WI0100048_GEO THERMAL_20120523

A�
NC - ENR--
North-Carolina-IDeparlm-ent-ofEn.vlronment grid
Division of Water Quality—
Beverly Eaves Perdue Charles Wakild, P. E.
Governor Director
May 23, 2012
Timothy and Pamela Ruemier
Post Office Box 752
Marshall, NC 28753
Natu-r-al-Resource&
Subject: Notification of Rule Revisions Affecting
Closed -Loop Geothermal LnjPction.Well Permit Holders
Permit Number: W10100048
Dear Mr. and Mrs. Ruemler:
Dee Freeman
Secretary
Our records indicate that you currently hold a permit for a closed -loop geothermal injection well
system. This letter is to inform you that on May 1, 2012, the North Carolina Administrative
Code Title 15A Section 2C .0200 entitled "Well Construction Standards — Criteria and
Standards Applicable Injection Wells" were revised. These revisions affect all permits issued
for injection wells including geothermal wells.
This letter is also to inform you that your closed -loop geothermal injection well(s) have become
"permitted by rule." Therefore, you are no longer required to renew your current permit
and the permit will be valid indefinitely as long as the wells are active and are operated in
accordance with the revised rules referenced above. Please keep in mind that if you abandon
the wells, a record of abandonment must be submitted to the Division of Water Quality. You
may view the revised rules on our website. at http://I)ortal.nedenr.orp web/wq/ups.
If you have any questions regarding your current permit or the rule revisions, please feel free to
contact our underground injection control staff at [phone].
Sincerely,
Eric G. Smith, P.G.
Hydrogeologist
cc: UIC Permit File
AQUIFER PROTECTION SECT#ON
1636 Mail Service Center, Ralegh, North Carolina 27699.1636
Location: 512 N. Salisbury St., Raleigh, North Carolina 27604
Phone: 91 H07-64641 FAX: [phone]
Intemet: www.ncwaterauaRy,org
An Equal[ Opportwlty'i Affirmative Aclier, Employer
One
NorthCarolina
Natmallff
1*

Cent►el.Flles: APS_ SwP-
03113/12
Permit Number WI0100048
Permit Tracking Slip
Program Category
Status Protect Type
Ground Water
Active Renewal
Permit Type
Version Permit Classification
Injection Mixed Fluid GSHP Well System (SQM)
2.00 Individual
Primary Revlewer
eric.g.smith
Coastal SW Rule
Permitted Flow
Permit Contact Affiliation
Facility -
Facility Name Major/Minor Region
Timothy and Pamela Ruemler SFR Minor Asheville
Location Address County
476 River Run Rd Madison
Marshall NC 2B753 Facility Contact Affiliation
Owner
Owner Name
Owner Type
Individual
Timothy Ruemler
Owner Affiliation
Timothy Ruemler
PO Sox 752
Oates/Events
Marshall NC
28753
Scheduled
Brig Issue App Received Grail InRiated Issuance
Public Notice Issue Effective
Expiration
05/07/07 02127/12
03/02/12 03/02/12
02/28/17
Regulated Activities
ReguestedlReceivett Events_
Heat Pump IniecUon
RO staff report requested
03/01/12
RO staff report received
03/02/12
Outfali NULL
Watwbody Name Stream Index Number Current Class Subbasln

Permit Number Wi41 00048
Program Category
Ground Water
Permit Type
Injection Mixed Fluid GSHP Well System (5QM)
Primary Reviewer
eric.g.smith
Coastal 5W Rule
Permitted Flow
Facili
Central Flies: AP5 5WP
43/01/12
Permit Tracking Slip
Status Project Type
In review Renewal
Version Permit Classification
Individual
Permit Contact Affiliation
Facility Name Major/Minor Region
Timothy and Pamela Ruemler 5FR Minor Asheville
Location Address County
476 River Run Rd Madison
Marshall NC 28753 Facility Contact Affiliation
Owner Name Owner Type
Individual
Timothy Ruemler Owner Affiliation
Timothy Ruemler
PO Box 752
Dates/Events Marshall NC 28753
Scheduled
Orlg Issue App Received Draft Initiated Issuance Public Notice issue Effective Expiration
05/07/07 0212.7112
r�
Regulated Activities
Heat Pump Injeniion
Qulfell NULL
Waterbody Name Stream Index Number Current Class 5ubbasin
r

"A�
i
N[DENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakiid, P.E.
Governor D i rector
March 2, 2012
Timothy and Pamela Ruemler
Post Office Box 752
Marshall, NC 28753
Ref: Issuance of injection Well Permits W10100048
Issued to Timothy and Pamela Ruemler
Marshall, Madison County, North Carolina
Dear Mr. and Mrs. Ruemler:
Dee Freeman
Secretary
In accordance with the application received on February 27, 2012, I am forwarding permit number WIOI00048 for the
construction and operation of a vertical closed -loop geothermal mixed -fluid heat pump injection well system to be located
at 476 River Run Road, Marshall, Madison County, NC 28753. This permit shall be effective from the date of issuance
until February 28, 2017, and shall be subject to the conditions and Iimitations stated therein, including the requirement
to install well identification tags as specified in Part H. Be sure to read the entire permit to ensure that you are aware
of all compliance requirements of the permit.
You will need to notify this office at least 48 hours prior to beginning construction and operation of the injection well
system, in order to continue uninterrupted legal use of the injection facility for the stated,purpose, you must submit an
application to renew the permit 120 days prior to its expiration date. This permit is not transferable to any person without
prior notice to and approval by the Director of the Division of Water Quality.
Please contact me at (9I9) 807-6407 or eric-t_,mnith((_Pncdenr;gov if you have any questions about your permit.
Best Regards,
Eric G. Smith, P.G.
cc: Landon Davidson, Asheville Regional Office
WI0100048 Permit File
Madison County Environmental Health Department
AQUIFER PROTECTION SECTION
1636 Mail Service Center, Rale�h, North Carolina 27699-1636
Location: 512 N. So4sbury St, Raleigh, Noo Carolina 21604
Phone: [phone] FAK 9 19 -1107-6496
Inlerne! wktuY[pmatmuefEtv.om
An Equal Opportunity 1 Wmatne Aft &nployer
Glue
Nbt Carolina
)aturull

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMNIISSION
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 HERESY GRANTED TO
Timothy and Pamela Ruemler
FOR THE CONSTRUCTION AND OPERATION OF 7 (SEVEN) TYPE 5QM INJECTION WELLS),
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 476 River Rim. Road,
Marshall, Madison County, NC 28753, and will be constructed and operated in accordance with the application
received February 27, 2012, and in conformity with the specifications and supporting data submitted, 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 February 28, 2017, and shall be
subject to the specified conditions and limitations set forth in Parts I through LAC .hereof.
Permit issued this the 2n4 day of March, 2012.
tCharles Wakild,P.E., Director
ivision of Water Quality
By Authority of the Environmental Management Commission.
Permit NWIOI00048 UICJSQM Page I of 5
per. 0312010

I i 1— 10 r , .'s s. .► 4
PART I - WELL CONSTRUCTION GENERAL CONDITIONS
I . The Permittee must comply with all conditions of this pemzit 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 accordancc 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
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 919-807-5406 and the Asheville Regional Office Aquifer Protection Section Staff, telephone
number 828-295-4500.
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 comers) and shown on aii updated Site Map. The Permittee
shall retain a copy of this record on site.
3. One well identification lag per grouping or `cluster' of wells shall he 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
This pem-iit 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 per nit 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 Permittcc, a formal permit amendment request must be submitted to the Iirector,
including any supporting materials as may be appropriate, at least 30 days prior to the date of the change.
?. 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 #W10I00048 UiC/5QM Page 2 of 5
per. 03/2010

PART IV -- PERFORMANCE STANDARDS
4. 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.
'. 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
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 919-807-6406. 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
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.
?. 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- acid appropriate samples associated with the
injection facility activities.
Permit #WI0100048 UIC/5QM Page 3 of 5
ver. 03/2010

PART VII — MONITORING AND REPORTING REQUIREMENTS
All required docunn+entation shall be submitted to:
Aquifer Protection Section — U1C Program Aquifer Protection Section
DENR — Division of Water Quality Asheville Regional Office
1636 Mail Service Center and 2090 U.S. Highway 70
Raleigh, NC 27699-1636 Swannanoa, NC 28778
Ph# 919-715-3221 823-296-4500
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 forrn(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 11.2 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 fours 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 Permittec.
7, In the event that the permitted facility fails to perforni satisfactorily, the Permittee shall take such
immediate action as may be required by the Director,
PART VIII — PERMIT RENEWAL
In order to contuiue uninterrupted legal use of the injection facility for the stated purpose, (lie Pennittee shall
submit an application to renew the permit 120 days prior to its expiration date.
Permit #W10100048 UIC/5QM Page 4 of 5
ver. 03/2010

- T . '^. ? ­- h
PART IX — CHANGE OF WELL STATUS
L 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.
(13) 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 VII. l of this permit.
Permit #W10100048 UiC/5QM Page 5 of 5
ver. 03/20113

Smith, Eric
From:
Stepp, Jonathan
Sent:
Friday, March 02, 2012 6:49 AM
To:
Smith, Eric
Cc:
Davidson, Landon
Subject:
RE: Permit WI0100048
Not much to see or change at this point, I will pass.
Thanks,
Jonathan
Jonathan Ste pp—[e-mail]
North Carolina Dept. of Environment and Natural Resources
Asheville Regional Office
Division of Water Quality - Aquifer Protection Section
2090 U.S. 70 Highway
Swannanoa, NC 28778
Tel: [phone]Sd0
Fax: [phone]
Notice: E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and
therefore may be disclosed to third parties.
From: Smfth, Eric
Sent: Thursday, March 01, 2012 9:57 AM
To: Stepp, Jonathan
Subject: Permit WI0100046
Jonathan:
Just for the record... did you want to do a pre -permitting inspection for geothermal permit renewal W10100048?
-Eric G. Smith
Eric G. Smith, P.G.
Hydrogeologist
NCDENR
Aquifer Protection 5ection
Groundwater Protection Unit
1636 Mail Service Center
Raleigh, NC 27699-1636
919-807-6407
919-807-6496 Fax
http://Po rta l.ncdenr.orgZwe blwg/ a ps
DISCLAIMER: Per Executive ❑rder No. 150, all a -mails sent to and from this account are subject to the North Carolina
Public Records Law and may be disclosed to third parties.

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water aua[4
Beverly Eaves Perdue Charles Wakild, P.E,
Govemor Director
February 28, 2012
Timothy Ruemler
Pamela Ruernler
PO Box 752
Marshall, NC 28753
Dear Mr. and Mrs. Ruemler:
Dee Freeman
Secretary
Subject: Acknowledgement of
Application No. WI0100048
Jeff Kaplan SFR
Injection Mixed Fluid GSBP
Well (5QM) System
Madison County
The Aquifer Protection Section acknowledges receipt of your permit application and supporting
documentation received on February 27, 2012. Your application package has been assigned the number
listed above, and the primary reviewer is Eric Smith.
Central and Asheville Regional Office staff' will perform a detailed review of the provided
application, and may contact you with a request for additional informiatioa. To ensure maximum
efficiency in processing permit applications, the Aquifer Protection Section requests your assistance in
providing a timely and complete response to any additional information requests.
Please note that processing standard review permit applications may take as long as 60 to 90 days
after receipt of a complete application. If you have any questions, please contact
Eric Smith at [phone] or [e-mail].
Sincemly,
0' A - &&Y
for Debra J. watts
Groundwater Protection Unit Supervisor
cc: Asheville Regional Office, Aquifer Protection Section
Permit He W10100048
AQUIFER PROTECTION SECTION -
1636 Mall Service Centar, Raleigh, North Carolina 27699-1636
Location: 512 N. Salisbury St., Raleigh, North Carolina 27604
Phase: 919M-641541 FAX: [phone]N
InMmet m w_ inwateraua3>t,r.ort
An E L4 Opportunity I AfRrmatlyu Aak)n Employer
One'
N Cara ' a
UMM1

Smith, Eric
From: Stepp, Jonathan
Sent: Friday, February 17, 2012 3:06 PM
To: Smith, Eric
Subject: RE:
Eric,
Mr. Ruemeler Wants to mate sure that we log his receipt of the letter for today so that he has plenty of time to
respond.
Thanks,
Jonathan
Jonathan Stepp—Jonathan.Ste go0)ncdenr.gov
North Carolina Dept. of Environment and Natural Resources
Asheville Regional Office
Division of Water quality - Aquifer Protection Section
2090 U.S. 70 Highway
5wannanoa, NC 28778
Tel: [phone]
Fax: [phone]
Notice: E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and
therefore may be disclosed to third parties,
From: Smith, Eric
Sent: Friday, February 17, 2012 2:SS PM
To: tirhaoer0)frontier&grn
Cc: Stepp, Jonathan
Subject: RE:
Mr. Ruemler:
Just fill out the forms as best as you can. There will probably be stuff on there you don't know. Don't worry about it for
now. As far as the signature from the previous owner, don't worry about that either. It's not necessary. If you have any
questions on the forms, please give me a call.
-Eric G. Smith, P.G.
Eric G, Smith, P.G.
Hydrogeologist
NCDENR
Aquifer Protection Section
Groundwater Protection Unit
1636 Mail Service Center
Raleigh, NC 27699-1636
919-807-6407
919-807-6496 Fax
h"p:j/portal.ncdenr.org/web/­w==Qla gs

DISCLAIMER: Per Executive order No. 150, all a -mails sent to and from this account are subject to the North Carolina
Public Records Law and may be disclosed to third parties.
From: Smith, Eric
Sent: Friday, February 17, 2012 12.S9 PM
To: '[e-mail]'
Cc: Stepp, Jonathan
Subject:
Mr. Ruernlen
Please find the attached forms to transfer Geothermal Permit WI0100048 into your name. I have also included the
letter that explains what we need. Please pay attention to the instructions on the forms.
Thank you,
Eric G. Smith, P.G.
Eric G. Smith, P.G.
Hydrogeologist
NCDENR
Aquifer Protection Section
Groundwater Protection Unit
1636 Mail Service Center
Raleigh, NC 27699-1636
919-807-6407
919-807-6496Fax
http: /Z Aorta l.ncden r.or-zJweb/wq/a ps
DISCLAIMER. Per Executive order No. 150, all a -malls sent to and from this account are subject to the North Carolina
Public Records Law and may be disclosed to third parties.

