WI0500156_GEOTHERMAL_20170323

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
Water Resources
Environmental Quality
S. JAY ZIMMERMAN
Kevin O'Dell and Angela Burton
411 Gilmore Road
Chapel Hill, NC 27516
March 23, 2017
Re: Issuance of Injection Well Permit
Permit No. WI0500156
Geothermal Heating/Cooling Water Return Well
Chatham County
Dear Mr. O'Dell and Ms. Burton:
In accordance with your permit renewal application received January 3, 2017, and additional
.information received January 18, 2017, I am forwarding Permit No. WI0500156 for the continued
operation of geothermal heating/cooling water return well(s) located at the above referenced address.
Please note that this renewed permit shall become effective on April 1, 2017, (i.e., the day after the
expiration date of the existing permit), which may differ from the date of this letter. This permit shall
be effective from April 1, 2017, until March 31, 2022, and shall be subject to the conditions and
limitations stated therein.
Please Note:
• Samples from the influent and effluent sampling ports of your geothermal well system
were collected by the Raleigh Regional Office on February 2, 2017.
In order to continue uninterrupted legal use of this well for the stated purpose, you should submit an
application to renew the permit 120 days prior to its expiration date. As indicated in the permit, this
permit is not transferable to any person without prior notice to, and approval by, the Director of the
Division of Water Resources. If you have any questions regarding your permit or the Underground
Injection Control Program, please call me at [phone].
Best Regards,
~f2,~
Michael Rogers, P.G. (NC & FL)
Underground Injection Control (UIC) Manager -Hydrogeologist
Division of Water Resources, NCDEQ
Water Quality Regional Operations Section
~-~::;7..,...Nothing Ci:m1pan:-$·.~--/·--
State of North Carolina I Environmental Quality I Division of Water Resource s
Water Quality Regional Operations Section
1636 Mail Seivice Center I Ral~igh, North Carolina 27699-1636
919-707-9129
Director
cc: Rick Bolich & Laura Robertson, Raleigh Regional Office
Central Office File, WI0500156
Chatham County Environmental Health Department
NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENTAL QUALITY
RALEIGH, NORTH CAROLINA
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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
Kevin O'Dell and Angela Burton SFR
FOR THE CONTINUED OPERATION OF ONE (1) GEOTHERMAL HEATING/COOLING WATER
RETURN WELL(S), defined in Title 15A North Carolina Administrative Code 02C .0224(a), which will be used
for the injection of heat pump effluent. The injection well(s) located at 411 Gilmore Road, Chapel Hill, Chatham
County, NC 27516 wilI be operated in accordance with the application submitted January 3, 2017, and conformity
with the specifications and supporting data received January 18, 2017, all of which are filed with the Department
of Environmental Quality and are considered a part of this permit_
This permit is for continued operation 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 renewed permit shall become effective on April 1, 2017, (i.e., the day after the
expiration date of the existing permit) until March 31, 2022, and shall be subject to the conditions and limitations
stated therein
Permit issued this the 23rd day of March 2017
S_ Jay Zimmerman, P.G.
Director, Division of Water Resources
By Authority of the Environmental Management Commission.
Permit#WI0500156 U105A7 Page 1 of5
per_ 1 M 512015

PART I -PERMIT GENERAL CONDITIONS
1. The Permittee shall comply with all conditions of this permit and with the standards and criteria specified
in Criteria and Standards Applicable to Injection Wells (lSA NCAC 2C .0200). Noncompliance with
conditions of this permit constitutes a violation of the North Carolina Well Construction Act and is grounds
for enforcement action as provided for in N.C.G.S. 87-94
2. This permit is effective only with respect to the nature, volume of materials and rate of injection, as
described in the application and other supporting data [ISA NCAC 02C .021 l(a)].
3. 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 [ISA NCAC 02C .0211(1)].
4. This permit is not transferable without prior notice and approval. 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, including any supporting materials as may be appropriate, at least 30 days prior to the date of
the change [15A NCAC 02C .021 l(q)].
5. 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 [lSA NCAC 02C .0203].
PART II -WELL CONSTRUCTION GENERAL CONDITIONS
1. The well supplying water for the geothermal heating and cooling system shall be constructed in accordance
with the requirements of rule 15A NCAC 02C .0107 except as required in Item #2 below.
2. Any injection well shall be constructed in accordance with the requirements of rule 15A NCAC 02C .0107
except that the entire length of the casing shall be grouted in such a way that there is no interconnection of
aquifers or zones having differences in water quality that would result in degradation of any aquifer or zone.
For screened wells, grout shall be emplaced from the top of the gravel pack to the land surface. For open-
end wells, the casing shall be grouted from the bottom of the casing to the land surface [15A NCAC 02C
.0224(d)(2),(3)].
3. Bentonite grout shall not be used to seal any water-bearing zone with a chloride concentration equal to or
greater than 1,500 milligrams per liter. In areas where elevated chloride levels are known to exist or are
probable, such as coastal areas, chloride levels shall be verified in the field to determine existing conditions.
[15A NCAC .0225(g)(8)].
4. The injection well system shall be constructed such that a sampling tap or other collection equipment
approved by the Director provides a functional source of water when the system is operational. Such
equipment shall provide the means to collect a water sample immediately after emerging from the water
supply well and immediately prior to injection into the return well [15A NCAC 02C .0224(d)(4)].
5. Each well shall be secured to reasonably insure against unauthorized access and use and shall be sealed
with a watertight cap or well seal as defined in G.S. 87-85(16).
6. Each well shall have permanently affixed an identification plate [15A NCAC 02C .0107G)(2)].
Pennit #WI0500156 UIC/5A7
ver. 11/15/2015
Page 2 of5
7. A completed Well Construction Record (Form GW-1) shall be submitted as described in Part V.l of this
permit.
PART III-OPERATION AND USE CONDITIONS
1. The Permittee shall cqmply with the conditions of this permit and properly operate and maintain the
injection facility in compliance with the conditions of this permit and the rules of ISA NCAC 02C .0200,
even if compliance requires a reduction or elimination of the permitted activity [ISA NCAC 02C .021 lG)].
2. The issuance of this permit shall not relieve the Permittee of the responsibility for damages to surface water
or groundwater resulting from the operation of this facility. 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 that may be required,
such as the repair, modification, or abandonment of the injection facility [15A NCAC 02C .0206].
PART IV -INSPECTIONS [ISA NCAC 02C .021 l(k)]
1. Any duly authorized officer, employee, or representative of the Division of Water Resources (DWR) 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. DWR 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 samples of the injection facility's activities.
PART V -MONITORING AND REPORTING REQUIREMENTS
1. Records of well construction, repair, or abandonment shall be submitted within 30 days of completion of
such activities. Copies of such records shall be retained on-site and available for inspection [15A NCAC
02C .0224(f)(2), (4)].
2. Monitoring of any well may be required to ensure protection of the groundwater resources of the State and
compliance with the groundwater quality standards specified in 15A NCAC 02L [15A NCAC 02C
.0224(f)(l )].
3. The Permittee shall report any monitoring or other information that indicates noncompliance with a specific
permit condition, that a contaminant may cause a violation of applicable groundwater quality standards, or
that a malfunction of the injection system may cause the injected fluids to migrate outside the approved
injection zone or area. As specified in rule 15A NCAC 02C .021 l(r), noncompliance notification shall be
as follows:
(A) Oral notification shall be given within 24 hours of the occurrence, or first knowledge of the
occurrence, to the Raleigh Regional Office, telephone number 919-791-4200
(B} Written notification shall be made within five days of the occurrence and submitted to the addresses
in Item #5 below.
Permit #WI0500 l 56 UIC/5A7
ver. 11/15/2015
Page 3 of 5
(C) The written notification shall contain a description of the noncompliance and its cause; the period of
noncompliance, including dates and times; if the noncompliance has not been corrected, the
anticipated time it is expected to continue; and any steps taken or planned to reduce, eliminate, and
prevent reoccurrence of the noncompliance.
4. The Permittee shall record the number and location of the wells with the register of deeds in the county in
which the facility is located. [15A NCAC 02C .0224(f)(3)].
5 . All forms, reports, or monitoring results required by this permit shall be submitted to:
UIC Program Staff
Division of Water Resources
1636 Mail Service Center
Raleigh, NC 27699-1636
and
Water Quality Regional Operations Section
DWR Raleigh Regional Office
1628 Mail Service Center
Raleigh, NC 27609
PART VI -PERMIT RENEWAL [15A NCAC 02C .0224(c)]
As required by rule an application for permit renewal shall be made at least 120 days prior to the expiration
date of the permit. This permit condition does not apply if the Permittee chooses to discontinue operation
of the well for injection of effluent from the geothermal heating and cooling system associated with this
permit.
PART VII-CHANGE OF WELL STATUS [15A NCAC 02C .0240]
1. Procedures for temporarily or permanently abandoning a well are the same as those specified in rule 15A
NCAC 02C .0113. While some of those criteria are given below, the Permittee bears the responsibility of
complying with all applicable regulatory requirements.
2. If a well will no longer be used for any purpose, then it should be permanently abandoned according to rule
15A NCAC 02C .0113(b) in order to prevent the well from deteriorating and acting as a source or conduit
of contamination, which is prohibited by General Statute 87-88( c ).
3. If a well is taken completely out of service temporarily, the Permittee shall install a water-tight cap or well
seal that cannot be removed without the use of hand or power tools.
4. When injection operations have ceased at the facility and a well will no longer be used for any purpose, the
Permittee shall permanently abandon that injection well in accordance with the procedures specified in 15A
NCAC 02C .0113(b), which include, but are not limited to, the following:
(A) All casing and materials may be removed prior to initiation of abandonment procedures if
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 in accordance with rule 15A
NCAC 02C .011 l(b)(l)(A),{B), and (C).
Permit #Wl0500 J 56 UIC/5A7
ver. 11/15/2015
Page 4 of5
(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 those cases when a subsurface cavity has been created as a result of the injection
operations, each well shall be abandoned in such a manner that will prevent the movement
of fluids into or between underground sources of drinking water.
(F) The Permittee shall submit a Well Abandonment Record (Form GW-30) as specified in
15A NCAC 2C .0224(t)( 4) within 30 days of completion of abandonment.
5. The written documentation required in Part VII ( 4 )(F) shall be submitted to the addresses specified in Part
V.5 above.
Permit #Wl0500156 UIC/5A7
ver. 11 /15 /2015
Page 5 of 5
WQROS REGIONAL STAFF REPORT FORM
UIC Program Support
Permit No. WI0500156
Date: 03/08/2017
To: Michael Rogers
Central Office Reviewer
County: Chatham
Permittee/Applicant: Kevin O'Dell & Angela Burton
Facility Name: O'Dell Geothermal Well
L GENERAL INFORMATION
1. This application is (check all that apply): D New [8J Renewal
D Minor Modification D Major Modification
a. Date of Inspection: 02/02/2017
b. Person contacted and contact information: Kevin O'Dell. 919-795-1305
c. Site visit conducted by: Laura Robertson
d. Inspection Report Printed from BIMS attached: D Yes [gl No
RECEIVEJ)INCDEQ/DWR
MAR 1 0 2017,
Water Qua11ty Regional
Operations Section
e. Physical Address of Site including zip code: 411 Gilmore Road . Chapel Hill. NC 27516
f. Driving Directions if rural site and/or no physical address:
g. Latitude: 35.852574 Longitude: -79.131866
Source of Lat/Long & accuracy (i.e., Google Earth, GPS, etc.t Goo gle Earth
IL DESCRIPTION OF INJECTION WELL(S) AND FACILITY
1. Type of injection system:
[8J Geothermal Heating/Cooling Water Return
D In situ Groundwater Remediation
D Non-Discharge Groundwater Remediation
D Other (Specify: )
2. For Geothermal Water Return Well(s) only
a. For existing geothermal system:
Were samples collected from Influent/Effluent sampling ports? [8J Yes D No.
Provide well construction information from well tag: The well total de pth is 600 feet and it was
installed in 2009. All other information was not visible on the tag due to electrical tape.
b. Does existing or proposed system use same well for water source and injection? [8J Yes D No
If No, please provide source/supply well construction info (i.e., depth, date drilled, well contractor,
etc.) and attached map and sketch location of supply well in relation to injection well and any other
features in Section IV of this Staff Report.
3. Are there any potential pollution sources that may affect injection? D Yes [gl No
What is/are the pollution source(s)? _________________________ _
What is the distance of the injection well(s) from the pollution source(s)? ____________ _
4. What is the minimum distance of proposed injection wells from the property boundary? ______ _
5. Quality of drainage at site: [gj Good D Adequate D Poor
6. Flooding potential of site: [gj Low D Moderate D High
Rev. 6/1/2015 Page I
WQROS REGIONAL STAFF REPORT FORM
UIC Program Support
7. For Groundwater Remediation systems, is the proposed and/or existing groundwater monitoring program
(number of wells, frequency of monitoring, monitoring parameters, etc.) adequate? ❑ Yes ❑ No. If No,
attach map of existing monitoring well network if applicable and recommend any changes to the groundwater -
monitoring program.
S. Does the map included in the Application reasonably represent the actual site (property lines, welts, surface
drainage)? ❑ Yes ❑ 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_ For Non -Discharge groundwater remediation systems only:
a. Are the treatment facilities adequate for the type of waste and disposal system? []Yes [—]No ❑ NIA.
If no, please explain:
b. Are the site conditions (soils, topography, depth to water table, etc.) consistent with what was reported by
the soil scientist and/or Professional Engineer? ❑ Yes ❑ No ❑ N/A. If no, please explain:
III. EVALUAEIONAND RECOMMENDATIONS
1. Do you foresee any problems with issuance/renewal of this permit? ❑ Yes ® No. If yes, explain.
2. List any items that you would like WQRGS Central Office to obtain through an additional information request.
Make sure that you provide a reason for each item:
_ Item _ reason
3. List specific special conditions or compliance schedules that you recommend to be included in the permit when
issued. Make sure that you provide a reason for each special condition:
i
Condition Reason -
I
I
4. Recommendation
❑ Deny. If Deny, please state reasons:
❑ Hold pending receipt and review of additional information by regional office
❑ Issue upon receipt of needed additional information
® Issue
5. Signature of report preparer(s):
Signature of WQRGS Regional Supervisor:
Date: •
Rev. 6/1/2015 Page 2

WQROS REGIONAL STAFF REPORT FORM
UIC Program Support
IV. ADDITIONAL REGIONAL STAFF REVIEW COMMENTS/ATTACHMENTS (If Needed)
-The well appears to be in very good condition, and is protected by cinder blocks and a covering.
-While purging water at the well (prior to sampling), flow was stopped when pressure tanks filled. Some of the
water was purged and YSI readings were collected from a spigot on the side of the house near the garage.
Purging at the well resumed once pressure tanks were emptied, and the water samples were collected at the well
itself.
Rev. 6/1/2015 Page3
·1~
AC35453 North Carolina Division of Water Resources Water Sciences Section Laborato r Results
Loe. Descr.: 411 GILMORE RD.,CHAPEL HILL INFLU!itfi Sample ID: AC35453
County: CHATHAM Collector: LRQBER~N VisitlO PO Number#
Region : RRO Report To BBQ Location ID: 5P019WI05000156 Date Received: 02/02/2017
River Basin ~ Collect Date: 02/02/2017 Priority COMPLIANCE Time Received: 11:00
Emergency Collect Time : ~ Sample Matrix: GROUNDWATER Labworks LoginlD ~
COC Yes/No Sample Depth Loe. Type: Water Supply Delivery Method Ham;! s!!!II Y!!CII!
Final Report Date: 3/3/17
Report Print Date: 03/03/2017
Final Re ~ort
ff this report is labeled preliminary report, the results have not been validated. Do not use for Regulatory purposes.
Blll.!.!!L Units Method Anal~sis
CAS# Anal '.)'.te Name PQL Qualifier Reference Date Validated bi
LAB
Sample temperature at receipt by lab 2.9 'C 212117 MSWIFT
MIC
Coliform, MF Fecal in liquid 1 B2 CFU/100ml SM 9222 0-1997 212/17 ESTAFFORD1
Coliform, MF Total in liquid 1 1 B2 CFU/100ml SM 9222 B-1997 212117 ESTAFFORD1
NUT
NO2+NO3 as N in liquid 0.02 0.17 mg/Las N EPA 353.2 REV 2 213/17 CGREEN
WET
Bromide 0.4 0.4 U mg/L EPA 300.0 rev2 .1 213/17 CGREEN
Chloride 1.0 2.7 mg/L EPA 300 .0 rev2.1 2/3/17 CGREEN
Fluoride 0.4 0,4 U mg/L EPA 300.0 rev2.1 213/17 CGREEN
Sulfate 2.0 3,2 mg/L EPA 300.0 rev2 .1 2/3/17 CGREEN
Total Dissolved Solids in liquid 12 148 mg/L SM 2540 C-1997 2/6/17 CGREEN
MET
7429-90-5 Al by ICP 50 50 U ug/L EPA 200.7 Rev4.4 2110/17 ESTAFFORD1
7440-70-2 Ca by ICP 0 .10 36 mg/L EPA 200.7 Rev4 .4 2/9/17 ESTAFFORD1
7440-47-3 Crby ICPMS 5.0 5.0 U ug/L EPA 200.8 Rev5 .4 2113/17 ESTAFFORD1
7440-50-8 Cu by ICPMS 2.0 59 ug/L EPA 200.8 Rev5 .4 2113/17 ESTAFFORD1
7439-89-6 Fe by ICP 50 50 U ug/L EPA20Q .7 Rev4.4 2110/17 ESTAFFORD1
7440-09-7 Kby ICP 0.10 0.71 mg/L EPA 200. 7 Rev4 .4 2/9/17 ESTAFFORD1
7439-95-4 Mg by ICP 0.10 3.4 mg/L EPA 200. 7 Rev4.4 2/9/17 ESTAFFORD1
7439-96-5 Mn by ICP 10 10 U ug/L EPA200.7 Rev4 .4 2/10/17 ESTAFFORD1
7440-23-5 Na by ICP 0.10 9 .2 mg/L EPA200.7 Rev4 .4 219/17 ESTAFFORD1
7440-02-0 Ni by ICPMS 2 .0 4 .7 ug/L EPA200.8 Rev5 .4 2113/17 ESTAFFORD1
7439-92-1 Pbby ICPMS 2 .0 2.0 U ug/L EPA200.8 Rev5.4 2113/17 ESTAFFORD1
7440-66-6 Zn by ICPMS 10 19 ug/L EPA 200.8 Rev5 .4 2113/17 ESTAFFORD1
WSS Chemistry Laboratory» 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone]
"Not Detected" or "U" does not indicate the sample is analyte free but that the analyte is not detected at or above the PQL.
Page 1 of 1
AC35454
North Carolina Division of Water Resources Water Sciences Section Laboratory Results
Leo. Dour.,.
County:
Region:
River Basin
Emergency
COC Yes/No
411 GILMORE_RP.CHAPEL
HILL EFMUENT
CHATHAM
Collector
L Rt39ERTSON
Visitio
RPO
Report To
R{ROO
Location ID'
SP019_MOSDO0134
CPF
Collect Data:
0210 122 l
Priority
CaMPUANCE
Collect Time
09_20
Sample Matrix:
GROUNDWATER
Sample Depth
Loc. Type:
Water Simply
Final AeDort
Sample ifl:
AC35454
PC Number #
Hate Received:
gmv2ol
Time Received:
ilm
Labworks LoginO
MSWIFT
Delivery Method
Hand delivered
FInet Report Date:
313117
Report Print Date:
0310312.017.
if this report is labeled preliminary report, the results have not been validated. Do not use for Regulatory purposes.
Reaul ilnits Method Analysis
CAS # AnalYte Narne PC3L Qualifler Reference Date validated by
LAB
Sample temperature at receipt by lab 2.9 °C
MiC
2J2117 MSWIFT
Coliform, MF Fecal in liquid 1 182 CFUl100m1 SM 9222 0-1997 212117 ESTAFFORDI
Coliform, MF Total in liquid 1 1 CFU1100ml SM 9222 9-1997 212117 ESTAFFORDI
NUT
NO2+NQ3 as N in liquid 0.02 U,1 B mg/Las N EPA 363-2 REV 2 213141 CGREEN
WET
Bromide
0.4
0.4 U
mglL
EPA 300.0 rev2.1
213117
CGREEN
Chloride
1.0
2.7
mg1L
EPA 300.0 revz.1
213117
CGREEN
Fluoride
0.4
OA U
mg&
EPA 300.0 rev2.1
213117
CGREEN
Sulfate
2.0
3.2
mg/L
EPA 300.0 mv2,1
213117
CGREEN
Total Dissolved Solids in liquid
12
142
rng1L
SM 2540 C-1997
216117
CGREEN
7429-90.5
Al by ICP
50
MET
50 U
ugli-
EPA200.7 ReV4A
2110117
ESTAFFORDI
7440-70-2
Ca by ICP
0.10
33
mgk
EPA 200.7 RBV4.4
219117
ESTAFFORDI
7440-47-3
Cr by ICPMS
5,0
5.0 U
ugk
EPA 200.8 Rev5.4
2113117
ESTAFFORDI
7440-SM
Cu by ICPMS
2.0
73
uglL
EPA 200.8 Rev5.4
2J13117
ESTAFFORDI
7439-89-6
Fe by ICP
50
so U
uglL
EPA 200.7 Rev4A
2110117
ESTAFFORDI
7440-09-7
K by {CP
0.10
0.69
mg1L
EPA 200-7 Rev4A
7JB117
ESTAFFORDI
7439-95-4
Mg by ICP
0.10
3.3
m91L
EPA 200.7 ReAA
219117
ESTAFFORDI
7439-96.5
Mn by ICP
10
10 U
uglL
EPA200.7 RevAlA
2110117
ESTAPFORD1
7440-23.5
Na by ICP
0.10
8.9
mg1L
EPA200.7 Rev4.4
719117
ESTAFFORDI
7440-02-0
Ni by ICPMS
2.0
5.3
uglL
EPA 200.8 Rev5.4
203117
ESTAFFORDI
7439.92-1
Pb by ICPMS
2.0
2.0 U
uglL
EPA 200.8 Rev5.4
21I3117
ESTAFFORDI
7440-68.6
Zn by ICPMS
10
28
uglL
EPA 200.8 Rev5.4
2113117
ESTAFFORDI
WSS Chemistry Lsborataryaa 1623 Mail Service Center, Raleigh, NC 2769 9.18 23 (219)1333008
'Not Detected" or "U" does not indicate the sample is analyte free but that the analyte is not detected at a above She P4L.
Page 1 of 1

