WI0300045_Regional Office Historical File Pre 2018 (2)

A7A
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
June 7, 2010
Bill Kluttz
Catawba College
2300 W. Imes Street
Salisbury, NC 28144
Subject: Permit Rescission
UIC Permit No. WI0300052
5A7 Geothermal Injection Well
Rowan County
Dear Mr. Kluttz:
Dee Freeman
Secretary
EC -ME
JUN-82010
NC DFNR MRO
DWQ - A. uifer Protection
D
Reference is made to your request for rescission of the subject Type 5A7 Geothermal Injection Well Permit
located at the above referenced address. Staff from the Mooresville Regional. Office (MRO) has confirmed that
this well is no longer being used for injection and a permit is no longer required. Therefore, in accordance with
your request, Underground Injection Control (UIC) Permit WI0300052 is rescinded, effective immediately.
If in the future, you wish to operate a Type 5A7 geothermal heat pump injection system, you must first apply
for and receive a new permit. Operating a geothermal heat pump injection system without a valid permit may
result in the assessment of civil penalties and/or the use of other enforcement mechanisms available to the state.
If it would be helpful to discuss this matter further, please do not hesitate to call Michael Rogers at (919)
715-6166.
Sincerely,
Coleen H. Sullins
Attachment(s)
cc Moor�ss�llle;Tcegic�nal�Office,.�.
APS Central Files - Permit No. WI0300052
Rowan County Environmental. Health Dept.
AQUIFER PROTECTION SECTION
1636 Mail Service Center, Raleigh, North Carolina 27699-1636
Location: 2728 Capital Boulevard, Raleigh, North Carolina 27604
• Phone: [phone] FAX 1: 919-715-0588; FAX 2: 919-715-60481 Customer Service: 1-877-623-6748
Internet: www.ncwaternualitv.orq
An Equal Opportunity \ Affirmative Action Employer
NorthCarolina
Naturally

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a:

AQUIFER PROTECTION SECTION
APPLICATION REVIEW REQUEST FORM
Date: March 15, 2007
To: ❑ Landon Davidson, ARO-APS
❑ Art Barnhardt, FRO-APS
® Andrew Pitner, MRO-APS
❑ Jay Zimmerman, RRO-APS
From: Jesse Wiseman , Groundwater Protection Unit
Telephone: [phone]
E-Mail: jesse.wiseman a,ncmail.net
A. Permit Number: WI0300052
B. Owner: Catawba College
C. Facility/Operation: Catawba College
❑ Proposed ® Existing
❑ David May, WaRO-APS
❑ Charlie Stehman, WiRO-APS
❑ Sherri Knight, WSRO-APS
Fax: (919) 715- D 1E© E a w E
MAR 1 9 2007
D
J
NC DENR MRO
DWQ -Aquifer Protection
❑ Facility n Operation
D. Application:
1. Permit Type: ❑ Animal n Surface Irrigation ❑ Reuse ❑ H-R Infiltration
❑ Recycle n FE Lagoon 111 GW Remediation (ND)
• UIC - (5A7) open loop geothermal
For Residuals: ❑ Land App. ❑ D&M n Surface Disposal
❑ 503 ❑ 503 Exempt n Animal
2. Project Type: ❑ New ❑ Major Mod. ❑ Minor Mod. ® Renewal Renewal w/ 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 30 calendar days, please take the following actions:
Return a Completed Form APSSRR.
❑ 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, reviews, as well as additional
information requests with other RO-APS representatives in order to prepare a complete Attachment B for
certification. Refer to the RPP SOP for additional detail.
When you receive this request form, please write your name and dates in the spaces below, make a copy
of this sheet, and return it to the appropriate Central Office -Aquifer Protection Section contact person
listed above.
RO-APS Reviewer: Date:
FORM: APSARR 02/06 Page 1 of 1

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 and 5QM Wells
In accordance with the provisions of NCAC Title 15A: 02C.0200
complete application and mail to address on the back page.
TO: DIRECTOR, NORTH CAROLINA DIVISION OF WATER QUALITY
DATE: / " ! P7 3 ft:'OL , 20 4.
A. PERMIT APPLICANT
Permit Number: VJ=o3 000,52 _
Name: e l +,1,14% ad, e.C.e
RECEIVED / DENR ! DWQ
AQUIFERPROTECTION SECTION
JUL 18 2006
(WIO######, listed at the bottom of each page of your peintit)
Address: 2 3 ob e$1 2 wives S
City: g 4Le $ State: 'ii e— Zip code: a &1 ¥ y
County: Roces p4
Telephone: 704/ - &' 5 - 952.0
B. PROPERTY OWNER (if different from applicant)
Name:
Address:
City: State: Zip code:
County: Telephone:
C. STATUS OF APPLICANT
Private: bc Federal: Commercial: State: Public:
Native American Lands:
D. FACILITY (SITE) DATA (Fill out ONLY if the Swill:, of Owner is Federal, State, Public or Commercial).
Name of Business. or Facility: l tCa_u beg- C GLe5
Address: 2_3 VO.>
City:
County: p CIAO
CJ ¢fries S—"
State:h) C_— Zip code: .2J / c C..(
Telephone:
Contact Person: 1� J 121144.1 Wes°
7D9- 695-4152,0
Standard Industrial Code(s) which describe commercial facility:'
Revised 5/05
GW/UIC-57 HPR Page 1 of 3

E. INJECTION PROCEDURE (specify any modifications to the injection procedure since the issuance of the
previous injection permit)
F. WELL USE Is(are) the injection well(s) also used e supplTwell(s) for eit r of the following. 7/774E
(1) The injection operation? YENO ,
(2) Your personal consumption? YES NO' ,
G. CONSTRUCTION DATA
(1) Specify any and all modifications to the well casing, grout or screens since the issuance of the previous
injection permit.
(2) NC. State Regulations (15A NCAC, 2C, Section .0200) require the permittee to make provisions for
monitoring well head processes. A faucet on both influent (groundwater entering heat pump) and
effluent (water being injected into )ie well) lines is required. Is there a faucet on:
(a) the influent line? - YES t/ NO
(b) on the effluent line? YES ,,/ NO
H. CURRENT OPERATING DATA
Injection rate:
Injection volume:
Injection pressure:
Injection temperature:
Average (daily) 2_42
Average (daily) 2.€, boP
Average (daily)
Annual Average
gallons per minute (gpm)
gallons per day (gpd)
pounds per square inch (psi)
degrees Fahrenheit (°F)
INJECTION -RELATED EQUIPMENT
Attach a diagram showing any modifications to injection equipment since the issuance of the previous injection
permit including the engineering layout of the (1) injection equipment, and (2) exterior piping/tubing associated
with the injection operation. The manufacturer's brochure, if detailed, should satisfy (1).
J. LOCATION OF WELL(S) Attach a map
Include a site map (can be drawn) showing: the orientation of and distances between the injection well(s) and any
existing well(s) or waste disposal facilities such as septic tanks or drain fields located within 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.
Revised 5/05
GW/UIC-57 HPR Page 2 of 3

M. CERTIFICATION
"I hereby certify, under penalty of law, that I have personally examined and am familiar with the information
submitted in this document and all attachments thereto and that, based on my inquiry of those individuals
immediately responsible for obtaining said information, I believe that the information is true, accurate and
complete. I am aware that there are significant penalties, including the possibility of fines and imprisonment, for
submitting false information. I agree to 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 Well • ; er cr Authorized Ag
If authorized agent is acting on behalf of the well owner,
please supply a letter signed by the owner
authorizing the above agent.
N. CONSENT OF PROPERTY OWNER (Owner means any person who holds the fee or other property rights in the
well(s). 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 well(s) 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].
RECEIVED 1 DENR 1 DWQ
AQUIFERPROTECTION SECTION
JUL 18 666
Revised 5/05
GW/UIC-57 HPR Page 3 of 3

Salisbu4'R4wan
WATER SYSTEM ID #:
Name of Water System:
Salisbury Water Treatment Plant Laboratory
405 N. Jackson Street
Salisbury, N.C. 28144 [phone]
NC Drinking Water Certification Lab #37618
BACTERIOLOGICAL ANALYSIS
Note: All appropriate information must be supplied for compliance credit.
(Itt+t ;AL4 Co11�� L
Sample Type: ErRoutine distribution ❑ Repeat
Location Where Collected: 1Jdi 1
County: V OGiGV1
❑ Plan Review 0 Special/Non-compliance
(Note: Sample MUST be collected from distribution system for routine compliance, not the well house.)
Location Code: 8 I
Collected By: 4iG.A row
(Please Prmt)
Mail Results to (water system representative):
J
I�AtJWL19::P rcicil'7it
Collection Date
ClL4/2.( / (
—(F.5f/I51 —
Collection Time
I : 2_3, rt M
— Specify AM or PM)
/ !
Lou LA S l /?4ft.e4)i, j tuv v i l'zgf
Phone #: (7ut( ) GL(S = LA -IC
Fax#: ( lot() 1 41., `l�-('z
Responsible Person's email: /1l'16t,/t4co G�
@ wbet. e L
Also Complete For REPEAT Samples:
Previous Positive Location Code:
Positive Collection Date:
Proximity of THIS sample to Previous Positive:
❑ Same Tap 0 Nearer to the Source ❑ Further from the Source
If Chlorinated:
Total Chlorine Residual: mg/L
Free Chlorine Residual: mg/L
Combined Chlorine Residual: mg/L
(Combined Chlorine = Total Chlorine minus Free Chlorine)
Note: Also record these values on your water usage report.
LABORATORY ID# 37618 ❑ Repeat Samples Required from Client 0 Resample Required from Client
CONTAMINANT i METHOD CODE
Total Coliform
Fecal/E. coli
312
316
PRESENT 1'
RESULTS
ABSENT
INVALID
CODE 3:
Heterotrophic P.C.
331 cfu/mL
(number)
Notes: l if Total Coliform bacteria is present, the laboratory must fax analytical results to the State within 48 hours.
2 If Fecal/E. coli bacteria is present, the laboratory must fax analytical results to the State on day test completed.
3 Invalid code #5 should be accompanied by an explanation in the comments below.
INVALID CODES:
1) Confluent Growth/No Coliform Growth Found
2) TNTC/No Coliform Growth Found
3) Turbid Culture/ No Coliform Growth Found
4) Over 30 Hours Old
5) Improper Sample or Analysis'
DATE: TIME:
ANALYSES BEGUN: rJ / 2 t / G Le
— -__ 1
G • .__..?- s- A M
(_MM/DD/YY)
ANALYSES COMPLETED:
Laboratory Log #: c Ott
COMMENTS:
01120t)2
0 u / /
Certified By: giCc, k is
1,'
(Specify AM or PM)
tv 4 !M
(Specify AM)rPMJ
(Print and sign name
Laboratory should Mail Results to:
Public Water Supply Section, Attn: Data Entry. 1(.04 4 h1ttil Service Center, Raleigh, NC 27609.1(yt4
Fax: [phone]

Salisbury Water Treatment Plant Laboratory
405 N. Jackson Street
Salisbury, N.C. 28144 [phone]
NC Drinking Water Certification Lab #37618
BACTERIOLOGICAL ANALYSIS
Note: All appropriate information must be supplied tor compliance credit.
WATER SYSTEM ID #: -
Name of Water System: 6,4til,;[ U t c/1(c t
County: 120;,,I6t.,
Sample Type: ©-outine distribution ❑ Repeat 0 Plan Review ❑ Special/Non-compliance
Location Where Collected: (4 ( 2-
(Note: Sample MUST be collected from distribution system for routine compliance, not the well house.)
Location Code:
/3 c
Collected By: Matt Fr, ua 1•1/
(Please Print)
Mail Results to (water system representative):
Collection Date
Lt/Z( /6L,
— -7.tn�/bIS/4Vj—
Collection Time
/ ° : -5 U , r� M
Specify AM or PM)
Also Complete For REPEAT Samples:
Previous Positive Location Code:
Positive Collection Date:
Proximity of THIS sample to Previous Positive:
❑ Same Tap 0 Nearer to the Source 0 Further from the Source
If Chlorinated:
Phone #: ( ) Total Chlorine Residual: mg/L
Free Chlorine Residual: mg/L
Fax #: ( )
Combined Chlorine Residual: mg/L
Responsible Person's email: @ (Combined Chlorine = Total Chlorine minus Free Chlorine)
Note: Also record these values on your water usage report.
LABORATORY ID# 37618 ❑ Repeat Samples Required from Client 0 Resample Required from Client
CONTAMINANT
Total Coliform
Fecal/E. coli
METHOD CODE
312
•
316
PRESENT I' 2
RESULTS
ABSENT
INVALID
CODE 3:
Heterotrophic P.C.
331
(number)
cfu/mL
Notes: If Total Coliform bacteria is present, the laboratory must fax analytical results to the State within 48 hours.
2 If Fecal/E. coli bacteria is present, the laboratory must fax analytical results to the State on day test completed.
3 Invalid code #5 should be accompanied by an explanation in the comments below.
ANALYSES BEGUN:
ANALYSES COMPLETED:
Laboratory Log #: 6")01.-
COMMENTS:
01 r_002
INVALID CODES:
1) Confluent Growth/No Coliform Growth Found
2) TNTC/No Coliform Growth Found
3) Turbid Culture/ No Coliform Growth Found
4) Over 30 Hours Old
5) Improper Sample or Analysis'
DATE: L TIME:
G' / z t /dL< i 0 `� if M •
(MMrDD )..____(Specy Abl or PM)
/ 2 Z / G %: / a ' ( .( ( Al
(MMIDDIYYL t
Certified By:
(Print and -sign name)
Laboratory shook' flail Results to:
Pui lic `Vatrr Supply Section, Attn: Data Entry, 16.34 Mail Service Center, Raleigh, NC: 27609-1634
•
Fax: [phone]

