WI0600001_Batenburg_19970620

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-,,.m-aps PinehUrst,'NC 28374
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Barber, Jim
From: Barnhardt, Art
Sent: Thursday, March 10, 2011 8:46 AM
To: Barber, Jim; Shields, Joel
Subject: FW: 5A7/5QM Permits for Fayetteville Region made Inactive
Has anyone ever been to this site? We could do a visit and get the data and update BIMS. Jim, it would be a good thing for you.
to have in your to-do list for a partial day close to home.
From: Smith, Eric
Sent: Thursday, March 10, 2011 8:43 AM
To: Barnhardt, Art
Subject: RE: 5A7/5QM Permits for Fayetteville Region made Inactive
Art:
It's up to you. It may be worth a follow up some time to check the actual status. You're lucky, for some of the regions I am
making up to 20 permits inactive!
-Eric
Eric G. Smith, P.G.
Hydrogeologist
NCDENR
Aquifer Protection Section
Groundwater Protection Unit
1636 Mail Service Center
Raleigh, NC 27699-1636
919-715-6196
919-715-0588 Fax
http'//h2o.enr.state.nc.us/aps/gpu.htm
DISCLAIMER: Per Executive Order No. 150, all a -mails sent to and from this account are subject to the North Carolina Public
Records Law and may be disclosed to third parties.
From: Barnhardt, Art
Sent: Thursday, March 10, 2011 8:40 AM
To: Smith, Eric
Subject: RE: 5A7/5QM Permits for Fayetteville Region made Inactive
As I recall, this, injection well did not function properly. The result was a surface discharge disposal of water. That was a long
time ago. I would imagine the injection well that was permitted is no longer being used for that purpose. Do we need to
determine if abandoned, or converted? -
From: Smith, Eric
Sent: Wednesday, March 09, 2011 3:52 PM
To: Barnhardt, Art
Cc: Slusser, Thomas; Watts, Debra
Subject: 5A7/5QM Permits for Fayetteville Region made Inactive
Art:
1

As you may be aware from Debra's email, there were numerous permits that were listed as "expired" in Ed Hardee's data pull.
My task was to look at the 5A7 and 5QM permits that were listed'as expired and determine the reason for the status.
For nearly all of the permits, -I- could not locate a physical folder nor could I find an electronic file. Therefore in a majority of
cases, my review was only restricted to the Comments Tab in "BIMS. Based on my review of the permits with comments, I
determined that a vast majority of the wells had either been abandoned or converted some time ago. Some of the permits had
no comments listed in BIMS that suggested a change in status. However, since I could not locate a physical folder (and due to
their age), we assumed that these files had been archived. The assumption being that if they had been archived, it was probably
for a reason such as a change in status from active to inactive.
For your region, I have made 1 permit inactive in BIMS. Here is a list of the permits:
Permit
Number ,
Owner Name
Facility Name
Permit Type
Effect Date
Ezpir
Injection Heating/Cooling
WI0600001
Michael Batenburg
Batenburg, Michael - SFR
Water Return Well (5A7)
06/20/97
061
Please let me know if there is any reason that any of the above permits should not have been made inactive. If so, please let me
know and we will determine What actions to take.
Thanks!
-Eric G. Smith
Eric G. Smith, P.G.
Hydrogeologist
NCDENR
Aquifer Protection Section
Groundwater Protection Unit
1636 Mail Service Center
Raleigh, NC 27699-1636
919-715-6196
919-715-0588 Fax
http://h2o.enr.state.nc.us/aps/gpu.htm
DISCLAIMER: Per Executive Order No. 150, all a -mails sent to and from this account are subject to the North Carolina Public
Records Law and may be disclosed to third parties.

W ATF Michael F. Easley, Governor
CEO 9Q William G. Ross Jr., Secretary
�O G North Carolina Department of Environment and Natural Resources
r Alan.W. Klimek, P. E. Director
3bud=i Division of Water Quality
p Y Coleen H. Sullins, Deputy Director
Division of Water Quality
June 24, 2003
Mr. & Mrs. Tucker
1600 Morganton Road, W4
Pinehurst, NC 28374
Dear Mr. & Mrs. Tucker:
The Underground Injection Control (UIC) Program of the North Carolina Division of Water Quality is
responsible for the regulation of irij ection well construction and operation activities within the state of North
Carolina. Our records show`that a geothermal heat pump system with an associated injection well was
constructed and permitted on your property. At this time the UIC Program's database indicates that this
injection well is operating under the name of Michael J. Batenburg. The permit for this injection well has
expired and therefore this well may, be in violation of General Statute §88-870) and other, state regulations.
The UIC Program would like assistance from you in resolving this situation by completing one of the
ID
procedures below.
1.) . If a geothermal heat pump system is operating on your property and you have an injection
well as part of this system, then please complete and sign the enclosed "APPLICATION FOR
PERMIT RENEWAL TO USE A WELL(S). FOR INJECTION WITH A HEAT PUMP SYSTEM" form. After
.the completion of the application please send it to the UIC Program using the address on the
last page of this form.
2.) If an injection well is not operating on your property then please complete and sign the
enclosed "STATUS OF INJECTION WELL SYSTEM" form indicating that an injection well is
not in operation on your property.
The UIC Program is sending this letter in expectation that you respond regardless of whether you currently
Have an injection well as part of your heating and cooling system. Please note, if you do not respond to this
letter an inspection of your property may be forthcoming to determine if an injection well is operating on
your property. If you are unsure whether you have an injection well, then please contact us so we can aid in
determining if an injection well is operating on your property.
If you would like assistance in completing this form, or if you have any questions regarding the UIC Program
or injection well rules, please contact me at [phone] or Evan Kane at [phone].
cc: UIC Files
Enclosures
Best Regards,
m6 A*
Mark Pritzl, Hydrogeological Technician
UIC Program
NCDENR
N. C. Division of Water Quality / Groundwater Section
1636 Mail Service Center Raleigh, N.C. 27699-1636 Customer Service
Phone: [phone] Fax: [phone] Internet: http://gw.ehnr.state.nc.us I-877-623-6748

NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY, GROUNDWATER SECTION
STATUS OF INJECTION WELL SYSTEM
Permit Number:.
Permittee Name: ^e �?C' �a 7���y�c•�1��
Mr Frank Tucker
1600 Morganton Rd Lot W4
Address: Pinehurst, NC 28374-6861
Please check the selection which most closely describes the current status of your injection well.
In addition, please provide the requested information.
1) _ Well is still used for injection activities.
2) Well is not used for injection but is used for water supply or other purposes.
3) _ Injection discontinued and: a) Well temporarily abandoned
b) Well permanently abandoned
c) Well not abandoned
If you checked (2), describe the well use (potable water supply, irrigation, etc), including pumping rate and other
relevant information.
iJf you checked (3)(a) or (3)(b), describe the method used to abandon the injection well. (Include a description of
.;how the well was: sealed and the type of material used to fill the well if permanently abandoned):
Certification: (For well abandonment)
"I hereby certify,' under penalty of law, that I am personally responsible for the proper abandonment of any
injection well as required in Title 15A NCAC 2C .0214 Criteria and Standards Applicable to Injection Wells."
Signature .
Date
Certification: (For information verification)
"I hereby certify, under penalty of law, that I have personally examined and am familiar with the information
submitted in this document, and that to the best of my knowledge the information is true, accurate, and complete."
Signature Date
ver.3/03 'GW/UIC-68

�OF WA TF9P Michael F. Easley, Governor
William G. Ross Jr., Secretary
�1 G North Carolina Department of Environment and Natural Resources
r Alan W. Klimek, P. E. Director
O - Division of Water Quality
Coleen H: Sullins, Deputy Director
Division of Water Quality
July 8, 2003
Mr. and Mrs. Tucker
1600 Morganton Road, Lot W4
Pinehurst, NC 28374-6861
Dear Mr. and Mrs. Tucker:
Your Status of Injection Well System form GW/UIC-68 has been received and reviewed. I have
amended your file to reflect the change of status of your injection well which is no longer in use
for injection purposes. The Groundwater Section appreciates your response to our written
inquiry about the status of your geothermal heat pump system.
If you at any time decide to resume using your well for injection purposes, you will need to
submit an application for injection well use to the Division of Water Quality/Groundwater
Section/UIC Program. Please contact the Division of Water Quality's Groundwater Section at
the address or telephone number printed on this letterhead for an injection well permit
application or a copy of the Well Construction Standards: Criteria and Standards Applicable to
Injection Wells.
If you have any questions regarding injection well rules please contact me at [phone] or
Evan Kane at [phone].
cc: CO-UIC Files
FRO-UIC Files
Sincerely,
mcuvk
-ZF-
Mark Pritzl
Hydrogeological Technician
UIC Program
N DENR
N. C. Division of Water Quality / Groundwater, Section
1636 Mail Service Center Raleigh, N.C. 27699-1636 FIU-18'7�7-623-6748
mer Service
Phone: [phone] Fax: [phone] Internet: http://gw.ehnr.state.nc.us

