WI0300114_Regional Office Historical File Pre 2018

1
MCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director `t r,:�'aSecretary
December 14, 2011
Ivan and C. Vianne W. Howitt
9524 Glenwater Dr.
Charlotte, NC 28262
Ref: Issuance of Injection Well Permit W10300114
Issued to Ivan and C. Vianne W. Howitt
Charlotte, Mecklenburg County
Dear Mr. and Mrs. Howitt:
DEC 222011
In accordance with the application received on December 5, 2011, I am forwarding permit number WI030014 for
the continued operation of a vertical closed -loop geothermal mixed -fluid heat pump injection well system located at
the above referenced address. This permit shall be effective from the date of issuance until November 30, 2016,
and shall be subject to the conditions and limitations stated therein.
NOTE: During the renewal process for this permit, it was noted that the following records were not submitted
when the geothermal wells were originally installed.
• Well Construction Record (GW-1)
• Triangulation Data
• Mechanical Integrity Pressure testing data (if available)
After installation, these records were required to be submitted according to requirements of 15A NCAC 2C
.0213(g) 30 days after your permit was originally issued April 9, 2007. Please submit these documents within 30
days of receipt of this permit renewal. If you are not able to provide us with the information, please submit to us a
written justification for the missing information.
Also, please pay special attention to Part V.2. The Permittee shall retain all records of repairs, pressure
tests, maintenance, and other activities needed to maintain normal operating conditions.
In order to continue uninterrupted legal use of the injection facility for the stated purpose, you must submit an
application to renew the permit 120 days prior to its expiration date. This permit is not transferable to any person
without prior notice to and approval by the Director of the Division of Water Quality.
AQUIFER PROTECTION SECTION
1636 Mail Service Center, Raleigh, North Carolina 27699-1636
Location: 2728 Capital Boulevard. Raleigh. North Carolina 27604
Phone: [phone] \ FAX 1: 919-715-0588: FAX 2: 919-715-6048 \ Customer Service: 1-87 7 -623-6748
internee www.ncwateraualitv.orq
iN Of. f l L-STC I na
uuai ODDcaunn , Affirmative ...MITI Employe,

Please contact me at [phone] or michael.roaersna,ncdenr.aov if you have any questions about your permit.
Best Regards,
Michael Rogers, P.G. (NC & FL)
cc: Irardre Griner 14^Tt�o'P're's?il i7011
WI0300114 Permit File
Mecklenburg County Environmental Health Dept.

