WI0400167_GEO THERMAL_20120518

Beverly-Eaves · Perdue
Governor
rA .·-~•~~-----NCDEHlf~.:
North Carolina Department of __ E_nvir9nr:n.entancl.N.a.turaLResources
Division of-VV~ter~ualii~----
CharlesWakild, P. E.
Director
May 18, 2012
Elon University
100 Campus Drive
Elon, NC 27244
Subject: Notification of Rule Revisions Affecting
Closed-Loop Geothermal .Injection Well Permit Holders
Permit Number: WI0400167
To Whom it May Concern:
Dee Freeman
Secretary
Our records indicate that you currently hold a permit for a closed-loop g~othermal injection well
system. This letter is to inform you that on May 1, 2012, the North Carolina Administrative
Code Title ISA 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 aboye. Please keep in mind that if you abandon
the wells, a record of abandonment must be submitted to the Division of Water" Quality. You
may view the revised rules on our website at http ://portal.ncdenr.org/web/wq/ap s.
If you have any questions regarding your current permit orthe rule revisions, please feel free to_
contact our underground injection control staff at [phone].
Sincerely,
Eric G. Smith, P.G.
Hydro geologist
cc: UIC Permit File
AQUIFER PROTECTION SECTION
1636 Mail Service Center, Raleigh, North Carolina 27699-1636
Location: 512 N. Salisbury St., Raleigh, North Carolina 27604
Phone: [phone] \ FAX: [phone]
Internet: www.ncwaterguality.org
An Equal Opportunity\ Affinnative Action Employer
Nirth Carolina
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North Carolina Department of Environment andfllr�-��es$rrs�? l
Division of Waler Qusi4
Beverly Eevea Perdue Charles Wakild- P. E.
Governor Di►oclor
January 24, 2012
R. A. SIMMONS WELL DRILLING CO., INC, ��� �Rf
60 DRILL RIG DRIVE
BUCHANAN, VA 24O66
subject; Notice of Deficiencies
Missing Injection Well Construction Data
Dear R, A. Simmons Well Drilling Company, lnc.:
Dee Freeman
Secretary
A recent review of our records indicates missing injection well construction data (GW-1 forms)
for wails constructed under the following oermIts:
r WI0300048 Keith and Cathy Pahl SFR
WIO400167 6alton McMichael Dr 50M
WI0SOO172 Main Orange County Courthouse
injection Mixed Fluid GSHP Weil Systern (6QM)
Injection Mlxmd Fluid GSHP Well System (Sam)
t4ction Mixed Fluid GSHP Well System (SQM)
It was required under the specific permit listed above that a cM of the GW-1 records were to
be submitted to the Aquifer Protection Section at the following address,
Aquifer Protection Section - U I C Program
DENR - Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
Within 30 days of the receipt of this letter, you must mail a copy of the completed GW-1
records for each of the referenced permits to the address listed above. You can also choose to
fax a copy to forms to [phone], If you were not the well contractor for the specified
permits, disregard this letter.
If you have not already done so for all of the above permits, please make sure you have
submitted a copy of the GW-1 records to our Information Processing unit listed at the bottom
of the GW-1 form. Failure to do so Is a violation of 15A NCAC 02C 0213(h)(1) and may result
in the assessment of civil penalties in accordance with North Carolina General Statute 87-94.
AOUIFER PROTECTION SECTION
106 Mks] Service Center, Rsla4n, Noah Carolina 2169RA634 One
Ui"tion; 512 N. Salobuey Si., Rraleth, Narm C�rollna 27�O NU� C'ar(7 Da
Prtvne, 919•907.8464 iFA ualN a19 9fl7�498 � 6 ��4 f
IrtlEmCt: ]t".4YaI!`r41,l �•0ro J A?r E091 00porltlnpy IAJd rngve AGfon l:mpioyar
RFr:FTvpn g7—R1-,12 12.47 FROG]- TO- NC DENR P&S P001/008

PW.}nfI
Stephen Smoks A s s%n� :.A*jO 28, Wo9
From: "Stephen Brooks" <s.brooks@simmonsdrilling,00m>
To: <[e-mail]>
Sent: Friday, August 28, 2009 12,08 PM
Subjoct: Injection Well Permit No. W10300048
Mr. Michaal Roger$
Envimnrnantal Specialist
DiNCvis�iontof Water Quaky PIE • 0 I 0 5 0 Q 0 4 V
Dear Mr. Rogers
KA4k OM.a CP+ky PChi stR
Some time sk-f March 19,1099, Richard Simmons Drilling Co., Int. of Virginia, or the Statesville. NC. offKe - Hallmark Drilling Co., was
subcontraOW by Mr. T,m Rust of Sin0ton Heong & Air (aoa Valloydale Rd., Charlotte, NC, 26214) to drill ? welIn far a residential closed•
bap geothermal installation on the WW side of take Nommnd. An air -rotary rig was in"Ily dispatches but found that oondMons dictated mud
drilling to be necessary- That eQuipment was diM101ted and the work campleted by driller Randy Phillips (NIC 02209) from our then
Momsville, NC. Office. That office was later moved to Statesvilie in
2002 and later closed in August of 2007.
To date we have been unable to locate the GbIFW this address though believe a copy would have been mailed to the contractor and DENR
upon paymont for tha work. We have been in eonted with the duller {Mr. Phillips no longer wonrs Tar our companyl. Although Mr. Phil]"
remlla doing the work he does not remerftf the number of bom, lithotegy ate. we feel nocases ry So accurately complete and submit a D1N-I
for this walk. V40 will however continue to sea rce Simmons archival to obtain the lnfo►maWn you request.