Salisbury Water Treatment Plant Laboratory
405 N. Jackson Street
Salisbury, N.C. 28144 [phone]
NC Drinking Water Certification Lab #37618
BACTERIOLOGICAL ANALYSIS
Note: All appropriate information must be supplied for compliance credit.
WATER SYSTEM ID #:
1
Name of Water System: �.Clfetbdn h < [.a 1,C t
County: '41,Jcv1
Sample Type: L(outine distribution ❑ Repeat 0 Plan Review 0 Special/Non-compliance
Location Where Collected: U/v -(I 3 •
(Note: Sample MUST be collecterrom distribution system for routine compliance, not the well house.)
Location Code: C- �} 3
Collected By: 4k t- row (---
(Please Print)
Mail Results to (water system representative):
Phone #: ( )
Fax #: ( )
Responsible Person's email:
Collection Date
OLs1zg /6G,
M715157710—
Collection Time
(l _ IS', i4M
7Specify AM or PM)
Also Complete For REPEAT Samples:
Previous Positive Location Code:
Positive Collection Date:
Proximity of THIS sample to Previous Positive:
D Same Tap 0 Nearer to the Source 0 Further from the Source
If Chlorinated:
Total Chlorine Residual: mg/L
Free Chlorine Residual: mg/L
Combined Chlorine Residual: mg/L
(Combined Chlorine = Total Chlorine minus Free Chlorine)
Note: Also record these values on your water usage report.
LABORATORY ID# 37618
❑ Repeat Samples Required from Client ❑ Resample Required from Client
CONTAMINANT
Total Coliform
Fecal/E. coli
Heterotrophic P.C.
Notes:
RESULTS
METHOD CODE
PRESENT 1,2 ABSENT
312
316
331 cfu/mL
(number)
INVALID
CODE 3:
If Total Coliform bacteria is present, the laboratory must fax analytical results to the State within 48 hours.
2 If Fecal/E. coli bacteria is present, the laboratory must fax analytical results to the State on day test completed.
3 Invalid code i15 should be accompanied by an explanation in the continents below.
ANALYSES BEGUN:
ANALYSES COMPLETED:
Laboratory Log #: Gam J
COMMENTS:
01 /_2.00 2
DATE:
Gl�/ Z '/if c.
_,(1)j@1/DD/vY)._
(I) Lt / Z c..
(MM/DD/YY)......_.._.:....._..�... _..._._..__..._........
Certified By: J-/cn.
INVALID CODES:
1) Confluent Growth/No Coliform Growth Found
2) TNTC/No Coliform Growth Found
3) Turbid Culture/ No Coliform Growth Found
4) Over 30 Hours Old
5) Improper Sample or Analysis'
TIME:
(' ( : 1 7 , rf M
(Suclfx AIM or PM)
A SSpecny Ahl.or-Pv�.
(Print and sign name)/
Laboratory should Mail Results to:
Public 'Water Supply Section, Attn: Data 1:!ntry. I 634 Mail Se),ice Center, Rale.igh,'NC' 27699-1634
Fax: [phone]

Salisheffd a
OT/Ll7/ES
Salisbury Water Treatment Plant Laboratory
405 N. Jackson Street
Salisbury, N.C. 28144 [phone]
NC Drinking Water Certification Lab #37618
BACTERIOLOGICAL ANALYSIS
Note: All appropriate information must be supplied for compliance credit.
WATER SYSTEM ID #:
Name of Water System: ((CG
al
Sample Type: Erlioutine distribution 0 Repeat
Location Where Collected: (t
Location Code:
Collected By:
1 -1 ce./1 1C i✓ I
(Please Print)
County: )dLJ6y\
0 Plan Review 0 Special/Non-compliance
(Note: Sample MUST be collected from distribution system for routine compliance, not the well house.)
Mail Results to. (water system representative):
Phone #: ( )
Fax #: ( )
Responsible Person's email:
Collection Date Collection Time
� Et/L( /ULt 1 d :r M
(M1V17150741'i— — —(Specify AM or PM)
• Also'Complete For REPEAT Samples:
Previous Positive Location Code:
Positive Collection Date:
Proximity of THIS sample to Previous Positive:
0 Same Tap 0 Nearer to the Source 0 Further from the Source
If Chlorinated:
Total Chlorine Residual: mg/L
Free Chlorine Residual: mg/L
Combined Chlorine Residual: mg/L
(Combined Chlorine = Total Chlorine minus Free Chlorine)
Note: Also record these values on your water usage report.
LABORATORY ID# 37618
0 Repeat Samples Required from Client ❑ Resample Required from Client
RESULTS
CONTAMINANT METHOD CODE
PRESENT 1'2 ABSENT
Total Coliform 312
Fecal/E. coli 316 jl
INVALID
CODE3:
Heterotrophic P.C.
331
(number)
cfu/mL
Notes: If Total Coliform bacteria is present, the laboratory must fax analytical results to the State within 48 hours.
2 If Fecal/E. coli bacteria is present, the laboratory must fax analytical results to the State on day test completed.
3 Invalid code #5 should be accompanied by an explanation in the comments below.
ANALYSES BEGUN:
ANALYSES COMPLETED:
DATE:
z ( / a.. CC
M1I11I/DD yL,
INVALID CODES:
1) Confluent Growth/No Coliform Growth Found
2) TNTC/No Coliform Growth Found
3) Turbid Culture/ No Coliform Growth Found
4) Over 30 Hours Old
5) Improper Sample or Analysis'
TIME:
1 4
Laboratory Log #: C e- G 1LI Certified By:
COMMENTS:
nl i20(12
fr�rCJ (Specify�� 7 od PM)
/14:04 /0°J'v/./
(Print and sign name)
Laboratory should f\iail Results to:
Public Water Supply Section, Attn: Data Ei.ntry, I6 31. Mail Service Center, Raleigh, NC 27699-I63 4
Fa s: 919.7I S.ti637

CAMPUS MAP LEGEND
1. Busby-Corriher Experimental Theater
2. Robertson College -Community Center
3. Hurley Residence Hall
4.Jann House / Public Safety
5. Facilities & Conferencing
6. Heath Hill House
6a. Heath Hill Lodge
7. Frock Athletic Complex
(football, soccer,softball,field hockey)
7a. Lacrosse Practice Field
7b.Whitley Softball Field
8. Newman Park (baseball)
9.Abernethy Physical Education Center
10. Ruth -Richards Athletic House
11. Pine Knot Residence Hall
12.Abernethy Residence Hall
13. Foil House Residence Hall
.,14. Salisbury -Rowan Residence Hall
15.Williams Music Building
16.Shuford Science Building
17.Center for the Environment
18.Omwake-Dearborn Chapel
19.HedrickAdministration Building
20.Cannon Student Center
21. Maintenance, Housekeeping & Grounds
22.Shuford Stadium (football, lacrosse)
23. Hayes Field House
24. Rowan Partnership for Children Center
25. Ketner Hall
26. Barger-Zartman Residence Hall
27. Corriher-Linn-Black Library
28.Ecological Preserve
29.Hollifield Residence Hall
30.Stanback Residence Hall
31. Hoke Hall
32.Woodson Residence Hall
33.Johnson Tennis Complex
34. President's House
35. Cloninger Guest House
VP = visitor parking
P = parking areas
`4i= call boxes
SuyM?gl/£i'D£
_ (q
A!FkuE
wpwlD ILK. To j\- -r'►-ese.
1.�f,L1,a/? 13la2I5S B
,17 if Foss►►3Lg
CATAWBA
COLLEGE
Salisbury, NC 28144-2488
r)fPANKDNIVE - -'•
r r
-9

01/02/2007 13:26 7042784599
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AQUIFER PROTECTION SECTION
APPLICATIO VEST FORM
Date: September 26, 2006 Ci
OZI to
To: ❑ Landon Davidson, ARO-APS An
❑ Art Barnhardt, FRO-APS c v
® Andrew Pitner, MRO-APS Z pa
❑ Jay Zimmerman, RRO-APS -pM r..s
From: Thomas Slusser , Groundwater Prot30 Un"'it
Telephone: [phone]
E-Mail: [e-mail] � &I
❑ David May, WaRO-APS
❑ Charlie Stehman, WiRO-APS
❑ Sherri Knight, WSRO-APS
fax: [phone]
A. Permit Number: WI0300052
B. Owner: Catawba College
C. Facility/Operation: Catawba College
❑ Proposed ❑ Existing ® Facility n Operation
D. Application:
1. Permit Type: ❑ Animal ❑ Surface Irrigation ❑ Reuse ❑ H-R Infiltration
❑ Recycle
❑ I/E Lagoon ❑ GW Remediation (ND)
® UIC - (5A7) open loop geothermal
For Residuals: ❑ Land App. ❑ D&M ❑ Surface Disposal
❑ 503 ❑ 503 Exempt n Animal
2. Project Type: ❑ New ❑ Major Mod. ❑ Minor Mod. ® Renewal ❑ Renewal w/ Mod.
E. Comments/Other Information: n 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 30 calendar days, please take the following actions:
® Return a Completed APSARR Form.
❑ Attach Well Construction Data Sheet.
❑ Attach Attachment B for Certification by the LAPCU.
❑ Issue an Attachment B Certification from the RO.*
* Remember that you will be responsible for coordinating site visits and reviews, as well as additional
information requests with other RO-APS representatives in order to prepare a complete Attachment B for
certification. Refer to the RPP SOP for additional detail.
When you receive this request form, please write your name and dates in the spaces below, make a copy
of this sheet, and return it to the appropriate Central Office -Aquifer Protection Section contact person
listed above.
RO-APS Reviewer: Date:
FORM: APSARR 07/06 Page 1 of 1

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 and 5QM Wells
In accordance with the provisions of NCAC Title 15A: 02C.0200
complete application and mail to address on the back page.
TO: DIRECTOR,NORTH CAROLINA DIVISION OF WATER QUALITY
DATE: / "'1 )4,7 3 rt="6'l.. 20
A. PERMIT APPLICANT
Permit Number: In/ZOj0005-2.
Name: n 641-4+ xb Pr C.o. t.0 eF,,e_.
RECEIVED / DENR / DWQ
AQUIFER'PROTECTION SECTION
JUL 18 2006
(WI0##0##, listed at the bottom of each page of your perrnit)
Address: a, j MD ti es'� TAvroas S r--
City: 6 i?`$ ..,' State: 'v e- Zip code: as/ Cf �f
County s� � Telephone:
B. PROPERTY OWNER (if different from applicant)
Name:
7061- 4Q5.- 5t$.zo
Address:
City: State: Zip code:
County: Telephone:
C. STATUS OF APPLICANT
Private: bk.., Federal: Commercial: State: Public;
Native American Lands:
D. FACILITY (SITE) DATA (Fill out ONLY if the Status of Owner is Federal, State, Public or Commercial).
Name of Business. or Facility: Cal-co_a bet -
Address: 23 ot> (,4) Q3 t ieS 1 -
City: , ,,,(,L 5 State:b .) &_. Zip code:.2? / (24
County: a) Telephone: 7 D L f - (A 95 _ 45 zo
Contact Person: 1t E U (L w000
Standard Industrial Code(s) which describe commercial facility:'
Revised 5/05
GW/UIC-57 HPR Page 1 of 3

E. INJECTION PROCEDURE (specify any modifications to the injection procedure since the issuance of the
previous injection permit)
F. WELL USE Is(are) the injection well(s) also used e suppl well(s) for eitlfbr of the following? ��f� 7/�/E
(1) The injection operation? YE St NO
(2) Your personal consumption? YES NO 74
G. CONSTRUCTION DATA
(1)
Specify any and all modifications to the well casing, grout or screens since the issuance of the previous
injection permit.
(2) NC. State Regulations (15A NCAC, 2C, Section .0200) require the permittee to make provisions for
monitoring well head processes. A faucet on both influent (groundwater entering heat pump) and
effluent (water being injected into tie well) lines is required. Is there a faucet on:
(a) the influent line? YES I./ NO
(b) on the effluent line? YES ../ NO
H. CURRENT OPERATING DATA
Injection rate:
Injection volume:
Injection pressure:
Injection temperature:
Average (daily) gallons per minute (gpm)
Average (daily) 2e, bop gallons per day (gpd)
Average (daily)
Annual Average
pounds per square inch (psi)
degrees Fahrenheit (°F)
INJECTION -RELATED EQUIPMENT
Attach a diagram showing any modifications to injection equipment since the issuance of the previous injection
permit including the engineering layout of the (1) injection equipment, and (2) exterior piping/tubing associated
with the injection operation. The manufacturer's brochure, if detailed, should satisfy (1).
J. LOCATION OF WELL(S) Attach a map
Include a site map (can be drawn) showing: the orientation of and distances between the injection well(s) and any
existing well(s) or waste disposal facilities such as septic tanks or drain fields located within 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.
Revised 5/05
GW/UIC-57 HPR Page 2 of 3

M. CERTIFICATION
"I hereby certify, under penalty of law, that I have personally examined and am familiar with the information
submitted in this document and all attachments thereto and that, based on my inquiry of those individuals
immediately responsible for obtaining said information, I believe that the information is true, accurate and
complete. I am aware that there are significant penalties, including the possibility of fines and imprisonment, for
submitting false information. I agree to 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 Well o ; er cr Auth•rized Ag
If authorized agent is acting on behalf of the well owner,
please supply a letter signed by the owner
authorizing the above agent.
N. CONSENT OF PROPERTY OWNER (Owner means any person who holds the fee or other property rights in the
well(s). 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 well(s) 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].
RECEIVED / DENR I DWQ
AQUIFERPROTECTION SECTION
JUL 18 2006
Revised 5/05
GW/UIC-57 HPR Page 3 of 3

NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY, AQUIFER PROTECTION SECTION
STATUS OF INJECTION WELL SYSTEM
Permit Number: AAte�.. ���',,
Permittee Name: C. *4L) brint. 1� �
Address: c 3 4 6.4J6- S&JUeS 670d'SC� Zt1,C'; 2W«y
Please check the selection which most closely describes the current status of your injection well.
In addition, please provide the requested information.
1) V 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 description of
how the well was sealed and the type of material used to fill the well if permanently abandoned):
Certification: (For well abandonment)
"I hereby certify, under penalty of law, that I am personally responsible for the proper abandonment of any
injection well as required in Title 15A NCAC 2C .0214 Criteria and Standards Applicable to Injection Wells."
Signature Date
Certification: (For information verification)
"I hereby certify, under penalty of law, that I have personally examined and am familiar with the information
submitted in this document, and that to the best of my knowledge the information is true, accurate, and complete."
to #7€1‘) Date
Revised 5/05 GW/UIC-68

SalsburyR�wan
Salisbury Water Treatment Plant Laboratory
405 N. Jackson Street
Salisbury, N.C. 28144 [phone]
NC Drinking Water Certification Lab #37618
BACTERIOLOGICAL ANALYSIS
Note: All appropriate inforrnation must be supplied for compliance credit.
WATER SYSTEM ID #: _ - _ - _ _ County: V 0(AC\n
Name of Water System: CtivtizWL4 liNsz-
Sample Type: Routine distribution ❑ Repeat 0 Plan Review 0 Special/Non-compliance
Location Where Collected: kq.,R 1
Location Code: 8
Collected By:
(Note: Sample MUST be collected from distribution system for routine compliance, not the well house.)
•
�(✓in r-'D(atti
(Please Print)
Mail Results to (water system representative):
061-(61(Z)If • 06 (
Collection Date
/,</Zf / pL
7T l7b —
Collection Time
2�, M
Specify AM or PM)
t rl',
1 %?/t/% { GttJW t%•I ... 1Jt?[ {'vr 6 f GcCi l li ��
``/ j ,
Zdu W J V1.9 Sf SztftS6iii
Phone #: 04( ) 045 - `t 2ZO
Fax #: (la`() `(t{Y Z
Responsible Person's email: Al46t/Wes G @ Gk{a w b t. e
Also Complete For REPEAT Samples:
Previous Positive Location Code:
Positive Collection Date:
Proximity of THIS sample to Previous Positive:
0 Same Tap 0 Nearer to the Source 0 Further from the Source
If Chlorinated:
Total Chlorine Residual: mg/L
Free Chlorine Residual: mg/L
Combined Chlorine Residual: mg/L
(Combined Chlorine = Total Chlorine minus Free Chlorine)
Note: Also record these values on your water usage report.
LABORATORY ID# 37618
0 Repeat Samples Required from Client 0 Resample Required from Client
CONTAMINANT ; METHOD CODE
PRESENT t, 2
Total Coliform
Fecal/E. coli
312
316
RESULTS
ABSENT
INVALID
CODE 3:
Heterotrophic P.C.
331
(number)
cfu/mL
Notes: l if Total Coliform bacteria is present, the laboratory must fax analytical results to the State within 48 hours.
2 If Fecal/E. coli bacteria is present, the laboratory must fax analytical results to the State on day test completed.
3 Invalid code #5 should be accompanied by an explanation in the comments below.
ANALYSES BEGUN:
ANALYSES COMPLETED:
Laboratory Log #: t G• 00
COMMENTS:
0112002
INVALID CODES:
1) Confluent Growth/No Coliform Growth Found
2) TNTC/No Coliform Growth Found
3) Turbid Culture/ No Coliform Growth Found
4) Over 30 Hours Old
5) Improper Sample or Analysis'
DATE:
U Lr / Z- ( /
/ -L / 0 L'
Certified By: J(Ct6 to
TIME:
1 O u S, A M
(Seeeify_M1 or PML
i 0 : �-( S , M
/ //
(Print and sign namey.
Laboraton. should Mail Results to:
Public Water Supply Section, ;tttrl: Data Entry. 1034 Mail Service Center, Raleigh, NC: 27609-163:4
I7 s:s' : 919.715.6637