JUL .0 9 2
DIVISION OF WATER QUALITY
GROUNDWATER SECTION
July 8, 2003
MEMORANDUM:
To: Art Barnhardt, L.G., Regional Groundwater Supervisor
Groundwater Section
Fayetteville Regional Office
From: - Mark Pritzl i9p, [e-mail]
"
Hydrogeological Technician
UIC Group
Groundwater Section
Raleigh Central Office
Re: Change of Status of an Injection Well Type 5A7 to inactive (discontinued
injection), Permit Number WI0600001
Mr. and Mrs. Tucker, Formally Michael J. Batenburg, has changed the status of their 5A7
injection well (open loop geothermal injection) to inactive and is located- in the city of Pinehurst,
Moore County. The Underground Injection Control files and database have been amended to
reflect this change of status. A copy of the submitted Status oflnjection Well System form is
enclosed for your FRO-UIC files. No further regulatory action is necessary. If you have any
questions, please contact me at [phone] or Evan Kane at [phone].
cc: UIC Files
Enclosures

AL
1Y
Register of Deeds
J
flj
Judy D. Martin,, Registrar
Search. Real Estate Index Criteria: Grantor Begins with BATENBURG
Showing Records 1 through 4 (4 records found as of 03/10/2011 11:11:48 AM count again)
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1 126791
741
275
09/17/1990 09/17/1990
DEED
BATENBURG
0 WELLES CHERIE R 0, LOT 22 BL N ROYAL
FRANCES M PURVIS DORNOCH SDH TP
2 99016324 1549 403 09/1011999 09/10/1999 DEED BATENBURG 0 TUCKER C FRANK 0 LOT 4 BL W ROYAL
FRANCES M PURVIS DORNOCH GOLF
VILLAGE M S TP
3 126791 741 275 09/17/1990 09/17/1990 DEED BATENBURG MICHAEL 0 WELLES CHERIE R 0 LOT 22 BL N ROYAL rall
__j DORNOCH SDH TP
4
549 403 / 09/1
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(Page 1 of 3)
09/16/1999
COi1NTY f{c.
$600.00
�&A Real Estate
Excise Tax
SEf -10 J I
MRS. JUr'I' n 4. ADAMS
REGIS T r Y+ DEED-S
Excise Stamps $600.0.0 Recording Time, Book & Page
Drafted by John M. May, Attorney at Law,
No Title Examination
120 Applecross Road
Pinehurst, NC 28374
Brief. Description for Index: Lot 4, Block W, Royal Domoch Golf Village
NORTH CAROLINA GE RAIL WARRANTY DEED
THIS GENERAL WARRANTY DEED made this 30th day of August, 1999, by and
between NUCHAEL J. BATENBURG and wife, TRANCES M. PURVIS BATENBURG
(hereafter "Grantor"), of Princeton, New Jersey, and C. FRANK TUCKER and wife, AGNES
C. TUCKER hereafter- "Grantee"
� )611 Whose address is 2-4 St. Andrews Drive., CCNC,
Pinehurst, NC
WITNESSETH:
The Grantor, for valuable consideration paid by the Grantee, the receipt of which is
hereby acknowledged, has and by these presents does grant, bargain, sell and convey unto the
Grantee; in fee simple, all that certain lot or parcel of land situated- in/near the .Village of
Pinehurst, Mineral Springs Township, Moore County, North Carolina, and more particularly de-
scribed as follows:
BEING all of Lot 4, Block. W, Royal'Dornoch Golf Village according to a corrected map
of Lots 3-10, inc., Block W, recorded in Map Book 7, Page 91, Moore County Registry.
Subject and together with utility easements and restrictive covenants that are enforceable
against the property, if any, and the lien for ad valorem property taxes for the current
year to be prorated at closing.
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(Page 2 of 3) ,
The property hereinabove described was acquired by Grantorby instrument recorded in
Deed Book 532, Page 452, Moore County Registry.
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and
appurtenances thereto belonging to the Grantee in fee simple.
And the Grantor covenants with the Grantee, that Grantor is seized of the premises in
fee simple, has the right to convey the same in fee simple, that title is marketable and free and -
clear of all -encumbrances, and that Grantor will warrant and defend the -title against the lawful
claims of all persons whomsoever except for the exceptions noted herein.
The.designations "Grantor" and "Grantee" as used herein shall include said parties, their
heirs, successors, and assigns, and shall include singular, plural, masculine, feminine or neuter
as required by context.
IN WITNESS WHEREOF, the Grantor has- hereunto set his hand and seal, the day and
year first above written.
STATE OF /I�� COUNTY
if 0
I, Notary Public of the County and State aforesaid, certify that Michael J. Batenburg and
wife, Frances M. Purvis Batenburg, Grantor, personally appeared before me this day and
acknowledged the executio f the foregoing instrument. Witness my hand and official stamp
or seal, this 3 "day of
My commission expires:
Notary Public .
I I JEWALMEM
NnWMX4FX*ZW
MYl80CL31,2QW
NORTH CAROLINA-MOORE
The foregoing certificats(c
to be
By of
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a Notary/Notades Publi
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C:\wp51\deeds\rdgv.W4 2

(Page 3 of 3)
CONSENT OF THE COUNTRY CLUB OF NORTH CAROLINA INC
THE COUNTRY CLUB OF NORTH CAROLINA, INC., hereby gives its written
consent to the foregoing conveyance of Lot 4, Block W, Royal Dornoch Golf Village, from
Michael J. Batenburg and wife, Frances M. Purvis Batenburg, to C., Frahk Tucker and wife,
Agnes C. Tucker, in accordance with the provisions of the Restrictive Covenants recorded in
the Moore County. Registry.
0
THE COUNTRY CLUB OF NORTH CAROLINA, INC. F..
cn W
By. i .,� f� c
John M. May, President
o
0
cm
4
C?1
C:\wp51\deeds\rdgv.R4 3

� . M Register of DeeA
Judy Do Martin, .Registrar
Search Real Estate Index criteria: Grantee Begins with LOWE MARK T
"Showing Records 1 through 1 ( 1 records found as of 03/10/2011 11:06:42 AM count again )
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1 2009018182
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Copyright© 2001 - 2011 Manatron, Inc. All Rights Reserved
J

(Page 1 of 3)
BOOK3662 - PAGE348' FOR REGISTRATION REGISTER OF DEEDS
Judy D. Martin
Moore County NC
December 04, 2009 10:09:28 AM
Book 3662 Page 348-360
FEE: $25.00
NC REVENUE STAMP: MOB
INSTRUMENT # 2009018182
IN5IRIJl1ENT 12009011112
NORTH CAROLINA GENERAL WARRANTY,DEED
STATE OF NORTH CAROLINA
COUNTY OF MOORE
Prepared Without Benefit of Title Search
M Or.K T Low
This instfument prepared by a return to: Charles W. Collini, Aftomey at Law
PIN: 856112779268 Post Office Box 1039
Revenue Stamps: $850.00 Wadesboro; NC 28170
THIS DEED,'Made this (��' of August, 2009, by
C. FRANK TUCKER and wife, AGNES C. TUCKER
hereinafter called the grantor (whether one or more);
MARK T. LOWE and wife, JANET D. LOWE
117 Lennox Drive
Wadesboro, North Carolina 28170
hereinafter called the grantee, (whether one or more);
WITNESSETH, That in consideration of the sum of $10.00 paid to the grantor by the grantee, the receipt of
which is hereby acknowledged, together with other good and valuable considerations, the grantor has
bargained and sold, and by these presents does hereby grant, bargain, sell and convey to the grantee, and his,
her and their heirs, successor and assigns all of their right, title and interest in the following described.land lying
in MOORE COUNTY, NORTH CAROLINA and more. particularly described as follows:
BEING all of Lot 4, Block W, Royal,Dornoch Golf Village according; to a corrected map of lots
3-10, inc., Block W, recorded in Map Book 7, Page 91, Moore County Registry,
Subject and together and with utility easements and restrictive covenants that are enforceable
against the property, if any, and the lien for ad valorem property taxes for the current year to be
prorated at closing.

