WI0100047_GEO THERMAL_20120523

NCDENR g
North Carolina -Department -of Environment. and -Natural -Resources
Division -of -Water Quality
Beverly Eaves Perdue- Charles Wakild, P-. E.
Governor Director
May 23, 2012
Phil and Amy Donehower
12 Apgar Road
Candler, NC 28715
Subject: Notification of Rule Revisions Affecting
Closed -Loop Geothe�u�al unjection Well Permit Holders
Permit Number: W10100047
Dear Mr. and Mrs. Donehower:
Dee Freeman
Secretary
Our records indicate that you currently hold a permit for a closed -loop geothermal injection well
system. This letter is to inform you that on May 1, 2012, the North Carolina Administrative
Code Title 15A Section 2C .0200 entitled "Well Construction Standards — Criteria and
Standards Applicable Injection Wells" were revised. These revisions affect all permits issued
for injection wells including geothermal wells.
This letter is also to inform you that your closed -loop geothermal injection well(s) have become
"permitted by rule." Therefore, you are no longer required to renew your current permit
and the permit will be valid indefinitely as long as the wells are active and are operated in'
accordance with the revised rules referenced above. Please keep in mind that if you abandon
the wells, a record of abandonment must be submitted to the Division of Water Quality. You
may view the revised rules on our website at http://portal.ncdenr.or-/web/wglaps..
If you have any questions regarding -your current permit or the rule revisions, please feel free to
contact our underground injection control staff at [phone].
Sincerely,
Eric G. Smith, P.G.
Hydrogeologist
cc: UIC Permit File
AQUIFER PROTECTION SECTION
1636 Mail Service Center, Raleigh, North Carolina 27699-1636 One
Location: 512 N. Salisbury St., Raleigh, North Carolina 27604 NorthCarolina
Phone: [phone] FAX: 91 M07-6496
Internet: ww rimateroualitv.orcr Xatimally
An Equa# Opportunity 1 Affirmative Action Employer

&TVK
CDENR
North Carolina Department of Environment and Natural Resources
Division of Water 4uality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
October 3, 2011
Phil Donehower
12 Apgar Road
Candler, NC 28715
Subject: Notice of Expiration (NOE)
5QM Geothermal Injection Well
Permit No. WI0100047
Buncombe County
Dear Mr. Donehower:
[lee Freeman
Secretary
The Underground Injection Control (UIC) Program of the North Carolina Division of Water
Quality (DWQ) is entrusted to protect the groundwater quality and resources of the State of
North Carolina, and is responsible for the regulation of injection well construction and operation
activities within the state. Our records indicate that the above -referenced operating permit for
the underground injection well system located on your property at 12 Apgar Road, in Candler,
NC, which was issued to you on March 9, 2007, and expires on February 29, 2012, is soon due
for renewal. If you wish to keep this permit and operate the injection well system, the permit
must be renewed and issued in your name.
If Your Injection Well is Currently Inactive:
If the injection well system is no longer being used for any purpose, it must be permanently
abandoned according to the regulatory requirements listed under NCAC Title 15A, Subchapter
2C, Section .0214. When each well is plugged and abandoned, the well abandonment record
(Form GW-30) must be submitted to our office to certify that the abandonment was properly
conducted.
If there has been a change of ownership of the property, an Injection Well Permit
Name/Ownership Change Form must also be submitted. The GW-30 and NameJDwnership
Change forms can be found at httr-.//rortal.ncdenr.ornJweb/wg/ans/__,n•nro/T-enortinti-forms.
If Your Injection Well is Currently Active:
If the injection well system is still active and you wish to renew your permit, the renewal
application must be submitted within 120 calendar days of the expiration of your permit.
According to our records, you must submit your permit renewal by November 1.2011.
AQUIFER PROTECTION SECTION
1636 Mail Service Canter, Rale+ h, North Carolina 27699-1636
Location: 2728 Capdai Boulevard, Raleigh. Nar0i Carolina 27604 One
Phone. 919-733-V211 FAQ: 1, 919-715-0588; FAX [phone] � Customer Service, 1-877-623.6748 NorthCaroli�np-
Intemet, www,ncwater�ua1V.om
AnERunl 6ppomunny % Airtr�nswe Amicr1 Emv*yei at
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In order to comply with the regulatory requirements listed under North Carolina Administrative
Code (NCAC) Title 15A, Subchapter 2C, Section .0211, you must submit one of the following
enclosed forms:
A. Application for Permit (Renewal) to Construct andlor Use ❑ Well(s) for Injection with
Geothermal Heat Pump System for Type 5QM WellQ) if the injection well system on
your property is still active.
B. Status of Injection Well System if the injection well system is inactive or has been
temporarily or permanently abandoned.
Please submit the appropriate forms to:
Aquifer Protection Section
Groundwater Protection Unit
UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Failure to submit these forms in a timely manner may result in the assessment of civil penalties
in accordance with North Carolina General Statute 87-94. For your convenience, a renewal
application and a UIC well system status form are attached along with a self-addressed envelope.
The above referenced forms are also available on-line at the DWQ website at
htip://r)ortal.ncdenr.orttiweb,'wLi al)s/i!mTro/pennit-aor,lications-4«eothermApps.
Thank you in advance for your cooperation and timely response. If you have any questions,
please contact me by phone at [phone] or by email at eric.�.smitltr!ncder3r.��Q�.
Sincerely,
Eric G. Smith, P.G.
Hydrogeologist
Enclosures
cc: Asheville Regional Office - APS w/o enclosures
APS Central Files - Permit No. 'WI4100047 w/o enclosures
2

Permit Number W10100047
Program Category
Ground Water
Permit Type
Injection Mixed Fluid GSHP Well System (SQM)
Primary Reviewer
michael,rogers
Coastal SW Rule
Permitted Flow
Facility
Facility Name
Phil and Amy Donehower SFR
Location Address
12 Apgar Rd
Candler NC 28715
Owner
Central Flies: AP5 5WP
10/27/11
Permit Tracking Slip
Status
Project Type
Active
Renewal
Version
Permit Ciassiflcatlon
2.00
Individual
Permit Contact Affiliation
Major/Mlnor Region
Minor Asheville
County
Buncombe
Facility Contact Affiliation
Owner Name Owner Type
Individual
Phil Donehower Owner Affiliation
Phil Donehower
12 Apgar Rd
Dates/Events Candler NC 28715
Scheduled
Orip Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
03/09/07 10/10/11 10/24/11 10/24/11 09/30/16
Regulated Activities Recuested/Received Events
Heat Pump Injection RO staff report requested 10/18/11
RO staff report received 10/19/11
Outfall N Jl__
Waterbody Name Stream Index Humber Current Class 5ubbasin

Central Files: APS SWP
10120/11
Permit Number WIO"I00047 Permit Tracking Slip
Program Category Status Project Type
Ground Water In review Renewal
Permit Type Version Permit Classification
Injection Mixed Fluid GSHP Well System (50M) Individual
Primary Reviewer
michael.rogers
Coastal SW Rule
Permitted Flow
Faci I'rh
Permit Contact Affiliation
Facility Name MajorlMlnor Region
Phil and Amy Donehower SFR Minor Asheville
Location Address County
12 Apgar Rd Buncombe
Candler NC 28715 Facility Contact Affiliation
Owner
Owner Name Owner Type
Individual
Phil Donehower Owner Affiliation
Phil Donehower
12 Apgar Rd
Dates/Events Candler NC 28715
Scheduled
oria Issue App Received Draft inklated Issuance Public Notice Issue Effective Expiration
03/09/07 10/10/11
Regulated Activities Rer.uestedlReceived Events
Heat Pump Injection Rd staff report requested 10/18/11
Rd staff report received 10/19/11
Outfall N-ULL
Waterbody Name Stream Index Number Current Class Subbasin