1f you have any questions about this m9 for
please call Stephen Brooks at (5401254-2209.
Thank you,
Stephen Brooks
Geothermal Manager
R.A. Simmons Drilling Co.. Inc.
RECEIVED 02-01-' 12 12:47 FROM- TO- VC DENT P&5 F002/008

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North Carolina Department of Environment qr�ft
-gturpi RdsdorZbs
Division of Water Quailtp
Beve4 Eaves Perdue Coleen H, Sullins
Govemor Director
Elm, tlnlvvrsit�
urrald Whilsingtcm - Sr, ► P of Finwxc & Technolkw /�
100C,arnpus U)-ivc +~ 1CD 4OzMG'C
Moo. N.C. 2"244 ul 1 Qq-00 13�
6AW11Cits = . W 18 ,� W ! fol at } ..
Sulject: Acknowledgement of intent to Construct Type SQW Irkjection well System
Permit No. W1 AOO134
336 Uaiwo McMichael V01-c. Elan, K '-"744
Dear Mr. W hirlu+gutn!
Dee Freernar.
Setireiary
On 41;2W2010. the Aquifer Protection Section (APS) rcceived notification of your intent to construct a closed -loop w ter --on v
geothermal injection well system for the operation of a ground -source Meat pump located at the address referenced above. Ail
indivlduel permit is not required for the construction and operation of this type of georhermal injection well system as long 9q the
following conditions are met:
The injection well System contains, oiniy potable wetter,
The Injection weli syete'rl iR constructed in accordance with woil construction mandardts apaviliod in North
Carolina Administrative Code Title 1 SA Section 2C Subchapter ,U213, and
The required notification rom) and associated maps have been completely and accurately submitted.
Failure to comply with all of these conditions constitutes a violation of the North Carol Ma Well COnStruc lion Act arid North Caro Iini
Adrnlnistrarive Code Title 15A Section 2C Subchapter .0211(u)(2). AdditionaJiy, you should contact the Alamtince County Nealtn
Department as they may have additional requirements for this type of system. Noncompliance with applicable state, county, or
municipal rules and rogulatioris may result: in the assessment of civil penalties.
Please contact Mlkrc Rogers at [phone] or MictydelRR to E.s(iicdenrLov if you Have any questions.
Tcw+ stvsstr Sincerely.
0
mCyeh~;� � ana
�upc;r. igtlr'
oc: ►�ynattsn-5alern itegianal Qf�cs • AFS 3�r� ` "r7f
AP5 Caantrat Files . Perrnit No. WltiaUi]1 ;a
.Aluntanre County Health 17ep1.
4wol,cr 8rnnk6 — RA Siriunions Driiiiitl; 6Q DI-01 Rj&DL BUCkklra,t. VA 24066
AQUIFER DR07-F Ttpht SCC•T1()r,
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t1Catlen: 272a s;vvlt?I aouiavam Rala,go.- ✓ onr, �aroim6 27Kd
°none: gty•73:,�231 F.q: Bit •i3.4598; 5ro046 L Iv"41 msr Service,1.BT?423.670
•nrsmel:yrWNr.ncwatet4uaiinr.nm
An Fauar imoOrtsmit- � AtlhrTt(fuvl).AdIoll einrkayet
W
rtl��al'oiiriaNatmially
PFCFTVFD 02-011-r 12 12:47 FROM- TO- NC DENH P8S P003/008

Rb"
North Carolina Department of Environment and NaWai �e arc
Division of Water Quality
Beverly ;Waves Derdue Coleen H. Sullins Dee Freeman
3overnor Director Secretar r
612120 10
Eloll University
Attn- Gerald Athittinatvn, VP Finance & T Wh
FI on, NC 27244 S;1&..%:, rr S I -f � Lj
W I 0µ00 I ---
Subject, Acknowledgement of Intent to ConstructTypc 5QW Injection Well System
Permit No. W104t10t37 -
33ivDalton McMichael Orivc
Dear Mr. whiaington-,
On 6 1!2010, the Aquifer Protection Section (APS) received notifwation of your intent to construct a closed -loop weterIoaty
gt:othermal injection well system for the operation of a ground -source beat pump located at the address referenced above. An
individual permit is no( required far the construction and operation of this type of geothermal injection well system as long as the
following conditions are rust:
The injection well system contains only potable water,
She injection well system is constructed in accordance with well cotlstruction 5whdar6 specixled in North
Carolinas Administrative. Cudc'Titlt 15A Section ?C Sutichupter .0213, and
The required notification fame and assoctated traps have been completely and accurately submitted.
Fail are to comply with aU of these wrid iduns constitutcs a violation of the Nortb Carolina Wei Construction Act and North Carolina
Administrative Code Title i SA Section 2C; Subchapter .0211(u)(2). Additionally, yo'u should contact the Alamarce Counry Health
Department as they may have addttionzl requirements 5ar this type of system- Noneompliancc with applicable state, county, or
municipal rules and regulations may result in the assessment of civil penalties.
Aiease contact Mike Rogers at [phone] or Micbael•Rrofzers i =ncdcnr,ny if you have any questions,
sitscerel y,
(XK� '63'
jor Dehru WVstt'
Supervi."Or
Ex: willston-S3iernRegionalOffice -APS
AP Central Files • Pcrmil Na, W1(14001 7
AJan)mcu County Bcaldi Dept.
