10-192-WQ-0003_Complete - Historical File_20190326

DIVISION OF ENVIRONMENTAL MANAGEMENT
GROUNDWATER SECTION
May 4, 1992
M E M O R A N D U M
TO: Fred Hankinson
FROM: Henry Kwiecinski
SUBJECT: UIC Permit Program Issuance - William B.
Costenbader
The central office has completed its review of the UIC
permit application for the injection facility to be operated
by William. B. Costenbader of Buncombe County. Attached you
will find a copy of this application along with the draft
permit and transmittal letter for this facility.
Subsequent to your review and approval of this
application, please complete the permit and transmittal
letter and forward them to the applicant. This will require
that you obtain the Regional Supervisor' s signature, date
the transmittal letter and fill in the expiration date of
the permit. As you have already sampled this facility, you
will not have to do so now. However, we have not received
copies of the sampling data. Please forward sampling data
copies as well as copies of the other completed documents
and send them to me.
If you have and questions concerning the permit
process, please give me a call .
Attachments

COUNTY �-.y}�r�n �e North Carolina
Department of Environment, Health, and Natural Resources LAB NUMBER a
QUAD NO. SERIAL NO. DATE RECEIVED ���' Time
Division of Environmental Management - .
LAT. LONG. U' From: Bus-Courie�� r
Groundwater Field/Lab Form Rec d by: 1
Other
Report to: ARO, FRO, MRO, RRO, WaRO, WiRO,WSRO, Kinston FO Other SAMPLE PRIORITY r
c
DATA ENTRY BY: ?/{" CK: -
Shipped by: Bus, Courier, Other � ROUTINE ❑ EMERGENCY 0 DATE REPORTED:
COLLECTOR(S): A DATE IME PURPOSE: BASELINE, COMPLAINT, COMPLIANCE, LUST, OTHER
ne) _
FIELD ANALYSES Owner
pH400 Spec. Cond.94 at 250C Location or site F12 �I `J LPL
Temp.10 oC Odor Description of sampling point Flgo '/0'r—
Appearance Taste Sampling Method Sample Interval
(pump, bailer, etc:)
Field Analysis By: � I Remarks
C r1 �,� pumping time, air temp, etc.)
LABORATORY ANALYSES
. f
BOD5 310 mg/I Dlss. Solids 70300 mg/1 Ag - silver 1077 ug/I Organochlorine Pesticides
COD High 340 mg/I Fluoride 951 mg/I At - Aluminum 1105 up/I Orpanophosphorus Pesticides
COD Low 335 mg%1 VHardness:Total 900 mg%I Be - Barium'1007 ug/I
� Coliform:MF Fecal 31616 ,C' / /loom[ Hardness (non-carb) 902 mg/l Ca - Calcium.916 mg/I Acid Hardlcides
Collform:MF Total 31504 &./_loom] Phenols 32730 ` ug/I Cd - Cadmium 1027 ug/I
TOC 680 mg%I' I Specific Cond. 95 uMhos/cm? Chromlum:Total 1034 ug/l Base / Neutral Extractable Organics
1 �
Turbidity 76 NTU Sulfate 946 mg/t-' Cu -.Copper 1042 ug/I Acid Extractable Organics
Sulfide 745 mg/I Fe - Iron 1045 ug/I
Hg -.Mercury 71906 ug/I Purgeable Organics (VOA bottle)
pH 403 73 units K - Potassium 937 mg/I
Alkalinity to pH 4.5 410 3 mg/I Mg -'Magnesium 927 mg/1 1.2 - Dlbromoethane CEDE)
Alkalinity to pH 8.3 415 ` mg/I Min - Manganese 1055. ug/I
Carbonate 445 mg/1 Na - Sodium 929
mg/I
Bicarbonate 440 3 mg/I NH3 as N 610 mg/I Ni - Nickel 1067 el ug/I
Arsenic:Total 1002 ug/I r TKN as N 625 mg/I Pb Lead 1051 ug/I
Carbon dioxide 405 mg/I ! NO2 tNO3 as N 630 mg/I Se - Selenium 1147 ug/I '