A v�w
RMEE►IR`
North Carolina Department of Environment and Natural Resources
Division of Water quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
October 24, 2011
Phil and Amy Donehower
12 Apgar Rd.
Candler, NC 28715
Ref: Issuance of Injection Well Permit WI0100047
Issued to Phil and Amy Donehower
Candler, Buncombe County
Dear Mr. and Mrs. Donehower:
Dee Freeman
Secretary
In accordance with the application received on October 10, 2011,1 am forwarding permit number WI0100047 for
the continued operation of a vertical closed -loop geothermal mixed -fluid heat pump injection well system located at
the above referenced address. This permit shall be effective from the date of issuance until September 30, 2016,
and shall be subject to the conditions and limitations stated therein.
Please be advised, 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.2, The Permittee shall retain all records of repairs, pressure
tests, maintenance, and other activities needed to maintain normal operating conditions.
In order to continue uninterrupted legal use of the injection facility for the stated purpose, you must submit an
application to renew the permit 120 days prior to its expiration date. This permit is not transferable to any person
without prior notice to and approval by the Director of the Division of Water Quality.
Please contact me at [phone] or michael.ro2erslancdenr.sov if you have any questions about your permit.
CC' Landon Davidson, Asheville Regional Office
WI0100047 Permit File
Buncombe County Environmental Health Dept.
AQUIFER PROTECTION SECTION
1636 Mali Service Center, Raleigh, North Carolina 276RS-1626
✓ or flan; 2728 Capital Boulevard, Relq4g>,, North Camllna 27VA
Phone, 919J33.3221 I FAk 1 M-715-0588, FAX 2: 919.715-6048 � Customer Service 1.677-623.6148
Interne[.wvrw, ncwa tenxr�al�4'sr.�r+2
Best Regards,
i
Michael Rogers, P.G. (NC d FL)
One
NOrtbCau'olina
ar. EquEl Gpaoriunlh +Af imiahvd A tine EmtlinVer

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 HEREBY GRANTED TO
Phil and Amy Donehower
FOR THE CONTINUED 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 closed400p
geothermal -mixed -fluid heat pump system. This system is located at 12 Apgar Rd., Candler, Buncombe
County, NC 28715, and will be constructed and operated in accordance with the application received October
10, 2011, and in conformity with the specifications and supporting data submitted, all of which are Sled with
the Department of Environment and Natural Resources and are considered, a part of this permit
This permit is for operation of an injection well and shall be in compliance with Title 15A North Carolina
Administrative Code 2C .0100 and .0200, and any other Laws, Rules, and Regulations pertaining to well
construction and use.
This permit shall be effective, unless revoked, from the date of its issuance until September 30, 2016, and shall
be'subject to the specified conditions and limitations set forth in Parts I through VII hereof.
Permit issued this the 248' day of October 2011.
a'. � - U)k�'
Coieen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission.
W1010DA-7 UIC/5QM-M.F. Renewal Page 1 of
Version 112010

' ; -1 " 19912 -01 f : l [9)►t . ill1143 3KeTol13-31t701Eels] ► 0- I.IL[9]ZK
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.
r. 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.
4. In the event that there are multiple wells with separate clusters, one well identification tag per 'cluster' of
wells shall be permanently affixed to the heating and cooling unit or tither nearby permanently fixed
location in a clearly visible location according to 2C .0213(g).
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 III - OPERATIONS AND MAINTENANCE REQUIREMENTS
The injection facility shall be properly maintained and operated at alI times.
?. 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.
W10l oo047 UIC'5QM-M.F. Renewal Page 2 of 4
Version 1/2010

PART IV - INSPECTIONS
1. Any duly authorized officer, employee, or representative of the Division of Water Quality may, upon
presentation of credentials, enter and inspect any property, premises, or place on or related to the injection
facility at any reasonable time for the purpose of determining compliance with this permit, may inspect or
copy any records that must be maintained under the terms and conditions of this permit, and may obtain
samples of groundwater, surface water, or injection fluids.
2. Department' representatives shall have reasonable access for purposes of inspection, observation, and
sampling associated with injection and any related facilities as provided for in N.C.G.S. 87-90.
3. Provisions shall be made for collecting any 'necessary and appropriate samples associated with the
injection facility activities.
PART V — MONITORING AND REPORTING REQUIREMENTS
1. Any monitoring (including groundwater, surface water, or soil sampling) deemed necessary by the
Division of Water Quality to insure surface and ground water protection, will be established and an
acceptable sampling reporting schedule shall be followed.
2. The Permittee shall retain all records of repairs, pressure tests, maintenance, and other activities
needed to maintain normal operating conditions.
3. The Permittee shall report by telephone, within 48 hours of the occurrence or first knowledge of the
occurrence, to the Asheville Regional Office, telephone number 828-296-4500, any of the following:
(A) Any occurrence at the injection facility that results in any unusual operating circumstances;
(B) Any failure due to known or unknown reasons that renders the facility incapable of proper
injection operations, such as mechanical or electrical failures;
4. Where the Permittee becomes aware of an omission of any relevant facts in a permit application, or of any
incorrect information submitted in said application or in any report to the Director, the relevant and
correct facts or information shall be promptly submitted to the Director by the Permittee.
S. In the event that the permitted facility fails to perform satisfactorily. the Permittee shalt take such
immediate action as may be required by the Director,
PART VI -- PERMIT RENEWAL
The Permittee shall, at least 120 days prior to the expiration of this permit, request an extension.
WI0 3 (w(14 ; UICI5QM-M,F. Renewal Page 3 of 4
Version 112010

PART V11— 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 for any purpose, the
Permittee shall abandon that injection well in accordance with the procedures specified in 13A NCAC 2C
.0214, including but not limited to the following;
f A a All casing and materials may be removed prior to initiation of abandonment procedures if
the Director finds such removal will not be responsible for, or contribute to, the
contamination of an underground source of drinking water.
(B) The entire depth of each well shall be sounded before it is sealed to insure freedom from
obstructions that may interfere with sealing operations.
(C) Each well shall be thoroughly disinfected, prior to sealing, if the Director determines that
failure to do so could lead to the contamination of an underground source of drinking
water.
(D) Each well shall be completely filled with cement grout, which shall be introduced into the
well through a pipe which extends to the bottom of the well and is raised as the well is
filled.
(E) In the case of gravel -packed wells in which the casing and screens have not been
removed, the casing shall be perforated opposite the gravel pack, at intervals not
exceeding 10 feet, and grout injected through the perforations.
(F) In those cases when, as a result of the injection operations, a subsurface cavity has been
created, each wet] 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 Pennittee shall submit a Well Abandonment Record (Form GW-30) as specified in
15A NCAC 2C .0213(b)(1) within 30 days of completion of abandonment.
3. The written documentation required in Part VII (1) and (2) (G) shall be submitted to:
Aquifer Protection Section-UIC Program
DENR-Division of Water Quality
1535 Mail Service Center
Raleigh, NC 27599-1535
WI01 WIN } LUC15QM-M.F. Renewal Page h of 4
Version 1/21010

Rogers, Michael
From; Davidson, Landon
Sent: Wednesday, October 19, 2011 3:15 PM
To: Rogers, Michael
Subject: FW: W10100047 Donehower 5QM Renewal application
N❑ inspection necessary (see Jonathan notes below). Renew. Thanks
L
G. Landon Davidson, P.G.
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ehs North Carolina Public Records Lays, and inn- be disclosed
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other regulathm
From, Stepp, Jonathan
Sent: Wednesday, October 19, 2011 3:13 PM
To: Davidson, Landon
Subject: RE. WI0100047 Donehower 5QM Renewal application
My recommendation is to proceed with permitting, I spoke with Mr. Donehower and there have been no changes on the
property since the original system was installed. This is something to consider before the new rules come out —It might
be more appropriate for folks with residential closed loop systems to be required to inform us of property modifications
(additional well install, additions, septic work, other excavations...) or a discontinuation of use/ change of status rather
than a renewal every 5 years. IMO this would be a money saving and time saving approach, however non-compliance is
something to consider ... if we stick with the 5 year renewal we should add a section to the form for system owners to
indicate these types of changes.
Thanks,
Jonathan
Jonathan Ste pp— Lon athan.Ste p o (-a'ncdenr.,-ov
North Carolina Dept. of Environment and Natural Resources
Asheville Regional Office
Division of Water Quality - Aquifer Protection Section
7090 U.S. 70 Highway
Swannanoa, NC 28778
Tel: 828-295-A500
Fax: [phone]
Notice: E-mail correspondence to and from this address may be subject to the North Carolina Pubiic Records Law and
therefore may be disclosed to third parties.