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE OPERATION OF A WELL FOR INJECTION
In accordance with the provisions of Article 7, Chapter 87; Article 21, Chapter 143, and other applicable
Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Ivan and C. Vianne W. Howitt
FOR THE OPERATION OF 7 (SEVEN) TYPE 5QM INJECTION WELL(S), defined in Title 15A North
Carolina Administrative Code 2C .0209(e)(3)(F), for the purpose of operating a vertical closed -loop
geothermal -mixed -fluid heat pump system. This system is located at 9524 Glenwater Dr., Charlotte,
Mecklenburg County, NC 28262, and will be constructed and operated in accordance with the application
received December 5, 2011, and in conformity with the specifications and supporting data submitted, all of
which are filed with the Depai tnient of Environment and Natural Resources and are considered a part of this
permit.
This permit is for operation of an injection well and shall be in compliance with Title 15A North Carolina
Administrative Code 2C .0100 and .0200, and any other Laws, Rules, and Regulations pertaining to well
construction and use.
This permit shall be effective, unless revoked, from the date of its issuance until November 30, 2016, and shall
be subject to the specified conditions and limitations set forth in Parts I through VII hereof.
Permit issued this the 14th day of December 2011.
2
Coleen H. Sullins, Direetor%��� 1�%"', V
Division of Water Quality
By Authority of the Environmental Management Commission.
WI03001 1 4
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Version 1/2010
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PART I — OPERATION AND USE GENERAL CONDITIONS
1. This permit is effective only with respect to the nature, volume of materials and rate of injection, as
described in the application and other supporting data.
2. This permit is not transferable without prior notice to, and approval by, the Director of the Division of
Water Quality (Director). In the event there is a desire for the facility to change ownership, or there is a
name change of the Permittee, a formal permit amendment request must be submitted to the Director,
including any supporting materials as may be appropriate, at least 30 days prior to the date of the change.
3. The issuance of this permit shall not relieve the Permittee of the responsibility of complying with any and
all statutes, rules, regulations, or ordinances, which may be imposed by other local, state, and federal
agencies, which have jurisdiction. Furthermore, the issuance of this permit does not imply that all
regulatory requirements have been met.
4. In the event that there are multiple wells with separate clusters, one well identification tag per `cluster' of
wells shall be permanently affixed to the heating and cooling unit or other nearby permanently fixed
location in a clearly visible location according to 2C .0213(g).
PART II — PERFORMANCE STANDARDS
1. The injection facility shall be effectively maintained and operated at all times so that there is no
contamination of groundwater that will render it unsatisfactory for normal use. In the event that the
facility fails to perform satisfactorily, including the creation of nuisance conditions or failure of the
injection zone to adequately assimilate the injected fluid, the Permittee shall take immediate corrective
actions including those actions that may be required .by the Division of Water Quality such as the repair,
modification, or abandonment of the injection facility.
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 peiniit shall not relieve the Permittee of the responsibility for damages to surface or
groundwater resulting from the operation of this facility.
PART III — OPERATIONS AND MAINTENANCE REQUIREMENTS
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.
.t_5..tt01
t la
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PART IV - INSPECTIONS
1. Any duly authorized officer, employee, or representative of the Division of Water Quality may, upon
presentation of credentials, enter and inspect any property, premises, or place on or related to the injection
facility at any reasonable time for the purpose of determining compliance with this permit, may inspect or
copy any records that must be maintained under the terms and conditions of this permit, and may obtain
samples of groundwater, surface water, or injection fluids.
2. Department representatives shall have reasonable access for purposes of inspection, observation, and
sampling associated with injection and any related facilities as provided for in N.C.G.S. 87-90.
3. Provisions shall be made for collecting any necessary and appropriate samples associated with the
injection facility activities.
PART V — MONITORING AND REPORTING REQUIREMENTS
1. Any monitoring (including groundwater, surface water, or soil sampling) deemed necessary by the
Division of Water Quality to insure surface and ground water protection, will be established and an
acceptable sampling reporting schedule shall be followed.
2. The Permittee shall retain all records of repairs, pressure tests, maintenance, and other activities
needed to maintain normal operating conditions.
3. The Permittee shall report by telephone, within 48 hours of the occurrence or first knowledge of the
occurrence, to the Mooresville Regional Office, telephone number 704-663-1699, any of the following:
(A) Any occurrence at the injection facility that results in any unusual operating circumstances;
(B) Any failure due to known or unknown reasons that renders the facility incapable of proper
injection operations, such as mechanical or electrical failures;
4. Where the Permittee becomes aware of an omission of any relevant facts in a permit application, or of any
incorrect information submitted in said application or in any report to the Director, the relevant and
correct facts or information shall be promptly submitted to the Director by the Permittee.
5. In the event that the permitted facility fails to perform satisfactorily, the Permittee shall take such
immediate action as may be required by the Director.
PART VI — PERMIT RENEWAL
The Permittee shall, at least 120 days prior to the expiration of this permit, request an extension.
WI0300 I4
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PART VII — CHANGE OF WELL STATUS
1. The Permittee shall provide written notification within 15 days of any change of status of an injection
well. Such a change would include the discontinued use of a well for injection. If a well is taken
completely out of service temporarily, the Permittee must install a sanitary seal. If a well is not to be used
for any purpose that well must be permanently abandoned according to 15A NCAC 2C .0213(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 manner that will prevent the movement of
fluids into or between underground sources of drinking water and in accordance with the
teinis and conditions of the permit.
(G) The Permittee shall submit a Well Abandonment Record (Form GW-30) as specified in
15A NCAC 2C .0213(h)(1) within 30 days of completion of abandonment.
3. The written documentation required in Part VII (1) and (2) (G) shall be submitted to:
Aquifer Protection Section-UIC Program
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
WI03001 14
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North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins . — es reman
Governor Director ! r retary
R.) I
r
December 6, 2011
Ivan Howitt
C. Vianne W. Howitt
9524 Glenwater Drive
Charlotte, NC 28262
Dear Mr. and Mrs. Howitt:
DEC 7 201i
,r DEPIR MRQ
- Aquifer Protection
Subject: Acknowledgement of
Application No. WI0300114
Ivan & C. Vianne Howitt SFR
Injection Mixed Fluid GSHP
Well (5QM) System
Mecklenburg County
The Aquifer Protection Section acknowledges receipt of your permit application and supporting
documentation received on December 5, 2011. Your application package has been assigned the number
listed above, and the primary reviewer is Michael Rogers.
Central and Mooresville Regional Office staff will perform a detailed review of the provided
application, and may contact you with a request for additional information. To ensure . maximum
efficiency in processing permit applications, the Aquifer Protection Section requests your assistance in
providing a timely and complete response to any additional information requests.
Please note that processing standard review permit applications may take as long as 60 to 90 days
after receipt of a complete application. If you have any questions, please contact
Michael Rogers at [phone] or [e-mail].
Sincerely,
for Debra J. Watts
Groundwater Protection Unit Supervisor
cc: Mooresville resvislle Regional Office. er xrxr ctlon :ectioxr
Permit File WI0300114
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; FAX2: 919-715-6048 \ Customer Service: 1-87 7-623-6748
Internet: www.ncwateraualitv.orq
An Equal Opportunity \ Affirmative Action Employer
One
NorthCaralna
atu

North- Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Ivan Howitt
9524 Glenwater Drive
Charlotte, NC 28262
Division of Water Quality
Coleen H. Sullins
Director
November 1, 2011
Subject: Notice of Expiration (NOE)
5QM Geothermal Injection Well
Permit No. WI0300114
Mecklenburg County
Dear Mr. Howitt:
Dee Freeman
Secretary
Pjr-. Icx
NOV - 2 2011
The Underground Injection Control (UIC) Program of the North Carolina Division of Water
Quality (DWQ) is entrusted to protect the groundwater quality and resources of the State of
North Carolina, and is responsible for the regulation of injection well construction and operation
activities within the state. Our records indicate that the above -referenced operating permit for
the underground injection well system located on your property at 9524 Glenwater Drive, in
Charlotte, NC, which was issued to you on April 9, 2007, and expires on March 31, 2012, is soon
due for renewal. If you wish to keep this permit and operate the injection well system, the permit
must be renewed and issued in your name.
If Your Injection Well is Currently Inactive:
If the injection well system is no longer being used for any purpose, it must be permanently
abandoned according to the regulatory requirements listed under NCAC Title 15A, Subchapter
2C, Section .0214. When each well is plugged and abandoned, the well abandonment record
(Form GW-30) must be submitted to our office to certify that the abandonment was properly
conducted.
If there has been a change of ownership of the property, an Injection Well Permit
Name/Ownership Change Form must also be submitted. The GW-30 and Name/Ownership
Change forms can be found at http://portal.ncdenr.org/web/wq/aps/gwpro/reporting-foums.
If Your Injection Well is Currently Active:
If the injection well system is still active and you wish to renew your permit, the renewal
application must be submitted within 120 calendar days of the expiration of your permit.
According to our records, you must submit your permit renewal by December 2, 2011.
AQUIFER PROTECTION SECTION
1636 Niail 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.ncwateraualitv.ora
An Equal Opportunity \ Affirmative .Action Employer
One
North Carolina

In order to comply with the regulatory requirements listed under North Carolina Administrative
Code (NCAC) Title 15A, Subchapter 2C, Section .0211, you must submit one of the following
enclosed forms:
A. Application for Permit (Renewal) to Construct and/or Use a Well(s) for Injection with
Geothermal Heat Pump System for Type 5QM Well(s) if the injection well system on
your property is still active.
-OR-
B. Status of Injection Well System if the injection well system is inactive or has been
temporarily or permanently abandoned.
Please submit the appropriate forms to:
Aquifer Protection Section
Groundwater Protection Unit
UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Failure to submit these forms in a timely manner may result in the assessment of civil penalties
in accordance with North Carolina General Statute 87-94. For your convenience, a renewal
application and a UIC well system status form are attached along with a self-addressed envelope.
The above referenced forms are also available on-line at the DWQ website at
http://portal.ncdenr. orQ/web/wq/aps/gwpro/p ermit-applications#geothermApps.
Thank you in advance for your cooperation and timely response. If you have any questions,
please contact me by phone at [phone] or by email at eric.u.smithna.ncdenr.gov.
Sincerely,
6" y j
Eric G. Smith, P.G.
Hydrogeologist
Enclosures
cc: Mooresville Regional Office - APS w/o enclosures
APS Central Files - Permit No. WI0300114 w/o enclosures

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
April 9, 2007
Ivan and C. Vianne Howitt
9524 Glenwater Drive
Charlotte, NC 28262
Re: Issuance of Injection Well Permit
Permit No. WI0300114
Issued to Ivan and C. Vianne Howitt
Dear Mr. and Mrs. Howitt:
0 1 3 2007
NC "DENR M o0
DWQ -A 'uifer Protection
In accordance with your application received February 26, 2007, I am forwarding Permit No.
WI0300114 for the operation of a vertical closed -loop geothermal mixed -fluid heat pump
injection well system to be located at 9524 Glenwater Drive, Charlotte, Mecklenburg County,
North Carolina 28262. This permit shall be effective from the date of issuance until March 31,
2012, and shall be subject to the conditions and limitations stated therein.
Pay special attention to the well construction standards in Parts II and V of your permit.
You must notify this office (Raleigh Central Office) and the Mooresville Regional Office at least
forty-eight (48) hours prior to constructing the system, and forty-eight (48) hours prior to
initiation of the operation of the system.
In order to continue uninterrupted legal use of this well for the stated purpose, you should submit
an application to renew the permit three months prior to its expiration date. As indicated in the
permit, this permit is not transferable to any person without prior notice to, and approval by, the
Director of the Division of Water Quality. If you have any questions regarding your permit or
the Underground Injection Control Program please call Mr. Qu Qi at [phone] or me at
[phone].
Best Regards,
Michael Rogers
Environmental Specialist II
cc: drew Pt_ner = Mooresville Regonal`Offic
Central Office File — WI0300114
Andrew Messer — Effecta Solutions
Attachment(s)
Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636
Internet: http://www.ncwaterquality.org 2728 Capital Boulevard Raleigh, NC 27604
An Equal Opportunity/Affirmative Action Employer— 50% Recycled/10% Post Consumer Paper
NorthCarolina
Naturally
Telephone: [phone]
Fax 1: [phone]
Fax 2: [phone]
Customer Service: [phone]