WATER QUALITY REGIONAL OPERATIONS SECTION
APPLICATION REVIEW RE QUEST FORM
Date: January 20, 2017
To: Rick Bolich -Laura Robertson
From: Michael Rogers, WQROS -Animal Feeding Operations and Groundwater Protection Branch
Telephone: [phone] Fax: [phone] E-Mail: [e-mail]
A. Permit Number: WI0500156
B. Applicant: Kevin O'Dell & Angela Burton
C. Facility Name:
D. Application:
Permit Type: Geothermal Heating/Cooling Water Return Well
Project Type: Renewal
E. Comments/Other Information:
D 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 return a completed W OROS Staff
Report.
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 Groundwater Protection Branch contact person
listed above.
Date: RO-WOROS Reviewer: -------------------------
COMMENTS:
NOTES: Please check with Shristi to see if she would want to g o out durin g the site
ins pection. Please record all well construction indicated on the well ta g if available.
Thanks.
FORM : WQROS-ARR ver. 092614 Pagel of 1
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary·
Water Resources
Environmental Quality
S. JAY ZIMMERMAN
January 20, 2017
Kevin O'Dell
Angela Burton
411 Gilmore Road
Chapel Hill, NC 27516
RE: Acknowledgement of Application No. WI0500156
Geothermal Heating/Cooling Water Return Well
Chatham County
Greetings:
The Water Quality Regional Operations Section (WQROS) acknowledges receipt of your
permit-application received on January 3, 2017, and supporting documentation received on January
18 , 2017 . Your application package has been assigned the number listed above, and the primary
reviewer is Michael Rogers.
Central and Raleigh 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 Water Quality Regional Operations Section
(WQROS) 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 919-807-6412 or [e-mail].
cc: Raleigh Regional Office, WQROS
Permit File WT0500156
Debra J. Watts, Supervisor
Animal Feeding Operations & Groundwater
Protection Branch
Division of Water Resources
.-7-"'Nothing 0:)mpares :-... -~'
Stale of Nonh Caroli na I Environmentai Quality I Division of Water Reso urces
Water Quality Regional .Opcn1tions Section
1636 Mai l Sen•ice Center I Raleigh, No rt h Caroli na 27699-1 636
9 19-707-9129
Director
·----·---------------------------------------------------
Rogers, Michael
From:
Kevin O'Dell [e-mail]>
Sent:
Wednesday, January 18, 2017 2:59 PM
To:
Rogers, Michael
Subject:
FW: WI0500156 O'Dell Geothermal Well
Attachments:
CCF01112017.pdf
KEVIN C. O'DELL, PE
VICE PReSIDENT, PROJECT MANAGER
504 MEADovn- NI7 ❑R
HILLSBOROuGH, NC 27278
PHONE: (91 9) 732•-3883
FAX: [phone]
SUtlt*11T
6ESt" AND ENG1kFEPJNG SUNICK
2 e
MOII1I-�10101( i
AV AWD %TVIN-N 171
2015
CREATIVELY INSPIRER — TECHNICALLY EJCEcuTED
t In Liu
h_ tt:,:! rwww.summitde.net
PLEASE CONSIDER THE ENVIRONMENT BEFORE PRINTING.
From: Kevin O'Dell[mailta:[e-mail]]
Sent: Wednesday, January 18, 2017 2:57 PM
To: '[e-mail]'
Subject: FW: WI0500156 O'Dell Geothermal Well
kco
KEVIN C. O'DELL, PE
VICE PRESIDENT. PROJECT MANAGER
504 MEADOwLAND DR
HILLSSOROUGH, NC 27278
PHONE: [phone]
FAX: [phone]
ACEC
YNGINE Lit;
1�:A1�T? 1ti74�i� A
2015

Sutltl[T
DESIGN AND ENGMEWNG SMYI M
r�c�,l� I,'S c:� rcsicl
2015
CREATIVELY INSPIRED — TECH>~ icAL-.Y ExECtrr ED
10 Lu
htto llwww.summitde.net
PLEASE CONSIDER THE ENVIRONMENT BEFORE PRINTING.
From: Kevin O'Dell [maiito:kevin.odell�d�surnmitde net]
Sent: Wednesday, January 11, 2017 10:35 AM
To: '[e-mail]'
Subject: RE: W10500156 O'Dell Geothermal Well
Per your request. Thanks loco
KEVSN C- ❑'DELL, PE
VICE PRESIDENT. PROJECT MANAGER
504 MEADOWLAND Dot
HILLSBOROUGH, NC 27278
PHONE: [phone]
FAX: [phone]
SUt*1L*11T
DESIGN AND EPNCAREERING SIiWCES
C
ON I 'S
AAARD NXII
2015
CREATIVELY INSPIRED — TECHNICALLY ExECUTED
httL-.://www.summitde.net
PLEASE CONSIDER THE ENVIRONMENT BEFORE PRINTING.
From: odellkcolLdaol.com [mai[to odellkcoin'aol.com]
Sent: Tuesday, January 10, 2017 2:11 PM
To: kevin..odeilrc summitde.net
Subject: Fwd: WI0500156 O'Dell Geothermal Well
-----Original Message ---
From: Rogers, Michael <michaet,ro_qersfa�nedenr govev
ACEC
Ft'61\EIRr.V4C,
rINCT I I rNq T
AWARD Wl:%-N Fft
2015
2015

To : odellkco <[e-mail]>
Sent: Tue, Jan 10, 201 7 2:02 pm
Subject: FW: WI0500156 O'Dell Geothermal Well
Kevin-
We rec'd the renewal application for your geothermal well. Thanks . However, Angela Burton, as a co-owner, still needs to
sign the application. Attached is the signature page. Please have her also sign and then send back as an attachment to
this email.
Thanks .
--Original Message----
F rom : Michael Rogers [mailto :michael.rogers @ ncdenr gov]
Sent: Tuesday, January 10, 2017 12 :50 PM
To: Rogers, Michael <michael.rogers @ ncdenr.gov>
Subject:
This E-mail was sent from "RNPAC7DD0" (Aficio 2075).
Scan Date: 01.10.2017 12:49:55 (-0500)
Queries to: robin.markham @ ncdenr.g ov
Spam
Phish/Fraud
Not s pam
Porn.et previous vote
3
Rogers, Michael
From:
Sent:
To:
Subject:
Attachments:
Kevin-
Rogers, Michael
Tuesday, January 10, 2017 2:02 PM
'[e-mail]'
FW: WI0500156 O'Dell Geothermal Well
20170110124955782.pdf
We rec'd the renewal application for your geothermal well. Thanks. However, Angela Burton, as a co-owner, still needs
to sign the application. Attached is the signature page. Please have her also sign and then send back as an attachment
to this email.
Thanks.
-----Original Message-----
From: Michael Rogers [mailto:[e-mail]]
Sent: Tuesday, January 10, 2017 12:50 PM
To: Rogers, Michael <[e-mail]>
Subject:
This E-mail was sent from "RNPAC7DD0" (Aficio 2075).
Scan Date: 01.10.2017 12:49:55 (-0500)
Queries to: [e-mail]
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Welcome to the Chatham County,
NC Land Records viewing
application.
The application
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FRPAkST067
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DaadNar Umrwarylk OOUKEWIC
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t�

North Carolina Department of Environmental Quality -Division of Water Resources
APPLICATION FOR A PERMIT TO CONSTRUCT OR OPERATE INJECTION WELL(S)
In Accordance With the Provisions of 15A NCAC 02C .0224
GEOTHERMAL HEATING/COOLING WATER RETURN WELL(S )
These well(s) inject groundwater directly into the subsurface as part of a geothermal beating and cooling system
CHECK ONE OF THE FOLLOWING:
__ New Application _X __ Renewal* __ Modification __ Permit Rescission Request*
*For Permit Renewals or Rescission Request, complete Pages 1 and 4 (signature page) only
Print or Type Information and Mail to the Address on the Last Page. Illegible Applications Will Be Returned As Incomplete.
DATE: ~12=/=28~ _____ _, 2016 PERMIT NO. WI0S00156 ____ (leave blank ifNew Application)
A. CURRENT WELL USE & OWNERSHIP STATUS (Leave Blank if New Well/Permit Application)
1. Current Use of Well
a. I wish to continue to use the well as [8] Geothermal Well [8] Drinking Water Supply Well
D Other Water Supply Use-Indicate use (i.e., irrigation, etc.) ________ _
b. Terminate Use: If the well is no longer being used as a geothermal injection well and you wish to
rescind the permit, check the box below. If abandoned, attach a co 1th JN.e. bandonment
Record (GW-30). KECE E ;N 1 JUt1 VVK
D Yes, I wish to rescind the permit JAN -3 2017
Water Qua\ity Regional
2. Current Ownership Status O erations Section
Has there been a change of ownership since permit last issued? D -Ws [8] NO
If yes, indicate New Owner's contact information:
Name(s) ---=K=ev..:....:i=n -=C.:.....;. O"'-'=D-=el:..:....l _,,t-L--_,,.,4..;...A/......_6-e--='---""'Ur"'"""----l;J'l--=Y:.L.J&c.=..~n2...=..;...,J;;.__ ________ _
'-I I J 6-f t-Mo/lt, Ile~ Mailing Address: [e-mail]
City: Chapel Hill State:_NC_Zip Code: 27516 County: Chatham
Day Tele No.: 919-795-1305 Email Address.:[e-mail]
B. STATUS OF APPLICANT (choose one)
Non-Government: Individual Residence X Business/Organization __
Government: State Municipal __ County__ Federal
C. WELL OWNER(S)/PERMIT APPLICANT -For single family residences, list all persons listed on the
property deed. For all others, list name of business/agency and name of person and title with delegated
authority to sign: Kevin O'Dell, An gela Burton
Mailing Address: ---=S=am=e _________________________ _
City: ____________ State: __ Zip Code: ______ County: _____ _
Day Tele No.: Cell No.:
EMAIL Address: Fax No.:
Geothermal Water Return Well Permit Application Rev. 3-1-2016 Page I
D. WELL OPERATOR (if different from well owner)— For single Family residences, list all persons Listed on
the property deed. For all others, list name businesslagency and name of person and title with delegated
authority to sign: Same
Mailing Address:
City: State: Zip Code: County:
Day Tele No.: Email Address.:
C. PHYSICAL LOCATION OF WELL(S) SITE
(1 ) Parcel Identification Numbe� (PIN) of well site: -County:---
(2) Physical Address (if different than mailing address): Same
City:
County
F WELL DRILLER INFORMATION
Well Drilling Contractor's Name:
NC Well Drilling Contractor Certification No.:
Company Naive:
I"
Contact Person: EMAIL Address:
Address:
City: _ Zip Code: _ _ —'_ State:
Office Tele No.: Cell No.: 1
HVAC CONTRACTOR INFORMATION (if different tan driller)
HVAC Contractor's Name.
NC HVAC Contractor License No.:
Company Name:
County:
Fax No..
Contact Person: EMA - Address:
Address:
City: "Lip Code: State: County:
Office Tele No.: Cell No.:
Zip Code: T _4 -
Fax No.:
WELL USE Will the injection well(s) also be used as the supply wet s) for the fallowing?
(1) The injection operation? YES NO
(2) Personal consumption? YES NO
L WELL CONSTRUCTION REQUIREMENTS — As specified in , -% NCAC!1'C 02 24(,d')-
(1) The water supply well shall be constructed in accordance with the water supply well requirements of
(2) if a separate well is used to inject the heat pump effluent, then the injection well shall be constructed
in accordance with the water supply well requirements of { 7A Nt-AC 0.C' ,41►t-, except that:
Geothermal Water Return Well. Permit Application Rev. 3-1-2016 Page 2

NOTE: In most cases an aerial photograph of the property parcel showing property lines and structures can be
obtained and downloaded from the applicable county GIS website. Typically, the property can be searched by
owner name or address The location of the wells in relation to property boundaries, houses, septic tanks, other
wells, et_ can then be drawn In by hand Also, a 'layer' can be selected showing topographic contours or
elevation data
NL CERTIFICATION (to be signed as required below or by that person's authorized agent)
i r. - ; requires that all permit applications shall be signed as follows:
I . for a corporation: by a responsible corporate officer;
2, for a partnership or sole proprietorship: by a general partner or the proprietor, respectively,
3. for a municipality or a state, federal, or other public agency: by either a principal executive
officer or ranking publicly elected official;
4. for all others: by all the persons) Iisted pn the_prapem deed.
If an authorized agent is signing on behalf of the applicant, then supply a letter signed by the
applicant that names and authorizes their agent to sign this application on their behalf.
"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, 1 believe that the information is file, 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_'
Si ure o1L4 e Ok r1A lids t+t
� PrtY �' Pp
lu� A- C - pee �)--
Print or Type Full Name and Title
SignatuJ'r of Property Owner/Applicant
Print or Type N411 Name and Title
Signature of Authorizes .%gent, if any
Print or Type Full Name and'itle
Submit two copies of the completed application package to:
Division of Water Resources - UIC
Water Quality Regional Operations Section (WQROS)
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone [phone]
Geothermal Water Return Well Permit AppUcat'son Rev. 3-1-2016 Page 4

(a) For screen and gravel -packed wells, the entire length of casing shall be grouted from the top
of the gravel pack to land surface;
(b) For open-end wells without screen, the casing shall be grouted from the bottom of the casing
to land surface.
(3) A sampling tap or other approved collection equipment shall provide a functional source of water
during system opL',(.ation for the collection of water samples immediately after water emerges from the
supply well and imi'v4iately prior to injection-
i
J. WELL CONSTRUCTION SIVXIFICATION5
(1) Specify the number and IiTe of wells to be used for the geothermal heating/cooling system:
*EXISTkG WELLS PROPOSED WELLS
*For existing wells, please atach a cop} of the Well Construction Record (Form GW-1 ) if available.
(2) Attach a schematic diagram of •ach water supply and injection well serving the geothermal
heatinglcooling system. A sing diagram can be used For wells having the same construction
specifications as long as the diau ttm clearly identifies or distinguishes each well from one another.
Each diagram shall demonstrate co(t�pliance with the well construction requirements specified in Part
H above and shall include, at a mtnti+lum, the following well construction specifications_
1,
(a) Depth of each boring N1low land surface
(b) Well casing and screen s�'�e, thickness, and diameter
(L:) Casing depth below land su�[ace
(d) Casing height "stickup" above land surface
(e)
(f)
(g)
K. OPERATING DATA
(1)
(2)
(3)
(4)
Grout material(s) surrounding
Note: bentoni(e grouts are pry
mg1L chloride or greater per
Length of well screen or open
Length of send or gravel packing
Injection Rate:
Injection Volume:
Injection Pressure:
Injection Temperature:
Average (daily)
Average (daily)
Average (daily)
Average (January)
and depth below land surface
1 for sealing water -bearing zones with 1500
and depth below land surface
ell screen and depth below land surface
per minute (gpm).
per day (gpd).
inch (psi)-
.' F. .average (July) ° F.
L. SITE MAP— As specified in I , attach a site-speci t , map that is scaled or otherwise
accurately indicates distances and orientations of the specified features from the inje ion well(s), The site map shall
include the following:
(1) All water supply wells, surface water bodies, and septic systems including drainfield, waste
application area, and repair area located within 250 feet of the injection well(s).
(2) Any other potential sources of contamination listed in located within 250
feet of the proposed injection well(s).
(3) Property boundaries located within 250 feet of the parcel on which the proposed injection well(s) are
to be located.
(4) An arrow orienting the site to one of the cardinal directions (north, south, west, or east)
Gmthermai Water Return Well Permit Application Rev. 3-1-2016 Page 3

GEOTHERMAL HEATING/COOLING WELL CONSTRUCTION DETAIL
Choose applicable Injection Well design and check the appropriate boxes. Fill In depths below land surface (BLS) and
details of well construction on the blank lines provided. Use additional sheets as needed.
Oven -Hole Well Desi n
LJ Proposed El Existing
❑ injection; ❑ Supply;
❑ Dual Purpose
Record Depths Below
Land Surface (BLS)
on Lines Provided
Bottom of easing
(Ft. BLS) -
rota] Depth
(Ft. BLS)
(FQ
Return or supply Line
Casing
Grout
WELL DETAILS
Casi Material:
Casing E meter (in.):
Grout Type:
Grout Depth (I S):
Top of Bentonite - al (if present);
Bottom of Bentonite - eal
Screen Material_
Screen Slot Size (in.):
Sand/Gravel Pack
Material Type:
Bentonite Sea
\ (f present)
Bedrock
Sand/Gravel Pack
)pen Hole
Screen
Screened Well Design
Proposed ❑ Existing
❑ Injection; ❑ Supply;
❑ Dual Purpose
(Ft.)
Record Depths Below
Land Surface (BLS) on
Limes Provided
(Ft. 13LS)
(Ft. BLS)
Bottom of casing
(Ft. BLS)
(Total Depth
Ft, BLS)
NC Certified Well Driller Name: Certification No.;

NOTE: fir most cases an aerial pljorograph of tfie prvpero• parcel showing property tries and structures can be
obrafrrcd and do;Puloatled from the applicable couxty CIS tveasite. Typlcal(v, the propentr can he searched by
owner srm3ae or address, Tire locaflon of die n,ells irr relation to prapertt' houndaries, houses. septic tanks, other
wells, etc. can rlterr be drarvtr in h)t hand Also, a `ta}rer' can be seleeYed showing topographic contours or
elevation (tala
M. CERTIFICATION [to be signed as required below or by that person's authorized agent)
15A NCAC 021C 0211 [e) requires brat all permit applicatiorss shalt be signed as follows-
I . for a corporation: by a responsible corporate officer.
?- for a partnership or sole proprietorship.- by a general partner or the proprietor- respectively,
3. far- a municipality or a state, federal, or other public agency.- by either a principal executive
officer or ranking publicly elected official;
4. for all others; by all-thepersoni sj listed on the propery deers.
If an authorized agent is signing on behalf of the applicant. !ben supply a letter signed by the
applicant that Thames and autborixes their agent to sign this application on their behalf.
"1 hereby certify, under penalty of law, that l have personally examined and am familiar with the information
submitted in this document and all attacbments thereto and that, based on my inquin, of those individuals
immediately responsible for obtaining said information, I believe that the information is tMe. accurate and
complete. I am aware that there are significant penalties, including the possibility of fines and imprisonmeur,
for submitting false inl'ormation. l 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 Pen -nit,"
Signature of Property uwnerlAppucant
Print ar Type Full Name and Title
Signature Property D�vnerJAppIicant
Vn- t yr�TyFuli Name and Title
Signature of Authorized Agent, ifaay - - -
Print or Type full Name and `i'itle -- - -
Submit two Copies of the completed application package to:
Division of rater Resources - IRC
Water Quality Regional Operations Section OVQROS)
1636 trail Service Center
Raleigb, NC 27699-1636
Telephone [phone]
Gtothermal Water Return lVdl Permit Application Rc.'- 3-1-20 t 6 Page 4

PAT MCCRORY
Gavernor
DCNALD R. VAN DER VAART
Water Resources
ENVIRONMENTAL QUALITY
December 20, 2016
CERTIFIED MAIL # 7015 1520 0000 7838 4412
RETURN RECEIPT REQUESTED
Kevin C. O'Dell
411 Gilmore Rd
Chapel Hill, NC 27516
Subject: Notice of Expiration (NOE)
Geothermal Water Return./Open-Loop Injection Well
Permit No. W10540156
Chatham County
Dear Mr. Kevin:
S-ram
S. JAY ZIMMERMAN
Direcror
The Underground Injection Control ([TIC) Program of the North Carolina Division of Water
Resources (DWR) 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
geothermal injection well system located on your property at the above referenced address was
issued on April 20, 2012, and expires on March 30, 2017. Per permit conditions and requirements
per 15A NCAC 2C .0224(c), the renewal application must be submitted at least 120 calendar days
prior to expiration of the permit if you wish to continue operating the injection well on your
property.
If Your Geothermal Water Return Well is Still Currentiv Being Used for Iniection:
In order to comply with the regulatory requirements listed under North Carolina Administrative
Code (NCAC) Title 15A, Subchapter 2C, Section .0211, you must submit the enclosed renewal
application (Application for a Permit to Construct or Operate Injection Wells — Geothermal
Heating/Cooling Water Return Wells)_ The farm is also available on-line at our website
http://portal.nedenr.org/web/wqlaps/gwpro/permit-applications.
If Your Geothermal Water Return Well is NO LONGER Being Used for Injection:
If the well is no longer being used for injection, you do not have to renew your permit. Check the
box in Part A of the attached renewal application that you wish to rescind the permit and indicate
the current status of the well (i.e., used as water supply well, irrigation well, inactive, plugged and
abandoned, etc.). If it 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
.0240. When the well is plugged and abandoned, a well abandonment record (Form GW-30) must
be submitted to our office to certify that the abandonment was properly conducted.
State a#Noek Cam1ma I EavimrimauW Quality I Wafer Reso=cs
1611 Mwl service Center I RaWgh, North Camlina 275994517
919 707 9000