From: Davidson, Landon
Sent: Wednesday, October 19, 2011 8:26 AM
To: Stepp, Jonathan
Subject: FW: WI0100047 Donehower 5QM Renewal application
For review.
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web pope: httpa/partal.nc6enr.org/web/wn/apS
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to third panic; ul+less the content is erelnpt bi, shUufe or
olhor regulauun.
From: Rogers, Michael
Sent: Tuesday, October 18, 2011 5:17 PM
To: Davidson, Landon
Subject: WIOI00047 Donehower 5QM Renewal application
Landon -
Attached is a 5QM renewal application. Please let me know if you wish to conduct a pre -permitting inspection or not.
Also, I gave the permit for Rusch to Debra for her signature.
Thanks
Michael Rogers, P.G. (NC & FL)
Environmental Specialist
NC Div of Water Quality- Aquifer Protection Section (APS)
1636 Mail Service Center
Raleigh, NG 2769 -1636
Direct Line (919) 715-61 fib; Fax [phone] {put to my attn on cover letter}
httoalnortal. ncden r. orglwehlwpla nslpworolnermit-applicakions#9eothermA��s
Email correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to thirdparties
2.

Ad
VC[DIERR
North Carolina Department of Environment and Natu4 Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Govemor Director
October 17, 2011
Phil Donehower
Amy Donehower
12 Apgar Road
Candler, NC 28715
Dear Mr. and Mrs. Donehower:
Dee Freeman
Secretary
Subject: Acknowledgement of
Application No. WIOI00047
Phil Donehower SFR
Injection Mixed Fluid GSHI'
Well (5QM) System
Buncombe County
The Aquifer Protection Section acknowledges receipt of your permit application and supporting
documentation received on October 10, 2011. Your application package has been assigned the number
listed above, and the primary reviewer is Michael Rogers.
Central and Asheville Regional Office staff will perform a detailed review of the provided
application, and may contact you with a request for additional information. To ensure maximum
efficiency in processing permit applications, the Aquifer Protection Section requests your assistance in
providing a timely and complete response to any additional information requests.
Please note that processing standard review permit applications may take as long as 60 to 90 days
after receipt of a complete application. If you have any questions, please contact
Michael Rogers at [phone] or michael.rogersCncdenr.gov.
Sincerely,
0 �.
for Debra J. Watts
Groundwater Protection Unit Supervisor
cc: Asheville Regional Office, Aquifer Protection Section
Permit File WI0106047
AQUIFER PROTECTION SECTION
1636 Mail Sennce Censer. Raleigh, North Carolina 27699.1636
Lo;atian: 2728 CaplLai Boulevard, Raleigh, Norsk CaroiIna 27604
Phone [phone] I FAX [phone]; FAX 2' 919.715-60461 Customer Service-1-877.62M748
Internet www.ncwateroualltv.om
An Equar 4poonunity ; Afrrmame.Aoco Ernployer ,
Qni th Carolina
N"Mr,7119

RECl NED / DENR I DWO
Aquifer Pratactba Section
Pr
NORTH CAROLINA DEPARTMENT' OF ENVIRONN= AND NATURAL RESOURCES OCT 10 zait
APPLICATION FOR A PERMIT TO CONSTRUCT OR OPERATE INJECTION WELLS
In Accordance With the Provisions of 15A NCAC 02C .0200
CLOSED -LOOP MIXED -FLUID GEOTHERMAL INJECTION WELLS
These wells circulate fluids other than potable water as part of a geothermal heating and cooling system
{check one} New Application Renewals Modification
• For renewals complete Parts A-C and the signature page.
and Mail to the Address on the Last Page.
DATE: 10 " S , 24-1-1
PERMTI' NO. `Ilj 1 Q 1( 004 7 {leave blank if New Application}
A. STATUS OF APPLICANT (choose one)
Nan -Government: Individual Residence110,
Business/Organization
Government: State Municipal County Federal
S. PERMIT APPLICANT — For individual residences, list each owner on property deed. For all others,
state
si nameofentity and name of person delegated authority to sign on behalf of the business or agency:
E� 11t 1 VC�E 1L Aj
Mailing Address: _ t-
City: avJfer State: .)t^ Zip Code: EC 7 / S County: f tteotCo,414 f,
Day Tele No.: J .I L -6-7G -534 ' j Cell No.: ?�[ - q4 3 - q4as--
EMAIL Address: p rdontlwiueg7 A-T. iu ET Fax No.:
C. LOCATION OF WELL SITE — Where the injection wells are pbysically located;
(1) Parcel Identification Number (PIN) of well site: S 6'74-814'-' 3?_83 County. Son {'cwL c-
(2) Physical Address (if different than mailing address):
City. State: NC Zip Code:
D. WELL DRILLER INFORMATION
Well Drilling Contractor's Name:
NC Well Drilling Contractor Certification No.:
Company Name:
Contact Person: EMAIL Address:
Address:
City: Zip Code: State: County:
Office Tele No.: Cell No,: Fax No.:
GPUMC 5QM Permit Application (Revised 1i24/2011) Page I

E.
HEAT PIMP CONTRACTOR INFORMATION (if different than driller)
Company Name:
Contact Person: EMAIL Address:
Address:
City:
Office Tele No.:
Zip Code:
F. WELL CONSTRUCTION DATA
Cell No..
State: County:
Fax No..
(1) Number of borings to be constructed*: Depth of each boring (feet):
* tf existing water supply wells wfll be used then provide the it1 ormation in item (4) below,
(2) Chemical additives to be used: R-22
Other
Propylene glycol
Ethanol
(other additives will need prior approval by NCDENR before use)
(3) Type of tubing to be used (copper, PVC, etc).
(4) Well casing. If the well(s) will use casing then provide the DTee (steel. PVC, plastic, etc.). diameter, depth,
and extent of casing appearing above ground:
(5) Grout (material surrounding well casing and/or piping):
(a) Grout type: Cement Bentonite** Other (specify)
"By selecung bmnaru[e grout, a variance is hereby mquested to 15A NCAC 2C .0213(dH 3 HA), which requires a cement type grout
(b) Grout depth of tubing (reference to land surface): from to (feet)
If well has casing, indicate grout depth: front to [feet?
G. WELL LOCATIONS — Maps must be scaled or otherwise accurately indicate distances and orientations of
Features located within 1000 feet of the injection well(s). Label all features clearIN and include a north arrow.
(2)
Attach a site -specific man showing the locations of the following:
* Proposed injection welts
* Surface water bodies
* Buildings
* Water supply wells
* Property boundaries
* Septic tanks and associated spray irrigation sites, drain fields, or repair areas
* Existing or potential sources of groundwater contamination
Attach a topographic map of the area extending 1/4 mile from the injection well site that indicates the
facility's location and the map name.
NOTE: In most cases, an aerial photograph of the property parcel showing property lines and strucrures can be
obtained and downloaded from the applicable couno, GIS wehslte. Ttilrically, (lee propert}, can be searched bt
owner name or address. The location of the wells in relation to proper{- boundaries, houses. septic tanks, other
wells, etc. can then he drawn in by hand. A[ro, a `later' can he selected showing topographic contours or
elevation data.
GPU/LJIC 5QM Permit Application (Revised 1/24/20I 1) Page 2

H. CERTIFICATION (to be signed as required below or by that person's authorized agent)
15A NCAC 02C .0211 N requires that all permit applications shall be signed as follows:
I. for a corporation: by a responsible corporate officer;
1 for a partnership or sole proprietorship: by a general partner or the proprietor, respectively;
3. for a municipality or a state, federal, or other public agency: by either a principal executive
officer or ranking publicly elected official;
4. for all others: by the well owner (which means all persons listed on the t ronert , deed 1.
If an authorized agent is signing on behalf of the applicant, then supply a letter signed by the
applicant that names and authorizes their agent to sign this application on their behalf.
N hereby certify, under penalty of law, that I have personally examined and am familiar with the information
submitted in this document and all attachments thereto and that, based on my inquiry of those individuals
immediately responsible for obtaining said information, I believe that the information is true, accurate and
complete. I am aware that there are significant penalties, including the possibility of fines and imprisonment,
for submitting false information. I agree to construct, operate, maintain, repair, and if applicable, abandon the
injection well and all related appurtenances in accordance with the approved specifications and conditions of
the Permit."
Signature of Property Owner/Applicant
I-lr d 6 C o t' Ll Utz E-ram'
Print or Type Pali Name
Signature, f Property Owner/Applicant
AWL 4 Gme�aWpi-
Print or a Full Name F
Signature of Authorized Agent, if any
Print or Type Full Name
Submit two copies of the completed application package to:
DWQ - Aquifer Protection Section
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone [phone]
r
RF-uiv EL1 i OENR I DVQ
Aquftr RroterfOn Section
OCT 10 ?011
GPUIUC 5QM Permit Application (Rwised 1 r24120111 Page I