Chloride 940 mg/I P:Total as P 665 mg/I Zn - Zinc 1092 ug/i
Chromium:Hex 1032 ug/I
Color:True 80, Pt-co
Cyanide 720 mg/I ) `t
Lab Comments: NI 0��� �Y�e1� c c� ci v f.,, D r-2 �'�n �(/ C.d✓b-jUf 'q'r"/// -,zt
'A, ved �W' �>ait Ali
GW-54 REV.9/90 For Dissolved Analysis-submit filtered sample and write"DIS"In block
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COUNTY try���� f/�'— North Carolina LAB NUMBER 8 r�� 1211
Department of Environment, Health, and Natural Resources c��� .`-�
ouaD No. sERIAL No. Division of Environmental Management DATE RECEIVED Time n
LAT. LONG. Groundwater Field/Lab Form Rec'd by: From: Bus Courier
Other
Report t : ARO, FRO, MRO, RRO, WaRO, WiRO, AMPLE PRIORITY DATA ENTRY BY: _10 CK:
WSRO, Kinston FO Other
ROUTINE ❑ EMERGENCY 0 DATE REPORTED: `►`—�2�— � ?✓
Shipped by: Bus,9. 2ZA)5&)
Other
'5 D
COLLECTOR(S): DATE —� TIME J PURPOSE: BASELINE, COMPLAINT, COMPLIANCE LUST, OTHER
I' (circle one)
FIELD ANALYSES Owner Da w► 1�h`����''�—
pH400 Spec. Cond.94 at 25Oc Location or site JLL +� �V F' `�OAJC�—
Temp.10 oC Odor Description of sampling point
Appearance Taste Sampling Method Sample Interval
(pump, bailer, etc:)
Field Analysis By: Remarks
(pumping time, air temp, etc.)
LABORATORY ANALYSES
BOD5 310 mg/I Dlss. Solids 70300 mg/1 Ag - Sliver 1077 ug/I Organochlorine Pesticides
COD High 340 mg/I Fluoride 951 mg/I At - Aluminum 1105 ug/I Organophosphorus Pesticides
COD Low 335 mg/I Hardness:Total 900 mg/I Be - Barium'1007 ug/I
Collform:MF Fecal 31616 /100ml Hardness (non-carb) 902 mg/I Ca - Calcium 916 mg/I Acid Hardicldes
Co111orm:MF Total 31504 /100ml Phonols 32730 ug/I Cd - Cadmium 1027 .� ug/I
TOC 680 mg/I Spoclllc Cond. 95 uMhos/cm2 Chromlum:Total 1034 � ,lti ug/I Base / Neutral Extractable Organics
Turbidity 76 NTU sulfate 945 mg/I Cu - Copper 1042I!' ug/I Acid Extractable Organics
Sulfide 745 mg/1 Fe - Iron 1045 ug/1
Hg Mercury 71900 ug/I Purgeable Organics (VOA bottle)
pH 403 units K - Potassium 937 mg/I
Alkalinity to pH 4.5 410 mg/I Mg - Magnesium 927 mg/I 1.2 Dlbromoelhane (EDB)
Alkalinity to pH 8.3 415 mg/I Mn - Manganese 1055 ug/I
Carbonate 445 mg/I Na - Sodium 929 mg/I
Bicarbonate 440 mg/I NH3 as N 610 0. b` mg/I NI - Nickel 1067 ug/I
Arsonic:Total 1002 ug/I TKN as N 625 mg/I Pb Lead 1051 ug/I
Carbon dioxide 405 mg/I NO2 t NO3 as N 630 n. mg/I Se - Selenium 1147 ug/I
Chloride 940 mg/I P:Total as P 665 mg/I Zn - Zinc 1092 ug/I
Chromlum:Hex 1032 ug/Ii�ra
Color:True 80 Pt-Co i`'� h
Cyanide 720 mg/i 16 �� A nn
Lab Comments: LL
GW-54 RE' 90 For Dissolved Analysis-submit filtered sample and wri, .)IS"In block
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NOTE:Assistance in obtaining these values may be facilitated by contac,—.b (a)your local or county health
official, (b) a commercial water-testing laboratory, (c) your well drilling contractor, or (d) the Regional
Hydrogeologist,North Carolina Dept.of Natural Resources &Community Development.
NOTE: If injection system is not for a heat pump,then a detailed analysis of both the source water and the
injection fluid may be required.