K,A. Sitmm usiq 17rtlIing (Steph4n S. 13rvokt) rill Drill itig Ofive,13vohanon. \1A 21006
AUUIFCP. PRa1ECTION SE0TION
163E Mail Servim Cooler. Raiegh. Noah Carolina 77899.10
LUG7iiae: 2726 G-anisa+Bvuisvar6, Raigigh NO& Carolina 276LU
Phone: [phone]a1 t FAX : [phone]e� FP 2: 949115-5446 , Customer Service 1.077.i:23.5746
lrllernat: Www-mcgPleLqualhY.00
One
1�orthCarolina
i,rr �.uuaI (tpponururr : A'71M,We AChQR EmofQyiI
PF!'FTVF1) 1 17:47 FROM —
TO- NC DENR P&S P��41088

ern
North Carolina Department of Environment and Natur'WAisr:nuh n � `: ?�
Division of Water Qua0y
Beverly Eaves Perdue Golosn H. 5ulfins Doe presrnarl
3cvemor olreoto( Gecreiary
lanuary 4. 2011
Gerald Whittington. Sr VP $ubiness Finance & Technology
Elort University
101) Campus Drive
Eiun, NC 27244
Subirctr Acknowledgement of Application No, WI0400167
Elon University
Irkiccdon Mixed Fluid GSHP Well System (SQM)
Alarnammce
Dear Mr. Whittington:
CoI( ir. rp_� ,-S
WL)a L0 r_-Lui d
Time Aquifer Pratection Section of the Division of Water Quality (Division) acknowledtes receipt of your permit appi+t ation and
supgorung materials on 0ctobar 15. 2 010 , This application package has been assigned rite number listed above and will be rtvi 5wcd
by John McCray.
The reviewer will perform a detailed review and contact you.with a request for additional information if necessary, To ensure the
maximum effiioiency in proces4ing permit applications, the Division rcquestss your assistance in providing a timely and complete
response to any additional information requests,
Please he aware that the Division's Regional Office. copied belvw. must provide rccoitlmendations prior to final action by the
D;vision. Please also note at thI% time, pl"t-OSSing Pitt` rttit uppIicationw can take w, lung ea 60 - 90 days after receipt of a complete
uppiiQativn.
If you have any question:;, please contact John McCruy at 919-7) 5.6169, or via e-mail If the reviewer is
unavailable, you may leave a message, and they will respond promptly,
PLEASE REFER TO THE ABOVE APPLICATION NUMBER WHEN MAMNG INQUIRIES (IN THIS PROJECT.
Sincerely.
-for Debra J. Watts
Supervisor
«: Winston-Salem Regional OfFtac. Aquifer Protection Section
KA Simmons Drilling (Stephen S, brooku)
Mcvhw•orks Mochar)ica3 (Andy Swofford)
Permit Appt;cation File WI0400167
Id 1S 1:10u strvip? Gvr o,: Aveof. NoO t:amlpm ?`a"8 ,js Er
t ocbDQJ . Z726 'ui:* bouisvav,. t old0.. Is01 :rimlir,517t,{jd
PncMe i FA}! 1: 94g-716•058b= FAX 2:91rs•716-8,10SO-02. 1,671-3$'-U46
• 4 jJ4, I.- _Fwra,�• t.�drfmarl Y* Aftr, RR ynry4Y:
One NofthCu olina
,1 t atu al4il
RFCFTVF_D 02-01-' 12 12:47 F2011-
TO- NC DENR P&S P005/008

IV
WMER"i
North Carolina Department of Environment
Division of Water ®unlit
Beverly Eaves Fordue Co6een H. Sullins
Govemor Director
January 28, 2011
Eiotw Univeniry
Attn: Ge-ndd Whiminetoe, 5eoior VP Dusimm Finance and Technology
100 Campus Drive
Elon, NC 27244
Ref., hivionce of Injoefion Well Permit W110400167
law d to Eton University
Eton, Aiamance County, North Carolina
Ueax l►lr. Whittitlgiom:
1 T @ � 0 T �
FM es 2011 1V
Natural Resources
r�
r r
Dee Freeman
semtary
Iu w=rdance with the application received art December l 5, 201 a,1 am forwarding permit number W 104001 b7 far
the construction and operation of a vertical closed -loop geathermW mixed-fl-uiA beat pump injed(M Well system,
This permit ab>t1l be effective from the date of Immance until December 31, 2015, and "I be subject to the
conditions and limitations grated d mrin, iwAding the requir+Lment to install wdl identifkaiion toga as
spedfied in Part II.3 andltio submit well construcrlon reeards as specified in Part VII.2. Pe sure to read the
entire permit to encore that you are a► 4T of all compliance requirements of the perEWt.
You will need to w* this office at cleant 48 bom prior to begimxing coasmctino and operation of the injection
well syetm. In order to continue unintwuptvd ftal use of the injection fgci 4 for the stated purpose, you must
subW an application to moew the pownit 120 days prior to its expiration date. This pemnit is .not transfrseble to
any peraoa 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 bave any questions about your permit.