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W _L 0 -1, 00 01/ 7
February 1, 2008
Rickey Kitchen
P.O. Box 99
Penrose, NC 28766
Subject: Geothermal Well Installation Data
Dear Mr. Kitchen:
Michael F. Easley, Governor
William G. Ross Sr., Secretary
North Carolina Department of Environment and Natural Resources
Coleco Sullins, Director
Division of Water Quality
In review of our records concerning closed -loop geothermal mixed -fluid injection well systems,
classified as 5QM type permits, we have found the following records have not been submitted
for permits where your company is listed as the heat pump installers:
• Well Construction Record (GW-1)
• Triangulation Data
• Mechanical Integrity Pressure or Vacuum/Leak testing data
In order to assist your clients (those who hold 5QM permits) in meeting the condition of their
permits, we request your assistance to provide the above information no later than March 15,
2008. For future reference, we recommend you provide this information to your clients as soon
as construction is complete to assist them in meeting the condition of their permits. Also, please
remember their permits require them to keep this information on -site as well.
To assist you, we have attached a list of permits where you are listed as the heat pump installer.
We have also attached a form to fill out the results of your mechanical integrity tests. Thank you
in advance for your cooperation and timely response. If you have any questions regarding this
letter, please call me at [phone] or Michael Rogers at [phone].
Sincerely,
0&o'-3,
Debra J. Watts
Environmental Supervisor
Groundwater Protection Unit
Attachment(s)
cc: APS Central Files (copy to each permit file on attached list)
Each Permittee on attached list
r��°�° rCaro a
)M'CV a&;
Aquifer Protection Section 1636 Mail Service Center
Internet: www.ncwateryuelil..ore Location: 2729 Capita] Boulevard
An Equal GpportunitylAtArmative Action Ernplcyer— 50% RecycW10% Post Consumer Paper
Raleigh, NC 27699-1636 Telephone: [phone]
Raleigh, NC 2160.4 Fax 1: [phone]
Fax 2: [phone]
Customer Service: [phone]

Mechanical Integrity Test Record
(For 5QM Geothermal Heat Pump Injection Well System)
OwnerlPermittee Name: Permit Number: WI
Facility Address:
Home Phone: Cell Phone:
Heat Pump Contractor Name:
Office Phone: Cell Phone:
Tester Name: Signature:
Date of Test:
Loop I Initial Pressure(psi) Final Pressure(psi) I Duration (minutes) Pass [Yes or Nn}
1 I
I
2
3
4
5
6
7 f
s
1 1
9
14
1
11
12
13
14
15
_
--- - ---- -
Any additional loop testing add to back of this form
Comments:
Other Test Methods and Results:
This form must be filled out and signed by the tester. The record must be received by Aquifer Protection Section 24 hours
prior to the initiation of the operation of the facility. You can send the form by mail: UIC Program, Mail Service Center 1636,
Raleigh, NC 2769� or by fax: [phone].
Mechanical Integrity Test Form ] 1r2007

chael
F. Easley, Governor
William G. Ross Jr.. Secretary
North Carolina Department of Env imoment and Natural Resources
Coleen Sullins, Director
Division of Water Quality
January 11, 2008
Rickey Kitchen
P.D. Box 99
Penrose, NC 28766
Subject: Geothermal Well Installation Data
Dear Mr, Kitchen:
In review of our records concerning closed -loop geothermal mixed -fluid injection well systems,
classified as 5QM type permits, we have found the following records have not been submitted
for permits where your company is listed as the heat pump installers:
Well Construction Record (GW-l)
Triangulation Data
Mechanical Integrity Pressure or Vacuum/Leak testing data
In order to assist your clients (those who hold 5QM permits) in meeting the condition of their
permits, we request your assistance to provide the above information no later than February 29,
2008. For future reference, we recommend you provide this information to your clients as soon
as construction is complete to assist them in meeting the condition of their permits. Also, please
remember their permits require them to keep this information on -site as well.
To assist you, we have attached a list of permits where you are listed as the heat pump installer.
We have also attached a form to fill out the results of your mechanical integrity tests. Thank you
in advance for your cooperation and timely response. If you have any questions regarding this
letter, please call me at [phone] or Michael Rogers at [phone].
Sincerely,
Debra J. Watts
Environmental Supervisor
Groundwater Protection Unit
Attachment(s)
cc: APS Central Files (copy to each permit file on attached list)
Each Permittee on attached list
AquiferProteLtion section 1636 Mail Service Cantu
Internet www.newaternvalitv.om Loeadow 2728 Capital Boulevard
An Equal OpportunitylAfArmative Adon Employer— 509E Recyded110% Post Consumer paper
ovatuAdly
Raleigh. NC 27699-1636 Telephone: [phone]
Raleigh, NC 27604 Fax 1; [phone]
Fax 2: [phone]
Customer Service: [phone]

Issued Permits with Rickey Kitchen Listed as Heat Pump Contractor
January 11, 2008
Permit No.
Name
Date Permit Issued
VVIO10004o
Crai2 Justus
315/2007
W 101 00047
Phil Donehower
319/2007
W 1010OD45
Habitat for Humani
3/12/2007
W10100052
Ran Thom son
9111/2007

Mechanical Integrity Test Record
(For 5QM Geothermal Heat Pump Injection Well System)
OwnerlPermittee Name: Permit Number: WI
Facility Address:
Home Phone: Cell Phone:
Heat Pump Contractor Name:
Office Phone: Cell Phone:
Tester Name: Signature:
Date of Test:
Loop Initial Pressure (psi) Final Pressure (psi) I Duration (minutes) Pass (Yes or No)
1
2
3 I
4
5
6 1
7
8 1
9
10 1
11 l I I
12
13
14
15
Any additional loop testing add to back of this form
Comments:
Other Test Methods and Results:
This form must be filled out and signed by the tester. The record must be received by Aquifer Protection Section 24 hours
prior to the initiation of the operation of the facility. You can send the form by mail: UIC Program, Mail Service Center 1636,
Raleigh, NC 27699 or by fax: [phone],
Mechanical lntcFity Test Farm 11=07

`OQF vv� r�G
Michael F. Easley, Governer
�.. r William G, Ross Jr., Secretary
North Caroline Deparanent of Envirm cot and Natural Resm=ca
❑ ,' Alan W, Klimek, P.E. Dirtctor
Division of Water Quality
March 9, 2007
Phil Donehower
12 Apgar Road
Candler, NC 28715
Re: Issuance of Injection Well Permit
Permit No. WI0100047
Issued to Phil Donehower
Dear Mr. Donehower:
In accordance with your application received February 7, 2007, 1 am forwarding Permit No.
WI0100047 for the operation of a vertical closed -loop geothermal mixed -fluid heat pump
injection well system to be located at 12 Apgar Road, Candler, Buncombe County, North
Carolina 28715. This permit shall be effective from the date of issuance until February 29, 2012,
and shall be subject to the conditions and limitations stated therein.
Pay special attention to the well construction standards in Parts II and V of your permit.
You must notify this office (Raleigh Central Office) and the Asheville Regional Office at least
forty-eight (48) hours prior to constructing the system, and forty-eight (48) hours prior to
initiation of the operation of the system.
In order to continue uninterrupted legal use of this well for the stated purpose, you should submit
an application to renew the permit three months prior to its expiration date. As indicated in the
permit, this permit is not transferable to any person without prior notice to, and approval by, the
Director of the Division of Water Quality. If you have any questions regarding your permit or
the Underground Injection Control Program please call Mr. Qu Qi at [phone] or me at
[phone].
Best Regards,
454-
Michael Rogers
Hydrogeological Technician II
cc: Landon Davidson — Asheville Regional Office
Central Office File — WI0100047
Andrew Messer — Effecta Solutions
Attachments)
Cft
C*n
Aquifer Protwino section 1636 Mail Serviee Ccntor Raleigh, NC 27699-1636 Telephone: [phone]
Internet: h=;UMMnmtcroua1itv.ora 2728 Capital Boulevard RWcigh, NC 27604 Fax 1: [phone]
Fax 2: [phone]
An Equal oppor4mlrylAffIrmativeAdon Empk>yer--50% Recyned110%Post GortsumerPaper Customer Service: [phone]