Page 2 of 2
If There has been a Change of Ownership of the Property:
If there has been a change of ownership of the property, an "Injection Well Permit
Name/Ownership Change" Form must also be submitted in addition to the renewal application_
This form is not enclosed but can be found at the website listed above. Please submit the applicable
forms to:
Division of Water Resources
UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Failure to submit the applicable forms in a timely manner may result in the assessment of civil
penalties in accordance with North Carolina General Statute 87-94. 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 shristi.shresth@�Lwncdenx.goy,
Regards,
pllcwhrlwAa
Shristi Shrestha
Hydrogeologist
Division of Water Resources
Water Quality Regional Operations Section
Enclosures
CC" Raleigh- Regional Office — WQROS w/o enclosures
Central Files - Permit No. W10500156 w/o enclosures

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Kevin C. C' Dell
Ln sem , 411 Gilmcre Rd
5y-.. Chapel. Hill, NC 27516
Lyiy�
= p5 Form 3800, April IN a ren ,a+u-
■ Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mallplece,
or on the front If space permits.
1. ArUclo Addressed to.
Kevin C. o' peil
411 Gilmore Rd
chapel HK NC 27515
A.
x rJ 0 Agent
© Addressee
B. ei,:ed by (Arir+t N.
C. Date of Delivery.
1-2—; 3 e ,
D. Is delivery aa&es$ dlff4�errt hvm item 17 ❑ Yes
It YES, enter delivery address below: ❑ NO
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.. . .
NA
5A1 ::.---
NCDENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
MEMORANDUM
Division of Water Quality
Charles Wakild, P. E
Director
August 23, 2012
Dee Freeman
Secretary
To:
Through:
Michael Rogers, The Central Office, APS
Jay Zimmerman 516-
From: Lin McCartney
Subject: Analytical Result Report-WI0500156, Kevin O'Dell,
Geothermal Heating/Cooling Water Well
Chatham County
Aquilc r Pro1cc1io11 Section
1628 Mail Service Center, Raleigh, North Carolina 27699-1628
Locmio11: 3800 Barrett Dr.. Raleigh, North Caro lina 27609
Phone: [phone] I r:AX: 919-571-4718
Internet: www.ncwaterq uality.o n,1
.\11 , 1 , Af'linmtivc Action Employer
RECEIVEDIDENR/DWQ
AUG 2 7 2012
Aquifer Protection Section
OnehC 1· N art aro 1na
Naturally
NCDENR
North Carolina Department of Environment and Natural Resources
Division or Water Quality
Beverly Eaves Perdue Cliaries Waki Id, P. E Dee Freeman
Governor Director Secretary
August 23, 2012
Kevin O'Dell
411 Gilmore Road.
Chapel Hill, NC 27516
Subject: Analytical Results of Well Water
Permit No. W105000156
Geothermal Heating/Cooling Water
Well
Chatham County
Dear Mr. O'Dell,
Enclosed please find the analytical results of the subject well water which was sampled on April 12,
2012. The influent (groundwater entering heat pump) and the effluent (water being injected into the
well) of the geothermal well system were sampled.
The analytical data indicate that all the parameters are in compliance with Groundwater Standards and
the subject welt is in compliance with the permit conditions. If you have any questions, please contact
me at [phone].
The Central Office-APS Files
Aquifer Protection Section
1629 Mail Service Center, Raleigh, Nurth Caroina 27699-162,1
Location: 3800 Barrett Dr.. Raleigh, Narth Carolina 27609
Phone: [phone] FAX; Q19.571-4718
[nterner www. •►oaf vuiergua[if�!,
An Equal Opportunity k AMrmative Aetian Empluyer
Sincerely,
Lin McCartney
Envirom-nental Senior Tech
NocthCarolina
;Vatwrally

r
Results
County
CHATHAM
Sample ID:
AB82557
River Basin
WA I-
C R
PO IVumt7er #
12G0281
t] 'AGE
Report To
RROSP
Date Received:
04/12/2012
r
Time Received:
12:13
Collector:
L MCCARTNEY
Labworks toginl0
DLEAVM
Region,
Report Generated:
Report
5118112
Sample Matrix:
GROUNDWATER
Loc. Type:
Reported:
0811El2012
Emergency Yes/No
Visiflo
COC Yes/No
Loc. DesGr.: IfEV114f4
Location 10:
5P019WI0500166
Collect Date: 0411212012
Collect Time: 11:00
Sample Depth
Result/Method Analysis
CAS # Analyte Name PQL Qualifier Units Deference pate Validated hs
LAB
Sample temperature at receipt by lab 2.1 °C 4112112 ❑LEAVITT
MIC
Coliform, MF Fecal in liquid
1
1 B2
CFU/I00ml
APHA9222D-20th
4112/12
ESTAFFORDI
Caliform, MF Total in liquid
1
1
CFU1100ml
APHA92226-20th
4112112
ESTAFFORDI
WET
Ion Chromatography
_TITLE_
mg1L
EPA 300.0
4119112
MOVERMAN
Chloride
1.0
2.4
mg/L
EPA 300.0
4119112
MOVERMAN
Fluoride
0.4
0.4 U
mg/L
EPA 300.0
4/19/12
MOVERMAN
Sulfate
2.0
2.0 U
mg1L
EPA 300.0
4119112
MOVERMAN
Total Dissolved Solids in liquid
12
154
mg1L
APHA254OC-18TH
4113/12
CGREEN
NUT
NO2+NO3 as N in liquid
0.02
0.16
mg1L as N
LaC10-107-04-1-c
4113112
CGREEN
MET
7429-90-5
A] by ICP
50
5011
ug/L
EPA 200.7
519112
ESTAFFORD1
7440-70-2
Ca by ICP
0.10
33
mg1L
EPA200.7
519112
ESTAFFORDI
7440-47-3
Cr by ICPMS
10
IOU
ug/L
EPA200.8
519112
ESTAFFORDI
7440-50-8
Cu by ICPMS
2.0
73
uglL
EPA 200.8
519112
ESTAFFORDI.
7439-89-6
Fe by ICP
50
50 U
ug/L
EPA 200.7
519112
ESTAFFORDI
Hardness by Calculation
1.0
97
mg1L
SM2340BEPA200.7
519112
ESTAFFORDI
7440-09-7
K by ICP
0.10
0.78
mg1L
EPA200.7
519112
ESTAFFORDI
7439-95-4
Mg by ICP
0.10
3.5
mg1L
EPA200.7
519112
ESTAFFORDI
7439-96-5
Mn by ICP
10
IOU
ug/L
EPA 200.7
519112
ESTAFFORDI
7440-23-5
Na by ICP
0.10
9.6
mg/L
EPA 200.7
519112
ESTAFFORDI
7440-02-0
Ni by ICPMS
2.0
7Z
ug/L
EPA 200.8
519M2
ESTAFFORDI
7439-92-1
Pb by ICPMS
2.0
2.0 U
ug/L
EPA 200.8
W9112
ESTAFFORDI
7440-66-6
Zn by ICPMS
10
58
ug/L
EPA 200.8
519112
ESTAFFORDI
Laboratory Section>> 1623 Mail Service Center, Raleigh, NC 27699-1823 [phone]
Far a rselalled descnp{Ian of The gvWlier cedes refee To r-, rr ,.:
Page 1 of 1

County:
CHATHAM
Sample ID:
ABS2558
River Basin
�laA7F
i .q
PO Number #
12G0282
Report To
RROSP
0'
Date Received:
04/12/2012
Collector:
L MCCARTNEY
(�►� -I
Time Received:
12:13
Labwoft LoginlD
OLEAVITT
Region:
RRO
r
Report Generated:
5/18/12
Sample Matrix:
GROUNDWATER
Date Reported:
08116/2012
Loc. Type:
Emergency YeslNo
Visitlp
COC Yes/No
Loc. Descr.: KEVIN O'
Location ID:
5PO19WI0500156
Collect Date: 04/1212012
Collect Time: 10:30
Sample Depth
CAS # Anayte Name POL Result/ Units Method Analysis Validated by
Qualifier Reference Date
LAB
Sample temperature at receipt by lab 2.1 "c 4112/.12 DLEAVtTT
MIC
Cal{form, MF Fecal in liquid
1
1 B2
CFU1100ml
APHA9222D-20th
4112/12
ESTAFFORDI
Coliform, MF Total in liquid
1
1 B2
CFU1100ml
APHA9222B-20th
4112(12
ESTAFFORDI
WET
Ion Chromatography
_TITLE_
mg1L
EPA300.0
4/19112
MOVERMAN
Chloride
1.0
2.0
mglL
EPA300.0
4119/12
MOVERMAN
Fluoride
0.4
0.4 U
mglL
EPA300.0
4119/12
MOVERMAN
Sulfate
2.0
2.9 U
mglL
EPA300.0
4/19/12
MOVERMAN
Total Dissolved Solids in liquid
12
153
mg1L
APHA254OC-18TH
4/13112
CGREEN
NUT
NO2+NO3 as N in liquid
0.02
0.16
mglL as N
Lac10-107-44-1-c
4113/12
CGREEN
MET
7429-90-5
Al by ICP
50
50 U
uglL
EPA 200.7
519112
ESTAFFORDI
7440-70-2
Ca by ICP
0.10
34
mg1L
EPA 200.7
519112
ESTAFFORDI
7440.47-3
Cr by ICPMS
10
10 U
UgIL
EPA 200.8
519112
ESTAFFORDI
7440-50-8
Cu by ICPMS
2.0
27
ugA-
EPA200.6
519112
ESTAFFORDI
7439.89-6
Fe by lCP
50
50 U
uglL
EPA 200.7
5/9112
ESTAFFORDI
Hardness by Calculation
1.0
100
mglL
SM2340BEPA 200.7
5/9112
ESTAFFORD1
7440-09-7
K by ICP
0.10
0.79
mg1L
EPA 200.7
519112
ESTAFFORDI
7439-95.4
Mg by ICP
0.10
3.6
mglL
EPA 200.7
519112
ESTAFFORDI
7439.96-5
Mn by ICP
10
IOU
uglL
EPA 200.7
519112
ESTAFFORDI
7440-23-5
Na by ICP
0.10
9.6
mg1L
EPA 200.7
519112
ESTAFFORDI
7440-02-0
Ni by ICPMS
2.0
2.0 U
uglL
EPA 200.8
519112
ESTAFFORI)l
7439-92.1
Pb by ICPMS
2.0
2.0 U
ug1L
EPA 200.8
519112
ESTAFFORDI
7440-66-6
Zn by ICPMS
10
51
uglL
EPA200.8
519112
ESTAFFORD1
Laboratory Section- 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone]
For a delailed der,0131ion of the quBLHer Codes refer !o
Page 1 w 1

Permit Number WI0500156
Program Category
Ground Water
Permit Type
Injection Heating/Cooling Water Return Well (5A7)
Primary Reviewer
michael. rogers
Coastal SW Rule
Permitted Flow
Facili
Facility Name
Kevin C. O'Dell SFR
. Location Address
411 Gilmore Rd
Chapel Hill
Owner
Owner Name
Kevin
Dates/Events
NC 27516
C O'Dell
Scheduled
Orig Issue
08/15/07
App Received Draft Initiated Issuance
03/30/12
Central Files : APS_ SWP_
05/01/12
Permit Tracking Slip
Status
Active
Version
2.00
Project Type
Renewal
Permit Classification
Individual
Permit Contact Affiliation
Major/Minor
Minor
·Region
Raleigh
County
Chatham
Facility Contact Affiliation
Owner Type
Individual
Owner Affiliation
Kevin C. O'Dell
411 Gilmore Rd
Chapel Hill NC 27516
Public Notice Issue
04/20/12
Effective
04/20/12
Expiration
03/30/17
Regulated Activities Re quested/Received Events -~---------------------
Heat Pump Injection RO staff report requested
RO staff report received
Outfall NULL
-Waterbody Name Stream Index Number Current Class
04/04/12
04/16/12
Subbasin
Permit Number WI0500156
Program Category
Ground Water
Permit Type
Injection Heating/Cooling Water Return Well (5A7)
Primary Reviewer
michael.rogers
Coastal SW Rule
Permitted Flow
Facilit
Facility Name
Kevin C. O'Dell SFR
Location Address
411 · Gilmore Rd
Chapel Hill
Owner
Owner Name
Kevin
Dates/Events
NC 27516
C O'Dell
Scheduled
Orig Issue
08/15/07
App Received Draft Initiated Issuance
03/30/12
Regulated Activities
Heat Pump Injection
Outfall hlULL
Central Files: APS_ SWP_
04/17/12
Permit Tracking Slip
Status
In review
Project Type
Renewal
Version Permit Classification
Individual
Permit Contact Affiliation
Major/Minor
Minor
Region
Raleigh
County
Chatham
Facility Contact Affiliation
Owner Type
Individual
Owner Affiliation
Kevin C. O'Dell
411 Gilmore Rd
Chapel Hill NC
Public Notice Issue Effective
Re q uested/Received Events
RO staff report requested
RO staff report received
27516
Expiration
04/04/12
04/16/12
Waterbody Name Stream Index Number Current Class Subbasin
A;'A NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue
Governor
Kevin C. O'Dell
411 Gilmore Road
Chapel Hill, NC 27516
Re: Issuance of Injection Well Permit
Permit No. WI0500156
Issued to Kevin C. O'Dell
Chatham County
Dear Mr. O'Dell:
Charles Wakild, P.E.
Director
April 20, 2012
Dee Freeman
~ecretary
In accordance with your application received March 30, 2012, I am forwarding Permit No. WI0500156 for the operation
of a SA 7 geothermal underground injection control (UIC) well heat pump system located at the above referenced address.
This permit shall be effective from the date of issuance until March 31, 2017, and shall be subject fo the conditions and
limitations stated therein.
The Raleigh Regional Office collected groundwater samples from your geothermal system on April 12, 2012. After the
laboratory analytical results are received, the results will be forwarded to you by the regional office .
. In order to continue uninterrupted legal use of this well for the stated purpose, you should submit an application to renew
the permit 120 days prior to its expiration date. As indicated in the permit, this permit is not transferable to any person
without prior notice to, and approval by, the Director of the Division of Water Quality. If you have any questions
regarding your permit or the Underground Injection Control Program please call me at [phone].
Best Regards,
~G-~~:-
Environmental Specialist
cc: Jay Zimmerman, Raleigh Regional Office
Central Office File, WI0500156
Chatham County Environmental Health Dept.
AQUIFER PROTECTION SECTION
1636 Mail SeNice Center, Raleigh, North Carolina 27699-1636
Location: 512 N. Salisbury St, Raleigh, North Carolina 27604
Phone: [phone] \ FAX: [phone]
Internet: www.ncwaterguallty.org
An Equal Opportunity I Affirmative Action Employer
N$rtllCaroli11a
0/llfui'all/l
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
Kevin C. O'Dell
FOR THE 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
injection well is located at 411 Gilmore Rd., Chapel Hill, Chatham County, NC 27516, and will be constructed
and operated in accordance with the application received March 30, 2012 , and in conformity with the
specifications and supporting data, all of which are filed with the Department of Environment and Natural
Resources and are considered a part of this permit.
This permit is for operation ofan 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 ofits issuance until March 31, 2017, and shall be
subject to the specified conditions and limitations set forth in Parts I through VIII hereof.
Permit issued this the ~day of "¼>ci I , 2012.
~)~
ii\ Charles Wakild, P.E., Director
~ Division of Water Quality
By Authority of the Environmental Management Commission.
Permit #WI0500156 UIC/5A7
ver. 03/2010
Page 1 of 5
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 sealed with a water-tight cap or well sealed, as defined in G.S. 87-85(16).
6. Each injection well shall be afforded reasonable protection against damage during construction and use.
7. Each geothermal injection well shall have permanently affixed an identification plate according to 2C
.0213(g).
PART II -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 ofthis permit does not imply that all
regulatory requirements have been met.
4. Continued operation of the injection system will be contingent upon the effluent not impacting
groundwater quality. The water quality of the effluent cannot be that of a lower quality than the influent,
which results in a degrading of water quality of the aquifer.
PART III-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
Permit #WI0S00156 UIC/SA7
ver. 03/2010
Page 2 of 5
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 IV -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.
PART V -INSPECTIONS
I. 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 VI-MONITORING AND REPORTING REQUIREMENTS
I. 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 Raleigh Regional Office, telephone number 919.:.791-4200, 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;
Permit #WI0500156 UIC/5A7
ver. 03/2010
Page 3 of 5
3. Where the Permittee becomes aware of.an omission of any relevant facts in a permit application:,-or of any
incorrect information submitted in said application or in any report to the Director, the relevant and
correct facts or information shall be promptly submitted to the Director by the Permittee.
4. In the event that the permitted facility fails to perform satisfactorily, the Permittee shall take such
immediate action as may be required by the Director.
PART VII -PERMIT RENEWAL
In order to continue uninterrupted legal use of the injection facility for the stated purpose, the Permittee shall
submit an application to renew the permit 120 days prior to its expiration date.
PART VIII-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)(l), Well
Construction Standards.
2. When operations have ceased at the facility and a well will no longer be used for any purpose, the
Permittee shall abandon that injection well in accordance with the procedures specified in 15A NCAC 2C
.0214, including but not limited to the following:
(A) All casing and materials may be removed prior to initiation of abandonment procedures if
the Director finds such removal will not be responsible for, or contribute to, the
contamination of an underground source of drinking water.
(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 #WI0500156 UIC/5A7
ver. 03/2010
Page 4 of 5
(G) The Permittee shall submit a Well Abandonment Record (Form GW-30) as specified in
15A NCAC 2C .0213(h)(l) within 30 days of completion of abandonment. · ·
3. The written documentation required in Part VIII (1) and (2) (G) shall be submitted to:
Permit #Wl0500156
Aquifer Protection Section-DIC Program
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
UIC/SA7
ver. 03/2010
Page Sof 5
Ro gers, Michael
From:
Sent:
To:
Cc:
Subject:
Michael,
Mccartney, Lin
Tuesday, April 17, 2012 3:43 PM
Rogers, Michael
Zimmerman, Jay
WI0500156, Kevin O'Dell
I have verified the height of the well head which is the casing extends above the ground. The casing extends above the
ground is 12 inches.
Thanks,
Lin McCartney
1
NA
NCDENR
RECEIVEO/OENR/OWQ
APR 16 2012
North Carolina Department of Environment and Natural ReAij~tection Section
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
April 13, 2012
MEMORANDUM
To:
Through:
From:
Michael Rogers, The Central Office, APS
Jay Zimmerman ~
Lin McCartney £ YYJ ·
Subject: Staff Report-WI0500156, Kevin O'Dell, 5A 7 Geothermal
Well Renewal Application
Chatham County
Aquifer Protection Section
1628 Mail Service Center, Raleigh, North Carolina 27699-1628
,.Location: 3800 Barrett Dr., Raleigh, North Carolina 27609
Phone: [phone] \ FAX: [phone] \ Customer Service: 1-877-623-6748
Internet: www.ncwatern uali 1v .org
An Equal Opportunity\ Affinnative Action Employer
Ni~hCarolina
Jvaturallu
AQUIFER PROTECTION REGIONAL STAFF REPORT
Date: Apri113.2012
To: Aquifer Protection Central Office
Central Office Reviewer: Michael Rollers
Regional Login No:
County: Chatha
Permittee: _Kevin O'DeW
Project Name: In'ection 5A7 Weld
Application No.: W1050015
L GENERAL INFORMATION
1. This application is (check all that apply): ❑ New 0 Renewal N
m
❑ Minor Modification ❑ Major Modification
❑ Surface irrigation 0 Reuse ❑ Recycle ❑ High Rate Infiltration ❑ Evaporation/Infiltration Lagoon'
❑ Land Application of Residuals ❑ Attachment B included ❑ 503 regulated ❑ 503 exempt
❑ Distribution of Residuals ❑ Surface Disposal
❑ Closed -loop Groundwater Remediation
Was a site visit conducted in order to
a. Date of site visit: 04-12-2012
® Other Injection Wells (including in situ relnediation)
this report? ® Yes or ❑ No.
b. Person contacted and contact information: Kevin O'Dell, 919-929-4168.919-795-1305
c. Site visit conducted by: Lin McCarWg1
d, Inspection Report Attached: ® Yes or ❑ No.
2. Is the following information entered into the BIMS record for this application correct?
® Yes or ❑ No, If no, please complete the following or indicate that it is correct on the current application.
For Treatment Facilities:
a. Location:
b. Driving Directions:
c_ USGS Quadrangle Map name and number:
d. Latitude: Longitude:
e_ Regulated Activities 1 Type of Wastes (e.g., subdivision, food processing, municipal wastewater):
For Disposal and Infection Sites:
(If multiple sites either indicate which_ sites_ the information aL)Vlies to. cop and paste a new section into the
document for each site, or attach additional Pmes_for each sitel
a, Location(s): 411 Gilmore Road Chapel Hill. NC 27516
b. Driving Directions: Hwy W to 15-501 S, right on Mann's Chapel Rd., right on Poythree Rd., left on
Gilmore Rd. -/2_mile on the left.
c. USGS Quadrangle Map name and number:
d. Latitude:35-51-09 Longitude: 79-07-52
H. NEW AND ALVOR MODIFICATION APPLICATIONS this section not needed br renewals or minor
rnnd1fleations, skip -to next section]
Description Of Waste(S) And Facilities
1. Please attach completed rating sheet. Facility Classification:
m
n
rr,
FORM: Stafif.Report-O'Dell

