WI0100052_GEO THERMAL_20120523

A Y"
NCDENR
North'Carolina DeT-tment of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, P. E.
Governor .Director
May 23, 2012
Ron and Linda Thompson
1245 Kentwood Lane
Pisgah Forest, NC 28768
Subject: Notification of Rule Revisions Affecting
Closed -Loop Geotile-1u1al Injection Well Permit Holders
Permit Number: WI0100052
Dear Mr. and Mrs. Thompson:
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 htth/lportal:ncdenr.org/web/wqlaps.
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,
/,,,, I
�Vuzc_
Eric G. Smith, P.G.
Hydrogeologist
cc. UIC Permit File
AQUIFER PROTECTION SECTION
1636 Mail Service Center, Raleigh, North Carolina 276994636 One
Location: 512 N. Salisbury St., Raleigh, North Carolina 27604 NOrthCarohna
Phone: [phone] FAX: [phone] ����`�����
Internet: w►wmwate uali ,o i�
An Equal Opportunity 1 Affirmative Action Employer

Permit Number WIOI00052
Program Category
Ground Water
Permit type
Injection Mixed Fluid GSHP Well System (50M)
Primary Reviewer
michael.rogers
Coastal SW Rule
Permitted Flow
Facill
Central Ree: AP5 SVVP
04/19/12
Permit Tracking Slip
Status
Project Type
Active
Renewal
Version
Permit Classification
2.00
Individual
Permit Contact Affiliation
Facility Name Major/Minor Region
Ron and Linda Thompson SFR Minor Asheville
Location Address County
1245 Kentwood Ln Transylvania
Pisgah Forest NC 28768 Facility Contact Affiliation
Owner
Owner Name Owner Type
Individual
Ron Thompson Owner Affiliation
Ron Thompson
1245 Kentwood Ln
Dates(Events Pisgah Forest NC 28768
Scheduled
Orig Issue App Received Draft Initiated hasuaece Public Notice Issue Effective Expiration
08111/07 04/05/12 04/13/12 04/13/12 03/31/17
Regulated Activities Requested/Received Events _
Meat Pump Injection RO staff report requested 04/05/12
RO staff report received 04/10/12
❑utfali NULL
Waterbody Name
Stream Index Number Current Class Subbasin

Permit Number WIOI00052
Program Category
Ground Water
Permit Type
Injection Mixed Fluid GSHP Well System (50M)
Primary Reviewer
michael.rogers
Coastal SW Rule
Permitted Flow
Facilit
Central Files: AP5 SWP
04/11/12
Permit Tracking Slip
Status Project Type
In review Renewal
Version >Permlt Classification
Individual
Permit Contact Affiliation
Faculty Name MajorlMinor Region
Ron and Linda Thompson SFR Minor Asheville
Location Address County
1245 Kentwood Ln Transylvania
Pisgah Forest NC 26758 Facility Contact Affiliation
Owner
Owner Name Owner Type
Individual
Ron Thompson Owner Affiliation
Ron Thompson
1245 Kentwood Ln
Dates/Events Pisgah Forest NC 2675E
Scheduled
Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
09/11/07 04/05/12
Regulated Activities Requested/Received Events
{seat Pump Injection RO staff report requested 04/05/12
RO staff report received 04/10/12
❑utfall :,!ULL
Waterbody Name Stream Index Number Current Class Subbasin

Al"AMA
An
HCDE
North Carolina Department of Environment and Natura
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, RE,
Govemor Director
April 13, 2012
Ron and Linda Thompson
1245 Kentwood Ln.
Pisgah Forest, NC 28768
Ref: Issuance of Injection Well Permit WIOI00052
Issued to Ron and Linda Thompson
Pisgah Forest, Transylvania County
Dear Mr. and Mrs. Thompson:
Resources
Dee Freeman
Secretary
In accordance with the application received on April 5, 2012, I am forwarding permit number WIOI00052 for the
continued operation of a vertical closed -loop geothermal mixed -fluid heat pump injection well system located at the above
referenced address. This permit shall be effective from the date of issuance until March 31, 2017, and shall be subject to
the conditions and limitations stated therein.
Also, please pay special attention to Part V.2. The Permittee shall retain all records of repairs, pressure tes#s,
maintenance, and other activities needed to maintain normal operating conditions.
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 [phone] or [e-mail] if you have any questions about your permit.
cc: Landon Davidson, Asheville Regional Office
WIO100052 Permit File
Transylvania County Environmental Health Dept.
AQUIFER PROTECTION SECTION
1636 Mail SeMm CDnlar, Raleigh, North Caroline 27699.1636
Location: 512 N. Salisbury St., Raleigh. North Car&ns 27604
Phone: [phone] FW 919-907-6 9
Internet www.rimaterquaillyga
An Squat Opportunlly l A*rwVve Action Employer
Hest Regards,
le�
Michael Rogers, P.G. (NC &. FL)
ne
Nockthcarolffia
Naturally

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE 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
I go33If.*I1008Rs: 1*1114: 11961t�:112M III02 u
Ron and Linda Thompson
FOR THE OPERATION OF 6 (SIX) TYPE 5QM INJECTION WELL(S), defined in Title 15A North Carolina
Administrative Code 2C .0209(e)(3)(F), for the purpose of operating a vertical closed -loop geothermal -mixed -
fluid heat pump system. This system is located at 1245 Kentwood Lane, Pisgah Forest, Transylvania County,
NC 28768, and will be constructed and operated in accordance with the application received April 5, 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 operation of an injection well and 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 March 31, 2017, and shall be
subject to the specified conditions and limitations set forth in Parts I through VII hereof.
Permit issued this the 13a` day of April 2012,
a', '� C/,A
Charles Wakild,. P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission.
W10100052 U1C15QM-M.F, Renewal Page 1 of
Version 112010

PART I — OPERATION AND USE GENERAL CONDITIONS
L' 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_
?. 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 an}, 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.
4. In the event that there are multiple wells with separate clusters, one well identification tag per 'cluster' of
wells shall be permanently affixed to the heating and cooling unit or other nearby permanently .fixed
location in a clearly visible location according to 2C .0213(g).
PART II— PERFORMANCE STANDARDS
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
groundwater resulting from the operation of this facility.
PART III — OPERATIONS AND MAINTENANCE REQUIREMENTS
1. The injection facility shall be properly maintained and operated at all times.
2. The Permittee must notify the Division and reeeive 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,
W10100052 UICI5QM-h4.F. Renewat Page 2 of 4
Version 112010

PART IV - INSPECTIONS
I , Any duly authorized officer, employee, or representative of the Division of Water Quality may, upon
presentation of credentials, enter and inspect any property, premises, or place on or related to the injection
facility at any reasonable time for the purpose of determining compliance with this permit, may inspect or
copy any records that must be maintained under the terms and conditions of this permit, and may obtain
samples of groundwater, surface water, or injection fluids.
2. 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 V —MONITORING AND REPORTING REQUIREMENTS
1. 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.
2. The Permittee shall retain all records of repairs, pressure tests, maintenance, and other activities
needed to maintain normal operating conditions.
3. The Permittee shall report by telephone, within 48 hours of the occurrence or first knowledge of the
occurrence, to the Asheville Regional Office, telephone number 828-296-4500, any of the following;
(A) Any occurrence at the injection facility that results in any unusual operating circumstances;
(B) Any failure due to known or unknown reasons that renders the facility incapable of proper
injection operations, such as mechanical or electrical failures;
4. Where the Permittee becomes aware of an omission of any relevant facts in a permit application, or of any
incorrect information submitted in said application or in any report to the Director, the relevant and
correct facts or information shall be promptly submitted to the Director by the Permittee.
5. in the event that the permitted facility fails to perform satisfactorily, the Permittee shall take such
immediate action,as may be required by the Director.
PART VI — PERMIT RENEWAL
The Permittee shall, at least 120 days prior to the expiration of this permit, request an extension.
WI010OD52 CTIC/5QM-M.F. Renewal Page 3 of 4
Version IM10

PART VII — CHANGE OF WELL STATUS
The Perrr ittee 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 15A NCAC 2C .0213 (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 15A 1`TCAC 2C
.0214, including but not limited to the following:
(A) All casing and materials niay 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.
(I3) The entire depth of each well shall be sounded before it is sealed to insure freedom from
obstructions that may interfere with scaling 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 sliall be completely filled with cement grout, which shall he introduced into the
well through a pipe which extends to the bottom of the wcli 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 he abandoned in such a mariner 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 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 VII (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
WIO I00052 UIOSQM-M.F. Renewal Page 4 of 4
Version 112010

Ro ers, Michael
From: Davidson, Landon
Sent: Tuesday, April 10, 2012 2:31 PM
To: Rogers, Michael
Subject: Wi0100049 and WICi100052
Please proceed with permitting both of these —thanks.
Landon
G. Landon DavWsan, P,G.
R P -C+1• f_1141 -rf :'.'pr �I r =Ti`
p _ i7rt:[��t `lap ar.•i5 a, �.
r
�.,_111- ti : I..i. i"arc
E+yet' pone; h[toSporta.l.nr_.denr,orgfwe�Jwgla{3s
Email correspondence to andfrom this address is subject to
the North Carolina Public Records Law and may be disclosed
to third parties unless the con ient is exempt by statute or
other regulation.