Salisbury Water Treatment Plant Laboratory
405 N. Jackson Street
Salisbury, N.C. 28144 [phone]
NC Drinking Water Certification Lab #37618
BACTERIOLOGICAL ANALYSIS
Note: All appropriate information must be supplied for compliance credit.
WATER SYSTEM ID #: _ - _ - _ County: IZowiv
Name of Water System: CMCLI61.961 (.a1 f t G t
Sample Type: D-routine distribution ❑ Repeat 0 Plan Review 0 Special/Non-compliance
Location Where Collected: kit Z
(Note: Sample MUST be collected from distribution system for routine compliance, not the well house.)
Location Code: 1�13 Z
Collected By: !1 tL'.t/1 16 w
(Please Print)
Mail Results to (water system representative):
Phone #: ( )
Fax #: ( )
Responsible Person's email:
Collection Date
Lc / Z ( / 6L
— — 41Cf7DD7vv —
Collection Time
/ 6 : 3 c ri M
7Specify AM or PM)
Also Complete For REPEAT Samples:
Previous Positive Location Code:
Positive Collection Date:
/ /
Proximity of THIS sample to Previous Positive:
❑ Same Tap ❑ Nearer to the Source ❑ Further from the Source
If Chlorinated:
Total Chlorine Residual:
Free Chlorine Residual:
mg/L
mg/L
Combined Chlorine Residual: mg/L
(Combined Chlorine = Total Chlorine minus Free Chlorine)
Note: Also record these values on your water usage report.
LABORATORY ID# 37618
0 Repeat Samples Required from Client 0 Resample Required from Client
CONTAMINANT
Total Coliform
Fecal/E. coli
METHOD CODE
312
316
PRESENT 12
RESULTS
ABSENT
INVALID
CODE 3:
Heterotrophic P.C.
331 cfu/mL
(number)
Notes:
If Total Coliform bacteria is present, the laboratory must fax analytical results to the State within 48 hours.
2IfFecal/E. coli bacteria is present,the laboratory must fax analytical results to the State on day test completed.
3 Invalid code #5 should be accompanied by an explanation in the comments below.
DATE:
ANALYSES BEGUN: U L/ 2 t / o Lt
ANALYSES COMPLETED:
Laboratory Log #: 6C, 00'7.--
COMMENTS:
0I/2002
LMM/DD/Wf)_..
INVALID CODES:
1) Confluent Growth/No Coliform Growth Found
2) TNTC/No Coliform Growth Found
3) Turbid Culture! No Coliform Growth Found
4) Over 30 Hours Old
5) Improper Sample or Analysis3
TIME:
i 0 : c( S / M
(Specify AM or PM)
0 & / 2 Z_ / U i,., l U1 : ` ( t , r4 M
Certified By: / [t
(Print an,d-sin name)
Laboratory should i'1ai1 Results to:
Public; Water Supply Section, Attn: Data Entry, 1634 Mail Service Center, Raleigh, NC 27609-1634
Fax:[phone]

WATER SYSTEM ID #:
Name of Water System:
Sample Type:
Salisbury Water Treatment Plant Laboratory
405 N. Jackson Street
Salisbury, N.C. 28144 [phone]
NC Drinking Water Certification Lab #37618
BACTERIOLOGICAL ANALYSIS
Note: All appropriate information must be supplied for compliance credit.
CAfet(Al b 4 ('Miele
E Routine distribution ❑ Repeat
County: 1201,JC„A
❑ Plan Review ❑ Special/Non-compliance
Location Where Collected:- Nf ( 3 •
(Note: Sample MUST be collected from distribution system for routine compliance, not tite well house.)
Location Code: 13 113
Collected By: J ktA FUi.i
(Please Print)
Mail Results to (water system representative):
Phone #: ( )
Fax #: ( )
Responsible Person's email:
Collection Date
c)c>/zg /66
—(M17/D11517Yr—
Collection Time
i S,_ , d M
Specify AM or PM)
Also Complete For REPEAT Samples:
Previous Positive Location Code:
Positive Collection Date:
/ /
Proximity of THIS sample to Previous Positive:
❑ Same Tap 0 Nearer to the Source 0 Further from the Source
If Chlorinated:
Total Chlorine Residual: mg/L
Free Chlorine Residual: mg/L
Combined Chlorine Residual: mg/L
(Combined Chlorine = Total Chlorine minus Free Chlorine)
Note: Also record these values on your water usage report.
LABORATORY ID# 37618
D Repeat Samples Required from Client ❑ Resample Required from Client
RESULTS
CONTAMINANT METHOD CODE
PRESENT t' 2 ABSENT
Total Coliform 312
Fecal/E. coli 316 ' 1C
INVALID
CODE 3:
Heterotrophic P.C.
331 cfu/mL
(number)
Notes:
t If Total Coliform bacteria is present, the laboratory must fax analytical results to the State within 48 hours.
2 If Fecal/E. coli bacteria is present, the laboratory must fax analytical results to the State on day test completed.
3 Invalid code #5 should be accompanied by an explanation in the comments below.
ANALYSES BEGUN:
ANALYSES COMPLETED:
INVALID CODES:
1) Confluent Growth/No Coliform Growth Found
2) TNTC/No Coliform Growth Found
3) Turbid Culture/ No Coliform Growth Found
4) Over 30 Hours Old
5) Improper Sample or Analysis'
DATE: TIME:
MM/DD/W
t-• l ( . ( 7 # M
Z . �i' / Lr t.
Laboratory Log #: i[ O 3 Certified By: 11-1
COMMENTS:
(SuE11). AM or PIT
: / 6z , r M,_
. �/ 9 S ecif Ah1 or Pht�
•
)
C.C4
(Print and sign name),"
01/2002
Laboratory should Mail Results to:
Public 'Water Supply Section, Attn: Data Entry. 1634, Mail Service Center, Raleigh, NC 27699-16 4
Fax: 919.715,663 7

Salisbury Water Treatment Plant Laboratory
405 N. Jackson Street
Salisbury, N.C. 28144 [phone]
NC Drinking Water Certification Lab #37618
BACTERIOLOGICAL ANALYSIS
Note: All appropriate information must be supplied for compliance credit.
WATER SYSTEM ID #: _ r
Name of Water System: �4,,,)W r, (r (lc y' g_
Sample Type: El outine distribution ❑ Repeat
Location Where Collected: t*ke.1(
Location Code:
Collected By: /1-(U't
(Please Print)
County: KeLJL' -‘
0 Plan Review 0 Special/Non-compliance
(Note: Sample MUST be collected from distnbution system for routine compliance, not the well house.)
Mail Results to (water system representative):
Collection Date Collection Time
0 LA / L f / U Lt
d
f : 5 i M
Specify AM or PM)
• AIso'Complete For REPEAT Samples:
Previous Positive Location Code:
Positive Collection Date:
Proximity of THIS sample to Previous Positive:
0 Same Tap 0 Nearer to the Source ❑ Further from the Source
If Chlorinated:
Phone #: ( ) Total Chlorine Residual: mg/L
Free Chlorine Residual: mg/L
Fax #: ( )
Combined Chlorine Residual: mg/L
Responsible Person's email: @ (Combined Chlorine = Total Chlorine minus Free Chlorine)
Note: Also record these values on your water usage report.
LABORATORY ID# 37618
0 Repeat Samples Required from Client ❑ Resample Required from Client
CONTAMINANT
Total Coliform
Fecal/E. coli
METHOD CODE
PRESENT
RESULTS
ABSENT INVALID
CODE 3:
312
316
• K
Heterotrophic P.C.
331 cfu/mL
(number)
Notes: If Total Coliform bacteria is present, the laboratory must fax analytical results to the State within 48 hours.
2 If Fecal/E. coli bacteria is present, the laboratory must fax analytical results to the State on day test completed.
3 Invalid code 45 should be accompanied by an explanation in the comments below.
ANALYSES BEGUN:
ANALYSES COMPLETED:
Laboratory Log #: Cc Gtl�(
COMMENTS:
01 /20t12
DATE:
Cr Cr /
0 L/ 2 2/ V L-,
(MM/DD/YY
Certified By: ,4/ FK,)
INVALID CODES:
1) Confluent Growth/No Coliform Growth Found
2) TNTC/No Coliform Growth Found
3) Turbid Culture/ No Coliform Growth Found
4) Over 30 Hours Old
5) Improper Sample or Analysis'
TIME:
/ : `f • if M
(Specify AM or PM)
(Specif AA1 o PM
/7
(Print and sign rime
1 , �
Laboratory should flail Result to:
Public Water Supply Section, Attn: Datn Entry- 1634 Mail Service Center, Raleigh, NC 27c )9-163,1
Fa.x:919.715,6637

CAMPUS MAP LEGEND
1. Busby-Corriher Experimental Theater
2. Robertson College -Community Center
3. Hurley Residence Hall
4.Jann House / Public Safety
5. Facilities & Conferencing
6. Heath Hill House
6a.Heath Hill Lodge
7. Frock Athletic Complex
(football, soccer, softball, field hockey)
7a. Lacrosse Practice Field
7b.Whitley Softball Field
8.Newman Park (baseball)
9.Abernethy Physical Education Center
10. Ruth -Richards Athletic House
11. Pine Knot Residence Hall
12.Abernethy Residence Hall
13. Foil House Residence Hall
14. Salisbury -Rowan Residence Hall
15.Williams Music Building
16.Shuford Science Building
17. Center for the Environment
18.0mwake-Dearbom Chapel
19. Hedrick Administration Building
20. Cannon Student Center
21. Maintenance, Housekeeping & Grounds
22.5huford Stadium (football, lacrosse)
23. Hayes Field House
24. Rowan Partnership for Children Center
25. Ketner Hall
26. Barger-Zartman Residence Hall
27. Corriher-Linn-Black Library
28.Ecological Preserve
29. Hol lifield Residence Hall
30. Stanback Residence Hall
31. Hoke Hall
32.Woodson Residence Hall
33.JohnsonTennis Complex
34. Presidents House
35. Cloninger Guest House
VP = visitor parking
P = parking areas
= call boxes
AVFNNF
W QUAD CI Kv To M Cu'Z -(" A.25 C.
(
Ilf
,?pS5l1�Lq
i CATAWBA
COLLEGE
Salisbury, NC 28144-2488
' 5' " -

DIVISION OF WATER QUALITY
AQUIFER PROTECTION SECTION
March 6, 2006
MEMORANDUM
To: Andrew Pitner
Mooresville Regional Office
From: Jesse Wiseman UJ
Central Office UIC Program
Re: Notice of Regulatory Requirement
UIC Permit No. WI0300052
Catawba College
Rowan County
UIC Peii lit No. WI0300052 (Injection Heating/Cooling Water Return Well (5A7)) issued to
Catawba College is due to expire on June 30, 2006. A Notice of Regulatory Requirement
regarding this permit was sent by this office to Dr. Kenneth Clapp on March 6, 2006. This letter
is attached for your record. No regional action is necessary at this time.
Attachment
cc: CO-UIC Files

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
March 6, 2006
Dr. Kenneth Clapp
Catawba College
2300 West Iln-1es Street
Salisbury, NC 28144
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
7002 2410 0003 0273 2443
Subject: Notice of Regulatory Requirement
North Carolina Well Construction Standards
Applicable to Injection Wells - Subchapter 2C
UIC Permit No. WI0300052 Issued to Catawba College
Rowan County
Dear Dr. Clapp: _
MAR 9 2006
NC DENR MRo
DWQ - Aquifer Protection
The Underground Injection Control (UIC) 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. The purpose of this letter is to inform you, as the current property
owner, of your responsibilities pertaining to injection well rules.
The permit referenced above was issued for the construction and operation of a geothermal heat
pump injection well at 2300 West Innes Street in Salisbury, North Carolina. This permit will
expire on June 30, 2006. This office attempted to bring your injection well into compliance by
sending you a Notice of Expiration, a blank permit renewal application, and an injection well
status form in February 2, 2006. To date the UIC Program has not received either the renewal
application or the status form. Please note that, as stated in PART VIII of your permit, a renewal
application is to be submitted at least 3 months prior to the expiration of this permit.
In order to comply with the regulatory requirements listed under North Carolina Administrative
Code (NCAC) Title 15A, Subchapter 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 WITHA
HEAT PUMP SYSTEM (form GW/UIC-57 HPR) if the injection well on your property is still
active;
B. Submit the form STATUS OF INJECTION WELL SYSTEM (form GW/UIC-68) if the injection
well is inactive or has been'temporarily or permanently abandoned.
NorthCarolina
!atiiraf(f
Aquifer Protection Section " 1636 Mail Service Center
Internet: www.ncwaterqualitv.org - Location: 2728 Capital Boulevard
An Equal opportunity/Affirmative Action Employer— 50% Recycled/10% Post Consumer Paper
Raleigh, NC 27699-1636 Telephone: [phone]
Raleigh, NC 27604 Fax 1: [phone]
Fax 2: [phone]
Customer Service: [phone]

Kenneth Clapp
' • ' ' March 6, 2006
Page 2 of 2
If the well 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. If
the injection well is to be permanently abandoned, a well abandomnent record must be submitted
to our office to certify that the abandomnent was properly conducted.
Again, we have provided you with the appropriate materials to update your UIC permit. You
must respond within 15 calendar days of the receipt of this letter, or a Notice of Violation will be
issued to you, which carries the possibility for an assessment of fines or cessation of operation of
the injection well system. Please contact Thomas Slusser at [phone] or myself at (919)
715-6182 if you have any questions about this correspondence, the UIC Program, or the enclosed
forms.
Sincerely,
Evan O. Kane, L.G.
UIC Program Manager
Enclosures
1. GW/UIC-57 HPR
2. GW/UIC-68
cc: OPT; itM es; �i� e e ona100 ff ee w o enclbsuues
CO-UIC Files w/o enclosures