Sbc Ti Knizu Winston-Salem Romonal olficr
W10400167 Pamaait File
Atamance County EAviroair►tentst Health Daps
AOUIFER PROTECTM SECTION
16M M8u Swo Ceftw, R&WO, NDRS Cwdina 27OW1636
LOMM' 2725 Capital aLM*"d, ReWo. NvT CWInG VW4
P"-, 919.133-Mi ! FAX i; J16.716-0M, FAX 2; 919 T19rA461 COMW price: 7 677 u23-87A9
i�aer�et
Best Regards,
John McCray
Envirmtmcaiislecialisl
a�4I�F
TO- NC DENR P&S P006/008
AP Equub OPPP=(" I furmae A00 EmpM
RECEIVED 02-01-'12 12:4rFRM
-

NORTH. CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSIOlt
D,EPARTMEN T OF ENVIRONNEENT AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE CONSTRUCTION AND OPERATION OF A WELL FOR INJECTION
In awcoiduoe with the provisions of Ariiole 7, Chapter 87; Ardelc 21, Chapter 143; sod other applicsble
Laws, Rules, and Regulations
PERMISSION IS HEREBY (}RANTED TO
Elvn University
FOR THE CONSTRUCTION AND OPERATION OF 112 TYPE 5QM INJECTION WELL(S), defined in
Title I SA North Carolina Administrative Code 2C .0209(e)(3)(F), for the purpose of operating a vertieal closed
loop geothermal mixed fluid meat pump system. This system is located at 336 Dalton M.cMiahacl Dr., Elan,
Aletuance County, and will ba constructed and operated its accordance with the application. received December
15, 2010, and in eonfarmity, with the specifications and supporting data sabmittod, all of which arefiled with
the De mment of Eavirominent and Natural Resourm and are considered a part of this permit
This permit is for Consmwdon and Opom ion of an i.njoction well and shall be its compliance with Title 1 SA of
this North CaroHaa Admini ive Code 2C .0100 and .0200 plus any other applicable Laws, Rules, and
Regulations putdaiirw to well ooaetruetiwa and use.
This poratit shall be affective, unless mvoked, from the date of its issuance antil Docembm 31. 2015, and shall
be subject to the speeified conditions and limitations set forth in Pmts I through IX hemof.
Permit iti>mad this the 28th day of January, 2010.
WF
4%
Coleea H. Sullins, Diector
Divisian of Water Quality
By Authority of the Eavirantnemtal Management Commission.
Permit NWIN00167
u+cf5QM
uer.03/2010
Page t of 5
RECEIVED 02-01-'12 12:47 FROM- TO- NO DENR P&5 P0071008

RE: Wt 0500172 Main Orange County Courthouse
R. A. Simmons Drilling Co., Inc. did not do this work.
Possibly-LoopMaster International Inc., Indianapolis, IN.
RECEIVED 0i-01-1 12 12: 4 7 FROM-TO-NC DENR P&S P008/008
Permit Number WI0400167
Program Category
Ground Water
Permit Type
Injection Mixed Fluid GSHP Well System (5QM)
Primary Reviewer
john.mccray
Coastal SW Rule
Permitted Flow
Facmt
FaciUty Name
Dalton McMichael Dr 5QM
Location Address
336 Dalton McMichael Dr
Elon
Owner
Owner Name
Elon University
Dates/Events
27244
Orig Issue
01/28/11
.App Received Draft Initiated
12/15/10
Scheduled
Issuance
Central Files: APS_ SWP_
01/31/11
Permit Tracking Slip
Status
Active
Project Type
New Project
Version
1.00
Permit Classification
Individual
Permit Contact Affiliation
Stephen S. Brooks
60 Drill Rig Dr
Buchanan
Major/Minor
Minor
VA
Region
Winston"'.Salem
County
Alamance
Facility Contact Affiliation
Stephen· Brooks
60 Drill Rig Dr
Buchanan
Owner Type
Non-Government
Owner Afflliatlon
Gerald 0. Whittington
100 Campus Dr
Elon
Public Notice Issue
01/28/11
VA
NC
Effective
01/28/11
24066
24066
27244
Expiration
12/31/1 ·5
_R_e-g_u_la_te_d_A_c_ti_v_it_ie_s _______________ Re auested/Received Events
Heat Pump Injection Region comments on draft requested
Region comments on draft received
Outfall
Waterbody Name Stream Index Number Current Class
01/12/11
01/20/11
Subbasin
HA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue
Governor
Coleen H. Sullins
Director
January 28, 2011
Elon University
Attn: Gerald Whittington, Senior VP BusinessFinance anct Technology
1.00 Campus Drive
Elon, NC 27244
Ref: Issuance oflnjection Well Permit WI0400167
Issued to Elon -University
Elon, Alamance County, North Carolina
Dear M:r .-Whittington:
Dee Freema_n
Secretary
In accordance with the application received on December 15,2010, I am forwarding permit number WI.0400167 for
the construction and operation of a vertical closed-loop geothermal mixed-fluid heat pump injection well system.
This permit shall be effective from the date of issuance until December 31, 2015, and shall be subject to the
conditions and limitations stated therein, including the requirement to install well identification tags as
specified in Part 11.3 and to submit well construction records as specified in Part ·VII.2. Be sure to read the
entire permit to ensure.that you are aware of all compliance requirements of the permit.
You will need to notify this office at least 48 hours prior to beginning construction and operation of the injection
well system. In order to continue uninterrupted legal use of the injection fac~lity 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 ~t [phone] or john.mcc:ray@ncdenLgov if you have any qu~stions about your permit.
cc: Sherri Knight, Winston-Salem Regional Office
Wl0400167 Permit File
Alamance County Environmental Health Dept.
