WI0100007_GEO THERMAL_20120518

A a
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, P. E.
Governor Director
May 18, 2012
Avery County Board of Education
775 Cranberry Street
Newland, NC 28657
Subject: Notification of Rule Revisions Affecting
Closed -Loop Geothermal L-section Well Permit Holders
Permit Number: V.-10 ; E
To Whom it May Concern:
Dee Freeman
Secretary
Our records indicate that you currently hold a permit for a closed -loop geothermal injection well
system. This letter is to inform you that on May 1, 2012, the North Carolina Administrative
Code Title 15A Section 2C .0200 entitled "Well Construction Standards --- Criteria and
Standards 4pplicable Injection Wells"' were revised. These revisions affect all permits issued
for injection wells including geothermal wells.
This letter is also to inform you that your closed -loop geothermal injection well(s) have become
"Permitted by rule." Therefore, you are no longer required to renew your current permit
and the permit will be valid indefinitely as long as the wells are active and are operated in
accordance with the revised rules referenced above. Please keep in mind that if you abandon
the wells, a record of abandonment must be submitted to the Division of Water Quality. You
may view the revised rules on our website at http:llportal.nedenr.org!web/wc /l ai)s.
If you have any questions regarding your current permit or the rule revisions, please feel free to
contact our underground injection control staff at [phone].
Sincerely,
Eric G. Smith, P.G.
Hydrogeologist
cc: ULC..Permit-File
AQUIFER PROTECTION SECTION
1636 Mail Service Center, Raleigh, North Carolina 27699-1636 One
Lccalon: 512 N. Salisbury Si., Raleigh, Noraii Carolina 276G4 IrTo�rtll ar )t.ina
Phone:: www.n water FAX
919$07=3496
IrrlerneL' www.newaleraualit .ore `
An Equal Dpporiunily l:JgrmaliveAdon Employer

Central Flies: APS— 5WP
10/15110
Permit Number W10100007
Permit Tracking Slip
Program Category
Status Project Type
Ground Water
Active Renewal
Permit Type
Version Permit Classification
Injection Mixed Fluid GSHP Well System (50M)
3.00 Individual
Primary Reviewer
Permit Contact Afflliation
michael.rogers
Danny Clark
Coastal 5W Rule
775 Cranberry St
Newland NC 28657
Permitted Flow
Facility Name Major/Minor Region
Newland Elementary School Minor Asheville
Location Address County
750 Linville 5t Avery
Newland NC 28657 Facility Contact Affiliation
Owner Name Owner Type
Avery County Board Of Educa Non -Government
Owner Affiliation
775 Cranberry St
Newland NC 28657
Scheduled
Qrig Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
10/18/00 08/30/10 09/30/10 09/30/10 08/31/15
Re2wated Activities ReouestedlReceived Events
Heat Pump Injection RO staff report requested 09/09/10
RO staff report received 09/28/10
Gutfall
Waterbody Name Stream Index Number Current Class Subbasin

Central Files: APS— SWP_
10/01 /10
Permit Number M0100007 Permit Tracking Slip
Program Category Status Project Type
Ground Water In review Renewal
Permit Type
Injection Mixed Fluid GSHP Well System (5QM)
Primary Reviewer
michaei.rogers
Coastal SW Rule
Permitted Flow
Version Permit Classification
Individual
Permit Contact Affiliation
Danny Clark
775 Cranberry St
Newland NC 28657
Facilit,
Facility Name MajorlMinor Region
Newland Elementary School Minor Asheville
Location Address County
750 Linville St Avery
Newland NC 28657 Facility Contact Affiliation
Oyiner
Owner Name Owner Type
Avery County Board Of Educa Non -Government
Owner Affiliation
775 Cranberry St
Q��eslE�ents Newland NC 28657
Scheduled
Crig issue App Received Draft Initiated Issuance Public Notice Issue Effective Ex iraVon
117118100 081301117 41�,10 �1
i "1L 11r ^ Activities -I,'R e - ' 7' n►_
Heat Pump injection RO staff repva requested 09/09/10
Ro staff report received 09/2811 fl
Outfall NLIL'
Waterbody Name Stream Index Number Current Class Subbasin

4 & AT
�Am7jr-
NCDEHR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sulllris
Governor Director
September 30. 1-010
Dann., Clark
ANrery County Board of Education
775 Cranberry St,
Newland, NC 28637
Subject: Issuance of Injection Well Permit
Permit No. W10100007
Issued to Avery County Board of
Education
Aven, County
Dear Mr. Clark:
Dee Freeman
Secretary
In accordance with your application received August 30, 2010, I am forwarding Permit No. W10100007
for the continued operation of a vertical closed -loop geothermal mixed -fluid heat pump injection well
system located at the Newland Elementary School, 750 Linville St., Newland, NC 29657. This permit
shall be effective from the date of issuance until August 31, 2015, and shall be subject to the conditions
and limitations stated therein.
Additionally, your UIC system is subject to inspection by the APS and at the time of the inspection must
display a permanently affixed identification plate identifying the presence of closed -loop geothermal
wells. This is in accordance with requirements of I5A NCAC 2C .0213(g) and Part 1,4, of your permit
issued September 30.2010. In the event there are multiple wells with separate clusters, one well
identification tag per 'cluster' of wells should be permanently affixed to the heating and cooling unit or
other nearby permanently fixed location in a clearly visible location.
Also, please pay special attention to Part V.Z. The Permittee shall retain all records of repairs,
pressure tests, maintenance, and other activities needed to maintain normal operating conditions.
These records should be submitted with the application for permit renewal.
In order to continue uninterrupted legal use of this well for the stated purpose, you should submit an
application to renew the permit four months (120 days) prior to its expiration date. As indicated in the
permit, this permit is not transferable to any person without prior notice to, and approval by, the Director
of the Division of Water Quality. If you have any questions regarding your permit or the Undergxound
Injection Control Program please call me at [phone].

Sincerely,
v
Michael Rogers, P.G. (NC & FL)
Envirtmmental Specialist
cc: Landmi Dntiridso r — Asheville Reszioml Office
Central Office File — WI0100007
Avery County Environmental Health Dept.
Attachment(s)

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE OPERATION OF A WELL FOR INIECTION
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
Avery County Board of Education
FOR THE CON TIN UED OPERATION OF TYPE 5QM INJECTION WELLS), defined in Title 15A North
Carolina Administrative Code 2C .0209(e)(3)(F), for the purpose of operating a vertical closed -loop
geothermal -mixed -fluid heat pump system. This system is located at Newland Elementary School, 750 Linville
St., Newland. Avery County, NC 28557 and will be constricted and operated in accordance with the application
received August 30, 2010, and in conformity with the specifications and supporting data submitted, all of which
are filed with the Department of Environment and Natural Resources and are considered a part of this permit.
This permit is for operatiqu of an injection well and shall be in compliance with Title 15A North Carolina
Administrative Code 2C .0100 and .0200, and any other Laws, Rules, and Regulations pertaining to well
construction and use.
This permit shall be effective, unless revoked, from the date of its issuance until Auaugt 3'1, 2015, and shall be
subject to the specified conditions and limitations set forth in Parts I through Yll bereof.
Permit issued this the 30`h day of September 2010.
J�� )_ u
V9civision
___
oleen H, Sullins. Director
of Water Quality
By Authority of the Environmental Management Commission.

PART I — OPERATION AND USE GENERAL CONDITIONS
1. This permit is effective only with respect to the nature, volume of materials and rate of injection, as
described in the application and other supporting data_
2. This permit is not transferable without prior notice to, and approval by, the Director of the Division of
Water Quality (Director). In the event there is a desire for the facility to change ownership, or there is a
name change of the Permittee, a formal permit amendment request must be submitted to the Director;
including any supporting materials as may be appropriate, at least 30 days prior to the date of the change.
3. The issuance of this permit shall not relieve the Permittee of the responsibility of complying with any and
all statutes, rules, regulations. or ordinances, which may be imposed by other local, state, and federal
agencies, which have jurisdiction. Furthermore, the issuance of this permit does not imply that all
regulatory requirements have been met.
-? In the overt that thert• are multiple wells with separate cluster~. on,-- xell identification tang Per 'chistev of
wells shall nr pennanenti at-iixed to the neatinL,. mid eoolina unit oi- other nearDN' permanentiv fixod
locaticm in a clean v v isih]e Iocation accorainc� to ?C .0211 3��,'l.
PART II — PERFORMANCE STANDARDS
1. The injection facility shall be effectively maintained and operated at all times so that there is no
contamination of groundwater that will render it unsatisfactory for normal use. In the event that the
facility fails to perform satisfactorily, including the, creation of nuisance conditions or failure of the
injection zone to adequately assimilate the injected fluid. the Permittee shall take immediate corrective
actions including those actions that may be required by the Division of Water Quality.such as the repair,
modification, or abandonment of the injection facility.
1 The Permittee shall be required to comply with the terms and conditions of this permit even if compliance
requires a reduction or elimination of the permitted activity,
3. The issuance of this permit shall not relieve the Permittee of the responsibility for damages to surface or
groundwater resulting from the operation of this facility,
PART Ill — OPERATIONS AND MAINTENANCE REQUIREMENTS
1. The injection facility shall be properly maintained and operated at all times.
1 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 pen -nit.
W1+) I �„ w' ^ UICI5QM-M.F. Renewal Page 2 of 4
Version 9/2010

PART TV - INSPECTIONS
1. Any duly authorized officer, employee, or representative of the Division of Water Quality may, upon
presentation of credentials, enter and inspect any property, premises, or place on or related to the injection
facility at any reasonable time for the purpose of determining compliance with this permit, may inspect or
copy any records that must be maintained under the terms and conditions of this permit, and may obtain
samples of groundwater, surface water, or injection fluids.
2. Department representatives shall have reasonable access for purposes of inspection, observation. and
sampling associated with injection and any related facilities as provided for in N.C.G.S. 87-90.
3. Provisions shall be made for Collecting any necessary and appropriate samples associated with the
injection facility activities.
PART V — MONITORING AND REPORTING REQUIREMENTS
1. Any monitoring (including groundwater, surface water, or soil sampling) -deemed necessary by the
Division of Water Quality to insure surface and ground water protection, will be established and an
acceptable sampling reporting schedule shall be followed,
1 The Permittee shall retain all records of repairs, pressure tests, maintenance, and other activities
needed to maintain normal operating conditions. These records shall be submitted with the
application for permit renewal.
3. The Permittee shall repot by telephone, within 48 hours of the occurrence or first knowledge of the
occurrence, to the Asheville Regional Office, telephone number [phone], any of the following:
(A) Any occurrence at the injection facility that results in any unusual operating circumstances;
(S) Any failure due to known or unknown reasons that renders the facility incapable of proper
injection operations, such, as mechanical or electrical failures;
4. Where the Permittee becomes aware of an omission of any relevant facts'in a permit application, or of any
incorrect information submitted in said application or in any report to the Director. the relevant and
correct facts or information shall be promptly submitted to the Director by the Permittee.
5. In the event that the permitted facility fails to perform satisfactorily, the Permittee shall take such
immediate action as may be required by the Director.
PART VI — PERNQT RENEWAL
The Permittee shall, at least 120 days prior to the expiration of this permit, request an extension.
W1010 00- M05QM-M.F. Renewal Page 3 of
Version 9/2010

PART V111— 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(h)(1), Well
Construction Standards.
?. When operations have ceased at the facility and a well will no longer be used far any purpose, the
Permittee shall abandon that injection well in accordance with the procedures specified in 15A NCAC 2C
.0214, including but not limited to the following:
(A) All casing and materials may be removed prior to initiation of abandonment procedures if
the Director finds such removal will not be responsible for, or contribute to, the
contamination of an underground source of drinking water.
(B) The entire depth of each well shall be sounded before it is sealed to insure freedom from
obstructions that may interfere with sealing operations-
(C) Each well shall be thoroughly disinfected, prior to sealing, if the Director determines that
failure to d❑ 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 V11 (1) and (2) (G) shall be submitted to:
Aquifer Protection Section-UIC Program
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh. NC 27699-1636
WI,! i i)l y r:UIC/5QM-M.F. Renewal Page 4 of 4
Version 912010

OF WAT
-� OState of North Carolina
G
ll Department of Environment and Natural Resources
j r Division of Water Quality
Aquifer Protection Section
Regional Staff Report
09/2812010
To: Agmifer Protection Section Central Office Application No.: WI0100007
Attn: Michael Rogers Regional Login No.:
From. Jonathan St
Choose = item. Regional Office
I. GENERAL SITE VISIT INFORMATION
1. Was a site visit conducted? ® Yes or ❑ No
a. Date of site visit: 09/281201�
b. Site visit conducted by: Jonathan Stepp
c. Inspection report attached? ® Yes or ❑ No
d. Pcrson contacted: Dann. Clark and their contact information: ($28) 387 - 1580 ext.
e. Driving directions:
:i:. VR-OPCSE,1) a l:CH,ii t I E`y FOR N 11"! '-N Ails, fvlffl)liM iCATBa 114 -CATIONS
1. Fraciirty CWsiticatioii. (Please atradi col pleted r•ul:ing sheer In be attfa6led To, issuy;i t?ci-ioi#
Are cl'tt nr:w I.CBs[nlent i'aGiiiup; l?clf:rluate for the type of?xasfe and disposal s1°�tEtri? ❑ Y es car L] No
IFOG. explaiw.
3. Arc sire c-conditions (soils, depth to water table, etc) consisacji!t lvvith ilia submitted reparU," ❑ Yds ❑ ?�Io
if no, ple-pi.;e vxplaiic
17a 1.i3t.' j pros aiid ziik,. ]nap veprm;:lit the :1�:'�licl} 511e {111�E)j3+.f ' lilies, �ygil3z �iC. l? ❑ 'f GS l NlQ I :'
If i"io, pimie expiaiii'
:+. is The proposed resido ais niancagenaent plan adequate? ❑ Yes ❑ No NIA
lfno, please explairr,
6� Are the proposed application rates hydraulic:, nutrient) rlccel>mblc? ❑ Yes [] 1,4o ❑ NJA
If no, please expiahc
f. ke ,here %iv soback conflicts for proposed tl,mtinent, storage load disposal sites? ❑, Yes or ❑ No
If e<; atlacli a alap showing colifl7C•t areas.
t. is the proposed ur existing grotjudwater monitoring proL-rttm adequaN" ❑ Yes ❑ Nu
iFno, expia.in and rc:c!aiaamend any chanpeti to the .romjrtmiInr nionii,%:r6iF pmgni)n:
9. for rr:fiklwi ds. W 11 scjs n,4 Qs- other r,�cirictimis I)e mgU6.-2,1 n
If YCS* i?1;Ciit7; l5 {i1l4 sll `,i �r f
FORM: APSRSR 04-10
Page 1 of 3

M. EXISTING FACILITIES FOR MODIFICATION AND RENEWAL APPLICATIONS
1. Are there appropriately certified Operators in Charge (ORCs) for the facility? ❑ Yes ❑ No ® NIA
ORC: Certificate #: Backup ORC: Certificate #:
Ali the &i! i�_-n, S} aiiltenance a.nd ❑pera.tion of the Ireatnient fflCilitie3 8detlUetC kV the #V1}e of vaslC and di4ptvo,I
syst-in? ❑ Yes or ❑ No
if;io, plcase explain.
3_ Are ihez !;iu:, t.onditinns (e.g,, qoil3. ropography. dopth to wa?cr cable, tic) ntaiittwr c
assiatiJ;.-M, the H-FLSte' ❑ Yes cal ❑ No
If no, picase explain:
4. Ilas the site changed in any way that may affect the permit (e,g., drainage added, new wells inside the compliance
boundary, new development, etc.)? ❑ Yes or E No
If yes, please explain:
5. is the residuals inmagcment plan adequate? Ej Yes or ❑ No
If ]ic_ plcasc ex,pla i
G, Are tlir_ rates (P.g_ hyrirrlulic; 11[lU ieict ) still Ficcept861e" [] i°os 0;:1 ,� 1,10
ifgic,. ;,le�;tie �xg�ls'sn:
7. Is the existing groundwater monitoring program adequate? ❑ Yes ❑ No Z NIA
If no, explain and recommend any changes to the groundwater monitoring program:
8. Are the iv any se'ibauli f.o,iflicts lix existinL, hvafirlent, storwic: and dkj, ,osai siws'2 ; _� sfes ijr
U uri. mulch n 1110-p shov�iIII', c:01.111icI areas.
9. Is the description of the facilities as written in the existing permit correct? ® Yes or ❑ No
If no, please explain:
10. Were monitoring wells properly constructed and located? ❑ Yes ❑ No ® NIA
If no, please explain;
i 1. Air the rn-.-mit•:ti'iril,ryFelt c.sA •dinate-, r,orrect in S1-YesA
i; r,c.. ;?I.:a:;c ,'nII-,plc;t:o ilie rr.7ilowing, +c l:ri?nd uiblo i I rri
.s���.�toriaitr E,�eli
,Lf.�ti¢�rde
i -- - - •
r r.
r•
•• r n
.
12. 1ias n n;vie-w ofa11 :,cl'r-Inonlioring data been conducied (e.g., ND1vIIF- "-'1 AR, C1ki)' es or ❑ N
1l}eas4: i..miniarizf, any lmaiings itsulling from illiq revicw:
13. Are there any permit changes needed in order to address ongoing BINS violations? ❑ Yes or ® No
If yes, please explain;
14. Check all that apply:
® No compliance issues ❑ Current enforcement action(s) ❑ Currently under JOC
❑ Notice(s) of violation ❑ Currently under SOC ❑ Currently under moratorium
J Please explain and attach any documents that may help clarifyanswerlcomments (i.e., NOV NOD etc,)
15. Have all compliance dates/conditions in the existing permit been satisfied? ❑ Yes ❑ No ® NIA
If no, please explain:
16. Are there any issues related to compliance/enforcement that should be resolved before issuing this permit?
❑ Yes ❑No®N/A
If yes, please explain:
FORM: APSRSR 04-10 Page 2 of 3

: 6
t
AT. REGIONAL OFFICE RECOMMENDATIONS
I. Do you foresee any problems with issuance/renewal of this permit? ❑ Yes or ® No
If yes, please explain:
2. List any items that you would like APS Central Office to obtain through an additional information request:
Item Reason
3. List specific permit conditions recommended to he removed from the permit when issued:
Condition
--771
Reason
4. List specific special conditions or compliance schedules recommended to be included in the permit when issued:
Condition Reason
5. Recommendation: ❑ Hold, pending receipt and review of additional information by regional office
❑ Hold, pending review of draft permit by regional office
❑ Issue upon receipt of needed additional information
Z Issue
❑ Deny (Please state -reasons: }
Signature of report preparers
Signature of APS region supervisor:
Date: at - Lr- 'I-L) 1 L7
V. ADDITIONAL REGIONAL STAFF REVIEW ITEMS
FORM: APSRSR 04-10 Page 3 of 3

Rogers, Michael
From:
Stepp, Jonathan
Sent:
Tuesday, September 28, 2010 4:53 PM
To:
Rogers, Michael
Cc:
Davidson, Landon
Subject:
W10100007
Attachments:
W10100007_newiand_eiem.pdf
Please find the field report attached.
Thanks,
Jonathan
Jonathan Stepp — Jonathan.Stepara�ncdenr.ov
North Carolina Dept. of Environment and Natural Resources
Asheville Regional Office
Division of Water Quality- Aquifer Protection Section
2090 U.S. 70 Highway
Swannanoa, NC 28778
Tel: [phone]
Fax: [phone]
Notice, E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and
therefore may be disclosed to third parties.

Rogers, Michael
From:
Stepp, Jonathan
Seat:
Thursday, September 16, 2010 10:62 AM
To:
Rogers, Michael
Cc:
Davidson, Landon
Subject:
W1 010007 Avery County Newland Elementary School
I plan to take a look at this one, it looks like no one has been on site since 2000.
Jonathan
Jonathan Stepp—Jonathan.5tepp@ncdenr..gov
Forth Carolina Dept- of Environment and Natural Resources
Asheville Regional Office
Division of Water quality - Aquifer Protection Section
2090 U.S. 70 Highway
Swannanoa, IBC 28778
Tel: [phone]
Fax: [phone]
Notice: E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and
therefore may be disclosed to third parties.

le
HCDEHR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly laves Perdue Coleen H, Sullins
Governor Director
September 7, 2010
Danny Clark
Avery County Hoard of Education
775 Cranberry Street
Newland, NC 27657
Subject: Acknowledgement of Application No. WIOI00007
Newland Elementary School
Injection Mixed Fluid GSHP Well System (5QM)
Avery
Dear Mr. Clark:
Dee Freeman
Secretary
The Aquifer Protection Section of the Division of Water Quality (Division) acknowledges receipt of your permit application and
supporting materials on August 30, 2010. This application package has been assigned the number listed above and will be reviewed by
Michael Rogers.
The reviewer will perform a detailed review and contact you with a request for additional information if necessary. To ensure the
maximum efficiency in processing permit applications, the Division requests your assistance in providing a timely and complete
response to any additional information requests;
Please be aware that the Division's Regional Office, copied below, must provide recommendations prior to final action by the
Division. Please also note at this time, processing permit applications can take as long as 60 - 90 days after receipt of a complete
application.
If you have any questions, please contact Michael Rogers at 919-715-6166, or via e-mail at michsel,rogers@ncdenr,gov. If the
reviewer is unavailable, you may leave a message, and they will respond promptly. Also note that the: Division has reorganized. To
review our new organizational chart, go to hur:/'h2o.cnt.state.nc.us/documents/dwQ nrachart,ndf.
PLEASE REFER TO THE ABOVE APPLICATION NUMBER WHEN MAKING INQUIMS ON THIS PROJECT,
Sincerely,
Owf.�,
-for Debra J. Watts
Supervisor
cc: Asheville Regional Office, Aquifer Protection Section
Pemut Application File W10100007
AQUIFER PROTECTION SECTION
1536 Mail Service Center. Raleigh, North Carolina 27699-1636
L=Von, 2728 Capital Boulevard. Raleigh. North Carolina 27604
Phanc 919.733.341 t FAX [phone]. FAX 2 919-7t5-6048'; Customer Service 1-677£23-R48
IMemat www.ncwa[ergualltv•or4
NorthCarolina
An Euual Qppntwmty l Arnrmalive Anti i EmWove

NORTH CA.ROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES (NCDENR)
APPLICATION FOR PERNOT TO CONSTRUCT AND/OR USE A WELL(S) FOR
INJECTION WITH A GEOTHERMAL HEAT PUMP SYSTEM FOR:
TYPE 50M WELL(,S i
New Permit Application OR X Renewal (check one)
DATE: 8 u5 , 20LC
PERMIT NO. U0j QQQQ'`l (leave blank if NEW permit application)
A. PROPERTY OWNER(S)IAPPLICANT(S)
List each Property Owner listed on property deed (if owned by a business or government agency, state name of
entity and a representative wlauthority For signature): I Qer QA0, L."'
(1 ) Mailing Address; 2 e
City: 1` e—uSk azA State: N Zip Code: 4—WiS I County:/4meltta
Home/Office Tele No.: 0 2-5; - 733 - Low 0 Cell No.: L3 Z9 - 3&7 - 1584
EMAIL Address: Aar, aw c lQQ_ k is) ueeL erg k - Ne4
(2) Physical Address of Site (if different than above):
City_ [Vcxzr'" State: 1iC., Zip Code: _ZIB106 77 _County:
Home/Office Tele No.: CeII 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 Address:
Address:
City: State: Zip Code: County
Office Tele No.: CeII No..
Website Address of Company, if any.
C. STATUS OF APPLICANT
RECEIVED 1 DENS 1 �lylli�
Private: Federal: Commercial:
A[�III•r� �r�'�rn
State: —)L Municipal: Native American Lands: AUG 3 4 2010
GPUIMC 5QM Well Permit Applization (Revised 712008) Page 1