Smith, Eric
From: Stepp, Jonathan
Sent: Friday, February 17, 2012 12:34 PM
To: Smith, Eric
Subject: RE: Documents for Geothermal Permit WI0100048
Eric,
Please find contact information for Timothy Ruemler below:
239-465-7872
t i rha oe r r� fro ntie r.co m
Jonathan Stepp — Jonathan.Steprr ncdenr.go_v
North Carolina Dept. of Environment and Natural Resources
Asheville Regional Office
Division of Water quality - Aquifer Protection Section
2090 U.S. 70 Highway
Swarmanoa, NC 28778
Tel: [phone]
Fax: [phone]
Notice: E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and
therefore may be disclosed to third parties.
Frain: Smith, Eric
Sent: Friday, February 17, 2012 8:13 AM
To: Stepp, Jonathan
Subject: RE: Documents for Geothermal Permit W10100048
Jonathan:
Yes, call if you don't mind and get the owner's address and tell them that we will be sending some information. I'll then
send the information to the new owner. I really appreciate your help.
Thanks!
-Eric G. Smith
Eric G. Smith, P.G.
Hydrogeologist
NCDENR
Aquifer Protection Section
Groundwater Protection Unit
1.636 Mail 5ervice Center
Raleigh, NC 27699-1636
919-807-6407
919-807-6496 Fax
httG:tiortal.ncdenr.or web/wq/aj)s

DISCLAIMER: Per Executive Order No. 3.50, all a -ma ils sent to and from this account are subject to the North Carolina
Public Records Law and may be disclosed to third parties.
From: Stepp, Jonathan
Sent: Thursday, February 16, 2012 4:46 PM
To: Smith, Eric
Subject: RE: Documents for Geothermal Permit WI0100O48
Eric,
I attempted to deliver the documents today and was unable to do so. The drive that I needed to enter was gated and
long. I spoke to a neighbor who said that the new owner lives in Florida. I did get a phone number, I can call if you
would like so that I am able to explain how I got hold of the number unless you want to call, Just let me know,
Thanks,
Jonathan
Jonathan Stepp—[e-mail]
North Carolina Dept. of Environment and Natural Resources
Asheville Regional Office
Division of Water Quality - Aquifer Protection Section
2090 U.S. 70 Highway
Swannanoa, NC 28778
Tel: [phone]
Fax: [phone]
Notice: E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and
therefore may be disclosed to third parties.
From: Smith, Eric
Sent: Wednesday, February 08, 2012 4.45 PM
To: Stepp, 3onathan
Subject: Documents for Geothermal Permit WI0I00048
Jonathan:
Same deal as before:
I am trying to get a Change of Ownership and Permit Renewal forms to a geothermal well owner in the Asheville Region.
The permit is W10100048 (Jeff Kaplan). The new property owners are Timothy and Pamela Rue mler. Their physical
address is 476 River Run Road in Marshall, NC. After some searching, I found that they d❑ have a Post Office Box listed
as 752 (Marshals, NC). I tried sending this information via certified mail to their physical address and their Post Office
Box address but, in both cases, it came back as unclaimed. I was wondering if you could somehow get this information
to them by hand -delivering it? if not, don't worry about it and I'll go the sheriff route.
-Eric G. Smith
Eric G. Smith, P.G.
Hydrogeologist
NCDENR
Aquifer Protection Section

Groundwater Protection Unit
1636 Mail Service Center
Raleigh, NC 27699-1636
919-807-64O7
919-807-6496 Fax
http:ZZE)ortal.ncdenr.org/web/wq,laps
DISCLAIMER: Per Executive Order No. 150, all a -mails sent to and from this account are subject to the North Carolina
Public Records Law and may be disclosed to third parties.

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Department of r.nvironmeni anu o4arurar mesources
Division of Water Quality
STATUS OF INJECTION WELL SYSTEM
Permit Ntimber
Pernuttee Narno
Address
Please check the selection which most closely describes the current status of your injection well system:
1) ❑ WeII(s) still used tor injection activities, or may be in die future.
2) ❑ Well(s) not used for lniQction but is/are used for water supply or other purposes.
3) ❑ Injection discontinued and: a) I Well(s) temporarily abandoned
la Y I i Wcll(s) permanently abandoned
c) Weil(s) not abandoned
4 ] ❑ Injection well(s) never constructed 1
Current Use of Well _
If you checked (2)_ describe the well use (potable water >Aipply, irrigaiti n, monitorin luding pumping rate and other
relevant information.
Well Abandonment 7)_
�
If you checked (3)(a) or (3)(b), describe the I'k:eti}N used to abandon the injection well.
was .sealed and the type of material used to fii l the well iJ'permanently abandoned).-
Iude a desc t
h n ofhow the t
11
r F -�
Permit Rescission:
Ifyou checked (2),(3), or (4) and will not use a well for injection on this site in the fulurr., you should request rescission of the
permit. Do you wish to rescind the permit?
❑ Yes [ ' No
Certification:
" I bcrcby certify, under penalty of law, that] Have personally- examined and am familiarwitli the information submitted
in this document, and that to the best of my knowledge the information is true. accurate, and cornplc,,e."
Signature
Date

a
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
PERNIIT NAN OWNERSHIP CHANGE
Any changes made to this fares will result to the applicnUon being returned.
a= FORMMAY BE PHO719COPIM FOR USEASANGRIGPIQ
1. Submit one original of the wmplewd and awoprialety executed Permit NamcAOwwmhip Change Form
For a champ of owwrs* the cerMation t be signed by both thecane perntit holder and the new
applicant. For a naaue ChMw only, the ceraf == nmak be signed by the applicant.
2. Provide legal docamientabou of the fiwzfer of owneerahip (such as a conhwi, deed, article of iucorpon on,
etc.) for ownership changes.
3. Change of Ownership Applicabous far Homewmem Associations (HQAs) shall include the HOAs bylaws,
covenants, etc. [15A 02T _0115(c)]
4. Submit a propcdy executed Operation and Maintenawc Agreement for all Single Family Residence Sudace
Iragation peraw requesting a change of owmrship.
1. Permit number:
2. Permit holder's name:'
KCa p Irk
3. Permits sigiing afciars name and title:
4. Ma iEg address: jaip4- KA j 4U] Al
City:
Telephone Mw6cr C--j
III noVI 1 I kI " vi Ij1: 1NL1,#JT�T;NN(O A
(AC=n legally nIsganoble for pert)
Stele Zip:
1. This request for a permit change is a result of_
a_ Charge in owmrship Of pVDPertyleomPany
b. Name champ only
E;nn-k a. nkrr--r- 'I'D n n►prw^� n -- -r ,)
(title)
Facsimile comber C--)

c_ Other (Please explain):
lurznly AT. Dhirlr' I l)Plnlllru,%a 13-- . -F'7

2. New owner's name (name to be used in permit):
m ❑+h� s ' U.e.wt. ter
3. New owner's or signing official's name and title:
(Person legally respoaMble for permit)
(title)
4. Mailing ?0 -Bay 7sa address:
City: _pi-qcshall State: NL zip:
)�7s3
Telephone member. CS $ } Cv 44 - o y 0 5;- Fame mtrmber: L�
n! CRRTMCATION
1. Cumut Penmitaees ctrdfrcad=
L attest that this application for namrJownetship change has been
reviewed and is awn ate and complete to the beat of my kwwledge- I unkmaand that if all mquned parts of
this applicafion ate not completed and that if all mquired sporting iiformation and attachmems are not
included, this application package will be manned as income- I understand I will contimre to be
responsible for compliance with the c+ma peamt mail a new permit is issuetL
Signature: Date:
Applicant's Certification_
L "r mAy attest that this application fior namelownership change has been
reviewed and is accurate and complete to the best of my luiow�;p_ I undemland that if all m1aired parts of
this application are not compic ed and thK if aft. required stggmrdW information and adtachmemts are not
inchuled, this application package will be wkff ed. as incomplete. - I further co fy that the applicant or any
affiliate has not been convicted of an entvitontaenial came. has not abandoned a wastewater facility without
proper closmre4 does not have an outing civil putty where all. appeals have been exhausted or
abandoned, are eonqpliant With any active cvmplianm schedule, and do not have any overdue annual fees
u order Rule 2T .0105..
Signature: :iilz a1 t �_I.3- F U a t e
THE COMPLETED APPLICATION PACKAQS INCLUDINGALL SUPORTING INFOIRbr►►'FIONAND
MATFJUAL% SHOUID BE SENT TO TIM FOLLOWING ADDRESS:
NORTH CAROLINA DEPARTAI ENT OF ENVIROtUd I M AND 14ATiURALRII.SOUSC1S

DIVWON OF WATER QUALM
AQMM PItO'I MOM SSCTION
16M MAIL SZRVIC$ CENTER 2720 CAPITAL SOULKVARD
RALEIG$ NORTH CAROLINA 2709-1636 RAIMG$ NORTH CAROUNA 2704
TELKMONE NU R; [phone]
rnDlL A- ukTrvl i o rnnlowvin D�,. -f 'I

NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AMID NATURAL RESOURCES
APPLICATION FOR A PERMIT TO CONSTRUCT OR OPERATE INJECTION WELLS
In Aoaardanoe Nigh the Pwvisions of 15A NCAC 02C .0200
These wells c wuh to flnida other thanpotable woer w part cif a guthermal heating and woft system
(check one) New Application Renewal � Modification
* For renewals comp%te Faits A-C and the signature page.
DATE: � ►ri�q�' D� 20 ta,
PERMI'1 NO. "t ❑ I �QO 18 (leave blank ifNmApplication)
A. STATUS OF APPLICANT (choose one)
Non-Govemmcnt: IkWidnal Residence ration
Government State Municipal County Federal
R PERMIT APPLICANT — For individual residences, list tk owner on property deed For all others,
state name of entity md ' of person delegated authority to sign an alf of the business or agency:
n�o e�! (er c L?c,we.[a, S. ke t� der
Mailing Address:
e?() 9cN -79-�,
City: 1 1 as ha State:� 3p County
Day Tele No_: R ��?� Cvci ^1-o�fia stl No_:
E AI LAddress:— Io ! p, Fax
UQ,N
C. LOCATION OF WELL SM — WMuare the injeudon wells are physically Ioeated:
(1) Parcel Identification Number (PIN) of Well site: q'T/(v - 3 3 —SV oD may:
Mexcli So►U
(2) Physical Address (¢ diffbn= than mailing address)_ q 7p -F: ver R L(
City: S15tme: jc Zip Code:
a F7s3
D. VIELL DRILLER INFORMATION
Well Drilling Contractor's Name:

N
NC well Drilling Contractor Ca ificatiom No.:
Company
Address:
City:
Office Tele No-:
No,-
Tip Code: State: County:
CeD No..
E. HEAT PUMP CONTRACTOR PWORMAnON (if differw than driller)
Company
Name:
ContactPerson-I�
Asir
Address:
City:
Office Tele No.:
NQ.
FJM
Zip Cade: State: County.
Cell No-:
F. WELL CONSTRUMON DATA
(1) Number of borings io be canstructed*: Depth of each boring
EAa
(feet):
If existing water sally wells wrll he used then p owde the mformatian in item (4)
below.
(2)C`.homical additives to be used: R 22 Prripylene glycol Ethanol
Other (other additives will need Prior approvel by NCDENR before use)
(3)Type of tubing to be used (copper, PVC, etc):
(4) Well casing. If the well(s) will use casing then pmvide the b. (steel, PVC, plastic, etc.), ditamoiM dcWL
and cxd tit of casing appearing above ground:
(5) Grout (mabarml s mmmding well c&4M andlaor piping):
(a) Grout type: Cement mite** Other (specify)
ss BY WWCfag bastcdm glow, avwim cc is hereby Z=MmWd W 13ANCAC 2C .Q213(dXIXA). which m4uim a mm-d type BMUL
(b) Grout depth of tubing (rdim=cc to land surface): hom to (feet)
If well has cog, indicate grout depth: f om to (feet)