(Page 2 of 3)
BOOK3662 - PAGE349
For deed reference see Deed Book 1549, Page 403, Moore County Registry:
TO HAVE AND TO HOLD said land and premises, with all the rights and appurtenances thereunto belonging,
or otherwise appertaining to the said grantee, and his, her or their heirs, successors and assigns in fee simple.
And the grantor for himself, herself, and themselves and their heirs, executors and administrators covenant and
agree, and the grantee's heirs, successors and assigns, that the grantor is.seized of said premises in fee and
has the right to convey same in fee simple; that the same are free and clear of encumbrances and that the
grantor does hereby forever warrant and will forever defend,the said title to the same against the -lawful claims
of all persons whomsoever.
Whenever used, the singular shall include the plural, the plural the singular and the use of any genders shall
be applicable to'all genders.
IN TESTIMONY WHEREOF, the said grantor does hereto subscribe his name and affix his seal this the day
and year first above written.
.•.-C� G�k:...lze (SEAL) C' SEAL)'
C. FRANK TUCKER AGNtS C. TUCKER
STATE OF NORT CAROLINA
COUNTY OF = NS00
This is to that certify, C. FRANK TUCKER and wife, AGNES C. TUCKER personally appeared'before me this day and
acknowledged the due execution of the foregoing instrument.
This l _—day of , 2009.
Notary Public A
Printed Name of Notary Public .

(Page 3 of 3)
BOOK3662 - PAGE360
CONSENT OF THE COUNTRY CLUB OF NORTH CAROLINA, INC.
THE COUNTRY CLUB OF NORTH CAROLINA, INC., hereby gives its written
consent to the foregoing conveyance of Lot 4, Block W, Royal Dornoch Golf Village,
from C. Frank Tucker and wife, Agnes C. Tucker to Mark T. Lowe and wife, Janet D.
Lowe, in accordance with the provisions of the, Restrictive Covenants recorded in the
Moore County Registry.
THE COUNTAY CLUB OF NORTH CAROLINA, INC.
By:.
President

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Home > Wadesboro Yellow Pages> General Practice Attorneys > Lowe Mark T Attorneys Office
Lowe Mark T Attorne s Office Attorneys
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Lowe Mark T Attorneys Office, Wadesboro, NCI

Permit 10600001 Version: 1.0 Status: Inactive
Entered By. I alt.scheper
Comment 'UIC Comment: New Owner Dlcontinued Use, Frank Tucker

Afrilfatibn0etafis ; Affiliation Usage A701iations SFiarsd AiltlresslPhone
Honorarium
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FirstName.iM¢hael '`
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Work Phone:�(919),692-9068 E# a
Middle Name:
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Last Name.' tenburg
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Physical Address:
Address Lin.1', 1600 Morganton Rdvk ,
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AddressLine2: `
City P.mehurstq
State. NC '
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Wells' "lnjeclion�P_ermtt: LSER.Comments M&torq 'Inspections ,+Incidents Violation
Enforcements r s r
Detaitg 1 Detads 2 Events Reg Activities Affiliations Reviewers Related Permits,
Permit 0600001 „.�v6rslon: 1.0
„Status: inactnre
Permit Type: Inectlon Heating/Coo ling Water Return Well, (6A7)
PermitClassifcation: ilndividuai,„ ,;
PrimaryRelated Permit:
Program Category i0round Water ;,
Admin Region Fagetteville
Faalily iBatenburg; Michael-3FR
Details County Moore°=
I
Owner. iM haei Batenburg
Dgtails.. , 'ProJectTgpe Renewal -?
Dates . ..
Issued: 06120l1997 - Orig `issued: 041141160
tld 3r s�.r� ni
Effective: 0612011997'; ` Statutory
❑ Nix buhsun ca r €�s IracWng SIIP .„ ,
D New Farm C, Existing Farm! �.. Farm
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a Expire: 0613012002,' „ Inactivei 0310812011
❑lnrroo ,�e Avail. Acres
SOC:
❑ Raintreaker boAce
❑ Olf, 6c �r: v
Last Updated By: enc g.smith -
Last Updated On 3191201A 3 47 PM
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MEMO
To:'
Date:
MGM
Subject:
1/0-P-A-z I k 0(-L-4,-V4 C) cof
S,J) r a
From:
�North Carolina Department of Environment,
A
DEHNR Health, and Natural Resources ® printed on Recycled Paper

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathon 6. Howes, Secretary
A. Preston Howard, Jr., PE., Director
AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
Chemistry Laboratory r--- VE
-4405 Reedy Creek Road rtlai Raleigh, North Carolina 27607-6445 3 a1997,
FAX:, [phone]
DATE: `S 3
FAX TO s �a Kca A I 6—
FAX NUMBER:
RE(3 OFFICE
FROPS:A) E ��Dq/Chemistry Lab lPh.: [phone]
DER OF PAGES INCLUDING THIS SHEET: S
COMMENTS:
Labor&ory Section
4405 Reedy Creek Road. Raleigh. North CarollnC 27607-6445 Telephone [phone] FAX [phone]d1
An Equal Opportunity Affirmative Action Employer 50%recycled/ 10%post-cons mer paper
SO/T0'd Odd 01 ANOiUdOHd-1 ANiSIW3H0 W3Q WOa=l ET:ST L66T-02-AHW

COUNFY
QUAD NO:
MOORE
REPORT TO : CO Regional OIBce
COLI-DCTOR(S) : PAMtVAX1S
DATE: J11597
71ME:
PORPOSE: OHntr
Locmim or Sise:
Destsiplien of.rmnpling point
Sampling Nethed:
Remmkt:
LABORATORY ANAT.YCYc
H01D310 nwL
COD High 340 TnWL
COD Low 313 mlyL
X
Coliferna:hlFFem131616 <I ilcoml
X
Coliferm: MF ToW 31504 <2 il00ml
Toc M811
rubility NTL'
Residue., Suspended 330 mWL
Tcral Suspended solids mWL
pH units
Alkalinity to pH 4.5 mg1L
Alkalinity• to pH 8 3 rrwL
Carhonme mgrL
Bkuberute mWL
Carban diweide mgiL
X
Chloride 2 mWL
Chromium: Ilex 1032 ogrL
Color. TMe 80 c.u.
CyaQe720 nvNL
DIVISION OFOVATER QUAIATY
Cive,k"Ubarnsary Report I Cveand Welev Qaeliry
SAMPLE PRIORITY
1- IRMTINE OEMEROENCY
0GUY OF CUSTODY
ElSAMPLETWE M
BA7ENBIIAC
X
Diu Solids MOD
130
mg,ti
Fhroride 951
mg,L
X
Hardness:laml9W
60•
msyL
Hardnew (noo-curb) 902
mg/L
Phenols 32730
ug1,
SpeciGeCond 95
ublkmrcm2
Sulfate
my7,
Sudfuie 74S
ML
NHAS
ftwL
Owl end Greaoe
mejt.
Silica
tnWL
Boron
Formddehyde
mg1L
1:113 at N 610
<0-01 •
RWL
TKN as N 625
MWL
X
Y02 fYO3 as n 630
<0.01 '
mglL
P: TOW as P 665
mWL
P01
rnglL
AS-Sil-w 463M
ug,'L
AI-Atuminum d6557
uWL
As-Arsenie 46551
ugrL
Ha -Barium 46358
UNL
Co-Calciurn 46552
mgrL
Cd-Cadfum 4059
uWL
X
Cr-Chremium46!60
<25 uWL
X
Cu-Copper 1042
12 iWL
X
Fe- Iron 1015
< 5 0 ugrL
HS- hteroury 71900
uWL
K-Porassium 463SS
mg/L
X
Ms- Magnesiwn 927
4.3 mWL
X
t11n :Manganese 105E
_ 110_usL _._.
Na-Sodium 929
rngr7.
X
lii-Nickel
<10 uWL
X
Pb-Lead 46564
< 10 ugtL
Se -Selenium
uWL
!C
Zn Zinc 46S67
13 ug-L
COMMENTS: "RECEIVED UNPRESERVED; Hardness and Nutrient samples need to preserved with sulfuric acid to pH <2
Lab Mtuntwr
7GO864
Dole Reeeiss:d :
UIjpy7
T)rne Receiwd :
4:33 AM
Receisstd By
lG
Release! By : DS
Dale reporled : 51131W
Orgpnaphosphoms Pesticides
Nihovn Pesticides
i I Acid Herbicides I
Oawline
TGO"APH