D. WELL DRILLER INFORMATION
Company Name:
Well Drilling Contractor's Name:
6 NC Contractor Certification No.:
Contact Person: EMAIL Address:
[[ Address:
City: Zip Code: County:
Office Tele No.: Cell No,:
E. HEAT PU IP CONTRACTOR INFORMATION (if different than driller)
Company Name:
^ Contact Person: EMAIL Address:
Address:
i f l City: Zip Code: County:
Office Tele No.: Cell No.:
F. INJECTION PROCEDURE (brietly 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: Number of borings:
Approximate depth of each boring (feet):
(2) Chemical additives to be used in closed -loop system (only those chemicals indicated have been approved):
R-22 propylene glycol ethanol other {o(her additives will
need prior approval by NCDENR before use)
(3) Type of tubing to be used (copper, PVC, etc):
(4) Well casing. Is the well(s) cased? (check either (a.) YES or (b,) NO below)
(a) YES if yes, then provide casing information such as ire (steel, PVC, plastic, etc.), diameter,
depth, and extent of casing appearing above ground:
(b) NO
(5) Grout (material surrounding well casing and/or piping);
(a) Grout type: Cement Benionite Other (specify)
(b) Grout depth of tubing (reference to land surface): from to (feet)
If well has casing, indicate grout depth: from to (feet)
H. INJECTION -RELATED EQUIPMENT
y Attach a diagram showing the engineering layout or proposed rnodrfication ❑f the injection equipment and exterior
��'+ piping/tubing associated with the injection operation. The manufacturer's brochure tnay provide supplementary
information.
GPUfUIC 5QM Well Permit Application (Revised V7008) Page 2

L LOCATION OF WELL(S)
Attach two copies of maps showing the following information:
(1) Include a site map (can be drawn) showing: buildings, property fines, surface water bodies, potential sources
of groundwater contamination 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 a topographic map of the area extending one mile 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 properlies? YES J_NO
If Yes, than indicate location on attached map(s).
K. CERTIFICATION
Note: This Permit Application must he signed by each person appearing on the recorded legal property deed.
"I herehy certify, under penalty of law, that l 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, l 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."
Signature of Pr erty Owner Applicant
o.n LC' toy
Print or Type 11 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:
North Carolina DENR-DWQ
Aquifer Protection Section
L]IC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone [phone]
AQ*j�oe)�QF/V'91D
0/0
AVG 3 Q �" �P,N
2010
GPUIWC 5QM Well Permit Application (Revised 7/2008) Page 3

State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STATUS OF INJECTION WELL SYSTEM
Permit Number: ice3 j ()_I C,1�)nQfl
Permittee Name:�d_ - 1�704Q8 � F;hx 4 • i 0 ty
Address:
Please check the selection which most closely describes the current status of your injection well system:
1) VWell(s) still used for injection activities, or may be in the future.
2) ❑ Well(s) not used for injection but is/are used for water supply or other purposes.
3) L Injection discontinued and. a) ❑ Well(s) temporarily abandoned
b) ❑ Well(s) permanently abandoned
c) ❑ Well(s) not abandoned
4) ❑ Injection well(s) never constructed
Current Use of Well
If you checked (2). describe the well use (potable water supply, irrigation, monitoring, etc), including pumping rate and other
relevant information.
Well Abandonment
If you checked (3)(a) or (3)(b), describe the method used to abandon the injection well. (Include a description Qfhow the well
was sealed and the 0,pe of material used ta.fall the well if permanently abandoned]:
Permit Rescission:
If you checked (2).(3), or (4) and Aril] not use a well for injection on this site in the future, you should request rescission of the
permit. Do you wish to rescind the permit?
Ll Yes ❑ No
Certification:
T "I hereby certify, under penalty of law, that I have personally examined and am familiarwith the information submitted
in this document, and that to the best of my knowledge the information is true, accurate, and complete."
Signature Date
Revised 5105
QUC ,7 0 ?018 �f'

Ai'A
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor director
August 2. 2010
Avery County Board of Education
775 Cranberry Street
Newland, NC 28657
Subject: Notice of Expiration (NOE)
SQM Geothermal Injection Well
Permit No. WIO100007
Avery County
Dear Avery County Board of Education:
Dee Freeman
Secretary
The Underground Injection Control (EPIC) Program of the North Carolina Division of Water
Quality (DWQ) is entrusted to protect the groundwater quality and resources of the State of
North Carolina, and is responsible for the regulation of injection well construction and operation
activities within the state. Our records indicate that the above -referenced operating permit for
the underground injection well system; which was issued on December 12, 2005, and expires on
December 31, 2010, has not been renewed. If you wisb to keep this permit and operate the
injection well system, the permit must be renewed and issued in your name. Our records do not
indicate that the well system has been plugged and abandoned,
In order to comply with the regulatory requirements listed under North Carolina Administrative
Code (NCAC) Title I6A, Subchapter 2C, Section .0211, you must submit one of the following
forms:
A. Application for Permit (Renewal) to Construct andlor Use a Wells) fior Injection with
Geothermal Near Pump System .for Type 5QM Well(s) if the injection well system on
your property is still active.
B. Status of Injection Well System if the injection well system is inactive or has been
temporarily or permanently abandoned.
If there has been a cbange of ownership of the property, an Injection Well Permit
Name/Ownership Change Form must also be submitted.
AQUIFER PROTECTION SECTION
1636 Mail service Genler, Ralerah. North GOML[na ?T69�4-1636
Loeatlan 2728 Capital 6ouipvar', Rals+al . North Carolina 27604
Phone 91°-733-3721 1 FAX [phone]. FAX 2:919-713-f9NG 1 Gustorrer Servlcd- 1.677-623.674E
lntemet www.n4waieryuaiity.o_rg
An E71�jI Crppo"nny I Af irmarivz xWron Employer
One _
NorthCarolina

If the injection well system is no longer being used for any purpose, it must be permanently
abandoned according to the regulatory requirements listed under NCAC Title 15A, Subchapter
2C, Section .0214. When each well is plugged and abandoned, the well abandonment record
(Form GW-30) must be submitted to our office to certify that the abandonment was properly
conducted. if the injection well system is still active and you wish to renew your permit, the
renewal application must be submitted within 30 calendar days of the receipt of this letter to:
Aquifer Protection Section
Groundwater Protection Unit
VIC Program
1636 Mail Service Center
Raleigh, NC 2 7699-163 6
Failure to submit these forms in a timely manner may result in the assessment of civil penalties
in accordance with North Carolina General Statute 87-94. For your convenience, a renewal
application and a UIC well system status form are attached along with a self-addressed envelope.
The above referenced forms are also available on-line at the DWQ website at
htt ://h2o.enr.statc.nc.usia sl,.�nu/fonns.htm.
Thank you in advance for your cooperation and timely response. If you have any questions,
please call me at [phone].
Sincerely,
Eric G. Smith. P.G.
Hydrogeologist
Attachments
cc: As1w.-Aale 1? egivnul Office APS w/o enclosures
APS Central Files - Permit No. W-1010000 7 wlo enclosures

0 0� VA rFMichael F. Easley, Governor
William G. Ross Jr., Secretary
r North Carolina Department of Enviroament and Natural Resvurres
5 c "44
A1aa W. K]imCk, l'.f?. Director
Division of Water Quality
December 12, 2005
Meg Julian, Principal
Newland Elementary School
750 Linville Street
Newland, NC 28657
Ref: Issuance of Injection Permit WTOIO0007
Newland Elementary School
Dear Ms. Julian:
In accordance with your application submitted on September 15, 2005 we are forwarding Permit Number
WI0100007 for the operation of a vertical closed -loop geothermal mixed -fluid beat pump injection well
system at 750 Linville Street, Newland, North Carolina.
This permit shall be effective from the date of issuance until December 31, 2010 and shall be subject to the
conditions and limitations stated therein. In order to continue uninterrupted legal use of this well for the
stated purpose, you should submit an application to renew the permit 120 days prior to its expiration date. As
indicated in the permit, this permit is not transferable to any person without prior notice to, and approval by,
the Director of the Division of Water Quality.
Please read the permit carefully to be sure you understand all its conditions. Please contact me at 919-715-
6166 or Evan Kane at 919-715-6182 if you have any questions regarding this letter or the Underground
Injection Control (UIC) Program.
Best Regards,
Thomas Slusser
Hydrogeological Technician 11
UIC Program
cc: Landon Davidson, Asheville Regional Office
CO-UIC Files
1��"[1hCamlina
Natm ily
Aquifer Prowction Section 1636Mail Service Center Raleigh, NC 27699-1636
twernet: hltp:llh2o.enr.state.nc.us 2728 Capital Boulevard Raleigh, NC 27604
An Equal OpporlunitylAffirmative Action Employer— 5t7,ffi Recycled110% Post Consumer paper
Phone [phone] Caslomer Service
Fax [phone]B i-877.623-6748
Fax [phone]M

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE OPERATION OF A WELL FOR INJECTION
In accordance with the provisions of Article 7, Chapter 87; Article 21, Chapter 143, and
other applicable Laws, Rules, and Regulations
PERMISSION IS HERESY GRANTED TO
AVERY COUNTY BOARD OF EDUCATION
FOR THE OPERATION OF A TYPE 5QM INJECTION WELL SYSTEM, 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 Newland
Elementary School: 750 Linville Street in Newland, Avery County, North Carolina, and will be
operated in accordance with the application submitted September 15, 2005 and in conformity with
the specifications and supporting data submitted, all of which are filed with the Department of
Environment and Natural Resources and are considered a part of this permit.
This permit is for Operation 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 anyother
Laws, Rules, and Regulations pertaining to well construction and use.
This permit shall be effective, unless revoked, from the date of its issuance until December 31, 2010
and shall be subject to the specified conditions and limitations set forth in Parts I throughN 6 hereof.
Permit issued this the 0day of 4af— , 2005.
*N� Ian W. Klimek, Director
Division of Water Quality
By Authority of the Environmental Management Commission.
Permit No. W10140047 PAGE l OF 4
GW/U1.C-5 ver. 11/44

1. The injection facility shall be effectively maintained and operated at all times so that there is
no contamination of groundwater which will render it unsatisfactory for normal use. In the
event that the facility fails to perform satisfactorily, including the creation of nuisance
conditions or failure of the injection zone to adequately assimilate the injected fluid, the
Permittee shall take immediate corrective actions including those actions that may be required
by the Division of Water Quality such as the repair, modification, or abandonment of the
injection facility.
2. The Permittee shall be required to comply with the terms and conditions ofthis permit even if
compliance requires a reduction or elimination of the permitted activity.
3. The issuance o fthis permit shall not relieve the Permittee of the responsibility for damages to
surface or groundwater resulting from the operation of this facility.
PART II - 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 III - INSPECTIONS
1. Any duly authorized officer, employee, or representative of the Division of Water Qualitymay,
upon presentation of credentials, enter and inspect any property, premises, ar 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.C.S. 87-90.
3. Provisions shall be made for collecting any necessary and appropriate samples associated
with the injection facility activities.
Permit No, W10100007 PAGE 2 OF 4
G WAAC-5 ver. 11104

PART 11111 - MONITORING AND REPORTING REQUIREMENTS
1. Any monitoring (including groundwater, surface water, or soil sampling) deemed necessary by
the Division of Water Quality to insure surface and ground water protection, will be
established and an acceptable sampling reporting schedule shall be followed.
2. The Permittee shall report by telephone, within 48 hours of the occurrence or first knowledge
of the occurrence, to the Asheville Regional Office, telephone number(828) 296-4500, any of
the following:
(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 V - PERMIT RENEWAL
The Permittee shall, at least three (3) months prior to the expiration of this permit,
request an extension.
PART VI - CHANGE OF WELL STATUS
l , The Permittee shall provide written notification within 15 days of any change of status of an
injection well. Such a change would include the discontinued use of a well for injection. If a
well is taken completely out of service temporarily, the Permittee must install a sanitary seal.
If a well is not to be used for any purpose that well must be permanently abandoned according
to 15A NCAC 2C .0213(h)(1), Well Construction Standards.
2. When operations have ceased at the facility and a well will no longer be used for any purpose,
the Permittee shall abandon that injection well in accordance with the procedures specified in
15A NCAC 2C .0214, including but not limited to the following:
Pemit No. WIO100007 PAGE 3 Off' 4
GW/TJIG5 ver. 11/04

(A) All casing and materials may be removed prior to initiation of abandonment
procedures if the Director finds such removal will not be responsible for, or
contribute to, the contamination of an underground source of drinking water.
(B) The entire depth of each well shall he 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 he abandoned Mi 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-3 Q) as
specified in 15A NCAC 2C .0213(h)(1) within 34 days of completion of
abandonment.
3. The written documentation required in Part VI (1) and (2) (G) shall he submitted to:
Aquifer Protection Section-UIC Staff
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
LUTAI ll IkJ I QIT7 �7�I r ���►rfi111f y x. �L�] M 1I411101Y 11CfN&I
None
Permit No. WI0100047 PAGE 4 OF 4
GWARC-5 ver. I I /D4

I ,
AQUIFER PROTEC'HON SECTION REGIONAL STAFF REPORT
Date:
To: Aquifer Protection Section Central Office
Central Office Reviewer:
Regional Login No:
County:
Permittee:y e vaV 5'eAWci-
Project Name: L&&dWD btem Simei-
Application No.: Wr 01 0000
QIl GENERAL INFORMATION
1. This application is (check all that apply): ❑ New 19 Renewal
❑ Minor Modification ❑ Major Modification
Surface Irrigation LI Reuse U Recycle [J High Rate Infiltration LJ Evaporation/Infiltration Lagoon
❑ Land Application of Residuals ❑ Attachment 13 included ❑ 503 regulated ❑ 503 exempt
❑ Distribution of Residuals ❑ Surface Disposal
❑ Closed -loop Groundwater Remediation ❑ Other Injection Wells (including in situ remediation)
` Was a site visit conducted in order to prepare this report? :$ Yes or ❑ No.
a. Date of site visit: V&o /I�3a p �'
b. Person contacted and contact information: �.1 tR�w+vj r'e+'+t�P AM1" RMECP0N *M
c. Site visit conducted by; DEC 4 7 2005
d. Inspection Report Attached: ❑ Yes or ❑ No.
2. Is the following information entered into the SIMS record for this application correct?
❑ Yes or ❑ No. If no, please complete the fallowing or indicate that it is correct on the current application.
For Treatment Facilities:
a. Location:
b. Driving Directions:
c. USGS Quadrangle Map name and number:
d. Latitude
Longitude;
e. Regulated Activities / Type of Wastes (e.g., subdivision, food processing, municipal wastewater):
For Disposal and Inieetion Sites:
(If multi)ie sites either indicate which sites the information avolies to, cony and haste a new section into the
document for each site or attach additional -paves for each site
a. Location(s): �cGrr s: l�1 ]/ Adw/4
Cga v rw, NC 194 W re 11&dd wa R-o4 eft 1 &
b. Driving Directions: 1- 4+0 6 re Ex.f IV
UJ ZZ/ i
C. USGS Quadrangle Map name and number;
d. Latitude: XA4'SS'4" Longitude: #°5>i zsa"
H. NEW AND MAJOR MODIFICA TIONAPPLICA TIONS this section not needed for renewals or minor
modifrcalions, skis; to next section)
Description Of Waste(S) And Facilities
1. Please attach completed rating sheet. Facility Classification:
2. Are the new treatment facilities adequate for the type of waste and disposal system?
FORM: Doc4.doc

AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
❑ Yes ❑ No ❑ NIA. If no, please explain:
3. Are the new site conditions (soils, topography, depth to water table, etc) consistent with what was reported by
the soil scientist and/or Professional Engineer? ❑ Yes ❑ No ❑ NIA. If no, please explain:
4. Does the application (maps, plans, etc.) represent the actual site (property lines, wells, surface drainage)? ❑
Yes ❑ No ❑ NIA. If no, please explain:
5. Is the proposed residuals management plan adequate and/or acceptable to the Division. ❑ Yes ❑ No ❑
NIA. If no, please explain:
C. Are the proposed application rates for new sites (hydraulic or nutrient) acceptable?
❑ Yes ❑ No ❑ NIA. If no, please explain:
7. Are the new treatment facilities or any new disposal sites located in a I00-year floodplain?
❑ Yes ❑ No ❑ NIA. If yes, please attpWl� a map ,showing areas of 100-year• floodplain and please explain
and recommend any mitigative measures/special conditions in Part IY:
8. Are there any buffer conflicts (new treatment facilities or new disposal sites)? ❑ Yes or ❑ No. If yes, please
attach a map showing conflict areas or attach any new maps you have received from the applicant to be
incorporated into the permit:
9. Is proposed and/or existing groundwater monitoring program (number of wells, frequency of monitoring,
monitoring parameters, etc.) adequate? ❑ Yes ❑ No ❑ NIA. Attach map of existing monitoring well
network if applicable. Indicate the review and compliance boundaries. If No, explain and recommend any
changes to the groundwater monitoring program:
10. For residuals, will seasonal or other restrictions be required? ❑ Yes ❑ No ❑ NIA if yes, attach list of sites
with restrictions (Certification B?)
III. RENEWAL AND MODIFICATIONAPPiICATIONS use Previous section for new or ma'ar modi rcation
s stems
Description Of WastelSZ And Facilities
1. Are there appropriately certified ORCs for the facilities? ❑ Yes or ❑ No.
Operator in Charge: Certificate #: t,
Backup- Operator in Charge: Certif cate ##:
2. Is the design, maintenance and operation (e.g. adequate aeration, sludge wasting, sludge storage, effluent
storage, etc) of the treatment facilities adequate for the type of waste and disposal system? ❑ Yes or ❑ No.
If no, please explain:
3. Are the site conditions (soils, topography, depth to water table, etc) maintained appropriately and adequately
assimilating the waste? ❑ Yes or ❑ No. If no, please explain:
FORM: ❑oc4.doc 2

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

AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
IV. INJECTION WELL PERMITAPPLICATIONS (Complete these two sections for all systems that use injection
wells, including closed -loop groundwater remediation cffluent injection wells, in situ remediation injection wells, and heat
pump injection wells.)
Description Of WeIl"S And Facilities — New, Renewal, And Modification
I, Type of injection system:
❑ Heating/cooling water return flow (5A7)
® Closed -loop heat pump system (5QM15QW)
❑ In sure remediation (5I)
❑ Closed -loop groundwater remediation effluent injection (SUNon-Discharge" )
❑ Other (Specify_
2. Does system use same well for water source and injection? ❑ Ycs N No
3, Are there any potential pollution sources that may affect injection? ❑ Yes IR No
What is/are the pollution source(s)? _ . What is the distance of the injection well(s) from the pollution
sources)? ft.
4, What is the minimum distance of proposed injection wells from the property boundary? ft.
5, Quality of drainage at site: [gGood ❑ Adequate ❑ Poor
6. Flooding potential of site: ® Low ❑ Moderate ❑ High
7. For groundwater remediation systems, is the proposed and/or existing groundwater monitoring program
(number of wells, frequency of monitoring, monitoring parameters, etc,) adequate? ❑ Yes ❑ No. Attach
map of existing monitoring well network if applicable. If No, explain and recommend any changes to the
groundwater monitoring program:
S. Does the map presented represent the actual site (property lines, wells, surface drainage)? ❑ Yes or ❑ No. If
no or no reap, please attach a sketch of the site. Show property boundaries, buildings, wells, potential pollution
sources, roads, approximate scale, and north arrow.
Injection Well Permit Renewal And Modification Onl►:
1, For heat pump systems, are there any abnormalities in heat pump or injection well operation (e.g. turbid water,
failure to assimilate injected fluid, poor heating/cooling)?
❑ Yes 0 No. If Yes, explain:
2. For closed -loop beat pump systems, has system Iost pressure or required make-up fluid since permit issuance
or last inspection? ❑ Yes 2; No. If v es. explain:
3. For renewal or modification of groundwater remediation permits lofanv ttvVel. will
continued/additional/modified injections have an adverse impact on migration of the plume or management of
the contamination incident? ❑ Yes ❑ No. Ifyes. explain:
4. Drilling contractor: Name:
FORM: Doc4,doc 4

AQUIFER PROTEC'i'ION SECTION REGIONAL STAFF REPORT
Address:
Certification number;
5. Complete and attaeb Well Construction Data Sheet.
FORM: Doc4.doc

AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
V E VA L UA TION A ND RECOMIMIENDATIONS
l • provide any additional narrative regarding your review of the application.:
?. Attach Well Construction Data Sheet - if needed information is available
3. Do you foresee any problems with issuanc enewal f this permit? ❑ Yes EK No. If yes, please explain
briefly.
4. List any items that you would like APS Central Office to obtain through an additional information request.
Make sure that you provide a reason for each item:
Item Reason
5. List specific permit conditions that you recommend to be removed from the permit when issued. Make sure
that you provide a reason for each condition:
Condition Reason
6. List specific special conditions or compliance schedules that you recommend to be included in the permit when
issued. Make sure that you provide a reason for each special condition:
Condition Reason
7, Recommendation: ❑ Hold, pending receipt and review of additional information by regional office; ❑ Hold,
pending review of draft permit by regional office; ❑ Issue upon receipt of needed additional information;
Issue; ❑ Deny. If deny, please state reasons:
r
B. Signature of report preparer(s):—
• r
Signature of AFS regional supervisor:
Date: t21o/Z&OA
ADDITIONAL REGIONAL STAFF REYIEWITEMS
FORM: Dor.4.doc 6

G� W A TER
DUJa
Seple mlicr 11), 2005
iMC41.41lial7, Principal
Newland Elementary School
750 Linville Street
Nc.vland, NC 28657
Rel'. I't i-mil Relvewal Applitalion Receip(
InJection Permit. W10100007
Newland Elementary School
f)c:u- Ms. Ledford:
KlicNid I I.;Is1Cv,L unLlAtli
WIllulnl i i. Iglu ,h . �LTr[i:1ly
Ni Lrllll .11Lf11n.i I lcpai I le o 111111-In kon HL'III anil N;11iImI 1tL-!,-w PL'C4
Mali W. X11111 I:. 1' I. 1 =irrrlul
l)16NW11 id W;avl Qw I111%.
Your renewal application fol- a permit to use x well for 1110 injection of geothermal beat p><nnp C1110enl has
11CCil rrccived and is under review- A ill cill her of the ArluiICr Proteel ion Seel ion's Asheville Rcgioil a1 Office
staff AAvIII he cori(adina you tO arrange an inspection of the injection well as hart of the review.
Please contact me at 919-715-6166 or Evan Kane at 919-715-6182 if you have any questions rcoarding this
[ransmlltal or the Underground lnjcction Control Program.
Best Regards.
J
Thomas Slusscr
Hydrogeological Tcchniclu 11
U IC Program
cc, Landtsll Davidson, AslieviNE: Regional Office
{'0-1-1IC. Files
Ni,l�hC:lrvlifua
ahmilly
-X µlifer PYNtectit n Sce6v 1636 Mail Service C'eiiwi- Raleigh. NU 27099-1630 Phone [phone] C USWIFIXT SLTYICA!
inicrnlcl: h1op.02t)cnr,4ale-ne_ps 2728 Capital Boulevard IL•lleixh, NC- 2760A Fux ()19) 715-0588 1477d123-(+748
l-ax (L)) 9) 715.6048
An Equal OpportunitylAf frro ve Adkm EnVbyer -- 50% Rec7cledIS0% Posl Consumer Paper

NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
RENEWAL APPLICATION FOR PERMIT TO USE WELL(S) FOR INJECTION WITH A
HEAT PUMP SYSTEM
Type 5A7 are QM IN
In accordance with the provisions of NCAC Title 15A: 02C.0200
complete application and mail to address on the back page.
RECEIVED/ DENRI DWO
TO: DIRECTOR, NORTH CAROLINA DIVISION OF WATER QUALITY AOUIF6R PROTF00M SECTION
DATE: �C�%T `� , 24 0 ` SEP 15 2005
A. PERMIT APPLICANT,
� r
Permit Numbe : �4 Cf I ca r� (W IOJJ00 , listed at the bottom of each page of your permit)a '
Name: e`,I ] C%�
b:
City: State: Zip code: -�) 96 J-7
County: AjJ'/ `'' j Telephoner �' �.�•�� f�
B. PROPERTY O 'NER (if different from applicant)
Name:
Address: l xs!'�cff
City: Zf � f � � State: Zip code:
County: Telephone: f.2,k 73 Y leo0
C. STATUS OF APPLICANT
Private: Federal: Commercial: State: Public: J�
Native American Lands:
D. 1'ACILTTY (fiITF) DATA (Fill out ONI-�'-f dic .sranis of Owner is Federal. 5tat--, Public or Commercial).
Name of Businels or Facility:
Address:
City: 1 0-e f State: �}A lip code: ?- r
County: T'elephon x/
Contact Person:
Standard Industrial Code(s) which describe commercial facility:
Revised 5105 GWMC-57 HPR Pagel of3

E. INJECTION PROCEDURE (specify any modifications to the injection procedure since the issuance of the
previous in ection permit)
)Z/7
t _ WELL USE Is{are} the injection well(s) also used as the supply wall(s� either of the following?
(1) The injection operation? YES NO
(2) Your personal consumption? YEST NO
G. CONSTRUCTION DATA
(1) Specify any and all modifications to the well casing, grout or screens since the issuance of ilre previous
injection permit.
(2) NC. State Regulations (15A NCAC, 2C, Section .0200) require the permittee to make provisinns 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. Is there a faucet on;
(a) the influent line? YES_ NO
(h) on the effluent line? V1~S �_ NO
H. CUHRENT OPERATING DATA
(1) Injection rate: Average (daily) gallons per minute (gpm)
(2) Injection volume: Average (daily) gallons per day (gpd)
(3) Injection pressure: Average (daily) pounds per square inch (psi)
(4) Injection temperature: Annual Average degrees Fahrenheit ff )
I. INJECTION -RELATED EQUIPMENT
Attach a diagram showing any modiffcadons to injection equipment since the issuance of die previous ipicction
permit including the engineering layout of the (t) injection equipment, and (2) exterior pipuigltuhing associated
with the injection operation. The manufacturer's brochure, if detailed, should satisfy (1).
LOCATION OF WELL(S) Attach a map
Include a site map (can be drawn) showing: the orientation of and distances between the unjection well(s) and any
existing well(s) or waste disposal facilities such as septic tanks or drain fields located wilhin 1000 feet of the
ground -source heat pump well system; include buildings, property lines, surface water bodies, any other potential
sources of groundwater contamination. Label all features clearly and include a north arrow to indicate
orientation.
K. PERMIT LIST: Attach a list of all permits or construction approvals, received or applied for by the applicant
that are related to the site. Examples include:
(1) Hazardous Waste Management program permits under RCRA
(2) NC Division of Water Quality Non -Discharge permits
(3) Sewage Treatment and Disposal Permits
L. OTHER MODIFICATIONS: Indicate any other modifications to the injection well system (equipment, fluid,
operation, etc.) that have occurred since the issuance of the previous injection permit and have not been noted
elsewhere on this application.
RCYL$cd 5/05 GWItfIC-57 HPR Page 2 of 3

M. CERTIFICATION
"I hereby certiry, 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, accuratc and
complete. I am aware that there are significant penalties, including the possibility of fines and imprisonment, for
submitting false information, I agree to operate, maintain, repair, and if applicable, abandon the injection well
and all related appurtenances in accordance with the approved specifications and •onditions of the Permit."
(Si tore of Well Owner or Authorized Agcnt)4,1,
ff authorized agent is acting on behalf'of the well ownee:PW
please supply a letter signed by the owner
authorWng the above agent.
N. CONSENT OF PROPERTY OWNER (Owner means any person who holds the Fee or other property rights in the
welks). 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 operate an injection wells) as outlined in this application and that it shall be the responsibility of the
applicant to ensure that the injection well(s) conform to the Well Construction Standards (Title 15A NCAC
Subchapter 2C .0200)
(Signature of Property Owner if Different From Applicant)
Please return the completed Application package to:
UIC Program
Aquifer Protection Section
North Carolina DENR-DWQ
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone: [phone]
Revised 5105 GWMIC-57 HPR Page 3 of 3

NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY, AQUIFER PROTECTION SECTION
STATUS OF 1N.3FCT0N WELL SYSTEM
Permit Number
Permittee Name: 'r� i) Z �,J
Address: �a n L/i, �L ,� ;r-k 1 eql cr)
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
4} _ Injection well never constructed
If you checked (2), describe the well use (potable water supply, irrigation, etc), including pumping rate and other
relevant information. _
If you checked (3)(a) or (3)(b), describe the method used to abandon the injection well. (Include a descnption of
how the well was sealed and the type of material used to fill the vwll 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."
NEE.
XMA;Mdl��
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 corn plete."
Signature -
Date
Revised 5105 GW/UIC-68

■ Complete Items � and S. Also complete
Rem 4 It Restricted Delivery Is desired.
! PiI t your name and address on the reverse
so that we can return the card to you.
r Attach this card to the back of the mailpiece,
or on the front It space permits.
1. Article Addressed to:
Meg Julian
Newland Elementary School
750 Linville Street
Newland NC 28657
A.
x
LI3,yfteoelved by {Printed me) C. pate o! Defrvery
a, is deWery addresstIIft 0 t from ltem 17 Ct yes
if YES, eater del[vsry address below. ❑ NO
a. seryicee
CerYsfled Malt CZ Express watt
0 Regmwed 0 Return Recetptimr merchandise
0 Insured Mall 0 c.o.D.
4. Restricted Dativery9 {Extra Fee) ❑ Yes
2. aMc[e14umtm3r 7002 2410 0003 0274 5511
(Transfer tromp se►v
PS Form 38111, August 2001 Domestic Return Receipt 2ALt F11-03 z-oM

Michael F. Easley, GRvemor
William G. Ross lr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
August 1, 2005
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
7002 2410 0003 0274 5528
Meg Julian
Newland Elementary School
750 Linville Street
Newland, NC 28657
Ref: Notification of Expiration
North Carolina Well Construction Standards
Applicable to Injection Wells - Subchapter 2C
UIC Permit No. WI0100007 Issued to Avery County Board of Education
Dear Ms. Julian:
The Underground Injection Control (LTIC) Program of the Division of Water Quality is responsible for
the regulation of injection well construction and operation activities within the state of North Carolina.
Our records show that the operating permit referenced above for the injection wells at Newland
Elementary School will expire on October 31, 2005. In addition, our records do not indicate that these
wells have been abandoned.
In order to comply with the regulatory requirements listed under North Carolina Administrative Code
(NCAC) Title 15A, Suhchapter 2C, Section .0211, you must take one of the following actions:
A. Submit the form RENEWAL APPLICATION FOR PERMIT TO USE WELL(S) FOR INJECTION WITH A
HEAT Pump SYSTEM (form GWICTIC-57 HPR) if the injection wells are still active;
B. Submit the form STATUS OF INJECTION WELL SYSTEM (form GWICTIC-68) if the injection wells
are inactive or have been temporarily or permanently abandoned.
If the welts are no longer being used for any purpose, they must be permanently abandoned according to
the regulatory requirements listed under NCAC Title 15A, Subchapter 2C, Section .0214. If the
injection wells are to be permanently abandoned, well abandonment records must be submitted to our
office to certify that each abandonment was properly conducted.
14`�y L3rolina
,Natlrrally
Aquifer Protection Section 1636 Mail service Center Raleigh, NC 27699-1636 Phone [phone] Custorrrr Service
trttemet: h1tp:/Rr2o.enr.stale.ne.us 2728 Capital Boulevard Raleigh, NC 27604 Fax [phone]
Fax [phone]
An Equal OpportunitylAffirmaWe Actim employer — 50% Recydedl10% Post Consumer Paper

Meg Julian
August 1, 2005
Page 2 of
Please submit the appropriate form(s) within 30 days of the receipt of this letter. If you have any
questions regarding the permit and injection well rules, or if you would like assistance completing these
forms please contact Thomas Slusser at [phone] or myself at [phone].
Sincerely,
Jesse Wiseman
Processing Assistant
UIC Program
cc: f-....Ag+-IAAI .&—r t--U- .. f f L1A--e w o encIosures
CO-UIC Piles w/o enclosures
Enolos=s

Name
Date
Tv a of Permit/Comments
Mark Prital
p.. �� � �n
eat Pump . Remediation Other
��
e.10-,,wJ flu;rl5
Amy Aaot;
Heat Pump Remediation Other
Ted Bush
rO'f�'�aoo

Divis1ON OF WATER QUALITY
GROUNDWATER SECTION
October 18, 2000
MEMORANDUM
To: Landon Davidson, L.G.
Groundwater Section
Asheville Regional Office
From: Mark Pritzl [e-mail]
Hydrogeological Technician II
UIC Group
Groundwater Section
Raleigh Central Office
Re: issuance of a Closed -Loop Geothermal -Mixed -Fluid Injection Well System
(Type 5QM-):
Permit Number WI0100007 to operate 55 wells for the injection of a closed -loop
ground -source heat pump system has been issued to Avery County Board of Education, in
Newland, North Carolina. This is a new permit and the Underground Injection Control
Group anoreciates Tina Parsons' assistance with the THOROUGH insnection and review
Lqgl. Please retain the application and paper work for the ARO-UIC riles, If you have any
questions regarding this permit or the UIC program, please contact me at [phone].
cc: CO-UIC Files
Enclosures

OIA
KJ
NCDENR
Mrs. Meg Julian
JAMES 5. HUNT JR. Newland Elementary School
GOVERNOR 750 Linville Street
Newland, NC 28657
BILL HOLMAN
SECRETARY Dear Mrs. Julian:
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
October 17, 2000
DIVISION OF WATER QUALITY
In accordance with your application submitted on September 7, 2000, we are
KERR T. S7EvEN9 forwarding Permit No. WI0100007 for the construction and operation of a vertical
DIRECTOR closed -loop geothermal -mixed -fluid heat pump injection well system at 775
Cranberry Street, Newland, NC in Avery County.
This permit shall be effective from the date of issuance until October 31, 2005, and shall
be subject to the conditions and limitations stated therein, including the requirement to
notify this office by telephone 48 hours prior to initiation of operation of the facility. In
accordance with NCAC Title 15A, Suhchapter 2C, Section .0213(h), the well owner is
responsible for submitting a record of well construction within 30 days of completion.
The well construction data for every well constructed for this project should be
submitted on a OW-1 form and this form is enclosed for your convenience.
In order to continue uninterrupted legal use of this well for the stated purpose, you
should submit an application to renew the permit three months prior to its expiration
date.
If you have any questions regarding your permit please feel free to contact me at
[phone].
Sincerely,
M �P�
Mark Pritzl
Hydrogeological Technician II
Underground Injection Control Program
cc: CO-UIC Files
ARD UlC Files
■
Enclosures
GROUNDWATER SECTION
1.636 MAIL SERVICE CENTER, RALEIGH, NC 17609-1636 - 17213 CAPITAL, BLVD., RALBICH, NC 27604
PHONE [phone] FA% 9t9-7't8-0SS8
AN EQUAL OPPORTUNITY I AFFIRMATIVE ACTIO14 EMPLOYER - !30% RECYCLIEUM0% POST -CONSUMER PAPER

i►C13014 ; t : OITiTWML .
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
Avery County Board of Education
FOR THE CONSTRUCTION AND OPERATION OF AN INJECTION WELL SYSTEM for
the purpose of operating a vertical closed -loop geothermal -mixed -fluid heat pump system. This
system is located at 775 Cranberry Street, Newland, North Carolina, in Avery County, and will
be constructed and operated in accordance with the application dated July 27, 2000, and in
conformity with the specifications and supporting data submitted, all of which are filed with the
Department of Environment and Natural Resources and are considered a part of this permit.
This permit is for Construction and Operation only, and does not waive any provisions of the
Water Use Act or any other applicable Laws, Rules, or Regulations. Operation and use of an
injection well shall be in compliance with Title 15A North Carolina Administrative Code 2C
.0100 and .0200, and any other Laws, Rules, and Regulations pertaining to well construction and
use.
This permit shall be effective, unless revoked, front the date of its issuance until October 31,
2005, and shall be subject to the specified conditions and ]imitations set forth in Parts I through
X hereof.
��� rr
Permit issued this the day of G� — , 2000.
Ted L. Bush, Jr., Assistant Chief
Groundwater Section
Division of Water Quality
By Authority of the Environmental Management Commission.
Permit No. WI0100007 PAGE 1 OF 6

PART I - WELL CONSTRUCTION GENERAL CONDITIONS
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
.0244). Any noncompliance with conditions of this permit constitutes a violation of the
North Carolina Well Construction Act and is grounds for enforcement action as provided
for in N.C.G.S. 87-94.
2. This permit shall become voidable unless the facility is constructed in accordance with the
conditions of this pennit, the approved plans and specifications, and other supporting data.
3. Each injection well shall not hydraulically connect separate aquifers.
4. Each injection well shall he constructed in such a manner that water from land surface
cannot migrate into the gravel pack or well screen.
S. Each injection well shall be secured to reasonably insure against unauthorized access and
use. Each well shall be permanently labeled with a warning that it is for injection purposes
and the entrance to eacb well must be secured with a locking cap.
6. Each injection well shall be afforded reasonable protection against damage during
construction and use.
7. Each injection well shall have permanently affixed an identification plate.
A completed Well Construction Record (Form GW-1) must be submitted for each
injection well, to the Division of Water Quality (Division), within 34 days of completion
of well construction.
PART II - WELL CONSTRUCTION SPECIAL CONDITIONS
At least forty-eight (48) hours prior to constructing each injection well, the Permittee shall
notify the Groundwater Section -Underground Injection Control (UIC), Central Office
staff, telephone number [phone].
19111 : I�� �► t l•9 I� 7IMM618M �1"CISi
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 -
Permit No. WI0100007 PAGE 2 OF 6

2. This permit is not transferable without prior notice to, and approval by, the Director of the
Division of Water Quality (Director). In the event there is a desire for the facility to
change ownership, or there is a name change of the Permittee, a formal permit amendment
request must be submitted to the Director, including any supporting materials as may be
appropriate, at least 34 days prior to the date of the change.
3. The issuance of this permit shall not relieve the Pennittee of the responsibility of
complying with any and all statutes, rules, regulations, or ordinances which may be
imposed by other local, state, and federal agencies which have jurisdiction. Furthermore,
the issuance of this permit does not imply that all regulatory requirements have been met.
PART IV - PERFORMANCE STANDARDS
1. The injection facility shall be effectively maintained and operated at all times so that there
is no contamination of groundwater which 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
Pen nittee 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.
The issuance of this permit shaII not relieve the Permittee of the responsibility for damages
to surface or groundwater resulting from the operation of this facility.
PART V - OPERATION AND MAINTENANCE REQUIREMENTS
The injection facility shall be properly maintained and operated at all times.
2. The Permittee must notify the Division and receive prior written approval from the
Director of any planned physical alterations or additions in the permitted facility or
activity not specifically authorized by the permit.
3. At least forty-eight (48) hours prior to the initiation of the operation of the facility for
injection, the Permittee must notify by telephone the Groundwater Section -Underground
Injection Control (UIC), Central Office staff, telephone number [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,
Permit No. W10100007 PAGE 3 OF 6

PART VI - INSPECTIONS
1. Any duly authorized officer, employee, or representative of the Division of Water Quality
may, upon presentation of credentials, enter and inspect any property, premises, or place
on or related to the injection facility at any reasonable time for the purpose of determining
compliance with this permit, may inspect or copy any records that must be maintained
under the terms and conditions of this permit, and may obtain samples of groundwater,
surface water, or injection fluids.
1 Department representatives shall have reasonable access for purposes of inspection,
observation, and sampling associated with injection and any related facilities as provided
for in N.C.G.S. 87-90.
3. Provisions shall be made for collecting any necessary and appropriate samples associated
with the injection facility activities,
PART VII - MONITORING AND REPORTING REQUIREMENTS
1. Any monitoring (including groundwater, surface water, or soil sampling) deemed
necessary by the Division of Water Quality to insure surface and ground water protection,
will be established and an acceptable sampling reporting schedule shall be followed.
2. The Permittee shall report by telephone, within 48 hours of the occurrence or first
knowledge of the occurrence, to the Asheville Regional Office, telephone number (828)
251-6208, any of the following:
(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.
Permit No. WI0100007 PAGE 4 QF 6

PART VIH - PERMIT RENEWAL
The Permittee shall, at least three (3) months prior to the expiration of this permit,
request an extension.
PART IX - CHANGE OF WELL STATUS
The Permittee shall provide written notification within 15 days of any change of status of
an injection well. Such a change would include the discontinued use of a well for
injection. If a well is taken completely out of service temporarily, the Permittee must
install a sanitary seal. If a well is not to be used for any purpose that well must be
permanently abandoned according to 15A NCAC 2C .0213(h)(l), 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.
(S) 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.
Permit No, WI0100007 PAGE 5 OF 6

(G) The Pernuttee 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 1X (1) and (2) (G) shall be submitted to:
Groundwater Section-UIC Staff
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
PART X - OPERATION AND USE SPECIAL CONDITIONS
Permit No. W10100007 PAGE 6 OF 6

Re: newland uir
Subject: Re: newland uic
Date: Man, 16 Oct 2000 14:36:35 -0400
From: Tina Parsons <Tina.Parsons [e-mail]>
Organization: NC DENR - Asheville Regional Office
Tv: Mark Pritzl <[e-mail]>
Thanks Mark!
Padgett & Freeman Architects, PA
30 Choctaw Street
Asheville, North Carolina, 28801
Mark Pritzl wrote;
> Tina,
> You will be getting a copy of the UIC permit for the ARO-UIC files. I will.
> cc "Padgett & Freeman" if you send me their address. There is a slight
> waiting period, time for Ted Bush to review and sign the permit, then they
> can drill.
> Mark
> Tina Parsons wrote:
> > Hi Mark:
> > Three more questions.
> > will there be a waiting period after the permit is issued, or can they
> > proceed with drilling immediately upon permit issuance (say, end of the
> > week) ?
> >
> > Will the consultant (in this case Padgett & Freeman) also receive a copy
> > of the permit (they would like to and I wasn't sure how that worked)?
> > Will I recei ve a copy of t_he permit for my file. (again, riot_ sure what
> > that procedure is)?
> >
> > Thanks again, tina.
> >
> > Tina Parsons - [e-mail]
> > North Carolina Dept. of Environment and Natural Resources
> > Asheville Regional Office
> > Division of Water Quality - Groundwater Section
> > 59 Woodfin Place
> > Asheville, NC 28801
> > Tel. [phone]
> > Fax: [phone]
>
-------------------------------------------------------
> Name: Mark. Pri tzl .vcf
> Mark.Pritzl.vcf Type: VCard (text/x-vcard)
> Encoding; 7bit
> Description: Card for Mark Pritzl
Tina Parsons [e-mail]
I of 2 10/18/00 8.41 AM

newiand school uic
Subject: newland school uie
Date: Mon, 16 Oct 2000 13.59:11 -0400
From: Tina Parsons <[e-mail]>
Organization: NC DENR - Asheville Regional Office
To: MARK PRITZL <[e-mail]>, [e-mail],
Tina Parsons <[e-mail]>
Hi Mark:
Gene Edwards, his engineer, and Sam Shanks were here this afternoon.
They brought in all the information that I had asked for and/or had
remaining questions on. I am satisfied that they have met all the
conditions to meet permit requirements_ tins_
Tina Parsons - [e-mail]
North Carolina Dept. of Environment and Natural Resources
Asheville Regional Office
Division of Water Quality - Groundwater Section
59 Woodfin Place
Asheville, NC 28801
Tel: [phone]B
Fax: [phone]
1 of 1 10/16/00 2.35 PM

NCDENR
JAM IES e. HUPCTJIt.
GOVERNOR
WATNE MCdEv1TT
SECRETARY
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
ASHEVILLE REGIONAL OFFICE
DIVISION Of WATER QUALM
GROUNDWATER SECTION
b October 2000
0
To: Mark Pritxl
UIC Group, COI
Thr-ough: Landon Davidson
�
Asheville Region Supervisor --
Fr-om: Tina Parsons
a.
Hydrogeologist - Ash a Region
Re: UIC Inspection for Newland Elementary School
I have reviewed the UIC Application and visited this site on Monday IS September
2000. I have the following comments:
Injection system, as described by applicant, will be a vertical closed loop Earth
Coupled Heat Pump. Site will have 55, approximately 3I6` deep heat exchange wells
to cool system fluids in pipes only, System fluids will not be in contact with
groundwater unless leakage or breakage of system lines or joints occurs.
Mixture of propylene glycol to potoble water used in the system is 30,70, or
approximately 30% glycol. Glycol is food grade and poses no threat to human
health or the environment.
Applicant still needs to provide details and schematics of possible receptors,
contaminant sources, & complete detailed schematics of heat pump system.
Applicant provides no geologic control except f or the two test holes on site.
Applicant should address this somehow and indicate groundwater flow directions,
Applicant needs to address flooding issue with site. Word of mouth history
indicates no flooding events, but applicant should check USGS & DWQ stream
gauge data for confirmation of said history to insure system well heads will not
act as conduits for contamination during flood events.
I NTZRCHAMOE HIIILDI NO, SO WOODRIN PLACE, ASH EVILLE, NORTH CAROI-IIYA 2BBOI
PHONE [phone] FAX B28-251.6452
AN EGUA4 OPPORTUNITY 1 AFFIRMATIVE ACTl Dt4 EMFLOVER - 50% RECYCLEDII O% POgT-CONSUMER PAPER

Page 1 of 2
North Carolina Department of Environment and Natural Resources
Division of Water Quality -Groundwater Section
PRECONSTRUCTION INJECTION FACILITY INSPECTION
REPORT -FORM A
INJECTION WELL PERMIT NO. WI
NAME OF OWNER Air .. ('° 1
DATE / 0,9
ADDRESS OF OWNEReI_ff II(vS
- - aanyy l • , "a d i (O(- 4 I q 5 4! — ;A 4e lw dIc'" 1-
VL Y] • i .� 3 .,1�_V�]4�JCSJ
(Streetl road or lot and steddi vision. cou► ty, town)
LOCATION OF PROPOSER] I JECTION WELL (and source wells), if applicable)
(Streetl road or tot and suddivision ,•county, town, if different than owner's address, plus description of location on site)
� I
Potential pollution source 14,'5 Ie?t ,I� �yr Distance from well 7� '�
Potential pollution source _ Distance from well
Potential pollution source
Distance from well
Minimum distance of proposed well from property boundary
Quality of drainage at site odt f ", rFlooding potential of site wO0f- /I'
(good,ad ua epoor) (higli,moderate,low)
DRAW SKETCH OF SITE
(Show property boundaries, buildings, wells, potential pollution sources, roads, approximate scale, and north arrow,)
March 98