G. WELL LOCATIONS — Maps must be scaled or otimrwm X=watdY ideate dishances and orientations of
features looted within 1000 feet of the injection vMR(s).
(1) Attach a site -specific neap showing the locations of the following:
* Proposed injection wells + Buildings * Property boundaries
* Sud'aoe water bodies * Wader supply wells
* Septic tanks and assaeiaded spray irrigation sites, drain fields, or repair areas
* Existing or potential sous of groundwater contamination
(2)Attach a topograpbic asap of the axes eating 114 mile fiom the injection well site that indicates the
facility's location and the map name.
NOTE• in awa cases; an aerial p Wh of Ae properry PS xhowh g Eves and MoUdreres Can be
obwned and down&adedf vm Ake gWEcable axody GIS ►nebsw- Tjpwally, the properly ran be seouc*ed by
owner nine our oddness. The hwaiion of the veffs in retaow to properV boundarie& houses, septic taut, other
we&, etc. ran then be dfaKw in by hand. Alsvy a `layer' am be saLaoted showfigg toapegnVhic contarers or
elevaenn dal&

H. CERTIFICATION (to be sigma as requireil below or by that person's authorized agent)
15A NCAC 02C _0211(b) requires that all permit applications shall be signed as follows:
1. for a corporation: by a responsible corporate officer,
2_ for a partnership or sole psuprichprfti by a general partner or the proprietor, respectively,
3. for a municipality or a state, federal, or other public agency: by either a principal executive
officer or ranking publicly elected officiaL;
4. for all others: by the well owner (z hich means all persons listed on the Vmpuly deed).
If an authorized agent is signing an behalf of the applicant, then supply a letter signed by the
applicant that names and authorizes their agent to sign this application on their behalf.
"I hereby car*, under penalty of law, that I have personally examined and am familiar with the information
submitted in this document and all attachments thereto and the based on my inquiry of those individuals
immediately responsible fDr obommg said information, I believe that the information is true, accurate and
complete. I an aware that there are significant penalties, inr]uding the possibility of fines and imprisonment,
for submitting false information_ 1 agree to construes opera, maintain, repair, and if applicable, abandon the
injection well and all relatedapparWumes in accordance with the approved specifications and conditions of
the Permit,"
— —_�--------------------
Sigrtrmme of Property OwnedApplieW
f VKtifk y J� —1, -, Lr
Print or Type Full Name
Signature of ra er/Applicant
rint or Type Full Name
Signature of Authorized Agent, if any
Print or 'type Full Name
Submit two copies of the completed application pacmge to:
DWQ -Aquifer Protection Section
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone [phone]

BOOK 471 PAGE 202
Lnwr Phi 11 2=
�state of MISON
. North WOW sty
Aa■I aot ■ts Excleo Tax
Excise Tax, $2,000
Tax Lot No, Parcel Identifler No.
Verified by _ County an the, day of . .2008
FILED in MAMSM CwfjX am
Nov 14 20CIB at LL'0M AM
by Suaen Rector
Rs of or of Deeds
Mali after recording to GREG GOOSMANN, GOOSMAN ROSE, P.A., BOX 81
This Instrument was prepared by ROBERT J. DEUTSCH, attorney_
Brief Description for the index FLot i, Reserve at River Run Subdlvision I
NORTH CAROLINA GENERAL WARRANTY DEED
THIS DEED made NOVI
GRANTOR
JEFFREY S. KAPLAN end wife,
13ASHA KAPLAN
GRANTEE
TIMOTHY J. RUEMLER and wife,
PAMELA S. RUEMLER
Address.
476 River Run
Marshall, NC 28753
Tne designation Grantor and Grantee as used herein shall include said partles, their heirs, successors, and assigns, and shall
include singular, plural, masculine, feminine or neuter as required by context.
WITNESSETH, that the Grantor, fora valuable consideration paid by the Grantee, the receipt of which is hereby
acknowledged, has and by these presents does grant, bargain, sell and convey unto the Grantee in fee simple, all that certain
lot or pa real of land situated In the City of , MADISON County, North Carolina and more partimtarly described as follows:
BEING ALL THAT PROPERTY SET FORTH ON EXHIBIT "A" ATTACHED HERETO AND
INCORPORATED HEREIN BY REFERENCE.
i I=-1652}

�Ren r �7J Pig �P� The property hereinabave described was acquired by Grantor by instrument recur ed n 3S a 490.
A map showing the above described property is recorded in Plat Book 6. Page A and Plat Book 6, Page 729.
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the
Grantee in fee simple
And the Grantor covenants with the Grantee, that Grantor is seized of the premises in fee simple, has the right to convey the
same in fee simpie, that SiDe is marketable and free and clear of all encumbrances, and that Grantor will warrant and defend the
title against the lawful claims of atl persons whomsoever except for the exceptions hereinafter stated
Title to the property hereinabove described is subject to the following exceptions
IN WITNESS WHEREOF, the Grantor has hereunto set his hand and seal, or if corporate, has caused this instrument to be
signed in its corporate name by its duly authorized officers and its seal to he hereunto affixed by authority of its Board of
❑irecto rs, the day and year first above written.
(Seal)
VF. APp
BASHA KAPLA
BILECIDnIbe Ctxntt % N''orth Carolina
f certify that the following persons) personally appeared before the this day, each aclinowledging to me that
he or she votunlarily signed the foregoing document for the purpose stated fherein and in the capacity indicated:
JFFFRFV S. KAPLA,N and wife, BASHA KAP LAN, Grantors herein.
Date: November 2008
O t-tA P. or
taafa4r
a,suc
�s
pC
1123075321
\Printed Name of Notary Public
ly Commission expires: 0- 30

BWK 171 PACE 20
EXHIBIT "A'
BEING all of LOT 1 of THE RESERVE AT RIVER RUN (PHASE 1), as shown on the plat
recorded in Plat Book 6, at page 4, Madison County Registry, reference to which is hereby
made and incorporated herein for a greater certainty of description.
ALSO CONVEYED Is the 60-foot right-of-way reserved in the Deed recorded in Book 210, at
page 389, Madison County Registry, which right-of-way enlarges the 15-foot right-of-way
appearing on the recorded plat
ALSO CONVEYED HEREWITH are any and ail rights reserved in that Deed to Jubilee
Community.Inc. as recorded in Book 210, at page 389, Madison County Registry,
ALSO CONVEYED HEREWITH are any and all of those reserved rights from prior
conveyances as such rights may affect the property conveyed herein, as well as any and all of
those rights reserved by Sarah Virginia Lentz In any real property contiguous to or
appurtenant to the property conveyed herein heretofore rested in Sarah Virginia Lentz, such
rights having been conveyed without limitation by Sarah ' Iirgiuia Lentz to the Grantors herein
by that deed recorded In Deed Book 350, at Page 490 of the Madison County, NC Register's
Office.
IT 1S THE INTENT of the Grantor, and the Grantees, that any and all of those dominant
rights heretofore retained by Grantor are conveyed to Grantees, without limitation, Including
those referred to and conveyed in Deed BoI ak 350, at Page 490, Madison County Registry.
ALSO CONVEYED HEREWITH, SPECIk CALLY SUBJECT TO the benefits and burdens
of the Road Maintenance Agreement appearing In Book 224. at page 545, Madison County
Registry, as relates to the IS -foot road access over and across the western portions of Lots 1, 2
3 and 4 of River Run, as shown in Plat Book 4, at page 46, Madison County Registry, and that
Road Maintenance Agreement as set forth in Deed Book 284, at page 564, Madison County
Registry,
SUBJECT TO those Restrictive Covenants- pertaining to RIVER VIEW FARM (Plat Book 4,
at page 792), and RIVER RUN (herein conveyed) of record in that certain Deed to Sanders
from the Sarah Virginia Lentz, appearing in Book 284, at page 564, Madison County Registryy,
EXCEPT no more than seven (7) single-family residences may be constructed within RIVER
RUN Subdivision; however, the lot lines, as existing on the plat, may be altered provided that
only seven (7) residences are allowed_ Paragraph 11 (TEMPORARY STRUCTURES) shall
also burden RIVER RUN.
GRANTOR hereby transfers any and all of the special rights and obligations of the Grantor as
Declarant/Developer of the Subdivision to Grantee, and it is the intention of the parties hereto
that any and all dominant rights bereto6re retained by the Grantor are conveyed to the
Grantee, without ilmitation, including, but not limited to all governmental rights and permits
and all the rights reserved In that certain 1}eed recorded in Book 210, at page 389, Madison
County Registry. 'J�v
023WM25 f

NDG�\R
North Carolina Department of Environment and Natural Resources
Division of Water Ouallty
Beverly Eaves Perdue Charles Waklld, P. E.
Ci NWW I Meclor
January 18, 2012
CERTIFIED MAIL # 7006 2150 0003 5467 1322
RETURN RECEIPT REQUESTED
Timothy and Pamela Ruemler
Post Office Box 752
Marshall, NC 28753
Subject: C hangs of Ownership and Permit Renewal
Permit No. WI0100048
SQM Geothermal Injection Well
Madison County
Dear Mr. and Mrs. Ruemler:
Dee Freemen
Secretary
The Underground Injection Control (UIC) Program of the North Carolina Division of Water
Quality (DWQ) is entrusted to protect the groundwater quality and resources of the State of
North Carolina, and is responsible for the regulation of injection well construction and operation
activities within the state. Our records indicate that the above -referenced permit was issued to
Jeff Kaplan on May 7, 2007, and expires on April 30. 2012.
This permit was issued for the operation of a 5QM (Closed -Loop Mixed -Fluid) Geothermal
Injection Well on your property located at 476 River Run in Marshall, North Carolina. As the
new property owners, you are responsible for maintaining this permit. Therefore, it is important
that you submit a Change of Ownership form within thirty (30) days of receipt of this letter.
Sincc the rerinit :v, cct to e� pire shortly grid in order to comply with the regulatory requirements
listed under North Carolina Administrative Code (NCAC) Title 15A, Subchapter 2C, Section
.0211, you must also submit one of the following forms:
A. Application for Permit (Renewal) to Construct andlor Use a Well(s) for Injection
with Geothermal Hear Pump ,system for ?Type SQM Well(s) if the injection well
system on your property is still active.
-OR-
-4 05,; iqh, N 90hcarol a278a9.6=7 N� Cara ' a
LocOm. 512 N. SiMebury SL Raleigh, Horth Cardfne 27W4
Prone: eiaso7.eaao i FAX ets-aor4as�
Intemel, ffl N.ncwataocualltv.ora
An ftW OPAeduplh' 1 Orm ovo Acdon @moo w

S. Status of Injection Well System if the injection well system is inactive or has been
temporarily or permanently abandoned.
Please submit the forms to:
Aquifer Protection Section
Groundwater Protection Unit
UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Failure to submit these forms in a timely manner may result in the assessment of civil penalties
in accordance with North Carolina General Statute 87-94. For your convenience, a Change of
Ownership form, a renewal application, and. a UIC Well System Status form are attached along
with a self-addressed envelope. The above referenced forms arc also available on-line at the
L7WQ website at httj_i;1113o al,nccl nr�gr 'weblw� a-3s/ W ral�d�tt�it���icatic�ns �, othcrmApjt 4.
Thank you in advance for your cooperation and timely response. If you have any qucstions,
please contact inc by phone at [phone] or by email at Laic i.
Sincerely,
zL
0, z /7�
Eric G. Smith, P.G.
Hydrogeologist
Enclosures
cc: Asheville Regional Office - Aquifer Protection Section w/o enclosures
APS Central Files — Permit WIU 100048 w/o enclosures

AII'VIAW,
1 \`fDeYirf \�■
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eavas Pardue Charles WaWld, P. E.
Oovmrna Direeiar
January 18, 2012
CERTIFIED MAEL # 7006 2150 0003 54671322
RETURN RECEIPT REQUESTED
Timothy and Pamela Ruemler
Post Office Box 752
Marshall, NC 28753
Subject: Change of Ownership and Permit Renewal
Permit No. W10100048
5QM Geothermal Injection Well
Madison County
Dear Mr. and Mrs. Ruemler:
Dee Freemen
Secretary
The Underground Injection Control (llIC) Program of the North Carolina Division. of Water
Quality (DWQ) is entrusted to protect the groundwater quality and resources of the State of
North Carolina, and is responsible for the regulation of injection well construction and operation
activities within the state. Our records indicate that the above -referenced permit was issued to
Jeff Kaplan on May 7, 2007, and expires on April 30, 2012.
This permit was issued for the operation of a 5QM (Closed -Loop Mixed -Fluid) Geothermal
Injection Well on your property located at 476 River Run in Marshall, North Carolina. As the
new property owners, you are responsible for maintaining this permit. Therefore, it is important
that you submit a Change of Ownership form within thirty (30) days of receipt of this letter.
si±ice the permit is -et to expire: shnrtly and in nrder to cotnply with the remilaton, requircrnent5
listed under North Carolina Administrative Code (NCAC) Title 15A, Subchapter 2C, Section
.0211, you must also submit one of the following forms:
A. Application for Permit (Renewal) to Construct andlor Use a Wells)for Injection
with Geothermal heat Pump System for Type 5QM Wells) if the injection well
system on your property is still active.
-OR-
One
Low5m: W N. 8apeNry St Raloth, HoM CaMIN 27004 Card '
P a
a*,-9fB.�'14W I FAX. 9IM7-MO
1nwet,� uai1i1&m atual y
a+ Eaue+ *l Mmsttm Ac%n Emo%w