AQUIFER PROTECTION REGIONAL STAFF REPORT
IV. INJECTION WELL PERMIT APPLICATIONS (Complete these two sections for all systems that use injection
wells, including closed-loop groundwater remediation effluent injection wells, in situ remediation injection wells, and heat
pump injection wells.)
Description OfWell(S) And Facilities-New, Renewal, And Modification
1. Type of injection system:
~ Heating/cooling water return flow (5A7)
D Closed-loop heat pump system (5QM/5QW)
D In situ remediation (51)
D Closed-loop groundwater remediation effluent injection (5Lf'Non-Discharge")
D Other (Specify: )
2. Does system use same well for water source and injection? ~ Yes D No
3. Are there any potential pollution sources that may affect injection?~ Yes D No
What is/are the pollution source(s)? The septic tank. The septic tank is approximately 121 feet distance from
the well.
4. What is the minimum distance of proposed injection wells from the property boundary? 46Jt
5. Quality of drainage at site: ~ Good D Adequate D Poor
6. Flooding potential of site: ~ Low D Moderate D High
7. For groundwater remediation systems, is the proposed and/or existing groundwater monitoring program
(number of wells, frequency of monitoring, monitoring parameters, etc.) adequate? D Yes D No. Attach
map of existing monitoring well network if applicable. If No, explain and recommend any changes to the
groundwater monitoring program: NI A
8. Does the map presented represent the actual site (property lines, wells, surface drainage)?~ Yes or D 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.
Injection Well Permit Renewal And Modification Only:
1. For heat pump systems, are there any abnormalities in heat pump or injection well operation (e.g. turbid water,
failure to assimilate injected fluid, poor heating/cooling)?
D Yes ~ No. If yes , ex plain:
2. For closed-loop heat pump systems, has system lost pressure or required make-up fluid since permit issuance
or last inspection? D Yes D No. If yes . ex plain:
3. For renewal or modification of groundwater remediation p ermits ( of any typ e), will
continued/additional/modified in jections have an adverse impact on migr ation of the plume or management of
the contamination incident? D Yes D No. If yes , ex plain:
FORM: Staff.Report-O'Dell 4
AQUIFER PROTECTION REGIONAL STAFF REPORT
4. Drilling contractor: Name: W.W. Maness & Sons, Inc.
Address: 196 Woodrow Road
Robbins, NC 27325
Certification number: 2460
5. Complete and attach Well Construction Data Sheet.
V . EVALUATION AND RECOMMENDATIONS
1. Provide any additional narrative regarding your review of the application.:
2. Attach Well Construction Data Sheet -if needed information is available
3. Do you foresee any problems with issuance/renewal of this permit? D Yes IZ! No. If yes, please explain
briefly. __ .
4. List any items that you would like APS Central Office to obtain through an additional information request.
Make sure that you provide a reason for each item:
Item Reason
5. List specific Permit conditions that you recommend to be removed from the permit when issued. Make sure
that you provide a reason for each condition:
Condition Reason
6. List specific special conditions or compliance schedules that you recommend to be included in the permit when
issued. Make sure that you provide a reason for each special condition:
Condition Reason
FORM: Staff.Report-O'Dell 5
AQUIFER PROTECTION REGIONAL STAFF REPORT
7. Recommendation:. ❑ Hold, pending receipt and review of additional information by regional office; ❑ Hold,
pending review of draft permit by regional office; ❑ Issue upon receipt of needed -additional information;
Issue; ❑ Deny. If deny, please state reasons:
8. Signature of report preparers):
Signature of APS regional supervisor:
v(
Date: k, Zu -Z-`
ADDITIONAL REGIONAL STAFF ICEVIE'WITEMS
Well construction inspection and well water sampling were conducted on April 12, 2012.
The following comments are highlighted as a result of the inspection,
A review of the construction data indicates that the subject geothermal injection well has been constructed
in accordance with N.C. State Regulations (Title 15A NCAC 2Q, Well Construction Standards.
The following items were checked:
R
1. Well Casing ; s]�,r.�t �o
• Casing :Diameter: 6.25 inch ri - ..A . `��� . %�' r
• Casing depth: from ground to 42 feet. Casing extends above ground 9 inches.
Type: Galvanized Steel. 0 W101 :5 o br.cle -f-❑ Vf'r fy 4h e h rs hfi o
2_ Grout L w6,'rL1 r S s ���� rc! -� ca b � figs C�sr,,� Riei­-e .ds
• Grout type- Cement j rao.,o4
• Grout surface and grout depth- Around well casing from 0 to 20 feet.
3. Identification plate
■ The well has an identification plate.
The plate contains the following information: Contractor Registration No. 2460; Date
Well Completed 7-26-2006; Total Depth of Well: 600ft; Casing Depth: 42 ft; Diameter: 6
'/a inches; Static Water Level: 25 ft; Yield: 5 GPM.
4. The.location of the well
• The septic tank (potential pollution source) is approximately 125 feet distance from the
well.
• The minimum distance of the well from the property boundary is about 46 feet.
• The minimum distance of the well from the building is 72 feet.
Over all, this geothermal injection well is in compliance with well construction standards.
However, we are awaiting the lab results of the well water to complete this application process.
FORM: Staff -Report -O'Dell 6

Permit: WI0500156
SOC:
County: Chatham
Region: Raleigh
Compliance Inspection Report
Effective: 08/15/07 Expiration: 07/31/12
Effective: Expiration:
Owner: Kevin C O'Dell
Facility: Kevin C. O'Dell SFR
411 Gilmore Rd
Contact Person: Kevin C O'Dell Title:
Chapel Hill NC 27516
Phone:
Directions to Facility:
From downtown Carrboro take Jones Ferry road appx 4 miles. Turn Lon Demacus Rd. Go appx 1.5 miles and tum R on Poythress
Rd . Go acpx 1,2.5 mjles and turn R on Gilmore Rd. Property is appx .3 miles.
System c1ass1f1cat1ons:
Primary ORC:
Secondary ORC(s):
On-Site Representative(s):
Related Permits:
Inspection Date: 04/12/2012
Primary Inspector: Lin McCartney
Secondary lnspector(s):
Entry Time: 10:30 AM
Certification:
Exit Time: 12:00 PM
Phone:
Phone: [phone]
Ext.4243
Reason for Inspection: Routine Inspection Type: Compliance Sampling
Permit Inspection Type: Injection Heating/Cooling Water Return Well (5A7)
Facility Status: ■ Compliant O Not Compliant
Question Areas:
■Wells
(See attachment summary)
Page: 1
Permit: WI0500156
Inspection Date: 04/12/2012
Owner• Facility: Kevin C O'Dell
Inspection Type: Compliance Sampling Reason for Visit: Routine
Inspection Summary:
Well construction inspection and well water sampling were conducted on April 12, 2012.
The following items were checked:
1. Well Casing
* Casing: Diameter: 6.25 inchess
* Casing depth: from ground to 42 feet. Casing extends above ground 9 inches.
2. Grout
* Grout type: Cement
* Grout surface and grout depth-Around well casing from Oto 20 feet.
3. Identification Plate
* The well has an ID plate.
* The plate contains the following information: Contractor Registration No. 2460; Date Well Completed 7-26-2012; Total
Depth of the Well: 600 ft; Casing Depth: 42 ft; Diameter: 6.25 in; Static Water Level: 25 ft; Yield: 5 GPM.
4. The location of the well
* The septic tank (potential polltion source) is approximately 125 feet distance from the well.
* The minimum distance of the well from the property boundary is about 46 feet.
* The minimum distance of the well from the building is about 72 feet.
Over all, this geothermal injection well is in compliance with well construction standards.
However, we are awaiting the lab results of the well water to complete this application processs.
Page: 2
RIVATE
5y�y[ CC
11 GILMCiRE RD �.
31
17 "� xx faR p
Im 0 �p
r r
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,Q , ri , . RF-d PINE.lj e
CHATHAM COUNTY, NC
Property Map �T
r"T:�:� Dlaclalnner. .RV
The dd9 providedc m Ilea map are prepared l01 the elveatory of red prnpa:ty f—d wi6w.
Chedtem Coady, M and Ora mmplied from recorded VAto. deeds, end vgw pLewc mcofds
` eod dd.. Tics data 3a for irftmma§anal purposes Doty and should net be -b6 fi tl d
for ■ ua:a Ulieatarah, property appraiad, alway, arfor mnho vpds�aea,. One Inch = 1024 Feet

Chatham Count y Property Record Card (can't)
DATE 2/10/12
TIME 15:35:26
USER TINA
ODELL KEVIN CHARLES
CHATHAM CO TAX DEPARTMENT
PROPERTY CARD
FOR YEAR 2012
PARCEL Ib; . 008106'7
IMPROVEMENT# 1 MAJOR IMPR-M
PAGE 3
PIN ... 9766 01 15 0451 PROG# AS2006
+----24----+
5-12--+
3
0
+ 4------33---+---+
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3
5
9 +--15--+
+
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+
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2
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3
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A
++B14--+--13-+---18+--+
1 1
2 2
+--------36-------+
M R
D D
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D U
2.00
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AC
AC
06
D
D
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D U
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9.00
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D
D
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TOTAL PARCEL VALUES----
L
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FMV ..... .
APV ..... .
PB 2004/23 LOT 2
SPLIT OUT OF 0002690
COVERED PORCH
12.00
36.00
D D
D U
FRAME GARAGE FINISHE
2.00 M R
9.00 D u
SINGLE FAMILY UNIT w
1.00 D u
2.00 D u
18.00 D D
LAND I OVR
101,100
101,100
2.00
12.00
D R
---------TRAVERSE
13.00 D U 2.00 D R 11.00
---------TRAVERSE------------------------------
13.00 M
30.00 D
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2.00
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M R
D D
18.00
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M U
D L
28.00
15.00
FLOOR: 1.00 ---------TRAVERSE------------------------------
12.00 D R
5. 00 D R
2.00 D L
IMPROVEMENTS/ OVR
474,470
474,470
COMMENTS
1.00
12.00
13.00
D U
D D
D U
TOTAL LAND/IMPROVE
575,570
575,570
7.00
4.00
2.00
D L
D R
D L
2. DO
33.00
14.00
2011 VALUE
575,570
575,570
Chatham County Property Record Card {can't)
DATE 2/10/12
TIME 15:35:26
USER TINA
ODELL KEVIN CHARLES
3.99 3.74 NET
CHATHAM CO TAX DEPARTMENT
PROPERTY CARD
FOR YEAR 2012
PARCEL ID .. 00810S7
PAGE 4
PIN ... 9766 01 15 0451 PROG# AS2006
A QUIFER PROTECTION SECTION
APPLICATION REVIEW RE QUEST FORM
Date: A pril 4 , 2012
To: □ Landon Davidson, ARO-APS
□ Art Barnhardt, FRO-APS
□ Andrew Pitner, MRO-APS
[8] Jay Zimmerman, RRO-APS
□ David May, WaRO-APS
□ Morella Sanchez King, WiRO-APS
□ Sherri Knight, W-SRO-APS
From: Michael Ro gers Groundwater Protection Unit
Telephone: [phone] Fax: [phone]
E-Mail: [e-mail]
A. Permit Number: WI 0500156
B. Owner: O'Dell
C. Facility/Operation: -. __
D Proposed [8J Existing D Facility D Operation
D. Application:
1. Permit Type: D Animal D SFR-Surface Irrigation □ Reuse D H-R Infiltration
D Recycle D I/E Lagoon D GW Remediation (ND)
[8J UIC-5A7 Open Loop Geothermal Well
For Residuals: D Land App. D D&M
D 503 D 503 Exempt
D Surface Disposal
D Animal
2. Project Type: D New D Major Mod. D Minor Mod. [8J Renewal D Renewal w/ Mod.
E. Comments/Other Information: · IXl
NOTE: Please return a completed APSARR Form after completing the site inspection and collecting water samples.
At a later date, after the laboratory results are received by your office, send us a copy of the cover letter & laboratory
analytical results, which you send to the Permittee. Please record all information on the well tag and put on staff
report. Thanks.
[8J Return a completed APSARR Form after the site inspection. At a later date, after the lab
results are received, please send a copy of the cover letter & laboratory analytical results, which
you send to the Permittee.
D Attach Well Construction Data Sheet.
D Attach Attachment B for Certification by the LAPCU.
D 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
.ar.A NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue
Governor
Charles Wakild, P.E. Dee Freeman
Secretary
Kevin C. O'Dell
411 Gilmore Road
Chapel Hill, NC 27516
Dear Mr. O'Dell:
Director
April 3, 2012
Subject: Acknowledgement of
Application No. WI0500156
Kevin C. O'Dell SFR
Injection Heating/CooJing
Water Return Well (SA 7)
System
Chatham County
The Aquifer Protection Section acknowledges receipt of your permit application and supporting
documentation received on March 30, 2012. Your application package has been assigned the number
listed above, and the primary reviewer is Michael Rogers.
Central and REGION 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].
Scr~ly, 4 . ~
forDcb ~s
cc: Raleigh Regional Office , Aquifer Protection Section
Permit File WI0500156
AQUIFER PROTECTI ON SECTION
1636 Ma il Service Ce nter, Raleigh , North Caro lin a 276 99 -1636
Location : 512 N. Sa lisbury St., Raleig h, North Carolina 276 04
Phone : [phone] \ FAX: [phone]
Internet: www .ncwaterquality.org
An Equ al Oppo rtun ity I Affirmativ e Ac ti on Employer
Groundwater Protection Unit Supervisor
One
North Carolina
Jvatttrnll!f
NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
APPLICATION FOR A PERMIT TO CONSTRUCT OR OPERATE INJECTION WELLS
In Accordance With the Provisions of 15A NCAC 02C .0200
OPEN -LOOP GEOTHERMAL INJECTION WELLS
These wells discharge groundwater directly into the subsurface as part of a geothermal heating and cooling system
(check one) New Application _Renewal's Modification
+ For renewals complete Parts A-C and the signature page,
Print or Type Information and Mail to the Ad&r is on the Last Page. Illegible Applications Will Be Returned As Incomplete.
DATE:
PERMIT NO. ��MlSjlOjleave blank if New Application)
A. STATUS OF APPLICANT (choose one)
Non -Government: Individual Residence Business/Organization
Government: State Municipal County Federal
B. PERMIT APPLICANT — For individual residences, list each owner on property deed. For all others,
s name of entity and name ofte-rrsson delegated authority to sign on behalf of the business or agency:
[Je
Mailing Address: W l� +� or?, WV_61 ''``k._
City:
Day Teh
EMAIL
P 6 A l 1 _ State: X� Zip Code: V5 /I— County:
C. LOCATION OF WELL SITE — Where the injection wells are physically located:
(1) ParceI Identification Number (PIN) of well site: ` l r] County: 4&61—
(2) Physical Address (if different than mailing address):
City: _ _ _ State: NC Zip Code:
D. WELL DRILLER INFORMATION RECEMMENRMWC
Well Drilling Contractor's Name:
NC Well Drilling Contractor Certification No.: _ MAR 3 4 r0+2
Company Name:. Aquifer section
Contact Person: EMAIL Address:
Address:
City: Zip Code: State: County:
Office Tele No.: Cell No.: Fax No.:
GPU/UIC 5A7 Permit Application (Revised 3/18QOI t ) Page 1

E. HEAT PUMP CONTRACTOR INFORMATION (if different than driller)
Company Name: _______________________________ _
Contact Person~: ---------------=E=MA~I=L~A~d=dr~e=ss==------------
Address: __________________________________ _
City: Zip Code: ____ State: __ County: _________ _
Office Tele No.: · Cell No.: Fax No.: -------------------~~~-------
F. WELL USE Will the injection well(s) also be used as the supply well(s) for the following?
(1)
(2)
The injection operation?
Personal consumption?
YES ___ _ NO __ _
YES ___ _ NO ___ _
G. WELL CONSTRUCTION DATA
(1)
____ PROPOSED Well(s) to be construc;ted for use as an injection well. Provide the data in (1) through
(6) below as PROPOSED construction specifications. Submit Form GW-1 after construction.
---------'EXISTING Well(s) being proposed for use as an injection well. Provide the data in (1) through (6)
below to the best of your knowledge. Attach a copy of the Well Construction Record (Form
GW-1) if available.
Well Construction Date: _______ Number of borings: ___ _
Depth of each boring (feet): _______ _
(2) Well casing type: Galvanized steel __ ·_ Black steel ___ .-. Plastic __ ._ Other (specify) _____ _
Casing thickness (in.): __ Diameter (in.): __ _
Well depth: from: ___ to: . feet below l~~ sµrface
Casing extends abov~ ground ____ .inches
(3). Grout rilaterial surrounding well casing:
(4) __
(5)
(6)
(a). Grout type: Cement__ Bentonite* Other (sI?ecify) ______ _
*By ~electing bentonite grout, a variance is hereby requested to ISA NCAC 2C .0213(d)(l)(A), which requires a cement type grout.
(b) Depth of grout around well casing (relative to land surface): from ___ to ___ feet
Well Screen or Open ~orehole depth (relative to land surface): from ____ to ____ feet
N.C. State Regulations (Title ISA NCAC 2C .0200) require the Permittee to make prov1s1ons for
monitoring wellhead processes. A faucet on both Influent (groundwater entering heat pump) and Effluent
(water being injected back into the well) lines is required. Is there a faucet on:
(a) Influent line? Yes No (b) Effluent line? Yes No
Source Well Construction Information. If the water source well is a different well than the injection
well, attach a copy of the well construction record (Form GW-1). If Form GW-1 is not available, provide
the following data:
From what depth, formation, and type of rock/sediment units will the groundwater be withdrawn? (e.g.
granite, limestone, sand, etc.)
Depth: Formation: Rock/sediment unit: ----------------------
NOTE: THE WELL DRILLING OR HEAT PUMP CONTRACTOR CAN HELP SUPPLY THE DATA IF THIS
INFORMATION IS OTHERWISE UNAVAILABLE.
GPU/UIC SA 7 Pennit Application (Revised 3/18/2011) Page2
H. OPERATING DATA
(1) Injection Rate: Average (daily) gallons per minute (gpm).
(2) Injection Volume: Average (daily) gallons per day (gpd).
(3) Injection Pressure: Average (daily) pounds/square inch (psi).
(4) bijection Temperature: Average (January) ° F, Average (July) __ ° F.
I. WELL LOCATIONS -Maps must be scaled or otherwise accurately indicate distances and orientations of
features located within 1000 feet of the injection well(s). Label all features clearl y and include a north arrow.
(1) Attach a site-specific map showing the locations of the following:
* Proposed injection wells * Buildings * Property boundaries
* Surface water bodies * Water supply wells
* Septic tanks and associated spray irrigation sites, drain fields, or repair areas
* Existing or potential sources of groundwater contamination
(2) Attach a topographic map of the area extehdirig i/4 mile from the injection well site that indicates the
facility's location and the map name.
NOTE: In most cases, an aerial photograph of the property parcel slwwing proper:ty lines and structures can be
obtained and downloaded from the applicable county GIS website. Typically, the property can be searched by
owner name or address. The location of the wells in relatipn to property boundaries, houses, septic tanks, other
wells, etc. can then· be drawn in by hand. Also, a 'layer' can be selected showing topographic contours or
elevation data.
GPU/UIC SA 7 Permit Application (Revised 3/18/2011) Page 3
J. CERTIRCA'TIDN (to be signed as required below or by that person's authorized agent)
15A NCAC 02C A211(b) requires that all permit applications shall be signed as follows:
1. for a corporation: by a responsible corporate officer;
2. for a partnership or sole proprietorship: by a general partner or the proprietor, respectively;
3. for a municipality or a state, federal, or other public agency: by either a principal executive
officer or ranking publicly elected official;
4. for all others: by the well owner (which means all persons listed on the roperty deed).
If an authorized agent is signing on behalf of the applicant, then supply a letter signed by the
applicant that names and authorizes their agent to sign this application on their behalf.
I hereby certify, under penalty of law, that I have personally examined and am familiar with the information
submitted in this document and all attachments thereto and that, based on my inquiry of those individuals
immediately responsible for obtaining said information, I believe that the information is true, accurate and
complete. I am aware that there are significant penalties, including the possibility of fines and imprisonment,
for submitting false information. I agree to construct, operate, maintain, repair, and if applicable, abandon the
injection well and all related appurtenances in accordance with th approved specifications and conditions of
the Permit." e
S'gnature of Propar�y Pfwn Xp�licant
or T*a Full Name
Signature of Property Owner/Applicant
Print or Type Full Name
Signature of Authorized Agent, if any
Print or Type Full Name
Submit two copies of the completed application package to:
DWQ - Aquifer Protection Section
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone [phone]
GPt3MC SA7 Permit Application (Revised 31 B1201 i )
RECENE /DENR/M
MAR 3 0 1 u `�
Aquifer Protection Seccdon
Page 4