North Carolina
GROUNDWATER FIELD/LAB FORM Department of Environment, Health, and Natural Resources
DIVISION OF WATER QUALITY - GROUNDWATER SECTION
County Mo [[6AMPLE TYPE SAMPLE PRIORITY Lab Number 7 O
o/e
'QuadNo a��^f�erial No. ater E] Routine Date Received ime
Lat. 2S ! h t f 3.5 t Long. �4 %�, 31 `oif ❑ Emergency _ _--
ther Recd by:. From: Bus, Co r, Hand el.,Other:�l
Report To: ARO FR - MRO; RRO, WaRO, WiRO,�0 Chain o1 Custody ,
Data Entry By: Ck:
WSRO; Kinston FO, Fed. Trust, <entr ,Other: Date Reported:
8hlpped by: Bus, Courier, Hand Del., Other;,
Purpose:
Collector( s): v L Date S Time, �OQ Baseline, Cornplalnl, am lianc LUST, Pesticide Study; Federal Trust, Other:.
LD T S. lilrcleOS
Owner .6v<-
H4C0b 6 Spec. Cond.9A at 250 C Location or site r
Temp.10 l •�C., Odor izne /Pescription of sampling point e s
ae-
Appearance C e�,i' 50,ng d1 r. ���ffu. � Sampling Method Q f,.10 -- P'- et Sample Interval
FieldAnaiysisBy: - ni51� Pipe Remarks ds �Jk��np.•p10�,;....
Lab Comments:
GW-54 REV. 719E) For Dissolved Analysis - submit filtered sample and write MIS" in block
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COUNTY : MOORE
QUAD NO:
REFORTTO : CO
Regivealofice
COLLEUOR(S) : PAIiHMAKis
DATE: 1JIS 97
11161E:
PURP03E:
Owner:
Localian or Sae:
Dvscriplica of sampling point
Sampling Meshod:
Rema,kr:
LABORATORY ANAT.Vcli_c
DOD 310 cnly'L
COD High 340 rngA.
COD Law 335 mg,L
X
Coliform: MF Fecal 31616 < 1 /100ml
X
Coliform: MF ToW 31504 <1 il00unl
me mg"!
Turbilky N-rI3
Residue., Smpended 530 mgrL
Told Suspended solids MwL
PH units
Alkalinrry m pH 4.1 mN1,
Alkrfinky to pit 8.3 Y%L
Cams. ue nvL
111rarhoraae rnW1.
Carbon dioxide mglL
X
Clemide 2 mglL
Chromium: Hex 1032 U.I,
Color: Tnw a* U.U.
Cymide 720 %.L
DIVISION OF WATI£R QUALITY
Chemistry LaEoealo" Report/Ground Wafer Qaalily
SAMPLB PRfORLTY
aROUTIXE DEMERGL-NCY
❑ MAIN OF CUSTODY
EFF
—1 SAMPLETYFE
SATENBLiRG
X
Din Solids 703C0
130
rnWL
Fluoride 951
mg/t
X
Hardness:lcal900
63e
mglL
Hardness (non<arb) 902
rnWL
Phenols 32730
twL
Specific Cond, 95
u\fho%Wn2
Sulfate
inwL
Sullide7-I5
mg1L
MHAS
rnWL
Oil and Oreame
rnVL
Silica
m8L
Borom
Formaldch3•da
mWL
NH3asN610
<0.01
mgeL
TKN as N 623
rnWL
X
KO2 -IN03 as n 630
<0.01
mS'L
P: Tow as P C65
IFWI.
PO4
mlyL
ASSdvet 46566
uSIL
AI-Alurrinum 46537
U9.1
As -Arsenic 4655 L
UWL
B&-Baium 46559
owl.
Ca -Calcium 46552
-&11
Cd-Cedium 46599
uWL
X
Cr-CMicmium46160
<25 uq'L
X
Cu- Copper 1042
<2.0 v&L
X
Fe- Iran INS
190 ugrL
Hg- \leccuq• 71900
uVL
K-Pola,-tium 46355
m1SIL
X
bfg-\ragrxsium917
4.2 mglL
Y
1�1n•Mhngaaese lOSS '�'"�
86 'r:
Var Sodiwn 929
rng'L
X
Ni Niew
<10 ug.L
X
ft-Lead46564
<10 uWL
SeSelenium
uWL
X
Zn 2iao46567
<10 ugiL
asia,ntavts: ^Ic16C.LIV IP Ll"IM ;SERVED; Hardness and Nutrient samples need to Be preserved with sulfuric geld to pH <2
Lab Number : 7GO865
Dale Rtceivcd :
4/13M
Time Received :
4:35 AM
Received By
3a
Released By • DS
Ootereported: M13.'97
Orpnophwpho" Pesticides
Niuogc: Pesticides
Acid Habecidei
D
I
W
m
I
kD
lD
r
47
ill
O
3
r 1caMMAPn

0
D
Lab Comments:
North Carolina
Department of Environment, Health, and Natural Resources
DIVISION OF WATER QUALITY - GROUNDWATER SECTION
SAMPLE PRIORITY. Lab Number 76 5 '
El Routine . Date Received Time S
❑ Emergency
Rec'd by: From: Bus, CourldCan,d Del.
Other:
Report To: ARO FR MRO, RRO, WARO, WiRO, ❑ Chain of Custody Data Entry By: Ck:
WSRO, Kinston FO, Fed. Trust, entr , Other: Date Reported:
Shipped by: Bus, Courier, Hand Del., Other• Purpose:
Collector(s): 6_.� G '3 Date 7 Time �00 ti. Baseline, Complaint, om Banc ,LUST, Pesticide Study, Federal Trust, Other:
FIELD ANA S Owner "�`«0°�a�
H400 �'�6 �� 6 SlRec• Cond. at 25o C Location or site �i "&gdl
Temp. ro I boC Odor s description of sampling point s
Appearance - G ersi� / S��rt �i Frw�. cFf'�'��. Sampling Method 4teb — P� �►Q Sample Interval
Field Analysis By: �- 6C i�— P� p e Remarks d� s��a�g• pn �o.�"p' baler, s�' ,
GROUNDWATER FIELD/LAB FORM
County 1,1000' SAMPLE TYPE
Quad No a�� r a% r serial No: ® Water
Lat. 3S f t, 13•S Long. - 7qo%l 3 , /O ❑ Sail
❑ Other
LABORATORY ANALYSES
BOD 310 m /I k Dlss ids 70300 m 1 A - Silver 46566 u /I Organochlorine Peslicides
COO High 340 mg/I
Flourlde 9m m I
Al - Aluminum 46557 u /I
OrganophoWhorus Pesticides .
COD Low 335 m /I
Hardness: Total goo
As - Arsenic 46551 .. u N
Nitr en Pesticides,
Collforrn: MF Fecal 31616 if 0ornl
Hardness non-carb sot M44
Ba--,Barium 46558 uqA
Acid Herbicides
Colilorm: MF Total31504 1100ml
Phenol§32730 uall
Ca -Calcium 46552 ma/11
PCB's
TOC 680 mo
SDeCifiC COnd, 95 utylhoslcml
Cd - Cadmium 46559 u
Turbidity 76' NTU
-Sulfate 945 m I
Cr Chromium 46560 uad
Residue., Suspended 53o mg/I
Sulfide 745 moll
Y
Cu - Copper 46562 U94
Fe - Iran 46663
Sernlvolatile Organics
Oil and Grease Mall
Hg - Mercury71900
TPH - Diesel Range
pH 403 unit
K - Potassium 46555
Au.11,
Alkalinity to pH 4.5 410 rngA
M - Magnesium 46654
Alkallnlly to pH 8.3 415 mgrl
Mn - Man anese 46565
Carbonate 445 mg/I
NH as N610 mqA
Na - Sodium 46556 m
Volalile Organics (VOA bottle)
Bicarbonate 44o 'm
TPH - Gasoline Ran e
Carbon dioxide 405 mgll
NO + NO as N 630 MO
Pb - Lead 46564 - u I
TPH - BTEX Gasollrta Range .
Chloride 940 mg/1
P: Total as P 665
Se - Selenium- uall
Chromium: Hex 1032 u /I
Zn - Zinc 46567 u ll
Color: True 8o CU
Cyanide 720 mg/I
GW-54 REV. 7M6. / For Dissolved Analysis - submit littered sample and write "DIS" In black... `l

t
JUN 2 4 1997
FAYETTEVILLE
REG. OFHCE
GROUNDWATER SECTION
June 23; 1997
wu u*: tp11
To: Art Barnhardt
Groundwater Section
Fayetteville Regional Office
From: Marcus Geist
UIC Group
Groundwater Section
Raleigh Central Office
Re: Issuance of injection well permit.
.Permits No. WI0600001 to use a well for the injection of
heat -pump effluent has been issued to Mr. Michael Batenburg; a
copy of the permit is enclosed for your files. If you have any
questions, please contact me at [phone].
__Y
cc: UIC Files
FRO Files
Enclosures
C:\WPDOCS\PERMIT\SNDPERMM.WPD