B. Status of Injection Well System if the injection well system is inactive or has been
temporarily or permanently abandoned.
Please submit the forms to:
Aquifer Protection Section
Groundwater Protection Unit
UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Failure to submit these forms in a timely manner may result in the assessment of civil penalties
in accordance with North Carolina General Statute 87-94. For your convenience, a Change of
Ownership form, a renewal application, and a UIC Well System Status form are attached along
with a self-addressed envelope. The above referenced forms are also available on-line at the
DWQ website at Mtn:11uartal nedenr.orglweblwalanslgarolpermit-applications#geothermApps.
Thank you in advance for your cooperation and timely response. If you have any questions,
plcase contact ine by phone at [phone] or by email at a rigzimith(a-Incdettr.gov,
Sincerely,
zi
� d' "'� /�
Eric G. Smith, RG,
Hydrogeologist
Enclosures
cc: Asheville Regional Office - Aquifer Protection Section w/o enclosures
APS Central Files — Permit WI0100048 w/o enclosures

inj
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For delivery information
visit out website at www-u—sps—.com
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(Endorsamenl Required)
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0
(Endorsement Roquimd)
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Total
Timothy and Pamela Ruemler
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Post Office Box 752
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Marshall, NC 28753
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For delivery information visit our wetrsfte 8t wwn� usps.nnms�
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RCDENR
North Carolina Department of Environment and Natural Resources
Divlslon of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
January 4, 2012
CERTIFIED MAIL # 7006 2150 0003 5467 1254
RETURN RECE_IPT REQUEST D
Timothy and Pamela Ruemler
476 River Run
Marshall, NC 28753
Subject: Change of Ownership and Permit Renewal
Per, No. WI0100048
5QM Geothermal Injection Well
Madison County
Dear Mr. and Mrs. Ruemler:
Dee Freeman
Secretary
The Underground Injection Control (UIC) Program of the North Carolina Division of Water
Quality (DWQ) is entrusted to protect the groundwater quality and resources of the State of
North Carolina, and is responsible for the regulation of injection well construction and operation
activities within the state. Our records indicate that the above -referenced permit was issued to
Jeff Kaplan on May 7, 2007, and expires on April 30, 2012.
This permit was issued for the operation of a 5QM (Closed -Loop Mixed -Fluid) Geothermal
Injection Well on your property located at 476 River Run in Marshall, North Carolina. As the
new property owners, you are responsible for maintaining this permit. Therefore, it is important
that you submit a Chanue of Ownership form within thirty (30) days of receipt of this letter.
Since the permit is set to expire shortly and in order to comply with the regulatory requirements
listed under North Carolina Administrative Code (NCAC) Title 15A, Subchapter 2C, Section
.0211, you must also submit one of the following forms:
A. Application for Permit (Renewal) to Construct and/or Use a Well(s) for Injection
with Geothermal Meat Pump System for 2�pe 5QM Well(s) if the injection well
system on your property is still active.
.OR -
AQUIFER PROTECTION SECTION
153E Mal; Service Cenle+ Raleigh,10011 Gamlina 27649.1636
Lojawn. 2728 Capital bmu evam Raieipr. Norm Carolrrna 27604 J11C Prune 314-733 a221 - FA;: 1. 919•715-a58S: FA:,'_1 91(-715 304C l CuSkcme, Serviewe 1-877-62?474 N oi-tn uri)L-,L
lnreret yvww nGwaSerguaiiv.ora �
Hil ~U�-� r��l'{7.�1i:1 �1 h11'RI18nV� P.tlll:ri _,RI RILry�" /*y •!7r-'�•
�'� CSrxf.,- 4t�r-i!
A

B. Status of lr!jection 13 ell Svstem if the injection well system is inactive or has been
temporarily or permanently abandoned.
Please submit the forms to:
Aquifer Protection Section
Groundwater Protection Unit
UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1 d36
Failure to submit these forms in a timely manner may result in the assessment of civil penalties
in accordance with North Carolina General Statute 87-94. For your convenience, a Change of
Ownership form, a renewal application, and a UIC Well System Status form are attached along
with a self-addressed envelope. The above referenced forms are also available on-line at the
DWQ website at htti,:/mortal.nedear.ora/webiwulans!t:-wproipermit-ar,vlicatiotis#aeothennAr)t)s.
Thank you in advance for your cooperation and timely response. If you have any questions,
please contact me by phone at [phone] or by email at eric.a.smithra7ncdenr aov.
Sincerely,
Eric G. Smith, P.G.
Hydrogeologist
Enclosures
cc: A_)eville Regional Office - Aquifer Protection Section w/o enclosures

HCDEHR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coieen H. Sullins
Governor Director
January 4, 2012
CERTIFIED MAIL # 7006 2150 0003 5467 1254
RETURN RECEIPT REQUESTED
Timothy and Pamela Ruemler
476 River Run
Marshall, NC 28753
Subject: Change of Ownership and Permit Renewal
Permit No. WI0100048
5QM Geothermal Injection Well
Madison Countv
Dear Mr. and Mrs. Ruemler:
Dee Freeman
Secretary
The Underground Injection Control (UiC) Program of the North Carolina Division of Water
Quality (DWQ) is entrusted to protect the groundwater quality and resources of the State of
North Carolina, and is responsible for the regulation of injection well construction and operation
activities within the state. Our records indicate that the above -referenced permit was issued to
.Leff Kaplan on May 7, 2007, and expires on April 30, 2012.
This permit was issued for the operation of a 5QM (Closed -Loop Mixed -Fluid) Geothermal
Injection Well on your property located at 476 River Run in Marshall, North Carolina. As the
new property owners, you are responsible for maintaining this permit. Therefore, it is important
that you submit a Change of Ownership form within thirty, (30) days of receipt of this letter.
Since the permit is set to expire shortly and in order to comply with the regulatory requirements
listed under North Carolina Administrative Code (NCAC) Title 15A, Subchapter 2C, Section
.0211, you must also submit one of the following forms:
A. Application for Permit (Wenewal) to Construct andlor Use a Well(s) for Injection
with Geothermal Heat Pump System for Type 5QM Well(s) if the injection well
system on your property is still active.
"
AQUIFER PROTECTION SECTION
1636 Mail SerWoc Cerites, Raleigh, North Carolina 27699-1636
Location: 2728 Capital Boulevard, Raleigh. North Carolina 27604
Phorw: 919-73' -3221 1 FAX is 919iiW585; FAX 2: 9i9-715-5048 I Customer Service: 1-B77-623-6746 NorthCarolina
Irrterret: wwvw,ncwateraualitsl.arg
An Equal ❑ppommity,, ATkrmatiw Acoan Ennloyer f� ■ �/atuwI4`'
4�

B. Status oj'lnjection Well System if the injection well system is inactive or has been
temporarily or permanently abandoned.
Please submit the forms to:
Aquifer Protection Section
Groundwater Protection Unit
UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Failure to submit these forms in a timely manner may result in the assessment of civil penalties
in accordance with North Carolina General Statute 87-94. For your convenience, a Change of
Ownership form, a renewal application, and a UIC Well System Status form are attached along
with a self-addressed envelope. The above referenced forms are also available on-line at the
DWQ website at http:llportal.nedear.or web/wq/apslgwproipermit-applications4geotheniiApps.
Thank you in advance for your cooperation and timely response. If you have any questions,
please contact me by phone at [phone] or by email at ericc!,,smith igicdenr, ,ov.
Sincerely,
Eric G. Smith, P.G.
Hydrogeologist
Enclosures
cc: Asheville Regional Office - Aquifer Protection Section w/o enclosures
AP Central Files — Permit W10100048 w/o enclosures

-A�
NCDE�IR
North Carolina Department of Environment and
DlvIslon of Weer Quality
Beverly Eavea Pardue Charies Wakild, R E
C'Mmor Director
January 18, 2012
CERTIFIED MAIL # 7006 2150 0003 5467 1322
RETURN RECEIPT REQUESTED
Timothy and Pamela Ruemler
Post Office Sox 752
Marshall, NC 28753
Subject: Change of Ownership and Permit Renewal
Permit No. WI0100048
5QM Geothermal Injection Well
Madison County
Dear Mr. and Mrs. Ruemler:
Natural Resources
Dee Freemen
secretary
The Underground Injection Control (UIC) Program of the North Carolina Division of Water
Quality (DWQ) is entrusted to protect the groundwater quality and resources of the State of
North Carolina, and is responsible for the regulation of injection well construction and operation
activities within the state. Our records indicate that the above -referenced permit was issued to
Jeff Kaplan on May 7, 2007, and expires on April 30, 2012.
This permit was issued for the operation of a 5QM (Closed -Loop Mixed -Fluid) Geothermal
Injection Well on your property located at 476 River Run in Marshall, North Carolina. As the
new property owners, you are responsible for maintaining this permit. Therefore, it is important
that you submit a Change of Ownership form within thirty (30) days of receipt of this letter.
Since the permit is set to expire shortly and in order to comply with the regulatory requirements
listed under North Carolina Administrative Code (NCAC) Title 15A, Subchapter 2C, Section
.0211, you must also submit one of the following forms:
A. Application for Permit (Renewal) to Construct andlor Use a Well(s) for Injection
with Geothermal Heat Pump System for Type 5QM Wells) if the injection well
system on your property is still active.
-OR-
1e17 W1 Service Center, Ralelph, North Camllna 2700.1617
Loodon: 612 N, 5atlrbury$t Ualgh, Nord Camllna 27604 N��� Cary ' a
Phone: 919-807•63001 FAX: [phone] i �
Internet: www,ncwatamui�iaom Wwiii
y
An Equal OpporWnit l AWmahvn Adon Inplayer

B. Status of Injection Well System if the injection well system is inactive or has been
temporarily or permanently abandoned.
Please submit the forms to:
Aquifer Protection Section
Groundwater Protection Unit
UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Failure to submit these forms in a timely manner may result in the assessment of civil penalties
in accordance with North Carolina General Statute 87-94. For your convenience, a Change of
Ownership form, a renewal application, and a UIC Well System Status form are attached along
with a self-addressed envelope. The above referenced forms are also available yn-l:ne at the
DWQ website at >ttn:.!'�r�ortal_nc-denn"r' ,yeh/WLt/a y! �rvprs�l t-appliG titans#b of rmAn .
Thank you in advance for your cooperation and timely resrnnCe: if yo>> have any questions,
please contact me by phone at [phone] or by email at Qnc is., wmith wricdcar Gov.
Sincerely,
Eric G. Smith, P.G.
Hydrogeologist
Enclosures
cc: Asheville Regional Office - Aquifer Protection Section w/o enclosures
APS Central Files — Permit W10100048 w/o enclosures

1.
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
PERMIT NAME/OWNERSHIP CHANGE
Any changes made to this form will result in the application being returned.
{THIS FORM MAY BE PHOTOCOPIED FOR USE AS AN ORIGINAL}
1. Submit one original of the completed and appropriately executed Permit Name/Ownership Change Form,
For a change of ownership, the certification must he signed by both the current permit holder and the new
applicant. For a name change only, the certification must be signed by the applicant.
2. Provide legal documentation of the transfer of ownership (such as a contract, deed, article of incorporation,
etc,) for ownership changes.
3. Change of Ownership Applications for Homeowners Associations (HOAs) shall include the HOAs bylaws,
covenants, etc. [15A 02T .0115(c)]
4. Submit a properly executed Operation and Maintenance Agreement for all Single Fancily Residence Surface
Irrigation permits requesting a change of ownership.
11. CURRENT PERMIT INFORMATION
1. Permit number:
2. Permit holder's name:
3. Permit's signing official's name and title:
(Person legally responsible for permit)
4. Mai ling address:
City:
Telephone number: C_1
IIL NEW QWNERINAXE INFORMATION
1. This request for a permit change is a result of_
State:
a. Change in ownership of property/company
— b. Name change only
c. Other (please explain):
(title)
Zip:
Facsimile number. (__)
FORM: PNOC 12/30/2009 Page I of 2

2. New owner's name (name to be used in permit):
3. New owner's or signing official's name and title:
4. Mailing address:
City: Slate:
Telephone number: t_!1
IV. CERTIFICATION
(Person legally responsible for permit)
(title)
Zip:
Facsimile number: { y
1. Current Permittec's Cenification:
I, , attest that this application for namelownership change has been
reviewed and is accurate and complete to the best of my knowledge. I understand that hall required parts of
this application are not completed and that if all required supporting information and attachments are not
included, this application package will be returned as incomplete. I understand I will continue to be
responsible for compliance with the current permit until a new perunit is issued.
Signature: Date:
2. Applicant's Certification:
I, , attest that this application for namemwnership change has been
reviewed and is accurate and complete to the best of my knowledge. I understand that if all required parts of
this application are not completed and that if all required supporting information and attachments are not
included, this application package will be returned as incomplete. . I further certify that the applicant or any
affiliate has not been convicted of an environmental crime, has not abandoned a wastewater facility without
proper closure, does not haNre an outstanding civil penalty where all appeals have been exhausted nr
abandoned, are compliant with any active compliance schedule, and do not have any overdue annual fees
under Rule 2T .0105.
Signature:
THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL SUPPORTING INFORMATION AND
NtATERIALS. SHOULD BE SENT TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DEPARTI►4ENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
AQUIVER PROTECTION SECTION
Via U.S. Postal Senzce
1636 MAIL SERVICE CENTER
RALEIGH, NORTH CAROL INA "699-16$6
Via Courier/ Special Deliverv:
2728 CAPITAL BOULEVARD
RALEIGH. NORTH CAROLINA 27604
TELEPHONE NUMBER: [phone]
FORM: PNOC 12/30/2009 Page Z of 2