WIDENR
North Carolina Department of Environment and Natural Resources
Division of Wafer Quality
April 5, 2012
Ron Thompson
Linda Thompson
1245 Kentwood Ln.
Pisgah Forest, NC 28768
Dear Nit. Thompson:
Subject: Acknowledgement of
Application No. WIOI00052
Ron Thompson SFR
Injection Mixed Fluid GSI P
WEll (5QM) System
Transylvania County
The Aquifer Protection Section acknowledges receipt of your permit application and supporting
documentation received on 04/0512012. Your application package has been assigned the number listed
above, and the primary reviewer is Michael Rogers.
Central and Asheville Regional Office staff will perform a detailed review of the provided
application, and may contact you with a request for additional information. 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 50 to 90 days
after rereirt of R romrletP Rt,nlir,9000. Tf you have anN, opestinnc. nlease cntrtnot
r
s ;reretey, � }
for Debra J. atts
Grount ater Protection Unit Supervisor
cc: Asheville Regional Office, Aquifer Protection Section
n':"l,' t File W10:0005"
AQUIFER PROTECTION SECTION
1636 M64 5ecAm Center, Raleigh, North Camlina 27699-1636
Lac Wn: 512 N. 5allsbury 3L, RaWgh, Nwth Carolina 27604 One
Phone:919-8g7-rA641FAX: 919-8Q7-496 N6 }-Caro a
Intamet: www.ncNatemuaft.om A 1i` �.
An Equal OpporhmltyIAftmavveAdon Employer

Pr
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 MMD-FLUID GEOTHERMAL INJECTION WELLS
These wells circulate fluids other than potable water as part of a geothermal heating and cooling system
(check one) New Application ►/ Renewal} Modification
* For renewals complete Parts A-C and the signature page.
inr or Type Information and Mail to the Address on the Last Page. Illegible Applications Will Be Returned As Incomplete,
&-- p t-fm I r c)#Tc
DATE: 5�: yno 28
PERMU NO. _ft'010G0" (leave blank if New Application)
A- STATUS OF APPLICANT (choose one)
Nan -Government: Individual Residence —Z
Government: state Municipal
RECEIVEDIDENRIM
Business/Organization APR, 4 2�12
County Federal
AquTer Protection Section
B. PERMIT APPLICANT — For individual residences, list each owner on property deed_ For all others,
AVAFr�I
04
0
state name of e 'ty and name of person delegated authority to sign on behalf of the business or agency:
vga�f4
Day Tele No.: Cell No.: 7I 7— S—r10 j
EMAIL Address: nr#�Vf1rCN, Pgvi►l.FaxNo.: R 08 - 77— 0-4g�E
C. LOCATION OF WELL SITE — Where the injection wells are physically located:
(1) Parcel Identification Number (PIN) of well site; _IS— 4�Catuity: �I+�
(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:
State: NC Zip Code:
Contact Person: EMAIL Address:
Address:
City:
Office Tele No.:
Zip Code:
Cell No.:
State: County:
Fax No.
GPURJIC 5QM Pennit AppliCadOn (Revised 1I241201 ! )
Page 1

H. 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,
2. for a partnership or sole proprietorship: 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 iwhich means all arsons fisted on the procern deed).
If an authorized agent is signing on behalf of the applicant, then supply a letter signed by the
applicant that names and anthorizes their agent to sign this application on their behalf.
"1 hereby certify, under penalty of law, that I have personally examined and am familiar with the information
submitted in this document and all attachments thereto and that, based on my inquiry of those individuals
immediately responsible for obtaining said information, I believe that the information is true, accurate and
complete. I am aware that there are significant penalties, including the possibility of fines and imprisonment,
for submitting false information. I agree to construct, operate, maintain, repair, and if applicable, abandon the
injection well and all related appurtenances in •e with the approved specifications and conditions of
the Permit"
-s rl ,��
Signature of Property Owner/Applicant
o� (dP/./
Print or Type Ful Name
Si�--s Lure ofPrope/rty Owner/A licant
jr� j- 11.�9P-0�
Print or Type Full Na)J
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]
RECEiVEDIDENRIDWQ
APR d tS 2a1Z
Aquifer Pmteebon Section
GPUAAC 3QM Permtt Application (Revised W4C1011) Page 3

kvwx
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakiid, P. E,
Governor Director
March 30, 2012
Ron Thompson
1254 Kentwood Lane
Pisgah Forest, NC 28768
Subject: Notice of Expiration (NOE)
5QM Geothermal Injection Well
Permit No. WI0100052
Transylvania County
Dear Mr. Thompson:
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 operating permit for
the underground injection well system located on your property at 1254 Kentwood Lane in
Pisgah Forest, NC, which was issued to you on September 11, 2007, and expires on August 31,
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 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 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 ht1p://Portal.ncdenr.or~Jwe/aLs/g,,vLro/reporting-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 Mati 3, 2012.
AQUIFER PROTECTION SECTION
1636 Mail Service Center, Raleigh, Norlrt Carolina 27699.1636 ne
Locabon: 512 N. Salisbury St., Raleigh, North CarvHna 27604 l�{orthCarolina
Phone:[phone]FAX: 91M07-6496 •�■�} rr
Intemet; MM,nmateruuality.ory rl� ra�+i+i
An Equal Opponunily i AfRrmahve Action Employer

In order to comply with the regulatory requirements listed under North Carolina Administrative
Code (NCAQ Title ISA, 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 Neat Pump System for Type 5QM Wells) if the injection well system on
your property is still active.
S. 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
http:llportal.nedenr.orglweb/wc lapslpwprolpermit-applications#geotherinApps.
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.Q.smithrd'ncdenrryeov.
Sincerely,
Eric G. Smith, P.G.
Hydrogeologist
Enclosures
cc: Asheville Regional Office - APS w/o enclosures
APS Central Files - Permit No. WI0100052 w/o enclosures

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of Water 0ualiry
WiL,L CON't°R.nCTan c azlw>«�►rfON 2t303
1. WELL CION RACTOR:
g. WATER
ZONES (depth):
LaMi Wei — —
Top
Bottom
Top Hoaam
Well Contractor (Indk duii} Hama
Top
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TOP Bownk—
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B. GROUT:
Deplh
Materiel Method
2. WELL INFORMATION!
Tap Q
Bottom IOU
Ft. Goo Therntal Pour
WELL CONSTRUCTION PERMrrA WIQ100052
Top
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F(, Grcut
OVER ASSOCWTED PERMIT01appliodwa}
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SITE WELL ID A(d aP0liotbla3
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a. WELL Lr$e (Check Applicable BoorJ: Reaidenbat Water Supply o
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Ft In. In.
DATE DRtLL6D -1 �7
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TIME COMPLETED AM ❑ PM �
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A. WELL LOCATION:
10. SANINGRAVEL PACK,
Depth
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crm Pisgah Forest couNTY Trans Ivania
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1I. DRILLING LOG
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Formation De"Aptloq
LATITUDE 35 OMS OR DD
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LONGITUDE 63 " 4MS OR OD
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LatttudeRong&Wa sours: 2bP8 Qropographlc map
1
(Ibca;Uon d1 wall muatba Shown on a USGS lops map andartadred to
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this form ifftf i,sirnp GPS) Lat. & Long. Unknown
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5. WELL OWMER
Ban T homggon
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Owner Name
!
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ah Forest NQ 28Z68
CCIr or Tewq State Zip Code
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Area code Phone number
1x. REMARKS;e.
1a 6 ] Geothermal Bores
WlLL DETAILS:II:
r. TOTAL OWTH, Igo,
b. DOW WELL REPLACE DUSTING WELL? YES ❑ NO ❑ I DO HEREBY CF-RTl1=Y THAT THIS WELL WAS CONSTRUCTED IN
a WATER LEVEL Below Top of Casing: N/A FT. ACCORDANCE W1rH 1S4 NCAC 2C, WELL CONSTRUCTION
(Else "+" if Abmm Top of C"hg) = STAnrDAR.DS. AND THAT A COPY OF THIS RECORD HAS BEEN
PROVIDED TO THE WELL OWNER.
d. TOP OF CASING is NIA FT. Above Land Surface"
'Top of casing te;Tninated aVor below land surface may require } 2.2-1Z
a uari?vice in accordance with 15A NCAC 2C .0118. E 'F`h'A n TiFIE❑ W�tLL CpNTRAG7QR DATE
s. YIELD (gpm): NIA METHOD OF TEBT N/A La<,i weds ' _
f. DISINFECTION: Type, N� Amount PRINTER NAME OF PERSON CONSTRUCTING THE WELL
, ibl it ►irithiri ; 04i1 � .of o mpirtian ta: '0tVisiorl Df WstSr Qtrallty . Inforrimiaw'Proc.eaaing, Form GW1a
Y'(�'�fiilRaiE g: rtiic13Fetliberr Raleigh,.ftC P7G88.161, Phone: [phone] tom. 2419
bG 3EVd CNI SMIAdM GMV COME898L8 90 ; TT ZT0L1801Z0