Page 2 ❑F2
PRECONSTRUCTION INJECTION FACILITY
INSPECTION REPORT - FORM A (coat.)
COMMENTS
J
r
r
i r 6 l.,-e-
k.,tijs
h cl far
ike,.f
o�[�
1�•, r l_taL. + c�_r
--cba
iJ
0 60 itin ta?_c.
_ �, f 3 -- - ,,,.� , lu : o�-_ �1�,; �•1 � • � � -, icy. l . 1;•c�,..�� s� �
ll . __ �
+ e, _eav,,l.� Y�ik�lS 'f Sc1nA v.«"t;c• ,.�-cgg,��
f f .._ t. �[r=.
Gak�p�..�.r.c.—
T
owl C" c4•-Or- k G ��a• 1� SC���^y�rrxa GCS
kec � u
J1
1�0
. - 016-t v-t
11'
pw�Y nA AIi [Aw �NGH.1 _ C6: _AY UrJ ����
`l
ALP k'Y 4 iH t0.
w 1
•; it3 tti] -A*,Yet_�56v1(5)
INSPECTOR l r. a -�), T:� So v- c
Office w C_b E 14 R 6, 0 A o
WITNE S S
Address
WITNESS
Address
March 98

10/09/00 10:44 $423 543 7109 NOR -WELL
NC =WEU
MECHANICAL CONTRACTORS October 9, 2000
North Oarolina Dept. of Environment & Natural Resources
Division of Water Quality
Grolmd Water Section
Asheville, NC
Atha: Ms, Yaw Parsons
Re: Newland Elementary SMornl, Newland, NC
Permit Application to Construct wells for a Heat Pump System
Deu& on existing well, within or near 1000" radius from aite per Braswell Well DrtDling.
ftQMM Q ner
Well IAwb
%VRter 2nne
_ - _ V411►[�
Rock f vpe r"Un rim-Ah
Grout
!Donn Robbins
SOD ft
460 IL
8 GPM
Med1lard 5almlvom Approx. 50 ft
0 fL
MU7EMt M=tiZnMr
300 IL
260 fk
30 GPM
72 M
20 8
ManitmhAor®er
3001
1251
I GPM
8o iL
20 V.
Marie Bladwc
125 Fr.
5 GPM
Approx. 30 &
0 fl.
US Tcxd1c
3W &
20U to 2.50 IL
80 GPM
Blue S afs 8p &
20 R
In reference to item # I 0 of UTC Inspection comments, items that may be considered
poteatal pollution sources in the area-
1 . Sankary sewer tines on: school property and city sewer lines.
1 3,000-gallon tcmporary fuel ail tank ubove ground just outside the school's boiler
room. The tank is double wall the outer wall serving as secondary cuatairunent
and i5 provided with an anti--sypon valve.
Please give me a call if you have any questions or need additional information.
Siftcerely,
�W
Sam Shanks
Project Manager
SSlklw
CC: Mr. Mark Pritzl, Groundwater Section, Raleigh, NC
Z 002
136 East Elk Avenue • Ellzabethton, Tennessee 37643 • [phone] • [phone] • Fax (515) 543-T149
LICEMEU IN TENNESSEE. VIRGINIA & NORTH CAHOLINA

00 rCP 7 t, ° C r R OF TRANSMITTAL
NOR -WELL COMPANY, LiC.
136 East Elk Avenue
Elizabethton, TN 37643
Telephone: [phone], Fax [phone]
TO: VIC Program
Groundwater Section
North Carolina DENR-DWQ
1636 Mail Service Center
Raleigh, NC 27699`1636
We are sending you the following items:
� 4TY .
1 jAdditional information oer UIC
iris ion comments for Newland
Elementary School oectherma!
These are transmitted as.
xx
Sent by: Sam Shanks
Date: 25-Sep-00
Attn: Mr. Mark Pritzl
For. Neland Elementary
School
For approval
For your use
As requested
Approved as submitted
Approved as noted
Returned for corrections
Comments attached
Retumed for deposit

FROrt
�'• 5C����s I sEcrroN
;r zaoa
Tay
Throe, ~3-'SFr r�t'''�,► o[�j
From y�.� 4�11Ot
Rai UIC Inspe"Ton}"or 4ewland w4rnentaiy School
I have reviewed the urc cpp1 :scion and visited this site on Monday 18 September ZGDO.I
have the following comments:
applicant needs to supply c-:nplete area schemotic To scale showing all 1 he details of `nc
tanSTrutTlgrt layauT.
,e Applicant needs to supply a we^king schematic of the HVAC system, properly labeled, and
indical ing 1 hose parts that a,e to be In contact with the groundwater,
vo3�Applicant needs to provide +�a results o f mechanical integrity tests ineiudimg a detcriptian
of the iest(a) and the mctha*;s) usod. � 7 PA,eRR 7b Zhs?W& ►►e.d , AVr9rL 'rPJi1%..r *i
�1. Applicant needs to supply Information, specifications, and schematics of all test
wells on property.
1S`
Applicant needs to supply rc:x, address, and details of all groundwater users identified to
the area.
-;�-T ApplicanT needs To Indicate property owner on application,
r` . Applicant needs lu suply bo, •ng logs for test wails.
�9 Applicant needs to ind+cote s construction details of injection wells in wall field.
.a;Y Applicant needs to identify c'I potentioI paIIutIan sources in thin; area, Alea ee identify on nap
of arco and provida name anc addressee of source.
A*ti- Ic this area part of federal :mdian IamdO �' {u ��P �f� .�e� ■,r �.� �� L���� .
Please.. see file GICWJpnMIrlSpra tslU£Cluienewlond and 616;WIDatalUrCrnspection Pica-"
for Co►npla to de tails.
DRAFT
—END---

0
c
f

Feb-18-00
11.34A A_F.E- 827+838t5786 P.02
FIBERGLASS lavolAN H 01wo LES
FEATURES
LIGHTWEIGHT, ONE-
PIECE ALL FIBER-
GLASS CONSTRUC-
TION, NO JOINTS TO
LEAK
9
USE STANDARD 22"
RING & COVER
,f
ADJUST TG CRADE
WITH BRICK OR CON-
E RINGS CRE
RUGGED 3" COLLAR
SPHERICAL DOME
FOR MAXIMUM
STRENGTH
HEAVY STRUCTURAL
REINFORCING BAND
THICK HOOP -WOUND --
SHELL HAS
SUPERIOR STRENGTH
DESIGNED FOR H-20
(16,000# AXLE)
WHEEL LOADING
SMOOTH INTERIOR
WALLS
EXTRA WIDE LEDGE
MAKES BRICK COUR-
SING EASIER,
CLEARLY LABELED
HEIGHT FOR EASY
IDENTIFICATION
4'-0" INSIDE
DIAMETER, STAN-
DARD H EIG= ;TS 2' TO
20' IN SIX iNCH
INCREMENTS
(TALLER HEIGHTS
AVAILABLE)
CUT-OUTS MADE
EASILY WITH
MASONRY SAW
ECONOMICAL, QUICK, SIMPLE INSTALLATION ON
WET CONCRETE FOUNDATION
ASSOCIATED FIBERGLASS ENGINEERS
P.O. BOX 14335 a FORT WORTH, TEXAS 76117 PHDNE [phone]

Driscopipe 5300
Closed Loop Ear:1 Coupled Heat Pump Applications
The c'.osec. loop earth couplet (CLE ' _-zip
industry requires a piping materia!-.vr.:c- _ _
outs,andirg toughness, resiliency arc to
provide a cost-eHect:ve. thermally iC:e'_ a:amative
to conver-noral heating and ccolirc
Perormance-aroven priscop;Ge 5.iD0 C' �— guard
Pipe is aver/ high molecular
polyethylene which offers superior F-_ __ 7-a make
it the unqualified choice for elizontal
CLSC heat pump systems.
Outstanding Ther-mal Efficienc-y
The relative thermal efficiency at varcus -- -ais is
expressec ❑y their respective k-values..= - g-er
k-value reflects greater heat trans-Lar Z!.:
drisccpipe 5= Climate Guaro crcv:c__ r tionai
hear :rnsrer capabilities when CCMCa_ BC := -a
average k-value of other thermoplas,:c -"-__
i ne average thermat conductivities zz- of
various thermoplastics are listed beicw,
PVC . . . . . . . . .. . . . . . 0.087
Pciybutylene . . . .. .. . . . 0.125
Ddscopipe 5=Climate Guard 0.225
'expressed in STUHIft-'F
Dependable Resiliency
Seasonal temperature fluctuations Tay a--
significant stress err the piping poach r; =C heat
pump systems. Qriscopipe 53= has b=on xed at
-180OF and 140OF and proven to provice :.pie
service at these temperature extremes. � a Braque
resiliency of Climate Guard systerns asz-,x trig
term perarmance .-. season -after -se=„-_
year -after -year.
Secure Joining
Climate Guard pipe and linings are ;cir _: -e bunt
saddle fusion technique. The integrity cf :Y cining
method demonstrates an overall strengr; to or
exceeding that of the pipe itself. Quick- -e-mac a fusion
efiminates the potential for leaking mod: ��r_-1 icints
and costly system repair. Qriscopipe ci'E-:- a
complete line of fittings which connec: Guard
to other piping materials or system ccircc its.
Unique Chemical -Corrosion ResLwnce
❑riscopipe 53ap is inert to most cnernica.,
comaounds. Heat transfer fluids soon a_ _-- sr-e
glycol, sodium chloride and talc:L:m -Ens no
arect ors-rhe pressure capat ilit'1 arcrc::_--
performance of Climate Guard. Gns. pp p= -z= wiii
not rust. rot. pit, corrode cr omrzrkise ram__.'_ ' -nty
Corrosive soils into which it may �_,a �Dac=Z-
Assured Longevity
You benefit from the thermal aM, c:er.cy. ---tis.
resiliency and easy handling of Orisi==e -5-00
Climate Guard. These cutstancing cL:aijr'zz
combined with the heat fusion memcc: Jc - -= arc
Phillips ❑riscopipe's corrmitrhert to C;uP_ ce a
piping material which offers perfcr,,,anc_ _ _ _
longevity in yarn couplet he.t YLmc -rs.
The security of a Climate Guarc system`. by
a a"Q-year limited warranty against derec-s _:er,al
and/or workmanship.
Installation Guidelines
• Carefully inspect the pipe to ce:ect c , _- age
that may have occurred during SMIPPIr-C 1 a
result of excessive abuse at tree icb
• Care should be taken to make Sure ~a: -s Wtal
system pressure, operating plus surge. =� net
exceed the pressure rating of a spec-.'Fc w� or
Scneduie of pipe.
• To Insure long term performance, CIima:e
Guard should be installed strictly in
with accepted engineering design me;==gy
for water source heat pump applicaru^s � c
in accordance with the Oriscopipe -SysiRErs
Installwon" brochure availat:le from
Phillips ❑riscapipe.
• When laid in a trench. care should be
insure that the bottom of the ditcn is 3~C' and
free of sharp or angular objects.
• When installed down -hole, as in a ve^csi GCp.
ample precautions should be taken to mae =fir=
the ballast used to facilitate the inseancr. "—_=B
does not impinge. gouge or cut into Cry-- ce
5300 Climate Guard.
• Prior to installation, Climate Guard shout tee.F"

DP=oP >E &1W NOWAL PHYSICAL PROPERTIES
=Car-W
r+t
Uri i :A
''raainal Vaivaa
Material Designation
?>~7LSTll
-
Pt3400
Marrarial Classification
ASS D-1244
-
LI2 C 3 P34
Cali classification
ASS 0-3350
-
143434C
Density (3)
ASS[ 0-1505
qn/cmrs
0.953
malt Flow (4)
,L,� 0-1239
ga/10 min
0.11 E 3.14 kq..0
Flax modulus (5)
AS-M 0-790
pal
135,000.........
Tensile St . (4)
Aar D-63a
pal
3100............
ESCR (3)
AS= 9-1593
F., Kra
F,s 500a
KOS a 73'F (4)
X-a--X 0-2837
psi
1d00
ti-v Stabilizar (C)
ASS ]--lda]
tC
2.3
Hardness
A-5-M :1-214a
Shot■ *D'
65
compressive Strsngt2L
(Yield)
L`� 0-695
psi
1600
Tensile Strength 4
AZ=4 ,7-53a
Yield (Type IV Spec.)
_• sin)
psi
3200
Elongation ! Yield
3-6aa
i, minimum
a
Tensile Strength I
Break (Type IV Spec.}
L`M 3-619
psi
50200
Elongation tl Break
"-Mw— 7-638
;, minimum
IS
Modulus of Elasticity
lL' 3-638
pei
LI0,000
ESCR:
(Cared A,B,C: Mold. Slab;
L`77M 7-1693
l,i,Hrs
F435000"
(Compressed Rinq (Pipe))
.L-`� i-1249
FSe,xrs
7sa>100a
slow crack Growth
3a=_a'_'_e Method
Gays to
Fe:1.64
Failure
Impact Stzanq--1 (LZ00)
Ash D-216
En-ib/in
(.125" =3
',Ma=od A)
Notch
42
Linear Thermal
Exparimian Cost.
J�`� D-494
in/in/'r
1.2 X la';
Thermal Conductivity
A-�'r C-177
8TU-in/
2.7
Ftt/hrs/'F
Brittleness Temp.
7L'CY 0-746
'r
4-la0'F
Vieat Solt. Temp.
AS—J. ]--1515
'Y
+357
Halt Fusion Cond.
-
pei 4 'F
75 f 400°r
a Thl■ list of T±p'_ ?tysical Properties is intandad for bamic
characterization of _a pipe, and dons not represent speci_'_c
determinations or apes=�Clena.
as Teats were discant!--rzad 'zaicauea no failures and no indication of stress
crack initiation.
0 Averago Malt Index 7al_a vitas a standard deviation of 0,01.
f Average Tensile 9treaa at Yield with a standard deviation at 150 psi
e Average Flexural xod•_:ms pith a ■eandard deviation of 2000 pal
Rr9+lhps OnSc�prQa. I� (herernanar Calrea "Praruos =�
warrants its Crtscoatae I5= CN-ate Guard ` ."t. ca sic
for a penaa at 50 years against rust. rot elecrraiyoc na
defatrs to wprkmenSnip area ma[anels when V arrzeo inC �1ea
,n ciozaa too0 Gann couptea water source neat sy:��-s •�
accoraants wntt[ the rnsaatranon gurdeknes pnntee n �s
procnure This warranty applies only ra 0rijca&Q6 S=
Guatel atom dud rucirtg. It does nu a0my as any tusici 7 =1=1 or
Other tTetnod ar CeY1Ce omit [d lain Q7e pipe ar tt[mr'+r� v��r
dams it apafy in IM da*n and insiallanpn at the rfW@m s; sy
other competent of the system.
Whim instarted AMC utilized as inaacated atxnre. P"Jiffm
OnsccQipe wid. d tls $= climate Guard aide or tLarr -W ewm
50 years from me aate at pumnasa, sueafy Ina Job ti -e
cr.gMtal purcrtaser-
To Secure Product Information or Lewes a
Message for a Sales Engineer orTerrmal-i
Service Representative:
MR11.
Atfi: Customer Service Department
P.Q. box 83-3866
2929 North Central Expressway
Suite 100
F(irh aiFrlenn Tmvna 71U19 1
i Phttiips CrisCapipe writ replace free at cnat re area I , G
pred aid. a auannry at riaw pnscaoice 53DDC'mwe G.>x =W
or Mbng sGuat ro that ate bd to ba deleceye_
2. Phillips Crrscaptae wiA Day as direcr ta= merges uO b 5v5i:
per linear top[ incurred on the jab site in rears" 3sa Caere
plod at tubing, and replacing ma saute w.or chow Onscatim
S= Climate Guard pipe or rub+nq.
subject to any eaprasa Wan'anosa afnmined'a+ Phfips oft=om
ft-13aJ*s order and applicaEM to the speeiffC 900ft se QmmmL
[Re faragpmg warranties arm in lieu of as Otter settees etersomL
whommir written or are! to no event shwa ROWOrnmpips kic-Ze
Gable for loam or use or new inddealm, or Cortset[U@nwda�i
whether or not caused by or rasulting At= use at Gn=0198-Q b
Climate Guard pipe or tu", whether used Siag[y aria
Cornainatlon with other product$ at mated" rapers szams alarm
aitaw this e:dusion. so it may riot apply b tau rMis -Gramm
awes the aurchaser specs6c legal fv", am them matt ae =W
ngn[s whrCn vary from State to Satire•
Phone:
U.S. Domestic Tall Free [phone]
TWX: Fax: '
910-867-0918 214-783-2669
PLMCS WITH no
PO.Rm...

•���r'�y'�33.7 '.�.� •_-
."
a
i�'�';�•.-^'.�y�`'�va
___ +' . =`.i.. �ia�• Jam. �_:,
_ _...y;' _ - _
•{
~�'�.+�.'~�
"��' --- ._
�M1
: it Y"� fr
��-
TYPICAL' :HEADER
DETAIL!'SCALE
SAND BACKFILL
SUPPLY HEADER
RETURN HEADER
TO SE REAAOV n
WELL -BORE
me
;.5rta�q�l.E,SS STE
HOSE
K, ,-
_ -
W
_
W �
-- "
SUP
- _
zIN.
Go i'
-
NOT TC
CONCRETE OR 04 �- f
BEN TONI TI_ PLUG 314
-- BORE HOLES ARE -BetY`
- { OR THE DEPTH AND s
U-gEHD ASSEAABLY
- -'' NUMBER OF BORE
USE DRILL CUTRNGS OFF SAND
FOR GROUTING. USE SENTONITE
PLUG WKERE REQUIRED FOR
AQUIFIER PROTECTION -
r , HOLES SPEGFIE•D BY
- A CER nFI£D CALCULATION
FROM THE GSC INSTALLER
BASED SiE .SOIL _
_ COND4TIONS AS TESTED
•_ r -- :i�:E � ,-, -:. - •' -' _ lam? -
i- ., max-. - ' . ,. _ • _ _ _ - j �....� F---r:. - .. - - - - . .
,BODE HOLE
NOT -30 scam
.= y��.`-`�',y 'fir- _•-. _ '_ _{_
PIPIN - : DETAIL.-
w s^AJI •�71�

C. Coordinate the laying of herder piping with existing utilities, new mechanical and electrical
utilities.
?. iNSTr1LLATION OF PIPING:
A. Cnstall piping in accordance with manufacturer's written instructions.
B. The pipe and pipe fittings rnnst be joined using socket or butt heat fusion process. No outer
method is acceptable. Exer:ise extreme caution to completely remove the cutout material.
Bell reducer fittings shall ^y used at all pipe reductions to eliminate trapped air_
C. Avoid sharp bends in pipir_- installation and install elbow f tongs if necessary_
D. Connect geothermal water -:Ding through to flow header center manifold in The mechanical
room. Manifold to be pro ::ded by the Mechanical Contractor.
3. TESTLNG AND CLEANNG:
A. Cleanliness: During installation, trash, soil, and small animals shall be kept out L i the pipe.
Ends of the high density pc ethylene pipe shall be taped or capped until the pi-pe is joined
to the circuit-
B. Pressure Testing: Each ,�,,iyethylene loop assembly shall be pressure tested prior to
installation. Testing shall he by air or water pressure, at up to 100 psi for a minimum of half
hour. Results of all tests shall be recorded and supplied to the Contracting Officer upon
completion of the Project_
C. Cleaning and Operation T-ling;
1 } Cleaning: Flush systems and apparatus upon completion of pressure and
miscellaneous tests. Completely open valves and flush each system with clean water
prior to any chemical cleaning. Repeatedly flush at short intervals un -11 twice the
system water capacity has been flushed thoroughly. Chemically clean system
immediately follok_ng flushing operations. Circulate a solution consisting of
trisodium phospha::. in a proportion of one pound of chemical to ever; 50 gallons
of water in the sy5-.:m. Completely fill system with cleaning water solution; vent
system and plat-, in cperation with automatic controls operating and valve fully open.
Circulate the solution through the system for a minimum of 4 hours; immediately
drain system and Ilush with clean water until the PH at the farthest drain match the
clean water input. Keep strainers unplugged during cleaning operation_ Refill system
CP
with clean water.
15513-7

Ewbank
and associates
SYSTEMS PROFESSIONALS
P ❑. Box 148, Fairview, O lahn- a 73737 Phoneifax 580-227-3352 E-mail e► tanK01airiew-ok.net
Thermal Conductivity Test Results
Newland Elementary School
Newland, North Carolina
Earth Energy Engineering pe;tarm2.4 a thermal conductivity test at the Newland E;e...entary
School in Newland, North Car m-1:- on November 10, 1999. Testing was done by Biii Nagle with
a Ewbank- portable test unit.
The test borehole was 275 feet in zepth and 5" in diameter. A 1" inch loop was insza' _-d and the
borehole was backfilled wits =5 =.one. Static water level was not reported The iL r-ions
encountered were primarily hard Lat with 17 feet of overburden.
The thermal conductivity (k) va:u. for this borehole is 1.7 htuIdegree F-hr-foot, Ynis is an
average conductivity per foot for -.'�e borehole. This value represents the rate at wtuicn the
borehole and rock will transfer n?. _ To accurately measure the thermal conductivity -.f the
formation a borehole should be dn]ed and grout with a bentonite grout to prevent Zmay low of
water through the borehole.
All test equipment, methods. o:coedures, calculations, and interpretation is done in accordance
with the recommendations zrid Z.::-uelines of the International Ground Source Her. P,---np
Association.

Drill Lag for Newland Elementary Schaal
Hole # f
West end of fletd
27 ft PVC casing inserted and ramc;ed
From
TQ
Material GPM
tit
Ft
0
17
Sandy clay
17
48
Gray flinty rock sort
48
52
Broken 40
52
285
Gray flinty rock hard (sramte)
Total water make 40
Hole 0 2
Eastern end at bail field
56 Ft PVC casting insered and removed
From
To
Material GPM
tt
ft
0
2
Topsoil
5
10
Rock layer
10
28
Clay $ gravel
28
80
Sandstone
80
81
Water 25
80
295
Gray flinty rock hard (mite)
Total water maks 25

� � � _ _7JAf��� ►:ica�aS�E _ p_ a�rr15 -
i
-Lo
t3 al
-
- - --- 7S
I
--AWAY
�l
=!1
____ `3� �{ • �til5 ASH lS _uti[o �,i mac- rr+In�N e..p++1�5 . _
;i
-�,i SY �k ►J s F 3o % o -f-N
I
1j
_
�i --

09/23/00 09:20 12423 543 7109 NOR -WELL
[a001
MECHANICAL CONTRACTORS
Date: 1?-z3-&o
Time: ra:o-o a."
To: t -c ff2Qkm,
Atten: nWA MCir . ax qt't-71S-'P5 :9
From:.5AAt NoWkj
Number of pages, including cover sheet:
136 East Elk Avenue
Elizabethton, TN 37643
[phone]
Fax: [phone]
If you do not receive all pages, please call as soon as possible.