State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STATUS OF INJECTION WELL SYSTEM
Permit Number: W .1 () f; OD J5:h
::::7~;•= 0X:1
D~L ~~/ ~~J ~I ]\/ NC ))15d
Please check the selection which most closely describes the current status of your injection well system:
1) ~ Well(s) still used for injection activities, or may be in the future.
2) D Well(s) not used for injection but is/are used for water supply or other purposes.
3) □ Injection discontinued and: a)□ Well(s) temporarily abandoned
b) □ Well(s) permanently abandoned
c) □ Well(s) not abandoned
4) □ Injection well(s) never constructed
Current Use of Well
If you checked (2), describe the well use (potable water supply, irrigation, monitoring, etc), including pumping rate and other
rrl_evant info qn,a~n. ~ n ~
J.\JAJ ',J.e/\~ ~r ,.mw-vc,1 Q-01,\/L(e._. N,,{)J) f-4'·'12 •
Well Abandonment
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):
Permit Rescission:
If you checked (2), (3), or ( 4) and will not use a well for injection on this site in the future, you should request rescission of the
permit. Do you wish to rescind tIJs,permit?
□ Yes 't\] No
Certification:
"I hereby certify, under penalty oflaw, that I have pe. onally examined and am familiar with the information submitted
in this document, and that to the:--i:-'-~-:-um"""re""'":-'-kn-ow..._le-d""'"ge_t_,,h_e,,_in-+fi-01-r _·_i _n_i_s -tr_u_•• occ? :i)~.''
Revised 5/05 GW/UIC-68
RECEIVED/DENR/DWQ
MAR 3 U (,J 1Z
Uner · Kif! ;:;er,to11 Aq :« Protect' ,... ..
NCDENR
North Carolina Department of Environment and Natural Resources
l]ivision of Water Quality
Beverly Eaves Perdue Charles Wakild, P. E.
Governor Director
March 1, 2012
Kevin O'Dell
411 Gilmore Road
Chapel Hill, NC 27516
Subject: Notice of Expiration (NOE)
SA7 Geothermal Injection Well
Permit No. W10500156
Chatham County
Dear Mr. O'Dell:
Dee Freernan
Secretary
The Underground Injection Control (UIC) Program of the North Carolina Division of Water
Quality (DWQ) is entrusted to protect the groundwater quality and resources of the State of
North Carolina, and is responsible for the regulation of injection well construction and operation
activities within the state. Our records indicate that the above -referenced operating permit for
the underground injection well system located on your property at 411 Gilmore Road in'Chapel
Hill, NC, which was issued to you on August 15, 2007, and expires on July 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
Namc/Ownership Change Form must also be submitted. The OW-30 and Name/Ownership
Change forms can be found at http:llportal.ncdenr.__or-/weblwcllat7slawgr_oh•eporting-forms.
If Your Injection Well is Currently Active:
If the injection well system is still active and you wish to renew your permit, the renewal
application must be submitted within 120 calendar days of the expiration of your permit.
According to our records, you must submit your permit renewal by April 2, 2012.
AQUIFER PROTECTION SECTION
1636 Va+I Serilce Center, Ralgh, North Carolina 27699.1636
Location: 512 N. Salisbury St, Raleigh; North Carolina 27604
Rhone: 9 19 -8 07-64 64 1 FAK 91M07.6496
Internet, nw.ncffltarattality.a1g
An Equal Opportunity I At mative Action Emplay®r
One
NoilhCarolina
Natlirndy

In order to comply with the regulatory requirements listed under North Carolina Administrativ e
Code (NCAC) Title 15A, Subchapter 2C, Section .0211 , you must submit one of the follO\ving
enclosed forms:
A. Application for Permit (Renewal) to Constru ct and/or Use a Well(s) for Injection with
Geothermal Heat Pump System for Type 5A7 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.org/web/wq/ ap s/ £Wpro/perrn it-app lications#QeothermA pps.
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.!l [e-mail].
Sincerely,
c£: dJ , .. ~r---
Eric G. Smith, P .G.
Hydrogeologist
Enclosures
cc: Raleigh Regional Office -APS w/o enclosures
A P S C entral F iles -P erm it N o . W I05 0 0 156 w/o enclo sures
2
Permit Number WI0500156
Program Category
Ground Water
Permit Type
Injection Heating/Cooling Water Return Well (5A7)
Primary Reviewer
michael. rogers
Permitted Flow
Facilit
Facility Name
Kevin C. O'Dell SFR
Location Address
411 Gilmore Rd
Chapel Hill
Owner
Owner Name
Kevin
Dates/Events
NC
C
Orig Issue App Received
01/11/07
27516
O'Dell
Draft Initiated
Scheduled
Issuance
Central Files: APS_ SWP_
08/14/07
Permit Tracking Slip
Status
In review
Project Type
New Project
Version Permit Classification
Individual
Permit Contact Affiliation
Major/Minor
Minor
Region
Raleigh
County
Chatham
Facility Contact Affiliation
Owner Type
Individual
Owner Affiliation
Kevin O'Dell
9.905 Oak Hollow Rd
Chapel Hill NC
Public Notice Issue Effective
g/1s/o,
27516
Expiration
7/J; /t<
Re gulated Activities Re quested/Received Events -----------------------
Heat Pump Injection RO staff report requested
Outfall NULL
Waterbody Name
RO staff report received
RO staff report received
Stream Index Number Current Class
01/17/07
03/21/07
07/23/07
Subbasin
Michael F. Easley, Governor
William G. Ross ir., Secretary
North Carolina Department of Environment and Natural Resources
D --s
August 15, 2007
Kevin C. O'Dell
9905 Oak Hollow Road
Chapel Hill, NC 27516
Re: Issuance of Injection Well Permit
Permit No. W10500156
Issued to Mervin C. O'Dell
Dear Mr. O'Dell:
Coleen ff. Sullins, Director
Division of Water Quality
In accordance with your signed application received January 11, 2007, 1 am forwarding Permit
No. W10500156 for the operation of a 5A7 geothermal underground injection well (UIC) heat
pump system located at 411 Gilmore Road, Chapel Hill, Chatham County, North Carolina. This
permit shall be effective from the date of issuance until July 31, 2012, and shall be subject to the
conditions and limitations stated therein.
In order to continue uninterrupted legal use of this well for the stated purpose, you should submit
an application to renew the permit four (4) 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.
Also attached is a summary of the laboratory sampling results from water samples collected from
your geothermal well on July 12, 2007, Results indicated zinc levels exceeding the maximum
contamination levels per NCAC 2L 200. However, according Raleigh Regional Office staff, it
is not unusual to see elevated zinc levels in groundwater pumped through newly installed wells
with steel casing. It is recommended that you have the well re --sampled and tested in
approximately 6 months to see if there is a decrease in the zinc concentrations.
If you have any questions regarding your permit or the Underground Injection Control (UIC)
Program please call Mr. Qu Qi at [phone] or me at [phone].
Best Regards,
`Michael Rogers
Environmental Specialist
GPU — UIC Control Program
cc: Jay Zimmerman — Raleigh Regional Office
Central Office File
Attachtnent(s)
Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636
Internet; htip Ywww.nnwatemaafitv.are 273E Capital l3oule�r,ad Raleigh, NC 27604
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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
KEVIN C. O'DELL
FOR THE 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 injection well is located at 411 Gilmore Road, Chapel Hill, North Carolina,
and will be operated in accordance with the application received January 11, 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 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 July 31, 2012,
and shall be subject to the specified conditions and limitations set forth in Parts I through VIR
hereof.
Permit issued this the 2t, day of 2007.
Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission.
W10500155 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 (l SA 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 uriauthorized 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-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.
WI0500156 Page3
PART III -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 creatfon 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 IV -OPERATION AND MAINTENANCE REQUIREMENTS
1. The injection facility shall be properly maintained and operated at all times.
2. The Permittee must notify the Division and receive prior written approval from the
Director of any planned physical alterations or additions in the permitted facility or activity
not specifically authorized by the permit.
PART V -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.
WI0500156 Page4
PART VI -MONITORING AND REPORTING REQUIREMENTS
l. 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 Raleigh Regional Office, telephone number (919) 791-
4200, 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 Pennittee.
4 . In the event that the permitted facility fails to perform satisfactorily, the Permittee shall
take such immediate action as may be required by the Director.
PART VII -PERMIT RENEWAL
The Pennittee shall, at least 120 days prior to the expiration of this permit, request an extension.
PART VIII -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 discontinuation of use of a well for
injection. If a well is taken completely out of service temporarily, the Permittee must
install a sanitary seal. If a well is not to be used for any purpose that well must be
permanently abandoned according to 15A NCAC 2C .0213(h)(l), Well Construction
Standards.
2. When operations have ceased at the facility and a well will no longer be used for any
purpose, the Permittee shall abandon that injection well in accordance with the procedures
specified in 15A NCAC 2C .0214, including but not limited to the following:
(A)
WI0500156
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.
Pages
(B) The entire depth of each well shall be sounded before it is sealed to insure
freedom from obstructions that may interfere with sealing operations.
(C) Each well shall be thoroughly disinfected, prior to ·sealing, if the Director
determines that failure to do so could lead to the contamination of an
underground source of drinking water.
(D) Each well shall be completely filled with cement grout, which shall be
introduced into the well through a pipe, which extends to the bottom of the
well and is raised as the well is filled.
(E) In the case of gravel-packed wells in which the casing and screens have
not been removed, the casing shall be perforated opposite the gravel pack,
at intervals not exceeding 10 feet, and grout injected through the
perforations.
(F) In those cases when, as a result of the injection operations, a subsurface
cavity has been created, each well shall be abandoned in such a manner
that will prevent the movement of fluids into or between underground
sources of drinking water and in accordance with the terms and conditions
of the permit.
(G) The Permittee shall submit a Well Abandonment Record (Form GW-30)
as specified in 15A NCAC 2C .0213(h)(l) within 30 days of completion
of abandonment.
3. The written documentation required in Part VIII (1) and (2) (G) shall be submitted to:
WI0500156
Aquifer Protection Section-DIC Staff
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
Page6
LABO RA TORY ANALYTICAL RES UL TS
5A7 GEOTHERMAL UNDERGROUND INJECTION CONTROL (UIC) WELL
PERMIT NO.: WI 0500156
PERMITTEE: Kevin C. O'Dell
SAMPLE COLLECTED DATE: 7/12/2007
Coliform, total Col iform, fecal pH
1 CFU/100ml 1 CFU/100ml units
MCL=1 MCL=1 MCL = 6.5-8.5
I Influent 1 1 6
I Effluent 1 1 6
NO2-+ NO3-as N Phosphorus Nitrate
mg/L mg/L mg/L
MCL= 10 MCL=nss MCL= 10
I Influent 0.16 0.07 0.16
I Effluent 0.16 0.08 0.16
Calcium, Ca Cadmium,Cd Chromium, Cr
mg/L uail pg/L
MCL= nss MCL=1.75 MCL=50
I Influent 35 <1 <10
I Effluent 33 <1 <10
Manganese, Mn Sodium, Na Nickel, Ni
l,lg/L mg/L µg/L
MCL= 50 MCL= nss MCL=100
I Influent <10 9.1 <10
I Effluent <10 8.7 <10
MCL = Maximum Contamination Level per NCAC 2L .0200 (GA Standards)
nss = no state standard
na = not analyzed
Total Dissolved Solids
mg/L
MCL=500
157
157
Nitrite
mg/L
MCL=1
<.01
<.01
Copper, Cu
ua/L
MCL= 1000
28
32
Lead, Pb
µg/L
"MCL= 15
<10
<10
*The laboratory sample matrix interfered with the ability to to make any accurate determination; Estimat~
Chloride, Cl
mg/L
MCL=250
2.5
2.6
Silver, Ag
ua/L
MCL=17.5
na
na
Iron, Fe
ua/L
MCL=300
<50
<50
Selenium, Se
ua/L
MCL= 50
na
na
Sulfate
mg/L
MCL=250
<2
<2
Aluminum, Al
ua/L
MCL=nss
<50
<50
Mercury, Hg
ua/L
MCL= 1.05
na
na
Zinc,Zn
pg/L
MCL=1050
1200
1300
Ammonia, NH3 TKN
mg/L mg/L
MCL=nss MCL= nss
<.02 <.2
<.02 <.2
Arsenic,As Barium, Ba
ua/L lJ Q/L
MCL=50 MCL=2000
na na
na na
Potassium, K Magnesium, Mg
mg/L mg/L
MCL= nss MCL= nss
na 3.6
na 3.4
Flouride, F
mg/L
MCL=2
<.4
<.4
Michael F. Easley, Governor
�p G
t
William G. Ross Jr.. SWretary
worth Carolina Department of rmvironment and Natural Reso=es
P'
Coleen R sullins; Director
Division of Vv'ater Quality
August 15, 2007
Kevin C. O"Dell
9905 dale Hollow Road
Chapel Hill, NC 27516
Re: Issuance of injection Well Permit
Permit No. WI0500156
Issued to Kevin C. O'Dell
Dear Mr. O'Dell:
In accordance with your signed application received January 11, 2007, 1 am forwarding Permit
No. W10500156 for the operation of a 5A7 geothermal underground injection well (UIC) heat
plump system located at 411 Gilmore Road, Chapel Hill, Chatham County, North Carolina. This
permit shall be effective from the date of issuance until July 31, 2012, and shall be subject to the
conditions and limitations stated therein.
In order to continue unintemipted legal use of this well for the stated purpose, you should submit
an application to renew the permit four (4) 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.
Also attached is a summary of the laboratory sampling results from water samples collected from
your geothermal well on July 12, 2007. Results indicated zinc levels exceeding the maximum
contamination levels per NCAC 2L .200. However, according Raleigh Regional Office staff, it
is not unusual to see elevated zinc levels in groundwater pumped through newly installed wells
with steel casing. It is recommended that you have the well re -sampled and tested in
approximately 6 months to see if there is a decrease in the zinc concentrations.
If you have any questions regarding your permit or the Underground Injection Control (UIC)
Program please call Mr. Qu Qi at [phone] or me at [phone].
Best Regards,
-Michael Rogers
Environmental Specialist
GPU - UIC. Control Program
cc: Tay Zimmennan - Raleigh Regional Office
Central Office File
Attacliment(s) 71> thCamlina
�Ll�llil7i'a'!f
Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636 Telephone: [phone]
lntcvnet: h :// MCWat9MLaliLV,0T 2728 Capital Boulevard Raleigh, NG 27604 Fax t: [phone]
Fax 2: [phone]
An Equal DpportunitylAffrmaWe Act on Employer- 50% Recycledll0% Post Consumer Paper 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
I{EVIN C. ❑'DELL
FOR THE 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 injection well is located at 411 Gilmore Road, Chapel Hill, North Carolina,
and will be operated in accordance with the application received January 11, 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 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 July 31, 2012,
and shall be subject to the specified conditions and limitations set forth in Parts I through VIII
hereof.
Permit issued this the 2-` day of , 200T
Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission.
W10500156 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 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, 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-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 notke to, and approval by, the Director of the
Division of Water Quality (Director). In the event there is a desire for the facilityto
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.
WI0500156 Page3
PART III -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 IV -OPERATION AND MAINTENANCE REQUIREMENTS
1. The injection facility shall be properly maintained and operated at all times.
2. The Permittee must notify the Division and receive prior written approval from the
Director of any planned physical alterations or additions in the permitted facility or activity
not specifically authorized by the permit.
PART V -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.
WI0500156 Page4
PART VI -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 Raleigh Regional Office, telephone number (919) 791-
4200, 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 Pei:mittee.
4. In the event that the permitted facility fails to perform satisfactorily, the Permittee shall
take such immediate action as may be required by the Director.
PART VII -PERMIT RENEW AL
The Permittee shall, at least 120 days prior to the expiration of this permit, request an extension.
PART VIII -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 discontinuation of use of a well for
injection. If a well is taken completely out of service temporarily, the Permittee must
install a sanitary seal. If a well is not to be used for any purpose that well must be
permanently abandoned according to 15A NCAC 2C .0213(h)(l), Well Construction
Standards.
2. When operations have ceased at the facility and a well will no longer be used for any
purpose, the Permittee shall abandon that injection well in accordance with the procedures
specified in 15A NCAC 2C .0214, including but not limited to the following:
(A)
WI0500156
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.
Pages
(B) The entire depth of each well shall be sounded before it is sealed to insure
freedom from obstructions that may interfere with sealing operations.
(C) Each well shall be thoroughly disinfected, prior to sealing, if the Director
determines that failure to do so could lead to the contamination of an
underground source of drinking water.
(D) Each well shall be completely filled with cement grout, which shall be
introduced into the well through a pipe, which extends to the bottom of the
well and is raised as the well is filled.
(E) In the case of gravel-packed wells in which the casing and screens have
not been removed, the casing shall be perforated opposite the gravel pack,
at intervals not exceeding 10 feet, and grout injected through the
perforations.
(F) In those cases when, as a result of the injection operations, a subsurface
cavity has been created, each well shall be abandoned in such a manner
that will prevent the movement of fluids into or between underground
sources of drinking water and in accordance with the terms and conditions
of the permit.
(G) The Permittee shall submit a Well Abandonment Record (Form GW-30)
as specified in 15A NCAC 2C .0213(h)(l) within 30 days of completion
of abandonment.
3. The written documentation required in Part VIII (1) and (2) (G) shall be submitted to:
WI0500156
Aquifer Protection Section-DIC Staff
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
Page6
LABORATORY ANALYTICAL RES UL TS
5A7 GEOTHERMAL UNDERGROUND INJECTION CONTROL (UIC) WELL
PERMIT NO.: WI 0500156
PERMITTEE: Kevin C. O'Dell
SAMPLE COLLECTED DATE: 7/12/2007
Coliform, total Coliform, fecal pH
1 CFU/100ml 1 CFU/100ml units
MCL=1 MCL=1 MCL = 6.5-8.5
I Influent 1 1 6
I Effluent 1 1 6
NO2-+ NO3-as N Phosphorus Nitrate
mall mg/L ma/L
MCL= 10 MCL= nss MCL= 10
I Influent 0.16 0.07 0.16
I Effluent 0.16 0.08 0.16
Calcium, Ca Cadmium.Cd Chromium, Cr
mg/L uatL ua/L
MCL= nss MCL= 1.75 MCL=50
I Influent 35 <1 <10
I Effluent 33 <1 <10
Manganese, Mn Sodium, Na Nickel, Ni
ua/L mg/L µg/L
MCL= 50 MCL= nss MCL=100
( Influent <10 9.1 <10
I Effluent <10 8.7 <10
MCL = Maximum Contamination Level per NCAC 2L .0200 (GA Standards)
nss = no state standard
na = not analyzed
Total Dissolved Solids
mg/L
MCL= 500
157
157
Nitrite
mall
MCL=1
<.01
<.01
Coooer, Cu
µg/L
MCL=1000
28
32
Lead, Pb
ug/L
MCL= 15
<10
<10
*The laboratory sample matrix interfered with the ability to to make any accurate determination; Estimatei:l
Chloride, Cl
mg/L
MCL=250
2.5
2.6
Silver.Ag
ua/L
MCL= 17.5
na
na
Iron, Fe
µg/L
MCL=300
<-50
<50
Selenium, Se
ua/L
MCL= 50
na
na
Sulfate
mg/L
MCL=250
<2
<2
Aluminum, Al
ua/L
MCL= nss
<50
<50
Mercury, Hg
ua/L
"1CL = 1.05
na
na
Zinc,Zn
ug/L
MCL=1050
1200
1300
Ammonia, NH3 TKN
mg/L ma/L
MCL= nss MCL= nss
<.02 <.2
<.02 <.2
Arsenic,As Barium, Ba
µg/L ug/L
MCL= 50 MCL=2000
na na
na na
Potassium, K Magnesium, Mg
mg/L mg/L
MCL=nss MCL=nss
na 3.6
na 3.4
Flouride, F
mg/L
MCL=2
<.4
<.4
Michael F. Easley, Govemur
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Coleen H. Sullins, Director
Division of Water Quality
August 9, 2007
Mike Rogers
DWQ APS Central Office
Parker Lincoln Building
2728 Capital Boulevard
Raleigh, NC 27604
Subject: NC DWQ Lab Results
UIC (5A7) Injection Water Well
Permittee: Kevin C. O'Dell
Permit Number: WI0500156
Chatham County
Dear Mike Rogers,
NC DWQ Lab Results indicated that there was a slight elevation in the zinc concentration over
the 2L Groundwater Quality standards of 1.05 ppm but not enough to hold up the permit. The influent
zinc concentration was 1.2 ppm while the effluent zinc concentration was 1.3 ppm. ]ay Zimmerman
(supervisor APS-RRO) noted that this was not unusual with wells that have steel casing.
Should you have any questions, please call me at [phone].
Sincerely,
Ed Owen
Environmental Senior Tech
Raleigh Regional Office
attachments: NC DWQ Laboratory Section Results
Cc: APS-RRO File
NOw Garurulll{�d ina
t
Aquifer Protection Section
Raleigh Regional Office 1628 Mail Service Center Raleigh, NC 27699-I628 Phone [phone] Customer Service
Internet: www,ncwaterquafity.org I.Alcation: 3800 Barrett Dr. Ralcigh NC 27609 Fax [phone]
An Equal Opportun4fAl'irnialive Action Employer— 50% Recycledlt0% Post Consurner Paper