wT 01-00C) _�Z,
February 1, 2008
Rickey Kitchen
P.O. Box 99
Penrose, NC 28766
Subject: Geothermal Well Installation Data
Dear Mr, Kitchen:
Michael F. Easley, Governor
Wiltiarn G. Ross Jr., Secretary
Nash Carolina Department of Eovironment and Natural Resources
Coleen Sullins, Director
Division of Water Quality
In review of our records concerning closed-Ioop geothermal mixed -fluid injection well systems,
classified as 5QM type permits, we have found the following records have not been submitted
for permits where your company is listed as the heat pump installers:
Well Construction Record (G W-1)
Triangulation Data
Mechanical Integrity Pressure or Vacuum/Leak testing data
In order to assist your clients (those who hold 5QM permits) in meeting the condition of their
permits, we request your assistance to provide the above information no later than March 15,
2008. For future reference, we recommend you provide this information to your clients as soon
as construction is complete to assist them in meeting the condition of their permits. Also, please
remember their permits require them to keep this information on -site as well.
To assist you, we have attached a list of permits where you are listed as the heat pump installer.
We have also attached a form to fill out the results of your Mechanical integrity tests. Thank you
in advance for your cooperation and timely response. if you have any questions regarding this
letter, please call me at [phone] or Michael Rogers at [phone].
Sincerely,
Ai
Debra J. Watts
Environmental Supervisor
Groundwater Protection Unit
Attachment(s)
cc: APS Central Files (copy to each permit file on attached list)
Each Permittee on attached list
Aquifer Protection Section 1636 Mail Service Center
Internet. ► WW ncWaternua,lin.ar^ Location; 2728 Capital Boulevard
An Equal OpportuOyfAffirms ive Action Employer-50% Recycled110% Past Consumer Paper
ghC;W ��rta
.atU
Raleigh, NC 27699-1636 Telephone: [phone]
Raleigh, NC 27604 Fax I : (919) 7I5-0588
Fax 2; [phone]
Customer Service: [phone]

Issued Permits with Rickey Kitchen Listed as Heat Pump Contractor
.January 11, 2008
Permit No.
Name
Date Permit Issued
WI0100046
Cra!2 Justus
3/6/2007
WI4100047
Phil ❑onehower
3/9/2007
W10100045
Habitat for Humanity
3/12/2007
W10100052
Ron Thompson
9/11/2007

Mechanical Integrity Test Record
(For SQM Geothermal Heat Pump Injection Well System)
OwnerlPermittee Name: Permit Number: WI
Facility Address:
Home Phone: Cell Phone:
Heat Pump Contractor Name:
Office Phone: Cell Phone:
Tester Name: Signature:
Date of Text:
Any additional loop testing add to back of this form
Comments:
Other Test Methods and ResWts:
This farm must be filled out and signed by the tester. The record must be received by Aquifer Protection Section 24 hours
prior to the initiation of the operation of the facility. You can send the farm by mail: LIC Program, Mail Service Center 1636,
Raleigh, NC 27699 or by fax: [phone],
Mechanicai integrity Test Form 1112007

ichael
F. Bwley, Governor
William G. Roan Jr., Secretary
North Carolina Department of Environment and Natural Resources
Colcen Sullins. Dirccmr
Divisions of Wa= Quality
January 11, 2008
Rickey Kitchen
P.O. Sox 99
Penrose, NC 28766
Subject: Geothermal Well Installation Data
Dear Mr. Kitchen:
In review of our records concerning closed -loop geothermal mixed -fluid injection well systems,
classified as SQM type permits, we have found the following records have not been submitted
for permits where your company is listed as the heat pump installers:
■ Well Construction Record (GW-1)
0 Triangulation Data
Mechanical Integrity Pressure or Vacuum/Leak testing data
In order to assist your clients (those who hold 5QM permits) in meeting the condition of their
permits, we request your assistance to provide the above information no later than February 29,
2008. For future reference, we recommend you provide this information to your clients as soon
as construction is complete to assist them in meeting the condition of their permits. Also, please
remember their permits require them to keep this information on -site as well.
To assist you, we have attached a list of permits where you are listed as the heat pump installer.
We have also attached a fora to fill out the results of your mechanical integrity tests. Thank you
in advance for your cooperation and timely response. If you have any questions regarding this
letter, please call me at [phone] or Michael Rogers at [phone].
Sincerely,
3• uoks
Debra J. Watts
Environmental Supervisor
Groundwater Protection Unit
Attachment(s)
cc: APS Central Files (copy to each permit file on attached list)
Each Permittee on attached list
Aquifer Protection Section 1636 Mail Service Center
Internet WWW.ncWKWguaiih.ore Location: 2728 Capital Boulevard
An Equal OpportunityWirmatwe lotion Employer— 50% Re[yded110% Post Consumer Paper
90'rncamli
naurally
Raleigh, NC 27699-1636 Telephone: [phone]
Raleigh, NC 27604 Fax 1: [phone]
Fax 2: [phone]
Customer Service: [phone]

Issued Permits with Rickey Kitchen Listed as Heat Pump Contractor
January 11, 2008
Permit No.
Name
Date Permit issued
WI0100046
Crai Justus
316/2007
WI0100047
Phil Donehower
3/9/2007
WIO100045
lHaMatforHumanky
3/12/2007
WI0100052
IRonThompson
9/1112007

Mechanical Integrity Test Record
(Par 5QM Geothermal Heat Pump Injection Well System)
Owner/Permittee Name: Permit Number:
Facility Address:
Home Phone:
Heat Pump Contractor Name:
Cell Phone:
Office Phone: Cell Phone:
Tester Name: Signature:
Date of Test:
Loop Initial Pressure (psi) Final Pressure (psi) _ Duration (.minutes) Pass ("es or No)
1 2 1
3
4 1
5
6
7 1
1 10
—1- - — - - — - 1 - - -
12
13 I
Any additional loop testing add to back of this form
Comments:
Other Test Methods and Results:
This form must be filled out and signed by the tester. The record must be received by Aquifer Protection Section 24 hours
prior to the initiation of the operation of the facility. You can send the form by mail: UIC Program, Mail Service Center 1636,
Raleigh, NC 27699 or by fax: [phone].
Mechanical Integrity Test form 11f2007

Permit Number W10100052
Program Category
Ground Water
Permit Type
Injection Mixed Fluid GSHP Well System (5OM)
Primary Reviewer
michael.rogers
Permitted Flow
Facilit
Central Files: APS SvVP
09/11/07
Permit Tracking Slip
Status Project Type
In review New Project
Version Permit Classification
Individual
Permit Contact Affiliation
Facility Name Major/Minor Region
Ron Thompson SFR Minor Asheville
Location Address County
1245 Kentwood Ln Transylvania
Pisgah Forest NC 28768 Facility Contact Affiliation
Owner
Owner Name Owner Type
Individual
Ron Thompson Owner Affiliation
Ron Thompson
1245 Kentwood Ln
Pisgah Forest . NC 28768
Dates/Events
Scheduled
Orig Issue App Received Draft initiated Issuance Public Notice Issue Effective Expiration
08/20107
egulated Activities
Heat Pump Injection
Private residence, single family
Outfall NULL
gh ///z
RecLuested/Received Events
RO staff report requested 08/22/07
RO stall report received 09/10/07
Waterbody Name Stream Index Number Current Class Subbasin

10,OF -�
Michael F. Easley, Governor
tra r William G. Ross Jr., Se retary
North Carolina Department of Environment and Natural Resources
"C
Coleen H. Sullins, Director
Division of Water Quality
September 11, 2007
Mr. Ron Thompson
524 Three Mile Knob Road
Apt. # 1
Pisgah Forest, NC 28768
Re: issuance of Injection Welt Permit
Permit No. W10100052
Issued to Ron Thompson
Dear Mr. Thompson:
In accordance with your application received August 20, 2007, 1 am forwarding Permit No.
WI0100052 for the operation of a vertical closed -loop geothermal mixed -fluid heat pump
injection well system to be located at 1245 Kentwood Lane, Pisgah Forest, Transylvania County,
North Carolina 28768. This permit shall be effective from the date of issuance until August 31,
2012, and shall be subject to the conditions and limitations stated therein.
Pay special attention to the well construction standards in Parts H 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 (90 days) prior to its expiration date. As
indicated in the permit, this permit is not transferable to any person without prior notice to, and
approval by, the Director of the Division of Water Quality. If you have any questions regarding
your permit or the Underground Injection Control Program please call Mr. Qu Qi at (919) 715-
6935 or me at [phone].
Best Regards,
Michael Rogers
Environmental Specialist
cc: Landon Davidson — Ashville Regional Office
Central Office File — W10100052
Attachment(s)
irhl
Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636 Telephone: [phone]
Internet httn:llwww,ncviatemualitY.org 2728 Capimtl Boulevard Raleigh, NC 27604 Fax 1: [phone]
Fax 2: [phone]
An Equal opporhmitylAftnatine Action Employer— SD% Recyrlad/1D% Past Consumer Paper CugbDr � Service [phone]