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
Ivan and C. Vianne Howitt
FOR THE CONSTRUCTION AND OPERATION OF 7 TYPE 5QM INJECTION WELLS,
defined in Title 15A North Carolina Administrative Code 2C .0209(e)(3)(F), for the purpose of
operating a "direct expansion" type vertical closed -loop geothermal -mixed -fluid heat pump
system. This system is located at 9524 Glenwater Drive, Charlotte, Mecklenburg County, North
Carolina, and will be constructed and operated in accordance with the application received
February 26, 2007, and in conformity with the specifications and supporting data submitted, all
of which are filed with the Department of Environment and Natural Resources and are
considered a part of this permit.
This permit is for Construction and Operation only and does not waive any provisions of the
Water Use Act or any other applicable Laws, Rules, or Regulations. Operation and use of an
injection well shall be in compliance with Title 15A North Carolina Administrative Code 2C
.0100 and .0200, and any other Laws, Rules, and Regulations pertaining to well construction and
use.
This permit shall be effective, unless revoked, from the date of its issuance until March 31, 2012,
and shall be subject to the specified conditions and limitations set forth in Parts I through IX
hereof.
4
Permit issued this the 9" day of G'Q(y \. , 2007.
ao,v,
Alan W. Klimek, Director
Division of Water Quality
By Authority of the Environmental Management Commission.
Permit No. WI0300114
Page 2

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 not be located in an area generallysubject to flooding. Areas that
are generally subject to flooding include those with concave slope, alluvial or colluvial
soils, gullies, depressions, and drainage ways.
5. Each injection well shall be secured to reasonably insure against unauthorized access and
use. Each well shall be permanently labeled with a warning that it is for injection purposes
and the entrance to each well must be secured with a locking cap.
6. Each injection well shall be afforded reasonable protection against damage during
construction and use.
7. Each injection well shall have permanently affixed an identification plate.
8. A completed Well Construction Record (Form GW-1) must be submitted for each injection
well to: DENR-Division of Water Quality, Aquifer Protection Section UIC-Staff, 1636
Mail Service Center, Raleigh, NC 27699-1636, within 30 days of completion of well
construction.
PART II - WELL CONSTRUCTION SPECIAL CONDITIONS
1. Prior to constructing the injection well system, the Permittee or his agent shall test the pH of
the soil at a depth of three feet at the planned well location. If the resulting soil pH is less
than 6 standard units or greater than 11 standard units, the well system shall be equipped with
a compatible cathodic protection system. All testing results shall be kept on site available for
inspection.
2. At least forty-eight (48) hours prior to constructing system, the Permittee shall notify the
Aquifer Protection Section's Underground Injection Control (UIC) Program Central Office
staff, telephone number [phone] and the Mooresville Regional Office Aquifer
Protection Section Staff, telephone number [phone].
3. All underground tubing shall be refrigeration grade copper tubing.
Permit No. WI0300114 Page 3