NORTH CAROLINA h U V
ENVIRONMENTAL MANAGEMENT COMMISSION . JUN
2 1997j
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA FAYE-TTEVILLE
REG. OFFICE
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
PERMISSION IS HEREBY GRANTED TO
Mr. Michael J. Batenburg
FOR THE OPERATION OF AN INJECTION WELL for the purpose of injecting
heat pump effluent. This well is located at 1600 Morganton Road
W4, Pinehurst, North Carolina,in Moore County, and will be operated
in accordance with the application dated Februray 12, 1997, and in.
conformity with the specifications and supporting data submitted,
all of which are filed with the Department of Environment, Health,
and Natural Resources and are considered a part of this permit.
This permit is for Operation 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,. No. W10600001, is a renewal and renumbering of
Permit No. 62-0147-WO-0001, which was issued on March 10, 1992, and
shall be effective, unless revoked, from the date of its issuance
until June 30, 2002, and shall be subject to the conditions and
limitations specified in Parts I through VIII herein. This permit
replaces and shall also supersede Permit No. 62-0147-WO-0001.
Permit issued this the Day of June, 1997.
U
Ted L. Bush, Jr., Assistant Chief -
Groundwater Section
Division of Water Quality
By Authority of the Environmental Management Commission.
Permit No. W10600001

PART I — GENERAL CONDITIONS .
1. The Permittee must comply with all conditions of this permit
and with the standards and criteria specified in Criteria and
Standards.Applicable to Injection Wells (15A NCAC 2C .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 is effective only with respect to the nature,
volume of materials.and rate of injection, as described in
the application and other supporting data.
3. 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.
4. 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 II — PERFORMANCE STANDARDS
1. The injection facility shall be effectively maintained and
.operated at all times so that there is no contamination of
groundwaters which will render them 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 (Division) 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.
Permit No. WI0600001
PAGE 2 OF 5

3. The issuance of this permit shall not relieve the Permittee
of the responsibility for damages to surface or groundwaters
resulting from the operation of this facility.
z
PART III — 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.
PART IV - 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 (see attached diagram).
PART V - MONITORING AND REPORTING REQUIREMENTS
Any monitoring (including groundwater, surface water, or soil
sampling) deemed necessary by the Division of Water Quality
to insure surface and ground water protection, will be
established and an acceptable sampling reporting schedule
shall be followed.
2. The Permittee shall report by telephone, within 48 hours of
the occurrence or first knowledge of the occurrence, to the
Groundwater Section Staff, Regional Office, telephone number
() -, any of the following:
Permit No. W10600001 PAGE 3 OF 5

(A) Any occurrence at the injection facility which
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.
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.
PART VI — PERMIT RENEWAL
The Permittee shall, at least three (3) months prior to the
expiration of this Permit, request an extension.
PART VII — CHANGE OF WELL STATUS
1. The Permittee shall provide written notification within 15
days of any change of status of an injection well. Such a
change would include the discontinued use of a well for
injection. If a well is taken completely out of service
temporarily, the Permittee must install a sanitary seal. If
a well is not to be used for any purpose that well must be
permanently abandoned according to 15A NCAC 2C .0213, 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.
Permit No. W10600001 PAGE 4 OF 5

(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.
(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:
Groundwater Section - UIC Staff
DEHNR - Division of Water Quality
P.O. Box 29578
Raleigh, N.C. 27626-0578
PART VIII - SPECIAL CONDITIONS
NONE
Permit No. W10600001 PAGE 5 OF 5

State of North Carolina
Department of Environment,
Health and Natural Resources, a
Division of Water Quality,.
James B. Hunt, Jr., Govetn6r.
Jonathan B.'Howes, Secretary
A. Preston Howard, Jr., P.E., Dire'cto*r U. H N FZ
GROUNDWATER'SECTION,
June 23, -19 97
Mr: Michael J. B atenburg
1600 Morganton Road, M4
..Pinehurst, NC 28374
De'at'Mr,. Batenburg'.
In accordance withyour,'application'dated February 12, 1997, we
,are forwarding Permit No. WI0600001 for the operation of a
geothermal heat pump :injection well at-1600 Morganton Road ,W4,in
Pinehurst, NC in Moore ,County.. -.A copy of the laboratory test
results'6f water samples collected on April.15, 1-997 is also.
-enclosed.
This permit shall be effective .from,lthe- date of issuance
-.,until.,June 30, 2002, and.shall'be subject to the,conditions and
limitations stated therein, including the requir�ement to notify
this office by telephone,48 hours prior.to initiation of
operation of the facility,.-'
In order to continue uninterrupte'd-l-'egal, 'use' of this well for the
stated purpose, you should submit an application 'to renew the-'
permit three months,prior to its expiration date.
If you have any questions regarding your,permit p1ease feelfree
.to contact -me at (919) - 7-15 _- 6166.
Sincerely,
04
k"
Marcus A. Geist
Underground Injectibn,Control Program
C:\WPDOCS\PERMIT\TRAN5A7.WPD
cc: UIC Files
FRO Files
Enclosures
_Groundwater Section" N 7W 14 Voice 919-733-3221 . FAX [phone]
P.O. Box'29578, Raleigh, North Carolina 27626-0578 %fc An Equal Opport6nity/Affirmative Action Employer,
2728 Capital Blvd — Raleigh, North Carolina 27604 500/6 recycles/ 10% post-co'ns-umer paper

June 4, 1997
MEMORANDUM
To: Mr. Michael J. Batenburg
1600 Morganton Road W4
Pinehurst, NC 28374
From: Marcus Geist tel. (919)
715-6166�
c
Underground Injection Control
Group
NC - DEHNR, Groundwater
Section
Raleigh, NC 27626
Re: Groundwater Sampling Results
from April
15, 199.7
Influent Water Sample
Effluent Water
Sample
Coliform, fecal <1/1OOml
Coliform,
fecal
<1/1OOml
Coliform, total <2/1OOml
Coliform,
total
<1/1OOml
Chloride 2mg/L
Chloride
21iig/L
Total Dissolved Solids 13Omg/L
Total Dissolved
Solids 13Omg/L
Hardness 6Omg/L
Hardness
53mg/L
NO2 + NO3 as N <0. O1mg/L
NO2 + NO3 as ' N
<0. 01mg/L
Chromium, Cr <25ug/L
Chromium,
Cr
<25ug/L
Copper, Cu 12ug/L
Copper, Cu
<2ug/L
Iron, Fe <5Oug/L
Iron, Fe
19Oug/L
'Magnesium, Mg 4.3 mg/L
Magnesium,
Mg
4.2.mg/L
Manganese, Mn 110 ug/L
Manganese,
Mn
85 ug/L
Nickel, Ni <10ug/L
Nickel, Ni
<10ug/L
Lead, Pb <10ug/L
Lead, Pb
<1Oug/L
Zinc,` Zn 13ug/L
Zinc, Zn,
<1Oug/L
C:\WPDOCS\MEMOS\SAMPRESL.WPD