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMI USSION
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
PHIL DONEHOWER
FOR THE CONSTRUCTION AND OPERATION OF 10 TYPE SQM INJECTION WELLS,
defined in Title 15A North Carolina Administrative Code 2C .0209(e)(3)(F), for the purpose of
operating a "direct expansion" type vertical closed -loop geothermal -mixed -fluid heat pump
system. This system is located at 12 Apgar Road, Candler, Buncombe County, North Carolina,
and will be constructed and operated in accordance with the application received February 7,
2007, and in conformity with the specifications and supporting data submitted, all of which are
filed with the Department of Environment and Natural Resources and are considered a part of
this permit.
This permit is for Construction and Operation only and does not waive any provisions of the
Water Use Act or any other applicable Laws, Rules, or Regulations. Operation and use of an
injection well shall be in compliance with Title 15A North Carolina Administrative Code 2C
.0100 and .0200, and any other Laws, Rules, and Regulations pertaining to well construction and
use.
This permit shall be effective, unless revoked, from the date of its issuance until February 29,
2012, and shall be subject to the specified conditions and limitations set forth in Parts I through
IX hereof.
Permit issued this the day of Y'�4-. , 2007.
IrAlan W. Klimek, Director
Division of Water Quality
By Authority of the Environmental Management Commission.
Pem�t No. WI0100047 Page

PART I - WELL CONSTRUCTION GENERAL CONDITIONS
1. The Permittee must comply with all conditions of this permit and with the standards and
criteria specified in Criteria and Standards Applicable to Injection Wells (15A NCAC 2C
.0200). Any noncompliance with conditions of this permit constitutes a violation of the
North Carolina Well Construction Act and is grounds for enforcement action as provided
for in N.C.G.S. 87-94.
2. This pemnit shall become voidable unless the facility is constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other supporting data.
3. Each injection well shall not hydraulically connect separate aquifers.
4. Each injection well shall not be located in an area generally subject to flooding. Areas that
are generally subject to flooding include those with concave slope, alluvial or colluvial
soils, gullies, depressions, and drainage ways.
5. Each injection well shall be secured to reasonably insure against unauthorized access and
use. Each Well shall be permanently labeled with a warning that it is for injection purposes
and the entrance to each, well must be secured with a 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.
8. A completed Well Construction Record (Form GW-1) must be submitted for each injection
well to: DENR-Division of Water Quality, Aquifer Protection Section [TIC -Staff, 1636
Mail Service Center, Raleigh, NC 27699-1636, within 30 days of completion of well
construction.
PART H - WELL CONSTRUCTION SPECIAL CONDITIONS
1. Prior to constructing the injection well system, the Permittee or his agent shall test the pH of
the soil at a depth of three feet at the planned well location. If the resulting soil pH is less
than 6 standard units or greater than I 1 standard units, the well system shall be equipped with
a compatible cathodic protection system. All testing results shall be kept on site available for
inspection.
2. At least forty-eight (48) hours prior to constructing system, the Permittee shall notify the
Aquifer Protection Section's Underground Injection Control (UIC) Program Central Office
staff, telephone number [phone] and the Asheville Regional Office Aquifer
Protection Section Staff, telephone number [phone].
3. All underground tubing shall be. refrigeration grade copper tubing.
Permit No, W10100047 Page 3

4. Prior to installation, all tubing to be placed in boreholes ("loops") shall be checked for leaks
by pressurizing the loop to a gage pressure of at least 350 pounds per square inch (psig),
immersing the loop in water and examining it for leaks, Loops with leaks shall not be
installed.
5. Prior to installation, each loop shall be visually inspected for damage such as kinks, dents,
and scrapes. Each loop shall be checked to verify that the nitrogen charge applied to the loop
by the manufacturer before shipping is still present at a pressure of at least 300 psig. The
loop manufacturer shall be notified in the event of damage or pressure loss, and the
manufacturer's instructions shall then be followed. The nitrogen charge may be released
only when the loop is installed and ready to be connected to the manifold.
6. Soreholes shall be large enough to allow insertion of the loop plus a tremie pipe for grouting.
7. After insertion of the tubing into the boreholes, an approved grout (as defined in Title 15A
North Carolina Administrative Code 2C .0100) shall be pumped via tremie pipe into the
annular space of eacb borehole so as to completely fill it from bottom to top,
S. All tubing junctions shall be brazed using lead-free brazing material. The brazing material
shall have a galvanic potential as close as practicable to that of the tubing material.
9. Dry nitrogen shall be circulated through the tubing during brazing to prevent oxidation.
10. After installation and prior to operation of the system, a mechanical integrity test shall be
conducted by pressurizing the injection well system to 400 psig with dry nitrogen and
monitoring for leaks using an ultrasonic or other leak detector of equal sensitivity and
monitoring pressure in the system for at least 2 hours. Alternatively, an equivalent vacuum
test is acceptable. Any pressure fluctuation other than that due to thermal expansion and
contraction of the testing medium shall be considered a failed mechanical integrity test. Any
leaks shall be located and repaired prior to charging the system with refrigerant. A copy of
the post -installation pressure or vacuum test record (initial pressure reading,. - inal pressure
reading, and the duration of the test) shall be submitted to the Aquifer Protection Section.
The test records must be received by the Aquifer ProtectigA Section at least twee -four 24
lours prior to the initiation of the operation of the facility for injection.
11. The location of each of the system manifolds shall be recorded by triangulation from two
permanent features on the site (e.g., building foundation corners), The Permittee shall retain a
copy of the triangulation records. The Permittee shall also submit a copy of the triangulation
records to the Aquifer Protection Section within 30 days of completion of well construction.
12. The written documentation required in Part 11, parsgrraphs ( 10) and { 11) shall be submitted to:
Aquifer Protection Section-UIC Staff
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
Pit No. wlol00047 Page 4

PART III - OPERATION AND USE GENERAL CONDITIONS
1. This permit is effective only with respect to the nature, volume of materials and rate of
injection, as described in the application and other supporting data.
2. This permit is not transferable without prior notice to, and approval by, the Director of the
Division of Water Quality (Director), In the event there is a desire for the facility to
change ownership, or there is a name change of the Permittee, a formal permit amendment
request must be submitted to the Director, including any supporting materials as may be
appropriate, at least 30 days prior to the date of the change.
3. The issuance of this permit shall not relieve the Permittee of the responsibility of
complying with any and all statutes, rules, regulations, or ordinances, which may be
imposed by other local, state, and federal agencies which have jurisdiction. Furthermore,
the issuance of this permit does not imply that all regulatory requirements have been met.
PART IV - PERFORMANCE STANDARDS
The injection facility shall be effectively maintained and operated at all times so that there
is no contamination of groundwater that will render it unsatisfactory for normal use. In the
event that the facility fails to perform satisfactorily, including the creation of nuisance
conditions or failure of the injection zone to adequately assimilate the injected fluid, the
Permittee shall take immediate corrective actions including those actions that may be
required by the Division of Water Quality such as the repair, modification, or abandonment
of the 'injection facility.
2. The Permittee shall be required to comply with the terms and conditions of this permit
even if compliance requires a reduction or elimination of the permitted activity.
3. The issuance of this permit shall not relieve the Permittee of the responsibility for damages
to surface or groundwater resulting from the operation of this facility,
PART V - OPERATION AND MAINTENANCE REQUIREMENTS
l . The injection facility shall be property maintained and operated at all times.
2. The Permittee roust notify the Division and receive prior written approval from the
Director of any planned physical alterations or additions in the permitted facility or activity
not specifically authorized by the permit.
3. At least forty-eight (48) hours prior to the initiation of the operation of the facility for
injection, the Permittee must notify by telephone the Aquifer Protection Section's
Underground Injection Control (UIC) Program Central Office staff, telephone number
[phone], and the Asheville Regional Office Aquifer Protection Section Staff,
telephone number [phone]. Notification is required so that Division staff can
Permit No. WIOI00047 Page 5

I
nspect or otherwise review the injection facility and determine if it is in compliance with
permit conditions.
MA-I'VA"JJ3IZ&U 314M M IGIM
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.
16A 114 dkV I ad 1IL'1 it 111] 9 lec" ►►1 tl :4 3i I) al 0-10Ca-,I &fill I in au■ i a1►'il if y
1. Any monitoring (including groundwater, surface water, or sail 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)
296-4544, any of the following:
(A) Any occurrence at the injection facility that results in any unusual operating
circumstances;
(B) Any failure due to known or unknown reasons that renders the facility incapable of
proper injection operations, such as mechanical or electrical failures;
(C) Any loss of refrigerant in the system, regardless of the origin of the loss;
(D) Any recharging of the refrigerant system.
3. Where the Permittee becomes aware of an omission of any relevant facts in a permit
application, or of any incorrect information submitted in said application or in any report to the
Director, the relevant and correct facts or information shall be promptly submitted to the
Director by the Permittee.
4. In the event that the permitted facility fails to perform satisfactorily, the Per-mittee shall
take such immediate action as may be required by the Director.
Permit No. W14100047 Page 6