4. Prior to installation, all tubing to be placed in boreholes ("loops") shall be checked for leaks
by pressurizing the loop to a gage pressure of at least 350 pounds per square inch (psig),
immersing the loop in water and examining it for leaks. Loops with leaks shall not be
installed.
5. Prior to installation, each loop shall be visually inspected for damage such as kinks, dents,
and scrapes. Each loop shallbe checked to verify that the nitrogen charge applied to the loop
by the manufacturer before shipping is still present at• a pressure of at least 300 psig. The
loop manufacturer shall be notified in the event of damage or pressure loss, and the
manufacturer's instructions shall then be followed. The nitrogen charge may be released
only when the loop is installed and ready to be connected to the manifold.
6. Boreholes shall be large enough to allow insertion of the loop plus a tremie pipe for grouting.
7. After insertion of the tubing into the boreholes, an approved grout (as defined in Title 15A
North Carolina Administrative Code 2C .0100) shall be pumped via tremie pipe into the
annular space of each borehole so as to completely fill it from bottom to top.
8. All tubing junctions shall be brazed using lead-free brazing material. The brazing material
shall have a galvanic potential as close as practicable to thatof the tubing material.
9. Dry nitrogen shall be circulated through the tubing during brazing to prevent oxidation.
10. After installation and prior to operation of the system, a mechanical integrity test shall be
conducted by pressurizing the injection well system to 400 psig with dry nitrogen and
monitoring for leaks using an ultrasonic or other leak detector of equal sensitivity and
monitoring pressure in the system for at least 2 hours. Alternatively, an equivalent vacuum
test is acceptable. Any pressure fluctuation other than that due to thermal .expansion and
contraction of the testing medium shall be considered a failed mechanical integrity test. Any
leaks shall be located and repaired prior to charging the system with refrigerant. A copy of
the post -installation pressure or vacuum test record (initial pressure reading, final pressure
reading, and the duration of the test) shall be submitted to the Aquifer Protection Section.
The test records must be received by the Aquifer Protection Section at least twenty-four (24)
hours prior to the initiation of the operation of the facility for injection.
11. The location of each of the system manifolds shall be recorded by triangulation from two
permanent features on the site (e.g., building foundation comers). The Permittee shall retain a
copy of the triangulation records. The Permittee shall also submit a copy of the triangulation
records to the Aquifer Protection Section within 30 days of completion of well construction.
12. The written documentation required in Part II, paragraphs (10) and (11) shall be submitted to:
Aquifer Protection Section-UIC Staff
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
Permit No. WI0300114 Page 4

PART III - OPERATION AND USE GENERAL CONDITIONS
1. This permit is effective only with respect to .the nature, volume of materials and rate of
injection, as described in the application and other supporting data.
2. This permit is not transferable without prior notice to, and approval by, the Director of the
Division of Water Quality (Director). In the event there is a desire for the facility to
change ownership, or there is a name change of the Permittee, a formal permit amendment
request must be submitted to the Director, including any supporting materials as may be
appropriate, at least 30 days priorto 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 that will render it unsatisfactory for normal use. In the
event that the facility fails to perform satisfactorily, including the creation of nuisance
conditions or failure of the injection zone to adequately assimilate the injected fluid, the
Permittee shall take immediate corrective actions including those actions that may be
required by the Division of Water Quality such as the repair, modification, or abandonment
of the injection facility.
2. The Permittee shall be required to comply with the terms and conditions of this permit
even if compliance requires a reduction or elimination of the permitted activity.
3. The issuance of this permit shall not relieve the Permittee of the responsibility for damages
to surface or groundwater resulting from the operation of this facility.
PART V - OPERATION AND MAINTENANCE REQUIREMENTS
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. Atleast forty-eight (48) hours prior to the initiation of the operation of the facility for
injection, the Permittee must notify by telephone the Aquifer Protection Section's
Underground Injection Control (UIC) Program Central Office staff, telephone number
[phone], and the Mooresville Regional Office Aquifer Protection Section Staff,
telephone number [phone]. Notification is required so that Division staff can
Permit No. WI0300114 Page 5

inspect or otherwise review the injection facility and determine if it is in compliance with
permit conditions.
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 that results in any unusual operating
circumstances;
(B) Any failure due to known or unknown reasons that renders the facility incapable of
proper injection operations, such as mechanicalor electrical failures;
(C) Any loss of refrigerant in the system, regardless of the origin of the loss;
(D) Any recharging of the refrigerant system.
3. Where the Permittee becomes aware of an omission of any relevant facts in a permit
application, or of any incorrect information submitted in said application or in any report to the
Director, the relevant and correct facts or information shall be promptly submitted to the
Director by the Permittee.
4. In the event that the permitted facility fails to perform satisfactorily, the Permittee shall
take such immediate action as may be required by the Director.
Permit No. WI0300114 Page 6

PART VIII - PERMIT RENEWAL
The Permittee shall, at least 120 days prior to the expiration of this permit, request an
extension.
PART IX - CHANGE OF WELL STATUS
1. The 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 accordingto 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 manner
that will prevent the movement of fluids into or between underground
sources of drinking water and in accordance with the terms and conditions
of the permit.
Permit No. WI0300114 Page 7

(G) The Permittee shall submit a Well Abandonment Record (Form GW-30)
as specified in 15A NCAC 2C .0213(h)(1) within 30 days of completion
of abandonment.
3. The written documentation required in Part IX (1) and (2) (G) shall be submitted to:
Aquifer Protection Section-UIC Program
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
Permit No. WI0300114 Page 8