09/23/00 09:20 IT423 543 71O9 YOR-WELL raj002
Alr— B#Soriw Ar.rc
MECNAN/CAL CONTRACTORS
136 Elk Avenue
Elizabethton, TN 37643
423-543-4373
FAX: [phone]
Date: o[-,7-3 -60 Time: /*:co ► rh
To. U 1c 1996G9*m I PeJi'eX SD I
Atten: /,V 4waavPUOW Fox
From: -56M-SAN#jxs
Number of pages, including cover sheet: cz.
If you do not receive all pages, please call as soon as possible.
Remarks:(Ate, w---
se- fit!€ firfecty6o r1 wj _ ►IES-r _ —
ors &VAy-,cWgL ,nl ►w�1r

oar2a/49 09:21 0123 343 7109 NOR --WELL
�ROt 1n3.22,i990 11 1 f. i
r@R QVAj�'ri
[may Ir�
Ta:
Tkrm
From; IN "10ot
RV VIC Insprt%niSchaal
14 ays reviewed the UIC appllcotion and visited this site on Monday 113 September 2000. I
have the following aantl'n"U..
Applicant heads to supply a complete area schematic To scale showing all the details of the
conrfructlon layaur,
,%Z Appllcant needs to supply a working schernotfG of the HVAC aratcm, propariy labeled, and
indisal ing 161c Parts shot aro to be In contact with the growndwaier.
oo-JJApplicant needs to provide the results of mechanical in#ogrlty Tacto including a daseription
of the test(9) and the method(s) usa. } AU&a Tb
Applicant heads to rupply eomplete Information, specifications. and schemotles of all lest
wells en property.
Applicant needs to supply runt, dddrass, and details of ail groundwaTer ti&xrs Identif led in
the arts,
_;�-T Rppl}canT needs to indicate property owner on upplical-19m
,,�fApplican I needs to aupply baring lags for test +welIs.
Appiicamt needs tv indicate The construction details of lnjection walls in wall field.
. L� . Applicant reds th identify all potential pollutlarl Sourced in tkie eras, please identify an n+ap
of area and provide ►nme and addrescsc of source.
4f' It 11hls arse part a federal Indian lands? yI �} jy
01.. i • t �' /l,-rr- Iw. a" dA �-el I. `.S__Ie- ._'}O�Y'i
PIAosc See bile GJ6WIDr,te16I.5prcjeers/VIC/uicneWon f c17d6/6WIDatolvrc Inspaer/0n `Pit n rea
for ccmplefe derails
DRAFT
•**EN4*tr
U 003

05:21
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09/23/00 09*21 0423 543 7109 NOR -WELL Dos
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09/23/00
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09:22
C423 543 7109
NOR -WELL
IA006
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FIBERGLASS
mMmANm'BH'%fj
"LES
FEATURES
LIGHTWEIGHT, ONE-
PIECE ALL FIBER-
GLASS CONSTRUC-
TION, NO .JOINTS TO
LEAK
USE STANDARD 22"
RING & COVER
f
i ADJUST TOGRADE
WITH BRICK OR CON-
CRE T E GRADE RINGS
RUGGED 3" COLLAR
SPHERICAL DOME -
FOR MAXIMUM
STRENGTH
HEAVY STRUCTURAL
REINFORCING BAND
THICK HOOP-WOUNE
SHELL HAS
SUPFRIOR STRENGTI
DESIGNED FOR H-20
(16,000# AXLE)
WHEEL LOADING
SMOOTH INTERIOR
WALLS
EXTRA WIDE LEDGE
MAKFS BRICK COUR-
SING EASIER
CLEARLY LABELED
HEIGHT FOR EASE'
IDENTIFICATION
4 --0" INSIDE_
DIAMETER, STAN-
DARD HEIGHTS 2' TO
20' IN SIX INCH
INCREMENTS
(TALLER HEIGHTS
AVAILABLE)
CUT -GUTS MADE
EASILY WITH
MASONRY SAW
ECONOMICAL, QUICK, SIMPLE INSTALLATION ON
WET CONCRETE FOUNDATION
ASSOCIATED FIBERGLASS ENGINEERS
P.O. BOX 14335 FORT WORTH, TEXAS 76117 - PHONE [phone]R.

09123 00 00: 22 12423 543 7109 __- NOR -WELL (6007
Driscopipe 5300
Closed Loop Earth Coupled Heat Pump Applications
%,e C'.csed !ocp earvt couple! (CL i _ mp
ind4Str.i requires_ a pining rnare rial wniC, -
Cur3tancirg toughness. resiliency art to
prDvrde a cos:-ai cave. thermaiy a: -native
to =nvenliCnal heating avid C3fllr C
aeprrnanca-proven ❑riscopipe 5w
r4 ::... m CuarC
Pipe iS a very high moiecuiar weicnt ,.;C:7 c --iy
polyeInyler.e whic`i ❑ffer5 Superior LEr -a __-a: mi?ke
it the unqua iF}d choice 'or eitrier vi:ririzonral
CI -EC heat Dump systems.
Outstanding Thermal Efficiency
i ne rVa4ve thermal of ic!ency of various --am—als is
expresser' by their respective k-values. .A
k-value refiiects grwater het; trans ier
Crisccpipe 5= Clirnate Guano proviues exwxtivnz!
heai'MrSlar ap24rlities when compares .c -?
ave.-age k-valLe of other ttlermaplastfC" -� �5
i ne average thermal conductivities (k•va v;as" of
various t:'.ermeplastics are listed below:
PVC - . . . . . .. . . . . .. _ .. . 0.087
Palyautytene 0125
Criscapme MWClirrlaie Guard O] 225
.expressed in BTUNIft-T
Dewdabie Resiliency
Seasonal temperature fluctuations
significant stress on the piping ponion ct CL:27, heat
Pump systems. oriscopipe S.wo has beet. xted at
-180°F and 1 0'F and provurl to provide —&:�71e
5e.vrce at these temperature ex( emes, ire —rique
resiliency of Climate Guard systerns assLres'cng
tern perormanca ... 32ason-after-seascn
year-crier.year.
Secure Joining
Climate Guard pipe and firings are;iotnr :�-: 71e outs
sadVe fLslon iecnntque, TI ie in of :~* Lining
method aemonsrrates an overall strenc:nn ac�l to or
excee-cirg {hatof the pips itself. Quick. rehacJe fusion
eliminates tree poterma for leafing mi ec- ercal joints
and cosily system repair. Drisccpipe Qlfeers
CGmpiere line at iiwas which connect C+=ale Guarc
to ether pining materials or system ccmccr_�r rn.
Unique Chemical -Corrosion Res' —nce
Griscapipe 5300 is inert to mast cnEmiLG
cornnounds. Heat trarzier flu,cs suer; cs z----. _ne
glycol. 50diLim Cnlorid e and calcium chicrce -_vim is
EF,ect on- the pressure ca;abiliry or lone :sr--
periorm2nce of Climate Guard. 0r1scrC:Le :E--4 ,, a
nci r1SL rat, air, ccrrodo or cther'rvise r!�aC::c iE+
corrosive s0 js into which it may i e plac ec.
Assured Longevity
You benefit from the thermal 6ffic en,cy.;.
resiliency and easy h2rldling of nriscecib=
Climate Guard. These outstanding C;u2t11._c_
corr,b.ined with triE heat fusion m£ihcc cf c - ar-_
P*liitigs 3riscopipas corrini{ment to cuaiia. n _.:Ce
pining material ,Nv ic:h offers nerfcrmanc� ; Z
ierigevity in aartn cCupleC heat pump
i Me security of 3 Climate Guard systerr iS av 4y
a 50-year Iimilec warranty against deiF_:? _.ter 31
and/or workmanship.
Installation Guidelines
• Carefully Inspect the pipe to defect any ca7-a,e
that may nave occurred during sf'ippirg �,; r:. a
result of excessive abU59 at the jab sits, yy
• Care should be taken to make sure that J e �taf
system pressure, operating piss surge.:: not
exceed the pressure rating of a speci5c or
Schedule of pipe.
• .o .ngure long term performance. Clir. 2L}
Guard should be in5taileC strictly in zcticr .ca
with accepted engineering design metroctgy
for water source neat purnp applfcatims al --
in 2ccCrcance Witt] the Driscapipe 'cyst
'nsta,laticn' brochure avaiiable from
Phillips Oriscopipe.
• When laic' in a trend+, care shgv,C be :e ,er :Q
insi,re tl gat the bottorn of ;he ditch is 341.t:cu ;Prl
Igoe cf sharp or angular objects.
When installed Cflwn-hale. as in 2 ver!CcJ Cc❑
ample precautions 3moula lee taken to mF_xz sure
the toallast used to facilitate the insar[iarl I - e:
does not impinga. gouge cr cut inro Drisc_�ne
5= Climate Guard.
• Prior to installation. Climate Guard srlCulb tn-
with water and hydrastaticaliy tested -

09/23/00 09:23 IM423 543 7109 NOR -WELL la008
=QQz tY
.+i GALS■
Ca
material Cas£grtati,on
?F1_f7L3TX
xa_arial ClaataitiCatian
AN= D-124A
Six C 3 Ala
Call GIaV><ai-iaatian
A. = D-3330
w
347434C
Donaity L 31
ASS 3--1$05
qZ/C;X3
0.955
malt Flan t4)
AS= �2-1238
SU/10 min
O.LL 9 3.16 ]t4..0
i:ax m d"Uml (5)
AS_.X D-794
psi
136, aBG....... . _ •
Tensile St=. (4)
ISTR m-61a
psi
3200.....r......+
FSCR (3)
J6S4 0-L691
7" us
r 3000
HDB 4 73"F (4)
A9-w D-iti3l
O
V-V Stabilize! CC)
A= D-1603
1L
C
Z,s
Hartmass
AS-X 9-2240
shore *,Do
63
CamprssmiVe Stzwgrh
{Yield)
A_T_+d D-625
ps;
1690
Tensile stsemyth 0
A5_.A 3-538
Y1a1C (TY" ry space.)
(:• •si.rtt
yal,
33a0
t?longati4n 8 Yield
7.0—_'Y_ n-622
'4, M.Lni3tL'4
a
Tonsil■ S%Z-%-Mh 4
Sresk (Type IV Spec.)
iS Y 7-633
psi
50:00
eleagation a areak
2631-4t 7»63s
i, ainiaus
75o
KCCulus of P-148tiG.zy
AS= 7-4176
psi
L3a, oco
ESGZ:
{Cued A,H,C: Kold. Slab)
A 0-1691
r Hzs
? a500a.w
{Cacprassed R13Yq C71pa))
AS7'K F-1348
Fig -Hrs
F'31000
5.1w C;ar-k Grawth
34}3 lla MAUIC4
pays to
F; 6A
Failure
Iapart Straagrh (IZGQ)
11Sti 6-256
In-Lb/irk
t.Ilsw TlIltj
{3aY'ed a)
Htsech
sx
Uneer TA+z=atl
ExpbRsion C06f.
AS-W 0-1545
1n/in/"'r
1.2 X 10.4
Thaaal ConduC--lVityr
A.:---.- C-L77
aTu-in/
2.7
m* /are r
Brittlanaas Tamp.
AS-'X D-746
'r
K-180*r
V;t:aL 30m 'tarp.
A5_-A 0-033
■l
t751
Meat P'ttsion Cond.
-
psi 4 ■l
75 1 4007
• This list of Typical ?hyrsi.Fal Properties is interidsd tar hazit:
charac--ari;ation et era pipe, and do" not sapresent specific
derara natl9 a or spee4__4-mt4oeteR-
■■ Tanta Vera disoont'--u d Marisa no tailuzes and no indication of stress
crack laitiatitat:.
p Average Melt index Value Yit; a trandara deviation at 0.01.
f Avsrage Tensile Strew art rleld with a Standard deviation at ;54 psi
Watlrage Tlssti--aL ]ROGrilt:.e Vith a st&rA&rd aaviatlan a[ 1000 psi
Ao-a14C3 C:•sCantt�a, tnc. {heretnaRer ca6ka'Pru1GRi ^ l
warri 9 its Dn5GCO4per S34a cwnate Geraro ` fte VC :ny
nor a Derma ar50 Years Agiknmt *utt. rpt, aleetraty= ism. aria
deletes wswprunargrnp Ind matey aft when udG;ea arrc +marled
m bused e0d0 darts Caw= w 2W SOVma heat pump syueg er
accom4 atwith the Insmm6oe gvl me ms pnrltais � term
broe» ov, Thve w&mWanrhm list) to Gr=ootpoS= Csrax
Gom Mee and Lomw It cae net aa0y m arty ta=M occ_-Aor
dtsrer+rae0+od or ee.tee used to loin tlla pion or ttstxr+g.
dl70S d aoclr to the ae� AAC'v%M1tAft rt d Me sysratn at d 3V
otlterCarsrporttr+tGale systerll-
Vt7Mrr &mow wo SJas irrdupm dDare. Pruw=
0�[xar,.rn. rt � i1719C�1rr�tC Gard 1aa ar ry�rr roes �
So mm borm ma Cate of 0=maae. 9u00ty tree hmkN.mn m . •
Ora to V otLnukisor
To Secure Product Irdarmauon or Leave a
Message tar a SaJtfls Engineer or Techni aj
Service Representative:
Mall:
AM: CusmmerService Department
PC. Box 83.3866
2929 North CemrW Expressway
swe 100
Ricnardsan, Texas 75063
1 PhAkas 6risCORoGe rapW-a lies at erwga alto lrt7s
prebarcz. a cypnety Of now orleccooe =W C9matrGk6ky ace
or tv4tng ea:ual In mat ara"a low detects
2 pm0oS I]Ai moq NLwl M at atmmz taporcFarr�aa tip 30 M 5�;
per 61A sir MCI eTawled an fete jab rile In "U"CYtrtg me adt;�+e
1:10r of DAFMO. ttn4 rimlipcog the earn *mm A4rw Crrm.. ce
& o Guerrero Gvsrd pipe or tumrtg_
SuOjeG � at+y express warraotiee s�rAaiMd �n Or�scavvr.
fisa'e sa6ea older awed apprtr�fa tC ate ipeaNe gu0ds: ri
me doregoim watrertffns are let Fell of ail other ffimp rrrmrarwasr
whiner w om pr oraL M no "" shalt PhWkm 0r=QP PL tr-26
kabw tar Inns at use or rew irtddmud or causquent10 dawaW
Whether a- rtt7t Gawmid W or rt xd& q kM We of Drkwpkn Z=
Curnam Guard ppe or httw& whserer woo s6"4r is
carneil LION w;dr otnar X=K is ar rlt 1W4WL S to — = ra
alldw Lrwa i;xftmgn, so.t may mt apply to yoLL has
gives d%a elurchaeer spec k regal ng tlS ar10 Twe may oe ars
n9rus wm,-m wary IMm tlitri .a state.
Phone:
U.S, Comeadc Toll Free (800) 52743662
TWX-. ftx: '
910-6674618 214-783-2689
PL10" WIT" PllfF�frS
POWER TO IWN. ' ' -

09/23/00 09:24 $423 543
7109
NOR -MELT,
's �- - ...
'ter
_ > ,
•:i..
• ' 'ti•.� �'•»s: _ j'
•:'-;
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Jy6id�l
HEADERMETAIL
-
-• :NOS -SCALE
- - �t-
,HEADER TRENCH
SAND BACKFll_L. ----
SUPPLY HEADER
Lu
• J �
:
60
RETURt+r HEADER =;
TO BE REVMJOVED
CONCRETE OR
K14TONIT'E PLUG - - 3�
BORE HOLES ARE .3001 "
OR THE DTEI -AND
U—BEND ,ASSEMBLY' —
USE 'DRU CUTTINGS OR SAND
FOR GROLrnNG. 'USE SENTOMTE
PLUG INHERE REWRED FOR
AQUiFIER PROTECTION ' -
IIJL HOLES SPECIFIED 9Y
_ - A CERIIFiM CALCULATION
FROM TrJE GSG INSTALLER
WED SATE .SOIL
CONDrnONS AS TESTED
- I
009
- :;I��Al�ED •k3Qc
sM
C40
VT �
- - —
-
_'
.T:.:
•
_•rep:::'.` —
-
[^—.f't't
�. _
- -� -
_
B RE i�OLE
PIPING-. DETAIL
µ'Y
Y
•:-.+ �`�`•
-4�•• - .i•'' -_ ..� -
�� -•ice
-• t
•
�=`�" e � -ITT.. ,�++j.,' •��
.^
- -
- - -
_
_-•�� .-/, _i�. if::!
.. ...._� .-_ ._... ;.['2 _ -
=r. _ _ - - -,�.� - :��-�'• ,_ ate.

09/23/00 09'24 12423 543 7109 NOR -WELL 0010
C�
C. Coordinate the laying of header piping with existingutilities, new mechanical and electrical
utilities.
�. INSTA.LL.ATICN OF PIPINCI
--- A. Install piping in accordance with manufacturer's written instructions.
B. The pipe and pipe fittings must be joined using socket or butt heat fusion process. No other
method is acceptable. Exercise extreme caution to completely remove the cutout material.
Bell reducer fittings shall he used at all pipe reductions to eliminate trapped air-
C. Avoid sharp bends in piping installation and install elbow fittings if necessary.
D. Connect geothermal water piping through to flow header center manifold in the mechanical
room. Manifold to be provided by the Mechanical Contractor.
3. TESTNG AND QLEAl� �,--
A. Cleanliness: During installation, trash, soil, and small animals shall be kept out of the pipe.
Ends of the high density polyethylene pipe shall he taped or capped until the pipe is jovncd
to the circuit. _
D. Pressure Testing: Each polyethylene loop assembly shall be pressure tested prior to
installation. Testing shall he by air or water pressure, at up to 100 psi for a miaimum ofhalf
hour. Results of all tests shall be recorded and supplied to the Contracting Officer upon
completion of the Project_
C_ Cleaning and Ovation Testing:
I) Cleaning. Flush systcros and apparatus upon completion of pressure and
miscellaneous tests. Completely open valves and flush each system with clean water
prior to any chemical cleaning. Repeatedly flush at short intervals until twice the
system water capacity has beers flushed thoroughly. Chemically clean sYstem
immediately following flushing operations. Circulate a solution consisting of
trisodiurn phosphate, in a proportion of one pound of chemical to every- 50 gallons
of water in the system. Completely fill system with cleaning water solution; vent
system and place in operation with automatic controls operating and valve fullyopm.
Circulate the solution through the system for a minimum of 4 hours; immediately
drain system and flush with clean water until the PH at the farthest drain match the
clean water input. Keep strainers unplugged during cleaning operation. Refill system
with clean water-
15513-7

09/23/00 09:25 IM423 $42 7109 NOR -%YELL
Ewban k
and associates
GEO SYSTEMS PROFESSIONALS
F.O. Box 148, Fairview, Oklahoma 11737 PhorwJFax 580-221.3352 E-mail ewbai�k airview"oknet
Thermal Conductivity Test Results
Newland Elementary School
Newland, North Carolina
Earth Energy Engineering performed a thermal conductivity test at the Newland Elementary
School in Newiand, North Carolina on November 10, 1999. Testing was done by Bill Nagle with
a Ewbank portable test unit_
The test borehole was 275 feet in depth and 6 in diameter. A 1" inch loop was installed and the
borehole was back611ed with *9 stone. Static water level was not reported. The Formations
encountered were primarily hard flint with 17 feet of overburden.
The thermal conductivity (k) values for this borehole is 1.7 btuldegree. F-hr-foot. This is an
average conductivity per foot for the borehole_ This value represents the rate at which the
borehole and rock, will transfer heat. To accurately measure the thermal conductivity of the
formation a borehole should be drilled and grout with a bentonite gout to prevent any flow of
water through the borehole.
All test equipment, methods, procedures, calculations, and interpretation is done in accordance
with the reconmeudations and guidelit:es of the International ground Source Heat Pump
Association,

❑8?23/00 09:25 0423 343 7100 NOR --WELL
Drill Log for Newland Elementary School
Hole # 1
West end of Feld
27 ft PVC casing inserted and removed
From
To
Material G P M
ft
it
0
17
Sandy clay
17
4e
Gray flinty rock sctt
48
5c
Broken 40
52
285
Gray flinty rock hard (granite)
Total water make 40
Hole # 2
Eastem erd at ball Field
55 l; PVC casing insened and removed
From
To
Material GPM
ft
ft
0
2
Topsail
5
10
Rack layer
10
28
Ciay & gravel
28
80
Sandstone
84
81
Water 25
80
295
Gray flinty rock hard (granite)
Total water make 25

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--__' __-----_~__--_-. _'--�--� -----_---
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Actift VZS_
-----_-'
/|��l^ -"CS IS NOT

2yb tr Li� 4,d QAc.
[9
DIVISION OF WATER QUALITY
GROUNDWATER SECTION
September 7, 2000
MEMORANDUM
To: Landon Davidson, L.G.
Groundwater Section
Asheville Regional Office
From: Mark Pritzl AR [e-mail]
Hydrogeological Technician II
UIC Group
Central Office
Re: Request for review of a closed -loop geothermal -mixed -fluid -injection well system permit
application and a routine inspection of Avery County Board of Education's geothermal
injection wells in Newland, NC, Avery County.
1. Please review the application and submit any comments to CO-UIC. Retain the
application for your UIC file.
2. Please inspect the proposed injection facility to verify the location and construction
plans specified in the application and to also verify compliance with NCAC
T15A:02C.0200 standards, using the enclosed Injection Facility Inspection Report (form
B) as a guide.
3. Return any application review comments and the completed Injection Facility
Inspection Report (form B) by September 30, 2000. If the inspection cannot be
accomplished by this date, please inform RCO-UIC promptly. The UIC group greatly
appreciates your assistance with the completion of UIC program activities.
After the permit has been issued and operation is about to commence, the RCO- UIC may request
the ARO to inspect the facility in operation

A
Gla_
NCDENR
JAMe,s B. HUNT JR.
GOVERNOR
STL,L HOLMAN
SECRETARY
1 cnn T. STFCVSNS
❑IREGTOR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT ANO NATURAL RESOURCES
September 7, 2000
Mrs, Meg Julian
Newland Elementary School
750 Linville Street
Newland, SIC 28657
Dear Mrs, Julian:
DIVISION OF WATER QUALITY
Your application for a permit to construct and/or use a well for a "Closed -Loop
Geothermal -Mixed -FIuid-Injection Well System" has been received and is under
review, A member of the Groundwater Section's Asheville Regional Office staff will
be contacting you to arrange an inspection of the geothermal injection system as part
of the review.
If you have any questions regarding the permit or injection well rules please
contact me at [phone] or Amy Axon at [phone].
Sincerely,
1q.' 1 A
Marls Pritzt
Hydrogeological Technician II
Underground Injection Control Program
M. UIC Files
ARO Files
GPOIJNOWATER SECTION
1636 MAIL SERVICE CENTER, RALVGH, NG 27699-1G36 - 2728 CAPITAL, 8LVR., RALE I(iH, NG 27604
PH0NE919-733-322t FAX919-715-OS96
AN EC) UAL OPPORTUNITY I AFFI RMAT; VP ACTION EMPLOYER - 50 REG YCLE 0/10% POS T•CCIN S U M ER PAPER

\'ORTH CAROLEN.-1.
DEPART IEN7 OF FN-1,-1R0N?N'fENT -A-ND NATUR-%L RESOURCES
APPLICATION FOR PER -MIT TO CONSTRUCT AND/OR USE A
WELLS) FOR I -SECTION WITH A HEAT PUMP SYSTEM
Type 5A7 and SQ1i Wells d°�t W' It���s
In Ac`orc'.a[ct -1-th the provisions ofYCAC Title 15A: GIC.0200
Com-, em oIication and -mail to mdziress on the back page. 1�• S(5�!'
TO: D ECTOR, N0RTH CAROL --NA DP'ISIONT OF TER QLr.4LITY
DATE: 7-27 . 2000
A. SYSTEM CLASSiFICATO ?:ease c!'1ec calurrlL w��c7ti2tcnes oropo�ed;}'s:�..._
Tvpe A: ,ve"s--niect water used to heating or cooling for
(2) X T)Le 3Qti: • contain a subsurface sr s,em of continuous pio;ra. ; is
isolated hom tnviranment and [:'CSs,_[s a fluid other tha;s ;7ot3:--e water.
This in--iL:Z'cs s- .cuss that cire u12te =c=:.<<es Such as antifreezes ;.., : --wTD 1Qi1
inhibi:ars.
(3) _ Type 3Q',ti x-c: =contain a subsu-fZCc s. s:e , of COn7 MuolrS piping, r .:s
iso:ated a c^ :. --eavircnment and w-:1-: c;rculatrs pozable wzctr. If 4oc selected
this ► ull type, then complete form CZ;'-S? CL, [Noti -cation Of lnrarr To
Coarwuct A C osed-Loop Ceotharm :-R"arer Only Injeerion Well S:S-.Xnt,
B. PERMIT APPLICANT
N;ri,e. Avery County Board of Education
:,;jdreSS: 775 Cranberry Street
City: Newland Sate: --= "Lip Cede: 286 57 Cvurty: e�T
Telephone: [phone]
C_ PROPERT`11 ❑ VL-.111"ER di:::c:r .1 from app;lcart)
dame: �
Address:G-
Cary_ Sate: Zip Cc4e: CoLsmrv- w
Telephone:
D. STATUS OF APPLICANT
Private: F:a- .
State: i•funi.: x
Cormmc-cist:
crican Lands:
GW-7 i HP Part, 2000)
SIG E'E9' ON
Pa"-C i -,f ;