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMIM9SSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE CONSTRUCTION AND OPERATION OF A WELL FOR INJECTION
In accordance with the provisions of Article 7, Chapter 87; Article 21, Chapter 143, and other
applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
RON THOMPSON
FOR THE CONSTRUCTION AND OPERATION OF 6 TYPE 5QM INJECTION WELLS,
defined in Title 15A 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 1245 Kentwood Lane, Pisgah Forest, North Carolina, and will
be constructed and operated in accordance with the application received August 20, 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 August 31,
2012, and shall be subject to the specified conditions and limitations set forth in Parts I through
IX hereof.
Permit issued this the J� day of , 2007.
tColeen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission.
WIOI00052 Page 2

PART I - WELL CONSTRUCTION GENERAL CONDITIONS
I. The Permittee must comply with all conditions of this permit and with the standards and
criteria specified in Criteria and Standards Applicable to Injection Wells (15A NCAC 2C
.0200). Any noncompliance with conditions of this permit constitutes a violation of the
North Carolina Well Construction Act and is grounds for enforcement action as provided
for in N.C.G.S. 87-94.
2. This permit shall become voidable unless the facility is constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other supporting data
3. Each injection well shall not hydraulically connect separate aquifers.
4. Each injection well shall not be located in an area generally subject to flooding. Areas that
are generally subject to flooding include those with concave slope, alluvial or colluvial
soils, gullies, depressions, and drainage ways.
5. Each injection well shall be 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 locldng cap.
6. Each injection well shall be afforded r=onablc 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 (UIC) Program Central Office
staff, telephone number [phone] and the Ashville Regional Office Aquifer Protection
Section Staff, telephone number [phone].
3. All underground tubing shall be refrigeration grade copper tubing.
WI0100052 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 (prig),
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 cbarge 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 lass, 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 1 SA
North Carolina Administrative Cade 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 psig 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 post -installation pressure or vacuum test record (initial pressure reading, 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 twee -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 II, paragraphs t 10) and (I I I shall be submitted to:
Aquifer Protection Section-UIC Staff
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
WI0100052 Page 4

PART III - OPERATION AND -USE GENERAL CONDITIONS
1. This permit is effective only with respect to the nature, volume of materials and rate of
injection, as described in the application and other supporting data.
2. This permit is not transferable without prior notice to, and approval by, the Director of the
Division of Water Quality (Director). In the event there is a desire for the facility to
change ownership, or there is a name change of the Permittee, a formal permit amendment
request must be submitted to the Director, including any supporting materials as may be
appropriate, at least 30 days prior to the date of the change.
3. The issuance of this permit shall not relieve the Permittee of the responsibility of
complying with any and all statutes, rules, regulations, or ordinances, which may be
imposed by other local, state, and federal agencies, which have jurisdiction. Furthermore,
the issuance of this permit does not imply that all regulatory requirements have been met.
PART IV - PERFORMANCE STANDARDS
1. The injection facility shall be effectively maintained and operated at all times so that there
is no contamination of groundwater that will render it unsatisfactory for normal use. In the
event that the facility fails to perform satisfactorily, including the creation of nuisance
conditions or failure of the injection zone to adequately assimilate the injected fluid, the
Permittee shall take immediate corrective actions including those actions that may be
required by the Division of Water Quality such as the repair, modification, or abandonment
of the injection facility.
2. The Permittee shall be required to comply with the terms and conditions of this permit
even if compliance requires a reduction or elimination of the permitted activity.
3. The issuance of this permit shall not relieve the Permittee of the responsibility for damages
to surface or 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 (LTIC) 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
WIOI00052 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.
2. 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 VII - MONITORING AND REPORTING REQUIREMENTS
1. 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.
2. The Permittee shall report by telephone, within 48 hours 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 systern, 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 be 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.
W10100052 Page 6

PART VIII - PERMT RENEWAL
The Permittee shall, at least 90 days prior to the expiration of this permit, request an
extension.
PART IK - CHANGE OF WELL STATUS
I . 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 15A NCAC 2C .0213(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 15A NCAC 2C .0214, including but not limited to the following;
(A) All casing and materials may be removed prior to initiation of
abandonment procedures if the Director finds such removal will not be
responsible for, or contribute to, the contamination of an underground
source of drinking water.
(B) The entire depth of each well shall be sounded before it is sealed to insure
freedom from obstructions that may Interfere with sealing operations.
(C) Each well shall be thoroughly disinfected, prior to sealing, if the Director
determines that failure to do so could lead to the contamination of an
underground source of drinking water.
(D) Each well shall be completely filled with cement grout, which shall be
introduced into the well through a pipe, 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 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.
WTOI00052 Page 7

(G) The Permittee shall submit a Well Abandonment Record (Form GW-30)
as specified in 1 SA NCAC 2C .02.13 (h)(1) within 30 days of completion
of abandonment.
The written documentation required in Part TX (1) and (2.) (G) shall be submitted to:
Aquifer Protection Section-UIC Program
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 2.7699-1636
WIO100052 Page 8

77 C. .inda Thompson I"T?-2685 p.1
q// -710 7
70—
:� �� �! E �uG /. '16. J C t4eZC ct7&64—)

07 a,
I
i_Ir)da Thompson
L28-877-2685 p 2
NORTH CAROLIttiA
DEPARTMENT OF ENVIRONMENT AND N ATU M RESOURCES
APPLICATION FOR PERMIT TO CONSTRUCT ANDIOR USE A
WELL(S) FOR INJECTION WITH A HEAT PUMP SYSTEM
Type 5A7 an, 5 =Wals
In Accordance with tiw provisions of NCAC Title 1$A: 02C.020D
Complete application and mail to address on the back page.
31RECTOR NORTH CAROLINA DIVISION �'= WATER QUALITY
SATE: _ �4 1-7 �.::20
- YSTEM CLASSIFICATION Please check c�- in which matches proposed system.
l) Type 5A7 wells inlea water used to provide Keating or cooling for sm.=ures.
'3) x Type 5QM wells contain a subsurface system of continuous piping, that is
isolated from the environment and circulates a fluid other than potable water.
This includes systems that circulate additives such as antifreezes and/or corrosion
inhibitors.
Type 5QW wells contain a subsurface system of continuous piping, that is
isolated from the environment and only cimulates potable water. If you sclected
this well type, then cDmplete form GW-57 CL, Aardflcarrian Oflntew To
C'anstrucd A Qossed-Loop Geother►sal-Water Only Injection Weft.3j►stemL
t` "FRMIT APPLICANT
'address:—
ity: sG'r4,<� Z T StateWC" Z n Code: County: r ✓h►.sl��
eiephone: 712- � S = 11Pl
°'RAPE-W, Y OWNER (if different from applic,
`,ame:
address:
'ity: Sate- Zip rode: County:
e l ephone:
,A'ATUS OF APPLICANT
t'rivate: x Federal: +minercW
;ticate: Municipal: dative Amer. Lands-
',G6 GWi1j7C-37 HP Page 1 of 4

;7 AM Linda Thompson '3-877-2885 P.3
ACiLITY (SITE) DATA
Fill out CJNLY ifthe Status of Owner is Feder
:acne of Business or Facility:
Zip Code:
Conic
HEAT P1.1NIP CONTRACTOR DATA
Name: Rickey Kitchen
Address: P.O. Box 92
xte, Mimic, or Commercial).
-rson:
Coo;
Ci-[y. _ Pen=ose Zip Code: COU
Telephor�; &28-862-7865 Cori.. �,_rson: Ric
G. INJECT (ON PROCEDURE {Briefly describe. I
Injection wells (bare holes) will be u.
lo=s will be pl,:ced in she temporaru .
from the bottom to "a top. Y
WELL USE Will the injection well(s) also
(1) 1 he injection operation?
(2) Personal consumption?
CONSTRUCTION DATA (check one)
EXISTING WELL bain-1
(1) through (7) below to •'
1 [Well Construction Rec.
x PROPOSED WELL to h,
data in (1) through (7) bi-
Form G W- l after constru,
(1) WelI Drilling Conhuctor's Name: '
NC Contractor Certification number:
(2) Date to be Constructed
Approximate depth of each boring (fce
(3) Well casing: Ls the well(s) rased?
(a) YES lfyes, then provide
Type: Galvanized steel Black steel
Casing depth: From to
Casing extends above ground
(b) NO x
he irnjecu(
-a` a geo
notes.
^ransy lvan:La
Kitchen
eli{s) will be used.)
7sal beat oink. Geothermal ground
holes ►uil,' be continuously grouted
—ed as the st. ly well(s) for the following?
.S NO x
l_ s NO x
,sed for u� .
an injection well. Provide the data in
't oryour
wledge. Attach a copy of Form GW-
f available
-:,;tTueted 1,
-.e as an injection well. Provide the
,1, PROPO`
.'D construcdonn specifications. Submit
Numbe,'
yorings:
/" f t
:sing infbm . in below.
�'la5tic� )dw(spesciiy
Iference t Id surface)
:e*,d 7106 GW/UIC-511 ! Page 2 of