AQUIFER PROTECTION SECTION
1636 Mail Service Center, Raleigh, North Carolina 27699-1636
Location: 2728 Capital Boulevard, Raleigh. North Carolina 27604
Phone: [phone] \FAX 1: 919-715°0588; FAX 2: 919-715-6048 \ Customer Service: 1-877-623-6748
lnte.rnet www.ncwaterguality.org
· An Equ;:i! Opportunity\ _Affirmative Action Employer
Best Regards, -
-,)'/ ·#-··':-.✓:2 7:4·~0: ~ C~-
Joh.n McCray.
Environmental Specialist
Ni~th Carolina
;Natural/11
NORTII cARf>LINA
'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
Elon Univetsity
FOR THE CONSTRUCTION AND OPERATION OF 112 TYPE SQM 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 336 Dalton. M.cMich.ael Dr.~ Elon,
Alamance County, and will be· constructed and operated in accordance with the application received December
15, 2010, and in conformity with the specifications and supporting data submitted, all of which are filed with
the Department of Environment arid Natural Resources and are considered a part of this permit. ·
\
This permit is for Construction and Operation of an injection well and · shall be in compliance with Title 15A of
th ~ North Carolina Administrative Code 2C .0100 ·and .0200 plus ·any other applicable Laws, Rul~s, and
Regulations pertaining to well construction and use.
This permit shall be effective, unless revoked, from. the .date of its issuance until .Dec~ber 31 ·. 2015, and shall
be subject to the specified conditions and limitations set forth in Parts I through IX hereof.
Permit issued ·this the 28th day of January, 2010.
U'\coleen H. Sullins, Director
\\ "Division of Water Quality
By Authority of the Environmental Management Commission.
Permit #WI0400167 UIC/SQM
ver. 03/2010
Page 1 of 5
PART I -WELL CONSTRUCTION GENERAL CONDITIONS
1. The Pennittee 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 \Vell 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 afforded reasonable protection against damage during construction and use.
PART II-WELL CONSTRUCTION SPECIAL CONDITIONS
1.
,., .....
,.,
.J.
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 vVinston-Salem Regional Office Aquifer Protection Section Staff,
telephone number (336""'71-5000.
The location of each of the system manifolds shall be recorded by triangulation from three permanent
features on the site (e.g., building foundation corners) and shown on an updated Site Map. The Permittee
shall retain a copy of this record on site.
One well identification tag per grouping or 'cluster'· of wells shall be permanently affixed to the heating
and cooling unit or other nearby permanently fixed location in accordance with 15A NCAC 2C .0213(g).
PART III --OPERATION AND USE GENERAL CONDITIONS
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 Pennittee, 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 pennit shall not relieve the Permittee of the responsibility of complying with any and
all statutes, rules, regulations, or ordinances, which may be imposed by other local, state, and federal
agencies, which have jurisdiction. Furthermore, the issuance of this permit does not imply that all
regulatory requirements have been met.
Permit #WI0400167 UIC/SQM
ver. 03/2010
Page 2 of 5
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 Pennittee 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 Pennittee of the responsibility for damages to surface or
ground water 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 Pennittee 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
, Pennittee must notify by telephone the Aquifer Protection Section's Underground Injection Control (UIC)
Program Central Office staff, telephone numb~r [phone]. Notification is required so that Division
staff can ·inspect or otherwise review-the injection facility and determine if it is in compliance with permit
conditions. ··
PART VI -INSPECTIONS
1. ~y duly authorized officer,-employee, or representative of the Division of Water Quality may, upon
.presentation.of credentials, enter and irispe9t.any_property,'·preinises, or place cm ·ort~latedto .the _inJection
facility at any ·reas·onable ·time· for the_-purpose-·of detehnining-comp1iance with thi~ ·pef1?.1i( ~ay 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. Division representatives shall· have reasonable access for purpo'ses 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.
Permit #WI0400167 UIC/SQM
ver. 03/2010
Page 3 of 5
PART VII -MONITORING AND REPORTING REQUIREMENTS
1. All required documentation shall be submitted to:
Aquifer Protection Section -UIC Program
DENR-Division of Water Quality
1636 Mail Service Center and
Raleigh, NC 27699-1636
Ph# 919-715-3221
Aquifer Protection Section
Vv'mston-Salen~-Regional Office
585 Vlaughtm\;~ St::-eet
Winston-S,"1.lem. NC 27107-224.l
Ph# 3:,6-.77; -500C
2. A completed Well Construction Record (Fonn GW-1) for each injection well must be submitted to the
Aquifer Protection Section Central Office and the Winstor1-Salem Regional Office within 30 days of
con" ·~tion of well construction. Copies of the GW-1 form(s) shall also be given to the Permittee and
retaL __ J on site to be made available for inspection.
3. A copy of the site map updated with manifold locations required in Part II.2 of this permit shall be
submitted to the Aquifer Protection Section Central Office and the Wins~on-Saiem Regional Office within
30 days of completion of well construction.
4. Any monitoring (including groundwater, surface water, or soil sampling) deemed necessary by the
Division of Water Quality to insure surface and ground water protection will be established and an
acceptable sampling reporting schedule shall be followed.
5. The Pennittee shall report by telephone, within 48 hours of the occurrence or first knowledge of the
occurrence, to the Winston-Sa1~m Regional Office, telephone number (336)7T1 -500G, any of the
following:
(A) Any occurrence atthe injection facility that results in any unusual operating circumstances;
(B) Any failure due to known or unknown reasons that renders the facility incapable of proper
injection operations, such as mechanical or electrical failures;
(C) Any loss of refrigerant in the system, regardless of the origin of the loss;
(D) Any recharging of the refrigerant system.