E. F- ,CII.ITY (SITE) DATA
(Fill out ONLY if the Status of L-:G-ner is Federal. State. Municipal or Commercial).
Name of Business or Facilirnv: Newla S
Address: 750 Linville Street
Cary: Newland, NC Zip Code: 28657 Count}': Avery
Telephone: 828-733•-4911 C❑n:act Ptt---o:;: Mrs. He • Julian
F. HE3T Pl SIP CONTR kC T OR D A72:
Name: :'orwell ComDars. Inc.
Address: 136 East Elk Ave
City. Elizabethton Zip Code: TN County: Carter.
T elephore; 423-543-4373 Contsct p=-o^: Sam Shanks 1�pqjIS— 6Lt�' 711
G. LtiJECT10N, PROCEDLiR.E c`fi"f!y hc,-- rasa '; J==:ion weli(s) will be sSed.}
::ell field to consist cf 55 holes 1? Et. dee:) to be
grvuud--coupled heat . xzhanger for a hem= a Tin HVAC s- srem.
H_ -=.'ELL USE 'till the iriec= cz well(s) also be use«s _..e supply ueil(s} for the
[;} The in;cction operz"c" Y-ES x _ O
{2) Personai cor,sumptic-:° YES NO Y
�. CONTSTRucnONT D �TA
a EXJST:NG 7-V7ELL being propose :e; USe as an injection Well. ir.
(i} tnr ou& 7) belo%v to the bes: oI'vour lmoNVledge. Rrmch a cap'_ o; Fort-. G«--
I Cx- el1 Cons-cr action Record) if 2z ail�ble.
nla PROPOSED �;ELL to be conf,_c:e_ for tse as an injection.Prov di-2 the
data it. (1) .hrough (7) below a; ?R0?0SED cor:srLction Suibm:_
Fc,:n G . after consrmcti❑n.
0) Well D-Alizg Coast c:c.'s Name; Braswa ll Well Dr illin g
NC Contractor Cez—,iEca don number: 2=53
OC`
('72) Date to be conswuctenug., : 2 88t"�;L- bzr aFbor�r.�s: 5s
Approxima:e depth oreach boring (feet); 3 6
(3) Well casing: 15 the wz2(s) cased? h4
(a) YES n/a If Yes, hen provide :he cas:,= in[orm.vion bellow.
Type_ Galvanized steel Black ,reel P:tz,ric Other (specify)
Casing depth: From t0 ft. (r_ _ trace to tard suriac_ j
Casing exterds above aches
(b) NiO
GW 3' HP (Jan. 2000)
7/u s u6`v4 1 0N
Pane 2 r1r4

(T °) Gran: .;
(, taterin] suoU'n:Hr_g Well casing andior gaping):
(a) Grout type: Ce; :r... Bentonite S Dther (specity) _lnstall 20_ LL p_f
(b) Grouted surface z-u grout depth [referee bentonize grout from botLo=
to land surface): of ditch lime and grout
around c:oti_'.00p pipin„ from to (feet). between aquifers as
necessary.
around we".] �,-in: from to {feet).
(5) Screens (for Type _5A yells)
(a) Depth: From n f a to feet below ground surface.
(a) - .C. State RcgU1a-_D=s 177:11e 1.5A NCAC 2C :01240) require the oermittee to m- stir rro:isians
for mom-toring we".",tad processes. A faucet on -both influent (fiuid entering 'rta-. pump) and
effluent {t�uiC heir._ y;e•._e3 into the well) line is .required. Will there be a fi_ce; on:
(a) the influent line" _ es n a no— the affluent. line'? > zs no
(7) SO RCE Iv -ELL CONSTRUCTIGIN rNFDRM ;: )N (if different from inject --or. weh).
Attach a copy of F of__ GW-1 (Well Consrr= on. Record). If Form GW-1 -or available,
provide the data in ray. (I) of this application to the best of your kmiolz :edge.
N0-LE: THE 1v ELL D U-N +DN`T}tkCTOR C,- PN SLPP-_T = 'DATA FOP EI T 14E R ExISTI}':i RJR
PROPOSED 'W'EL'LS 7 _HIS hIFORAf aTiOv I5 i ?� ni�� �`" 47i?E� �tEA,tiS.
J. PROPOSED G? EFA.I1'C D-' ; (far Type AT w el'=}
[?)
Injection rate:
Averse [daily. =
—canons per minute (g*r.;a)-
(Z)
Injecrion Volume:
Average (daily_;
26=4 gallons per day (pol. ;Total volume =n
(1)
Injection pressure:
Average
40 poundslsquare inch ;asi)5.y $tom}
(-')
Injection Temperar�:.- e:
kverage (7anuary) -=
' F_ Average (July) 85 - F_
K.
FLUID DAT:k
'I) Fluid source (for Type=A7 welts) IF underVpn.,.:-::, from what depth, for —mat —on a.-d type of
rock'scdirnent unit►::;1 :::e fluid be dra% n (e,c.. 3.anire, times.one, sand, erc.)_
Depth. n/a Fzrmation: Ro:k'scdir.-GrEunit:
(2) ae,nica1 Analysis of So; ice Fluid (for Type =Q3I welts)
Provide a complete Iik;Lng of all chemicals acdtd to the circulating heat tiansfe: t1'_4L:
inhibited propylene glycol
1'~_ nUECTIDIN-RELATED EQU-2- [E:NT
Attach a diagram showing, tl=c =3ineerin, lavout of .e in;ectior. equ:preen; and a xte, _or pip ��c'rrDin
associated witz the inject -ion. :-xration_ The manufa,2rer s brochure may provi;e suprlem irn
information.
GW-57 HP (Jm 2000)
Page 3 v 4

IM, LOCATION OF W I LL(S) two maps.
(1) Include a site reap (cyL ;c draw.-n) shoving: buildings, property lines, surface Rster bodies.
Potential sources of o-=dwatcr corimnination and the orientation of and d:sz2zLes between
the proposed well(s) wye z=� existing well(s) or waste disposal facilities suc;� as septic Mnks or
drain fields located ;it _m 1000 feet of the georhermal heat pump well Label all
feaa:res clearly and norz,h arron'.
(2) Include a topographic = afthe ar.s extending one mi'.c frorn the prope:ry bc-w_raries and
indicate the faciliry's'o.=non and the map nante-
N. P> F-MIT LIST: Attach a '.: o- permits or consm.;ction approvals that are relate'? .a - t site.
ENarncpies include:
(1) Hazardou!; Wasre la prog-ram permnts under RCI-�\
(2) NC ❑;vision of Nor.-Discbarge permits
(3) Sewasgc Treatrrenr and Perr,-its
O, CERTIFICATION
"I herebv certify, under F=na:7- lam, that I have personally examined and am __."ar ,.vitr the
information submitted in and all attachments thereto and ihat. basal c- Liqui:-w of
Those individuals immediatel,~ansibie for obtaining said information, I belief a aa_ t = information
is true_ accurate and ;= wx, are: rhaC there are significant penclties, inc iud possibility
of fines arn4 impr;sorrr:e `..a: _;;mitring false information. I agree to consrrssct, o_Y.a; mzinmir,.
repair, and if applicable, irjec%an veil ar:d all rclaz:.d aopurtenarce; :n azzc. -ice -,ith
C'ne approved spec Iilca:':o s =..L=_.^_ditions of E'lIC Permit.
(5 igrature of Well O---ner or Authori_eA : _en-')
fit aurk0rized agent is aerirtr 0l1 ocis ulP ojU:e Mz:: '-7%r.
please supply a letrer signed by rite owner au.tror.zi�x - ahos•r ZZIML
?- CONSENT OF PROPER-1-Y G7'-N'ER (Owner means any person who holds the fee e- o es proper? -
rights in the .well beir,. co---5_ Z;ted. A well is real property- and i?-:, consz uctic _ on la.-iC zesty
ownership in the -ae absence of contrary agreement in u-ritirg_)
If the property is ow-ted by sa=eoae other than the applicant. the property- owner ne7z7o conse=lj to
allow the applicant to cons.: Lz-. mch injection swell as outlined in this application arc it sW1 be
the responsibility of the rspp ► t to ensure that the injection n'ell(s) confo,� to i,e ' Well
Construction Standards (Tine 1-ANCAC ?C .0200)
[Signature Of Properry Owner If 1) i ffer_ _ r: r,z A; ?liczant) -
Flease return; �.0 espies of the corr,pleted Application p_,:kagc to:
UIC Program
Groundwater Section
North Carolina DEAR-DNVQ
1636 MatiI Service Center
Raleigh, NC 27699-1636
Telephone (M) 715-6165
GW-57 HP (tan, 2000)
Pace 4c=w
C/� I r P,Ffii I a Wd74t.I_ i- 5 1 '0£ I un`

Page 1 of 1
L
T
� � t. -:fin jam• _ i .ti -li~..-
'�`-'! I � �. �_ _ Thewe[erentl saver 6ata d
war taw wosl, a ceww4
�. •�� >♦ 4 O6�GR�9a[ 61r4liR�r9d it
I
1
_ ; jfi.^1 • } Slew
�•. 4 ~ wet
300 0 300 600 Ft;et
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0818 /2SQD_ 14:53 4234226994 PSS:CHEMICALCQ PAGE DI
lo! GR£®EVILLI F;oo P'3, a 5. Safety 6.0.4u I SSya y. a vs ►.
DCZAJV YRTWORK 1=2GINCT FK01M 1-800-OLIIN 911
IBIS KATERIAL SAFETY DATA SHEET (NOS) 10 BEEN PRSPARBD IP COMPLIANCE WITS THE
FENRAL OSHA WARD COMI ICATION STAIMAR .39 CFR 1910.1200. IRIS P10=7 MAI It
CONSIDERED TO iS A RAIARDOUS CiIMICAL UNDER THAT STAKDARD.(REPSA TO TIM 0SU
CLJISSIPICATIOX IN 3EC.I.)TBIS INFaWTION IS REQUIRED TO BL DISCLOM FOR 9APETY
Ix Tim S aAmACS.rn 616PCSuix TO Tax Ca'Q1Q uy, IF ANY, I3 OYITE DIFFaHiT.
3. FROWCT I'DE TI1ICRTION
REVISION 94
1
RIVISION DATE
6/03/90
PRODUCT CODE
CP800642#
FILE b1=1R a
CPE00414.0010
P1 MUCT 1FANg t
PDO TLXXE GLYCOL
SYWCXYXS: PG; Kethyl Ethylene Glycol; 1,2-d1hydroxypropone
CHERICAL FAMILY: Glycols
PORMULA: C, H, O,
USE DESCRIPTION: Solvent, carrier. intermediate
OSKA HAZARD CLAS31PICRTION: Not considered hazardous per 24 CFR 1910.1200.
I t . CDI@QMOIT DATA
PR4DUCT COI1POSITION
[AS or CHEXICAL'NAKEt 1,I-Propariedlo1
CAS NUMBERS 97-35-6
PERCENTAGE RARGE: 98-100L
HAZARDOUS FIR 29 CFR 19:0.1200. No
EXPOSURE STANDARDS: 50 Mw [8 hr. 1W for total vapor and aerosol. 10
sl<<evbie motor (8 hr. TWA) for aerosol alone - AIHA
VUL Guidelin■
111. FR=CAUTION1 rOl 51F9 11AML I NG kIM STM1142
AO NOT TAKE INTERNA117. AVOID COW7ACT WITH SKIN, EYES AIM CLO71ING. UPON
CONTACT WITK SKIN 01 EYES, WASH OFF WITH MATtA.
STORAGE CON'DITIGIIS6. Store in a cool, dry, well ventilated plate.
DO NOT STORK AT TZMERATIMES ABOVE: 49 Dej.0 (130 Dog.?)
PRODUCT STABILITY AND COI4ATIBILITY
SHELF LIFE LIMITATIONS: 6 month& in drums or 12 months in lout%
u; x'.

96/03!2000 14:53 423422609d PBS:CHEMICALC}
T�:'S��EYIL[I Fro; F.S. i 5. Sr[aty r urru j,y1,� PAGE 02
„
I
INCOMPATISLt KATUII,LS FOR PACKAGING: Storage in unlined mild steel say
cause discoloration and altar !laver
INCO?iPAtI1LE 11ATERIALS FOR STORAGE OR TRANSPORT,. Do not store or ship
vith strong oxidizers as a spill say result in a fir*.
IV. PUTSIGIL UTA
APPWANCE1 Clear. colorless liquid
FRE€LING POINT: -60 Deg.0 C-76 Deg•T}
BOILING V011 T: 167.4 Dag.0 (369 Dag.T)
DICUMPOSI710M TCISPUATM: No Data
MCIFIC GRAVITY: 1.04
BT:LX DENSITY! 1.66 Ibs.lgal
pX P 25 OBG.C: Not Applicable
VAPOR PRESSURE 0 23 DEG.C: c O.1m d=
SOLUBILITY IN WATER: Complete
VOLATILES, PERCENT ET VOLUME: We Data
EVAPORATION RATE: %a beta
VAPOR DEHSITYL 2.62
MOLECULAR WEIGHT. 76.1
OOOR: Slight
CCEYFICIENT OF OIL/W1ATIR DISTRIBUTION: No Date
V. PSRR0M PRO?iCMI ZQUL"MMI' REQUIRPMTS
P060NA1. FROTICTION FOR ROUTINI GSE OF PIODUCT:
RESPIRATORY PICTECIIM Respiratory protection not normally requires.
Sowever, it vapars. mists or aerosols are generated, wear a NIOSH
approved respirator it any exposure exceads the racceoaended exposure
guideline.
VKHTILATICK: It vapors, mists or aerosols are grner■Led, use local
exhaust ventilation to msintein levels to below the recomended
exposure guideline. Otherwise, use general exhaust ventilation.
SKIN ASA] EYE PROTECTIVE EQUIPMENT: Neoprene gloves and chemical
$06SLes.
EcurMENT SPECIfICATIOMS (118EN APPLICABLE):
RESPIRATOR 7YPE: Not normally required. However. wear a NIOSH approved
organic vapor/dust mist respiratory if levels exceed
the recommended exposure guid*line.
PROTECTIVE CLOTHING TYPE (This includes: gloves, boots, apron.
protective eeit): Meoprena
PAG1 2 OP 10 CF1:00640

08103/2000 14: 53 42342260134 PES:CHEMICALCC PAGE 0"
73� GREERMLIE Froor n.B._ i 5 Sifs:.y 9-03-08 IMPS P. J oC A
lin
VI. FIRZ AND EEpLOSION NAEIUL.D INFORMATI09
FLARKA1ILITY DkTA:
FLAAMMLEz life
CONBUSTIBLEi No
PrROPHORIC: No
FLASH POINT: 107 Deg.0 (225 Deg.F) lost Xethvdt Cleveland open cup
AUTOIGAITION TWERA7MZ: =71 Deg.0 (700 Deg.F)
FLAT W LE LIAITS AT NORAAL ATKOSFRERIC TWEAATURK Anti PRESSURE (PERCENT
YOLME IN A.IR) 1 LEL - 2.61 UEL - 12.52
YFFA EATIMS:
Health: 0
Flawabi i ity: 1
Reactivity, 0
11M EATINGS:
Flaimsbility: 1
Reactivity: 0
EXTINOVISKIN9 ILIA; Alcohol lass, carbon diasids, dry ebavical, Later
spray
FIRE FIGHTING TECKRIQULS AND COKMENTS: Us■ water to cool containers
exposed to fire. See Section 1Ll far protactiv■ equipment for fire
fighting.
VII. R ACTIVITY I1RaRMAT1ON
CONDITIM MOD WHICH TRIS PRODUCT MY 1E UNSrAil.E=
'WIL ATULLS ABOVE: 318 Deg.0 (423 Deg.F)
MWICAL Is= 01 IHPACT: No
ELECTRICAL (STATIC) 015C MGEI No
UZARMUS FOLTURTLATIOW; Wi11 not occur
INCOMPATIBLE KATERIALSz Strong axidiLars
HALMDOUS M RMSITION FRODUCTSi Carbon dioxide: carbon sonoxids
SDrIIY.1RT OF RLACTIYITT c
OXIDILU.
No
PY107MMICr
xd
ORGANIC FEROAZIM;
Ka
WATER SEACTIVEi
1►o
pAGB 3 or 10
oc 11r,a
CF9096471

66162312606 14:53 4234226094 PBS: CHEMICALCO PAGE 84
To. GRWEVILLE FrMP ?,3, i S. Safety 1-03-I0 1Mpa P. 4 at lu
V111. TIRST AID
EYES: Immediately flush with large amount& of pacer for st least 15
minutes, occasionally lifting, the upper and Lower eyelids. Cali a
physician at once.
SKIM Iamedistaly flush with rater for IS minutes. Wash the co"taninated
11kin with soap and rat*r. If irritation develops. Call a physiciM.
II clothing ecmea in contact with the product, the clothins should
be laundered before re —we.
INOBSTION: Ismadiately drink water to dilute. Consult a physician if
symptoms develop.
INHALATION: This product is not toxic by inhalation. Reanva individual
to fresh air.
I X . TOXICOLOGY MD KULTH I NFORNAT I Ofl
10085 OF ABSORPTION
Ingestion
WARNING STATLUNTS AND WARNING PSOPERTIES
DO NOT TAU IN'TFBuuy- nOLONGID CONTACT WITH THE ETE3 MT CAUSE
IRRITATION. PROLIONM OR REFILATSD SKIM CONTACT MAY CAUSL IRRITATION.
MMAN TRRESNOLD RESrMSE ABTA
ODOR TI(RESHOLD: No data
IRRITATION TiLRf=0LV, MIa dot•
INSEDIATLLT DASIMOUS M LIFE QR RLALTM; The IDLM concentration has net
been established for this product.
SIGNS. SY'MrM. AND EFFECTS OP EXPOSURZ
I NNALAT IOM
ACUTEI
No significant adverse offsets to health would be eapected to occur
from inhalation with sorest ue* of this product due to its io►+
volatility and vapor prsoaure.
CHROKIC :
Thera are no known or reported effects fro& ekronic exposure
Mn
ANTE:
Contact with the skir. is not aspect*& to produce epprscisbio
irritation. Skin contact way cause transient roftea■ if not was -had off
and left cm the skin for an extended period of time. This irritant
offset would not be expected to result in permanent dwapa.
PAGE 4 OF 10 CPEDO6430

0E{0312000 I4:53 4234226094 PBS:CHEMICALCO PAGE 05
To* BEEN VILLE From- M. i 5. Safetp 8-DI-00 IMPa P. '� oc is
CHROMIC.
There are so known er reported effects frog c rocic exposure except
for eff"to eimiler to those eapecionced from single exposure.
EYE
Tropylens glycol ham not caused any eye injury in human■ or laboratory
sainals. Sow►ver, contact with the eyea may cause transient eye
redness, stinging, twitching and testing if not washed out and left in
the eye for an extended period of time. No corneal involvement or
Visual impairment would be expected.
INGESTION
ALIITY i
Ingestion soy Cause gastrointestinal discomfort with any or all of tine
following, syaptams: nausea, vaaitieg. lethargy or disrrhes.
CHRONIC:
There are ae known or reported effects from chronic espesurs except
for effects siailer to those experienced for ■iogle exposure.
aDICAL. CORDITIORS AGGRAVATED 11 9XPOSURB
There or* so medical conditions known to be aggravated by exposure.
INTUACTIONS WITR OTREI! CHLLPIICAL S WHICH ENHANCE iORICITT
Thera are as cheaicale known to enhance the toxicity of the product.
AKIPWL TOxICOLOGT
ACUTE TOXICITY;
IAhalation LC SO: No date
Dorul LD SO: ■ f glkg. (rabbit)
Oral LD 50: e 5 g/kg. (rat)
Irritation: May cause mild skin and ■ys irritation free prolonged
aeuts expeeure.
ACUTE TAJIGET ORGAN TOXICITY:
go organs known to bs dem Sed from exposure to this product. May cause
mild eye and skin irritation [Coal prolonged acute exposure.
CHRONIC TARGET ORGAN T071I C I TT
There are me known or reported effects from repeated exposure.
PAGE. 5 of 20
eY_ W;P
CP A00642.b

©sly r?sae 14:5:� 4234226094 PBS:CHEMICALCO
To r
GRE13EVILLE From: P.9, 1 S, SaftLy a-U-1-uu IIrpu u V. P k AU 6
REPIODUCTIVE AWD DEVELOPMTAL TOXICITTs
Thar* are no known or reports* effects an reproductive function or
latel development from exposure to this product.
Continuous brooding reproductivq studies were conducted using vice and
rats. The Animals wave fad propylene glycol in their feed or vater, me
adverse effects on reproduction were found in either species.
propylene glycol tam been tested and was found to be nen-terstogenic
in vice. and it doss not affect maternal or sobryo-toxicity in mica.
rats, hamsters, or rabbits.
CARCINOGENICITY:
This product is not known or reported to be carciacgsnic by any
reforenca source including IAAC, OS1dA. VIT! or EPA.
Propylene glycol has been tested for careinogsnicity in rate sad vice.
It Vas found to he non-carcinoganic in bath a feeding study using rate
and in a Alin application study using ales.
MUTAGENICITY:
This producL is not known or reported to he mutaganic.
Propylene glycol has been tooted in a battery of in vitro and in vivo
sutagenicity and jenotoxicity &easy@. The veijht of avidehc■ from
these assays 56 SSDIA that propylene glycol is not mucaganie.
AQUATIC TOXICITY:
ColdfiAh (Caraesius ■urarue) , 24 hr. LC 50: > SDOO nV 1
(measured, static)
Rainbow trout (Selma gairdneri), 24 hr. Acute Isthelityfvartallty
(non-1,0 0 teatira)i '- 50.000 ag/L (nominal, static)
Brine shrisrp, 14 hr. LCSOt y 10.000 mall (nominal, static)
Daphnia aagns, 48 hr. ECSO: s 10,000 mg/1 (nominal, static)
lI. ?R"SPOItTATION 11MORYIATtDu
THIS MAT&RIAL I5 NOT REGULMD AS A DOT MAEARODUS MATERIAL.
11. SPILL An LZU"t PEMDIM95
FOR ALL TRANSPORTATION ACCIDINTS, CALL CHEMTR$C AT BOO-4Ie-9300.
REPORTABLE QUAJITIIV: Met Applicable
SPILL MITIGATICX PADMUR$S1
Evacuate all non essential personnel. Harirdout eoneentrotions in Air
may be found in local spill area and ionadiately downwind. Utilise
emergency response peraenal protective equipment prior to the start of
PALM 6 or 10 CPI: M424