I. INJECTION-RELATED EQUIPMENT:
Attach a diagram showing the engineering layout of the (1) injection equipment, and (2) exterior
piping/tubing associated with the injection operation.
NOTE: The manufacturer's brochure,if detailed,should satisfy(1)above if the system is a heat pump.
J. LOCATION OF WELL(S):
Attach a detailed map showing the orientation of and distances between the proposed well(s), any existing
well(s) that will in any way be involved in the injection opera-tion, and at least two (2) nearby reference
points such as roads,toad intersections, streams,etc. The roads should be identified by U.S.,N.C. or SR
(county secondary road)numbers, and streams should be named. In addition,the diagram should show the
direction and approximate distance to any existing water-supply and/or injection wells within 1,000 feet of
the proposed injection well.
K. CERTIFICATION:
"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. I am aware that there are significant penalties,including the possibility of fines and
imprisonment,for submitting false information. I agree to operate and use the injection well and all related
appurtenances in accordance with the approved specifications and conditions of the Permit."
1 .
(Signature obgwaWor Authorized Agent)
FOR OFFICE USE ONLY:
1. Initial Application: Complete Incomplete
If INCOMPLETE,Date of Notification and Resubmittal
2. Standard Industrial Code(s)which best reflect the principal products or services provided by this
facility-if applicable.
(a) (b) (c) (d)
3. APPLICATION NO.
GW-57B May,1989,Replaces GW-57A,and GW-57B(2/84)

PROPOSED WELL to be constructed for use as an injection well. Furnisn uie data in (1) through (8)
below as PROPOSED construction specifications.
NOTE: THE WELL DRILLING CONTRACTOR CAN SUPPLY THE DATA FOR EITHER EXISTING
OR PROPOSED WELLS IF THIS INFORMATION IS UNAVAILABLE BY OTHER MEANS.
(1) Well Drilling Contractor's me: I& "- 1,,J
(2) Date(to be)Constructed P4V L l ; Approximate Depth aaZ ft.
(3) Well Casing:
(a)Type:Galvanized Steel Black Steel Plastic Other(Specify)
(b)Inside Diameter: �inches; Wall thickness(inches) or schedule#
(c)Casing Depth:From U to 1-0 _ft.(referenced to land surface)
(4) Cement Grout:
(a)Around inner or"primary" casing:From O to 2-P ft.
(b)Around outer(pit)casing,if present:From to ft.
(5) Screen(s): (if applicable) /*\J.
(a)Type: ;Inner Diameter. inches
(b)Depth:From to feet below land surface
(6) Gravel: (if applicable) From: to feet below land surface
(7) N.C. State Regulations (15, 2, 2C, Section .0200) require the permittee to make provisions for
monitoring well head processes. A faucet on both the influent(water from well)and effluent(water
into well) lines is required. Is there a faucet on (a) the influent line YES ENO , or(b)
the effluent line YES ,,�NO ?
(8) Attach a diagram showing the details of construction of the existing and/or proposed well(s).
G. PROPOSED OPERATING DATA: (The manufacturer's brochure should include this information.)
(a)Injection Rate: Average(Daily) gallons per minute(gpm)
(b)Injection Volume: Average(Daily) I lD 9-0 gallons per day(gpd)
(c)Injection Pressure: Average(Daily) 40 pounds/square inch(psi)
(d)Injection Temperature: Winter Average(Daily) _degrees F
Summer Average(Daily) degrees F No-T uj'M
H. INJECTED FLUID DATA:
(1) Fluid Source(From what depth and what type of rock/sediment unit does the fluid to be injected
derive,i.e.granite,limestone,sand,etc.) /1
Depth: 2� Rock/sediment unit:
(2) Chemical Analysis of Source Water:The following chemical characteristics MUST accompany
this application;
PH q,3 Total Hardness ppm(parts per million or mg/1); Iron ppm; '7 d
Chloride�_ppm; Nitrate o.o 1 ppm; Coliform bacteria L. counts/100 ml
Say
GW-57B May,1989,Replaces GW-57A,and GW-57B(2/84)

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF NATURAL RESOURCES AND COMMUNITY DEVELOPMENT
APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL FOR ..