COPY
MOORESVILLE REGIONAL OFFICE
DIVISION OF WATER QUALITY
AQUIFER PROTECTION SECTION
March 22, 2007
MEMORANDUM
To: Michael Rogers Central Office
From: Kevin Bubak Hydro Tech 1
Enclosed: APSARR Form for Ivan Howitt Geo Thermal Application Permit #
WI0300114
cc: Shawna Caldwell — Mecklenburg County Environmental Health

AQUIFER PROTECTION SECTION
APPLICATION REVIEW REQUEST FORM
Date: March 6, 2007
To:
I
Landon Davidson, ARO-APS
❑ Art Barnhardt, FRO-APS
® Andrew Pitner, MRO-APS
Jay Zimmerman, RRO-APS
II
From: Michael Rogers , Groundwater Protection Unit
Telephone: [phone]
E-Mail: [e-mail]
A. Permit Number: WI 0300114
B. Owner: Ivan and C. Vianne Howitt
C. Facility/Operation:
® Proposed
D. Application:
0
David May, WaRO-APS
s Charlie Stehman, WiRO-APS
Sherri Knight, WSRO-APS
1 MAR - 9 2007
EWQ Aquifer Protection
pia: , �
Existing
n Facility
RECERFD i OENR / DWG
AQUIFFQ.ppn-nzt,',TICIN SECTION
IC
MAP ) 20a7
n Operation
I. Permit Type: n Animal I I SFR-Surface Irrigations Reuse n H-R Infiltration
❑ Recycle I I I/E Lagoon ❑ GW Remediation (ND)
® UIC - (5QM) closed loop mixed fluid geothermal
For Residuals: ❑ Land App. ❑ D&M
n 503 ❑ 503 Exempt ,
2. Project Type: ® New ❑ Major Mod. ❑ Minor Mod. I I Renewal I I Renewal w/ Mod.
n Surface Disposal
n Animal
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 21 calendar days, please take the following actions:
® Return a Completed APSARR Form.
❑ Attach Well Construction Data Sheet.
n 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: 3 2,2 _ 6'?
FORM: APSARR 07/06
Page 1 of 1

AQUIFER PROTECTION REGIONAL STAFF REPORT
Date: 3/22/07
To: Aquifer Protection Central Office
Central Office Reviewer: Michael Rogers
Regional Login No:
County: Mecklenburg
Permittee: Ivan Howitt
Project Name:
Application No: WI0300114
INJECTION WELL PERMIT APPLICATIONS (Complete these two sections for all systems that use injection wells,
including closed -loop groundwater remediation effluent injection wells, in situ remediation injection wells, and heat pump
injection wells.)
I.Description Of Well(S) And Facilities — New, Renewal, And Modification
1. Was a site visit conducted in order to prepare this report? ►1 Yes or ❑ No.
a. Date of site visit: 3/21/07
b. Person contacted and contact information: Vianne Howitt 704/547-9287
c. Site visit conducted by: Kevin Bubak
2. Inspection Report Attached: ® Yes or ❑ No
3. Type of injection system:
❑ Heating/cooling water return flow (5A7)
Closed -loop heat pump system (5QM/5QW)
❑ In situ remediation (5I)
n Closed -loop groundwater remediation effluent injection (5L/"Non-Discharge")
❑ Other (Specify: )
4. Are there any potential pollution sources that may affect injection? n Yes ® No
What is/are the pollution source(s)? The site has no apparent pollution sources is on public water & sewer
What is the distance of the injection well(s) from the pollution source(s)? ft.
5. What is the minimum distance of proposed injection wells from the property boundary? 20 ft.
6. Quality of drainage at site: ® Good ❑ Adequate ❑ Poor
7. Flooding potential of site: ® Low ❑ Moderate ❑ High
8. Does the map presented represent the actual site (property lines, wells, surface drainage)? ® Yes or n No. If
no or no map, please attach a sketch of the site. Show property boundaries, buildings, wells, potential pollution
sources, roads, approximate scale, and north arrow.
9. Is the following information entered into the BIMS record for this application correct? n Yes or 1 No. If no,
please complete the following or indicate that it is correct on the current application.
Was queried was not found in Bims production.
a.
b.
c.
d.
Location(s):
Driving Directions: attached in report
USGS Quadrangle Map name and number:
Latitude: 35.3152400388951 Longitude: 80.7473285788382
FORM: Ivan Howitt APRSR040929 03 22 07 1