M/© /2000 14:53 423422Ep94 PES:CHUPICALCO PAGE Oi
Ta-. GREEAEVIUE Fran: P.$. 1 5, SaEsty 8-01-00 1-44pir P. I of lu
any response. Recieve ell source@ of ignition. Stop source of ■pill as
Soon a@ possible and notify appropriate porsonnal.
AIR RLLEASE: vapors any be suppressed by the use of water foS. Contain
all liquid for treatment and/or disposal as a (potential)
ha, rdaus waste .
WATU RLLLM lr: This material is heavier than and soluble in water.
Notify all downstream water users of possible
cvntaeination. Divert water flow aroused spill if possible
add safs to do so. If Liftable to divert, ereata sr
overflow dale to contain saterial. Remove with a
vacuum system or puaptng dowice for treatieent and/or
disposal. ContLou■ to handle as described in land *pill.
LAND SPILL: Create a dike or trench to contain materials. Spill
materials may be absorbed using ■and or vermiculite. Do
not place @pill moterials bask in their original container.
Containerize and label all spill materials properly.
Decontaminate aLL clothing and the epill area using strong
detergent end flush with large amounts of water.
SPILL RUIt1Mi
Dispose of ptr guidelines under Section ALI, WASTE DISPOSAL.
PERSONAL PROTECTION FOR 1MAGENC1 SPILL AND FIRE-FIGKTiNG SITUATIQAT;
In case of fire, use normal fire.fightireg equipment (including a xtOSH
approved sell-eentaised breathing apparatus: SCIA).
III. MASTS 0I9po"L
If this pradnct becomes a waste, it DOH NOT seat the criteria of a
heiardoue waste as de!<inod under 40 CFI, 261, in that it does riot asrhibit
the characteristic■ of hazardous waste of Subpart C, mar is it listed as a
hazardoua waste ender Subpart D.
As a nonhazardous liquid metes it should be disposed of in accordance
with local, State and federal regwlstival by Incineration.
PACE 7 Or 10
ac WQ.
CPE00db1#

7E�03'/2eOEl 14: 53 4 234 22 60 94 PES: CHEMICALC❑
To- 6RE®EVT'.iF From, P.3. 5 S. Safety I-bJ-ua L:'IIP i P. a PAGE 9$
CAU MUST BE TAXI TO FIEVINT ENVIROXMtNTAL CONTAMINATID9 FROM THE U11
OF THIS l4ATLRIAL. TXr USER OF THIS MATERIAL HA9 THE RSSPONSIIILITY TO
OIBFoSL OF UHU3bD MATERIAL, 11311 9 AXD CONTAIX91S IN COIPLIANCL WITH
ALL RELEVANT LOCAL, STATE A)M FEDERAL LAWS AND RKGULATIONS REGARDING
TREATMENT, STORAGE A1ID DISPOSAL FOR KAZAADOUS AND NONHAZARDOUS wASTtS .
1111. ADDITIONAL RNOULATOR* STATUS INrOW TIDM
TOXIC SUSSTAIICSS CONTROL ACT:
This substance is listed on the Toxic Substance& Control Act
inventory.
SUPERFUND AMS)Ui3ENTS AND Rll UTRORIIATIDM ACT TITLE III:
A"D CATEGORIES, PER 40 CFR 370,1:
IFAITiln
None
PHYSICAL:
Ilona
ZMERGEHCY PLADMING AND COWNkITY AIGRT TO KROW, PER. 40 CFR 333, APP.Ae
EXTREMELY KALAADOUS SUBSTAMCL - THRESKOLD PLAWIIiG QUANTITY:
None Established
SUPPLtAR NOTIFICATION 290'VIRLPMRTS, PER 40 CP2 372,43:
?lone Established
EIV, ADDITIONAL Ill1r01 aTI01i
XSDS REVISIOX STATUS: Revisions mods to Exposure standards, Pareonal
Protective Equipaent, Spill & Leak Procedwre&, and Refarerco Section
xr . KLJOR WERENCZE
I. Ishidele, X., at al., primary Plutagenicity Screening of Food
Additives Currsntly Used in Japan, Paad and Chemical Toxicology,
Vol. 22. No. B. pp. 623-636, 1984.
2. Hayashi, M., or ■l., Ricrobuclsys Text in Mica an 39 Food Additives
and Light Kiaerallaasoue Chemicals, Food and Chemical Toxicology.
val. 24, No. 6, pp, 487-300, 1988,
3. bridis, A. L., at al., Ths Acute Tonicity of Scat Petrochemicals to
Goldli&h, relater Research, Vol. 13. pp. 623-616, 1979.
4. (iawerth, S.. at al., Salmoneils Rutagenicity Teat Results for 230
Cha&icala, Fnviraomartal MVtagdrssis Supplement ]re. 1, pp. 1-1:2,
1913.
5, llajewski, H. S.,et al., Acute Lethality and Sub -Lethal offecta of
Acetone, Ethanol, and Propylens Glycol on the Cardievascular and
Respiratory Systems of Rainbow Trout (Saiao goirdneri), Water
Sauearch, yal. 13, pp. 217-221, 1079.
FAGS 8 OF 10 CPS00642#

0-0/03/2000 14:53 4234226094 PBS:CHEMICALCO PAGE 05
To, GiEMYTILE Froo, P's, 6 S. safety 5-B3-00 l�llpa P. 9 of 14
6. Xuhe, Renate, at al., Results of the Harmful tffoato of Selected
Water Pollutants {Anilines. Phonolss Aliphatic Compounds) to Ilaphaia
*apes. Water Aaesaxch. vo1. 23, No. A, pp. 695-499, 2999.
7. AMU Database (mquatie tonicity), Chemical Information systems.
Inc.. Toraoa, M.
8. Effects of Toxic Chemicals an the Aoproductiv■ System. American
ladical Amsociation, Chicago, IL, 1953.
9. Final Eovert on the Safety Aseseament of rropylone Glycol and
relypropyless Glycols. Journal of the American College of
Toxicology. Vol. 13, Na. 6, pp. 437-491. 1994.
10. Workplace Enviromorntal Exposure Level Guide (WEEL Guide), Propylone
Glycol, American Industrial Hygiene Aaeociation, Fairfax, VA, 1983.
11. 3K 1996 Respirator 5alectien Guide. 3li Occupational Health and
Snviroeaental sefety Division. St. Paul. a. 1996.
Additional references are available upon requoat.
PACs 9 of 10
CFE00642t

08/03/2606 14: 53
To: GREaEVILLE
4234226094 PES. CHEMICALCO
Frea; P,a.• I S- 51EAty
6-03-00 1:9fpn p, 1I] OAla 10
THE INFOAK,ATION IN THIS K&UP.IAL SA.MTY VATA TiNI:ET SHOULD BE PROVIDED TO
ALL WHO WILL U$F, RAIIpi.E, STOU, TIMSPOR7, o! OTHRIIWIS$ BE BRPOSED TO
THIS PRODUCT. ms INFokkuTOR R,aB 68EN P'REPARCD FOR TmE GuimmcE OY PL.AwT
INGIKEBRING. OPLRATIONS AND ILWA+GEPMT AND FOR PERSONS ROARING WITH OR
R&NDLING TH13 PRODUCT. OLIN BELIEVES THIS INrtORI TION TO BE RLLIASLE AND
UP TO DATE AS OF THE RATE OF PUBLICATION. BUT MAUS NO WARRANTY THA? IT
IS. ADDITIONALLY. IF TI[IS KATUTAL SAFETY DATA SIMST 15 BOIL THAN TREE
YBAAS OLD, YOU SNQULD CONTACT OLIA AT T)M PEONS NUKB8A LISTED BBLOW TO
KAXE CERTAIN TILAT THIS SKEET IS CURRENT.
OLIN ASW CONTROL GROUP
Olio Corporation
SOl Xerritt 7
P.O. Ear 450C
Nerralk. Cl 04954-4300
PAvna Number: (80C) 311-MSDS
Otlx CORPORATION SLINSIOIAAILf amp AFFILIATCO WIT=ES: ASA-1-9Lt14 LTD.,
BE;Ci.EPORT IRA$$ COOPORATION, OLIN AEROSPACE COMPANY, &.4. CSTE■ COMP►MV,
OLIN FABRICATED METAL PIODUCTS,IMC_, OLIN MUMT SPECIALTY aROGUCTS.rnC..
OLIN SPECIALTY METALS COADCRATION. GENERAL 7EFINIX CORAORATIOm, NIACNLOE.
PMTSICS INTERNATIONAL COWAkY, SUPINION POOL PRODUCTS, INC.. ETOEYL. C A_
DC+p •ICROELECTRONIC W ERIALS, INC., OLIN [MaiwE[RED SYSTENS, INC
r6051t
MA-OLIN MET►L CORPeRkTIOk, motoisCLOB. $.A
PAC[ 10 OF 10 CP8086420

Wednesday 02 of Aug 2+ , Faxination
-) 423 t, 7109 Page 1 of y
FAX
To - Sam Shanks/ C-W Conccntratc
C0111p3I13
Department :
Fa� numbu : 142 3-i4 t7109
Subject.
Date. 08/02/00
Total number of pages : 4
From : tphy

Wednesday 02 of Aug 2( , Faxination ->423 r 7109
MATERIAL SAFETY DATA SHEET: C-W CONCENTRATE
(000000-000000- -4429) PATE OF ISSUE
2/2h/2000
Gll1Aali"j XQ L[W A Sy11l7nyil1S
N IA
-------_-_---------------------
Ohsanical rasnilyt
PEOSPFL4TE I$[LI,:ATF. SLs Mi.
________________________
Hanufacturar'c Namur
C 11FEnD CADr, DIV. OF MR �O✓•I c'.
------------------------------
Add[acs-
BOX I.2170
IRVTM41 TEX;.s
------ed`ay: -----------------
Prapar
L SCYNTOW
SECTION I - GENERAL INFORMATION
Pre4ti" Code lumbar
441P
Tra4e Naule a Synonyms
C-w cLt•:�srlTRnrs
(ornlula Mixeur8- —r x
Page 2 of 4
Pape: 1
SUPERSEDES
12/O6/j939
Rmergency Phone Num6ig
977_438-1321
SECTION II - HAZARDOUS INGREDIENTS
THE HAZARDS PRESENTED BELOW ARE THOSE OF THE INDIVIDUAL COMPONENTS
chemical Name �I_ngrociont_s • Hazard TI.V PEL STS7, CAS 4
SODIUM ^FIIPOLYPHOSPP.ATF IJ 14.IN3 I I7 xrix7 I NOT EST.
597i1IM mETA.5r, ICAT3 e•3 VTiL3YPiAT? __R,ZLTffT I MC/Ni i i M�:IMi 1 N•Ji' ES'C. Ea 14-yE-U
P C•LYP}:Y3THYLEh16 H ILOYLP9EMYL L'TVi?P. PKOSPHATE =RR=' 2n NT NOT @Sr. 1 mfrr MT. 1 HOT E511. 5=011-70-1
SECTION III - PHYSICAL DATA
Boiling Point (P),
NIA
ipecifit Gravity (R20-1)s
N/A
------------------------
vapor Prom sure 4M Hal1
------ -------- -------- ---------
M/A
--------- --------- •----------------- ------------
Colors
BLUE
-------- -- --- --- — ---------------
Vapor Density (Air-1):
.—-------- ---------------------
N/A
--------------- ------ ----'-------------^
odor.
-----------
❑O.:RLEGS
------ --- ------- —---------
rE P 100% s
-.'-------------------.-...._
1' Q 106
Clarity,
OPACUZ
----- ---- —--- ------------------------------------
i volatile by Volume:
--------------
--- ------------------ -------------------------------
Evaporation Rite (SU AIC+1)
NIA
------------------- ------------
N20 Solubility:
------------------------------_----------------------
COMPLUE
"-"'�. ------------------------------
Viscosity:
pG4D3R
SECTION IV - FIRE AND EXPLOSION HAZARD
Flash Point Flamm,.tblo LiMitt :.El. LBI.
N0111_V1_%M 1 rvlt. Nix
..-._-_»_..._—------ ------- --------------------
Ex6iaquishing 67edia
K z--Fualll x c--n LerjhL1 Fuda. n s--c42 A a'--Dly 71KJAL4Utt1 ri a--Hatr_t 15Play w %; Ottiti
---------- --- — --------------------- ^^^^
Special Fire lighting PYOCeftre3,
IIREFIGPTERS SHOULD NEAR A SELF-CONTAIN20 SRBATHIN„ APPARATUS AND ?OLL PROTE.CTIVI GSAH. SXTINyiiLSfilNi MEDIA 8Hi?i3:..0 BE
C&OSPN BASED 01 THE NATURE ❑F TEE SDRRCUMDIPh: PTAR.
---------- —------- —------------- — ------- .---------- ._____-_---------- — __----______-________--_
Unusual lire and Explosion H1AaXds,
KIND RIMN.
VrPA 704 Hazard Rating (0-Insignificant 1-Slight 2-Haderate 3-Migh 4-Extrame)
1 t--Eedlt]1 I c_-F1auLLRAbJ11ty 0 a--IirnUtiv_ty c--5per_jd1
SECTION V - HEALTH HAZARD DATA
Threshold Limit values
N1T SSTAPLISHEA FOR MIXTURE- SEE 6c:^Iuli II•
___-_-_ ^--------------__ -____ _- ___--,^^_--------------- ^ _^^_ - ----- — ---------------------------------------
-Acute (Shark Term Exposure)
SRT_N CONTJ,C-.'; CaUSES SEVERE IRKrTAT=ON : BVN A5 REDr:3SS, I'ICHM; AND A BURNMG: 5ENSeiTTO`I. EYE CO}ITAM CAUSES 3EVL'fi8
tUITATT,19 SEEN AS Ty ARIPr, RE➢1S1:5S, AYD A aIR IF6 IWHALATION: 1i::SE.s. FESPIRATURY IRR_TATION SZE:' AS
M)GKING AND SVSEZ=rG. INSESTIC.N: MAT CRf1SE IRRITATION WITH P^-SSIBLB NAFJ6L71, V7MITING AND FrE& R- Y.LF.
----------^---------^--------^-------- -
-chronic (long Term Exposure)
NO KUMAN :HRONE7 EYFECTS KMOWN. MEDICAL CriN['iITTrNS ILn;RAVAVED PY EXPOSURE 14A£ PRE-EXISTLrL: RESPIRATOAY ARID SCIN
CONDITEONS SUCH AS AST914A, EMPHYSEMA, AND D¢W4ATITIS_ TAAGBT ORGANS: NONE K14M. THERE IS Ne, pRiMARY 2Lv1T9 07 ENTRY
INTC- 7V? RMY. 'ME PR -MAY R^VlE OF PxPOSIM IS MV AN:) RYE C-uNTA•CT.
Primary Routes of Entry, _— Inhalatlon c--Ingestion �-Aeaorptian
---^-'--- --- — -------- ------ ..._—---- ---_-
EnergenCT ana rlrst Rid rroceauzez:

Wednesday 42 of Aiig 21 , Faxination ->423 f, 7109 Page 3 of
MATERIAL SAFETY DATA SHEET: C-W CONCENTRATE Page-.2
SECTION V - HEALTH HAZARD DATA (continued
-Inhalation$
M010" PTION TUR ATMA TO PRE(,"I AIR. G*.iif! MB➢ICAL ATTUTiTIC17 I? novrwroiy 10.-RITATIC1) GGWLGFG 7R IF LIRGATfi=03 BLcal<55
DIP?ICULT.
---------- ------------`------------------------------------------------.-------w_--_-_r_-------.----------------
-Eye Cnntatt=
EPW4 D'ATBLY BIr59 THE EYES WLTH WATER. 3EMOi7?, AM CGPTTAIT LEN&B5 AND CONTINUE ?I•USKLNG F?R AT LEAST l'• MINUTES. FOLD
1111114 HY41.1111,' AHAMP 'ITj KYtiIIHb' NINNIFn: i*F TAISNI'40K ti 4111'A::s TIE' THp: }.VIUK AM, ICI I1ti WITH 6IA'1•r.k. r:!'I' Imm4ew.A'0W, MM111.'--Ali
ATTENTION.
-Skin Contact:
WISE ;%TFECT3D P.REAS WITH LaCB : 40UNTS CP ZaND AND WATER FOR 15 KNOTES. REK7VE CC-NTWRAT70 CFC7RIN\: AND SRO86, GET
TK48DIATE DUD:CAL ATTENT:Of1. WM11 Cr--MTING AND CLOAti rIOIIG UIiEORD i1I1UGIi_
_-----------`-`------ ------------------ —------- ---,...... ---
-Zngectiom:
GIVE i TO 4 GLABbEE OI WATER. SLIT DO 14CT INDUCE VOMITING. IF YCMITIK OCCURS, GIr FLUIDS AGA=V. SUN KEWCAL ATTKNTIDN
IP DFSCVISPO$T +71CCVR8_
-Motes to Physician:
THERE IS SIC SPECIFIC ANTIC^TE. TEA? THE PATIENT SvMPTOMATICALLY_
SECTION VI - TOXICITY INFORMATION
Product cantoinc chomicaia Listca os Carcinogen or Potential Cmreinogcn Syl
IF.Z•_--� No NTP--n NO 05 A--� Vo f.CGI[I--a 110 Cl"1IE2--5 k:❑
--------------------------------------------------------------------------------------
SUDIUN TrTE PGi.7ARC-SFHA"P.
ORL-FAT LUSI:r: 3iir': M,_IRG l
5CX4IUM ME4'P.SIL=117TE PEAT??YDF3TE
ORL-FAT LD�Gt 1153 NtiIYG
N' ._HMN 7S'] SIN 4H VY'V M4H _
d�;°.Y�'XY3TRYLEN'e N.�?vYL2�ETaYL ETiTRA PITS::SPri.ITE
H- TC•VICITV DA'CA AVAT_LAaLF
NUY T'ESTtD POi P'RTRA7Y EYE TRRfTATI•DII, EDGIUN FGTAEILICAT� AR:f]JC2C
C D7RCETV$, V0N-RrM7SS; P.T P. INJURY, P. I+lfi WATER 60LUT =vN OF SODLU?i
HtTAGILI_T.TB F:t,MQC13❑ COR_=L•AL ❑?A�L'CL GRAM 2-S ApL GLO LIGIILNG,
i r1fTIC GTLA6i+ 1_-7, CCVJrJ =TV,%. , _t1VTCuTG (EUDE 2-_' KND R3DNBGC
'2AAOB J. A .+ WATER SOLUTION OF : Q7.EUM META31L,_C!,T3 PRODUCED CCRNEAL
DPA-ITY GRfwE 1, LRTT_S GRAVE 1-2, CO[•TJU!]CTT'JAL �HEM,-SIS GRADE 2-5
ANC REDNESS GRADS J. 4.
SECTION VII - REACTIVITY DATA
S`acility- I S__tiranla r__11ncr Thle
- - - - - - - - - - - - - - - — - - - - - - - - - - - - - - - -»- ---------------------------
Inconlpotlbllity (MetariaSL to xvold)m
ST 9c OYIDIIINC ACEN^_E aUcit RG CBLORINE HLEACHI REOLrt1;C AC$t1TE EUCS A6 8OD1',M TBIOrUFATEi ACIUE %FJD A116E6,
-_.-.---------------------------------- . _
Ha:ardous aecompoaition Products:
OXIhF,S OF CAP5C.N, ?HC•SPHG'HOCI. ANC 9DE)TtIM; AMM--F•rl GAB.
— ---------------- —__-__- r_. ___-_-___ «___ --
Hazardous PoXymerimatlan: nay GCcUr 7C W11) loot OCcar
SECTION VIII - SPILL OR LEAK PROCEDURES
StA17% to he TAUAn 1f Material is Released or Spilled:
TMMSFIR a'CLID INTO A PR^PERLY L"OLK C•7NT'AINEP POR REUSE ❑? DISPOG&L- IV NBCiSSARY WASH AR.FA 14T7H KATBR AOD PICF: UP
b}A" WATER FOR DISaCSAL. AV,ZIC CREATING GUSTY CO.+OLTIOa;5_ I9EAR APPWPP.LATE PROT.'CTIVE CLr'THIVS_
- T____ ___—__________-_--.--._.-- ------- —__-_---_____T_
waste Disposal mutho4(5)=
CISP'7u� uF ITj %4ITF AI,' 1`90 PL, ?PnT6, ANC REGULATr4'NS.
I' COE A1OIIti.
SECTION IX - SPECIAL PROTECTION INFORMATION
Required ventilat nme
L. IAL V$NTTLATT['4'1 75 7.FC vfCA'G£G TO COprPR L EMPOSURE FROM OPEFATIGNS ^RAT CAN CUBR4Te ➢uS'CY CG3:TJIT?: !is_
Respiratory Protections
A Ti:45iE 11iu;il, : F=IAOVDD RROPIni.TCR ?Oil LXFOWIRC AOCVE T11E A•'_^C-ITI TLV CR QZHA PBL OR W119RL ➢[11;TI7JG LKUTG.
--- ---------------------- ------------ -------- .-..-----
Glove Protection:
i'rE0?RENF •]R NITRJL3 RUBBER GLCV�S S:1Cl Lu SE WOR.ti.
K" Protection:
CkA,Ml CP.L G,.GGL25 ?HOV:.O 82 LR3RTi.
----- ----------------- —_______—_-__
othou Protec*Amnl
WBAa FRO+PDCTIVP, CLCT9174G wn2N aA.NDLI@IG.