PT
NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
APPLICATION FOR A PERMIT TO CONSTRUCT OR OPERATE INJECTION WELLS
In Accordance With the Provisions of 15A NCAC 02C .0200
CLOSED -LOOP MILD -FLUID GEOTHERMAL INJECTION WELLS
These wells circulate fluids other than potable water as part of a geothermal heating and cooling system
(cheek one) New Application Renewal* Modification
* For renewals complete Parts A-C and the signature page,
int or Type Information and Mail to the Address on the Last Page. Illegible Applications Will Be Returned As Incomplete.
DATE:
20
PERMIT NO. __— _(leave blank if New Application)
A. STATUS OF APPLICANT (choose one)
Non -Govern rent: Individual Residence Business/Organization
Government: State Municipal County Federal
C.
PERMIT APPLICANT — For individual residences, list each owner on property deed. For all others,
state name of entity and name of person delegated authority to sign on behalf of the business or agency:
Mailing Address:
City: Stage: Zip Code: County:
Day Tele No.: Cell No.:
EMAIL Address. Fax No.:
LOCATION OF WELL SITE — Where the injection wells are physically located:
(1) Parcel Identification Number (PIN) of well site:
(2) Physical Address (if different than mailing address):
City:
D. WELL DRILLER INFORMATION
Well Drilling Contractor's Name:
NC Well Drilling Contractor Certification No.:
Company Name:
Contact Person:
Address:
State: NC Zip Code:
EMAIL Address:
County:
City: Zip Cade- Stage: County -
Office Tole No,: Cell No.: Fax No.:
C[PUIUIC 5QM Perniit Application (Revised 1/24/2011) Page 1

E.
HEAT PUMP CONTRACTOR INFORMATION (if different than driller)
Company Name:
Contact Person: EMAIL Address:
Address:
City:
Office Tele No.:
Zip Code: State: County:
F. WELL CONSTRUCTION DATA
Cell No.:
Fax No.
(1) Number of borings to be constructed*: Depth of each boring (feet):
* If existing water supply wells will be weed then provide the informatian in item (4) helaw.
(2) Chemical additives to be used: R-22 Propylene glycol
Other
Ethanol
(other additives will need prior approval by NCDENR before use)
(3) Type of tubing to be used (copper, PVC, etc):
(4) Well casing. If the well(s) will use casing then provide the type (steel, PVC, plastic, etc.), diameter, depth.
and extent of casing appearing above ground:
(5) Grout ( material surrounding well casing andlar piping):
(a) Grout type: Cement Bentonite** Other (specify)
** By setec6ng bentonite grout, a variance is hLrebv requested to 15A NC AC 2C .02131dh 1 HAI, which requires a Cement type grout
(b) Grout depth of tubing (reference to land surface): from to (feet)
If well has casing, indicate grout depth: from to (feet)
G. WELL LOCATIONS— Maps must be scaled or otherwise accurately indicate distances and Orientations of
features located within JOOO feet of the injection well(s). Label all features clearly and include_a north arrow.
(I i Attach a site -specific map showing the locations of the following:
* Proposed injection wells # Buildings * Property boundaries
* Surface water bodies * Water supply wells
* Septic tanks and associated spray irrigation sites, drain fields, or repair areas
* Existing or potential sources of groundwater contamination
(2) Attach a topographic map of the area extending 1 /4 mile from the injection well site that indicates the
facility's location and the map name.
NOTE! let most cases, air aerial photograph of the property parcel shotving properly 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, other
wells, etc. can then be drawn in by hand Also, u 'layer' can be selected showing topographic contours or
elevation data.
GPU/UIC 5pN1 Permit Application (.Revised 112412011) Page 2

IEL CERTIFICATION (to be signed as required below or by that person's authorized agent)
15A NCAC 02C .0211(b) requires that all permit applications shall be signed as follows:
1, for a corporation: by a responsible corporate officer;
I. for a partnership or sole proprietorship: by a general partner or the proprietor, respectively;
3. for a ' miiiiicipality or a state, federal- or other public agency: by either a principal executive
officer or ranking publicly elected official;
4. for all others. by the well owner (which means all persons listed on the pmperty deed).
If an authorized agent is signing on behalf of the applicant, then supply a letter signed by the
applicant that names and authorizes their agent to sign this application on their behalf.
"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, incltiding the possibility of fines and iinprisonment,
for submitting false information. I agree to construct, operate, maintain, repair, and if applicable, abandon the
injection well and all related appurtenances in accordance with the approved specifications and conditions of
the Permit."
Signature of Property Owner/Applicant
Print or Type Full Name
Signature of Property Owner/Applicant
Print or Type Full Name
Signature of Authorized Agent, if any
Print or Type Full Name
Submit two copies of the completed application package to:
DWQ - Aquifer Protection Section
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone [phone]
GPU/LTiC 5QM Permit Application (Revised 1 /24/2011) Page 3

State of North Carolina
Department of Environmcut and Natural Resources
-Division of Water Quality
STATUS OF INJECTION WELL SYSTEM
Permit Number:
Permittee Name:
Address:
Please check the selection which most closely describes the current status of your injection well system:
3 ) ❑ Well(s) still used for injection activities, or may be in the future.
2) ❑ 'Well(s) not used for injection but is/are used for water supply or other purposes.
3) ❑ Injection discontinued and: a) ❑ Well(s) temporarily abandoned
M ❑ Well(s) permanently abandoned
c) ❑ Well(s) not abandoned
4) ❑ Injection well(s) never constructed
Current Use of Well
If you checked (2). describe the well use (potable water supply, irrigation, monitoring, etc), including pumping rate and other
relevant information.
Well Abandonment
If you checked (3)(a) or (3)(b), describe the method used to abandon the injection well. (include ❑ description Uf how the well
was sealed and the type afmaterial used to fill the well ifpermanend), abandoned):
Permit Rescission:
If you checked (2), (3), or (4) and will not use a well for injection on this site in the future, you should request rescission of the
permit. Do you wish to rescind the permit?
❑ Yes ❑ No
Certification:
"I hereby certify, under penalty of law. that I have personally examined and am familiar with the information submitted
in this document, and that to the best of my knowledge the information is true, accurate, and complete."
Signature
Date
Revised 5/05 GWIUIC-fib

gy 3. Wig
NCDEN
North Carolina Department of Environment and Natura
Division of water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
December 2, 2011
Jeff Kaplan
50 Al Faye Farm Way
Weaverville, NC 28787
Subject: Notice of Expiration (NOE)
5QM- G eothermal Injection Well
Permit No. WI0100048
Madison County
Dear Mr. Kaplan:
Resources
Dee Freeman
Secretary
The Underground Injection Control (U1C) Program of the North Carolina Division of Water
Quality (DWQ) is entrusted to protect the groundwater quality and resources of the State of
North Carolina, and is responsible for the regulation of injection well construction and operation
activities within the state. Our records indicate that the above -referenced operating permit for
the underground injection well system located on your property at 4.76 River Run Road in
Marshall, NC, which was issued to you on May 7, 2007, and expires on April 30, 2012" is soon
due for renewal. if you wish to keep this permit and operate the injection well system, the permit
must be renewed and issued in your name.
If Your lniection Well is Current)N Inactive:
If the injection well system is no longer being used for any purpose, it must be permanently
abandoned according to the regulatory requirements listed under NCAC Title 15A, Subchapter
2C, Section .0214. When each well is plugged and abandoned, the well abandonment record
(Form GW-30) must be submitted to our office to certify that the abandonment was properly
conducted.
If there has been a change of ownership of the property, an Injection Well Permit
Name/Ownership Change Form must also be submitted. The GW-30 and Name/Ownership
Change forms can be found at hnt+;llportal.ncdenr.orL,IweblwalansA,\,.-prolrenortinL-farms.
If Your Infection Well is Currently Active:
If the injection well system is still active and you wish to renew your permit, the renewal
application must be submitted within 120 calendar days of the expiration of your permit.
According to our records, you must submit your permit renewal by .lanunr► 1. 2012.
AQUIFER PROTECTION SECTION
1636 Mail Gomm Center, Raleigh, North Carolina 27699.1636
Location: 2728 Capital Boulevard Raleigh North C-amllna 27£64 ln
Phone [phone] I FAX 1: 919.715-0501 FAX [phone] l Cus¢omer Serve'Ae
: 1-a77-523-674F � � �T�AiT ii
Irtlemet' Www.nCW-aterQuall .0M
An Equal Cippnm rnity L Alrllm Oliva ArTion Ern ploy or k n r N

In order to comply with the regulatory requirements listed under North Carolina Administrative
Code (NCAC) Title 15A, Subchapter ?C, Section .0211, you must submit one of the following
enclosed forms:
A. Application . for Permit (Renewal) to Construct andlor Use a Wells) _ for Injection with
Geothermal Heat Pump Sistem ,for Type 50M Wells) if the injection well system on
your property is still active.
B. Status of Injection Well System if the injection well system is inactive or has been
temporarily or permanently abandoned.
Please submit the appropriate forms to;
Aquifer Protection Section
Groundwater Protection Unit
UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Failure to submit these forms in a timely manner may result in the assessment of civil penalties
in accordance with North Carolina General Statute 87-94. For your convenience, a renewal
application and a UIC well system status form are attached along with a self-addressed envelope.
The above referenced forms are also available on-line at the DWQ website at
httn :11 n art ai , n c d enr, o rt /web! w n +' a ns l gw nr o In erm i t-a n nl i cati o n s# QeothermAr+p s .
Thank you in advance for your cooperation and timely response. If you have any questions,
please contact me by phone at [phone] or by email at eric.y-.smith(q—),ncdenr.gov.
Sincerely,
Eric G. Smith, P.G.
Hydrogeologist
Enclosures
cc' Asheville Regional Office - APS w ❑ enclosures
APS Central Files - Permit No. W10100049 w/o enclosures

a�A
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coieen H. Sullins
Governor director
December 2, 2011
Jeff Kaplan
476 River Run Road
Marshall, NC 28787
Subject: Notice of Expiration (NOE)
5QM Geothermal Injection Well
Permit No. WIG100048
Madison County
Dear Mr. Kaplan:
Gee Freeman
Secretary
The Underground injection Conttol (UIC) program of the North Carolina Division of Water
Quality (DWQ) is entrusted to protect the groundwater quality and resources of the State of
North Carolina, and is responsible for the regulation of injection well construction and operation
activities within the state. Our records indicate that the above -referenced operating permit for
the underground injection well system located on your property at 476 River Run Road in
Marshall, NC, which was issued to you on May 7, 2007, and expires on April 30, 2012, is soon
due far renewal. If you wish to keep this permit and operate the injection well system, the permit
must be renewed and issued in your name.
If Your Injection Well is Currently Inactive:
If the injection well system is no longer being used for any purpose, it must be permanently
abandoned according to the regulatory requirements listed under NCAC Title I5A, Subchapter
2C, Section .0214. When each well is plugged and abandoned, the well abandonment record
(Form GW-30) must be submitted to our office to certify that the abandonment was properly
conducted.
If there has been a change of ownership of the property, an Injection Well Permit
Name/Ownership Change Form• must also be submitted. The GW-30 and NamelOwnership
Change forms can be found at httr.//nortal.ncdenr.or-- web/wu/ar)s/Lwi-,ro/reportinL,-forms.
If Your Injection Well is Currently Active:
If the injection well system is still active and you wish to renew your permit, the renewal
application must be submitted within 120 calendar days of the expiration of your permit.
According to our records, you must submit your permit renewal by danuar % 1. 2012.
AQUIFER 0ROTEGT[ON SECTION
1636 Mall Service Genmr Raleigh. North Carolina 2769cr1636.
LOCMn. 2728 rmial boulevard. Raleigh, North Carolina 2761a4 Onc
Phone. 919-M-32-71 1 FAX ;: 919.715-058$: FAX ^ 919-715.6048 0UStnmer Se(VlM: 1-877-623-�748
ic�rtl��aI�n::
Intemezwww,nrwatertzualitY,org .yn qr� `■r
kO EOW8 0P0Gr1LJ-11V Afnrrn3nvp, Ac!nn Empip rp1 F
F ►sI L G6 t