DIVISION OF WATER QUALITY
AQUIFER PROTECTION SECTION
February 2, 2006
MEMORANDUM
To: Andrew Pitner
Mooresville Regional Office
From: Jesse Wiseman
Central Office UIC Program
Re: Notification of Expiration
UIC Peiiiiit No. WI0300052
IECIEHWE
F E B - 6 2006
NC DENR MIRO
DWQ - Aquifer Protection
UIC Permit No. WI0300052 (Type 5A7) issued to Catawba College is due to expire on June 30,
2006. A Notification of Expiration regarding this permit was sent by this office to Dr. Kenneth
Clapp of Catawba College on February 2, 2006. This letter is attached for your record. No regional
action is necessary at this time.
Attachment

!
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
February 2, 2006
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
7002 2410 0003 0274 9915
Dr. Kenneth Clapp
Catawba College
2300 West Innes Street
Salisbury, NC 28144
Ref: Notification of Expiration
North Carolina Well Construction Standards
Applicable to Injection Wells - Subchapter 2C
UIC Permit No. WI0300052 Issued to Catawba College
Dear Dr. Clapp:
The Underground Injection Control (UIC) 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
geothermal heat pump injection wells at 2300 West Ines Street in Salisbury, North Carolina will
expire on June 30, 2006. In addition, our records do not indicate that the wells have been
abandoned.
In order to comply with the regulatory requirements listed under North Carolina Administrative
Code (NCAC) Title 15A, Subchapter 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 GW/UIC-57 HPR) if the injection wells are still
active;
B. Submit the form STATUS OF INJECTION WELL SYSTEM (form GW/UIC-68) if the injection
wells are inactive or have been temporarily or permanently abandoned.
If the wells 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
NorthCarolina
,Naturally
Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636 Telephone: [phone]
Internet: http://h2o.enr.state.nc.us 2728 Capital Boulevard Raleigh, NC 27604 Fax 1: [phone]
Fax 2: [phone]
An Equal Opportunity/Affirmative Action Employer— 50% Recycled/10% Post Consumer Paper Customer Service: [phone]

\,
'Dr. Kenneth Clapp
February 2, 2006
Page 2 of 2
be submitted to our office to certify that each abandonment was properly conducted. If the
injection wells are still active, a renewal application is to be submitted at least 3 months prior to
the expiration of this permit, as stated in PART VIII of your permit.
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 Evan Kane at (919)
715-6182.
Enclosures
cc:
ELM
g nat-c,VIG
CO-UIC Files w/o enclosures
Sincerely,
yevu—
Jesse Wiseman
Processing Assistant
UIC Program

MOORESV1LLE REGIONS.. OFFICE
DIVISION OF WATER QUALITY
GROUNDWATER SECTION
July 7, 2002
MEMORANDUM
TO: Mark Pritzl, RCO
FROM: Matt Heller !`f
SUBJECT: Catawba College UIC Sample Results
I have attached the analytical results for this site. Please call me at [phone] if you
have any questions.

DIVISION OF WATER QUALITY
Chemistry Laboratory Report / Ground Water Qualitl1
COUNTY : ROWAN SAMPLE PRIORITY
QUAD NO: n ROUTINE
REPORT TO : MRO Regional Office n CHAIN OF CUSTODY
COLLECTOR(S) : M HELLER
DATE: 6/12/200Z WD SAMPLE TYPE
TIME:
PURPOSE:
LABORATORY ANALYSIS
BOD 310
mg/L
COD High 340
mg/L
COD Low 335
mg/L
X
Coliform: MF Fecal 31616
1 B2 Q1
/ 100m1
X
Coliform: MFTotal 31504
1 B2 Q1
/100m1
TOC
mg/I
Turbitity
NTU
Residue., Suspended 530
mg/L
Total Suspended solids
mg/L
pH
units
Alkalinity to pH 4.5
mg/L
Alkalinity to pH 8.3
mg/L
Carbonate
mg/L
Bicarbonate
mg/L
Carbon dioxide
mg/L
Chloride
mg/L
Chromium: Hex 1032
ug/L
Color: True 80
c.u.
Cyanide 720
mg/L
COMMENTS:
Owner: CATAWBA COLLECT;
Location or Site:
Description of sampling point
Sampling Method:
Remarks:
EMERGENCY
Lam, iFurs
Iztanx
torsi a h5_c
JUL 0 8 2002
NC DEPT. OF ENVIRONMENT
AND NATURAL RESOURCES
MOORESVILLE REGIONAL OFFICE
X
Diss. Solids 70300
420
mg/L
Fluoride 951
mg/L
Hardness: total 900
mg/L
Hardness: (non-carb) 902
mg/L
Phenols 32730
ug/L
Specific Cond. 95
umhos/cm2
Sulfate
mg/L
Sulfide 745
mg/L
MBAS
mg/L
Oil and Grease
mg/L
Silica
mg/L
Boron
Formaldehyde
mg/L
NH3 as N 610
mg/L
TKN as N 625
mg/L
X
NO2 +NO3 as n 630
•0.18
' mg/L
P: Total as P 665 -
mg/L
PO4
mg/L
Ag-Silver 46566
ug/L
X
Al -Aluminum 46557
50U
ug/L
As -Arsenic 46551
ug/L
Ba-Barium 46558
ug/L
X
Ca -Calcium 46552
99
mg/L
Cd-Cadium 46559
ug/L
X
Cr-Chromium 46560
25U
ug/L
X
Cu-Copper 1042
2.0U
ug/L
X
Fe- Iron 1045
50U
ug/L
Hg- Mercury 71900
ug/L
X
K-Potassium 46555
2.2
mg/L
X
Mg- Magnesium 927
4.8
mg/L
X
Mn-Manganese 1055
18
ug/L
X
Na-Sodium929
15
mg/L
X
Ni-Nickel
10U
ug/L
X
Pb-Lead 46564
10U
ug/L
Sc-Selenium
ug/L
X
Zn_Zinc46567
610
ug/L
Lab Number : 2G1060
Date Received : 6/13/2002
Time Received : 9:30 AM
Received By : DS
eleased'ByI3)6
: AR
Date reported : 7/3/2002
Organochlorine Pesticides
Organophosphorus Pesticides
Nitrogen Pesticides
Acid Herbicides
Semivolatiles
TPH-Diesel Range
Volatile Organics (VOA bottle)
TPH-Gasoline Range
TPH-BTEX Gasoline Range
2G1060.xls

GROUNDWATER FIELD/LAB FORM
North Carolina
Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
County
Quad No Serial No.
Lat. Long.
Report To: ARO, FRO,. RRO, WaRO, WiRO,
WSRO, Kinston FO, Fed. Trust, Central Off., Other:
Shipped by: Bus, f our': , Han el., Other:
Collector(s): Date_
FIELD ANALYSES
pH 400 Spec. Cond.94 l
°C Odor
Temp.ln
Appearance/ter
Field Analysis By:
LABORATORY ANAL SES
SAMPLETYPE SAMPLEFRIORITY
? -Water Routine
❑ Soil ❑ Emeraencv
❑ Other
❑ Chain of Custody
O
10(0
Date Received 13 tOTime:
Rec'd By: From:Bu
Other:
Data Entry By:
Data
Reported:
Purpose:
// a Time,_._// ro Baseline, Complaint, Compliance, LUST, Pesticide Study, Federal Trust, Other: "�/�
�,c (circle ono)
Owner ze,.. . .. _ 6.0lf<. " x
at 25°C Location or Site .,.��.f -� � Z4 - /,fir __(mac: _ /
Description of sampling point c2tfi/ Ad X..z.41" -.•te _�t�.re i�^
..>; Sampling Method G[ 'Sample Interval zA...< - fi 4e3
Remarks Pu aier.elct
mpl gtim°,airlemp/ c.)
BOD 310
mglL
COD High 340
mglL
COD Low 335
mg/L
Colirorm: MF Fecal 31616
/100m1
Coliform: MF Total 31504
/100m1
TOG 680
mg/L
Turbidity 76
NTU
Residue, Suspended 530
mg/L
pH 403
units
Alkalinity to pH 4.5 410
mglL
Alkalinity to pH 8.3 415
mg/L
Carbonate 445
mglL
Bicarbonate 440
mg/L
Carbon dioxide 405
mg/L
Chloride 940
mg/L
Chromium: Hex 1032
ug/L
Color: True 80
CU
Cyanide 720
mg/L
Diss. Solids 70300 • mg/L
Fluoride 951 mg/L
Hardness: Total 900 mg/L
Hardness (non-carb 902 mg/L
Phenols 32730 ug/I
Specific Cond. 95 uMhos/cm
Sulfate 945 mg/L
Sulfide 745 mg/L
Oil and Grease mg/L
NH3 as N 610 mg/L
TKN as N 625 mglL
NO2 + NO3 as N 630 mg/L
P: Total as P 665 mg/L
Ag-Silver 46566
ug/L
7'G
Al -Aluminum 46557
ug/L
As -Arsenic 46551
ug/L
Ba-Barium 46558
ug/L
Ca -Calcium 46552
mg/L
Cd-Cadmium 46559 ,
ug/L
ye,...
Cr-Chromium 46559
ug/L
X
Cu-Copper 46562
ug/L
Fe -Iron 46563
ug/L
Hg-Mercury 71900
ug/L
K-Potassium 46555
rng/L
-
Mg -Magnesium 46554
mglL
-K
Mn-Manganese 46565
ug/L
X
Na-Sodium 46556
mg/L
' -
Ni-Nickel
uglL
---,,e,„
Pb-Lead 46564
ug/L
Se -Selenium
ug/L
4
Zn-Zinc 46567
ug/L
Organochlorine Pesticides
Organophosphorus Pesticides
Nitrogen Pesticides
Acid Herbicides
PCBs
Semtvolatile Organics
TPH-Diesel Range
Volatile Organics (VOA bottle)
TPH-Gasoline Range
TPH-BTEX Gasoline Range
LAB USE ONLY
Temperature on arrival:
Lab Comments
GW-54 REV. 12/87
For Dissolved Analysts -submit filtered sample and write'DIS" in block.

COUNTY: ROWAN
QUAD NO:
REPORT TO : MRO
COLLECTOR(S) : M HELLER
DATE: 4/12/2002
TIME:
PURPOSE:
LABORATORY ANALYSIS
Regional Office
BOD 310
mg/L
COD High 340
mg/L
COD Low 335 •
mg/L
X
Coliform: MF Fecal 31616
1 B2 Q1
/100m1
X
Coliform: MF Total 31504
1 B2 Q1
/100m1
TOC
mg/1
Turbitity
NTU
Residue., Suspended 530
mg/L
Total Suspended solids
mg/L
pH
units
Alkalinity to pH 4.5
mg/L
Alkalinity to pH 8.3
mg/L
Carbonate
mg/L
Bicarbonate
mg/L
Carbon dioxide
mg/L
Chloride
mg/L
Chromium: Hex 1032
ug/L
Color: True 80
c.u.
Cyanide 720
mg/L
COMMENTS:
Owner:
Location or Site:
Description of sampling point
Sampling Method:
Remarks:
DIVISION OF WATER QUALITY
Chemistry Laboratory Report / Ground Water Quality
gan
SAMPLE PRIORITY
X❑ ROUTINE
n CHAIN OF CUSTODY
W❑ SAMPLE TYPE
CATAWBA COLLEGE
EMERGENCY
srm S`2:., ue
.,7111 r �j
v1i an If 0'
iv
JUL 0 8 2002
PAC QEPT. OF ENVIRONMENT
AND NATURAL RESOURCES
i)OFtESVLLE REGIONAL OFFICE
X
Diss. Solids 70300
420
mg/L
Fluoride 951
mg/L
Hardness: total 900
mg/L
Hardness: (non-carb) 902
mg/L
Phenols 32730
ug/L
Specific Cond. 95
umhos/cm2
Sulfate
mg/L
Sulfide 745
mg/L
MBAS
mg/L
Oil and Grease
mg/L
Silica
mg/L
Boron
Formaldehyde
mg/L
NH3 as N 610
mg/L
TKN as N 625
mg/L
X
NO2 +NO3 as n 630
0.20
mg/L
P: Total as P 665
mg/L
PO4
mg/L
Ag-Silver 46566
ug/L
X
Al -Aluminum 46557
85
ug/L
As -Arsenic 46551
ug/L
Ba-Barium 46558
ug/L
X
Ca-Calcium46552
99
mg/L
Cd-Cadium 46559
ug/L
X
Cr-Chromium 46560
25U
ug/L
X
Cu- Copper 1042
2.0U
ug/L
X
Fe- Iron 1045
160
ug/L
Hg- Mercury 71900
ug/L
X
K-Potassium 46555
2.2
mg/L
X
Mg- Magnesium 927
4.8
mg/L
X
Mn-Manganese 1055
19
ug/L
X
Na- Sodium 929
15
mg/L
X
Ni-Nickel
10U
ug/L
X
Pb-Lead 96564
10U
ug/L
Se -Selenium
ug/L
X
Zn Zinc46567
610
ug/L
X
Lab Number : 2G1061
Date Received : 6/13/2002
Time Received : 9:30 AM
Received By : DS
�)3)6
eleased By : AR
Date reported : 7/3/2002
Organochlorinc Pesticides
Organophosphorus Pesticides
Nitrogen Pesticides
Acid Herbicides
Semivolatiles
TPH-Diesel Range
Volatile Organics (VOA bottle)
TPH-Gasoline Range
TPH-BTEX Gasoline Range
2G1061.xls

GROUNDWATER FIELD/LAB FORM
North Carolina
Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
County
Quad No Serial No.
Lat. Long.
Report To: ARO, FRO,?RRO, WaRO, WiRO,
WSRO, Kinston FO, Fed. Trust, Central Off., Other:
Shipped by: Bus, -ta n�lyel., Other:
Collector(s): ��, hg, c,
FIELD ANALYSES
pH Ono 7, 'A- Spec. Cond.si at 25°C
Temp.in Z'• '7 °C Odor z/i.a-�
SAMPLETYPE
1 Water
❑ Soil
❑ Other
❑ Chain of Custody
Appearance
Field Analysis By: /h//,.
LABORATORY ANALYSES
SAMPLEpRIORITY
Routine
❑ Emeraencv
Lab Number
Date Received
Rec'd By: �S
Other:
Data Entry By: Ck:
Data
Reported:
Hand Del.,
Purpose:
Date ‘iz4� Time /7`,<f Baseline, Complaint, Compliance, LUST, Pesticide Study, Federal Trust, Other:
4! E>~r Co%�
Description of sampling point 6����1 -14S4 Ti„ 7 ue-=..
Sampling Method Svc/l�� Sampt"e Interval2
RemarksP� filer. el i ) et-4^
(Pumping tirtie, air temp., etc.)
BOD 310
mg/L
COD High 340
mg/L
COD Low 335
mg/L
A
Coliform: MF Fecal 31616
/100m1
r
Coliform: MF Total 31504
/100m1
TOC 680
mg/L
Turbidity 76
NTU
Residue, Suspended 530
mg/L
pH 403
units
Alkalinity to pH 4.5 410
mg/L
Alkalinity to pH 8.3 415
mg/L
Carbonate 445
mg/L
Bicarbonate 440
mg/L
Carbon dioxide 405
mg/L
Chloride 940
mg/L
Chromium: Hex 1032
ug/L
Color: True 80
CU
Cyanide 720
mg/L
1
02-Time:
om:Bus, c
Owner
Location or Site
XDiss.
Solids 70300
mg/L
Fluoride 951
mg/L
Hardness: Total 900
mg/L
Hardness (non-carb 902
mg/L
Phenols 32730
ug/I
Specific Cond. 95
uMhos/cm
Sulfate 945
mg/L
Sulfide 745
mg/L
Oil and Grease
mg/L
NH3 as N 610
mg/L
TKN as N 625
mg/L
`>.<
NO2 + NO3 as N 630
mg/L
P: Total as P 665
mg/L
Ag-Silver 46566
ug/L
j,
AI -Aluminum 46557
ug/L
As -Arsenic 46551
ug/L
Ba-Barium 46558
ug/L
"
Ca -Calcium 46552
mg/L
Cd-Cadmium 46559 .
ug/L
X
Cr-Chromium 46559
ug/L
,+<,
Cu-Copper 46562
ug/L
Fe -Iron 46563
ug/L
Hg-Mercury 71900
uglL
7(
K-Potassium 46555
mg/L
.c
Mg -Magnesium 46554
mg/L
,(
Mn-Manganese 46565
ug/L
Na-Sodium 46556
mg1L
X
Ni-Nickel
ug/L
Pb-Lead 46564
ug/L
Se -Selenium
ug/L
X
Zn-Zinc 46567
ug/L
organochlorine Pesticides
Organophosphorus Pesticides
Nitrogen Pesticides
Acid Herbicides
PCBs
Semivolalile Organics
TPH-Diesel Range
Volatile Organics (VOA bottle)
TPH-Gasoline Range
TPH-BTEX Gasoline Range
LAB USE ONLY
Temperature on arrival:
Lab Comments
GW-54 REV. 12/87
For Dissolved Analysis -submit filtered sample and write 'DIS" in block.