6. \Vhere the Pennittee becomes aware of an omission of any relevant facts in ~ permit application, or of any
in _ ::reef information submitted in said application or in any report to the Director, the relevant and
correct facts or information shall he promptly submitted to the Director by the Pem1ittee.
7. In the event that the permitted facility fails to perform satisfactorily, the Pennittee shall take such
immediate action as may be required by the Director
PART VIII -PERMIT RENEW AL
In order to continue uninterrupted legal use of the injection facility for the stated purpose, the Pennittee shall
submit an application to renew the permit 120 days prior to its expiration date.
Permit #WI0400167 UIC/SQM
ver. 03/2010
Page 4 of 5
PART IX-CHANGE OF WELL STATUS
1. The Permittee shall provide written notification within 15 days of any change 'of status of an injection
well. Such a change would include the discontinued use of a well for injection. If a well is taken
completely out of service temporarily, the Pennittee must install a sanitary seal. If a well is not to be used
for any purpose, then that well must be permanently abandoned according to ISA NCAC 2C .0213(h)(l).
Notification shall be submitted to the addresses given in Part VII. I of this permit. .
2. When operations have ceased af the facility and a well will no longer be used for any purpose, the
Pennittee shall abandon that injection well in accordance with the procedures specified in 1 SA NCAC 2C
.0214, including but not limited to, the following:
(A)
(B)
(C)
(D)
(E)
(F)
CG)
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.
The entire depth of each well shall be sounded before it is sealed to insure freedom from
obstructions that may interfere with sealing operations.
Each weff shall be thoroughly disinfected, prior to sealing, if the Director determines that failure
fo do so could lead to the contamination of an underground source of drinking water.
Each well shall be completely filled with cement grout, which shall be introduced into the well
through a pipe that·extends to the bottom of the well and is raised as the well is filled.
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.
In those cases when, as a resuit.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.
The_P~ittee. shall submit.a copy of the Well Abandonment Record (FormQW-3.0) as sp~cified
in 15A-NCAC 2C .0213(h)(l}\vithin 30 days ·of completion of a~andonment. ·--Copies shall be
submitted to the addresses given in Part VII. 1 of this permit.
Permit #WI0400167 UIC/SQM
ver. 03/2010
Page 5 of 5
Permit Number WI0400167
Program Category
Ground Water
Permit Type
Injection Mixed Fluid GSHP Well System (5QM)
Primary Reviewer
john .mccray
Coastal SW Rule
Permitted Flow
Facili v
Facility Name
Dalton McMichael Dr 5QM
Location Address
336 Dalton McMichael Dr
Elon
Owne r
Owner Name
Elon University
Dates/~ve nt s
NC 27244
Scheduled
Orig Issue App Received Draft Initiated Issuance
12/15/10
Re a ulated Activities
Heat Pump Injection
Outfall ~'.'JL ...
Central Files: APS_ SWP_
01/24/11
Permit Tracking Slip
Status
In review
Project Type
New Project
Version Permit Classification
Individual
Permit Contact Affiliation
Stephen S. Brooks
60 Drill Rig Dr
Buchanan VA
Major/Minor
Minor
Region
Winston-Salem
County
Alamance
Facility Contact Afflliatlon
Stephen Brooks
60 Drill Rig Dr
Buchanan VA
Owner Type
Non-Government
Owner Affiliation
Gerald 0. Whittington
100 Campus Dr
Elon NC
Public Notice Issue Effective
Re uested/Received Events
Region comments on draft requested
Region comments on draft received
24066
24066
27244
Expiration
01/12/11
01/20/11
Waterbody Name Stream Index Number Current Class Subbasln
Mccray, John
From: Knight, Sherri
Sent: Thursday, January 20, 2011 3:48 PM
To: Mccray, John
Subject: RE: 5QM applications W 10400165 and W 10400167
I just heard back from the driller on the Elon project. The wefts were installed and tested last summer, t don't have an
issue with the change if CO doesn't have any concerns with the product. I assume the chlorine will dissipate over usage
of the system if they use sodium hypochiorite. I assume we approve of both sodium hypochlorite and potassium ortho
& potyphosphate Since they are on the application form.
Sherri Knight, PE
NC DENR Winston-Salem Regional Office
Div€sign of Water Quality, Aquifer Protection Section
585 Waughtown Street
Winston-Salem, NC 27107
Voice: [phone]
FAX: [phone]
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties.
From: Mccray, John
Sent: Thursday, January 20, 2011 1:58 PM
To: Knight, Sherri
Subject: 5QM applications WI0400165 and WI0400167
Ms, Knight,
I was hoping you have an update on these two 5QM applications. Should we proceed with issuing these permits?
Best Regards.
John Mccray
1

Permit Number WI0400167
Program Category
Ground Water
Permit Type
Injection Mixed Fluid GSHP Well System (SQM)
Primary Reviewer
john.mccray
Coastal SW Rule
Permitted Flow
Facilit,
Facility Name
Elon University
Location Address
336 Dalton McMichael Dr
Elon
Owner
Owner Name
Elon College
Dates/Events
NC 27244
I •
Central Files: APS _ SWP_
01/04/11
Permit Tracking Slip
Status
In review
Project Type
New Project
Version Permit Classification
Individual
Permit Contact Affiliation
Stephen S. Brooks
60 Drill Rig Dr
Buchanan VA
Major/Minor
Minor
Region
Winston-Salem
County
Alamance
Facility Contact Affiliation
Owner Type
Non-Government
Owner Affiliation
Gerald 0. Whittington
100 Campus Dr
Elon NC
24066
27244
Orig Issue App Received Draft Initiated
Scheduled
Issuance Public Notice Issue Effective Expiration
12/15/10
Re g ulated Activities
Outfall NlJl.!