07 0. Jnda Thompson
p,4
Grout (material surrounding well casing andlor pipit
(a) Grout type: CW=t x Bentonite x
(b) Grouted surface and grout depth (reference to
x around closed loop piping; From a
around well casing; from to
Screens (for Type 5A7 wells)
tstu
siiiam sand &
pecify) superpla8ticiser
le):
t(feet).
(a) Depth: From to feet below ground
N.C. State Regulations (Tide 15A NCAC 2C .0200) ruire the permittee to make provisions
for monitoring wellbead processes. A faucet on loth uent (fluid entering heat pump) and
etfluent (fluid being injected into the u.ell) lines is requ cc_ Will there be a faucet on:
(a) the influent line? yes n (b) Lh effluent line? yes no
SOURCE WELL CONSTRUCTION iNFORMA.TIOIifdifferent from injection well).
Atwch a copy of Form GW-1 (Well Construction 1,:600Id). If Form CW-I is not available,
provide the data in part K (1) of this application form to the best of your knowledge.
NOTE: TtM WELL I3AILLM CONTRACTOR CAN SUPPLY THE DATA FOR @fT EXISTING OR
PROPOSED WELLS IF THIS INFORMA DON IS UNAVAILAB v-- BY OTHER MEANS.
ROPOSED OPERATING DATA (far Type SA7 wells)
Injection rate: Average (daily) c:fIons per minute (gpm).
Injection Volume: Average (daily) gallons per day (gpd).
i) Injection Pressure: Average (daily) poundslsquare inch (psi).
•t) injection Temperature: Average (Ja:auary? FF .verage (July) c F.
1 :JECTION FLUID DATA
Fluid source (for Type SA7 wells) If ur Pound, trt , what depth- formation and type of
rock/sediment unit will the fluid be dr'av e.g., gram! limestone, sand, etc.).
ll De -- Formation: r'. ) Sediment unit
'. F Chemical Analysis of Source Fluid (far ee 5QM w is)
Provide a complete listing of all chemi. added to the circulating heat transfer fluid:
9-22 Relrigeramt
-lJECTION-RELATED EQUIPMENT
�.ttaeh a diagram showing the engineering layout of the injection equipment and extenor pipingltaubing
ssociated with the injection operation. The manufacturer's brochure may provide supplementary
nformation.
OCATTON OF WELL(5) Attach two maps.
!06 GWILUC-57 KF Page 3 of 3
Jk

Linda Thompson
13-877-2685 p.5
R:
include a site map (can be drawn) shoes
potential sources of gsotmdwater wnta,-
the proposed weIl(s) and any existing vx,
drain fields located within 1000 feet
a L ures clearly and include a north aro
Ir..lude a topographic map of the area e
indicate the facility's location and the n7
PERMIT LIST, Attach a list of all permits or
Example. include-
(1 } Hazardous Waste Management progran
(2) WC Division of Water Quality Non -Di; L
(3) Sewage Treatment and Disposal Penmit•
CERTiF1CATION
"I hereby certify, under penalty of law, that.
information submitted in this document and al
those individuals irnrnediately responsible for
is true. accurate and complete. l am aware th�r
of fines and imprisonment, for submitting fal-
rCpair, and if applicable, abandon the injectior-
s 1-c approved specifications and conditions of ti
If C.
PkaseSU/:
CONSENT OF PROPERTY OWNER (0%-nv4
rights in the well being constructed. A we
ownership in the landowner in the absence of t -
If the property is owned by someone other the -
allow Lho applicant to construct each injection
the responsibility of the applicant to ensue
Construoulon Standards (Title 3 5A NCAC 2C
txi
buildinqk property 1'snes, surface water bodies.
::ion and the orientation of and distances between
or waste disposal facilities such as septic tanks or
geothermal beat pump well system. label all
.rig one mile from the property bosmdaries and
Anne.
.sction approvals that are related to the site.
;+tits under P' RA
permits
c persomt
- xarnined and am familiar with the
chments t
to and that, based on my inquiry of
trig said it
:cation, I believe that the information
=' are sign
it penalties, including the possibility
ormaiion-
free to construct, operate, maintain..
and all
-d appurterm=s in accordance with
1
urc of Wei
-wrier or kid on3ix- Agent)
_ed agent ! : ng on behalf of the well owner,
l etter signs the awaer authorWng the above agent
:ns any pe: who holds the fee or der property
ical prop and its construction an land rests
try ageeear. Ill w6lln&)
applicant c property owner hereby consents to
as outlin, i this application and chat it shall be
,it the in; tar► well(s) conforms to the Well
(Sig, Of Prope: �lwner If Different From Applicant)
Please return twn copies of the t.• i.•ted Appl.• on package to:
UIC Yr am
Aquifer Prc_:-
rn Section
North Carolirn
-NR-Dv4'-
1636 Mail :�4
--.c Centet,
Raleigh, Nt
'r:99-1636
Telephone t 15-6934.
GW/LTIC-57 F-tY Page A of 4

07 OL
_Mda Thompson 2M77-26$5 p.6
MYI+VANIA COUNTY HEAL i H DEPARTMENT IMPROV ENT PEFIMIT DIAGRAM.
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September 11, 2007
Mr. Ron Thompson
524 Three Mile Knob Road
Apt. #1
Pisgah Forest, NC 28768
Re: Issuance of Injection Well Permit
Permit No. W10100052
Issued to Ron Thompson
Dear Mr. Thompson:
Michael F Easley, Gov ern or
William G. Ross Jr., 5ecrr[ary
Norlh CarDhua Department of Envu- went and Nahual Resources
Coleen H. Sullins, Director
Division of Water Quafiry
In accordance with your application re�veCAugust -0. 2)O07, Ijim forwarding Permit No.
WI0100052 for the operation of a vertical cos - ermal mixed -fluid heat pump
injection well system to be located at 1245 Kentwood Lane, Pisgah Forest, Transylvania County,
North Carolina 28768. This permit shall be effective from the date of issuance until August 31,
2012, and shall be subject to the conditions and limitations stated therein.
Pay special attention to the well construction standards in Parts U 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 (90 days) prior to its expiration date. As
indicated in the permit, this permit is not transferable to any person without prior notice to, and
approval by, the Director of the Division of Water Quality. If you have any questions regarding
your permit or the Underground Injection Control Program please call Mr. Qu Qi at (919) 715-
6935 or me at [phone].
Best Regards,
r
Michael Rogers
Environmental Specialist
cc: Landon Davidson — Ashville Regional Office
Central Office File — W10100052
Attachment(s)
ow
NprthCaropaa
,IY!!✓'111ally
Aquifer Protecricm Section 1636 Mail Service Centor Raleigh, NC 27699.1636 Telephone: [phone]
Intemer•. hftp:llwww.no-aLMuali!y.ors 2728 Capita] Boulevard Raleigh, NC 27604 Fax 1: [phone]
Fax 2: [phone]
An Equal Op pontur4lAffirrro nw Anion Employer— 50% Recyded110% Post Consumer Paper Customer Service., [phone]

NORTH CAROLINA
i OQ0I I'Tl7:iu 1 bra 1►.1Igo FIN` M"01u 1b:YZiI17u iu 1 &" ToWI
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
RON THOMPS ON
FOR THE CONSTRUCTION AND OPERATION OF G TYPE 5QM INJECTION WELLS,
defined in Title 15A 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 1245 Kentwood Lane, Pisgah Forest, North Carolina, and will
be constructed and operated in accordance with the application received August 20, 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 August 31,
2012, and shall he subject to the specified conditions and limitations set forth in Parts I through
IX hereof.
-t--
Permit issued this the _ day of rA,-r , 2007.
11
ItColeen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission.
WIOI00052 Page 2

� w" r��
r
7i 0-a =i
September 11, 2007
Mr. Ron Thompson
524 Three Mile Knob Road
Apt. #1
Pisgah Forest. NC 28768
Re: Issuance of Injection Well Permit
Permit No. WI0100052
Issued to Ron Thompson
Dear Mr. Thompson:
Michael F. Easley. Governor
William G. Rosa Jr., Secretary
North Carolina Department of Environment and natural Resources
Coleen K Sullins, Du=tor
Division of Water Quality
In accordance with your application received August 23, 2007, 1 am forwarding Permit No.
WI0100052 for the operation of a vertical closed -loop geothermal mixed -fluid heat pump
injection well system to he located at 1245 Kentwood Lane, Pisgah Forest, Transylvania County,
North Carolina 28768. This permit shall be effective from the date of issuance until August 31,
2012, and shall he 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 (90 days) prior to its expiration date. As
indicated in the permit, this permit is not transferable to any person without prior notice to, and
approval by, the Director of the Division of Water Quality. If you have any questions regarding
your permit or the Underground Injection Control Program please call Mr. Qu Qi at (919) 715-
6935 or me at (919) 715--6166.
Best Regards,
Michael Rogers
Environmental Specialist
cc: Landon Davidson - Ashville Regional Office
Central Office File - WI0100052
Attachment(s)
Aquifer Protection section 1636 Mail Service Center Raleigh, KC 27699-1636 Telephone.- [phone]
Internet: httn:llwww.ncwaerouality.org 2728 Capital Boulevard Raleigh, KC 27604 Fax 1: [phone]
Fax 2: (919) 715-6m
An Equal OpportunttylAfti mative Arlon Employer— 50% Rwidedl10% Post Consumer Paper Cuau mne 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
PERMISSION IS HEREBY GRANTED TO
RON THOMPSON
FOR THE CONSTRUCTION AND OPERATION OF 6 TYPE 5QM INJECTION WELLS,
defined in Title 15A North Carolina Administrative Code 2C .0209(e)(3)(F), for the purpose of
operating a "direct expansion" type vertical closed -loop geothermal-inixed-fluid heat pump
system. This system is located at 1245 Kentwood Lane, Pisgah Forest, North Carolina, and will
be constructed and operated in accordance with the application received August 20, 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 August 31,
2012, and shall be subject to the specified conditions and Iimitations set forth in Parts I through
IX hereof.
Permit issued this the
day of
Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission.
. 2007.
W10100052 Page 2