In order to comply with the regulatory requirements listed under North Carolina Administrative
Code (NCAC) Title 15A, Subchapter 2C, Section .0211, you must submit one of the following
enclosed forms:
A. Application for Permit (Renewal) to Construct andlor Use a Well(s) for Injection with
Geothermal Heat Pump System for Type 5QM Wells) if the injection well system on
your property is still active.
";a
B. Status of h7jeetion Well Svsten? if the injection well system is inactive or has been
temporarily or permanently abandoned.
Please submit the appropriate forms to.
Aquifer Protection Section
Groundwater Protection Unit
UIC Program
1636 Mail Service Center
Raleigh. NC 27699-1636
Failure to submit these forms in a timely manner may result in the assessment of civil penalties
in accordance with North Carolina General Statute 87-94. For your convenience. a renewal
application and a UIC well system status form are attached along with a self-addressed envelope.
The above. referenced forms are also available on-line at the DWQ website at
httn:i/t)ortal.ncdenr.or;/w_ebiwwansit= proePerm it-apnlications#veo_thermA p
Thant: you in advance for your cooperation and timely response. If you have any questions,
please contact me by phone at (9) 9) 715-6196 or by email at eric.«.smithrcilncdenr.izov,
Sincerely,
Eric G. Smith, P.G.
Hydrogeologist
Enclosures
cc: Asheville Regional Office - APS w/o enclosures
AP Central Files - Permit No. WIO100048 w/o enclosures

Central Files: AP5 SWP
051Wil)7
Permit Number WI01 00048 Permit Tracking Slip
Program Category Status Project Type
Ground Water In review New Project
Permit Type Version Permit Classification
Injection Mixed Fluid GSHP Well System (50M) Individual
Primary Reviewer
michael.rogers
Permitted Flow
Faclli
Permit Contact Affiliation
Facility Name MajorlMinor Region
Jeff Kaplan SFR Minor Asheville
!_acation Address County
476 River Run Rd Madison
Marshall IBC 28753 Facility Contact Affiliation
Dan Stewart
511 Wood Thrush Ct
Arden NC 28704
Owner Name Owner Type
Individual
Jeff Kaplan Owner Affiliation
Jeff Kaplan
50 Al Faye Farm Way
Weaverville NC 28787
Scheduled
Orig Issue App received Draft Initiated Issuance Public Notice Issue Effective Expiration
03/19/07 'QVO
Re_ ulated Activities Re,guested/Received_E_v_en_i_s
Heat Pump iniertion RO staff report requested 03/27/07
RO staff report received 04/23/07
Outfall DULL
Waterbody Name Stream Index Number Current Class Suabasin

Michael F. Easley, Govemor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
May 7, 2007
Mr. Jeff Kaplan
50 Al Faye Farm Way
Weaverville, NC 28787
Re: Issuance of Injection Well Permit
Permit No. wI0100048
Issued to Jeff Kaplan
Dear Mr. Kaplan,
In accordance with your application received March 19, 2007, I am forwarding Permit No.
WI0100048 for the operation of a vertical closed -loop geothermal mixed -fluid heat pump
injection well system to be located at 476 River Run Road, Marshall, Madison County, North
Carolina 28753. This permit shall be effective from the date of issuance until April 30, 2012,
and shall be subject to the conditions and limitations stated therein.
Pay special attention to the well construction standards in Parts II and V of your permit.
You must notify this office (Raleigh Central Office) and the Asheville Regional Office at least
forty-eight (48) hours prior to constructing the system, and forty-eight (48) hours prior to
initiation of the operation of the system.
In order to continue uninterrupted legal use of this well for the stated purpose, you should submit
an application to renew the permit three months 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 Mr. Qu Qi at [phone] or me at
[phone].
Best Regards,
Michael Rogers
Environmental Specialist H
cc: T.awnAnrL Davidson— Aal„ trifle Rao;nnnl office
Central Office File — W10100048
Andrew Messer — Effecta Solutions
Attachment(s)
Aquifer Protection Section 1636 Mail Service Cerra Raleigh, NC 27699-1636
Internet httnllwww.nawatagua�y.org 2728 Capital Boulevard Raleigh, NC 27604
An Equal Opportu-MylAffim adve Acdon Employer- 50% Recydedl10% Post Consumer Paper
Telephone: [phone]
Fax 1: [phone]
Fax 2: [phone]
Customer service: [phone]

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
lli�:�u►►ii`�l�i�:i�: �;7: in�i � •
JEFF KAPLAN
FOR THE CONSTRUCTION AND OPERATION OF 7 TYPE 5QM INJECTION WELLS,
defined in Title I5A North Carolina Administrative Code 2C .0209(e)(3)(F), for the purpose of
operating a "direct expansion" type vertical closed -loop geothermal -mixed -fluid heat pump
system. This system is located at 476 River Run Road, Marshall, North Carolina, and will be
constructed and operated in accordance with the application received March 19, 2007, and in
conformity with the specifications and supporting data submitted, 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 only and does not waive any provisions of the
Water Use Act or any other applicable Laws, Rules, or Regulations. Operation and use of an
injection well shall be in compliance with Title 15A North Carolina Administrative Code 2C
,0100 and .0200, 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 April 30, 2012,
and shall be subject to the specified conditions and limitations set forth in Parts I through IX
hereof.
Permit issued this the day of 2007.
lan W. Klimek, Director
Division of Water Quality
By Authority of the Environmental Management Commission.
WIU1 a0048 Page

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
A200). 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 secured to reasonably insure against unauthorized access and
use. Each well shall be permanently labeled with a warning that it is for injection purposes
and the entrance to each well must be secured with a lacking cap.
6. Each injection well shall be afforded reasonable protection against damage during
construction and use.
7. Each injection well shall have permanently affixed an identification plate.
8. A completed Well Construction Record (Form GW-1) must be submitted for each injection
well to: DENR Division of Water Quality, Aquifer Protection Section UIC-Staff, 1636
Mail Service Center, Raleigh, NC 27699-1636, within 30 days of completion of well
construction.
PART H - WELL CONSTRUCTION SPECIAL CONDITIONS
1. Prior to constructing the injection well system, the Permittee or his agent shall test the pH of
the soil at a depth of three feet at the planned well location. If the resulting soil pH is less
than 6 standard units or greater than 11 standard units, the well system shall be equipped with
a compatible cathodic protection system. All testing results shall be kept on site available for
inspection.
2. At least forty-eight (48) hours prior to constructing system, the Permittee shall notify the
Aquifer Protection Section's Underground Injection Control (LTTC) Program Central Office
staff', telephone number [phone] and the Ashville Regional Office Aquifer Protection
Section Staff, telephone number (829) 2964500.
3. All underground tubing shall be refrigeration grade copper tubing.
WIOI00048 Page 3

4. Prior to installation, all tubing to be placed in boreholes ("loops") shall be checked for leaks
by pressurizing the loop to a gage pressure of at least 350 pounds per square inch (psig),
immersing the loop in water and examining it for leaks. Loops with leaks shall not be
installed.
5. Prior to installation, each loop shall be visually inspected for damage such as kinks, dents,
and scrapes. Each loop shall be checked to verify that the nitrogen charge applied to the loop
by the manufacturer before shipping is still present at a pressure of at least 300 psig. The
loop manufacturer shall be notified in the event of damage or pressure loss, and the
manufacturer's instructions shall then be followed. The nitrogen charge may be released
only when the loop is installed and ready to be connected to the manifold.
6. Boreholes shall be large enough to allow insertion of the loop plus a tremie pipe for grouting.
7. After insertion of the tubing into the boreholes, an approved grout (as defined in Title 15A
North Carolina Administrative Code 2C .0100) shall be pumped via tremie pipe into the
annular space of each borehole so as to completely fill it from bottom to top.
8. All tubing junctions shall be brazed using lead-free brazing material. The brazing material
shall have a galvanic potential as close as practicable to that of the tubing material.
9. Dry nitrogen shall be circulated through the tubing during brazing to prevent oxidation.
10. After installation and prior to operation of the system, a mechanical integrity test shall be
conducted by pressurizing the injection well system to 400 prig with dry nitrogen and
monitoring for leaks using an ultrasonic or other leak detector of equal sensitivity and
monitoring pressure in the system for at least 2 hours. Alternatively, an equivalent vacuum
test is acceptable. Any pressure fluctuation other than that due to thermal expansion and
contraction of the testing medium shall be considered a failed mechanical integrity test. Any
leaks shall be located and repaired prior to charging the system with refrigerant. A copy of
the ost-installation ressure or vacuum test record Aal_pressure readin ,final -pressure
reading, and the duration_ of the test) shall be submitted_ to the Aquifer Protection Section.
The test records must be received by the Aquifer Protection Section at least twenty-four (24)
hours prior to the initiation of the operation of the facility for injection.
11. The location of each of the system manifolds shall be recorded by triangulation from two
permanent features on the site (e.g., building foundation corners). The Permittee shall retain a
copy of the triangulation records. The Permittee shall also submit a copy of the triangulation
records to the Aquifer Protection Section within 30 days of completion of well construction.
12. The written documentation required in Part 11, paragraphs (1 0)_and 01) shall be submitted to:
Aquifer Protection Section-UIC Staff
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
WI0100048 Page 4

PART 1111- OPERATION AND USE GENERAL CONDITIONS
I. 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.
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 dais 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 groundwater 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
[phone], and the Ashville Regional Office Aquifer Protection Section Staff,
telephone number [phone]. Notification is required so that Division staff can
W10100048 Page 5

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,
?. Department 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.
PART ``II - MONITORING AND REPORTING REQUIREMENTS
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.
?. The Permittee shall report by telephone, witbin 48 bours of the occurrence or first
knowledge of the occurrence, to the Ashville 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.
3. 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 he promptly submitted to the
Director by the Permittee.
4. 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.
WIOI 00048 Page 6

PART V111- PER.NUT RENEWAL
The Permittee shall, at least 120 days prior to the expiration of this permit, request an
extension.
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 that well must be
permanently abandoned according to 1 SA NCAC 2C .4213 (h)(1), Well Construction
Standards.
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 1 SA 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 sucb 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, which 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 14 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.
WI0144b48 Page 7

(G) The Permittee shall submit a Well Abandonment Record (Form GW-30)
as specified in 15A NCAC 2C .0213(h)(1) within 30 days of completion
of abandonment.
3. The written documentation required in Part IX (1) and (2) (G) shall be submitted to:
Aquifer Protection Section-UIC Program
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
W10100048 Page 8

AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
Date: 19 aw
To: A uifer Protection Section Central Office
Central Office Reviewer:
Regional Login No:
County: AD
Permittee:.�r�F ,,4�
Project Name:
Application No.: Wr at 00091
L GENERAL INFORMATION
1. This application is (zheck all that apply): X New ❑ Renewal
Minor Modification ❑ Major Modification
' ❑ Surface Irrigation ❑ Reuse ❑ Recycle ❑ High Rate Infiltration ❑ Evaporation/Infiltration Lagoon
❑ Land Application of Residuals ❑ Attachment B included ❑ 503 regulated ❑ 503 exempt
❑ Distribution of Residuals ❑ Surface Disposal
❑ Closed -loop Groundwater Remediation
Was a site visit conducted in order to prepa
X Other Injection Wells (including in situ remediation)
this report? 2 Yes or ❑ No,
a. Date of site visit: "7.
b. Person contacted and contact information: A4SRW444-, 6101-eet (fy/- s67)
c. Site visit conducted by: _A�
d. Inspection Report Attached:El Yes or ❑ No. /
2. is the following information entered into the RIMS record for this application
JZ Yes or ❑ No. If no, please complete the following or indicate that it is correct on the current application.
For Treatment Facilities:
a. Location:
b, Driving Directions:
c. USGS Quadrangle Map naive and number:
d. Latitude: Longitude:
e. Regulated Activities 1 Type of Wastes (e.g., subdivision, food processing, municipal wastewater):
For Disposal and laiection Sites:
(If multiple sites either indicate which sites the information ar+olies to, coov and haste a new section into the
document for each site, or attach additional aues for each site)
a. Location(s): ig[4_91 VV A#J Ra, 1►fkU 44CLI WC. z8?S3
b. Driving Directions: 07Sju d! "Or ed nrc. ra3 T640-6 A4AAS#4U'196+J AFA WX Afol, 0;8 ro noo (crrivj
c. USGS Quadrangle Map name and number:
d. Latitude: U 41 33. L" Longitude: tZ 39'37.1"
Ili NEW AND MAJOR MODIFICATTONAPPLICATTONS (this section not needed for renewals or minor
modilicatlons, skip to next section) T
Deserietion Of Waste(S) And Facilities
1. Please attach completed rating sheet. Facility Classification:
2. Are the new treatment facilities adequate for the type of waste and disposal system?
FORM: Documentl

AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
❑ Yes ❑ No ❑ NIA. If no, please explain:
3. Are the new site conditions (soils, topography, depth to water table, etc) consistent with what was reported by
the soil scientist and/or Professional Engineer? ❑ Yes ❑ No ❑ NIA. If no, please explain:
-4 Does the application (snaps, plans, etc.) represent the actual site (property lines, wells, stir -face drainage)? ❑
Yes ❑ No ❑ NIA. If no, please explain:
5. Is the proposed residuals management plan adequate and/or acceptable to the Division. ❑ Yes ❑ No ❑
NIA. If no, please explain:
6. Are the proposed application rates for new sites (hydraulic or nutrient) acceptable?
❑ Yes ❑ No ❑ NIA. If no, please explain:
7. Are the new treatment facilities or any new disposal sites located in a I00-year floodplain?
❑ Yes ❑ No ❑ NIA. If yes, please attach a map showing areas of l DO -year flood plain and please explain
and recommend any mitigative measures/special conditions in Part IV:
S. Are there any buffer conflicts (new treatment Facilities or new disposal sites)? ❑ Yes or ❑ No. If yes, please
attach a map showing conflict areas or attach any new maps you have received from the applicant to be
incorporated into the permit:
9. Is proposed and/or existing groundwater monitoring program (number of wells, frequency of monitoring,
monitoring parameters, etc.) adequate? ❑ Yes ❑ No ❑ NIA. Attach map of existing monitoring well
network if applicable. Indicate the review and compliance boundaries. If No, explain and recommend any
changes to the groundwater monitoring program:
10. For residuals, will seasonal or other restrictions be required? ❑ Yes ❑ No ❑ NIA If yes, attach list of sites
with restrictions (Certification B?)
III. RENEWAL AND MODIFICATION APPLICATIONS {use previous section for new or mWor ►rrordi ]cation
s sterns
Description Of Waste S And Facilities
1. Are there appropriately certified ORCs for the facilities? ❑ Yes or ❑ No,
Operator in Charge: Certificate #:
Backup- Operator in Charge: Certificate #:
2. Is the design, maintenance and operation (e.g, adequate aeration, sludge wasting, sludge storage, effluent
storage, etc) of the treatment facilities adequate For the type of waste and disposal system? ❑ Yes or ❑ No.
If no, please explain:
3. Are the site conditions (soils, topography, depth to water table, etc) maintained appropriately and adequately
assimilating the waste? ❑ Yes or ❑ No. If no, please e;cplain:
FORM. Document] I

AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
4. Has the site changed in any way that may affect permit (drainage added, new welts inside the compliance
boundary, new development, etc.)? If yes, please explain:
5. Is the residuals management plan For the facility adequate and/or acceptable to the Division?
❑ Yes or ❑ No. If no, please explain:
6. Are the existing application rates (hydraulic or nutrient) still acceptable? ❑ Yes or ❑ No. It no, please
explain:
7, Is the existing groundwater monitoring program (number of wells, frequency of monitoring, monitoring
parameters, etc.) adequate? ❑ Yes ❑ No ❑ NIA, Attach map of existing monitoring welt network if
applicable. Indicate the review and compliance boundaries. if No, explain and recommend any changes to the
groundwater monitoring program:
8. Will seasonal or other restrictions be required for added sites? ❑ Yes ❑ No ❑ NIA If yes, attach list of sites
with restrictions (Certification B?)
9. Are there any buffer conflicts (treatment facilities or disposal sites)? ❑ Yes or ❑ No. If yes, please attach a
map showing conflict areas or attach any new maps you have received from the applicant to be incorporated
into the permit:
10. Is the description of the facilities, type and/or volume of waste(s) as written in the existing; permit correct? ❑
Yes or ❑ No. If no, please explain:
1 i Were monitoring wells properly constructed and located? ❑ Yes or ❑ No ❑ NIA. If no, please explain:
12. Has a review of all self -monitoring data been conducted (GW, NDMR, and NDAR as applicable)? ❑ Yes or
❑ No ❑ NIA. Please summarize any findings resulting from this review:
13. Check all that apply: ❑ No compliance issues; ❑ Notice(s) of violation within the last permit cycle; ❑
Current enforcement action(s) ❑ Currently under SOC; ❑ Currently tinder JOC; ❑ Currently under
moratorium. If any items checked. please explain and attach any documents that may help clarify
answer/comments (such as NOV, NOD etc):
14. Have all compliance dates/conditions in the existing permit, (SOC, SOC, etc.) been complied with? ❑ Yes
❑ No ❑ Not Determined ❑ NIA.. If no, please explain:
15. Are there any issues related to compliance/enforcement that should be resolved before issuing this permit? ❑
Yes or ❑ No ❑ NIA. If yes, please explain:
FORM: Documentl 3

AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
IV IN. ECTION r=VELL PERMITAPPLICATIONS tComplete these two sections for all systems that use injection
wells, including closed -loop groundwater remediation effluent injection wells, in situ remediation injection wells, and heat
pump injection wells.)
Description Gf Well(S) And ;Facilities — New. Renewal, And Modification
1. Type of injection system:
❑ Heating/cooling water return flow (5A7)
Z Closed -loop heat pump system (5QM15QW)
❑ In situ remediation (51)
❑ Closed -loop groundwater rcmediation effluent injection (SU"Non-Dischargc")
❑ Other (Specify:
1 Does system use same well for water source and injection? ❑ Yes ® No
3. Are there any potential pollution sources that may affect injection? ❑ Yes ® No
What is/are the pollution source(s)? . What is the distance of the injections well(s) from the pollution
source(s)? ft.
4. What is the minimum distance of proposed injection wells from the property boundary? 00 ft.
5. Quality of drainage at site: [RGood ❑ Adequate ❑ Poor
6. Flooding potential of site: R Low ❑ Moderate ❑ High
7. For groundwater remediation systems, is the proposed and/or existing groundwater monitoring program
(number of welts, frequency of monitoring, monitoring parameters, etc.) adequate? ❑ Yes ❑ No. Attach
reap of existing monitoring well network if applicable. If No. explain and recommend any changes to the
groundwater monitoring program:
S. Does the map presented represent the actual site (property lines, wells, sui facts drainage)? 21 Yes or ❑ No. 11-
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.
Injection Well Permit Renewal And Modification Only:
1 _ For heat pump systems, are there any abnormalities in heat pump or injection well operation (e.g. turbid water,
failure to assimilate injected fluid, poor heating/cooling)?
❑ Yes ❑ No. If ves, explain:
2. For closed -loop heat pump systems, has system lost pressure or required make-up fluid since permit issuance
or last inspection? ❑ Yes ❑ No. Ryes, explain:
3. For renewal or modification of groundwater remediation l? rmits (ofany type). will
continued/additional/modified injections have an adverse im act on mhzration of the plume or management of
the contamination incident? ❑ Yes ❑ No. If ves. explain:
4. Drilling contractor: Name:
FORM: Documcrtl a

AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
Address:
Certification number:
5. Complete and attach Well Construction Data Sheet.
FORM; DocumentI

AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
l . EVAL UA TION AND RECOMMENDA TIONS
1. Provide any additional narrative regarding your review of the application.:
Z. Attach Well Construction Data Sheet - if needed information is available
3. Do you foresee any problems with issuance/renewal of this permit? ❑ Yes g No. If yes, please explain
briefly.
4. List any items that you would like APS Central Office to obtain through an additional information request.
Matte sure that you provide a reason for each item:
Item i Reason
S. List specific Permit conditions that you recommend to be removed from the permit when issued. Make sure
that you provide a reason for each condition:
Coudition Reason
6. 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 i Reason
7. Recommendation: ❑ Hold, pending receipt and review of additional information by regional office; ❑ Hold,
pending review of draft permit by regional office; ❑ Issue upon receipt of needed additional information; LK
Issue; ❑ Deny. If deny, please state reasons:
r
S. Signature ofreport preparer(s):
Signature of APS regional supervisor:
{J
Date: 11 Z47
ADDITIONAL REGIONAL STAFF REVIEW ITEMS
FORM: Document] 6

R Fitt WI0300114
Subject: Re: Howitt WI0300114
From: Whitney Battestilli <[e-mail]>
Date: Tue, 27 Mar 2007 17:03:44 -0400
To: Michael Rogers <[e-mail]>
Both will be bored and grouted to 100 ft. From my records, Kaplan is correct
on this point, however; Howitt erroneously indicates that we will grout only
to 50 feet.
Sorry about the mixup. We're actually automating the process of filling these
apps out s❑ these little mistakes should go away.
Regards,
--Whitney.
On Tuesday 27 March 2007 4:56:43 pm you wrote:
Whitney Battestilli wrote:
Yes, Kaplan is also 100 ft. Isn't this info included in the
application
in section I-2 ?
Regards,
--Whitney.
On Tuesday 27 March 2007 1:39:53 pm you wrote:
Whitney Battestilli wrote:
I Hi Mike,
The Howitt residence will be to 100 ft. I've also CC'd
andrew so that
you have his address.
Regards,
--Whitney.
On Tuesday 27 March 2007 6:50:33 am you wrote:
l of 2 4/2/2047 4:13 PM

Re, vitt W10300114
We need clarification on the proposed depth of the
borings for the
above permit- is it 50 or 100 feet depth? Also, does
Andrew have
email address?
Is the proposed depth for Kaplan the same- 100 ft.?
Yes, but I-4 indicates grout only from 0 to 50 feet. You are going
to
grout to 100 feet correct?
Whitney Battestilli
President and Co-founder
Effecta Solutions, LLC
www. effe ctas o lu tions . com
VOICE: [phone]
FAX: [phone]
2 of 2 4/2/2007 4.13 PM

AQUIFER PROTECTION SECTION
APPLICATION REVIEW REQUEST FORM
Date: March 27. 2007
To: ®
Landon Davidson, ARO-APS
❑
Art Barnhardt, FRO-APS
❑
Andrew Pitner, MRO-APS
❑
Jay Zimmerman, RRO-APS
❑ David May, WaRO-APS
❑ Charlie Stehman, WiRO-APS
❑ Sherri Knight, WSRO-APS
From: Michael Rogers , Groundwater Protection Unit
Telephone: [phone] Fax: [phone]
E--Mall: Michael,Rogers(i-ncmail.net
A. Permit Number: WI OI00048
B. Owner: Jeff I{anlaa
C. Facility/Operation:
® Proposed ❑ Existing ❑ Facility ❑ Operation
D. Application:
1. Permit Type: ❑ Animal ❑ SFR Surface Irrigation❑ Reuse ❑ H-R Infiltration
❑ Recycle ❑ I/E Lagoon ❑ GW Remediation (ND)
® UIC - (5QM) closed loop mixed fluid geothermal
ForResidusals: ❑ Land App. ❑ D&M ❑ Surface Disposal
❑ 5 03 ❑ 503 Exempt ❑ Animal
Z, Project Type: ® New ❑ Major Mod. ❑ Minor Mod. ❑ Renewal ❑ Renewal w/ Mod.
E. Com ents/Other Information:: ® I would like to accompany you on a site visit.
Effecta Solutions will provide corrected forms showlna the proposedborim depth as 100 feet.
Attached, you will find all information submitted in support of the above -referenced application for your
review, comment, and/or action. Within 21 calendar days, please take the following actions:
® Return a Completed APSARR Form.
❑ Attach Well Construction Data Sheet.
❑ Attach Attachment B for Certification by the LAFCU.
❑ Issue an Attachment B Certification from the RQ#
* Remember that you will be responsible for coordinating site visits and reviews, as well as additional
information requests with other RO-APS representatives in order to prepare a complete Attachment B for
certification. Refer to the RPP SOP for additional detail.
When you receive this request form, please write your name and dates in the spaces below, make a copy
of this sheet, and return it to the appropriate Central Office -Aquifer Protection Section contact person
listed above.
RO-APS Reviewer -
Date:
FORM: APSARR 07/06 Page 1 of 1

Mlcha6 F. Easley, Governor
William G. Roes Jr.. Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. director
Division of Water Quatlty
March 20.2007
Jeff Kaplan
50 Al Faye Farm Way
Weaverville, NC 28787
Subject: Acknowledgement of Application No. WIO100048
Jeff Kaplan SFR
Injection Mixed Fluid GSHP Well System (5QM)
Madison
Dear Mr. Kaplan:
The Aquifer Protection Section of the Division of Water Quality (Division) acknowledges receipt of your permit
application and supporting materials on March 19, 2007. 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
[e-mail]. 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
htty:llh2o.enr.state.ne.us/documents/dwq oruchart..pdf.
PLEASE REFER TO THE ABOVE APPLICATION NUMBER WHEN MAKING INQUIRIES ON THIS
PROTECT.
Sin;Deb...
for tts
Supervisor
cc: Asheville Regional Office, Aquifer Protection Section
Permit Application File WI0100048
Aquifer Protectlon Section 1636 Mall Service Center Raleigh, NC 276W1636
Internet: wwm ncwrataruyality.crq Location, 272B Capital Boulevard Raleigh, NC 27604
An Equal OpportimIty/Af mmlive Arlon Employer- 50% Racycled/T% Post Donsumer Paper
Telephone:
Fox 1:
Fax 2:
Customer Service:
��rdfb,
[phone]
[phone]
(919) 715.604E
(877) 623-674B

TopoZone - USGS Marshall (NC) Topo Map Page 1 of 1
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350 47' 33"N, 820 39' 53"W (NAD83/WGS84)
USGS Marshall (NC) Quadrangle M--5.044
Projection is UTM Zone 17 NAD83 Datum G--0•974
http:llwww.topozone. comlprint.asp?lat=3 5.7925 &lon=-82.66472&size=i&u=6&layer—DR... 5/7/2007