Wa_terbody Name Stream Index Number Current Class Subbasin
Permit Number W10400134
Program Category
Ground Water
Permit TNe
Injection W'Xer Only GSHP Well System (50W )
Primary Reviewer ,
michael.rogers
Coastal SW Rule
Permitted Flow
Facility Name
Elon University
Location Address
336 Dalton McMichael Or
Elon NC 2-7244
Owner Name
Elon College
Dates«vents——
Scheduled
orig Issue App Received Draft initiated Issuance
05/06/10 04/27/10
Rey uIated Activities
Heat Pump Injection
Outfall I.61i i
Waterbody Name
Central Files. AP$ SWp
01/04/11
Permit Tracking Slip
Status
Project Type
Active
New Project
Version
Permit Classification
1.00
individual
Permit Contact Affiliation
Stephen Brooks
60 Drill Rig Or
Buchanan
VA 24066
Majorftnor Region
Minor Winston-Salem
County
Alamance
Facility Contact Affiliation
D�ker Type
Non -Government
Owner Affiliation
Gerald G. Whittington
100 Campus Or
Elon NC 27244
Public Notice Issue Effective Expiration
05/06/10 05/06/10
Stream Index Number
Current Class Subbasin

Beverly Eaves Perdue
Governor
Gerald Whittington, Sr
Elon University
100 Campus Drive
Elon, NC 27244
Kia
MCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Coteen H. Sullins
Director
January 4, 2011
VP Business Finance S Technology
Subjects Acknowledgement of Application No. WI0400167
Elon University
Injection Mixed Fluid GSHP Well System (5QM)
Alamance
Dear Mr. Whittington:
Dee Freeman
Secretary
The Aquifer Protection Section of the Division of Water Quality (Division) acknowledges receipt of your permit application and
supporting materials on October 15, 21014. This application package has been assigned the number listed above and will be reviewed
by John McCray.
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 gpplications, 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 John McCray at 919-715-6168, or via e-mail at john.mccray@ncdenr,gov. If the reviewer is
unavailable, you may leave a message, and they will respond promptly.
PLEASE REFER TO THE ABOVE APPLICATION' NUM. BER WHEN IbIAKLNG INQUIRIES ON THIS PROJECT.
Sincerely.
Owfk, AD�OD,­q_
for Debra J. Watts
Supervisor
cc- Winston-Salem Regional Office, Aquifer Protection Section
RA Simmons Drilling (Stephen S. Brooks)
Mechworks Mechanical (Andy Swofford)
Permit Application He WI0400167
AQUIFER PR07F,;'!ON SECTION
1636 Mail Service Center, Raleigh. North Carolina 27699.1636
Location: 2728 Capital SoWevard, Raleigh. North Carolina 27604
Phone' 919.733-3221 t FAK 1. 919-715-0588: FAX [phone] t Customer Service: 1-877.623-6748
Intemer www.ncwaterouelmr.vna
An Equal Qnpertunih { AtF1rmanyF RcNCn Employer
O
NorthCarolina
,17aturally

NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES (NCDENR)
APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WE~L(S) FOR
INJECTION WITH A GEOTHERMAL HEAT PUMP SYSTEM FOR:
TYPE 50 M WELL(S)
____ New Permit Application OR __ X ___ Renewal (check one)
DATE: b Oe.c:.. 20 10
'-{\.) \ 04-CO \ (.Q q...
PERMIT NO ._ WX040Q13 4 _____ (leave blank if NEW permit application)
A. PROPERTY OWNER(S)/APPLICANT(S) ("".')
_.;
~.:,:;:
C:~1
")
1'\
List each Property Owner listed on property deed (if owned by a business or government agency, state name of 2
Tl
entity and a representative w/authority for signature):·_ -~E=L~O~N~UNI __ VE~R~S~IT_Y_._G_E_RAL __ D_
<.J1
✓"c o---i\., WHITTINGTON . SENIOR VP BUSINESS FINANCE AND TECHNOLOGY p-,,n
;?! a":" ....--1.:-·
(1)
-;::::;__ 6'...,_ -..... c:. _.:;.-........ Mailing Address: 100 CAMPUS DRIVE________________ t-,, -:,.:
f"T"I-
City: Elon State:·_NC_. _Zip Code: 27244 County: __ ---=AL-=·=AMAN..c=.==c.c=-c....C-=E'---r.