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MEMORANDUM
TO:
FROM:
SUBJECT:
MOORESVILLE REGIONAL, OFFICE
DIVISION OF WATER QUALITY
GROUNDWA Il ER SECTION
June 14, 2002
Mark Pritzl
GW Section — Central Office
Matt Heller ./r/'.
Post Construction Inspection(s)
Catawba College UIC System
WI0300052
The UIC Group requested that the MRO complete a post -construction inspection at the
above -referenced location on June 22, 2001. Susie Caldwell attempted to complete the inspection
in July 2001 and partially completed the inspection later that year. The system was not operational
until spring 2002. On April 3, 2002, I visited the site and completed the inspection of the wells. I
returned on June 12, 2002 to collect additional samples. I have attached the inspection report. I will
forward analytical results as soon as they are received.
Here are some key findings of the inspection(s):
• The wells are completed below grade and installed in vaults. The current construction of
the vaults is adequate to prevent damage and surface runoff. During the April 3, 2002
inspection; it was observed that sediment was entering the vault for well 43. I reinspected
well 43 on June 14. The area had been regraded and no additional sediment was noted.
a The individual wells do not have sampling ports. I suspect that they were not installed
due to the larger than normal diameter of the piping from the well. The piping from the
two source wells joins before entering the heat exchanger and splits after the heat

exchanger before returning to the two injection wells. I was able to collect a sample both
before and after the heat exchanger.
0 The injection wells are currently not able to accept all of the water that is moving through
the system. A portion of the water is being piped into a drainage ditch that leads to a
storm drain. The person I spoke with indicated that the college was considering drilling
one or more additional injection wells or creating an impoundment and using the water
for irrigation of nearby athletic fields.
Please call me at [phone] if you have any questions.

D
u
RtVISEP 1^411. LOCATION:7)
r. r •
N
1,01.),PAI.S):111

Page 1 of 2
North Carolina Department of Environment and Natural Resources
Division of Water Quality - Groundwater Section
INJECTION FACILITY INSPECTION REPORT - FORM B
INJECTION WELL PERMIT NO. WI wB 0co z. DATE V - 3. 0 2/4 tom- rr
NAME OF OWNER -I--c o id 0, 0. 0 LLB c e.
ADDRESS OF OWNER 45 ®o 4 5 - Innes S- --v ee4-
al LS h 3 13 C e► Li-
(Street/ road or lot and subdivision, county, town)
LOCATION OF INJECTION WELL (and source well(s), if applicable) C - 1 A
T L� O 1 ' GEC e ��`� it S C /1 Lct ' } r C' 1 cry j e-C {'i LA)e-( is L o C- a� G� c`5-4 , v-ro t t- r�d-4l'e
Lae v t ►r1C� «IYICi 1 ✓) c�
(Street/ road or lot and subdivision , county, town, if different than owner's address, plus description of location on site)
Potential pollution source
Potential pollution source
Distance from well
Distance from well
Potential pollution source Distance from well
Minimum distance of well from property boundary i >55
Quality of drainage at site ' ©-c:,d Flooding potential of site u,
(good.adequate,poor)' (high,moderate,low)
GPS Data:
/ j• : 7;,.. - %/ 1' / f
Latitude: ; S -i, / --,./ i a ; % %j Longitude: 70 7 V /;, . </ / / 1/1/
DRAW SKETCH OF SITE (Show property boundaries, buildings, wells, potential pollution sources, roads, approximate scale, a
north arrow.)
CG
/% J
DESCRIBE INJECTION SYSTEM (vertical closed loop, uncased borehole or cased water well; separate source well and
injection well; combination source and injection well; or other description as applicable __,,,G-
A Sev`—CE [ S C°L�t i L l NL%t C.C,+'l,Q-r ii.s-Q1(S — 1- // /<-:., z-,-( -cJ/. L'
/(JJ - LiA . %i` ' ' .%` L-'�:.in: .'c� i•' i•=.. �/7 , ! ._�-j e- s1 .` ✓( f A,
GW/UIC-2 March 28, 2001

INJECTION FACILITY INSPECTION REPORT -FORM B (CONTINUED)
Page 2 of 2
WELL CONSTRUCTION
Date constructed
Drilling contractor: Name
Address
Certification number <
Total depth of well �a°� Total depth of source well 9 f.S ' —r
(if applicable)
Inspection point Measurement Meets minimum standards
Casing
Grout
Depth
Diameter
Height (-Lr.-)
Depth
Screens
Depth(s)
Lenath(s)
I.D. Plate
Static water level
Well yield
Enclosure
Enclosure floor
Sampling port
(labeled) ,/'
Water tight pipe entry
Well enclosure entry
Vent
c) / —e1,4 /%n ;
!';
Yes
z
4/
_z
No
(A-41/ =47-47
Comments
Functioning of heat pump system (Determine from the owner if heat pump functions properly)
INSPECTORS ; L:%�
WITNESS
Office
Address
WITNESS
GW/UIC-2
Address
March 28, 2001

North Carolina - Dopartment of Environment, Health, and Natural Resources
Division of Environmental Management, Groundwater Section
P.O. Box 29535 • Raleigh, N.G. 27626 0535
Phone [phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR; Rowan Well Drilling
DRILLER REGISTRATION NUMBER: 1635 PERMIT NUMBER:
FOR OFFICE USE ONLY
QUAD NO SERIAL NO
Lat Long RO
Minor Basin
Basin Codc
Header Ent GW1 Ent
STATE WELL CONSTRUCTION
1. WELL LOCATION: (Show sketch Qf dig location below)
Neatcat Town: Salisbury Rowan
Catawba College Sports CentCounty:
(Road, CotntnCatawba'v..olleae No)
2. OWNER
ADDRESS
(Street or Route No)
City or Town
State Zip Code
DEPTH
From To
DRIT TINS T
Formation Description
0-.17 Band & clay
12-58
56-605
3. DATE DRILLED 6-25-01 USE OF WELL water
4. TOTAL DEPTH 60 S geothermal
5. CUTTINGS COLLECTED YES NO
6. DOES WELL REI?LACE EXISTING WP! _I YES NO
7. STATIC WATER LEVEL Below Top of Casing: 20 F'I'-
(Uce.,- if Above Top of Casting)
S. TOP OP CASTING IS 1 _FT. Above Land Surface*
* Casing Terminated at/or below land surface is illegal unless a variance is
issued in accordance with 15A NCAC 2C .01 IS
9. YIELD (gpm): METHOD OF TEST air
10. WATER ZONES (depth): —T2r an ee
11. CHLORINATION. Type: chlorine Amount: 10 oz.
12. CASING:
Depth Diameter
From ITo 5 R Ft. 6 2 5_
Prom To Ft.
Frurn To _Pt.
13. GROUT:
Depth Material
From _DTo_25 Ft. cement
From To _, Ft
gr air T't- -+rid tone
.granite
If additional space is needed usetack of fvtw
WaII Thickness
or Weight/Ft Material LOCATION SKE EcH
galvani zed (Show direction and distance from a least two State
Roads, or other map reference points)
Method
_pump
14. SCREEN;
Depth Diameter Slot Size
Front_ To Ft. in. in.
From To Ft. in in,
From To _Ft. in. in.
15. SAND/GRAVEL PACK
Depth Size
From To Ft
From To Ft
16. REMARKS:
1 DO HEREBY oTRTIPY TI IAT THIS WELL WAS CONS1IWCTED IN ACCORDANCE WITH 15A NCAC 2C. WELL.
CONSTRUCTION STANDARDS. AND THAT A COPY OF ' I.4 RE 0 RD AS BEE ' OV tDED TO TI Il; WELL OWNER
Material
Matcriat.
CGWI REV. 9/4I
Id
SIGi • 'UFCON 'ri • OR'CENT
Submit urigtn,l to t)iristna orEnvitnntnantal Management and copy to well owner
DATE
Vd WtiS:OT SOW ET ',add
961:6-929—P0L : "ON Xiid
: NQzld

Page 2 of 2
INJECTION FACILITY INSPECTION REPORT -FORM B (CONTINUED)
WELL CONSTRUCTION
Date constructed - ci /
Drilling contractor: Name
Address
,,fr7>
Certification number
Total depth of well
Inspection point
Total depth of source well
(if applicable)
Measurement Meets minimum standards Comments
Yes No
Casing
Depth � �1 445,
Diameter
Height ( 7 r�. .
Grout
Depth
Screens
Depth(s)
Length(s)
/
4�
7
I.D. Plate /
Static water level
2C'r.
Well yields
Enclosure
Enclosure floor
(LuneI GLe '�/�r. ".
•
Sampling port ®rrr/
(labeled) /09� J
Water tight pipe entry
Well enclosure entry
Vent
v
Functioning of heat pump system (Determine from the owner if heat pump functions properly)
INSPECTOR v .
WITNESS
Office ,/
Address
WITNESS
GW/UIC-2
Address
March 28, 2001

North Carolina - Department of Environment, health, and Natural Resources
Division of Environmental Management, Groundwater Section
P.O. Box 29535 - Raleigh, N.C. 27626 0535
Phone [phone]
WELL CONSTRUCTION RECQRD
DRILLING CONTRACTOR: Rowan Well Drilling
DRILLER REGISTRATION NUMBER: 1635 PERMIT NUMBER:
FOR OFFICE USE ONLY
QUAD NO SERIAL NO
Lat Long RO
Minor Basin
Basin Code
Header Ent GW-1 Ent
STATE WELL CONSTRUCTION
1. WELL LOCATION: (Show sketch of the location below)
Nearest Town: Salisbury County: Rowan
Catawba FF Cobba�ltt lege ddSports Center
(Road commanilyatawbtaSlCol legeo)
2. OWNER C::
ADDRESS
(Street or Route No)
City or Town
DEPTH 7�1 f_LNGLt1r:
From To Formation Description
0-27 sand riay
27-29
State Zip Code 2 9 — 4 4 5
3. DATE DRILLED 6 — 2 6 -- 01 USE OF WELL water
4. TOTAL DEPTH 44 5 geothermal
5. CG*1TINGS COLLECTED' YES NO
6. DOES WELL REPLACE EXISTING WEIR:? TES NO
7. STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use... if Above Top of Casting)
8. TOP OF CASTING IS _ 1 FT. Above Land Surface*
* Casing Terminated at/or below land surface is illegal unless a variance is
issued in accordance with 15A NCAC 2C .0118
9. YIELD (gpm): METHOD OF TEST
10. WATER ZONES (de : Et.. 15 GPM? 350 1IFT GPM
425 .ft. 45 GPM
11. CHLORINATION. Type: chlorine Amount: 10'oz.
12. CASING:
gyt,n i f-e
gr_anYt-P_
If additional space is needed use back of form
Wall Thickness
Depth Diameter or Weight/Ft Material • LOCATION SKETCH
_6- - 2 From P To 29 Ft. 5 q_alvinized. (Show direction and distsucc from a least two State
From _ _To _Pt. Roads, or other map reference points)
From To Ft. -.1/S' Csu (�Y
13. GROUT: T
Depth Material Method
From (1 To?F Ft. _ rPmeni- PurEP
From To Ft.
14. SCREEN: -
Depth Diameter Slot Size Material
From To Ft._ in. in
From To Ft in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK
Depth Size Marcri>:tI .
From To Ft
From To_ Ft
16. REMARKS:
af. v'IIetiVo(.
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WFI I
CONSTRUCCtON ST.ANDARDS, AND THAT A COPY OF S a HAS B sw PR! VIDED TO THE WELL OWNER
GWI REv.9/91
SIGNATIiREOFCOIv - C)' AGENT
Submit on%inui IC) Oivibiun Ur anvltonntentaI Management and ropy t0 well owner
DATE
Ed WtVE:@T Mee irT '-'- J 96T5-9E9-1702. : '0N XCd

Page 2 of 2
INJECTION FACILITY INSPECTION REPORT -FORM B (CONTINUED)
WELL CONSTRUCTION
Date constructed 27 0 f
7• /
Drilling contractor: Name
Address
// /CSC
Certification number z. . =-
Total depth of well -`C?;" / Total depth of source well
(f applicable)
Inspection point Measurement Meets minimum standards Comments
Yes No
Casing
Depth
Diameter
Height (A I .S:}—
Grout
Depth
q 1
`(
Screens
Depth(s)
Length(s) AJf71
I.D. Plate
Static water level
Well yield 6 00
Enclosure
Enclosure floor
(Qaa- _ d ✓Y /
Sampling port
(labeled) /jam
Water tight pipe entry
Well enclosure entry
Vent
•
/
IL/A. <
/��t.✓tom
Functioning of heat pump system (Determine from the owner if heat pump functions properly.)
INSPECTOR :' �� Office /0
WITNESS
WITNESS
GWTUIC-2
Address
Address
March 28, 2001