AQUIFER PROTECTION REGIONAL STAFF REPORT
IL EVALUATION AND RECOMMENDATIONS
1. Provide any additional narrative regarding your review of the application: In Speaking with Mrs. Howitt
about geothermal system she has done a lot of research on the differences in technology and the option
available to them. From my site visit my concern is the small fixed lot condition. There are 3 proposed
well location 2 of the proposed well location on either side of the house technically do not look like a
likely option. The small front patch in the front of the property is the best place depending on the
number of borings.
2. Recommendation: /1Issue
3. Signature of report preparer:
Signature of APS regional supervisor:
Date: ,- —ID/7
FORM: Ivan Howitt APRSR040929 03 22 07 2

FROM,:TIM KANE-KBHOME
FAX NO. :704 248 0994 Feb. 23 2007 05:17PM P1
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 .SQM Wells
in Accordance with the provisions of NCAC Title ISA:1/2C.0200
Complete application and mail to address on theback page.
TO: DIRECTOR, NORTH C' iNA Di NOF WA ERQUALITY
DATE: _ 2 ,� , 20 0 gt
A. SYSTEM CLASSIFICATION Please check column which matches proposed system.
(1)
Type 5A7 wells inject water used to provide heating or cooling for structures.
(2) x 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 comt lcte form GW-57 CL, Nofikallon Of Intent To
Construe tA Closed -Loop Geothermal -Water Only Injection Well System.
B. PERMIT APPLICANT
Name: 'vat Howitt
Address: 9524 Glenwater Drive c"D
City: Charlotte State: NC Zip Code: 28262 County: meekienvexg ..-;,
in
Telephone: [phone]
CA Na
ON
f:. PROPER1 ' 1 WN BR {if di#%ront front at i x) -o
_4 Name:
Address: o
City: Sate: Zip Code: County:
Telephone:
D. STATUS OF APPLICANT
Private: x Federal: Commercial:
State: Municipal: Native American Lands:
Revised 7/06
GwJUiC-57 HP Page 1 of 4

FROM.:TIM KRNE—KBHOME
FAX NO. :704 248 0994 Feb. 23 2007 05:18PM P2
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
Name: Bunn Mechanical
Address: 1551 Morrison Rd ..
City: Concord Zip Code; 28025 County: Cabarrug
Telephone: [phone]
Contact Person: Joey Dulit
G. INJECTION PROCEDURE (Briefly describe how the injection well(s) will be used..)
Injection wells (bore hales) will be used as a geothermal heat sink, Geothermal ground
loops will be placed in the temporary bore holes. Bore holes will be continuously grouted
from the bottom to the top.
H. WELL USE Will the injection well(s) also be used as the supply well(s) for the following?
(1) The injection operation? YES NO x
(2) Personal consumption? YES NO . x
1. 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 C*W-
1 (Well Construction Record) if available.
PROPOSED WELL to be constructed for use as an injection well. Provide the
data in (I) through (7) below as PROPOSED construction specifications. Submit
Form OW-1 after construction.
(1) Well Drilling Contractor's Name: 2ffecta Solutions, LLC - Stephen Keexser (939)-609-6591
NC Contractor Certification number: 3468
(2) Date to be constructed: Marsh 2001 Number of borings:
Approximate depth of each boring (feet): 100 ft
(3) Well casing: Is the well(s) cased?
(a) YES if yes, then provide the casing information below.
Type: Galvanized steel Black steel Plastic ... Other (specify)
Casing depth: From to ft. (reference to land surface)
Casing extends above ground inches
(b) NO ,,,,
Revised 7/06
GW/UIC-57 HP Page 2 of 4

FR❑M':TIM KANE—KBH❑ME
FAX NO. :704 248 0994 Feb. 23 2007 05:19PM P3
(4) Grout (material surrounding well casing and/or piping):
Silica Sand &
(a) Grout type: Cement x Bentonite X Other (specify) s'upgexplastici6er
(b) Ground surface and grout depth (reference to land surface):
x around closed loop piping; from 0 to 50 (feet).
around well casing; from to (feet).
(5) Screens (lbr 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_no (h) the effluent line? yes_
SOURCE WELL CONSTRUCTION INFORMA'I'LON (if different from injection well).
Attach a copy of 'Porn GW-1 (Weil Construction Record). If Form OW-1 is not available,
provide the data in part K (I) of this application form to the best of your knowledge.
(7)
NOTE: THE wEIi . 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) __saws per minute (gpm).
(2) injection Volume: Average (daily) gallons per day (gpd).
(3) Injection Pressure: Average (daily) pounds/squate inch (psi).
(4) Injection Temperature: Average (January) ° F. Average (July) ° 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: Fomtation: 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:
R-22 Refrigerant
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.
M. LOCATION OF WELL(S) Attach two maps.
Revised 7/06
CiW/IJI0-57 HP Page 3 of 4