Home/Office Tele ·No.: ---=3=3:..=6....:::2:....:..7=-8 =-54-=-=3:......c4_____;; _____ --..ac=--ae-=ll:..=N....:...;:o::..:.;. :'------------
EMAIL Address: [e-mail] __ _
(2) Physical Address of Site (if different than above): 336 DAL TON MCMICHAEL DRIVE
City: ELON State: _NC_ Zip Code: 27244 County: ALAMANCE
Home/Office Tele No.: 336 278 5490 Cell No.:
EMAIL Address: _______________ _
B. AUTHORIZED AGENT OF OWNER, IF ANY (if the Permit Applicant does not own the subject property,
attach a letter from the property owner authorizing Agent to install and operate UIC well)
Company Name: ____________________________ _
Contact Person . .:_: ---------------=EMAIL==--"'-A=d=dr=e=s=s: __________ _
Address: _______________________________ _
City: --------~ State: __ Zip Code: ______ County: _______ _
Office Tele No.: Cell No.:
Website Address of Company, if any: ______________ _
C. STATUS OF APPLICANT
Private: X Federal: Commercial:
State: Municipal: __ Native American Lands:
GPU/UIC SQM Well Permit Application (Revised 7/2008) Page 1
D. WELL DRILLER INFORMATION
Company Name: RA SIMMONS DRILLING CO. Inc. WC03588
Well Drilling Contractor's Name: --~B_RE~N~T_T~·~J~O~N=E~S _______________ _
NC Contractor Certification No.: ----"3-"-0-=-34--'-----------------------
Contact Person: STEPHEN S. BROOKS EMAIL Address: S.BROOKS @ SIMMONSDRILLING.COM
Address: 60 DRILL RIG DRIVE ______________________ _
City: BUCHANAN. VA Zip Code: 24066 County: BOTETOURT
Office Tele No.: 540 254 2289 Cell No.: 540 400 4411 ---------------
E. HEAT PUMP CONTRACTOR INFORMATION (if different than driller)
Company Name: MECHWORKS MECHANICAL CONTRACTORS INC.
Contact Person: ANDY SWOFFORD EMAIL Address: ASWOFFORD@ MECHWORKSINC.COM
Address: PO BOX 427 __________________________ _
City: BEAUFORT, NC Zip Code: 28516 County: CARTERET_
Office Tele No.: _336 333 2535 _______ Cell No.: _________ _
F. INJECTION PROCEDURE (briefly describe how the injection well(s) will be used)
G. WELL CONSTRUCTION DATA (Skip to Section H if this is a Permit RENEWAL )
(1) Proposed date to be constructed: __ 4/29/10 _____ Number of borings: __ 112 __ _
Approximate depth of each boring (feet): __ 440 _____ _
(2) Chemical additives to be used in closed-loop system (only those chemicals indicated have been approved):
___ R-22 propylene glycol __ ethanol _)_{__soDIUM HYPOCHLORITE (.5PPM),
POTASSUIM ORTHO & POL YPHOSPATE (l0PPM) other (other additives will need prior approval by
NCDENR before use)
(3) Type of tubing to be used (copper, PVC, etc): _HDPE _____________ _
(4) Well casing. Is the well(s) cased? (check either (a.) YES Q! (b.) NO below)
(a) YES ___ if yes, then provide casing information such as~ (steel, PVC, plastic, etc.), diameter,
depth, and extent of casing appearing above ground: ________________ _
(b) NO X ---
(5) Grout (material surrounding well casing and/or piping):
(a) Grout type: Cement__ Bentonite X Other (specify) ______ _
(b) Grout depth of tubing ( reference to land surface): from __ -440 __ to __ surface __ (feet)
If well has casing, indicate grout depth: from ___ to ____ (feet)
H. INJECTION-RELATED EQUIPMENT
GPU/UIC SQM Well Permit Application (Revised 7/2008) Page 3
. ot
Attach a diagram showing the engineering layout or proposed modification of the injection equipment and exterior
piping/tubing associated with the injection operation. The manufacturer's brochure may provide supplementary
information.
I. LOCATION OF MTLL(S)
Attach two copies of maps showing the following information:
0.) Include a site map (can be drawn) showing: buildings, property lines, surface water bodies, potential sources
of groundwater coniamination and the orientation of and distances between the proposed well(s) and any
existing well(s) or waste disposal facilities such as septic tanks or drain fields located within 1000 feet of the
geothermal heat pump well system. Label all features clearly and include a north arrow.
(2) include s topographic map of the area extending one toile from the property boundaries and
indicate the facility's location and the map name.
J. POTABLE WATER WELL(S)
Are there any potable water well(s) on the subject property or adjacent properties? YES NO
If Yes, than indicate location on attached map(s),
K. CERTIFICATION
Note: This Permit Application must be signed by each person appearing on the recorded legal property deed.
"I hereby certify, under penalty of law, that I have personally examined and azn 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 accordance with the appr(ti edj&L)ecifications and conditions of the Permit."
igrtur f Property Owner/Applicant
QWA4 4 a , W��'rNFm^( Sterne up.
or Type Full Name
Signature of Property Owner/Applicant
Print or Type Full Name
Signature of Authorized Agent, if any
Print or Type Full Name
Please return two copies of the completed Application package to:
LEC'�
North Carolina DENR-DWQAquifer Protection Section
UIC Program
1636 Mail Service Center
GPU1t7MC 5QM Weil Permit Application (Revised 7MOB) Page 4

Slusser, Thomas
From:
Sent:
To:
Subject:
Attachments:
Thomas,
Stephen Brooks [[e-mail]]
Wednesday, December 15, 2010 9:17 AM
Slusser, Thomas
Fw: Elon Geothermal Well Perm it
Di4 701012081604. pdf
The University has asked me to forward this application on to you.
Their concern is bacteria can grow in the installed undergrond
piping since the system will be dormant for quite some time as
the buildings are currently being built.
Call if you have any questions.
Thank you.
Stephen Brooks
Simmons Drilling
540-254-2289
1