022
WQROS Staff Report Rev. 4/15/2016
Page 2

DocuSign Envelope ID: 15E08DC2-008D-4E59-8F5E-BFED7BCE3681
IV. ADDITIONAL REGIONAL STAFF REVIEW COMMENTS/ATTACHMENTS (Optional /If Needed)
WQROS Staff Report Rev. 4/15/2016 Page 3