INJECTION ,
CLASS 5 WELLS W\;i�
TO: DIRECTOR,NORTH CAROLINA DIVISION OF ENVIRONMENTAL MANAGlim
�9g2
j1A
DATE: 2"1 Z , 19
In accordance with the provisions of Article 7, Chapter, 87; Article 21, Chapter 143, }��
pursuant thereto, APPLICATION is hereby made for a PERMIT to construct and/or use a well or well stem as
described below and in any accompanying data submitted as a part of this APPLICATION.
A. OWNER DATA: Name: I, � 00S &ek?�7
Address: t�­
City: Zipcode: c>&O
County: vu S Telephone: s
Ownership: Federal State Private
Public Commercial
Other(Specify)
B. FACILITY DATA (Fill out ONLY if the injection well(s)is (are) for the purpose of serving a business or
industry):
Business/Corporate Name:
Address:
City: Zipcode:
County: Telephone:
C. HEATING CONTRACTOR DATA(For heat pump systems only. Please give information for the contractor
that installed or will install your system):
Name: A4.4-,05 e_ r 'i 52,��.J yt -y
Address:
City: Zipcode: Telephone:
D. INJECTION PROCEDURE: Briefly describe how the injection well(s)will be uso.
E. WELL USE: Will the injection well(s)also be used as the supply well(s) for either of the following?:
(a) The injection operation? YES NO
(b) Your personal consumption? YES ✓ NO
F. CONSTRUCTION DATA: (check one)
EXISTING WELL being proposed for use as an injection well. Attach a copy of Form GW-1 (Well
Construction Record) and furnish (7 & 8) below. If Form GW-1 is not available, furnish the data in (1)
through(8)below to the best of your knowledge.
GW-57B May,1989,Replaces GW-57A,and GW-57B,(2/84)

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE OPERATION/USE OF A WELL OR WELL SYSTEM 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
Dr. William B. Costenbader
FOR THE OPERATION AND USE OF AN INJECTION WELL/WELL SYSTEM
located at 34 Deerhaven Lane, Asheville, North Carolina, Buncombe
County, in accordance with the application dated April 27, 1992,
and in conformity with the specifications and supporting data
submitted, all of which are filed with the Department of
Environment, Health, and Natural Resources and are considered a
part of this Permit.
This Permit is for Operation and Use only, and does not waive
any provisions of the Water Use Act or any other applicable Laws,
Rules or Regulations . Operation and use of a well or well system
shall be in compliance with Title 15 North Carolina
Administrative Code 2C, 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 May 12 . 1997 and shall be subject to
the specified conditions and limitations set forth in Parts I and
II hereof .
Permit issued this the 12th day of May 1992 .
Roy M. Davis
Regional Supervisor
By Authority of the Environmental Management Commission.
PERMIT. NO. 10 - 0192 - WO - 0003

r �S
State of North Carolina
Department of Environment, Health and Natural Resources
Division of Environmental Management
512 North Salisbury Street• Raleigh, North Carolina 27604
James G. Martin,Governor George T.Everett,Ph.D
William W. Cobey,Jr., Secretary May 1 2,1 99 2 Director
Regional Offices
Dr. William B. Costenbader
Asheville 34 Deerhaven Lane
704/251-6208 Asheville, NC 28803
Fayetteville
919/486-1541 Dear Dr. Costenbader:
Mooresville In accordance with your application dated April
704/603-1699 27, 1992, we are forwarding herewith Permit No. 10 -
Rale192 - WO - 0003 for the Operation and Use of a well,
919/5l'71-4700 for the purpose of injecting heat pump effluent, in
19/5 Buncombe County.
Washington This Permit shall be effective from the date of
919/946-6481 issuance until May 12 , 1997 and shall be subject
Wilmington
to the conditions and limitations stated therein.
919/395-3900 In order to continue uninterrupted legal use of
Winston-Salem this well for the stated purpose, you should make
919/896-7007 application for permit renewal at least 30 days prior
to its expiration date.
Sincerely,
Roy M .. Davis
Regional Supervisor
Attachment
cc: UIC Files
RRO Files
Pollution Prevention Pays
P.O. Box 29535,Raleigh,North Carolina 27626-0535 Telephone [phone]
An Equal Opportunity Affirmative Action Employer