FROM : T I M KANE-KBHOME
FAX NO. :704 248 0994 Feb. 23 2007 05:2OPM P4
(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 weil(s) or waste disposal facilities such as septic tanks or
drain Melds located within 1000 feet of the geothermal heat pump wall 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 L1ST 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 Notwpischarge 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. 1 am aware that there are significant penalties, including the possibility
of fines and imprisonment, for submitting false information. 1 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 Pewit"
N/ nit-AMA-2s -)4t77"7,(In
(Signature of Well Owner or Authorized Agent)
IfawIiorized agent is acting on behalf of the well owner,
please supply a letter signally 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 m the absence of Contrary agreement in writing.)
1f 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 walks) conforms to the Well
Construction Standards (Title 15A NCAC 2C .0200)
Revised 7/06
(Signature Of Property Owner If Different From Applicant)
Please return two copies of the completed Application package to:
UIC Program
Aquifer Protection Section
North Carolina DENR DWQ
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone [phone]
GW/UIC-57 HP Page 4 of 4

Economic Development GIS
Parcel: 04726134 - 9524 GLENWATER DR CHARLOTTE
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LEGEND
Selected Parcel
Charlotte -Douglas
International
Airport
Streets
Interstates
Major Roads
Minor Roads
Streams
Tax Parcels
Water Bodies
Regulated
Watersheds
CA
CA-1
CA-2
CA-3
CA-4
PA
PA-1
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The information provided by this program is compiled from recorded deeds, plats, tax maps, surveys, and other
public records and data. Users of this map data are hereby notified that the aforementioned public primary
information sources should be consulted for verification of the information. Mecklenburg County and its mapping
contractors assume no legal responsibility for the information contained herein.
'trio- 544Earlicalet ..ic Az;
4
,l, I,
Date Printed: 2/26/2007 8:27:46 AM

Print Page
Alb
Q'tf;91.0"6
rage 1< or z
Economic Development GIS
Parcel: 04726134 - 9524 GLENWATER DR C
The information provided by this program is compiled from recorded deeds, plats,
tax maps, surveys, and other public records and data. Users of this map data are
hereby notified that the aforementioned public primary information sources should
be consulted for verification of the information. Mecklenburg County and its
mapping contractors assume no legal responsibility for the information contained
herein.
LEGEND
Selected Parcel
A/ Charlotte -Douglas
International
Airport
Streets
Interstates
fMMajcr Roads
Af Minor Roads
Tax Parcels
n Water Bodies
2005 Aerial
Photos
CHANIR
CharIONA
http://gischamber.co.mecklenburg.nc.us/website/chamber/printpage.aspx?mappath=http://g... 2/26/2007

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• TerraServer Image Courtesy of the USGS
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© 2004 Microsoft Corporation. Terms of Use Privacy Statement
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�0. WAShP
.9 ti William G..Ross Jr., Secretary
CO; . ; North Carolina Department of Environment and Natural Resources
- Alan W. Klimek, P.E. Director
Division of Water Quality
Michael F. Easley, Governor
March 1, 2007
Ivan & C. Vianne Howitt
9524 Glenwater Drive
Charlotte, NC 28262
Subject: Acknowledgement of Application No. WI0300114
Ivan & C. Vianne Howitt
Injection Mixed Fluid GSHP Well System (5QM)
Mecklenburg
Dear Mr. & Mrs. Howitt:
The Aquifer Protection Section of the Division of Water Quality (Division) acknowledges receipt of your permit
application and supporting materials on February 26, 2007. This application package has been assigned the number
listed above and will be reviewed by Michael Rogers.
The reviewer will perform a detailed review and contact you with a request for additional information if necessary.
To ensure the maximum efficiency in processing permit applications, the Division requests your assistance in
providing a timely and complete response to any additional information requests.
Please be aware that the Division's Regional Office, copied below, must provide recommendations prior to final
action by the Division. Please also note at this time, processing permit applications can take as long as 60 - 90. days
after receipt of a complete application.
If you have any questions, please contact Michael Rogers at 919-715-6166, or via e-mail at
[e-mail]. If the reviewer is unavailable, you may leave a message, and they will respond
promptly. Also note that the Division has reorganized. To review our new organizational chart, go to
http://h2o.enr.state.nc.us/documents/dwq orgchart.pdf.
PLEASE REFER TO THE ABOVE APPLICATION NUMBER WHEN MAKING INQUIRIES ON THIS
PROJECT.
Sincer
1y,
for Debfa 3,/Watts
Supervisor
cc:
Mooresvill
Reg oval
fic
Aquife
Permit App ication File WI0300114
Pry tection
Sectio
NorthCarolina
Naturally
Aquifer Protection Section 1636 Mail Service Center
Internet: www.ncwaterqualitv.orq 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]