State Groundwater Quality Standards:
Classifications and Water Quality Standards Applicable To The
Groundwaters of North Carolina
(North Carolina Administrative Code Title 15A: 02L.20.0)
Coliform, total 1/100 ml
Chloride 250 mg/L
Total•Dissolved Solids 500 mg/L
NO2 + NO3 as N 1 mg/L
Chromium, Cr 50 ug/L
Copper, Cu 1000 ug/L
Iron, Fe 300 ug/L
Manganese, Mn 50 ug/L
Nickel, Ni 100 ug/L
Lead, Pb 15 ug/L
Zinc, Zn 2100 ug/L
mg/L = milligrams per liter = parts per million
ug/L = micrograms per liter = parts per billion
1000 ug/L = 1 mg/L

April 24, 1997
MEMORANDUM -
To: Marcus Geist, UIC Group, Raleigh Central .Office Groundwater
Through:: Art Barnhardt, FRO. Groundw
4,
.
From: Janet Paith, Hydrogeological'Technician I, FRO Groundwater
Subject: Comments on Routine Sampling/Inspection of Facility
Mr. Michael J. Batenburg .Residence, Moore County
Permit No: WI0600001
Dear Marcus,
On April 15, 1997, you; Beth Madis/FRO WQ, and I observed the .injection well system at the
Batenburg residence. The, household uses the well as a private drinking water source- The
injection well is located in the backyard; southwest -comer behind the,house. Thereis grass and
small shrubs surrounding the concrete, pad of the well.' When the protective' fake rock cover over,
the well is removed, an ID plate with, information is exposed on the concrete slab. At the well
head, one pipe draws the water to the heat pump -in the house and the .other pipe is the return.
Thirty-five percent of, the water is returned to the .well. Sixty-five percent of the water drains into .
a storm water sewer in the backyard- approximately 175ft from the house. There are no- influent
or effluent taps. -on the injection well in which to sample. Therefore, we took water samples from
the utility sirik inside the -house. Then, we sampled the effluent from the hose draining into the
storm water drain in the backyard:
In terms of -surface water, there are ponds in -the NC Country Club golf course about 1500ft away.
The well is near a surface storm -,water drainage area which could present. the potential for
flooding. The septic system is in the front yard greater than 100ft from the well. All other wells
are greater than-300ft away from the injection well. There is no evidence of hazardous waste
treatment ; storage, or disposal facilities nearby. Also, the neighborhood has access to city water.
The Groundwater section has found no reason to deny this permit renewal. Although, water
sample results are pending. If you need any other information, please call meat [phone].

North Carolina Department of Environment, Health", and Natural Resources -
Division of Environmental Management - Groundwater Section .
INJECTION FACILITY INSPECTION -REPORT FORK -.B
O6 0000 /
INJECTION WELL PERMIT NO. WI_ 2 - O ! y 7 - w C7 d Ob 1 DATE
NAME OF OWNER ,'
ADDRESS OF OWNER
'(Stree / road or lot and suddivision, county, 'town)
LOCATION OF INJECTION WELL ( and source - well (s) , i f: applicable`)
(Street/ road or 7ot-aril suddivision , county, town, if different than -owner's address, -p7us description•of location, on site)
Potential pollution source -1b! .yt dr
q(AgG,. Distance, from well _
Potential pollution source Distance from well,
Potential pollution source, Distance•from well
,Minimum distance 'of well from property boundary
.Quality;of drainage at site G Flooding potential of site '
(good;a uate,poor) (high, erate,low)
DRAW SKETCH OF SITE .(Show.pr+operty boundaries, bui7d ngs, wells, potential po77ution sources, roads, approximate
sca 7e, and north arrow.) �V1
A R L 0 1997
DESCRIBE INJECTION SYSTEM (vertical closed loop, uncased borehole or cased water well; separate source well and
injection we77; combination source and injection we77; or other description as ap 77*b7e)
�aGu,f /�✓�� Gc/Ct7-, a,• - Sri (o of uza ,ErCSCG�E�I.T `1

INJECTION FACILITY INSPECTION REPORT -FORM B.(CONTINUED),
WELL CONSTRUCTION
Date constructed 3 : _
Drilling contractor: Name. �jr / Dn Al.
Address
'In% � 5 ro Ai(, 7 7�. .
Registration number '
.Total depth of, well �,g Total
depth of
source well "
(if applicable)-
Inspection point
Measurement
Meets minimum.standards Comments
Yes
No
Casing`
'D'epth
'Diameter.,6
✓
Height- (A.L.S.)
Grout.
Depth
' Screens
Depth (s)
Length,(s)
I.D. Plate..
{�
Static ,water level '
Well yield
Enclosure
Enclosure-floor
V-11
(concreted)
Sampling port
'(labelled)
Water tight pipe entry
.Well enclosure entry
Vent
Functioning 'of heat pump
System (Determine from the owner 'if heat pump functions properly. )
INSPECTOR

DIVISION OF WATER QUALITY
GROUNDWATER SECTION,
March 18, 1997
MEMORANDUM
To: Art Barnhardt
Groundwater Section
Fayetteville Regional Office- MAR � Q 1997' ,
From: Marcus. Ggist- nai�bfia
UIC Group
Groundwater .Section
Raleigh Central Office
Re: Request for routine sampling/inspection of facility with
Injection well Permit No. WI0600001 issued to Mr. Michael J. Batenburg
1. Please review the application and submit any comments to RCO-UIC. Retain the
application for your UIC file.
2. Please inspect the injection well facility to visually determine the integrity of
wellhead construction, the presence and accessibilty of effluent and influent taps, and
other requirements for compliance with the NCAC T15A:02C.0200 standards, using the
enclosed Injection Facility Inspection Report (form B) as .a guide.
3. Please sample .the influent and effluent using the Samplingllnspection Procedure
for Injection Wells as a guide. Complete the enclosed Groundwater Field/Lab Report (form
GW-54).
Please return any application review comments and sample and inspect the
injection well facility by April 8, 1997 (within 3 weeks). (If sampling and inspection
cannot be accomplished by.this date; please inform RCO-UIC promptly.) Send a copy of
the completed Injection Facility Inspection Report (form B) to RCO-UIC and request the
DWQ lab to send a copy of the Groundwater Field/ Lab Report (form GW-54) to RCO-
UIC.
cc: UIC. Files
. .. FRO Files
Enclosures
4
i

`}r7
r
V33
l
y 1
3
' A

` NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT CONMUSSION � 1
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
APPLICATION FOR PERMIT TO C ONSTRUCT AND/OR USE A- WELL FOR INJECTION "I C_ 9d l
WITH A HEAT PUMP SYSTEM
Class 5 Wells.
TO: DIRECTOR, NORTH CAROLINA DIVISION OF WATER QUALITY
DATE: ,19
In accordance with the provisions of Article 7, Chapter87; Article 21, Chapter 143, and regulations pursuant
thereto, APPLICATION is hereby made for a PERMIT to construct and/or use a well or well system as described
below,and in any accompanying data submitted as part of this APPLICATION.
- -Please type or print clearly.' -
A PERMIT APPLICANT G��
Name: . �. 51- % E'4,1,8 K 6—
Address: 16 CL'> e4104 (.4 x. _ i c k/ E! ,D. W
City: P/A/jS Y ✓,4 S7— Zip code: X 4237 Y-
County: /h oy ie_ F
Telephone: (2-0 7 6 9 2.- -ZR
'
B. STATUS OF APPLICANT a� �-
Federal State Private _ r
Public Commercial Other
Native American Lands C. PROPERTY OWNER (if different from applicant) r =_
Name:
Address:
City-:- Zip code:' `
County:
„Telephone:
D. FACILITY (SITE) DATA (Fill out ONLY if the Status of Owner is Federal, State, Public or Commercial)
Name of Business or Facility:
Address:
City: Zip code:
- s -- - County:
eiephone: -
Contact Person:
E. HEATING CONTRACTOR DATA
Name: ro'Wcr_/ CoAlC7CO ,
Address: i/ e9 E. 'O A/W,=C Z Cyz= A v_
City:i u 7V C-,w-A) N65 Zip.code:
County: 114,0 o R_F
Telephone: C2 / D) A> 9'� � - -9 7 -r-
Contact Person -
F. - JNJECTION PROCEDURE (Briefly describe how the in ection-wells) will be,usedj
iP2: = 3 r'% 7-0of E k_
Ai4T i4 S.9 w� s
&i S_ 17 rv, O , 6 o i �` 7 -- tcJ 0 — oe O 1 7�A-T�o FeR -;L. /r19Z
G. WELL USE- . Will the injection well(s) also be used.as the ✓sypply-wells) for either of the following:
(a), ' The injectionloperation? YES ' NO :
(b) Your -personal consumption? YES'' NO
GW-57HP (10/96) Page,' 1' of 4