North Carolina - Department of Environment, Health, and Natural Resources
Division of Environmental Management, Groundwater Section.
P.O. Box 29535 • Raleigh, N.C. 27626 0535
Phone [phone]
WELL COS 7CTION RECORD
DRILLING CONTRACTOR: Rowan Well Drilling
DRILLER REGISTRATION NUMBER; 1635
FOR OFFILE USEOF LY
QUAD NO
Lat
Minor Basin
Basin Code
HParter Ent GW1 Ent
Long
SERIAL NO
RO
STATE WELL CONSTRUCTION
PERMIT NUMBER:
I. WELL LOCATION ,(Sbow sketch of the location below)
Ncarc t Town: Sal s. stfury County: Rowan
Catawba College Sports Center
(Road. Community or Subdivision and Lot No)
2. OWNER Catawba College
ADDRESS
(Street or Route No)
City or Town
State Zip Code
3. DATE DRILLED 6-27-01 USE OF WELL water
4, TOTAL DEPTH 405 ga3athermal
5. CUTTINGS COLLECTED YES NO
6. DOES WELL REPLACE EXISTING WELL? YES NO
7. STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use.: if Above Top of Casting)
B. TOP OF CASTING IS , 1 PT. Above Land Surface*
Casing Terminated aVor below land surface is illegal unless a variance is
issued in accordance with 15A NCAC 2C .01 I8
9. YIELD (gpm)' _fLSI METHOD OF TEST a i r
10. WATER ZONES (depth):
100. 245, and 390
11. CHLORINATION. Type: chlorine Amount: 10 oz..
12. CASINC:
Wall Thickness
From To
DRILLING LOG
Formation Description
0-25 clav
25-405 granite
If additional space is needed use back of form
Dtpth Diameter or Weight(Ft Materia: LCCATTON SKETCH
From 0 _To 29 Ft. 6.25 galvinized (Show direction and distance from a least two State
Fmm To Ft. Roads, or other map reference points)
From To Ft
t3_ GROUT:
Depth Material Method
From 0 To 20 Ft cement pump
From _ To _ Ft.
14. SCREEN:
Depth Diameter Slot Size
Material
From To Ft in. in,
From To Ft. in. in.
From .To Ft in in. •
15. SAND/GRAVEL PACK
Depth Size Material
From To _Ft
From To Ft
I6. REMARKS:
1 DO IIOREBY CERTIFY TI-IATTHIS WELL. WAS CONSTR
CONSTRUCTION STANDARDS, AND THAT A COPY OF'I�
CW.I REV 9/91
CFED IN ACCORDANCE WITH 15A NCAC 2C, WRI.I.
1S
EEN PROVIDED TOTHE WELL OWNER
Sl( 1T(JREOFCON 1'R Ci'OR OR AGE T
Submit original to Division of Environmental Management and copy to well owner
nATF.
Ed WtibE 33T EWE ET '.add
96 E-929—VOL : 'ON Xdd
: WONd

INJECTION FACILITY INSPECTION REPORT -FORM B (CONTINUED)
WELL CONSTRUCTION
Date constructed 27— c)
Drilling contractor: Name
Address
��/ _��
ins%<,1 earn S •- ;c.,,�G„ � /�✓z �. �-,��
Certification number
Page 2 of 2
//.4.,/z_f//
Total depth of well �; c> / Total depth of source well /
(f applicable)
Inspection point Measurement Meets minimum standards Comments
Yes No
Casing
Depth
Diameter
Height (A.t.S:)"
Grout
Depth
Screens
Depth(s)
Length(s)
Vy //
f `�
• /
I.D. Plate
Static water level Z C)
Well yield
Enclosure
•
Enclosure floor
(concrete)
Sampling port ✓✓ ,�,�
(labeled)
Water tight pipe entry
Well enclosure entry
i
Vent
/
6
Functioning of heat pump system (Determine from the owner if heat pump functions properly)
„ A /
INSPECTOR 7 �f�� Office
WITNESS Address
WITNESS
GW/UIC-2
Address
March 28, 2001

• e
North Carolina - Department of Environment. Health, anti Natural Resources
Division of Environmental Management, Groundwater Section
P.O. Box 29535 • Raleigh, N.C. 27626 0535
Phone [phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: Rowan Well Drilling
DRILLER REGISTRATION NUMBER: 1635
FOR OFFICE USE ONLY
QUAD NO SERIAL NO
Lat Long RO
Minor Basin
Basin Codc
Deader Ent GW 1 Ent
STATE WELL CONSTRUCTION
PERMIT NUMBER:
1.
WELL LOCATION: (Show sketch of the location below) •
Nearest Town: Salisbury County: Rowan
Catawba College Sports Center
(Road, Commtmity or Subdivision and Lot No)
2. OWNER Catawba College
ADDRESS
(Street or Route No)
DEPTH
From To
DRILLING LOG
Formation Description
0-15 play
15-30 sandstone granite
City or Town State Zip Cade 30-505 granite
S. DATE DRILLED 6-28-01 USE OF WELL water
4_ TOTAL D131 TI-1 505 geothermal
5. CUTTINGS COLLECTED YES NO
6. DOES WELL R1 LACE EXISTING WELL? YES NO
7. STATIC WATER LEVEL Below Top of Casing: 2 0 FT.
(Usc', if Above Top of Casting)
8. TOP OF CASTING IS 1 FT. Above Land Surface*
Casing Terminated atior below land surface is Mega! unless a variance is
issued in accordance with 1 SA NCAC 2C .0118
9. YIELD (gpm): d S.t. METHOD OF TEST a3 r
10. WATER ZONES (depth):
70, 245, 300 and 490 feet
11. CHLORINATION, Type: chlorine Amount: 10 OZ.
12. CASING: If additional space is needed use hack of fugal
WaI1 Thickness
Depth Diameter or Weight/Ft Material LOCATION SI{RTC_li
From 0_._To3 0 Ft. 6.25 gaivinized (Show direction and distance from a least two State
From To _Ft. Roads, or other nce points)
From To Ft.—.S.ioar}'S. G°ef►4'4r
13. GROUT:
Depth Material Method
Fmm 0 T020 Ft, cement pump
From To Ft.
14. SCREEN:
Depth Diameter Slot Size Material
1^rom To Ft in. in_
Prom To Pt. in. in.
From To Ft in. in.
15. SAND/GRAVEL PACK
Depth Size
From To Ft
From To Ft
16. REMARKS:
Material
i lu1esr; 1‘0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH""I5A NCAC 2C. WELL
CONSTRUCTION STANDARDS. AND Ti lAT A COPY OF IS RF.Cf�1R�) S B ROy )ED TO THE WELL OWNER
GW.I REV. 9)9l
SIGNATURE OF C:ON IRACPDR Olt AGENT DATE
Submit original to I)ivisiou of Environmental Management and copy u, wen owner
Sd WtiSZ:OT Z00Z ET "-bit! 96I6-929—t70L : -ON XHd
: WONA

Page 1 of 2
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Groundwater Section
PRECONSTRUCTION INJECTION FACILITY INSPECTION
ai°r11-1 �o REPORT-FA
INJECTION WELL PERMIT NO. WI (723- . DATE L- - /,5 -
NAME OF OWNER e_C :si-o/962_
ADDRESS OF OWNER kie.54 inf es S, e j bitiS/ j /Ve ,72✓
Aar),L, 2> 51
(Street/ road or lot and subdivision, county, town)
LOCATION OF PROPOSED INJECTION WELL (and source/�well(s), if applicable) �c,, L
' /2 fZE.:�Z:>rtG L��L -�c �T? o� %� r�/.• / d' f'�' /Z e�Li Cv� f_ 4-7Z
/', j' l / %` fr: Via./ C�l✓ti'- • j.z) ,C( R.;✓-!. ciL 4 r 446- tzuiz.)
(Street/ road or lot and subdivision , county, town, if different than owner's address, plus description of location on site)
Potential pollution source
Potential pollution source
Distance from well
Distance from well
Potential pollution source Distance from well
Minimum distance of proposed well from property boundary ro .,r�uc r (1> z f -
Quality of drainage at site r ,---irti Flooding potential of site (1 , P.trri
(gooddequate,poor) (high,moderate,low)
DRAW SKETCH OF SITE
(Show property boundaries, buildings, wells, potential pollution sources, roads, approximate scale, and north arrow)
rt
vtf"'�C�r
,\\
GW7'13:IC-1 March 28, 2001

Page 2 of 2
PRECONSTRUCTION INJECTION FACILITY
• INSPECTION REPORT - FORM A (cont.)
GPS Data:
Latitude: O c:) Longitude:
COMMENTS
-Dv.c L L 1 S frill (r rl 0)-0- ct4..d ` l cAL
Ltd 6 Lern.5 vJ€A,Ls
41' 3u .5S" `a-D` yNF. 1,4.41 v.9
INSPECTOR 4 z.t.aa-L . ,0-e-c'
Office fb1,(2 )
WITNESS ! cd, ,Actac. S
Address
v.cL',U-3Q.1 �"i 6t,�..
WITNESS
Address
GW/UIC-1 March 28, 2001

NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A
WELL(S) FOR INJECTION WITH A HEAT PUMP SYSTEM
Type 5A7 and 5QM Wells
In Accordance with the provisions of NCAC Title 15A: 02C.0200
Complete application and mail to address on the back page.
TO: DIRECTOR, NORTH CAROLINA DIVISION OF WATER QUALITY
DATE: 5 —1 4 , 20 01
A. SYSTEM CLASSIFICATION Please check column which matches proposed system.
(1) x Type 5A7 wells inject water used to provide heating or cooling for structures.
(2) _ Type 5QM wells contain a subsurface system of continuous piping, that is
isolated from the environment and circulates a fluid other than potable water.
This includes systems that circulate additives such as antifreezes and/or corrosion
inhibitors.
(3)
Type 5QW wells contain a subsurface system of continuous piping, that is
isolated from the environment and only circulates potable water. If you selected
this well type, then complet&form GW-57 CL, Notification Of Intent To
Construct A Closed -Loop Geothermal -Water Only Injection Well System.
B. PERMIT APPLICANT
Name: Todd Adams/DBA Rowan Well Drilling
Address:4840 Sherrills Ford Road
City: Salisbury State: NC Zip Code: 28147 County: Rowan
Telephone: ( 7 0 4 ) 636-7879
C. PROPERTY OWNER (if different from applicant)
Name: Catawba College
Address: West Innis Street
City: Salisbury Sate: NC Zip Code: 281 47County: Rowan
Telephone:
D. STATUS OF APPLICANT
Private: x
State:
Federal: Commercial:
Municipal: Native American Lands:
GW-57 HP (Jan, 2000) Page 1 of 4
0
L
N
iV

E. FACILITY (SITE) DATA
(Fill out ONLY if the Status of Owner is Federal, State, Municipal or Commercial).
Name of Business or Facility:
Address:
City: Zip Code: County:
Telephone: Contact Person:
F. HEAT PUMP CONTRACTOR DATA
Nan%pmfort Contractors
Address:
City: Salisbury
Zip Code: County:
Telephone: (7 0 4) 6 3 6— 6 91 5 Contact Person: Da v i d Les 1 le
G. INJECTION PROCEDURE (Briefly describe how the injection well(s) will be used.)
climate control starts pumps, enters heat exchange
and dumps into return wells
H. WELL USE Will the injection well(s) also be used as the supply well(s) for the following?
(1) The injection operation? YES x NO
(2) Personal consumption? YES NO x
CONSTRUCTION DATA (check one)
EXISTING WELL being proposed for use as an injection well. Provide the data in
(1) through (7) below to the best of your knowledge. Attach a copy of Form GW-
1 (Well Construction Record) if available.
x PROPOSED WELL to be constructed for use as an injection well. Provide the
data in (1) through (7) below as PROPOSED construction specifications. Submit
Form GW-1 after construction.
(1) Well Drilling Contractor's Name: Rowan Well Drilling
NC Contractor Certification number: 2 5 2 2
(2) Date to be constructed: 5 — 2 3 — 01 Number of borings: 4
Approximate depth of each boring (feet): 2 0 0
Well casing: Is the well(s) cased?
(3)
(a) YES x If yes, then provide the casing information below.
Type: Galvanized steel x Black steel Plastic Other (specify)
Casing depth: From to ft. (reference to land surface)
Casing extends above ground inches
(b) NO
GW-57 HP (Jan, 2000) Page 2 of 4

(4) Grout (material surrounding well casing and/or piping):
(a) Grout type: Cement x Bentonite Other (specify)
(b) Grouted surface and grout depth (reference to land surface):
x around closed loop piping; from 0 to 2 0 (feet).
around well casing; from to (feet).
(5) Screens (for Type 5A7 wells)
(a) Depth: From to feet below ground surface.
(6) N.C. State Regulations (Title 15A NCAC 2C .0200) require the permittee to make provisions
for monitoring wellhead processes. A faucet on both influent (fluid entering heat pump) and
effluent (fluid being injected into the well) lines is required. Will there be a faucet on:
(a) the influent line? yes x no (b) the effluent line? yeses no
SOURCE WELL CONSTRUCTION INFORMATION (if different from injection well).
Attach a copy of Form GW-1 (Well Construction Record). If Form GW-1 is not available,
provide the data in part K (1) of this application form to the best of your knowledge.
(7)
NOTE: THE WELL DRILLING CONTRACTOR CAN SUPPLY THE DATA FOR EITHER EXISTING OR
PROPOSED WELLS IF THIS INFORMATION IS UNAVAILABLE BY OTHER MEANS.
J. PROPOSED OPERATING DATA (for Type 5A7 wells)
(1) Injection rate: Average (daily) 7 5 gallons per minute (gpm).
(2) Injection Volume: Average (daily) gallons per day (gpd).
(3) Injection Pressure: Average (daily) 2 0 pounds/square inch (psi).
(4) Injection Temperature: Average (January) 6 5 ° F, Average (July) 6 5 ° F.
K. INJECTION FLUID DATA
(1) Fluid source (for Type 5A7 wells) If underground, from what depth, formation and type of
rock/sediment unit will the fluid be drawn (e.g., granite, limestone, sand, etc.).
Depth: 2 0 0 Formation: qra n i 1- P Rock/sediment unit:
(2) Chemical Analysis of Source Fluid (for Type 5QM wells)
Provide a complete listing of all chemicals added to the circulating heat transfer fluid:
L. INJECTION -RELATED EQUIPMENT
Attach a diagram showing the engineering layout of the injection equipment and exterior piping/tubing
associated with the injection operation. The manufacturer's brochure may provide supplementary
information.
GW-57 HP (Jan, 2000) Page 3 of 4

M. LOCATION OF WELL(S) Attach two maps.
(1) Include a site map (can be drawn) showing: buildings, property lines, 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.
N. PERMIT LIST: Attach a list of all permits or construction approvals 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
O. CERTIFICATION
"I hereby certify, under penalty of law, that 1 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."
ignature f Well Owner or Authorized Agent)
If authorized agent is acting on behalf of the well owner,
please supply a letter signed by the owner authorizing the above agent.
P. CONSENT OF PROPERTY OWNER (Owner means any person who holds the fee or other property
rights in the well being constructed. A well is real property and its construction on land rests
ownership in the landowner in the absence of contrary agreement in writing.)
If the property is owned by someone other than the applicant, the property owner hereby consents to
allow the applicant to construct each injection well as outlined in this application and that it shall be
the responsibility of the applicant to ensure that the injection well(s) conforms to the Well
Construction Standards (Title 15A NCAC 2C .0200)
za fDi? %IU✓/iefi
(Signature Of Property O r If Different From Applicant)
Please return two copies of the completed Application package to:
UIC Program
Groundwater Section
North Carolina DENR-DWQ
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone [phone]
GW-57 HP (Jan, 2000)
Page 4 of 4