03102/2007 12:43 FAX 828 85B 1751 AFFORDABLE COMFORT, INC.
12003/005
NORTH CAR01aNA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
APPLICATION FOR PERNIIT TO CONSTRUCT AND/OR USE A
WELLS) FOR IN3EC 1ON WVFH A HEAT PUKP SYSTEM
Type SA7 and 5QM WcW
Iu Acconkme iiith the prrn Wons of NCAC Title I SA: 02C.02UU
Cmupkde applleatiun and mall h3 nddrems an tbm back page_
7%> DMWMR, N A CAROLINA DIVISION OF WATER QUALITY
TI
DATE: 20
A SYSTEM CL.ASSTFICATIC N Please check caluma whiah matches proposed system.
(1) 'Type 5A7 wells *act water used to provide hectiag or cooling ilor shuct mean.
(2) x Type SQM[ wells wont do a aubmutoe Wryon= of oondw"a piping, *a is
isolated f m dw ewArown at W cimuWoa a &W odwr din potable • wn,
This inchuf a systama that cimtdmc additives segh as aatuzas mdlor aarroaioa
inhibibm.
(3) _ Type 3QW wale contact a subsmfkce system of cc dnuous p�ou& that is
isolated ftom the envixormnw aW u* cimWates potable water. It you seketed
th9s well Mm then jalate form GW-57 Q0 No on Of bow To
ConagraatA Clarad"Lonp C wdawia& Wait OWy Icy joam Wd! 3<yarism.
R PERMIT APPLICANT
Name:
Address: 47(a Iota LDf1
LYry: A.,mn LRSmte: L Zip Cade; On Comfy;
Telepbone: -
Q PROPERTY OWNER of different fizz+ applioaat)
Name: Y ,
Address: � �& ARV Far??,? - %Ift
City: +' uawe:NCy Tip code: +- ftl county;
Tekplto 5d/s -
A STATUS OP APPLICANT
Privam. x Fedual: Cammercial:
Sofa: Munic4=1: Nstive Ameri,tm Lau&
Ravind 7M GWAAC-57 HP Page i of 4

03/02/2007 12:44 FAX [phone] AFFORDABLE COMFORT, INC-
40004/005
E, FACILM (S[TE) DATA
(Fill ovt ONLY it`tbt Stara of OWM is Federal, Staoe, ileYuniaipal or Cvmsnar+eW)-
Name of Hine® or 1pwility.
Addrees:
Cary: Zip Coda: Coumy:
Talapbamoe: Contact Pam:
F. HEAT PUNO CONTRACTOR DATA
Name; Affordable Comfort
Ate; 7 Home e branch Road
City: wtaverville �Y Cam; 20787 Camay: Bunackd e
TWepbM; 026-254-0206 Cement l CnM Tracy Foader
O. INJECTION PROCEDURE (aridly deeoribe haw the injection well(s) will be used.)
Injection wells (bare hales) will be used as a geothermal heat mink. Oeothavaal ground
Imps will ba placed in the temporary born holes. Hare Doles will be oontiaunualy grouted
from the bortar to the top.
EL WELL USE Will the isyeu6m well($) also be used as the $apply weH($) few the follorring9
(1) the iogj+ectkm opmzdm7 YES NO
(2) Pwwnal oonsumpdou7 YES NO
1. CONSTRUMON DATA (Glcak ono)
IMSTT1NO VIMI, being proposed her use as an it*t1w wd1L Provide die date in
(1) ImnuA () below to the bat of your knowledge. Attach a OM of Farm GW-
1(Weu Coaadvwfim Rtoaad) if sva&Wc.
x PROPOSM WEI L to be con tinted for use as an Wycliam w@IL Ptvvide the
data in (1) thsvogh (7) below ae PROPOSED coou cdon specifte0m Sabah[
Foam GW-1 dh" oon m ainn_
(1) well Dhwng CAat7'aCwea Name: 8fletta 3olutlana, LLC - Stephen Komar
NC Co"WtarCadfieiatbm Dumber.. 3468
(2) Date bo be conswocted. !larch i 0 0 7 N'=bdr of bM inp: 7
■ffoo� dqp& of owl bm((400; Ica ft
(3) `W' Well casing: Is doe Weil($) caecd?
(a) YES If yam, ditto provide the aad ng irdaomadm below.
Type: Galvudwd siml, Mack mal Pla is Odw (Specify)
Casing d*6: Fs+aart to R (tdeac= ro land nurfaae)
Casing cxmnds above grated inches
(b) NO x
RVVINd 7/05 MUTC-57 Hp Page 2 of 4

03/02/2007 12:44 FAX [phone] AFFOR4A8LE COMFORT, 1HC.
IM 005/005
(4) aCfW (Madedal ceding well casing andlor Pipho-,
#ailics 84ad s
(a) Gout type; CMen x Bemanitie x 0"M (spadfy) 4uaexplaaticiver
(b) QMMW nrike and pmd dcp& Odwam to land sudize):: /-O D If- R&Z &i44+pL vx�)
aramd closed leap pulping; fromt to 50 (£ *Q,
Wound well "WAF, from W (feet).
(5) Saito gar Type SA7 weW}
(s) lDOOL From - to fact below ground surfhoe,
(6) N.C. State ltegvpWom (Title 15A NCAC 2C -0200) mozim de xmL mee to melee provisions
for nm itanng weld promeamm. A gnwL an bodk iuMnant (fluid enarmg heat pmp) and
eftlum (fluid bob* i4ected into &a well) lives is regailmi Will then be a f moct on,
(a) the ia&eat lme? Yes— no M tine effh mt line? Tea nto
('7) SOURCE WELL CONSTRUCTION IN IM MATTON (if different fiaea Howdon WOM.
Att�nah a oopi of From t3W-1 (Well Canst wdon Reowd), if Foam [1W 1 is net avagable,
provide the dam in part K (1) af dhie apphostion%m to the beet afyour knowledge.
NOTE: T H& wx J_ nKp ma coNT;AcmK GIN supra f Tm DAiApm Fill 13ltt8'l M Cat
PRDPOW wmJ a IF 7M3 VIFORMA17ON l9 UNAVAn*%MZ BY OVER M AW8
J. PROPOSED OPEltAMNO DATA (far Type SA7 wdb)
(1) hiection ratio: Average (daily) __pU s per min= (gppm)_
(2) Igjectk m Vah me: Average (&4) gallons per day (gpd).
(3) Injection Pew=. Avmp (may) podWs4um inch &0.
(4) I41ectiom Tempraamre: Avenge (inwezy) ° P, Average (My) ° F-
K- INiECITON FLUID DATA
(1) Fluid m x= (for Type SA7 wdie) If zmdmground, imam wbat depth, fern xtion and b1m of
ICC1 NdiMeait unit WM the fluid ba dMWn (e.g., grannie, RMOMOMA smrd, etc.}.
DeA: FM=Adoa iirWWsedizaept UWt: - - -
(2) Chonticel An*sia of Source FhW (far Type SQA![ wells)
Provide a oompletie hating of all d=kA added to the Circulating has tmaafer fluid;
A-22 Wriltr"t
L. INW11ON-RELATED EQUIPMENT
At rA it dhwwm allowing the eaSbwritzg lquat of ow Wevocin e74 meat =4 extem km FiFm8hubinS
aaavoided with the m1ecom oQcrt o m, T* roe u%cmm'4 bwbmc my provide supplementary
mfbtmfi&&
M. LOCATION OF WELLS) Attach two maps.
Revind Trod GWMIC-57 HP Pegs 3 of 4

03/0:'''/2007 13:17 FAX [phone] AFFORCABLE COMFORT, INC Z 001/001
(1) Inchide a site map (cart be drawn) showing: buildings, property lines, surface water bodies,
potential sources of groundwater centsmhu oon and clue orientation of and dia mces bctwcon
the proposed weil(s) and any existing well(s) or waste disposal facilities ttacb as septic taroks or
drain fields locatcd within 1000 Poet of the geodwmal heat pump was systom. Label all
featuns clearly and include a north arrow.
(2) Include a topographic map of the area extending one milt from the property boundaries and
indicate the facility's location and the may name.
N. PERMIT LIST: Attach a list of sill permin or conaouction appromdji that are related to the mite.
Examples include:
(1) Hazardous Waste Management program permits under RCRA
(2) NC Divisioa of Water Quality Net! -Discharge permits
(3) Sewage Tresiartent and Disposal Permits
O. CERTIFICATION
"I hereby certify, under penalty of law, that I have personally examined and am f6mdllar with the
information submitted in this documrmt and all attachments thzMo and tb nt, basod on my inquiry of
dim individuals immc"tely responsible fbr obtaining said information, I believe that the information
is true, aacnrate and complete. I on aware that there are siVificant perWtiee, including the possibility
of Turco raid imprisonment, fgr submitting false inilowurtioan. I agree to construct, operate. maiata n,
repair, and if applicable, abandon the injerdon well and all related appurtenances in acrordwce wim
the approved Mmodioatione and conditions of the Permit."
Vail1 r
(Sigiia o sir o r
Autltorixed Agent)
tffh+d W 4'edagmV fs 000rtg on bChalfvfrhe wail *wrier,
plawe n+pply a letter sWied by the owner autlnrizing the above agent
P. CONSENT OF PROPERTY OWNER (Owner means any person who holds the fee or other property
rights in the well being ciomtrttctrd. A well is real property and its c*atreiction on land rests
ownership in the landowner in the absence of contrary agreement in writing.)
If the property is owned by aameone otfaar &an the applicant, the property owner hereby oonsenes to
allow the applicant to construct each injeedon well as oudined in this application and Hier it shall be
the msponmbility of the applicant to ensure that the injection well(s) conforms to the Wall
Canmetiou Standards (Title 15A NCAC 2C .0200)
(Signature Of Property Owner if DiPtexent From Applicant)
Please return two copies of the completed Application pecbgr to:
UIC Program
A► offer rro*Wort Section
North Carolina DENR-DWQ
1636 Mall Service Center
RaldgJ4 NC 27699-1636
Telephone [phone]
Revised 7/M OWAM-57 HP Page 4 of 4

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NCDENR
North Carolina Department of Environment and
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor director
January 4, 2012
CERTIFIED MAIL # 7006 2150 0003 54671254
RETURN RECEIPT REQUESTED
Timothy and Pamela Ruemler
476 River Run
Marshall, NC 28753
Subject: Change of Ownership and Permit Renewal
Permit No. WI0100048
5QM Geothermal Injection Well
Madison County
Dear Mr. and Mrs. Ruemler:
Natural Resources
Dee Freeman
Secretary
The Underground Injection Control (LAIC) Program of the North Carolina Division of Water
Quality (DWQ) is entrusted to protect the groundwater quality and resources of the State of
North Carolina, and is responsible for the regulation of injection well construction and operation
activities within the state. Our records indicate that the above -referenced permit was issued to
Jeff Kaplan on May 7. 2007, and expires on April 30, 2 012 .
This permit was issued for the operation of a 5QM (Closed -Loop Mixed -Fluid) Geothermal
Injection Well on your property located at 476 River Run in Marshall, North Carolina. As the
new property owners, you are responsible for maintaining this permit. Therefore, it is important
that you submit a Chansze of Ownership form within thirty (30) days of receipt of this letter.
Since the permit is set to expire shortly and in order to comply with the regulatory requirements
listed under North Carolina Administrative Code (NCAC) Title 15A, Subchapter 2C, Section
.0211, you must also submit one of the following forms:
A. Application for Permit (Renewal) to Construct andlor Use a Well(s) for Injection
with Geothermal Beat Pump System for Type 50M Well(s) if the injection well
system on your property is still active.
.OR-
AQUIFEP PROTECTION SEC ROW
16.6 Ma11 Servrre C.eniei RaIEq Norr`i C.aroimna ?769U-16M
LCCM On. 2728 a rial boulevarr. Raise. Nor aroma 2±6g4 P',1 ' FA. i {114-7 rO5831 FA ' 91r 71--..n'_O �. uslom5r S L1Sr
ic
P�Zone: 91`;•?37 :_" "' "` ` erv:.° 1 � r 7ti�i3-v�4f
rnrerrcJ. www.ncrare-. uaril• ora �•iC]r�17 �_ 3i C►L i
=auE, '+G'[['H1l'i • krnn1611y2+4�L.110 LF' In"C l L 604 ��

B. Status oflnjection ffell System if the injection well system is inactive or has been
temporarily or permanently abandoned.
Please submit the forms to:
Aquifer Protection Section
Groundwater Protection Unit
UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Failure to submit these forms in a timely manner may result in the assessment of civil penalties
in accordance with North Carolina General Statute 87-94, For your convenience, a Change of
Ownership form. a renewal application, and a UIC Well System Status form are attached along
with a self-addressed envelope. The above referenced forms are also available on-line at the
DWQ website at httii;/iportal.nedenr.ort-,/web/wglar slewproln=it-a�)3-lications?FsreothermADvs.
Thank you in advance for your cooperation and timely response. If you have any questions,
please contact me by phone at [phone] or by email at eric.s-,.smithratncdenr.eov.
Sincerely,
� /:c 4
_'(',7
Eric G. Smith. P.G.
Hydrogeologist
Enclosures
CC.' Asheville Regional Office - Aquifer Protection Section xv,(w enclosun;s
AP Central Files - Permit W10100048 w/o enclosures