R 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 constructed for use as an injection well. Provide the
data in (1) through (7) below as PROPOSED construction specifications. Submit
Form GW-1 after construction.
(1) Well Drilling Contractor's Name:
NC Driller Registration number.
(2) Date to be constructed: Approximate depth:
— - — — - - (3)-- `rVell-casing: ---- --_ — -- -
(a) Type: Galvanized steel Black steel Plastic Other(specify) -
(b) Inside diameter. inches; Wall thickness inches or schedule #
(c) Casing depth: From to _ ft. (reference to land surface)
Casing extends above ground inches (must be at least 12 inches)
(4) Cement grout:
(a) Around inner or "primary" casing: From to ft.
(b) Around outer (pit) casing, if present: From to ft.
(5) Screens (if applicable):
(a) Type: Inner diameter. inches
(b) Depth: From to feet below land surface
(6) Gravel (if applicable): From to feet below land surface
(7) N.C. State Regulations (Title 15A NCAC 2C Section .0200) require the permittee to make
provisions for monitoring well head processes. A faucet on both influent (groundwater entering heat
pump) and effluent (water being injected into the well) lines is required. Will there be a faucet on:
(a) the influent line? yes no (b) the effluent line? yes no
NOTE: THE WELL DRILLING CONTRACTOR CAN SUPPLY THE DATA FOR Enim EXISTING OR
PROPOSED WELLS IF THIS INFORMATION IS UNAVAILABLE BY OTHER MEANS.
I. PROPOSED OPERATING DATA _
(a) Injection rate: Average-(daily)--—eallons-perminute (gpm)-
- (b) Injection volume: Average (daily) gallons per day (gpd)
(c) Injection pressure: Average (daily) pounds/square inch'(psi)
(d) Injection temperature: Annual Average degrees F
J. INJECTION FLUID DATA
(1) Fluid source. If underground, from what depth, formation and type of rock/sediment unit will the
fluid be' drawn (e.g., granite, limestone, sand, eic.).
Depth: Formation: Rock/sediment unit:
(a) SOURCE WELL CONSTRUCTION INFORMATION (if different from injection well).
Attach a copy of Form GW-1 (Well Construction Record). If Form GW-1 is not available,
provide the data in part H (1) through (7) of this application form to the best of your knowledge.
(2) Chemical Analysis of Sourc`e'Water: The follo_ wing chemical characteristics MUST accompany this
application:
pH ; .Total hardness ppm (parts per million or mg1l); Iron ppm;
Chloride ppm; Nitrate ppm; Coliform bacteria counts/100m1.
NOTE: Assistance in determining these values may be obtained by contacting (a) your local or county health -
offical, (b) a commercial water -testing laboratory, (c) your well drilling contractor, or (d) the regional
Hydrogeologist, North Carolina Department of Environment, Health, and Natural Resources.
GW-57 HP (10196) Page 2 of 4

K INJECTION -RELATED EQUIPMENT
R ECE0 t
F
1.
Attach a diagram showing the engineering layout of the (1) injection equipment, an ; 11''•
(2) exterior piping/tubing associated with the injection operation. The manufacturer's �roc�ufe, IMJ
detailed, should satisfy (1) above
L. TOPOGRAPHIC MAP
Ats,LlZ c:'y
Attach a scaled topographic map which extends one mile beyond the property boundaries of the
facility and indicates the location of the facility.
M. LOCATION OF WELL(S)
Attach a detailed, scaled map of the site of the facility, showing the location of and distances
between the proposed wells(s) (source wells and -injection wells) and any waste (including hazardous
waste) treatment, storage or disposal facilities; buildings; property boundaries; surface water -bodies;
and any other potential source of groundwater contamination. Additionally, indicate on the map the
direction and distance to existing wells (injection wells, water supply wells, dry wells, abandoned
wells) located within 1,500 feet of the proposed injection well(s). Include with the map a description
of each existing well, incorporating type, construction information, date drilled, and depth. Indicate
on the map at least two nearby reference points such as roads, road intersections, streams, etc., and
identify them by US, NC or SR (county secondary roads) numbers or name. Label all features
clearly. Include a north arrow on the map to indicate orientation.
N. CERTIFICATION
"I hereby certify, under penalty of law, that I have personally examined and am familiar with the
information submitted in this document and all attachments thereto and that, based on my inquiry of
those individuals immediately responsible for obtaining said information, I believe that the information
is true, accurate and complete. I am aware that there are significant penalties, including the possibility
of fines and imprisonment, for submitting false information. I agree to construct; operate, maintain,
repair, and if applicable, abandon the injection well and all related appurtenances in accordance with the
approved specifications and conditions of the Permit."
(Signa o Ow or d Agent)
Please supply a letter signed by the owner
authorizing the above agent, if authorized agent is signer.
O. CONSENT OF PROPERTY OWNER (Owner means any person who holds the fee or other property rights
in the well being constructed: A well is real property and its construction on land rests ownership in the
land owner in the absence of .contrary agreement in writing.)
If the property is owned by someone other than the applicant, the property owner hereby consents to
allow the applicant to construct each injection well as oulined in this application and that it shall be
the responsibility of the applicant to ensure that each injection well conforms to the Well
Construction Standards (Title 15A NCAC 2C .0200)
Name of Property Owner (Print):
Mailing Address:
(Signature of Property Owner if Different
From Applicant)
GW-57 HP (10/96)
Page 3 of 4

Please return the completed Application package to:
UIC Program'
Groundwater Section
North Carolina DEHNR-DWQ
P.O. Box 29578
Raleigh, NC 27626-0578
(Telephone: [phone])
(IW_r,7UD 11NQAN
D..,.._ I _r A -

SAMPLINGF/',INSPECTION'PROCEDURE-FOR INJECTION•WELLS WITH HEAT PUMP SYSTEMS
1. UIC-CO will send the RO a, request for sampling and inspection at a
permitted facility 4 months-prior,to expiration -of the current permit.
Sampling .and Anspection must - be completed 2 - months prior to permit
expiration date. A copy, of'the application for renewal will also be
sent.
2. Call permittee to arrange.appointment
3'. Prepare GW 'field/lab 16ri and GW-'5.4; s electing >the parameters to be
determined. The following parameters are required:
a):: metals (Cu; Cr, Fe., ' Mg, ` Mn, Ni, Pb; .--Zn) ,
b):chloride,
c) - hardness,
d)• total dissolved solids,-"
e) nitrate, and :
f) coliform (total and fecal).
4. Assemble lies and e ment su i IJ�. pp Qu p VL
A. Documentation:
1) application;.. MAR1 2• O 19971
2) field/lab form.GW-54,
3) . field log book,
4) injection well inspection form, and a' jzp,�t
5) - ID tags.
B. Maps and directions
C., Sampling instructions
D. Equipment:
c pH a mperatur_e meter '(.checked in lab) cooler, ice
zip -.lock plastic bags -for sample bottles paper towels
gloves; heavy duty Cake
gloves,,disposable latex_ rubber -bands.
plastic work tray or shallow case.. garbage bags..
03 ampules�(4 `5� ml-4°Q1i�) eye protection-
jp3astclampule: breaker
-containers (new, plastic,: ;pretagged;• 11- 500' ml;
Wc!Ete= l zed ansLpredosed- with_so-drum thjosulphate *"EDTA�at: DEM-lab
S. ,_Sample and inspect infection well facility:
A. Prepare for sampling.
1) Determine..that injection. facility has been. functioning-.' 1, ,
2) Turii on'heat-pump system so that fluid flows through the system,-
3) Locate influent(source)-and effluent• -.taps. (Remove well cover(s)
using gloves and proper lifting procedure..):
B:. Sample-the-influent.-
1) Open the tap, to purge .the. influent line "for 10 minutes:
.2) Put on -new, disposable gloves.
3) Collect a sample of influent .water in a.500 ml bottle and measure
pH and temperature -with meter. Record values on GW-54 form.
Discard sample. -
Collect 6'samples (for routine parameters) according to the
protocol described ih'Table 1 and to the procedure outlined below:
a) Place plastic tray near the -'sampling site.. On the tray place 5
5Wml bottles and' 1 250 ml. bottle:,_ the plastic bag containing
the acid ampules • and`-break'er,•, and 6,,, Zip=lock bags,..
b) .Open predosed 250 ml,;bottle.and qu ckly,.fill,"to .within 1/2 inch
of top with influent water, cap,and shake 'Do not prerinse.