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MEMORANDUM
To:
From:
DIVISION OF WATER QUALITY
GROUNDWATER SECTION
June 5, 2001
Matt Heller, L.G., Groundwater Supervisor
Groundwater Section
Mooresville Regional Office
Mark Pritzl Av. [e-mail]
Hydrogeological Technician If
UIC Group
Groundwater Section, Central Office
RECEIVED
JUN 0 7 2001
NC DEPT. OF ENVIRONMENT
AND NATURAL RESOURCES
MOORESVILLE REGIONAL OFFICE
Re: Request review and inspection of a new injection well permit application for the operation
of an open loop geothermal heat pump system.
The CO-UIC has received an application by Todd Adams with Rowan Well Drilling for a new
permit for the construction and operation of 4(four) injection wells located at Catawba College
2300 West Innis Street, Salisbury, NC. The proposed injection wells will be part of an open loop
geothermal heat pump system, therefore type 5A7 wells.
1. Please review the application and submit any comments to CO-UIC. Retain the
Of a Ate p leeL,E
application for your UIC
2. Please inspect the prop
plans submitted in the
standards are being com
Inspection Report -Form
You are requested to return any
Inspection Report -Form (A) to
accomplished by this date, pleas(
in the review and evaluation of ti
or comments at [phone],
cc: UIC Files
Enclosures
( ;Ate (r.k. TeVe\.7-C
rs • iilloet
Q19-7 e5---.67164,
5 z°ot
Lion and construction
Title 15A 2C.0200
9n Injection Facility
in Injection Facility
spection can not be
.iates your assistance
u have any questions

Michael F. Easley
Governor
Williams G. Ross Jr., Secretary
Department of Environment and Natural Resources
Kerr T. Stevens
Division of Water Quality
June 5, 2001
Mr. Todd Adams
4840 Sherrills Ford Road
Salisbury, NC 28147
Dear Mr. Adams:
Your application for a permit to use 4 (four) wells for the injection of geothermal heat
pump effluent has been received and is under review. A member of the Groundwater Section's
Mooresville Regional Office staff will be contacting you to arrange an inspection of the injection
well and collect water samples as part of the review.
If you have any questions regarding the permit or injection well rules please contact me at
[phone] or Meliktu Fanuel at [phone].
cc: CO-UIC Files
MRO-UIC Files
VA
IZEIENR
Customer Service
1 800 623-7748
Sincerely,
1��
Mark Pritzl
Hydrogeological Technician II
Underground Injection Control Program
Division of Water Quality / Groundwater Section
1636 Mail Service Center Raleigh, NC 27699-1636
Phone: [phone] Fax: [phone] Internet: http://gw.ehnr.state.nc.us

COUNTY : ROWAN
QUAD NO:
REPORT TO : MRO
COLLECTOR(S) : M HELLER
DATE: 413/200Z
TIME:
PURPOSE:
LABORATORY ANALYSIS
Regional Office
BOD 310
mg/L
COD High 340
mg/L
COD Low 335
mg/L
X
Coliform: MF Fecal 31616
1 B2 Q1
/100m1
X
Coliform: MFTotal31504
1 B2,Q1
/100m1
TOC
mg/I
Turbitity
NTU
Residue., Suspended 530
-
mg/L
Total Suspended solids
mg/L
pH
units
Alkalinity to pH 4.5
mg/L
Alkalinity to pH 8.3
mg/L
Carbonate
mg/L
Bicarbonate
mg/L
Carbon dioxide
mg/L
Chloride
mg/L.
Chromium: Hex 1032
ug/L
Color: True 80
c.u.
Cyanide 720
mg/L
COMMENTS :
Owner:
Location or Site:
Description of sampling point
Sampling Method:
Remarks:
DIVISION OF WATER QUALITY
Chemistry Laboratory Report / Ground Water Quality
SAMPLE PRIORITY
n ROUTINE
n CHAIN OF CUSTODY
n SAMPLE TYPE
CATAWBA COLLEGF
EMERGENCY
R€ jilt ed
Tors t �' r � �asr
1 f 1
ma
:rna n '`.
APR 2 9 2002
Lab Number : 2G0510
Date Received : 4/4/2002
Time Received : 9:15 AM
Received By : D
EtiCased Bylll:
Date reported : 04/222002
PIC DFPT OF EN r x
°tillNATURAL.i IRI:�PI II; dT
P:t'1AI;Z:Str i r4� a;;/RCES
X
Diss. Solids 70300
88 J2
mg/L
Fluoride 951
mg/L
Hardness: total 900
mg/L
Hardness: (non-carb) 902
mg/L
Phenols 32730
ug/L •
Specific Cond. 95
umhos/cm2
Sulfate
mg/L
Sulfide 745
mg/L
MBAS
mg/L
Oil and Grease
mg/L
Silica
mg/L
Boron
Formaldehyde
mg/L
NH3 as N 610
mg/L
TKN as N 625
mg/L
X
NO2 +NO3 as n 630
0.02U
mg/L
P: Total as P 665
mg/L
PO4
mg/L
Ag-Silver 46566
ug/L
X
Al -Aluminum 46557
580
ug/L
As -Arsenic 46551
ug/L
Ba-Barium 46558
ug/L
X
Ca -Calcium 46552
10
mg/L
Cd-Cadium 46559
ug/L
X
Cr-Chromium 46560
25U
ug/L
X
Cu- Copper 1042
61
ug/L
X
Fe- Iron 1045
1,600
ug/L
Hg- Mercury 71900
ug/L
X
K-Potassium 46555
4.3
mg/L
X
Mg- Magnesium 927
1.1
mg/L
X
Mn-Manganese 1055
34
ug/L
X
Na-Sodium929
18
mg/L
X
Ni-Nickel
10U
ug/L
X
Pb-Lead 46564
11
ug/L
Se -Selenium
ug/L
X
Zn_Zinc 46567
79
ug/L
Organochlorine Pesticides
Organophosphorus Pesticides
Nitrogen Pesticides
Acid Herbicides
Semivolatiles
TPH-Diesel Range
Volatile Organics (VOA bottle)
TPH-Gasoline Range
TPH-BTEX Gasoline Range
2G0510.xls

GROUNDWATER FIELD/LAB FORM
County
Quad No
Lat
/>E.4./ 11
Serial No
Long.
Report To: ARO, FR
WSRO, Kinston FO,
Shipped by: Bus
Collector(s): ,1. fi'/l, Date
FIELD ANALYSES
, RRO, WaRO, WiRO,
Trust, Central Off., Other
Hand Del., Other
PH400 Spec. Cond.94 /70 at 25° C
Temp.10 °C Odor 4 i Y-
Appearance 67e z i ,, // JJ
Field Analysis By: ,s9• /-/e/' /
LABORATORY ANALYSES
cS
BOO, 310 mg/I
COD High 340 mg/I
COD Low 335 mg/I
Coliform: MF Fecal 31616 /100m1
Coliform: MF Total 31504 /100m1
TOC 680 mg/I
Turbidity 76 NTU
Residue., Suspended 530 mg/I
pH 403 units
Alkalinity to pH 4.5 410 mg/I
Alkalinity to pH 8.3 415 mg/I
Carbonate 445. mg/I
Bicarbonate 440 mg/I
Carbon dioxide 405 mg/I
Chloride 940 mg/I
Chromium: Hex 1032 ug/I
Color: True 80 CU
Cyanide 720 mg/1
SAMPLE TYPR
ji-Water
❑ Soil
❑ Other
SAMPLE PRIORITY
.Routine
❑ Emergency
❑ Chain of Custody
North Carolina
Department of Environment, Health, and Natural Resources
DIVISION OF WATER QUALITY - GROUNDWATER SECTION
Lab Number
Date Received Time
Rec'd by:From: Bus ourie Hand Del.,
Other
Data Entry By: Ck•
Date Reported: 6�
J Purpose: '
Time / yr5 Baseline, Complaint, Compliance(birclo One)'
,LUST Pesticide Study, Federal Trust, Other (--
Owner C�7`� r✓f V.,-0-1Location or siteOfC— t)r c lam/,;
Description of sampling point /y�f /-i21.' - i / f e A// e 4„�
Sampling Method ///1/.� I// Sample Interval
Remarks (Pump. bail`, etc.)
/f4 .4 i-,a n / Ur
v(pumping Ilene, au lamp. plc.)
Diss. Solids 70300
Flouride 951
Hardness: Total 900
Hardness (non-carb) 902
Phenols 32730
Specific Cond. 95
Sulfate 945
Sulfide 745
011 and Grease
NH, as N 610
TKN as N 625
NO„ + NO, as N 630
P: Total as P 665
mall
mq/I
mq/I
mq/I
ug/I
uMhos/cm2
mq/I
mg/I
mgll
mq/I
mg/I
mq/I
mq/I
2K
x
Aq - Silver 46566
Al - Aluminum 46557
As - Arsenic 46551 •
Ba - Barium 46558
Ca - Calcium 46552
ug/I
ug/I
uq/I
uq/I
mq/I
Cd - Cadmium 46559 uq/I
Cr - Chromium 46560 uq/I
Cu - Copper 46562 ug/I
Fe - Iron 46563 ug/I
Hg - Mercury 71900 ug/I
K - Potassium 46555 ' mg/I
Mg - Magnesium 46554 mg/1
Mn - Manganese 46565 ug/I
Na - Sodium 46556
mg/I
Ni - Nickel ug/I
Pb - Lead 46564 uq/I
Se - Selenium ug/I
Zn - Zinc 46567 ug/I
Organochlorine Pesticides
Organophosphorus Pesticides
Nitrogen Pesticides
Acid Herbicides
PCB's
Semivolatile Organics
TPH - Diesel Range
Volatile Organics (VOA bottle)
TPH - Gasoline Range
TPH - BTEX Gasoline Range
Lab Comments:
GW-54 REV. 7/9r For Dissolved Analysis - submit filtered sample and write "DIS" in blo

NC DENR/DWQ Chemistry Laboratory
Report to: 4Sample Anomaly Report (SAR)
Lab Number:
Station Location:
[r 05/6
c41fJb C /l
S.ample Type: tii Priority: 41i.01/f 7;Le,-
Date collected: Y 13 /(,} 2- p Date received: / / 6�
Affected Parameter(s): 7 1 Jz ,
Analytical Area (check one):
WCH
O NUT
/$�) /ece /80
❑ METALS
O MICRO
The following anomalies occurred (check all that apply):
❑ Samples
❑ Improper container used
❑ VOA vials with headspace
❑ Sulfide samples with headspace
❑ Samples not received, but listed on fieldsheet
❑ Samples received, but not listed on fieldsheet
❑ Mislabeled as to tests, preservatives, etc.
❑ Holding time expired
❑ Prior to receipt in lab
❑ After receipt in lab
❑ Insufficient quantity for analysis
❑ Sample exhibits gross non -homogeneity
❑ Sample not chemically preserved properly
❑ pH out of range (record pH):
❑ Improper chemical
❑ Residual chlorine present in sample
❑ Color interference
❑ Heavy emulsion formed during extraction
❑ Sample bottle broken in lab - no reportable results
❑ VOA
❑ PEST
Sample ID:
County: 1&/,a(,i;yt Region: /&
Collector: )44
Date analyzed: 2/ / 5 /
❑ SVOA
Quality Control
❑ Instrument failure — no reportable results
❑ Analyst error — no reportable results
❑ Surrogates
❑ None added
❑ Recovery outside acceptance limits
❑ Spike recovery
❑ None added
❑ Recovery outside acceptance limits
❑ Failed to meet criteria for precision
❑ Internal standards
❑ Blank contamination
fd; QC data reported outside of controls (i.e. QCS, LCS)
❑ Incorrect procedure used
❑ SOP intentionally modified with QA and Branch Head
approval
❑ Invalid instrument calibration
❑ Elevated detection limits due to:
❑ Insufficient sample volume
❑ Other (specify):
Comments:
Corrective Action:
o Samples were rejected by DWQ Lab. Authorized by: Date: / /
❑ Accepted and analyzed after notifying the collector or contact person and determining that anothersamplecould not be secured...
❑ Sample(s) on hold until:
111 Sample reported with qualification. Data qualification code used: 'I-)
❑ Other (explain):
Notification Required (circle one)? Yes No
Person Contacted:
Lead Chemist Rev' (0
BIOCHEM (( 0 PEST
METALS / ❑ VOA
Form completed by: (/ / "/.44vi
Date:
Date: /_ / o ,
0 SVOA
Brancih Head Review (initi
QA/QC Review (init I): Logged into database by (initial):
QA1Form:LLsboratory\S AR
tan3/otabs

COUNTY : ROWAN
QUAD NO:
REPORT TO : MRO
COLLECTOR(S) : M HELLER
DATE: 4/3/2002
TIME:
PURPOSE:
LABORATORY ANALYSIS
Regional Office
BOD 310
mg/L
COD High 340
mg/L
COD Low 335
mg/L
X
Coliform:MF Fecal 31616
1 B2 Q1
/100m1
X
Coliform: MF Total 31504
1 B2,Q1
/100m1
TOC
mg/1
Turbitity
NTU
Residue., Suspended 530
mg/L
Total Suspended solids
mg/L
pH
units
Alkalinity to pH 4.5
mg/L
Alkalinity to pH 8.3
mg/L
Carbonate
mg/L
Bicarbonate
mg/L
Carbon dioxide
mg/L
Chloride
mg/L
Chromium: Hex 1032
ug/L
Color: True 80
c.u.
Cyanide 720
mg/L
COMMENTS :
Owner:
Location or Site:
Description of sampling point
Sampling Method:
Remarks:
DIVISION OF WATER QUALITY
Chemistry Laboratory Report / Ground Water Quality
SAMPLE PRIORITY
n ROUTINE
n CHAIN OF CUSTODY
APR 2 9 2002
n SAMPLE TYPE
NC DEPT. OF ENVIROMENT
CATAWBA COLLEGE AND NATURAL RESOURCES
• +RESVILE REGIONAL OFFICE
EMERGENCY
It)) t5e_6/
Lab Number : 2G0511
Date Received : 4/4/2002
Time Received : 9:15 AM
Received By • DS
�iS /v a)
Released y A
Date reported : 4/22/2002
X
Diss. Solids 70300
480 J2
mg/L
Fluoride 951
mg/L
Hardness: total 900
mg/L
Hardness: (non-carb) 902
mg/L
Phenols 32730
ug/L
Specific Cond. 95
umhos/cm2
Sulfate
mg/L
Sulfide 745
mg/L
MBAS
mg/L
Oil and Grease
mg/L
Silica
mg/L
Boron
Formaldehyde
mg/L
NH3 as N 610
mg/L
TKN as N 625
mg/L
X
NO2 +NO3 as n 630
0.12
mg/L
P: Total as P 665
mg/L
PO4
mg/L
CEiVE
Ag-Silver 46566
ug/L
X
Al -Aluminum 46557
780
ug/L
As -Arsenic 46551
ug/L
Ba-Barium 46558
ug/L
X
Ca -Calcium 46552
130
mg/L
Cd-Cadium 46559
ug/L
X
Cr-Chromium 46560
25U
ug/L
X
Cu- Copper 1042
2.OU
ug/L
X
Fe- Iron 1045
56
ug/L
Hg- Mercury 71900
ug/L
X
K-Potassium 46555
2.4
mg/L
X
Mg- Magnesium 927
4.4
mg/L
X
Mn-Manganese 1055
14
ug/L
X
Na- Sodium 929
17
mg/L
X
Ni-Nickel
10U
ug/L
X
Pb-Lead 46564
10U
ug/L
Se -Selenium
ug/L
X
Zn_Zinc46567
320
ug/L
Organochlorine Pesticides
Organophosphorus Pesticides
Nitrogen Pesticides
Acid Herbicides
Semivolatiles
TPH-Diesel Range
Volatile Organics (VOA bottle)
TPH-Gasoline Range
TPH-BTEX Gasoline Range
2G0511.xls