Amendment to My Application For a 5QM Well Permit
Subject: Amendment to My Application for a 5QM Well Permit
From: "Ron Thompson" <thompson@a mail2ron.com>
Date: Tue, 11 Sep 2407 12:49:41 -4740
To: <michael.rogers�7a ncmail.net>
CC: cthompson@a mail2ron.com>
Michael,
Based on a revision of specifications from the company providing my geothermal
equipment, the application should be changed to show 6 borings of 100 ft in depth versus
4. If further information is needed, please contact me.
Thanks again for your cordial and professional assistance in this matter.
Ron Thompson
1245 Kentwood Lane
Pisgah Forest, NC
717-645-1101
Visa. MasterCard. AMEX & Discover. CoIllpare Offers & Apply Online. Click here!
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I of 1 9/12/2007 9:19 AM

TE /tee ;i� oo- ss ,f�•G�� /.,v
`Z?-.4'7 `
I�
RECEIVED I DEN4 I DWQ
AQUIFER-PPOTF(MON! SECTION
AUG 2 3 2007

TO:
A.
a
10
NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A
WELL(S) FOR IN ECTTON WITH A HEAT PUMP SYSTEM
Type 5A7 and" Wel�.a
J
In Accordance with the provisions of NCAC Tide 15A: 02C:0200
Complete application and mail to address on the back page.
DIRECTOR ?QORTH CAROLINA DIVISION OF WATER QUALITY
DATE: _ zu4 / % , 20, P ?
SYSTEM CLASSIFICA JON Please check cohmm which matches proposed system.
(1) Type 5A7 wells inject water used to provide heating or cooling for structures.
(2) x" Type 5QM wells contain a subsurface system of continuous piping, that is
isolated from the environment and circulates a fluid other than potable water.
This includes systems that circxdate additives such as antifreezes andlor corrosion
inhihitors.
(3) _ Type 5QW wells contain a subsurface system of continuous piping, that is
isolated from the environment and only circulates potable water. If you selected
this well type, then complete: form GW-57 C L. NodJk-adbn QfI#1ead Tb
Cons&uct A .0 mEd-Loop Gentlkera>ml-Water Dray Inje edwr WeR SyxkwL
PF.A;MIT �I' ' 'CANT
Narne: arc t ❑ !
Address: _ _l am [ �f G � L:l� � .cic -
City: ZfS7- State :I�C'_ZiP Code: r County: 011A
Telephone: 7 — 46-' Sf - y v
PROPERTY OWNER (if different from applicant)
Name:
Address:
City:
Telephone:
Sate: Zip Code: County:
D. STATUS OF APPLICANT
Private: Federal:
State: Municipal:
Remised 7106 OWIMC-57 HP
Commercial.
Native American Lands:
RMENED I DENR 16WO
AMFFA'PPn F T1nni CFCTK)r-
AUG 2 3 ZUUr
Page 1 of 4

E.
FACILITY (SITE) DATA
(Fill out ONLY if the Status of Owner is Federal, State, Municipal or Commercial).
Name of Business or Facility:
Address:
City:
Telephone:
Zip Cade. County:
F. HEAT W AND rr %krro A f-PfAD F7 A T e
Name:
Addres
Contact Person:
City: _ ��srf?cS Zip Code: County:.. Z.fA&Vllf.�tli,¢
Telephone: &7-1A J Z ^7af -Contact Person: � rv/ fir f
G. INJECTION PROCEDURE (Briefiv describe how the iniecdon wells) will be used.)
e',�e- Wb GGaS P C.f- e4J /0,/sCae - 4['Cz3 ���`�� ��flfr.� �Y��'a 4 ��
F'Far�o�To� cs{ -ro- i'q
H. WELL USE Will the injection well(s) also be used as the supply wel(s) for the following?
(1) The injection operation? YES NO
(2) Personal consumption? YES NO
I. CONSTRUCTION DATA (check one)
EXISTING WELL being proposed for use as an injection well. Provide the data in
(1) through (7) below to the best of your knowledge. Attach a copy of Form GW-
1 (Well Construction Record) if available.
PROPOSED WELL to be oonstr cW for use as an injection well. Provide the
data in (1) through (7) below as PROPOSED construction specificadons. Submit
Form GW-1 after construction.
(I) Well Drilling Contractrnr's Name:, �b-eC Zkit_L�r� - 4e�Y 4, L, S
NC Contractor Certification number: 44 -0-33
(2) Date to be constnutai- ,cif f Number of borings:
Approximate depth of each boring (feet): j C D r 7
(3) Well casing: Is the wells) cased?
(a) YES If yes, then provide the casing information below.
Type: Galvanized steel Black steel Plastic Other (specify
Casing depth: From to fL (reference to land surface)
Casing extends above ground inches
(b) NO
Revised 7106 GW/UIG57 IW Page 2 of4

(4) Grout (material nwrounding well caging andJor piping,):
(a) Grout type: Cement .�' 9entonite : } Other (specify) ,rL-rl 94-4'
(b) Grouted surface and grout depth (reference to land surface):
around closed loop piping; from G to �� (feet).
around well caging; from to [feet).
(5) Screens (for Type SA7 wells)
(a) Depth: From to feet below ground surface.
(6) N.C. Slate Regulations (Title 15A NCAC 2C .0200) require the permitlee to make provisions
for monitoring wellhead processes. A faucet ozI both influent (fluid entering hog pump) and
effluent (fluid being injected into the well) lines is required. will there be a faucet on:
(a) the influent line7 yes no (b) the effluent line7 yes no
(7) SOURCE WELL CONSTRUCTION INFORMATION (if different from injection well).
Attach a copy of Form GW-1 (Welt Construction Record). If Form GW-i is not available,
provide the data in part K (1) of this application form to the best of yotw knowledge.
Nolm: 11M WUL DRY * CONTRACTOR CAN SUPPLY THE DATA FOR FiTIt R EXISTM OR
PROPOSED WELLS IF TEU9 INFORMATION 13 LINAVAEL ABLE BY MIER "&
J. PROPOSED OPERATING DATA (for Type SA7 weila)
(1) Injection rate: Average (daily) gallons per minute (ggm).
(2) Injection Volume: Average (daily)gallons per day (gpd).
(3) Injection Pressure: Average (daily) pounds/square inch (psi).
(4) Injection Temperature: Average (January) ° F, Average (July) ° F.
K- INJECTION FLUID DATA
(1) Fluid source (for Type 5A7 wells) If underground, firm what depth. formation and type of
rock/sediment unit will the fluid be drawn (e.g., granite, limestone, sand, etc.).
Depth: Fozmation_ _ Rock/sediment ►mic
(2) Chemical Analysis of 5ounce Fluid (for 7ype 5QM wells)
Provide a complete lasting of all chemicals added to the circulating hen transfer fluid:
L. INJECTION -RELATED EQUIPMENT
Attach a diagra;n showing the engineering layout ofthe injection equipment and exterior piping1tubing
associated with the injection operation- The manuxfacturees brochure may provide supplementary
information.
M. LOCATION OF WELLS) Attach two maps.
Revised. 7106 GWlUIG57 HP
Page 3 of 4

(1) Include a site map (can be drawn) showing: buildings, property lines, sa lhee water bodies.
potential sources of groundwater won and the orientation of and distances between
the proposed well(s) and any existing weli(s) or waste disposal %li#es swh as septic tanks or
drain fields located within 1000 feel of the geoffiermal mat pump well system. Label all
features clearly and include a north arrow.
(2) Include a topographic map of the area extending one mile from the property boundaries and
indicate the faeglhy's location and the map name.
N. PERMIT LIST: Attach a list of all peons or construction approvals that we rely to the site.
Examples include:
(1) Hazardous Waste Management program permits under RCRA
(2) NC Division of Water Quality Non -Discharge permits
(3) Sewage Tit and disposal Permits
a. CERTIFICATION
"I hereby certify, under penalty of law, that I have personally examined and am fianiliar with the
Mbrmahon 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 tru% accurate and completes. I am aware that there are significant penalties, including the possibility
of fines and imprisonmamt, for submdbng false imfroma mxL I free to consbuM operme, maintain,
repair, and if applicable, abandon doe injection well and all rehmed in aceordwace with
the approved spwifications and conditions of the Permit"
(Signature of Well Owner or Authorised Agent)
1f auhartmd ageff a arMW on b AWoff the well owwr,
pleaw ,s W* a kaer sWwd by the owner astho ZMg the above agent
P. CONSENT OF PROPERTY OWNER (Owner means any person who bolds the fee or other property
rights in the well being constructed. A well is real property and its fiction on land rests
oww rsbip in the landowner in the able r e of contrary aft in writing.)
If the property is owned by someone other than the applicant, the p uperty owner hoeby consents to
allow the applicant to construct each injection well as outlined in this application and that it shall be
the responsibility of the applicant to erasure that the injection well(s) confans to the Well
Construction Standards (Title 15A NCAC 2C .0200)
(Signature Of Property Owner If Different From Applicant)
Please return two oopws of the cnt opleaad Appfication pwkag+e to:
UIC Program RECEIVED i DENR r DWD
Aquifer Protection Section AMFp PpoTrr T IM �'FCPION
North Carolina DENR-DWQ A U G S 3 2001
1636 Marl Service Center
Raleigb6 NC 27699.1636
Telephone ('919) 715-6935
Revised 7/06 GWIULG57 HP Page 4 of 4