c) With -the influent water, prerinse each of the-5 500 ml bottles; -
holding the bottle.near the base, and"fill the bottle to within
1/2 inch of,top, to allow for adding acid,and mixing,:�.Cap
tightly immediately-
d) Separate metals and hardness bottles for acidifying.
Metals bottle
i)- Open bottle..
ii)' 'Tap liquid in a'HNO3 ampule down into,the.body of the ampule.'
iii) Place plastic breaker over the ampule,•point away,from face.and
from.other persons, and snap the -ampule at the_pre_scored line
by applying steady pressure:
,iv) Pour contents of ampule into the sample.bottle by.upending the
ampule over.the bottle and lightly tapping the bottom of -the
ampule -until the acid is completely dispensed — Dispose of
ampule in plastic garbage bag.
v) Cap bottle tightly; shake.;."
Hardness bottle (Repeat procedure above)'
d).. Dry all bottles -and place in zip -lock bags. Set bottles in
cooler and cover`with.ice. Record collection time-on•GW-54.'
C. Sample the effluent. (Follow the same procedure,'as for the
influent.)
D.' Inspect the well for proper -construction and verify the description
of the operation of the heat pump system and.'complete the inspection
form.
E.' Replace well cover(s).-
6.- Transport the -samples to the DEM or a commercial-laborator
immediately, considering.the-maximum'holding time of 6 hours -for coliform
analysis. on the GW-54 form, request that results be,sent to both-Ro and
UIC-CO. Send inspection report.(form B) to UIC-CO.
7. ,.UIC-CO staff -will issue the renewal permit prior to the ..date Of--,
expiration after reviewing the; sampling results'and;the well- inspection
data and considering'any.comment"s regional staff have submitted following
review of the application.:A copy -of the permit will be sent simultaneously
to the regional office for the files.
Table 1
Parameter
bottle
Preservative
Cool to
Holding -time
- a)Metals',
500ml-.
Add HNO3-to make
YF .0
'72 h
plastic
0.5% solution*
b)Chloride
500ml
None
N
28 d
plastic
c}Hardness
500ml
Add HNO3 to make
N
6.,m
plastic
0.5% solution*
d)Total
Dissolved
500ml
None
Y.
7 d
solids
plastic
e)Nitrate
500ml
None
Y
48-h
plastic
f)coliform
250ml
DEM predoses with
Y
6 h
(Total)
sterile
Na thiosulfate +
(Fecal)
plastic
EDTA
*5ml of 40% HNO 17(one
ampule) in 500ml
sample makes 0.4% solution.
' MARCH 1997

l State of North �Carolina
De artm&t bf Environment
Health and Natural Resources ` •
Fayetteville Regional Office .
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary ED EF. H'mNF:;Z
DIVISION OF WATER QUALITY
February A, 1997
Mr. Michael Batenburg
1600 Morganton Rd., W4
Pinehurst, NC 28374
Re: Renewal of injection well permit for.
heat pump effluent
Pinehurst, NC 28374
.Permit No. 62-0147-'WO-0001
Dear,Mr. Batenburg: ;
This letter is. to acknowledge the receipt Hof the subject new request dated January 18,
1997 and received in the Fayetteville Regional Office on- February 4, 1997..
Please complete the enclosed application and write at the top of the application that this
is a-renewal.:Send the .original and -one copy to the Central -Off ce at the .address shown on the
last page of the application. Once the Central Office processes your permit application, one of
our Fayetteville Regional Office staff will coordinate a time to go out to inspect and sample your
well. Pending approval, the Central Office will ,then reissue your .permit.
If you have any questions or need additional information, please call- me at (910) 486=
1541.
Wachovid Building, Suite 714,.Fayetteville
North Carolina 28301-5043
Voice 910-486-1541
Sincerely,
Beth R: Madis
Hydrogeological Technician.
� FAX [phone]i07
4 C An Equal Opportunity Affirmative Action Employer
60% recycled/10% post -consumer paper

MEMO -
I rel
Date:
Subject:
2-14 /,::-1-7
9
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4;
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ci
1. cv a
or _t
�r
et.
From:
North Carolina Department of Environment,
A*- A Health, and Natural Resources
D E H N F2 ® Printed on Recycled Paper

�Eefiad q. J _)29u rq
q
V - 1600oz9anEon ,=Roac%[j
'c
t J_J tnr_4usst, cJuo tt4 easoLa 28374
January 18, 1997 RECEVVEED
FFB 0 41997,
:State of North Carolina
--bept: of Natural Resources and Community Development
b` 'l 'of of Environmental Management
. - Divis_
512Nor.th Salisbury Street
Raleigh, North -Carolina 1611-7687
Dear Sirs:
I wish to make application for renewal of -PERMIT No. 62-0147-
WO-0001 for the operation and use of a well for the purpose
of injecting heat pump effluent in Moore County. Copy of a
letter dated March 10, 1992 and attachment from Mr. Nick
Noland, Regi-onal .-Supervisor is included -he-rewith for your
ready reference.
Please address future correspondence to me as follows:
M. J. Batenburg
1600 Morganton Road W4
Pinehurst, North Carolina 28374
Phone: [phone].
I shall await your further instructions with regard to my
request for a permit renewal.
..Very truly .yours,
Michael J. Batenburg
MJB;fspb
Encs.

?• d STAR
C ii .0 si
State of North Carolina
Department of Environment, Health, and Natural Resources
Division of Environmental Management
512 North Salisbury Street • Raleigh, North Carolina 27604
James G. Martin, Governor March 10, 1992 George T. Everett, Ph.D.
William W. Cobey, Jr., Secretary Director
Mr. Michael J. Batenburg
Regional Office; 1600 Morganton Road, W4
Pinehurst, NC 28374
Asheville "
704/251-6208
Dear Mr. Batenburg_:
Fayetteville
919/486-1541 In accordance with your application dated February 4,
Mooresville 1992 we are forwarding herewith Permit No. 62-0147-WO-0001 for
704/663-1699 the operation and use of a well for the purpose of injecting
Raleigh heat pump effluent in Moore County.
919/733-2314
This Permit shall be effective from the date of issuance
Washington until March 10, 1997
919/946-6481 and shall be subject to the conditions
and limitations stated therein.
Wilmington
919/3953900 In order to continue uninterrupted legal use of this well
Winston-Salem for the stated purpose, you should make application for permit
919/896-7007 renewal at least 30 days prior to its expiration date.
Sincerely,
Mick Noland
Regional Supervisor
Attachment
cc: UIC Files
FRO Files
P.O. Box 29535, Poleigh, North Carolina 27626-0535 Telephone [phone] / Pollution Prevention Pay,
An Equal Opportunity Affirmative Actinn Employer

9
NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE OPERATION/USE OF A WELL OR WELL SYSTEM FOR INJECTION
In accordance with the provisions of Article 7, Chapter 87;
Article 21, Chapter 143, and other applicable Laws, Rules and
Regulations
PERMISSION IS HEREBY GRANTED TO
Michael J. Batenburg
FOR THE OPERATION AND USE OF AN INJECTION WELL located at 1600
Morganton Road, W4, Pinehurst, North Carolina in Moore County, in
accordance with the application dated February 4, 1992 and in
conformity with the specifications and supporting data submitted,
all of which are filed with the Department of Environment, Health,
and Natural Resources and are considered a part of this Permit.
This Permit is for Operation and Use only, -and does not waive
any provisions of the Water Use Act or any other applicable Laws,
Rules or Regulations. Operation and use of a well or well system
shall be in compliance with Title 15 North Carolina,, Administrative
Code 2C, and any other Laws, Rules and Regulations -,pertaining to
well construction and use. ..
This Permit shall be effective, unless revoked, from the date
of its issuance until March 10, '19:97 and shall_ be -subject to
the specified conditions and limitations set forth in' Parts -I and -
II hereof.
Permit issued this the loth day of
March 1 9 2
Mi�ck Noland
Regional Supervisor
By Authority of the Environmental Management Commission.
PERMIT NO. 62 - 0147 - WO - 0001

PNI
2a JAN Gm
State of North Carolina
Department of Natural Resources & Community Developmen
Division of Environmental Management
512 North Salisbury Street
Raleigh, North Carolina 27611-7687
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