Wednesday 02 of Aug 21 , Faxinati6n ->423 '.' 7109 Page 4 of S
MATERIAL SAFETY DATA SHEET: C-W CONCENTRATE Page-3
SECTION ITC - SPECIAL PROTECTION INFORMATION (Continued)
SECTION X - STORAGE AND HANDLING INFORMATION
skorogC TCnrperaturc[ ihdao[e--� Y: ❑u:d Po: �- '[[3=nd--� ncf r:-7c•taL�d--:
t6'n irusr Ts-np�:r. t+1i�: i5"F rta>:i;nurT:•nq.:-c•�r Irr; 1211°P
------------------------------------------------------- .------------ .--------------------------------------
FracavGion3 ko be Takcn in Candling an$ 3toring:
SPC2E i4AT?R-AL IN Its ORIGIfOAL CON^. AI}I F.h, M-E? C]NTA[l16:Y WrZI+ 0OT IN L+Sr. 11557 .y:•L91 Fi[-71 :IAPF
..-,:LErI•:;N5 h5 THIS PRGLUCT WILL i AFE.
❑trier praLauti Onst
3ERP CUT OF RFMA H 67 CHLLCA£N. P2AC• THE 8lITLR£ LA22L IiE ?aRL r ZNP <'" P%cOUCT'- FOLLOW THE GABcL
SECTION ICI - REGULATORY INFORtMATION
chomioal llama CAS N• .bar
Non-
T1.u:; •._-�y•<<]11•I.ts `ist'd dbuv01C ]Ub.I•CL—L. tll`.' {rluit ilk i�yLl �� vt 37�^u:IIII�•E C1ir SuEr_r. Fl!I•LI
R:Ir::c3s�:lts 111d A�_nlitJ.U' ir..i lun Act of 1"76 —d 1:) CF_t uect _12.
--------------- -- ------------------- --- --- —----------- ----- ------------------ .,y.----------------
!lr•�tiu -�11 }-i,nr_�7?_oy-: lri- -Hr!1t 1nnar IrrnrP,?tinn 1yniP. - ar >! I'n-I So-ncr�,—r_
rnie -G0Es is unr rar Isers In -1e Sr.,I- at '3L _'Orr. 11.
SECTION ]CII - REFERENCES
•iFi R:SY011, LIT4IT' VRL'IF6 ±:7, R "R EMi1:AL S'!RSTA.tI•'E A�TD AL E\P,7SU?P
tt1CI-55, R�GIk, I°°:1.
I. •CSl-L[ F3L.
3AE:LLE.'CAY CF T'C+':_C EFFECm£ :ie :HEi35CJLEI_i�'i7'!�="e6, CCIF:F•7GL:C, 1^Pr'1.
_. VENu::Ac lSc uE.
ALL R; _[IIL F*GLtC7 C.7'.1: 3C rO.•1Ffi 1?; T-fII C!IRCETIT TLi�'% r_iIV;,;iTa-Jl'
-------------------------------------------
?RR=IRRITAN7. FL,6A/FL7',MK;F,AKMAB-E, CD:IR;C)FRE r)5IV
=hAC: CA iC L.47GENIC, TCX TLX 1I . w/A:NQT RPPLICABLE, lI/.,t7:C'7 t8Th5LIENEG,
L?VL•�ItiJrj ^PFPi �I?y, FH�C:e'Ei•,,SF?'-Pfr1R: LN iL':SE7 1�17P, TC�:TAL'-I,I HbI'6
',I, NV,Y-1 p, I.vI.,-IY�II, N .,MI II VF'H'k •,K'i 4,; I!iv I IMI•I',
.IWMA:r1A I' I I!• -.A,- ✓rNF PN- ".;: •1',. PI A, -
iAHI': 11. "1 CAIA I'1:•p•P ,.r'1.!-Y
r!!L AEE:iAi1�:N r+N CAMC'E R, t:•['C:MA'CI^:=AL TOa Ir-•Lr. ;Y rA-7r; P.4M,
S FF E'CY d HEALTH F.UI�iltf_ST wit lei!], A_fl:i fl:Rhf r. fii �'di[ ::%tfFSRE^:CE C. '7VFRMMEti;AL
Il�7VSTHII� Ht'GIEt:I S`I'S, TLV,TIi iu: f.E ]LG LIMIC-+lUl!h, �B L: FEfUS:S$_6G5 2XP:751JtiL
LE'lE1•, ETPLr&TGFT-:'F. Pa`5 F.AF_F: [i aE L-ll=T, HLG:MILG, MC'3:yOQE R*.'l3, EE='r6p.JP•7F:,
1IL_:Idl'^ADC+:IC, rv: Pti'LH:AC,?:1':%LhnT, VTIOC: =nRT1G![AMI:c NOT O^TII:tPQIGC CGACGI-
_'T_--G
Vppar 9 Limit
T#E INr Op74q'!•I Qt[ CONTAINED HEREIN IS BASED OS DATA CDSSI0CAz0 ACCURATE IN LIGHT or CUARExT CORmut.ASIov- mC?wcvTA, APO
WARRANTY IS eXpressen OR IMPLIED REGARDIRS THL ACCURACY Or THtSe DATA OR THF, RCSULTS To HE ORTAINLO FROM THE in
THEREOF.
CERTIFIED LUC , DIV. of FCa CORP. MaLUMC6 no responnieility for personal injury or property damage xuecd by the use,
_.L -..Se, r dip . —I ar Eh. proa„rt in a mrn„I.r > ,r r---A—1 as rH- praa,�cr lab,.l. IF1,Mr.
associated with such unrecomatended use, storage, or 31sposol of the product.

Wednesday 02 of Aug 21 , Faxination
-�423 3 7109 Page 1 of I
FAX
To : Sang Shanks/ WT-1000
Company
Depa rtment :
Fax number : 1423i437109
! Subject:
Date: 08/02/00
Total nuinber of pages : 4
From : 1phy

Wednesday 02 of Aug 2( , Faxinati6n ->423 4 7109 Page 2 of 4
MATERIAL SAFETY DATA SHEET: WT-1000 Page: 1
(000000-000000- -03761 DATE OF ISSUE $llPERSEDES
1/21/2000 4/12/1995
SECTION I - GENERAL INFORMATION
chemical Name a Synonyms xYddl] NAhLe w sy1f071YJHZ�
NIA Nr-Inrli!
_______—-------------------- —_______--- —
Chomital Family., Formula mixture --7 R
A17P LL±NE ! ITRI1'E SOLI) PION
.•1— ----------------- —----------- —-------------------------- —__—____.
CERTLPLVD LAW, OIV. I]F wa COPIB.
-..-..-......�������»..__— --- —__— --------------- —_____—
address:
50t 1311711
IRVING, ThXA:
Preparad By:
R ST4r aY1c3EHIST
Product 4ds Ihunher E*51r9%rM Fhphe ■UMtK:
017G 972-439-1391
SECTION II - HAZARDOUS INGREDIENTS
THE HAZARDS PRESENTED BELOW ARE THOSE OF THE INDIVIDUAL COMPONENTS
Chemical ]_lame InQredlentj, t!a¢ara TLV k,M1. ST514 CAS i
,GCOIUM NIT•RIT= 7C11!11 R r!O^e SST. 1 NOR ESr, 1 Nr:IC SST. Ibl1-uu-u
S-MIIJM MEmAkDRATE OrTAHYDRATP. IRR=TANS' NOT EST. 1 NOT, SST. l N}P EL..". 1Js};-lc-1
A11IOI.7I'R=t Mf T!lYLENE PHvSPF6MIC AC.iG1PENTASO7'rTM bALT iRR_TANC NOT EST, I NCIT SST. J NCIT ?ST. riUS-43_U
SECTION III - PHYSICAL DATA
Soiling Point {r}:
211
Spocliic crsvity
{H70-1)1 1.23
---------- — ------------ -------_----------
VApor FSO39lire CKM HO).
13
color-
WrTU-PALE VELLLY4
Vapor Density [ai;-l):
..---- --------------
4).6
Odor.
PUNGENT
PH @ 1001 s
--------
10,9
----------------------
------------- --------- — r.
Clarity.,
-- --------------------------
7Pa_lJE
--_------------ ----- —
S Volatile by Vn711l w
------- —__--.------- —---------
67
------------ ____ ----------------- —
Eaaporat ion Raid
---------------------- --_—_________—_-
tBU J1/C-1)• n. C)
----- ---- —____.r______.—____-_r
RPa salubIlity!
—_—--------------------------------
^>K? OL'ATF
—_____________________________--____..-____f
Viscosity-
_---_—________-___-_
NrRI-VISCOUS
SECTION IV - FIRE AND EXPLOSION HAZARD
Flach Point Flammable Limits LE'L VEL
KC,NFLAN. / EET*FnAfF Nlt !J)n M/r;
------___w------ -------- _,---------- --,.__—----- -- -----
Rxtingµishiag 1'adia
11[--ruwn N c--AlurAivl fc," X t--CG2 X [--ply CieJruC-JI if c-1V1ffLr1 spray x �.-rlL tti
- `--------- —-------------------- ----------- ------- '------- — ------
special Fire righting Proceduresr
7iR7FL;11T2RS SHOULD tiFAFI A SEL2--05NTAINE0 BREATHLH: AFDARNVUS AND FULL PROTECTIVE LYAR, Ry-l9GU75RUJu MFDIF 5ROUL0 RE
CROSY71 J77L-90 ON TAR 14TM OF THE SURROUMOrb4 FIRE_
------------------- - - --------- '------ ------- ------------------- -----------------------------------
unusual Fire and Explosion Razard:l
UNPON :,ECDFp OS I'F2�7r7, ran --um Z3 X'FriITn P=,CMrj—, _•K'^aCi! i2i❑ CQ.Y GL_:rl^. L'_ Iw--.l&A.r, 1: TEE _-V.TU 0? A PiP.E. D•iOIUM NIT&LFL CAN
EF+PLOO: AT TSHPEF:-,TUR£5 GCEA?6R TFAN 10010 F.
_--------------- ----------------------- —__-------------------- „--------w._- .--____-_---------- _----_______—__-._
TFP& 704 Hasard Rating (Geruslgnilicant 1-slight 2rt9oderato 5-High 4-Extreme)
2 c--Health l s--Plaiwab+llcy l c--Rr_actlVlty OX c..-.Special
-------------------------------------------------------------------------------------------------------------------------------
SECTION V - HEALTH HAZARD DATA
Threshold Limit Value-,
NOT n&4'A& I53EC PCP KTXTUR8.
eEfccts of "Crcxposurc;
-Acute (o"hort term Exposural
5y_;.! f:-aEgT21CT: CWJ585 IRR-.TPLr-N9 4EFN AS ITCHII:a A1:6 =!T'CT WITH DaHAr,.r aaXT:1 :-AN CAUSE SKiN zl"H
ANC, -c F'_PTICOS 7OE TO B:)? kNr"5. Y'E :041TACI't :BUSES CHRI AT=O:1 SEEN AS TEARING RND REDNZ55. ING-e5TL0Y: CAUSE5 iRRL7A'.1014
7n._—H PG55IHLE NAUSEA, VC44ITIN'_- AND ❑IP.EI11311.. LFLI(Gs AMA. 1j WrS MAr LArJS?, M?THEMar 1.:6i'f3M71'. '.=AUSCM!; pF
Si.=X, HuVACW nu 6ii8u Ra7UE, L:I:HT-F.ElVEP1ES6, ATAJCTA(Ir1CC]CJ P_7INATFOr]j, WEAniIE55, RAPID NEF.RTSERT, LP6&3RED hhEATN1N.3,
M }-JJ'I'AI• :•rr�WIN•.lM, Hi,i WHKI+ vl K1OPl, RtJOPII.FII r5�n!l ll] VHY.ti,Sllk H, ,'l rl ,I ANti', COMA APII1 r''::hIow.v 11M, 1'I'M. ^r l+f•l •A'I'I •. I,+1_ -'A ,�IN,ti
REST-i RATOR'! LRRITA^_'£Oh S?3p AS i'71jGHINr AND 5NVE'LLNG. 1NAA:.AT10N O? LAir;E AM71JP1rF -AN CAUSE 5uSTFbSII' EFF2CT5 SIMILAR Ti
TI{taE OAUSSI} 9Y IN,3VZTION.
---------- —---- _----------------------------- —--------------------------------------------------- —__—___-___�___
-chronic (Long Term Exposure)
x=xTUAB 11I^Tl UCCONDAIIY AFJDMF1 MAY ChurU TRB I'01%&TIC0 4Y tl_'C[WGAliIN6L, I11IC11 ATtE CARCINOGENIC COM?cu=.roc. TAAGU'P 01vANG:
L_VER, KIDWBYS, SPLEEN, TR3r4S, CIACLF:,ATCRY SYSTEM C-21DITIUN$ A1G&AV4TED HY SXZCSCRE. PRE-EXISTSNG 015EAtSE3 OF THE

Wednesday 02 of Aug 21 , Faxination -)A23 7109 Page 3 of c
MATERIAL SAFETY DATA SHEET: WT-1000 page- 2
SECTION V - HEALTH HAZARD DATA (Continued
SKIN, REEPIRATORY AND CAR=CVP=U1AF-SYSTEM.
Primacy Rdutee of Entry: X c-_Irhalntian X c--Inq':stian E c--Abaorptica
Ewrgency and FigsL sad lrxedut'es:
-inhalation:
KnMiWH 110W 'PHIS ARHA 'Ikl YHKh II AI 14. l KKK MHII Ii:A I, A'I"I'KNIA UN I V MkfiVI 4A'141HY I RIO 1'A9- C]N 11"V I41PS ilH 1 V KWA'171I N[3 i{ic0APIN
OiPPICULT.
-¢ye camteat,
RR nE Tlin 3:'%L S1I711 VIA^$R. REN_Vr IADLUV55'2n A.ID CONTI•IHS ILLG[IITIG WITH F:,UN Y ai" W.NTER P•DA G]VLA.?4Tt117TI -
A GGCttt MCUICAL ATT2.1TION IF ICAITEV9Lf1P:.
----------`---------------------------------------------------`----------------------------`----------------------
-Skin Contact:
WASH AFrECTED ARRAS WITH FI.EM17Y OF SOAP AHL WATER FOR SEVERAL MINVTBS. SEES MBDICA7. ATTENTrON IY IR.Ri'rP..r[Qr DEVELCY.5.
-Ingestion:
GIVE 3 TO 4 G :ASSES OF WATER, BUT DG NOT ILlptk_F VOKITING. IF VOMITING 01MLIRS, GIVE FLUIDS AGAIN. GET IMMEDIATE Kl$ ICAL
ATTP!rrr ON_ O.O VOT 4IVE ANYTHINC, BY MCVTX TO AN IACCONSCItlU$ OR COMVULSLNG PERSON.
-___________________________.--------------.--_____-__--_-___- __--____—____--- ---------__------
-Iretes to Physician:
THE AMORPTION OF NITRITES INTO TaH BOUT MAY LEAD TO THE CCINVER-a ION OF KEMOGLOHLN INTQ MET9EMQGL:51aIN WHL=N MAY CAUSE
CYANOSIS. THE REV3R9 ON OF METHBMOGLOBIN &ACK To BEMOGLOEIN OCC•?RS SPONTANEOUSLY AFTBR FXPOSURE 15 3LTMINATED.
SECTION VI - TOXICITY INFORMATION
Product coliteins chmulcals Liated x5 Garcinegen or Potential carcinogen Ay:
I AwI:__] Nn N'I'V.-] Ain 4"S.A--> NC: Ar'?il+l--S Nn II'1'M M w-_> Nn
------------------- —----- ------------------------------- ------------ --- -----------
3nCIUTS �IITWITr
GRi-FA^_ LDSL•�- 2SM;IF+� 3.
EY3-RBT STh01GARD CAA.22 TesTr 500 M:174 H:�rF4S_ MILD 1.
Q R-L- HMi1 L7LA r '- 1 silo/ KG 3.
Irl_-RA^ LC5:I: 55n MGI GG 3.
SODIUM MEr;,BORATE ':- A.HYDRATx
0IC--AA7 Ls=•;7: 233U Yi,/Ku 4.
ANT-KA!. ST'eDIES iNCICATE -RAT BC'RATES REDUCE GR INHIBIT SPE.714 PP9D11 C'C CAT.•:
CAUEIDFi TESTICLILAR ATROPHY AND 9:REN G.vE1'I TO FAEGNA,:T A?.'IM7+IJ5 OUA"N6 rEST-
ATTai4 CA75E5 DEV3Lf_-MENTAL 'IFAN!_,E5. THESE oTUDIES 'N�aa Satre CKRDHICALLY
All M'w':'w L:MF: XISV.N IN {x[;ktiti [:P THILti1S A,'l IcVjHji V,A 0::r:1I VATI i;ldA 1, KC uI1.81114 K.'j
nR!-RAT AND D ( ILu PPM' TESTIPPLAR ATR,7PF:Y G.
GP!.RAT A!'P OCG 25C0 PP14- }IC T1;5T=CU LAP CAAHr1:5 4.
C•LL-RA7 }'2004; GPM LEG TO FETAL I1t"'GHMATIJNS AMG MATERNAL TGXICT_TY 9.
A _: JlLNN STUDY OF S7;PIQSURs TC S!"iF_l:E ZUST IN .';N 'Y'^_UP.'.TI7tl"y EETL•I![C EHAL 'G
UAStiO^_.�I {MCTI[YGEi:FE[IGG PtI:f]I[: A-_~•iF8!}^, AN•7GI UFi rXLT
G•R[-PnT L;y ];=171203 MGIH:, 4.r 9TK_iBT EIG�V: �15'zc!r MGIiT. 4,
EY--RVT STNiGARG CRA=BE TEST: 3.7/1_QM H01_1R5: MILD 4.
Si,Tr-RST ST.APIDARD LRA=iE PEST: I!.315.11/id 1iGri Ku`: !•1']N-IFR IThT'ITl� 3_
6t.TQN7 EYYECiS C'N 6OVES AXTEiI SLHC[JTAHZQVS C1zJ3�.TI•,:tr' IN RATr F',:l 7 DAYS
WI I'H VF;M, ti1+r.l;'<11 ANH KIIINHI' wM 1•i•' :ti.
SECTION VII - REACTIVITY DATA
stability, 5tablq r_-UnstablQ
._---------------------------- ___-----_--------_����.__
Incompatibility (14atcrialr to avoid)!
CYANLG3Lr NiGUCIN; AGCNTD,IILITA6=C!lC,A1QIOtIfUAI C[ir_GRI63:r^iIT'lIA'•Tu A:.'L:G, ACi0G, NICCGC, jULCCYA`-ATCv V.!r ^.If=CGr1[,PATi'.'D,
CCMBUST.IBLES
Warardous Oecampoaition Producta:
OXIDES OF CARRON, HTTAOIEN AND P3C4SPHORDIIS AS WELL A5 p874P9rPIBS
RazardMUS Palymerizativn: r-_F53y GCtL= X V_-Will Not QCwlnr
SECTION VIII - SPILL OR LEAK PROCEDURES
Steps to be Taken if !•raterial I& Roloa Kad or Spillodl
DIRE AA1i CCHTAIN SVLL. l4SCRB WITH 21.11 INEFP 17.1T6kI.".L AND TRANCORP ALL R',TERIf.:+ INTO G PRDi'Y RGY :•1:HEL1;6 C+7NTT.INEA P •R
:,!GFOL'JCL. PRSVGtiT FRGpu�T PRCM CGl]TAMIHJAT'IN:i CALL CR Fl•O!1 Ei1TCRlt1_^, sEywl E Ai:D DTPAINTcz—_ DYF,Tumj At.A AJGIns •OF mTeft.
1lae to nl spot al ra tbbaC$I;
DISPOSE OF I1d ACCURDAN" WITH ALL rEGBML, STATE AND Loc-AL REGUTATION�.
----- ------ —--- ------_ -'-'"----------------
NoutraliilMg Xgeat3
AIA
SECTION IX - SPECIAL PROTECTION INFORMATION
Required Ventilation:
C,ErIE7".I, '39t1i E:f:['L;AI IS NLPA_.LLY %DEQQ..TE

D
Wednesday 02 of Aug 2+ , Faxinatiun -)423 1 7109 Page 4 of 5
MATERIAL SAFETY DATA SHEET: WT-1000 ppga: 3
SECTION IX - SPECIAL PROTECTION INFORMATION (Continued)
Rctpiratorp Proteetione
NC117 i?QUIR3C UHCER NRKAi., COWO-TTONS OF Ja"E.
..�«���....��.- __— ------- ------------- —------- —__---------
Glove protection_
Nm?k"h OR NITRILE ROBBER GL--w56 IF RB?Bh?Eil ❑fA PRDL,DNG6I7 oALN CQhTACT 16 "5EL".
----------------------- __--- _!._____-_ — _-________________»»__��__.__
ry■ Protearton:
SAFETY CLASSCS WI'T9 SIMB S923605 IF THE METHOD OP USH PRESENTS THE LIrELIROW OF 3118 CONTACT.
-------------------------------------------------------------------- -----------------------
-------------------------------
Other fsateetiong
GINSM.-MlY Rood[ CLPT46C.
SECTION X - STORAGE AND HANDLING INFORMATION
Storage Temperature, II.dOOJ:5— X NP_AL!d— Rt CrS �>:sLa —>
Mln ilrlr-JI Tc,I-PyI dL.IH: II P, 77dAil1IW11 I':rrIN-i[::ui-: I(iJ F.
-------------------------------------------------------------- ---_----------
Frecautions to ne TaXen In Handling and Staring: F -
M'PY ,^-iA1TAINAR8 •---NThlhi I•R70A-^T 3-FFIt7!IES WHICH MAY EKE-Blr BIMAALS OF T13E PASjOOCT. SEEP FRLM 6'AWRZ[%' IF PRODLI^T
PREMS AL10W IT TC• ELCN3LY WAPIA "i- F.0OA T39PERAT_MP2 ANL STIR TH^RCAJCRLY 13EMRe IJ51NG_
-___ .-___--...___________________-- ---------------------- -------- -------------------------- . ______--___--
Othor PXocautieni:
tZEP WT ❑A REAM OP CIIIS.:r11M. Up.0 Tilt nwrimi LADRL IIEPOIIB UOIlIG TCii Pnooricr. =;'-- [4 Tim LAuRL DIAECTIONC.
SECTION XI - REGULATORY INFORMATION
chemical Naive CAS I;;uabac Upper % Limit
ECDIUM Plf'riI'i't 7512-i.0-rr 34.
hnea tns�ryrll�nrs -» I1srAA AMVr Arp xiihiorrrn rh- e-MrrAvg rnqutre.manrC of11"r+` '1'fr,IR r____+�~�»�___________ ------
1 of rnv 1,LJ r--fnnA
Rrn?nAwrrS Ard Aar n' taaR nnn 4n crH lv,rr 17P.
----- —----------------------- ---------------------- --------------------- ---------------- ---------------
----------- -
Pleasa call for additional !ator%&L+en if you a.s a California cµFt=RnvF-
This &cDS 1.B not intended for users 1i the ctatt of California.
SECTION XII - REFERENCES
1_ TRRESI;+3LL LIMIT VAL-JES FOR CR6Mi JLL Sri TAi7U E5 AND R D OrrCAL
ETP•7SVAc iNGi•-'ES' 4CCLH, 1!'I•!•.
1. S.�x'3 G:,NGER:-I_y' FR--C•FE kTL?:i LF-NOLSTRIA- MATER-ALSr EF :HT!i vcolTIOAi,
Ri=Hi:Ii J. LEWIS, :F.
q . VEunQH' S MSDE.
ALL OCHFLON3"±T5 TV THrs PROuU[i CFsli 3E IN ii?$ C:3RRF.r4T INVEMT03Y.
-------------------------------------------------------------------------
V r[Hf .HH I'r'AN'1', r•'r,I.MI F'I RA1M:4'r..i inMAH•.s:, !:;]Mr�!:;rrM�rlr.'i'1 Hr•ti, is!iW; "„Hl.r ;tic YV:
".AP. ^ARC^. LN':Etl:r, _•x rTC•}: [•', NIA:N,T APPLI^AE-L3, t]lE:H7^_ FETABLISHEG,
CCC-CLEVEC .i TC' OPEN rUP, DIRCCraRrrCi;Y-'A1T.?'^ITI 7I7,SaD CUP. TCCirA:LIABUF
CLLSEU,:UP, LEL:Lti'NEq EXPL,35LGvr LIMI^_, 1:fiL:rJ7Gp.A LIMIT.
PrEPA,NATIDNRL PI4E PROTRi TiOv A'FSCC'ATtQY, ZAAC=LP1T3RNAT701)Aw AGEYCY FC•n
THE' FtFEARCR -N CA} ER, TCXICOL::CY PRO-.:Ic'.N, LLr;F 7rr'CCLIP.'.TI:'i!]l,?,
OPTIITY ,; r?srr,T11 1.CTi TtIIu'P3:71TI7tr, 11C1IiI11:P.Fi13R2_AH COV2VnI1JCJE '? CgVPMIMEtrTAL
L Ai Gr18TR.IAL HYGIENISTS, TLV;TLiRSSF.6LL LIMTT V:,I,132, P^.L•:PRRMTSSIHLE EXP:,SURE
LEVEL, STEL_i.HORT-^.ERM FXPO,S'?RE L.MI^, MLD;M1b0, KC•0;W,[AAArR, SEV:S EV£3E,
Fir7T:M1'fA'`a ENE`:.P-SPH!'M;A.SI?!iY\IAl7i,'?i^=:PftRTICir:.AY45 N]i OTH£RNI5E 7:LA55I'IE0
______________________-___----_-___--__------.--__ ___-.-_-._--_-______------ __________-
THE INFDR]U1TIIIH CONTAINED HEREIN IS 9ASED ON DATA CONSIDERED ACCURATE IN LICRT Of CVRRJENT FORMULATION. HOWEVER, NO
WARA YTY 15 EYPRCSS£D 01a I9PLI11D =QA1ZDIF6 TH9 ACCURACY OF THESE DATA OR THE RCSIILTS TO RY OBTAINED FRDH TRF V:
THEREOF,
CERTIFIED LABS, DIV. of NCH CORP. aaad— no raapon5ibility for personal injury or property damage c4tusad by the u5C[
storage, or disposal ❑f the pLuduct in a manner not recommended on the product label. Users assume all risks
associated ulth such unrecommeneed use, storage, or disposal o: the product.