GROUNDWATER FIELD/LAB FORM
County
Quad No Serial No
Lat. Long.
Report To: ARO, FR R RO, WaRO, WiRO,
WSRO, Kinston FO, Fd.Trust, Central Off., Other
Shipped by: Bus,
A LE SAMPLE PRIORITY
ater,Routine
❑ Soil 0 Emergency
❑ Other
0 Chain of Custody
and Del., Other
Collector(s): /�%c/%P� Date
FIELD ANALYSES
pH400 `/ 6 Spec. Cond.94
Temp.10 / 7. °C Odor
Appearance t /ems r_
Field Analysis By -
LABORATORY . ANALYSES
2.
/17 at25°C
BOD, 310
COD High 340
COD Low 335
Coliform: MF Fecal 31616
mg/1
mg/I
mg/I
/100m1
Coliform: MF Total 31504 /100m1
TOC 680
Turbidity 76
Residue., Suspended 530
mg/I
NTU
mg/1
pH 403 units
Alkalinity to pH 4.5 410 mg/I
Alkalinity to pH 8.3 415 mg/I
Carbonate 445
Bicarbonate 440
Carbon dioxide 405
Chloride 940
mg/I
mg/I
mg/I
mg/I
Chromium: Hex 1032 ug/I
Color: True 80 CU
Time Baseline, Complaint, Com liance ,LUST, Pesticide Study, Federal Trust, Other
� (6ucle ena)
Owner l�t/fa 4/4 �6A/,rYr-
Location or site U/e -' i`�.<,--74-
Description of sampling point 4c—fX/, -e-.174- ( ) • ✓e7/ f-/
Sampling Method c.
���
Remarks �.y, /�, vQ �� ° gates, at
/``/(pumping time. air temp. etc.)
Purpose: '
North Carolina
Department of Environment, Health, and Natural Resources
DIVISION OF WATER QUALITY - GROUNDWATER SECTION
Lab Number
Date Receiv
Rec'd by
Other
Data Entry By: Ck•
Date Reported:
Sample Interval
Diss. Solids 70300
Flouride 951
Hardness: Total 900
Hardness (non-carb) 902
Phenols 32730
Specific Cond. 95
Sulfate 945
Sulfide 745
011 and Grease
NH, as N 610
TKN as N 625
NO2 + NOa as N 630
P: Total as P 665
mn/I
mq/I
mq/I
mq/I
ug/I
uMhos/cm2
mq/I
mg/1
mg/1.
mq/I
mg/I
mq/I
mq/I
24.
x
7C
Aq - Silver 46566
Al - Aluminum 46557
As - Arsenic 46551 '
Ba - Barium 46558
Ca - Calcium 46552
uq/I
ug/I
uq/I
ug/I
mq/I
Cd - Cadmium 46559 uq/I
Cr - Chromium 46560
uq/I
Cu - Copper 46562 ug/I
Fe - Iron 46563 ug/I
Hg - Mercury 71900 ug/I
K - Potassium 46555 mg/I
Mg - Magnesium 46554 mg/I
Mn -Manganese 46565 ug/I
Na - Sodium 46556 mg/I
Ni - Nickel ug/I
Pb - Lead 46564 ug/I
Se - Selenium ug/I
Zn - Zinc 46567 ug/I
Cyanide 720 mg/I
Lab Comments:.
Organochlorine Pesticides
Organophosphorus Pesticides
Nitrogen Pesticides
Acid Herbicides
PCB's
Semivolatile Organics
TPH - Diesel Range
Volatile Organics (VOA bottle)
TPH - Gasoline Range
TPH - BTEX Gasoline Range
ryl
GW-54 REV. 7/9r For Dissolved Analysis - submit filtered sample and write "DIS" in blo

:Report to:
rr P
Lab Number: Lk- 6511 Sample ID:
Station Location: e4ti64 CD County: Je1-frtia-I'l ✓ Region:
Sample Type: �IJGfX�t/ Priority: , l) 'f4,Pi Collector: /�np
• l
Date collected: 17t / 3 / 02 Date received: 4 / y / DZ Date analyzed:II
j
Affected Parameter(s): J N I
NC DENR/DWQ Chemistry Laboratory
Sample Anomaly Report (SAR)
Ana ytical Area (check one):
WCH 0 METALS
❑ NUT 0 MICRO
The following anomalies occurred (check all that apply):
❑ Samples
❑ Improper container used
❑ VOA vials with headspace
❑ Sulfide samples with headspace
❑ Samples not received, but listed on fieldsheet
❑ Samples received, but not listed on fieldsheet
❑ Mislabeled as to tests, preservatives, etc.
❑ Holding time expired
❑ Prior to receipt in lab
❑ After receipt in lab
❑ Insufficient quantity for analysis
❑ Sample exhibits gross non -homogeneity
❑ Sample not chemically preserved properly
❑ pH out of range (record pH):
❑ Improper chemical
❑ Residual chlorine present in sample
❑ Color interference
❑ Heavy emulsion formed during extraction
❑ Sample bottle broken in lab - no reportable results
❑ Other (specify): •
❑ VOA
❑ PEST
❑ SVOA
Quality Control
❑ Instrument failure — no reportable results
❑ Analyst error — no reportable results
❑ Surrogates
❑ None added
❑ Recovery outside acceptance limits
❑ Spike recovery
❑ None added
❑ Recovery outside acceptance limits
❑ Failed to meet criteria for precision
❑ Internal standards
❑ Blank contamination
QC data reported outside of controls (i.e. QCS, LCS)
❑ Incorrect procedure used
❑ SOP intentionally modified with QA and Branch Head
approval
❑ Invalid instrument calibration
❑ Elevated detection limits due to:
❑ Insufficient sample volume
comments:',VQ,R, 11Tkotnia`57(0 Ol Rae." —��. 6-)
Corrective Action:
❑ Samples were rejected by DWQ Lab. Authorized by: Date: / /
❑ Accepted and analyzed after notifying the collector or contact person and determining that another sample could not be secured.
❑ Sample(s) on hold until:
• Sample reported with qualification. Data qualification code used: J) '
❑ Other (explain): 1
Notification Required (circle one)? Yes No
Person Contacted: /' g�,,n Date:
V /"'�""'
Form completed by: l Date: , P
Lead Chemist Revie (initial): ❑ SVOA
BIOCHEM4.0 0 ?EST
b METALS 0 VOA
Branch Head Review (initia
QA/QC Review (initia
Logged into database by (initial):
I a,2_vo I dbs
Q A1FocrnaaboatorASAR

MEMORANDUM
To:
From:
DIVISION OF WATER QUALITY
GROUNDWATER SECTION
June 22, 2001
Matt Heller, L.G., Groundwater Supervisor
Groundwater Section
Mooresville Regional Office
Mark Pritzl ( '. [e-mail]
Hydrogeological Technician II
Underground Injection Control (UIC) Group
Central Office (CO)
RECEIVED
JUN 2 7 2001
NC DEPT. OF ENVIRONMENT
AND NATURAL RESOURCES
RMOORESVILLE REGIONAL OFFICE
Re: Request for inspection and sample collection of Catawba College's geothermal injection
well system. This system is located at 2300 West Innes Street, Salisbury, NC.
1. Inspect the injection well site to verify that the location and construction plans
submitted in the application are accurate and the NCAC Title 15A 2C .0200 standards are
being complied with, using the enclosed Injection Facility Inspection Report (form B) as
appropriate.
2. Collect samples from the influent and effluent sampling ports and submit the results to
the CO-UIC Group.
You are requested to return the completed Injection Facility Inspection Report (form B) to
the CO-UIC by July 31, 2001. If the inspection can not be accomplished by this date,
please inform the CO-UIC group. The UIC group greatly appreciates Susie Caldwell's
assistance with this review. If you have any questions regarding this review or the UIC
program, please contact me at [phone] or Meliktu Fanuel [phone].
qla/co r 6,1% 4,
cc: UIC Files
Enclosure

Michael F. Easley
Governor
Williams G. Ross Jr., Secretary
- Department of Environment and Natural Resources
Kerr T. Stevens
Division of Water Quality
June 20, 2001
Dr. Kenneth W. Clapp
Catawba College
2300 West Innes Street
Salisbury, NC 28144
Dear Dr. Clapp:
In accordance with your application submitted on your behalf by Rowan Well Drilling dated May
30, 2001, we are forwarding Permit No. WT0300052 for the construction and operation of a
geothermal heat pump injection system at 2300 West Innes Street, Salisbury, North Carolina, in
Rowan County. Water samples will be taken at the influent and effluent sampling ports of this
geothermal heat pump system after construction is complete. Please note, if these sample results
exceed groundwater quality standards, it is the well owner's responsibility to take corrective
action as stated in Title 15A Subchapter 2C, Section .0206.
This permit shall be effective from the date of issuance until June 30, 2006, and shall be subject to
the conditions and limitations stated therein. In accordance with NCAC Title 15A, Subchapter 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 the GW-1 form and this form is enclosed for your convenience.
If you have any questions regarding your permit please feel free to contact me at [phone]
or Meliktu Fanuel at [phone].
cc: CO-UIC Files
MRO-UIC Files
Enclosures
ATA
NCbENR
Customer Service
1 800 623-7748
Sincerely,
tais04
Mark Pritzl
Hydrogeological Technician II
Underground Injection Control Program
Division of Water Quality / Groundwater Section
1636 Mail Service Center Raleigh, NC 27699-1636
Phone: [phone] Fax: [phone] Internet: http://gw.ehnr.state.nc.us

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE CONSTRUCTION AND OPERATION OF A WELL FOR INJECTION
In accordance with the provisions of Article 7, Chapter 87; Article 21, Chapter 143, and
other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Catawba College
FOR THE CONSTRUCTION AND OPERATION OF A TYPE 5A7 INJECTION WELL,
defined in Title 15A North Carolina Administrative Code 2C .0209(e)(3)(A), which will be used
for the injection of heat pump effluent. This system is located at 2300 West Innes Street,
Salisbury, North Carolina, in Rowan County, and will be constructed and operated in accordance
with the application dated June 1, 2001, 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 June 30, 2006,
and shall be subject to the specified conditions and limitations set forth in Parts I through X
hereof.
Permit issued this the ' day of , 2001.
Ted L. Bush, Jr., Assistant Chief
k Groundwater Section
Division of Water Quality
By Authority of the Environmental Management Commission.
Permit No. WI0300052 PAGE 1 OF 6
GW/UIC-5 March 28, 2001

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 permit shall become voidable unless the facility is constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other supporting data.
3. Each injection well shall not hydraulically connect separate aquifers.
4. Each injection well shall be constructed in such a manner that water from land surface
cannot migrate into the gravel pack or well screen.
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 the Division of Water Quality (Division), within 30 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].
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.
Permit No. WI0300052
GW/UIC-5 March 28, 2001
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 30 days prior to the date of the change.
3. The issuance of this permit shall not relieve the Permittee of the responsibility of
complying with any and all statutes, rules, regulations, or ordinances which may be
imposed by other local, state, and federal agencies which have jurisdiction. Furthermore,
the issuance of this permit does not imply that all regulatory requirements have been met.
PART IV - PERFORMANCE STANDARDS
1. The injection facility shall be effectively maintained and operated at all times so that there
is no contamination of groundwater 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 of this permit
even if compliance requires a reduction or elimination of the permitted activity.
3. The issuance of this permit shall not relieve the Permittee of the responsibility for damages
to surface or groundwater resulting from the operation of this facility.
PART V - OPERATION AND MAINTENANCE REQUIREMENTS
1. The injection facility shall be properly maintained and operated at all times.
2. The Permittee must notify the Division and receive prior written approval from the
Director of any planned physical alterations or additions in the permitted facility or activity
not specifically authorized by the permit.
3. At least forty-eight (48) hours prior to the initiation of the operation of the facility for
injection, the Permittee must notify by telephone the 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. WI0300052
GW/UIC-5 March 28, 2001
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.
2. Department representatives shall have reasonable access for purposes of inspection,
observation, and sampling associated with injection and any related facilities as provided
for in N.C.G.S. 87-90.
3. Provisions shall be made for collecting any necessary and appropriate samples associated
with the injection facility activities.
PART VII - MONITORING AND REPORTING REQUIREMENTS
1. Any monitoring (including groundwater, surface water, or soil sampling) deemed necessary
by the Division of Water Quality to insure surface and ground water protection, will be
established and an acceptable sampling reporting schedule shall be followed.
2. The Permittee shall report by telephone, within 48 hours of the occurrence or first
knowledge of the occurrence, to the Mooresville Regional Office, telephone number (704)
663-1699, 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. WI0300052 PAGE 4 OF 6
GW/UIC-5 March 28, 2001

PART VIII - 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
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.
2. When operations have ceased at the facility and a well will no longer be used for any
purpose, the Permittee shall abandon that injection well in accordance with the procedures
specified in 15A NCAC 2C .0214, including but not limited to the following:
(A) All casing and materials may be removed prior to initiation of
abandonment procedures if the Director finds such removal will not be
responsible for, or contribute to, the contamination of an underground
source of drinking water.
(B) The entire depth of each well shall be sounded before it is sealed to insure
freedom from obstructions that may interfere with sealing operations.
(C) Each well shall be thoroughly disinfected, prior to sealing, if the Director
determines that failure to do so could lead to the contamination of an
underground source of drinking water.
(D) Each well shall be completely filled with cement grout, which shall be
introduced into the well through a pipe which extends to the bottom of the
well and is raised as the well is filled.
(E) In the case of gravel -packed wells in which the casing and screens have
not been removed, the casing shall be perforated opposite the gravel pack,
at intervals not exceeding 10 feet, and grout injected through the
perforations.
(F) In those cases when, as a result of the injection operations, a subsurface
cavity has been created, each well shall be abandoned in such a mariner
Permit No. WI0300052
GW/UIC-5 March 28, 2001
PAGE 5 OF 6

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 IX (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
Water samples will be taken at the influent and effluent sampling ports from the
geothermal heat pump system after construction is complete. If the sample results reveal
violation(s) of groundwater standards, it is the well owner's responsibility to take
corrective action as stated in Title 15A North Carolina Administrative Code 2C .0206. In
addition, the well owner shall take immediate actions including those actions that may be
required by the Division of Water Quality such as repair, modification, or abandonment of
the injection facility.
Permit No. WI0300052
GW/UIC-5 March 28, 2001
PAGE 6 OF 6