PART VM - PERNUT RENEWAL
The Permittee shall, at least 120 days prior to the expiration of this permit, request an
extension.
PART IX - CHANGE OF WELL STATUS
1. The Perm.ittee shall provide written. notification - within 15 days of any change of status of
an injection well. Such a change would include the discontinued use of a well for
injection. If a well is taken completely out of service temporarily, the Permittee must
install a sanitary seal. If a well is not to be used for any purpose that well must be
permanently abandoned according to 15A NCAC 2C .0213(h)(1), Well Construction
Standards.
2. When operations have ceased at the facility and a well will no longer be used for any
purpose, the Permittee shall abandon that injection well in accordance with the procedures
specified in 15A NCAC 2C .0214, including but not limited to the following:
(A) All casing and materials may be removed prior to initiation of
abandonment procedures if the Director finds such removal will not be
responsible for, or contribute to, the contamination of an underground
source of drinking water.
(B) The entire depth of each well shall be sounded before it is sealed to insure
freedom from obstructions that may interfere with sealing operations.
(C) Each well shall be thoroughly disinfected, prior to sealing, if the Director
determines that failure to do so could lead to the contamination of an
underground source of drinking water.
(D) Each well shall be completely filled with cement grout, which shall be
introduced into the well through a pipe, which extends to the bottom of the
well and is raised as the well is filled.
(E) In the case of gravel -packed wells in which the casing and screens have
not been removed, the casing shall be perforated opposite the gravel pack.,
at intervals not exceeding 10 feet, and grout injected thmugh 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. W10100047 Page 7

(G) The Permittee shall submit a Well Abandonment Record (Form GW-30)
as specified in 15A NCAC 2C .0213(h)(1) within 30 days of completion
of abandonment.
3. The written documentation required in Part IX (1) and (2) (G) shall be submitted to:
Aquifer Protection Section-UIC Program
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
Permit No. WI0100047 Page 8

Permit Number W10`100047
Program Category
Ground Water
Permit Type
Injection Mixed Fluid GSHP Well System (50M)
Primary Reviewer
michael.rogers
Permitted Flow
Facili
Central Files: APS SWP
03/08/07
Permit Tracking Slip
Status Project Type
In review New Project
Version Permit Classificatioh
individual
Permit Contact Affiliation
Facility Name
Major/Minor Region
Phil Donehower SFR
Minor Asheville
Location Address
County
12 Apgar Rd
Buncombe
Candler NC 28715
Facility Contact Affli[ativn
Phil Donehower
12 Apgar Rd
Candler NC 28715
Owner name Owner Type
Individual
Phil Donehower Owner Affiliation
Phil Donehower
12 Apgar Rd
Candler NG 28715
Scheduled
Orig Issue App Received draft Initiated Issuance Public Notice Issue Effective Expiration
02/07/07
Regulated Activities ReauestedlRecelved Events _
Heat Pump Injection RO staff report requested 02/15/07
RO staff report received 02/28/07
Outfall NULL
Waterbody Name
Stream index Number Current Class 5ubbasin

AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
Date: A aaj
To: Agnifer Protection Section Central Office
Central Office Reviewer:
Regional Login No:
County•r �-
Permittee: �� V'Wowm
Project Name:
Application No.: W-r a 1 OOo 47
I. GENERAL INFORMATION
1. This application is (check au Lha[ apply): ERNew ❑ Renewal
❑ Minor Modification ❑ Major Modification
Surface Irrigation ❑ Reuse ❑ Recycle ❑ High Rate Infiltration ❑ Evaporation/Infiltration Lagoon
❑ Land Application of Residuals ❑ Attachment B included ❑ 503 regulated ❑ 503 exempt
❑. Distribution of Residuals ❑ Surface Disposal
❑ Closed -loop Groundwater Remediation j[Z 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: 7,TO2-ZI
b. Person contacted and contact information: 6wdt-
c. Site visit conducted by:
d. Inspection Report Attached: [9Yes or ❑ No.
2, Is the following information entered into the BIMS record for this application correct?
XYes or ❑ No. If no, please complete the following or indicate that it is correct on the current application.
For Treatment Facilities:
a. Location:
b. Driving Directions:
c. USGS Quadrangle Map name and number:
d. Latitude: Longitude:
RECEIv =D 1 DENR I OWQ
AWFFR MnTrrTl% REGION
FEB E 8 2007
e. Regulated Activities 1 Type of Wastes (e.g,, subdivision, food processing, municipal wastewater):
For Disposal and In'ection Sites:
(If multiple sites either indicate which sites the information applies to. copy and paste a. new -section into the
document for each site. or attach additional_ pages for each site
a. Locations): IZ 40440- 7_871 _
b. Driving Directions: US 14. Z 3 W. I L a-f f iG I fl 'r'S:9.1 9 oAI N al s 14 a.r
w*a C
c. USGS Quadrangle Map narne and number:
d. Latitude: K+ • 4&Z1 Z- Longitude: � z • ?d 7 S3 -
IL NEW AND MAJOR MODIFTCATIONAPPLICATIONS this section not needed for renewals or minor
modfrcations, skin to next section2
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?
FOAM: DocumentI I

AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
❑ Yes ❑ No O.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 ❑ N/A. 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:
?. Is the proposed residuals management plan adequate and/or acceptable to the Division. ❑Yes ❑ No
NIA. If no, please explain:
6. Are the proposed application rates for new sites (hydraulic or nutrient) acceptable?
❑ Yes ❑ No ® NIA. If no, please explain:
7. Are the new treatment facilities or any new disposal sites located in a 100-year floodp[ain?
❑ Yes ❑ No E, NIA. If yes, please attach a map showing areas of I00-year f7oodplain and please explain
and recommend any mitigative measures/special conditions in Part IV-
S. Are there any buffer conflicts (new treatment facilities or new disposal sites)? ❑ Yes or Q 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:
3. Is proposed and/or existing groundwater monitoring program (riumber of wells, frequency of monitoring,
monitoring parameters, etc.) adequate? ❑ Yes ❑ No E N/A. 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, W ill seasonal or other restrictions be required? ❑ Yes ❑ No Eq N/A If yes, attach list ❑f sites
with restrictions (Certification B?)
III. RENEWAL AND MODIFICATIONAPPLICdTIONS Luse previous section for new or major rnodi rcafion
s stents
Description Of Waste S And Facilities
1. Are there appropriately certified ORCs for the facilities? ❑ Yes or ❑ No.
Operator in Charge: Certificate #:
Backup- Operator in Charge: Certificate #:
w. 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 systern? ❑ 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: Document 1 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:
6. Are the existing application rates (hydraulic or nutrient) still acceptable? ❑ Yes or ❑ No. If no, please
explain:
7. Is the existing groundwater monitoring program (numher of wells, fregilency 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:
B. WilI seasonal or other restrictions be required for added sites? ❑ Yes ❑ No ❑ NIA If yes, attach list of sites
with restrictions (Certification B?)
9. Are there any buffer conflicts (treatment facilities or disposal sites)? ❑ Yes or ❑ No. If yes, please attach a
map showing conflict areas or attach any new maps you have received from the applicant to be incorporated
into the permit:
10. Is the description of the facilities, type and/or volume ofwaste(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 permit cycle; ❑
Current enforcement action(s) ❑ Currently under SOC; ❑ Currently under ]OC; ❑ 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, 1OC, etc.) been complied with? ❑ Yes
❑ No ❑ Not Determined ❑ NIA.. If no, please explain:
15. Are there any issues related to compliance/enforcement that should be resolved before issuing this permit? ❑
Yes or ❑ No ❑ NIA. If yes, please explain:
FORM: Docurnentl 3

AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
1 i ; INJECTION WELL PERMIT APPLICATIONS [Complete these two sections for all systems that use injection
wells, including closed -loop groundwater remediation effluent injection wells, in situ remediation injection wells, and heat
pump injection wells.)
Description Of Well 5 And Facilities — New Renewal. And Modification
l . Type of injection system:
❑ Heating/cooling water return flow (5A7)
LR Closed -loop heat punip system (5QM/5QW)
❑ In situ remediation (5I)
❑ Closed -loop groundwater remediation effluent injection (5U1"Non-Discharge")
❑ Other {Specify:
?. Does system use same well for water source and injection? ❑ Yes 0No
3. Are there any potential pollution sources that may affect injection? ❑ Yes 0 No
What is/are the pollution source(s)? . What is the distance of the injection well(,$)_from the pollution
source(s)? ft.
4. What is the minimum distance of proposed injection wells from the property boundary? ft.
5. Quality of drainage at site: N Good ❑ Adequate ❑ Poor
6. Flooding potential of site: L' 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: AJ
8. Does the map presented represent the actual site (property lines, wells, surface drainage)? Z Yes or ❑ No. If
no or no map, please attach a sketch of the site. Show property boundaries, buildings, wells, potential pollution
sources, roads, approximate scale, and north arrow.
ln'ection Well Permit Renewal And Modification Onlv:
J. For heat pump systems, are there any abnormalities in heat pump or injection well operation (e.g. turbid water,
failure to assimilate injected Fluid, poor heating/cooling)?
❑ Yes ❑ No. If ves. explain:
?. For closed -loon heat pump systems, has system lost pressure or required make-up fluid since permit issuance
or last inspection? ❑ Yes ❑ No. If ves. explain:
3. For renewal or modification of groundwater remediation permits of any type). will
continued/additional/modified injections have an adverse impact on migration of the plume or management of
the contamination incident? ❑ Yes ❑ No. If ves. explain:
4. Drilling contractor: Name: F �f''f!' Win' +:'r,_A L r- ` �c'� • _ �U .
FORM: Document] 4

AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
}
Address:
Certification number: 34(oe
5. Complete and attach Well Construction Data Sheet.
FOAM: Documents

AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
V EVALUATIONAND RECOMhIENDATIONS
I. Provide any additional narrative regarding your review of the application.:
2. Attach Well Construction Data Sheet - if needed information is available
3. Do you foresee any problems with issuance/renewal of this permit? ❑ Yes EINo. If yes, please explain
briefly.
4. List any items that you would like APS Central Off ce to obtain through an additional information request.
Make sure that you provide a reason for each item:
Item Reason
I
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. Ifdeny, please state reasons:
8. Signature of report preparer(s):
r � �
Signature of APS regional supervisor: J
Date: 2,0� ? Q 7 2-3
ADDITIONAL REGIONAL STAI'I' REVIEW ITEAIS
FORM: Document] 6

AQUIFER PROTECTION SECTION FES 16 2007
APPLICATION REVIEW REQUEST FORM
Date: February 15.2007
To: ® Landon Davidson, ARO-APS ❑ David May, WaRO-APS
❑ Art Barnhardt, FRO-APS ❑ Charlie Stehman, WiRD-APS
❑ Andrew Pitner, MRO-APS ❑ Sherri Knight, W SRO -AP S
❑ Jay Zimmerman, RRO-APS
From: Michael Rogers , Groundwater Protection Unit
Telephone: L 919 t 715-6166 Fax: [phone]
E-Maid: Michael.RogerswOncmail.net ,
A. Permit Number: W141.Oa447 AU FEB 2 1 25V
B. Owner: Phil Donehower
C. FacHUNIOneration:
® Proposed ❑ Existing ❑ Facility ❑ Operation
D. Apiffleation:
1. Permit Type: ❑ Animal ❑ SFR-Surface Irrigation❑ Reuse ❑ H-R infiltration
❑ Recycle ❑ IIE Lagoon ❑ GW Remediation (ND)
® [TIC - (5QM) closed loop mixed fluid geothermal
For Residuals: ❑ Land App. ❑ D&M ❑ Surface Disposal
❑ 503 ❑ 503 Exempt ❑ Animal
2. Project Type: ® New ❑ Major Mod. ❑ Minor Mod. ❑ Renewal ❑ Renewal wl Mod.
E. Comments/Other Information: ❑ I would like to accompany you on a site visit.
Attached, you will find all information submitted in support of the above -referenced application for your
review, comment, and/or action. Within 21 calendar days, please take the following actions:
® Return a Completed APSARR Form.
❑ Attach Well Construction Data Sheet.
❑ Attach Attachment B for Certification by the LAPCU.
❑ Issue an Attachment B Certification from the RO.*
` Remember that you will be responsible for coordinating site visits and reviews, as well as additional
information requests with other RO-APS representatives in order to prepare a complete Attachment B for
certification. Refer to the RPP SOP for additional detail
When you receive this request form, please write your name and dates in the spaces below, make a copy
of this sheet, and return it to the appropriate Central Office -Aquifer Protection Section contact person
listed above.
RU-APS Reviewer: Date. 1'
FORM: APSARR 07106 Page 1 of 1

AQUIFER PROTECTION SECTION
APPLICATION REVIEW REQUEST FORM
Date: Febru:ary 15. 2007
To: ®
Landon Davidson, ARO-APS
❑
Art Barnhardt, FRO-APS
❑
Andrew Pitner, MRO-APS
❑
Jay Zimmenman, RRO-APS
❑ David May, WaRO-APS
❑ Charlie Stehman, WiRO-A.PS
❑ Sherri Knight, WSRO-APS
From: Michael Rogers , Groundwater Protection Unit
Telephone: [phone] Fax: L9191715-0588
E-Mail: Michael.RoLfery&nemail.net
A. Permit Number: W10100047
B. Owner: Phil Donehower
C. Facilit%/Operation:
® Proposed ❑ Existing ❑ Facility ❑ Operation
D. Application:
1. Permit Type: ❑ Animal ❑ SFR-Surface Irrigation❑ Reuse ❑ H-R Infiltration
❑ Recycle ❑ IIE Lagoon ❑ GW Remediation (ND)
® llTC - (5QM) closed loop mixed fluid geothermal
For Residuals: ❑ Land App. ❑ D&M ❑ Suiface Disposal
❑ 503 ❑ 503 Exempt ❑ Animal
2, Prgject Type: N New ❑ Major Mad. ❑ Minor Mod. ❑ Renewal ❑ Renewal w/ Mod.
E. Comments/Other Information: ❑ I would like to accompany you on a site visit
Artached, you will find all information submitted in support of the above -referenced application for your
review, comment, and/or action. Within 21 calendar days, please take the following actions:
E Retum a Completed APSARR Form.
❑ Attach Well Construction Data Sheet.
❑ Attach Attaclunent B For Certification by the LA.PCU.
❑ Issue an Attachment B Certification from the RD.*
* Remember that you will be responsible for coordinating site visits and reviews, as well as additional
infomtation requests with other RO-APS representatives in order to prepare a complete Attachment B for
certification. Refer to the RPP SOP for additional detail.
When you receive this request form, please write your name and dates in the spaces below, make a copy
of this sheet, and return it to the appropriate Central Office -Aquifer Protection Section contact person
listed above.
RO-APS Reviewer:
Date:
FORM: APSARR 07/06 Page 1 of 1

D�OF WArEf��C. Michael F. Easley, Governor
William G. Ross Jr., Secretary
r North Carolina Department of Environment and Natural Resources
Alan W. Klimek. P.E. Director
•� """`� Division of Water Quality
February 13, 2007
PHIL DONEHO WER
12 APGAR RD
CANDLER NC 28715
Subject: Acknowledgement of Application No. W10100047
Phil ❑onehower SFR
hijection Mixed Fluid GSHP Well System (SQM)
Buncombe County
Dear Mr. Donehower:
The Aquifer Protection Section of the Division of Water Quality (the Division) acknowledges receipt of
your permit application and supporting materials on February 7, 2007. This application package has been
assigned the i'ltlmber 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 ❑ivision'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 by phone at [phone] or by email at
Miichael.Rogers cr)ncmail.net. 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 IittwPh2o.enr,state.ncTus/documents/dwq oro hart.1 df.
PLEASE REFER TO THE ABOVE APPLICATION NUMBER WHEN MAILING INQUEUES
ON THIS PROJECT.
Sincerely, —�
0
for Debrr, Watts
Supervisor
cc: Asheville Regional Office, Aquifer Protection Section
Permit Application File W10100047
orw
Nur hcarol ina
,W"91r11
Aquifer Protection Section 1536 Mal) Service Center Raleigh, NC 27699-1636 Telephone; [phone]
Internet: www.ncwaternuaiitv.ara Location: 2728 Capital Boulevard Raleigh, NC 276D4 Fax 1: [phone]
Fax 2: [phone]
An Equal QpportunitylAfliimiative Action Employer 50% Racycied/10% Post Consumer Paper Customer Service: (8T7) B23-6748

