WI0300380_Staff Report_20230918

Permit No. WI0300380
Date: 0911812023
County: Gaston
To: Blake Butcher
Central Office Reviewer: Blake Butcher
Permittee/Applicant: Gary G. and Susan D. Clark
Facility Name: Gary & Susan Clark SFR
L GENERAL INFORMATION
1. This application is (check an that apply): ❑ New ® Renewal
❑ Minor Modification ❑ Major Modification
a. Date of Inspection: 0911412023
b. Person contacted and contact information: Gary Clark geeclark59@gmail. com / [phone]
c. Site visit conducted by: Edward Watson and Maria Schutte
d. Inspection Report Printed from BIMS attached: ❑ Yes ® No.
e. Physical Address of Site including zip code: 8426 Catawba Cove Drive, Belmont, NC 28012
f. Driving Directions if rural site and/or no physical address: Travel on I-77 South to I-485 outer to exit 10B
to enter I-85 West toward Belmont, NC. Travel — 33 mile on I-85 exiting on exit 27 Belmont/Mt. Holly. Turn
left onto NC-273. After —2 miles turn left onto S. Central Av. Take S. Central Av. for 4 miles, then turn Right
onto Lower Armstrong Rd/NC-273. Travel 2.36 miles and enter the roundabout and take the 2nd exit onto S.
New Hope Rd./NC-279 (Traveling briefly into S. Carolina). S. New Hope Rd. becomes Pole Branch
Rd/SC/279. You are only on this road for —0.1 miles. Turn Right onto Catawba Cove Dr. Travel for —1.5
miles. The property is on the right.
g. Latitude: 35' 09' 32.51 " Longitude: -81' 04' 02.85"
Source of Lat./Long & Accuracy (i.e., Google Earth, GPS, etc.): GCS WGS 1984 to nearest 1 second.
IL DESCRIPTION OF INJECTION WELL (S) AND FACILITY
1. Type of injection system:
® Geothermal Heating/Cooling Water Return
❑ In situ Groundwater Remediation
❑ Non -Discharge Groundwater Remediation
❑ Other (Specify:
2. For Geothermal Water Return Wells only
a. For existing geothermal system only:
Were samples collected from Influent/Effluent sampling ports? ❑ Yes ® No.
Provide well construction information from well tag: The well construction is incomplete due to the
bentonite chip not being completed to the top ofgrade. The permittee was directed to contact the drilling
contractor to return to the site to perform completion activities.
b. Does the existing or proposed system use the same well for water source and injection? ® 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.
The return flow piping was not correctly configured to be able to collect a return sample. GW samples will be
collected after the system has been repaired. MRO is waiting for confirmation of the plumbing repair
completion. MRO staff will schedule a return visit once the repair has been completed.
3. Quality of drainage at site: ® Good ❑ Adequate ❑ Poor
4. Flooding potential of site: ❑ Low ® Moderate ❑ High
5. 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.
IIL EVALUATIONAND RECOMMENDATIONS
1. Do you foresee any problems with issuance/renewal of this permit? ❑ Yes ® No. If Yes, explain.
2. 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
3. Signature of Report Preparer(s): Edward Watson 0911512023
Signature of WQROS Regional Supervisor:
Docu Signed by:
Date: 9/18/2023 EF161FB69A2D84A3
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