TRANSYLVANIA COUNTY HEALTH CEPRTMENT IMPROVEMENT PERMIT DIAGRAM
Permit 60
File Name: e. n� d -Q
IC Na.: Pin Na.:
pvcA 100 ,
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http;Ilarcims.webgis.netlncltransylvanialprintable.asp?process= ndefined&x2=undefined&... 8/17/2007

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Pin: 9505-36-2901-000
Owner:
THOMPSON RONALD E & LINDA
824 LANDAU CT
CAMPHILL,PA 17011.8374
Use Cade: 0100
Sale Date: 200404
Sale Price: 120000
Acres: 7.14929642364
Township: 5
Deed Book: 229
Deed Page: 100
Sale Inst: WD
Sale Imp: V
Zoning:
Land Value: $43,330
Bldg Value: $0
Year Built:
XFOB Value: $0
Assessed Value: $43,330
Legal Address: N OF 5R 1541
Qq
0
http:llarcims.webgis.netlncltransylvanialprintable.asp?process=locate3 &x2=9032l9.3425... 8/23/2007

AQUIFER PROTECTION REGIONAL STAFF REPORT
Date: 09-07-07
To: Aquifer Protection Central Office
Central Office Reviewer
Regional Login No:
County:_ Trans.
Permiittee: Ron 'l liompson SFR WIOIOGO52
Project Name: WIOI00052
Application No.:WI0100052
L GENERAL INFORMATION
l . This application is {check au that appiyy_ ® New ❑ Renewal
❑ Minor Modification ❑ Major .Modification
❑ Surface Irrigation ❑ Reuse ❑ Recycle
High Rate Infiltration [J Evaporation/Infiltration Lagoon
❑ Land Application of Residuals ❑ Attachment B included ❑ 503 regulated ❑ 503 exempt
❑ Distribution of Residuals ❑ Surface Disposal
® Closed -loop Groundwater Remediation ❑ Other Injection Wells (including in situ remediation)
Was a site visit conducted in order to prepare this report? ® Yes or ❑ No.
a. Date of site visit: 09.06.07
b. Person contacted and contact information: Ron Thompson
c. Site visit conducted by: G. Davidson
d. Inspection Report Attached: ® Yes or ❑ No.
2. Is the following information entered into the BIMS record for this application correct?
® 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 name and number:
d. Latitude; Longitude:
e. Regulated Activities 1 Type of Wastes (e.g., subdivision, food processing, municipal wastewater):
For Disposa! and Iniection Sites:
It f multiple sites either indicate which sites the information applies to, copy and paste a new section into the
document for each site.-ar attach additional pages For each site
a. Location(s); 1245 Kentwood Ln., Brevard, NC 28768
b. Driving Directions: south on 64 out of Brevard, to Williamson, to Kentwood.
c. USGS Quadrangle Map name and number: Brevard
d, Latitude: 35/13/26.196 Longitude: 82/40/25.60
IL NEWAND MAJOR MGDIFICATIONAPPLICATIGNS this section not needed or renewals or minor
modircations, ski to next section)
Descri ition Of Watste 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?

AQUIFER PROTECTION 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 (maps, plans, etc.) represent the actual site (property lines, wells, surface drainage)? ❑
Yes ❑ No ❑ N/A. 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:
b. 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 100-year floodplain?
❑ Yes ❑ No ❑ N/A. If yes, please attach a map showing areas of 100-year floodplain and please explain
and recommend any mitigative measures/special conditions in Part IV:
8. 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 reaps 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 Iist of sites
with restrictions (Certification B?)
111, RENEWAL AND MODIFIGMONAPPLIC9770NS Luse previous section for new or my or mob leallon
s stems
Description Of Waste U And Facilities N/A
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 explain:
FORM: WIOIO0052 2

AQUIFER PROTECTION REGIONAL STAFF REPORT
4. Has the site changed in any way that may affect permit (drainage added, new wells 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;
G. Are the existing application rates (hydraulic or nutrient) still acceptable? ❑ Yes or ❑ No. If 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 well network if
applicable. Indicate the review and compliance boundaries. If No, explain and recommend any changes to the
groundwater monitoring program:
Sr Will seasonal or other restrictions be required for added sites? ❑ Yes ❑ No ❑ NIA If yes, attach list of sites
with restrictions (Certification H?)
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 rnaps you have received from the npplicant to be incorporated
into the permit:
1 0. 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:
11. Were monitoring wells properly constructed and located? ❑ Yes or ❑ No ❑ N/A. 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 tinder SOC; ❑ Currently under 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 mates/conditions in the existing permit, (SOC, JOC, 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 ❑ N/A. If yes, please explain:
FORM: W10100052 3

AQUIFER PROTECTION REGIONAL STAFF REPORT
IF! INJECTION WELL PERMITAPPLICATIONS (Complete these two sections for all systems that use injection
wells, including closed -loop groundwater remedialion effluent injection wells, in situ remediation injection wells, and heat
pump injection wells.)
Description Of We_lliSj_And Facilities -New, Rene►val, And Modification
1. Type of injection system;
❑ Heating/cooling water return flow (5A7)
Closed -loop heat pump system (5QM)
❑ In situ rertmediation (51)
❑ Ciased-loop groundwater remediation effluent injection (5LP Non -Discharge")
❑ Other (Specify:
2. 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/arc the pollution source(s)? Wliat is the distance of the injection welf(s) from the pollution
sources ? ft.
4. What is die minimum distance of proposed injection wells from the property boundary? 35 u>>s][22 to road ft,
5. Quality of drainage at site: ® Good ❑ Adequate ❑ Poor
6. Flooding potential of site: N Low ❑ Moderate ❑ High
7, For groundwater remediation systems, is the proposed and/or existing; groundwater monitoring program
(number of wells, frequency of monitoring, monitoring parameter's, eta.) adegn8te? ❑ Yes ❑ No. Attach
snap of existing monitoring well network if applicable. If No, explain and recommend any changes to the
groundwater monitoring program:
8. Does the snap presented represent the actual site (property lines, wells, surface drainage)? ❑ Yes or ® No. If
no or no map, please attach a sketch of the site. Show property boundaries, buildings, wells, potential
pollution sources, roads, approximate scale, and north arrow.
Injection Well Permit Renewal And Modification On[v:
1 For heat pump systems, are them any abnormalities in heat pump or injection well operation (e.g. turbid water,
failure to assimilate injected fluid, poor heating/cooling)?
❑ Yes ❑ No. If 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, If yes, explain:
3. For renewal or modification of jroundwater remediation vermits of any t )e will
continued/additional/modified in have an adverse impact on migration of the plume or management of
the contamination incident? ❑ Yes ❑ No. If es, explain:
4. Drilling contractor: Name:
FORM: W10100052 4

AQUIFER PROTECTION REGIONAL STAFF REPORT
EIVIRNMIT
Ceitifcation nunibu;
5. Complete and attach Well Construction Data Sheet.
FORM: WIOI00052

AQUIFER PROTECTION REGIONAL STAFF REPORT
V EYAL UATION AND RECOMMENDATIONS
1. Provide any additional narrative regarding your review of the application,:
2. Attach Well Construction Data Sheet- if needed information is available
3. Do you foresee any problems with issuance/renewal ❑fthis permit? ❑ Yes ® No. If yes, please explain
briefly.
4. List any items that you would like APS Central Office to obtain through an additional information request.
Make sure that you provide a reason for each item:
Item 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:
Condition Reason
G. 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
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; ❑
Issue; ❑ Deny. if deny, please state reasons. — -- —
8. Signature of report preparers):
Signature of APS regional supervisor:��_
Date:
ADDITIONAL REGIONAL STAFF REVIEW ITEMS
The six UIC wells wit] be not be rased so may wish to reiterate reVuirements of uneased wells in permit,
FORM; W 10100052

Permit: W10100052 Effective:
SOC: Effective:
County: Transylvania
Region: Asheville
Compliance Inspection Report
Expiration: Owner: Ron Thompson
Expiration: Facility: Ron Thompson SFR
1245 Kentwood Ln
Contact Person: Ron Thompson Title,
Pisgah Forest NC 28768
Phone:
Directions to Facility:
lake Ecusta Rd, south off of hwy. 64, right at light, immediate left on Wilson, proceed then left on Williamson Cris., proceed to Kentwood
yster�Gplasslticationa Chelsea Circle
Primary ORC: CoMfiication: Phone:
Secondary ORC(a):
On -Site Representatirre(s):
Related Permits:
Inspection Date: 0910612007 Entry Time: 10:00 AM Exit Time: 12:30 PM
Primary Inspector: Landon Davidson Phone: [phone]
Secondary Inspector(s):
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: injection Mixed Fluid GSHP We{I System (SQM)
Facility Status: ■ Compliant ❑ Not Compliant
Question Areas:
N Wells
(See attachment summary)
Page: 1