.+an aU U-r Wf t ididp pain l a a Clark
920-683-6339 p.l
NMTH CARC)LF A
DEPARTMENT OF ENVMOMA+MM AND NATURAL PJWt M
APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A
W 1=4S) FOR INJRMON WITH. A HEAT PUMP SYSTEM
Type SAT and SQM WsSa
In A wah ON pMvft6one OrNCAC Tide 13A: 0=0M9
canpim 4ppft" tad tmu % e1ftm Wd tm bmkpw,
TO: DIRECM N aTH CAROLMA DIVISION OF WATER QUALITY
n AT& i 12ff ant
A. SYSTSW CLASMICATM Ple ofc A ookxmt which masUilres pgtmd sysmm
(t) Type SA7 vMly fnicd warm uaad to ptarida Ding or onolt For #nwwms.
(2) x Type 3QU walla twitch a rtthsuram clrceoliaoaee pi*, tlw is
boWad Dun to crAmacmd and oitaalabes a OWN wbw thm pueblo water
'i Wv toduides ayab m -that clnmb ee addtdves such as mdfiwes+es amilm ommica
kgdmturs.
(3? Type 3QW welly owM ti a subagr>lloe syeM of 0601 WA piping. dud is
iaola Am the awbori and w d oolp► cdn aMea pabd m wam Iffyon aeleckd
dft WA ypa. JVm*7 Wm 0fhd1W Fa
CNW"W A G7a�der On& lysdl w "40WL
EmEnEff7ml-M,
•■
Arius:
c*r. C Cod -r t LJ—c TIpG`wa zfirs catuty: goncomt�
Tdaphor n 30DI. 212 - q 3h6:
C. MOPERT'Y OWMW CtPdif ams 41um M*k aoQ
Name:
Address:
Chr. Saba . _„ . Zip Cads: Cam:
Tdepbott.
D. STATUS OF Ai'PWCA►NT
Prlvsar: a Fsdow: Cmum ish
State: 1wU doipd= ....._. Native Aws scan Lands:
pfftbed 70 GWftj"7 HP
A�Urr���� SF �
75 o 7 2007
Pew I of s
TOO [A 'ovd'ZSNoD soa]'.Ig YV3 80:60 LOOVIC/TO

Jon 30 07 07122p Douglas Clark 82B-683-•G339 p.g
13. FACEL IY (SrM) DATA
(Nr out ONLY if the Scams of Owner Is Fa WaL sftee! AMaaiCIpal or CVWMWrow).
Name of live rom or Facility:
CRY: Zip Cade: C'.o wW.
Td iph- e-. Cowed Poems:
F, LSAT PUMP OONTRAC OR DATA
Nmw R'141y Mitahm
A4ldre : F.0. sox Op �..
C{ty; tarnzoe• Zip Cod= aaWa CGUW. Transyly anim
Tekpho= e3e-86e-7553 C.aaaUM Ric"y x1tchoo
G. 1NJWTIOrN PROCEDM (Brlasfly dmwelbe bow tree IW@ctUm well(e) will be used.)
mjeation wmllm Mora hales) will be uead ee aqT!!%bAxmI beat elels. deathezosl grownd
loops will be g oa_d_in_the teeporszy bus. base. Oo+ee bales wAll be ooutintioueLY frout4d
cram CAA loots -On to the top. —
H. 1 M®L ME Will the Injecdon woll(s) area be used as dw oupplr w Na) ke The FoU~
(1) The *radm gmra don? YES NO x
(2) Fat> "VI aansnmiptiaa? YES NO ;
1. C7O NM RUCT[UN E ATA (dwwk aab)
EaQV MG W U bring, proposed tar use as an injection well. Provide the 6qa in
(I) ftea k (7) below to rhea beat ofyour knowlecigo. Atmdh a copy cf Farm G W
I (WeA C nornmon Raoe r4) If mrdiabb.
>t MOPOOM WELL to be ovtasertieted for use as ail Injecdon wall. Provide the
daft in (1) tluou& (7) below w PROPOSM awatriiOtm sgsdait9astians. Submit
Form GW-1 aft+as ooa WAV;4on.
(1) Wall Dr}lfing OO saot�'s Neaaa: slLrara< "XMticMi<, i.LC - stapaan xemor
NC Cwna rCarMadon naea>,ear.
(2) Dates to be *WWftcbA- -_ / '- `Number aflsaetogs:
AppmbMw as dWIh of each boriasg (Saes):
(3) Well anal is the well(s) weed'
(a) YES Ifye% sham prarvlde• the owing i 1fi=atiaa below.
Ty W GalvatuLzad gaaasl bin* astoel.,,,,__ P66& OIlter (SWIM
Cniog AnOL FMM to ..— R (i eftattae to Led t u6n)
Cuing cxtmuh above graw4 -.aces
(b) 1O ;
Rininea 7M QW►u1CmT? HP Pop 1 of 4
to ,r
coo 12 •00SA IISNO3 F03118 YV-1 BO : BO LOOVIC/To

Jan 30 07 07t22p Dauglmtp Clark 026-863-63as p-3
(4) si}.f.ea SMO R
(a) l7l+out type: C,t wd I Bosdoolte x Otbw (4pww) sypezylaaticirax
(b) aerated tattfssoe ■rta �e land e�4uer.
_ SMWA t loop fie;
(5) got+eem (2WTnW 3A7 wells)
(a) DWft Fmm to - Pear bd w grotow aasios.
(6) N.C. Swe Rmulatlotah (lisle 1 SA NCAC 2C -M) mqWm the p mmimm to make Pmywatee
for moduwing wellhead pmcLmm A fimcat an bath ial umd (Raid matedog heat pump) and
adhmo (fluid belt hpx tad hm do wrtdi) Maas Is tegmmL WM dwo be a lfm m on:
(a) the fnflumN lindd yes__ na (b) we ed"l mM line? yes , no ..._ :-
(7) SOURCE WUL COMMUCTM LNFORWA7 10H (JfdiMWM frown itgeodoa wall).
Ankh o oopy of Partin OW-1 (Well CMM&wcdm R0004 Ire GW-t is teatwvallable;
povi& dw daft in pmt K (1) orlids appoom1cm fono to tin bM4 of your bWwbdVL
hVM THB aJML DXLVJ iCh OOVMACTMCAX MPPLY TMVMA MR EMR E1qX"M [ha
PXOPOSW WELL,a 1F TMB MPOU(A l M IS UNA VAIL KrL IBY OTEMa bWANS.
L PROPOSEV GPMAT[WG DATA (lrrr Tm 3A7 walls)
(t) lnjmdn rase: A va (dell►) _____mks per mdesrea (on).
(2) lr jedlon Volume: Avg WAY) 00mm per dW WM.
(3) 14*1don soma Aret+ p (lily) ptrmndWbgovm Inch [pet}
(4) 1*06on Tempetttth m Avwfte (January) " F. Are mp (Ady) .rw,..... ° F-
K. rW N FLUID DATA
(l) Fluid source (fbr jij SA7 wdb) if wW*Vomd� f m whd dcptlt. four dlorl rill lype of
mckhadtnmW unit will the flWd be di mmth (a.g,, pttte, 11trA f me4 sand. aee.k
Dwft - , FOR m _ Rocblsofiweat pelt:
(2) Chmmiaa] AWyals of Source Fluid (tar Tly" SQM wally)
Pmvlde a ownplete Baling of all dhom tbtls added to flea drcehflg flaw tteoskr fluid-,
n-2;* aaerigorant
L. INJECnMRELATED BOU PMEKr
Attach a diagcel► s howlug ttw antwaft lgltlt of ft hdwdon equis n , v wA admier pWnSAmb1% ,
amomated with to lnmtiw opmsdon. Inw ntt+t ulhctltter's btodAm may pv►'ide utp Wnwawy
fntronrweanh.
M. LOCATION OF vYn,[ S) Altacb two nwp&
Radmi 'M G1 RJIC-37;HP Pap 3 of4
Z0019 1Q0Hd',LGN00 B031IS M 84:00 LOOZ/Ts/TO

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Page 1 of 1
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013903 Z3 km SW of Asheville, North Carolina United States 01 Jul 1986
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Map Output
Page 1 of 2
BUNCOMBE COUNTY, NORTH CAROLINA
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