Permit: WI0100052 Owner • Facility: Ron Thompson
Inspection pate: 09/06/2007 Inspection Type: Compliance Evaluation Reason for Vlslt: Routine
Inspectlon Summary:
Site appears to meet requirements for 5QM, No GW-1 for the existing onsite water supply well, Driller was supposed to
submit GW-1 today but has not. Water supply well was constructed properly. Site drainage is very good with no flood
potential. Should probably reiterate 2C requirements in permit if deemed necessary since UiC wells are planned not to be
cased 0.0213(c)(1 )(B). Site sketch in application package is no accurate, see attached. Based on new calculations, 6
wells are required instead of 4 as application states.
Page: 2

Ran Thompson UIC Permit Field Inspection
W10100052
Note house footprint differs from sketch on permit.
�-' Contours are 20ft. intervals.
f�
Garage
BREVAR
l
Ige of douse 2780-ft
a -�
WSW
2800 It
P Feet
0 15 30 60I 80 120
r
t

AQUIFER PROTECTION SECTION
APPLICATION REVIEW REQUEST FORM ,lU ; 2, 7
Date; Au gust M 2007
,
To: ®
Landon Davidson, ARO-APS
❑
David May, WaR04PS.'`
El
Art Barnhardt, FRO-APS
El
Charlie St '[ man, WiRO-AILS
❑
Andrew Pitner, MRO-APS
❑
Sherri Knight, WSRO-APS
❑
jay Zimmerman, RRO-APS
From: Michael Rogers. AFO Unit '
Telephone: t919L5-6166 Fax: t9 ) 71 -0588
E-Afuil: Michael.Ro�ers-a7ncmail.net
A. Permit Number: Wl 0100052
B. Owner: Ron Thompsou
C. Facility/Operation:
2 Proposed ❑ Existing ❑ Facility ❑ Operation
D. App1leation:
L Permit Type: ❑ Animal ❑ SFR-Surface Irrigation❑ Reuse ❑ H-R Infiltration
❑ Recycle ❑ I/E Lagoon ❑ GW Remediation (ND)
0 UIC - (5QM) closed loop mixed fluid geothermal
For Residuals: ❑ Land App. ❑ D&.M ❑ Surface Disposal.
❑ 503 ❑ 503 Exernpt ❑ Animal
2. Project Tyke: ® New ❑ Major Mod. ❑ Minor Mod. ❑ Renewal ❑ Renewal w/ Mod.
E. Comments/Other Information. ❑ I would like to accompany you on a site visit.
N01T.- The reouested days for the submittal of the staff rcpoft_�R) has chaffed. Per the request of
Debra Watts, the re(uested dates for the submittal_ of the SR have been changed to 2 weeks for a VIC
report, and 4 weeks for a 5FR re }part. -
Attached, you will find all information submitted in support of the above -referenced application for your
review, comment, and/or action. Within 14 calendar days, please take the following actions:
`x Return, a Completed APSARR ,Form.
❑ Attach Well Construction Data Sheet,
❑ Attach Attachment B for Certification by the LAPCU.
❑ Issue an Attachment B Certification from the RO.*
Remember that you will be responsible for coordinating site visits and reviews, as well as additional
biformation 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 a•UL1r%u iate Ccntral Office -Aquifer Protection Section contact person
listed above. 0 -
RO-APS Reyieiyer� _ �J _ _ Date: d ?!`V7G— ---
pnu+ o�. �
FORM: APSARR 07/06 Paige 1 of I

T R1
z • `r�� L �
� f- F •mow *` ' �� f r Y r _�. sr ► • - .w�'r !�f -
View of site facing approximately E, NE. WSW to the right located behind
trailer. Garage shown with gray exterior finish was not shown in original
site sketch with application.
Proposed location of six UIC wells. Four wells were
shown on the UIC permit but new calculations suggest
six wells are necessary.

Approximate location of six UIC wells to be
drilled. Water supply well will be
approximately 33 ft., slightly upslope and to
the right of photo.
View of site facing approximately E, NE. WSW to the right located behind
trailer. Edge of house steps shown.

''.
WSW
1�'.
��
• • ; _
Proposed location of 5 UIC wells.
ow
!_ Or
r
• �t
-
�` _
ram_
�
Composite photo facing upslope, toward Kentwood Rd. Note location of water supply well in left of photo behind trailer. Orientation of
photo is opposite previous photos. White line overlay in photo if approximately 33 M

WIOI 00052 - staff rgport email 1 of 2
Subject: WI0100052 - staff report email 1 of 2
From: Landon Davidson <Landon.Davidson [e-mail]>
Date: Fri, 07 Sep 2007 13:55:59 -0400
To: Michael Rogers <Michael.Rogers [e-mail]>
Please find attached all necessary documents for inspection of the new permit. I do not
intend on sending a hard copy via courier unless absolutely necessary. Please call me if
there are any questions or anything missing. As you may know, we are filling in as our
well inspector position is currently vacant. Thanks.
Landon
G. Landon Davidson, P.G.
NCDENR - Division of Water Quality
Aquifer Protection Section
Regional APS Supervisor - Asheville Regional Office
2090 U.S. Hwy. 70
Swannanoa, N.C. 28778
ph.: 928-296-4500
fax: [phone]
email: landon.d,,[e-mail]
web page: http:Ilh2o.enr.state.ne.usla�w Thtml
Landon Davidson <Landon.Davidson{u ncmail.neQ
NC DENR - Asheville Regional Office
Division of Water Quality -Aquifer Protection Section
WI0100052.pdf Content -Type: applicationlpdf
Content -Encoding: base64
WI01011052site.pol' Content -Type: applicationlpdf
Content -Encoding: base64
D00090707.pdf Content -Type: applicationlpdf
Content -Encoding: base64
D00090707-001.pdf Content -Type: applicationlpdf
1 of 2 9/10/2007 10:12 AM

WI0100052 - staff rQport email 1 of 2
Content -Encoding: base64
2 of 2 9/10/2007 10:12 AM

AQUIFER PROTECTION SECTION
APPLICATION REVIEW REQUEST FORM
Date: Aueust 22.2007
To: ® Landon Davidson, ARD APS ❑ David May, WaRQ-APS
❑ Art Barnhardt, FRO-APS ❑ Charlie Stehman, WiRO-APS
❑ Andrew Pitner, MRO-APS ❑ Sherri Knight, WSRO APS
❑ Jay Zimmerman, RRO-APS
From: Michael. Ro)-ers , AFO Unit
Telephone: [phone] Fax: [phone]
Entail. Michael.Rogers avncmail net
A. Permit Number: WI 0100052
B. Owner: Ron Thompson
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
For Residuals: ❑ Land App. ❑ D&M ❑ Surface Disposal
❑ 503 ❑ 503 Exempt ❑ Animal
2. Project Type: ® New ❑ Major Mod. ❑ Minor Mod. ❑ Renewal ❑ Renewal wl Mod.
E. Comments/Other Information: ❑ I would like to accompany you on a site visit.
NOTE: The requested days for the submittal of the staff report (SR) has changed. Per the Muest of
Debra Watts, the requested dates for the submittal of the SR have been changed to 2 weeks for a UIC
report, and 4 weeks for a SFR report.
Attached, you will find all information submitted in support of the above -referenced application for your
review, comment, arid/or action. Within 14 calendar days, please take the following actions,
® Return a Completed APSARR Form,
❑ Attach Well Construction Data Sheet.
❑ Attach Attachment B for Certification by the LAPCU.
❑ Issue an Attachment B Certification from the RO.*
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:
Ate:
FORM: APSARR 07/06 Page l of 1

Michael F. Easley, Governor
Wllljam G. Ross Sr., Secretary
North Carolina Department of Environment and Nature Resources
Coleen H. Sullins Director
Division of Water Quality
August 22, 2007
Ron Thompson
1245 Kentwood Lane
Pisgah Forest, NC 26768
Subject: Aclmowledgement of Application No. WI0100052
Ron Thompson SFR
Injection Mixed fluid GSHP Well System (5QM)
Transylvania
Dear Mr. Thompson:
The Aquifer Protection Section of the Division of Water Quality (Division) acknowledges receipt of your permit
application and supporting materials on August 20, 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
michael,[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
http:llh2o.=.state.ne.ua/d=ments/dwq-omchart_pdf.
PLEASE REFER TO THE ABOVE APPLICATION NUMBER WHEN MAKING INQUIRIES ON THIS
PROTECT.
Sincerely,
for reblr�'Jf�tts
Supervisor
cc: Asheville Regional Office, Aquifer Protection Section
Permit Application File WI0100052
Aquffer Protection Section 1636 Mall Service Center
Intemst www.newatemualltv.oro Location: 2728 Capital Boulevard
An Equal OpportunitylAf rr atire Action Employer- 50% Recyded110% Post Consumer Paper
NYr Carolina
NtUM4
Raleigh. NC 27699-1636 Telephone: [phone]
Raleigh, NC 27604 Fox 1: (919) 71&0598
Fax 2: (918) 715-OM
Customer Service: [phone]