XCDj4Q LaSaratorectign (Resutts
Loc. Descr.; KEVIN C CZELL Sample 0: A1319269
� IA� PONumher# 7GO572
Location ID RROAPNLC "i VsdO
County: CHATttAM Q� W Ar�/�� Collect Date: 071IV2007
River Basin
Report To RROAP q Collect Tune:: 10:30
r
Region- RRO r bate Received: 0711212007
CDICector l= OWEN i' Tpme Received- 12.46
Sample Matrix: GROUNDWATER ' u
MMA
Loc. Type: WATER SUPPLY n Late Reporks rte i- 0610
Sample Depth � ` � Date Reported- 0810712II07
Emergency Yesft
CAC Yes1No
Sample Qualifiers and Comments
Routine Qualifiers
For a more detailed description of these qualifier codes refer to www.dwglab,org under Staff Access
A-Vafue reported is the average of two or more determinations
N3-t=sFimated concentration is r PC1L and >MOL
81-Countable membranes with c20 colonies; Estimated NE -No established PQL
B2- Counts from all filters were zero.
B3- Countable membranes with more than 60 or 80 colones; Estimated P-Elevated PQL Cue to matrix interference andlor sampie dilutipn
B4-Filters have counts of bath >60 or So and a 20; Estimated ❑1-Holding lime exceeded prior to receipt at tab.
B5-Too marry mionles were present; too numerous to Doan! (TNTC) 02- Holding time exceeded following receipl by lab
PQL- Practical Quantitation Umil-subject to change due to instrument sensitivity
.iR- Reported value failed to meet QG aiterla far either precision or accuracy; Estimated
,13-1"hs sample matrix interfered wish the ability to make any accurate determination; Estimated Lf- Samples analyzed for this compound but not detected
.f8-The lab analysis was from an unpreserved or improperly chemically preserved sample; Estimated X 1 - Sample not analyzed for this Compound
N1-The component has been tentatively idemifiad based on mass spectral library search and has an estimated value
LAB
Laboratory Section— 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone] Page 1 of 3

:NC CDWQ Laboratory Section (Rgsu[ts Sample ID AB1926 9
L~tionlD: ·RROAPNLC Collect Date: 07/12/2007
Loe. Descr.: ::-:KEVIN C O'DELL Collect Time:: 10:30
Visit ID
CAS# Analyte Name PQL Result Qualifier Units AnalysVDate Approved By /Date
Sample temperature at receipt by lab 3.8 ·c DSAUNDERS JGOODWIN
Method Reference 7/13/07 7/13/07
MIC
Collfonn, MF Fecal In llquld 1 B2 CFU/100ml BSWANSON MOVERMAN
Method Reference APHA9222D-20th 7/12107 7/20/07
Coliform, MF Total In llquld · 1 CFU/100ml BSWANSON MOVERMAN
Method Reference APHA9222B-20th 7/12/07 7/18/07
Alkallnlty to pH 4.5 of llquld _TITLE_ mgfL as CaC03 ADESAI MOVERMAN
Method Reference APHA2320B-20th 7/13/07 7/19/07
AlkaUnlty4.5 110 mg/las CaC03 ADESAI MOVERMAN
Method Reference APHA2320B-20th 7/13/07 7/19/07
Alkallnlty8.3 u mg/Las CaC03 ADESAI MOVERMAN
Method Reference APHA2320B-20th 7/13107 7/19/07
Bicarbonate 110 mg/l as CaC03 ADESAI MOVERMAN
Method Reference APHA2320B-20th 7/13/07 7119,0)
Carbonate u mg/las CaC03 ADESAI MOVERMAN
Method Reference APHA2320B-20th 7/13/07 7/19/07
pH__Alkallnlty 7.2 mg/Las CaC03 ADESAI MOVERMAN
Method Reference APHA2320B-20th 7/13/07 7/19/07
WET
Total Dissolved Sollds In llquld 12 157 mg/l AWILUAMS MOVERMAN
Method Reference APHA2540C-18TH 7/16/07 7/23/07
Chloride 1.0 2.5 mg/l MIBRAHIM MOVE.RMAN
Method Reference EPA300.0 7/17/07 7/20/07
Fluor1de 0 .4 0.4 u mg/l MIBRAHIM MOVE.RMAN
Method Reference EPA 300 .0 7/17/07 7/20/07
Ion Chromatography _TITLE_ mg/l MIBRAHIM MOVE.RMAN
Method Reference EPA300.0 7/17/07 7/20/07
Sulfate 2.0 2.0 u mg/l. MIBRAHIM MOVERMAN
Method Reference EPA300.0 7/17/07 7/20/07
NUT
NH3 as N In llquld 0.02 0.02 u mg/LasN MAJAYI CGREEN
Method Reference Lacl0-107-06-1-J 7/17/07 7/19/07
Total K)eldahl N as N In liquid 0.2 0.20 u mg/LasN MOVERMAN CGREEN
Method Reference Lachat107-06-2-H 7/18/07 7/23/07
NO2+N03 as N In liquid 0 .02 0.16 mg/las N MAJAYI CGREEN
Method Reference Lac10-107-04-1-c 7/17/07 7/19/07
Laboratory Section» 1623 Mall Service Center, Raleigh, NC 27699-1623 [phone] Page 2 of 3
:NC a.YWQ, £a6oratory Section ~su[ts Sample ID AB19269
Location ID : RROAPNLC Collect Date: 07/12/2007
Loe. Descr.: , KEVIN C O'DELL Collect Time:: 10:30
Visit ID
CAS# Analyte Name PQL Result Qualifier Units AnalysUDate Approved By /Date
Phosphorus_total as P In liquid 0 .02 0.07 mg/1..asP GBELK CGREEN
Method Reference Lac10-115-01-1EF 7118/07 7127/07
Nitrate as N In liquid 0.02 0.16 mg/LasN MOVERMAN CGREEN
Method Reference Lachat107-04-1-c 7123/07 7123/07
Nltr1te as N In llquld 0 .01 0.01 u mg/LasN GBELK CGREEN
Method Reference Lachat107-04-1-c 7/12107 7/19/07
MET
7429-90-5 Al bylCP 50 50 u ug/L SGOSS ESTAFFORD
Method Reference EPA200.7 7125/07 8/3/07
7440-70-2 cabylCP 0.10 35 mg/I.. SGOSS ESTAFFORD
Method Reference EPA200.7 7/24/07 813J07
7440-43-9 CdbylCPMS 1 .0 1.0 u ug/1.. DSTANLEY ESTAFFORD
Method Reference EPA200.B 7/16/07 8/3/07
7440-47-3 CrbylCPMS 10 10 u ug/L DSTANLEY EST AFFORD
\
Method Reference EPA200.B 7/16/07 8/3107
7440-50-8 CUbylCPMS 2 .0 28 ug/L DSTANLEY EST AFFORD
Method Reference EPA200.B 7/16/07 8/3/07
7440-48-4 FebylCP 50 50 u ug/L SGOSS ESTAFFORD
Method Reference EPA200.7 7125/07 8/3/rYI
7439-95-4 MgbylCP 0 .10 3.6 mg/I.. SGOSS EST AFFORD
Method Reference EPA200.7 7124/07 8/3/07
7439-96-5 MnbylCPMS 10 10 u ug/L SGOSS ESTAFFORD
Method Reference EPA200.8 7/25/07 8/3/07
7440-23-4 NabylCP 0 .10 9 .1 mg/I.. SGOSS EST AFFORD
Method Reference EPA200.7 7/24/07 8/3/07
7440-02-0 NI bylCPMS 10 10 u ug/L DSTANLEY EST AFFORD
Method Reference EPA200.8 7/16/07 8/3/07
7439-92-1 PbbylCPMS 10 10 u ug/L DSTANLEY ESTAFFORD
Method Reference EPA200.8 7/16/07 8/3/07
7440-66-6 ZnbylCP 10 1200 ug/L DSTANLEY ESTAFFORD
Method Reference EPA200.7 7/16/07 8(3107
Laboratory Section» 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone] Page 3 of 3
I North Carolina
GROUNDWATER FIELD/LAB FORM Department of Environment and Natural Resources
DIVISION OF WATER QUALITY - GROUNDWATER SECTION
County (
Quad No___
Lai.
Serial No.
Long. —
$AMPLE TYPE
Water
❑ Soil
�] Other
SAMPLE PRIORITY
Routine
Emergency
Report To: ARO, FRO, MRO RR , WaRO, WiRO, ❑ Chalh of Custody
WSRO, Kinston FO, Fed. Trust $ntral Off., Other:
Shipped by: Sus, Courier, and Del.) Other- i ►O V _
Collector(s): �tA Date 7 — } `y Time 1 J �D 4M Baseline,
OZ Con
FIELD ANALYCjE5 Owner �ccP , r, C .
pH ; . 0 Spec. Cond.� `77. 3 W 25° C Location or site `f 1 r f
Lab Number
Date Received p W :7Z.gb ime j� '?'- 2
Rec'd by: rom: sus, Courier �e ,
Other:
Data Entry By:_
Date Reported:
C k:
Pesticide Study, Federal
1!
Temp.10 r oC Odor ll b IUD Description of sampling point -
Appearance a Sampling Method Sample Interval
Field An*sis By: DL./tA Remarks 1 c_ fi in _
SOD 310 m
D' _ lids 7 oa
A - SilvBr 465fifi u
Or anochlorine Pestiades
COD High 340 mg/l
Flouride 95t
Al - Aluminum 46567 ugA
Organophosphorus Pesticides
COD Low 335 M9A
Hardness, Tolal 900 maA
As - Arsenic 46551 um
Nitrogen Pesticides
K
Coliform; MF FWW 31616 11 f}Oml
Hardness non-carb 902 nw
Ba - Barium 46558 u
Acid Herbicides
Co0form: MF TOW 31504 1100211
Phongl§32730 vaA
X
Ca - Calcium 46552 MA
PC9's
TOC 690 m
Cd - Cadmium 46559 u P
Turbidity 76 NTU
,
SUliate 945
Cr - Chromium 46M u I
Residue., Suspended 5W m9A
Sulfide 745 mo
Cu - Copper 46562 u
Fe - Iron 46M uaA
Semivolatile Organics
Oil and Grease m rl
H - Marcua 719M U0
TPH - Diesel Range
pH 403 units
K - Pota551um 465% m
Alkalinity to pH 4.5 410 mg1l
M - Magnesium 465U m
r')K
Alkalinity to pH 8.3 415 mgA
Mn -Man anese 46565 u 11
Carbonate 445 mgll
NH as N 61U
556 1Na - Sodium 46
Volatile Organics (VOA bottle)
Bicarbonate 440 m
TPH - Gasoline Range
Carbon dioxide 405 nx
Y
K
NO + NO g N 530 m
Pb -Lead 46ssa a
TPH - eTF.J[ Gasalira Range
Chloride 940
)(
P: Total as P 665 m
Se - Selenium u
Chromium: Hex 1032
)r 3
Zn - Zino 46567 u
r
1'�c
Color True 80
LA
Cyanide 720
Lab Comments: C C. 1 QL C t'rlUr r 0 � H LA f yi c (r i /V W1 D CO (_ 1./ t z [ ��, +2m Z jY�), l]
ih' kI '- � ( A -tx . '-" U- A t) , � � f ' b -,
GW-54 REV.1219 For Dissolved Analysis - submit filtered sample and write "DIS" in blo

LOC. Qascr.: KEVIN C a'DELL Sam pie ID: A819270
PO Number # 7GO513
Localionla: RROAPNLC VisltiD
county' CHATHAM�F WA7��
Collect Date: 0711212007
Rivet Hasid
Report To RRQAP Collect Time:; 10:30
Region' RRO� Dale Received: 07112Y2007
Coilectov E OWEN Time Received: 12:45
Sample Matrix: GROUNDWATER ,1 '
MA
Loc. Type: WATER SUPPLY J Lah+ Reporks rteLogd: p l B10
Sample Depth L f Date Reported: Qg10712007
Emergency YeslNo
CDC YestNG
Sample Qualifiers and Comments
Routine Qualifiers
For a more detailed description of these qualifier codes refer to www.dwglab.org under Staff Access
A -Value reported is the average of two or more determinations N3-Estimated concentration is a PQL and �M bL
81-Countable membranes with <20 colonies; Estimated
NE -No established pQL
B2- Counts from all lifters were zero.
P-Elevated PQL due to matrix interference andlor sample dilution
83- Countable membranes with more than 6t] or 00 colonies; Estimated
Bq-Fillers have taunts of both y60 or Sff and < 20; Estimated Q1-Holding time exceeded prior to receipt at lalo.
aS-Too many colonies were present; Zoo numerous to Count (TNTC= 02- Holding time exceeded following receipt by lab
J2- Reported vatue failed to meet QC criteria for either precision or accuracy; Estimated PQL- Practical Quantitation Limit -subject to change due to instrument sensitivity
J3-The sample matrix interfered with the ability to make any accurate determinatiofZ; Estimated U- Samples analyzed for this compound but not detected
XThe lab analysis was from an unpreserved or improperly chemically preserved sample; Estimated lCI- Sample not analyzed for this oompound
N1-The Component has been taritaUvely identified teased on mass spectral library search and has an estimated value
MIC
Laboratory Section— 1623 Mall Servlte Center, Raleigh, NC 27699-1623 [phone] Page i of

NC <lYWQ £a6oratory Section r.R§su[ts Sample ID AB19270
Lqcation ID: RROAPNLC Collect Date: 07/12/2007
Loe. Descr.: __ .. KEVIN C O'DELL Collect Time:: 10:30
Visit ID
CAS# Analyte Name PQL Result Quallfler Units Analyst/Date Approved By /Date
Collfonn, MF Fecal In liquid 1 B2 CFU/100ml BSWANSON MOVERMAN
Method Reference APHA9222D-20th 7/12/07 7/20/07
Collfonn, MF Total In liquid 1 B2 CFU/100ml BSWANSON MOVERMAN
Method Reference APHA9222B-20th 7/12/07 7/18/07
Alkalinity to pH 4.5 of liquid _TITLE_ mg/Las CaC03 ADESAI MOVERMAN
Method Reference APHA2320B-20th 7/13/07 7/19/07
Alkallnlty4.5 110 mg/L as CaC03 ADESAI MOVE.AMAN
Method Reference APHA2320B-20th 7/13/07 7/19/07
Alkallnlty8.3 u mg/Las CaC03 ADESAI MOVEAMAN
Method Reference APHA2320B-20th 7/13/07 7/19/07
Bicarbonate 110 mg/Las CaC03 ADESAI MOVEAMAN
Method Reference APHA2320B-20th 7/13/07 7/19/07
Carbonate 1 u mg/L as CaC03 ADESAI MOVERMAN
Method Reference APHA2320B-20th 7/13/07 7/19/07
pH_Alkallnlty 7.2 mg/Las CaC03 ADESAI MOVEAMAN
Method Reference APHA2320B-20th 7/13/07 7/19/07
WET
Total Dissolved Solids In liquid 12 157 mg/L AWILLIAMS MOVEAMAN
Method Reference APHA2540C-18TH 7/16/07 7/23/07
Chlortde 1.0 2.6 mg/L MIBAAHIM MOVERMAN
Method Reference EPA 300.0 7/17/07 7/20/07
Fluoride 0.4 0.4 u mg/L MIBRAHIM MOVE.AMAN
Method Reference EPA300.0 7/17/07 7/20/07
Ion Chromatography _TITLE_ mg/L MIBAAHIM MOVE:RMAN
Method Reference EPA300.0 7/17/07 7120/07
Sulfate 2.0 2.0 u mg/L MIBAAHIM MOVEAMAN
Method Reference EPA300.0 7/17/07 7/20/07
NUT
NH3 as N In liquid 0.02 0.02 u mg/LasN MAJAYI CGAEEN
Method Reference Lacl0-107-06-1-J 7/17/07 7/19/07
Total Kjeldahl N as N In liquid 0.2 0.20 u mg/LasN MOVEAMAN CGAEEN
Method Reference Lachat107-06-2-H 7/18/07 7/23/07
NO2+N03 as N In liquid 0.02 0.16 mg/LasN MAJAYI CGREEN
Method Reference Lacl0-107-04-1-c 7/17/07 7/19/07
Phosphorus_total as P In liquid 0.02 0.08 mg/LasP GBELK CGAEEN
Method Reference Lac10-115-01-1EF 7/18/07 7127/07
Laboratory Section» 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone] Page 2 of 3
WC Cl)WQ_ La6oratory Section CJ.?gsu{ts Sample ID AB19270
Location ID : • -RROAPNLC Collect Date: 07/12/2007
Loe. Descr.: ;-:·KEVIN C O'DELL Collect Time:: 10:30
Visit ID
CAS# Analyte Name PQL Result Qualifier Units Analyst/Date Approved By /Date
Nitrate as N In llquld 0.02 0.16 mg/LasN MOVERMAN CGREEN
Method Reference Lachat107-04-1-c 7/23107 7/23107
Nltrtte as N In llquld 0 .01 0.01 u mg/LasN GBELK CGREEN
Method Reference Lachat107-04-1-c 7112107 7119/07
MET
7429-90-5 /!JbylCP 50 50 u ug/L SGOSS ESTAFFORD
Method Reference EPA200.7 7125/07 8/3/07
7440-70-2 CabylCP 0 .10 33 mg/L SGOSS EST AFFORD
Method Relerence EPA200.7 7124/07 8/3/07
7440-43-9 CdbylCPMS 1.0 1.0 u ug/L DSTANLEY EST AFFORD
Method Reference EPA200.8 7116107 8/3/07
7440-47-3 CrbylCPMS 10 10 u ug/L DSTANLEY EST AFFORD
Method Reference EPA200.8 7116107 8/3/07
7440-50-8 CUbylCPMS 2.0 32 ugfl DSTANLEY EST AFFORD
Method Reference EPA200.8 7116107 8/3/071
7440-48-4 FebylCP 50 50 u ug/L SGOSS EST AFFORD
Method Reference EPA200.7 7125/07 8/3/07
7439-95-4 MgbylCP 0 .10 3.4 mg/L SGOSS ESTAFFORD
Method Reference EPA200.7 7124/07 8/3/07
7439-96-5 MnbylCPMS 10 10 u ug/L SGOSS EST AFFORD
Method Reference EPA200.8 7125107 8/3/07
7440-23-4 Na bylCP 0 .10 8.7 mg/L SGOSS ESTAFFORD
Method Reference EPA200.7 7/24107 8/3/07
7440-02-0 NlbylCPMS 10 10 u ug/L DSTANLEY EST AFFORD
Method Reference EPA200.8 7/16/07 8/3/07
7439-92-1 PbbylCPMS 10 10 u U!>'L DSTANLEY EST AFFORD
Method Reference EPA 200.8 7116/07 8/3/07
7440-06-6 ZnbytCP 10 1300 ug/L PGAUTHIER ESTAFFORD
Method Reference EPA200.7 7125/07 8/3107
Laboratory Section» 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone] Page 3 of3
North Carolina
GRQU.N DWATE R FIELD/LAB FORM Department of Environment and !Natural Resources
DIVISION OF WATER QUALITY - GROUNDWATER SECTION
County.. _C L4 A (r,_ SAMPL9IIPE SAMPLE PRIORITY Lab NumberWat- .x
Z_�Zp
Quad No Serial No. 0 soil ® Emergeency Date Received o y Time
Lat. Long. ❑ Other EmergRec'd by. C_4rom: Bus, Courier and ❑e
eFp� Other:
Report To: ARO, FRO, MRO RO aRO, WiRO, ❑Chain of Custody Data Entry By: Ck:
WSRO, KinsREEDate
ntral Off., Other: Date Reported:
Shipped by: ,l., Other �� L�
Purpose: C � �
Collector(s): �'-1,? % Z Time ± Q 3D PCM Baseline, Complaint Com Tian _ �LllS�, Pesticide Study, Federal TrustCOthr)
FIELD ANALY5 E5 Owner Ke V 11be(
pH4w —�.� Q Spec. Cond.,, e � at 250 C Location or site
Temp.,, ! oC Odor N-L) Description of sampling point
Appearance Sampling Method Sample Interval
Field Analysis By: 01 1 Remarks - J,5 n-. ' _
LABORATORY ANALYSES — `ten° lime,
& iefflI abc-,' -i `t - :1 `] ti — 1 S 0 3
BOD 310 m9A
❑'ss. SlI 70300
A - Silver 46566 ugA
Or anochlorine Pesticides
COD High 340 mgA
Flouride 951 gW
At - Aluminum 46557 4
❑rganophosphorus Pesticides
COD Low 335
As - Arsenic 46551 uan
Nitroqen Pesticides
Coliform: MF Fecal 31616 /100MI
Hardness non -carts 902
Ba - Barium 46558 uco
Acid Herbicides
Coliform: MF Total 31504 1100m1
Ca - Calcium 46552 man
PCB's
TOG s60
Cd - Cadmium 46559 u
Turbidity 76 NTU
Sulfate 945 rrKY1
Cr - Chromium 40560 u
Residue., Suspended 530 nVn
Suicide 745 mqA
Cu - Copper 46562 UgA
Fe - Iron 46M UgA
Semivoiatile Organics
Oil and Grease m I
H - Mercury 71900 ugvl
TPH - Diesel Range
pH 403 unit
K - Potassium 46555 m
Alkalinity to pH 4.5 410 mgA
M - Magnesium 46sm
Alkalinity to pH 8.3 415 mgA
Mn - Man anew 46565 uqA
Carbonate 44s mgA
NH as N 610 m
Na - Sodium 46566 m
Volatile Organics tVOA bottle]
Bicarbonate 440 m
TPH - Gasoline Range
Carbon dioxide 405 mgA
N + NO as N 630
Ph - Lead 465M u n
TPH - STEX Gasoline Flange
Chloride 940 mgA
k
P: Total as P W6 rngA
Se - Selenium UqA
Chromium: Hex 1032 u
Zn - Zinc 46567 u
Color; True so CU
Cyanide 720 mgA
Lab Comments: rf LAA o' ` { Gvl ?n� 1
GW54 REV, 1219 For Dissolved Analysis - submit filtered sample and write "DIS" in bit

AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
Date: 07/12/2007
To: Aq uifer Protection Section Central Office
Central Office Reviewer: Michael Ro gers
Regional Login No: 05
County: Chatham
Permittee: Kevin C. O'Dell
Project Name: UIC-(5A7) Open Loo p
Application No.: WI0500156
L GENERAL INFORMATION
1. This application is (check all that apply): D New [8J Renewal
D Minor Modification D Major Modification
D Surface Irrigation D Reuse D Recycle D High Rate Infiltration D Evaporation/Infiltration Lagoon
D Land Application of Residuals
D Distribution of Residuals
D Attachment B included
D Surface Disposal
D 503 regulated D 503 exempt
D Closed-loop Groundwater Remediation [8J Other Injection Wells (including in situ remediation)
Was a site visit conducted in order to prepare this report? [8J Yes or D No.
a. Date of site visit: 07/12/2007
b. Person contacted and contact information: Kevin O'Dell , Phone# [phone]
c. Site visit conducted by: Ed Owen
d . Inspection Report Attached: [8J Yes or D No.
2. Is the following information entered into the BIMS record for this application correct?
D Yes or [8J No. If no, please complete the following or indicate that it is correct on the current application.
For Treatment Facilities:
a . Location:
b. Driving Directions: __
c . USGS Quadrangle Map name and number: __
d. Latitude: Longitude: __
e. Regulated Activities I Type of Wastes (e.g., subdivision, food processing, municipal wastewat~f. __
For Disposal and In jection Sites: -::...0 -.-
(If multi ple sites either indicate which sites the information a pp lies to. copy and p aste a new section info the
document for each site. or attach additional pa ges for each site) ~
a . Location(s): 411 Gilmore Road. Chap el Hill . NC 27516
U l
b. Driving Directions: H wy 40 W to 15-501 S , ri eht on Mann's Chap el Rd .• ri ght on PoythresS:-Rd .. l~ft on
Gilmore Rd .• ½ mile on the left.
c. USGS Quadrangle Map name and number: B yn um-D22SW
d. Latitude: 35.51.09 Longitude: 79.07.52
II. NEW AND MAJOR MODIFICATION APPLICATIONS (this section not needed for renewals or minor
modifi cations , skip to next section )
Description Of Waste(S) And Facilities
1. Please attach completed rating sheet. Facility Classification: __
FORM: O'Dell staff report.doc 1
AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
2. Are the new treatment facilities adequate for the type of waste and disposal system?
D Yes D No D N/A. Ifno, please explain: __
3. Are the new site conditions (soils, topography, depth to water table, etc) consistent with what was reported by
the soil scientist and/or Professional Engineer? D Yes D No D N/A. Ifno, please explain: __
4. Does the application (maps, plans, etc.) represent the actual site (property lines, wells, surface drainage)? D
Yes D No D N/ A. If no, please explain: __
5. Is the proposed residuals management plan adequate and/or acceptable to the Division. 0Yes0No0
NI A. If no, please explain: __
6. Are the proposed application rates for new sites (hydraulic or nutrient) acceptable?
D Yes D No D N/ A. If no, please explain: __
7. Are the new treatment facilities or any new disposal sites located in a 100-year floodplain?
D Yes D No D N/A. If yes, please attach a map showing areas of 100-year floodplain and please explain
and recommend.any mitigative measures/special conditions in Part IV: __
8. Are there any buffer conflicts (new treatment facilities or new disposal sites)? D Yes or D No. If yes, please
attach a map showing conflict areas or attach any new maps you have received from the applicant to be
incorporated into the permit: __
9. Is proposed and/or existing groundwater monitoring program (number of wells, frequency of monitoring,
monitoring parameters, etc.) adequate? D Yes D No D N/A. Attach map of existing monitoring well
network if applicable. Indicate the review and compliance boundaries. If No, explain and recommend any
changes to the groundwater monitoring program: __
10. For residuals, will seasonal or other restrictions be required? D Yes D No D N/A If yes, attach list of sites
with restrictions (Certification B?)
IIL RENEWAL AND MODIFICATION APPLICATIONS (use previous section for new or maior modification
systems)
Description Of Waste(S) And Facilities
1. Are there appropriately certified OR Cs for the facilities? D Yes or D No.
Operator in Charge: __ Certificate #: __
Backup-Operator in Charge: __ Certificate #: __
2. Is the design, maintenance and operation (e.g. adequate aeration, sludge wasting, sludge storage, effluent
storage, etc) of the treatment facilities adequate for the type of waste and disposal system? D Yes or D No.
Ifno, please explain: __
3. Are the site conditions (soils, topography, depth to water table, etc) maintained appropriately and adequately
assimilating the waste? D Yes or D No. Ifno, please explain:
FORM: O'Dell staff report.doc 2
AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
4. Has the site changed in any way that may affect permit (drainage added, new wells inside the compliance
boundary, new development, etc.)? If yes, please explain: __
5. Is the residuals management plan for the facility adequate and/or acceptable to the Division?
D Yes or D No. If no, please explain: __
6. Are the existing application rates (hydraulic or nutrient) still acceptable? D Yes or D No. If no, please
explain: __
7. Is the existing groundwater monitoring program (number of wells, frequency of monitoring, monitoring
parameters, etc.) adequate? D Yes D No D N/A. Attach map of existing monitoring well network if
applicable. Indicate the review and compliance boundaries. If No, explain and recommend any changes to the
groundwater monitoring program: __
8. Will seasonal or other restrictions be required for added sites? D Yes D No D N/A If yes, attach list of sites
with restrictions (Certification B?)
9. Are there any buffer conflicts (treatment facilities or disposal sites)? D Yes or D No. If yes, please attach a
map showing conflict areas or attach any new maps you have received from the applicant to be incorporated
into the permit: . __
10. Is the description of the facilities, type and/or volume ofwaste(s) as written in the existing permit correct? D
Yes or D No. If no, please explain: ____ _
11. Were monitoring wells properly constructed and located? D Yes or D No D N/ A. If no, please explain:
12. Has a review of all self-monitoring data been conducted (GW, NDMR, and NDAR as applicable)? D Yes or
D No D N/A. Please summarize any findings resulting from this review: __ _
13. Check all that apply: D No compliance issues; D Notice(s) of violation within the last permit cycle; D
Current enforcement action(s) D Currently under SOC; D Currently under JOC; D Currently under
moratorium. If any items checked, please explain and attach any documents that may help clarify
answer/comments (such as NOV, NOD etc): ____ _
14. Have all compliance dates/conditions in the existing permit, (SOC, JOC, etc.) been complied with? D Yes
D No D Not Determined D N/ A.. If no, please explain: __
15. Are there any issues related to compliance/enforcement that should be resolved before issuing this permit? D
Yes or D No D N/A. If yes, please explain: __
FORM: O'Dell staff report.doc 3
AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
IV. INJECTION WELL PERMIT APPLICATIONS (Complete these two sections for all systems that use injection
wells, including closed-loop groundwater remediation effluent injection wells, in situ remediation injection wells, and heat
pump injection wells.)
Description·OfWell(S) And Facilities-New. Renewal, And Modification
1. Type of injection system:
~ Heating/cooling water return flow (5A7)
D Closed-loop heat pump system (5QM/5QW)
D In situ remediation (51)
D Closed-loop groundwater remediation effluent injection (5L/''Non-Discharge")
D Other (Specify: )
2. Does system use same well for water source and injection? ~ Yes D No
3. Are there any potential pollution sources that may affect injection? [8J Yes D No
What is/are the pollution source(s)? wood pile , ditch, garage. septic svs tem. What is the distance of the
injection well(s) from the pollution source (s)? 15 . +100 , 50 , 100 ft.
4. What is the minimum distance of proposed injection wells from the property boundary? 50 ft.
5. Quality of drainage at site: ~ Good D Adequate D Poor
6. Flooding potential of site: ~ Low D Moderate D High
7. For groundwater remediation systems, is the proposed and/or existing groundwater monitoring program
(number of wells, frequency of monitoring, monitoring parameters, etc.) adequate? D Yes D No. Attach
map of existing monitoring well network if applicable. If No, explain and recommend any changes to the
groundwater monitoring program: __
8. Does the map presented represent the actual site (property lines, wells, surface drainage)?~ Yes or D 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.
Injection Well Permit Renewal And Modification Onlv:
1. For heat pump systems, are there any abnormalities in heat pump or injection well operation ( e.g. turbid water,
failure to assimilate injected fluid, poor heating/cooling)?
D Yes ~ No. If yes . explain:
2. For closed-loop heat pump systems, has system lost pressure or required make-up fluid since permit issuance
or last inspection? D Yes ~ No. If yes . explain:
3. For renewal or modification of groundwater remediation permits (of any typ e). will
continued/additional/modified in jections have an adverse impact on migr ation of the p lume or mana gement of
the contamination incident? D Yes D No. If yes . explain: NI A
4. Drilling contractor: Name: W.W. Maness & Sons , Inc.
FORM: O'Dell staff report.doc 4
AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
Address: 196 Woodrow Road
Robbins , NC 27325
Certification number: 2460
5 . Complete and attach Well Construction Data Sheet.
FORM: O'Dell staff report.doc 5
AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
V. EVALUATIONAND RECOMMENDATIONS
1, Provide any additional narrative regarding your review of the application.:
2. Attach Well Construction Data Sheet if needed information is available
3. Do you foresee any problems with issuance/renewal of this permit? ❑ Yes ® No. If yes, please explain
briefly.
4. List any items that you would like APS Central Office to obtain through an additional information request,
Make sure that you provide a reason for each item:
Item Reason
5. List specific Permit conditions that you recommend to be removed from the permit when issued. Make sure
that you provide a reason for each condition:
Condition Reason
6. List specific special conditions or compliance schedules that you recommend to be included in the permit when
issued. Make sure that you provide a reason for each special condition:
Condition. Reason
7, Recommendation: ❑ Hold, pending receipt and review of additional information by regional off ce; ❑ Hold,
pending review of draft permit by regional office; ❑ Issue upon receipt of needed additional information;
Issue; ❑ Deny_ If deny, please state reasons;
8. Signature of report preparer(s): t1A V 1 — I .z "
Signature of APS regional supervisor:
Date:
ADDITIONAL REGIONAL STAFF REVIEW ITEMS
System is running good. no problems
FORM: O'Dell staff report.doc 6

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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 tj 1 � G DATE I — t-L 01
NAME OF OWNER 1('0- V 1r� c), [ } is I !
ADDRESS OF OWNER � 9 1) �'
(Streetl road or lot and subdivision, county, town)
LOCATION OF INJECTION WELL (and source well(s), if applicable)
(Streetl road or lot and subdivision , county, town, if dierent than owner's address, plus description of location on site)
Potential pollution source Distance from well [ 5-
Potential pollution source (V- 'J e� Distance from well I- t a 0 `
Potential pollution source rRc. Distance from well 5­0
rn4e'v"Li FouktkitV so;-r[c icf tc _ D th"'We' wtt{ let)'
Minimum distance of well from pfoperty boundary -- -
Quality of drainage at site Cx p Flooding potential of site L o +,,
(goodadequatepoor) (high, moderate, low)
DRAW SKETCH OF SITE (Show property boundaries, buildings; wells, potential pollution sources, roads, approximate scale, and
north arrow.) - - —'
FAO
wit
4U
Vita
1
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)
t �,x�!4 Lk 44�li Qn A ( l-ll (k n4OLIA

INJECTION FACILITY INSPECTION REPORT -FORM B (CONTINUED)
WELL CONSTRUCTION
Date constructed - b
Drilling contractor: Name ,lnL
Address ML '.Aran%,
C
Registration number 4 (0. [)
Total depth of well 0, Total depth of source well
(if app1icable)
Inspection point Measurement Meets minimum standards Comments
Yes No
Casing
,
Depth
I/
Diameter
s�Yg ''
✓
Height (A.L.S.)
_
1)
sG
Grout
Depth
� D `
V/'
Screens
So+ t diK..;j-wj o;F ccjhk}
5 �L
Depth(s)
Length(s)
I.D. Plate
✓ 6 w ur
a'
Static water level
Well yield
E- 6-p/n
Enclosure
Enclosure floor
(concrete)
Sampling port
(labeled)
Water tight pipe entry
Well enclosure entry
Vent
Functioning of heat pump system
(Determine from the owner if heat pump functions properly.)
INSPECTOR aCl
Office
WITNESS
Address
WITNESS Address March 1998

0
North Carolina
Department of Environment and Natural Resources
Division of Water Quality
Groundwater Seeflon—
WELL AND PUMP INSPEGTION
REPORT
Well Location: 12C f Date 1 L
(Town, Community, Subdivision and Lot No,) WELL TYP �L
t County
Owner: v h Road/Street
Address 0 _ Quad No. 13 N
Serial No.
Long. . SZ
!! LL Well Construction II ,� j --1
Well Contractor �.+t1.�JL�_ m N ,�S 1 It 1Ji ,' e 6r � tz P _ � h� .u; 1 U C � I UT
Name
Contractor Certiiieaon # 4
Address
Check Items
Meets Min. Standards
Remarks
Permit Re aired ? Nj
Measured
Yes No
Permit No.
( � t_s-
L................
�
Location - Distance From:
Water Tight Sewage/waste collection . .
Waste disposal (septic tank drain field)
t }
Other Poll. Source ]
Other Poll. Source [ }
Cas'
Depth.—.— ........... ........„.,,,,. ,.,?„,„,..,,.,
Weightlthickness..................................
�
tCir�ae-w�e]
Flastkc 'Galv.' italn. St, Other
�C+arbo
T � r
✓,
Height (A.L.S.),.,,.,..,.,,.,.,,,..................
Omer ( .
Drilling FluidslAddiilyes
Type...................... ,,,,.,,,,..,,........ .........
Grout
Type.... ............. .............. ....... --.........
F
Thickness..,. .........................................
II
Depth ..... ........... -.,............................. ,.
Other [
Screens
�t�`�t +�� +^�+►5i�� is F
Screened interval ....... .. ........................
Other ( ] .
Deyel6ment ................„ .,,.,.,.,,,,.„..,,,,,
Total Suspended solids ......,... ,,,,,,. ,,, .
Turbidity ...........................................,,.
Settleable Solids—., ................... ....... ..
V
I.D. Plate
Well Contractor .....................................
+
Abandonment,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
Temporary ,,,,,,,,,,,,,, ,
Permanent ............................................
GW-36 Rev. 1/2000
i
Applies to wells constructed after December 1, 1992
K'nnt n n RAVArstn)

Well Test .............................................. .
Duration ............................................... .
Frequency/Accuracy of measurements
Other( __________ ).
Disinfection
Chlorination
Other(---------) .
Cuttin gs ............................................... ..
Reports ................................................ ..
Construction (GW-1) ........................... .
Abandonment (GW-30) ....................... .
Well Head C_omo1eJicm
Access port .......................................... .
Hose bib .............................................. .
Pitless Adaptor .................................... .
Pitless Adaptor Unit ............................. .
Suction line .......................................... .
Tee Uet) ............................................... .
Valved flow .......................................... .
Vent ..................................................... .
Water tight pipe entry .......................... .
Well entry ............................................ .
Check items
Measured
Meets Min. Standards Remarks
Yes No
v s &pf',,,
·✓
~
✓
✓ .
✓
✓
Applies to wells constructed after December 1, 1992
Date Well Constructed 7 -2 b -0 l,
Pumo Installation
Pump Installation Contractor --------------------------------
Name Address Reg.#
PUMP CONT RA CTOR l,D, PLATE PRESENT ? cv@ ----Date Pum p Installed
Violations noted attributable to the pump installation contractor are as follows:
(1) ND ?~ :t"b ff AJ-,
(2)
(3)
INSPECTOR (,d D(pG.._ RRO
Name Office
Witness {es }
(If Available) Name Address Type
Name Address Type
Permit: WI0500156
SOC:
County: Chatham
Region: Raleigh
Effective:
Effective:
Contact Person: Kevin C O'Dell
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On-Site Representative(s):
Related Permits:
Inspection Date: 07/12/2007
Primary Inspector: Ed Owen
Secondary lnspector(s):
Joseph Gyamfi
Reason for Inspection: Routine
Compliance Inspection Report
Expiration:
Expiration:
Title:
Owner: Kevin C O'Dell
Facility: Kevin C . O'Dell SFR
411 Gilmore Rd
Chapel Hill NC 27516
Phone:
Certification: Phone:
Entry Time: 10:00 AM Exit Time: 11 :30 AM
Phone:
Phone:
Inspection Type: Compliance Evaluation
Permit Inspection Type: Injection Heating/Cooling Water Return Well (5A7)
Facility Status: ■ Compliant O Not Compliant
Question Areas:
■Wells
(See attachment summary)
Page: 1
Permit: WI0500156
Inspection Date: 07/12/2007
Inspection Summary:
Owner -Facility: Kevin C O'Dell
Inspection Type: Compliance Evaluation Reason for Visit: Routine
WI0500156 Heat Exchange System working good, No problems. Effluent temperature was 25.7 degrees C and Influent
temperature was 21.2 degrees C.
Influent & Effluent Water Samples taken on 7-12-07
Lab Codes:
lnfl=7G0572
Effl=7G0573
7-12-2007
AB19269
AB19270
Page: 2
AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
Date: 03/12/2007 County: Chatham
To: Aquifer Protection Section Central Office Permittee: Kevin ODell
Central Office Reviewer: Micheal Rogers Project Name: 5A7 & W15 Well
Regional Login No: 45 Application No.. W10500156
L GENERAL INFORMA TION
1. This application is (check all Shai appiy):.N New .❑ Renewal
❑ Minor Modification ❑ Major Modification
Surface Irrigation LJ Reuse L Recycle L High Rate Infiltration U EvaporationlInfdtration Lagoon
❑ land Application of Residuals ❑ Attachment B included ❑ 503 regulated ❑ 503 exempt
❑ Distribution of Residuals ❑ Surface Disposal.
❑ Closed. -loop Groundwater Remediation ® Other injection Wells (including in situ remediation)
Was a site visit conducted in order to prepare this report? ® Yes or [] No.
a. Date of site visit: 03/12/2007
b. Person contacted and contact information: Kevin ODe11,Ph.ff 9197951305
c. Site visit conducted by: ]Greer, RRO-APS
d, Inspection Report Attached:.® Yes or.[-] No.
2. Is the following information entered into the BIMS record for this application correct?
® Yes or ❑ No. If no, please complete the following or indicate that it is correct on the current application.
For Treatment Facilities:
a_ Location:
b- Driving Directions:
c. USGS Quadrangle Map name and number:
d. Latitude: Longgitude: __
e. Regulated Activities 1 Type of Wastes (e.g., subdivision, food processing, municipal wastewater): NIA
For Disposal and 1 niection Sites:
t If multir)ie sites either indicate which sites the information avvhes to, cove and paste a new section into the
document for each site, or attach additional 12aces for each site!
a. Location(s): 411 Gilmore Road, Clsapet Hill NC 27516
b. Driving Directions: 'See May west _
c. USGS Quadrangle .Map name and number: D22NE
d. Latitude: 35.51.09 Longitude: 79,07.52
II. NEWAND MAJOR MODIFICATION APPLICATIONS Ith& Section not needed ,for renewals .or.►ninor
modlmcadons, skip to nW section)
Description Of Waste(S I And Facilities
1. Please attach completed rating sheet. Facility Classification:_

AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
2 . Are the new treatment facilities adequate for the type of waste and disposal system?
D Yes D No D N/A. Ifno, please explain: __
3. Are the new site conditions ·(soils, topography, depth to water table, etc) consistent with what was reported by
the soil scientist and/or Professional Engineer?-D Yes D No D NI A. If no, please explain: __
4. Does the application (maps, plans, etc.) represent the actual site (property lines, wells, surface drainage)? D
Yes D No D N/A. Ifno, please explain: __
5.. ls the proposed .residuals -management plan adequate and/or acceptable to the Division.
NI A. If no, please explain: __
6. Arethe proposed application rates for new sites (hydraulic or nutrient) acceptable?
.Q Yes .O No .0 NIA. Ifno,.please explain: __
7. Are the new treatment facilities or any new disposal sites located in a 100-year floodplain?
0Yes0No0
·□ Yes D No ·□ NIA. If yes, please attach a map showing areas of 100-year floodplain and please explain
and recommend any mitigative measures/special conditions in Part IV: __
8. Are there any buffer conflicts (new treatment facilities or new disposal sites)? D Yes or D No. If yes, please
attach a map showing conflict areas or attach any new maps you have received from the applicant to be
incorporated into the permit: __
9. Is proposed and/or existing groundwater monitoring program (number of wells, frequency of monitoring,
monitoring parameters, etc.) adequate? 0 Yes · 0 Ncf CJ N/ A. Attach map of existing monitoring well
network if applicable. Indicate the review and compliance boundaries. If No, explain and recommend any
changes to the groundwater monitoring program: __
10. ·For residuals, will seasonal or other restrictions ·be required? -□-Yes ·□-No ·□-NIA ·If yes, attach1ist of sites
with restrictions .(Certification B?)
/IL RENEWAL AND MODIFICATION APPLICATIONS (use previous section fo r new or maior modific ation
systems)
Description OfWaste(S) And Facilities
1. Are there appropriately certified ORCs for the facilities? D Yes or D No.
··opera.tor in•Charge: __ -certificate#: __
Backup-Operator in Charge:~ Certificate#~
2. Is the design, maintenance and operation (e.g. adequate aeration, sludge wasting, sludge storage, effluent
storage, etc) of the treatnieriffacilities adequate -for the type of waste aricl ·disposal systeiri? -□ Yes or D No.
Tfno, please explain: __
3. Are the site conditions (soils, topography, depth to water table, etc) maintained appropriately and adequately
assimilatingthe waster □ Yes or □·No. ""Ifno, please explain: __
AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
4. Has the site changed in any way that may affect permit (drainage added, new wells inside the compliance
. boundary, new development, etc.)? ·If yes, please explain: __
5. Is the residuals management plan for the facility adequate and/or acceptable to the Division?
D Yes or D No. Ifno, please explain: __
6. Are the existing application rates (hydraulic or nutrient) still acceptable?□ Yes or ·□ No. If no, please
-explain: __
7. Is the existing groundwater monitoring program (number of wells, frequency of monitoring, monitoring
parameters, etc:) adequate? ·□-Yes ·□ No ·□ 'NIA. Attach map of existing monitoring well network if
applicable. Indicate the review and compliance boundaries. If No, explain and recommend any changes to the
groundwater monitoring program: __
·s. ·wm seasonal or other restrictions-be required for added sites? :O ·Yes ·□·No ·□-NIA 1fyes, attach"list of sites
with restrictions (Certification B?)
9. Are there any buffer conflicts (treatment facilities or disposal sites)? 0 Yes or D No. If yes, please attach a
map showing conflict areas or attach any new maps you have received from the applicant to be incorporated
int-0 the pennit: __
10. Is the description of the facilities, type and/or volume of waste(s) as written in the existing permit correct? D
Yes or □ No. Ifno, please explain: ___ _
11. Were monitoring wells pr-0perly -eonstructed ~ located? 0 Yes -or O No t8] NIA. If no, please explain:
12. Has a review of all self-monitoring data been conducted (GW, NDMR, and NDAR as applicable)? D Yes or
D No D NIA. Please summarize any findings resulting from this review: __ _
13. Check all that apply: 0 No compliance issues; 0 Notice(s) of violation within the last permit cycle; ·□
-Current -enforcement -action(s) -0 -Currently -under . SOC; D -Currently -under J0C; D -Currently under
moratorium. If any items checked, please explain and attach any documents that may help clarify
answer/comments (such as NOV, NOD etc): ____ _
14. Have all compliance dates/conditions in the existing .permit, .(SOC, J0C, etc.) been complied with? D Yes
D No D Not Determined ON/A.. If no, please explain: __
15. Are there any issues related to compliance/enforcement that should be resolved before issuing this permit? D
Yes-or O No D NIA. -If-yes,-please eXcplain: __
AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
IV. INJECTION WELL PERMIT APPLICATIONS (Complete these two sections for all systems that use injection
wells, including closed-loop groundwater remediation effluent injection wells, in situ remediation injection wells, and heat
pump injection wells.)
Description Of Well(S) And Facilities -New, Renewal, And Modification
I. Type of injection system:
[8] Heating/cooling water return flow (5A7)
D Closed•loop heat pump system (5QM/5QW)
D In situ remediation (51)
D Closed-loop groundwater remediation effluent injection (5Lf'Non-Discharge")
D Other (Specify: )
2. Does system use same well for water source and injection? [8] Yes D No
3. Are there any potential pollution sources that may affect injection? D Yes [8] No
What is/are the pollution source(s)? . What is the distance of the injection well(s) from the pollution
source(s)? ft.
4. What is the minimum distance of proposed injection wells from the property boundary? 50 ft.
5. Quality of drainage at site: [8] Good D Adequate D Poor
6. Flooding potential of site: [8] Low D Moderate D High
7. For groundwater remediation systems, is the proposed and/or existing groundwater monitoring program
(number of wells, frequency of monitoring, monitoring parameters, etc.) adequate? D Yes D No. Attach
map of existing monitoring well network if applicable. If No, explain and recommend any changes to the
groundwater monitoring program: N/ A
8. Does the map presented represent the actual site (property lines, wells, surface drainage)? [8] Yes or D 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.
Iniedion Well Permit Renewal And Modification O nJy :
I. For heat pump systems, are there any abnormalities in heat pump or injection well operation (e.g. turbid water,
failure to assimilate injected fluid, poor heating/cooling)?
D Yes ~ No. If yes, wg,lain:
2. For closed-loop heat pump systems, has system lost pressure or required make-up fluid since permit issuance
or last inspection? D Yes D No. If yes, explain:
3. For renewal or modification of groundwater remediation p ermits (of any type ), will
continued/additional/modified injections have an adverse impact on mi1rration of the plume or manM ement of
the contamination incident? D Yes D No. If yes. explain:
4. Drilling contractor: Name: WW Maness & Son
AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
Address : 196 Woodrow Road
Robbins NC 27323
Certification number: 2460
5 . Complete and attach Well Construction Data Sheet.
AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
V. EIVALUATIONAND RECOMMENDATIONS
L Provide any additional narrative regarding your review of the application..
2, Attach Well Construction Data Sheet - if needed information is available
3. Do you foresee any problems with issuancr*enewal of this permit? ❑ Yes ®hlo. If yes, please explain
briefly_
4. List any items that you would like APS Central Office to obtain through an additional information request.
Make sure that you provide a reason for each item:
Item Reason
5. List specific Permit conditions that you recommend to be removed from the permit when issued. Make sure
that you provide a reason for each condition:
I Condition _ Reason I
d. List specific special conditions or compliance schedules that you recommend to be included in the permit when
issued. Make sure that you provide a reason for each special condition:
Condition
Reason
7. Recommendation: ❑ Hold, pending receipt and review of additional information by regional office; ❑ Hold,
pending review of draft permit by regional office; ❑ Issue upon receipt of needed additional information;
Issue; ❑ Deny. If deny, please state reasons:
$. Signature of reportpreparer(s): LJ
w
Signature of APS regional
Date:
ADDITIONAL REGIONAL STAFF REVIEW ITEMS
System will be sampled when up_&_running around 0 Alml D7

Pennit: WI0500156
SOC:
County: Chatham
Region: Raleigh
Effective:
Effective:
Contact Person: Kevin c O'Dell
Directions to Facility:
Primary ORC:
Secondary ORC(s):
On.Site Representative(s):
Related Pennits:
Inspection Date: 03/12/2007
Primary inspector: Jimmie W Greer
Secondary lnspector(s):
Reason for Inspection: Routine
Compliance Inspection Report
Expiration:
Expiration:
Owner: Kevin C O'Dell
fac-ility: Kevin C. -O'Oell SFR
411 Gilmore Rd
Chapel Hill NC 27516
Phone:
Certification: Phone:
Entry Time: 11 :00 AM Exit Time: 12:00 PM
Phone: [phone]
Inspection Type: Compliance Evaluation
Pennit Inspection Type: Injection HeatingfCooting water Return WeH (5A7)
Facility Status: ■ Compliant O Not Compliant
Question Areas:
■Wells
(See attachment summary)
Page: 1
Permit:WI0500156
Inspection Date: 03/12/2007
Inspection Summary:
OWner -Facility: Kevin C O'Dell
fnspection Type: -Compflance Evatuation
System is installed but not turned on as of this date , on line around 1st of April 07
Reason for Visit: Routine
Page:2
Page 1 of 2
North Carolina Department of Environment and Natural Resources
Division of Water Quality -Groundwater Section
PRECONSTRUCTION MJECTION FACILITY INSPECTION
REPORT -FORM A
INJECTION WELL PERMIT NO. WI o � DATE ) - Z?
NAME OF OWNER z,i L� r-� - _ ",/
ADDRESS OF OWNER
1� *� 29 !7- — / ' aS77
(5treal road or lot and suddivision, courtly, town)
LOCATION OF PROPOSED INJECTION WELL (and source well(s), if applicable)
(S ov e V road or lot and suddMi ion , county, town, if different than owner's address, phu description of location on site)
Potential pollution source j,d Distance from well i. _
Potential pollution source s��,-��E } ,�-� Distance from well
Potential pollution source zu';r- Distance from well Z:)
Minimum distance of proposed well from property boundary _0 f
Quality of drainage at site -- Flooding potential of site
( dequate,poor) (high.moderu
DRAW SKETCH OF SITE
(Show property boundaries, buildings, welU, potential pollution sources, roads, appros;mate scale, and north arrow.)
mffcb 98

I
Page 2 of 2
PRECONSTRUC N INJECTION FACILITY
FORM A (cant.)
CONEWENTS
Office l i , P'3 1Z v�
WITNESS
Address
WITNESS
Address
March 98

444
E
GILMORE ��UA'bGLS9FRl�535�� �
EXISTING 60' PUBLIC

North Carolina Department of Environment and Natural Resources
Division of Water Quality - Groundwater Section
INJECTION FACILITY INSPECTION REPORT - FORM B
INJECTION WELL PERMIT NO. DATE
NAME OF OWNER
ADDRESS OF OWNER I �� , Irry.>r� T *� ��.��� �� -` 2
(Streetl road or lot and subdivision, county, town)
LOCATION OF INJECTION WELL (and source well(s), if applicable)
(Street) road or rot and subdivision , county, town, if different than owner's address, plus description of location on site)
Potential pollution source G, j , A- Distance from well I�3"�
Potential pollution source �3 ►z F', Distance from well W,21
Potential pollution source ,f �t= . Distance from well -:s�
i
Minimum distance of well from property boundary -a 'y "
Quality of drainage at site Flooding potential of site
ood, quote poor) (high, moderatOEQ
DRAW SKETCH OF SITE (Show property boundaries, buildings, webs, potential pollution sources, roads, approximate scale, and
north arrow.)
i
DESCRIBE closed loop, encased borehole or cased water well, separate source well and
injection well,-JEon
jbination source and injection weI or other description as applicable)

INJECTION FACILITY INSPECTION REPORT -FORM B(CONTINUED)
WELL CONSTRUCTION
Date constructed 2� & - Z_na 4
Drilling contractor: Name L,2 ow Ailly
Address t 6 Al
hcwle * 97��
Registration number ;�, 64>
Total depth of well(. nV Total depth of source well zs,,�-rY,e
(if applicable)
Inspection point Measurement Meets minimum standards Comments
Yes Na
Casing
Depth
4;1 -
Diameter
Jy
Height (A.L.S.)
Z,
+�
Grout
Depth
dO
Screens
Depth(s)
-
Length(s)
�-
I.D. Plate
Static water level
►�
Well yield
Enclosure
14`
+�
Enclosure floor
(concrete)
Sampling port
(labeled)
Water tight pipe entry
Well enclosure entry
Vent
Functioning of heat pump system (Determine from the owner f eat pump functions properly)
INSPECTOR L D ffice
WITNESS Address
WITNESS
Address
Marcb 1998

K ODell.WI0500156 3112/2007 2:05:19 PM
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Map of 411 Crilmare Rd Chapel Hill, NC by MapQuest http://www,mapquest.corn/maps/map-adp?searchtype=addressl
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Map of 411 Gilmore Rd Chapel Hill, NC by MapQuest . htip://www_mapquest.coinimaps/map.adp?searchtype=address
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2 of 2 1/22/2007

A QUIFER PROTECTION SECTION
APPLICATION REVIEW RE QUEST FORM
Date: Janua1y 17 . 2007
To: 0 Landon Davidson, ARO-APS
0 Art Barnhardt, FRO-APS
0 Andrew Pitner, MRO-APS
~ Jay Zimmerman, RRO-APS
□ David May, WaRO-APS
□ Charlie Stehman, WiRO-APS
□ Sherri Knight, WSRO-APS
From: Michael Rogers , Groundwater Protection Unit
Telephone: [phone] Fax: [phone]
E-Mail: [e-mail]
A. Permit Number: WI 0500156
B. Owner: Kevin O'Dell
C. Facilitv/Operation:
D Proposed ~ Existing D Facility D Operation
D. Application:
1. Permit Type: D Animal D SFR-Surface Irrigation □ Reuse O H-R Infiltration
D Recycle D 1/E Lagoon D GW Remediation (ND)
~ UIC -(5A7) open loop geothermal __
For Residuals: D Land App. D D&M
D 503 D 503 Exempt
D Surface Disposal
D Animal
2. Project Type: D New D Major Mod. D Minor Mod. ~ Renewal D 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 21 calendar days, please take the following actions:
C8J Return a Completed APSARR Form.
D Attach Well Construction Data Sheet.
D Attach Attachment B for Certification by the LAPCU.
D 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
�F W A
Michael F. Easley, Governor
William G. Ross Jr., Secretary
f%j Ir North Carolina Department of Environment and Natural Resources
p f Alan W. Kfimek, P.E. Director
Division of Water 4uality
.January 16, 2007
Kevin O'Dell
9905 Oak Hollow Road
Chapel Hill, NC 27615
Subject: Acknowledgement of Application. No, W10500156
Kevin C. O'Dell - SFR
Injection Heating/Cooling Water Return Well (5A7)
Chatham
Dear Mr. O'Dell:
The Aquifer Protection Section of the Division of Water Quality (Division) acknowledges receipt of your permit
application and supporting materials on January 11, 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 fill - 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
hnp://h2o.enr.state.nc.usldocuments/dwg orachart.pdf.
PLEASE REFER TO THE ABOVE APPLICATION NUMBER WHEN MAKING INQUIRIES ON THIS
PROJECT
Sincerely,
1�
far' Debr efts
supervisor
cc: Raleigh Regional Office, Aquifer Protection Section
Permit Application File WI0500156
Aquifer protection Section 1636 Mail Service Center Raleigh, NG 27699-1636
Internet: www.ncwatercuality.oro Location: 2728 Capital Boulevard Raleigh, NC 27604
An Equal Opporpun4y/Attlrmative Action Employer- 50% Regded110% Post Consumer Paper
Telephone:
Fax 1:
Fax 2:
Customer Service:
tcwnimmZY
[phone]
[phone]
[phone]
[phone]

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 DMSION OF WATER QUALITY
DATE: } , 20D-7_
A. SYSTEM CLASSIFICATION Please check column which matches proposed system.
( 1) 1 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 coin0ete form GW-57_ CL, Notification Oflntent To
Construct A Closed -Loop Geothermal -Water Only Injection Well System.
S. PERMIT APPLICANT
Name. { i
Address: t V ^ Q.L C
City State: ! ) t_ Zip CodeCounty:
Telephon : ' j'k ] C �a
C. PROPERTI' OWNER (if dit lerent from applicant)
Name: EE-
Address:
` C]r�
City: Sate: Zip Code - .XIS) i County:
Telephone: 10,
D. STATUS OF APPLICANT
Private: Federal: Commercial:
State: Municipal: Native American Lands:
Revised 7106 GWIUIC-57 HP Page i of 4

E. FACILITY (SITE) DATA
(Fill out ONLY if the Status of Owner is Federal, Stalk ,,Municipal or Commercial).
Name of Business or Facility:
Address:
City:
Telephone:
F. HEAT PUMP CONTRACTO
e
Name:
G.
Zip Code: County-.
Contact Person:
DATA
Address: C _U _ l s �• 5L�;1
City: Zip Code-DC County:
Telephone: Dof D Contact Person: 1
(Briefly describe how the injection wells) will be used.)
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
(2) Personal consumption? YES NO
I. 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-
I (Well Construction Record) if available.
PROPOSED WELL to be constructed for use as an injection well. Provide the
data in (1) through (7) below as PROPOSED construction specifications. Submit
Form GW-1 after construction. rr
(1) Well Drilling Contractor's Name: 4 U__ ]!��a� l �, I
NC Contractor Certification mLnnber: _ - �_D
(2) Date to be constructed: ~ L Number o 1borings: j
Approximate depth of each boring (feet): LO C T 1
(3) Well casing: Is the well(s) cased?
(a) YES _�S_ If yes, then provide the casing information below.
Type: Galvanized steel y' Slack steel Plastic Other (specify)
Casing depth: From tojl,),'� ft. (reference to land surface)
e.�
Casing extends above ground 1 inches
(b) NO
Revised 7106 GWIUIC-57 HP Page 2 of 4

(4) Grout (material surrounding well casing and/or piping):
(a) Grout type: Cement~ Bentonite Other (specify) _______ _
(b) Grouted surface and grout depth (reference to land surface):
__ around closed loop piping; from ___ to ___ (feet).
~ around well casing; from __Q__ to20 f (feet).
(5) Screens (for Type 5A7 wells)
(a) Depth: From __ to __ feet below ground surface. /Vone_
(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 _b{_ no__ (b) the effluent line? yes _J{_ no __
(7) 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.
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 SA7 wells)
(1)
(2)
(3)
(4)
Injection rate:
Injection Volume:
Injection Pressure:
Injection Temperature:
Average (daily) 9 gallons per minute (gpm).
Average (daily~O gallons per day (gpd).
Average (daily) ----1Q pounds/square inch (psi).
Average (January)5°"4 ° F, Average (July)6£ ° 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.~,. granite, limestone, sand, etc.). -oo/ G · Depth: ~~ Formation: ro..,l\·\ e_ Rock/sediment unit: _____ _
(2) Chemical Analysis of Source Fluid (for Type SQM wells)
' Provide a complete listing o'f'3.}-lchemicals 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.
M. LOCATION OF WELL(S) Attach two maps.
Revised 7 /06 GW/UIC-57 HP Page 3 of4
(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
0. CERTIFICATION
"I hereby certify, under penalty of law, that I have personally examined and am familiar with the
information submitted in this document and all attachments thereto and that, based on my inquiry of
those individuals immediately responsible for obtaining said information, I believe that the information
is true, accurate and complete. I am aware that there are significant penalties, including the possibility
of fines and imprisonment, for submitting false information. I agree to construct, operate, maintain,
repair, and if applicable, abandon the injection well and all related appurtenances in accordance with
the approved specifications and conditions of the Permit."
,viv~cnQQ
(Signature of 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 !SA NCAC 2C .0200) V _ _ 1,-, ~
00.~ 0-0 10,t;I
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 of4
GILMORE ROAD SR1535)
EXISTING 60' PUBLIC

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Page I of I
141
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0 0.3 0.6 0.9 1.2 1.5 km
0 0.2 0.4 0.6 0.8 1 Mi
UTM 17 668785E 3969031N (NAD27)
USGS Bynum (NC) Quadrangle M=-8. 522
Projection is UTM Zone 17 NAD83 Datum G= 1. 095
http://Www.topozone.comlprint.asp?lat--35.85277&IoTt--79.13088&size=l&u==4&layer--DR... 1/2/2007

CHATlAM COUNTY HEALTH DEPARV1AENT
80 EAST STREET, P.O. BOX 130 . PITTSBORO, NC 27312.0130
Phone [phone] - Fax [phone]
4FF,(CE USE ONLY
TPtd
Application for
Improvement Permit $ _ Construytion Authorization $
(vatid for 60 months from date issuedy
Improvement Permit $ Repair Permit $
[Perpetual - plot [t- = 60')
required larthln 30 days of site approval; ]�
CZWell Permit $ Revise Operation Permit $
=Well Re -site Permit $
Permit No.
Date Redd: 4 _� F o�,
Amt_ Redd: s � a ? M
E.H.S. Frr I
If the information in the Application for an Improvement Permit is falsirred, changed, or the site is altered,
then the lrn rovement Permit and/or Authorization to Construct shall becoml invalid.
r
OWNER'S NAME: Keilhi C Ufll MaWrTg Address: r Work Phone' A
Road skaar
!i! f
' ! h F 1 ��I 4� Home Ph4n&
i{ cly a Trp Code
r
APPLICANT'S NAME:
(if different than Owner)
Mailing Address: Work Phone:
Road I sweet
Ciry Stare Iip Code
i
PROPERTY A00RESS: rr i JI S Subdivision:
R aV I St of
Home phone:
Lot Number;
YY' I + r ! 1 4 'C"- Tax Parcel Number; _ Ui to L
r Cary V-9/L � -
Acres Existing: 3 1 1, Propoaed• 3 i
REVEL❑PMENT INFORMATION
l
E lV New Single Family Residence Residential Speclfteatlons:
bxpansion or Alteration of Existing Septic System
Repair to Existing Subsurface Sewage Disposal System
Type of Structure
Max. number of bedrooms (2 peopialbedroom] La
Max. number of occupants (lt, more than 2 peopielbedroom)
Basement? ye' s No
List basement plumbing fixtures'
. '.'i; i"r_'L.,; : ' NON-RESIDENTIAL SPECIFICATIONS
Type
Max number or'empioyaw:
Total Square Facrage of Building:
Flax number of saute: Other:
WATER 'SUP Y Is public water avaiiablei' EJYes No Unknown
Planned source of. water- New Well Existing Well Community Well Public
For Construction Auther-izatian Applications only: flank sewage system in order of preference;
Conventional 0 Modified Conventional =Altemative tLLP etc.l ElInnovative a other (specify)
The applicant shall notify the total health department upon submittal of this application if any of the fallowing apply to the property in
question. it the answer to any question is "yes", applicant must attach supporting documentation.
Is the site located in any designated wetlands? Yes NO
Is any wastewater going to he generated on the site other than domestic sewage? Yes No
Is the silo subfact to approval by any other public agency? Yes No
I have read this application and certify that the information provided herein is true, complete and correct Authorlred county and state officials
ars granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. 1 understand that ! am
z
solely responsible for the proper identification and _labeGnq of all property lines and corners and making the site accessible so that a ecmplate
site- eval terion can be arfqrmed. The issuaaca of a permit in no way guarantees the issuance of other permits (i.e. Building Permits)
�r
Signature Y �- } { 'If 6
Probe owner's or owr:er's legal representative''' aliggmiiture [Required) DAW
"Must provide documentation to suppart ciairn as owner's legal representative cavnass 12-01 rev +0,021.03"43-M

PREMIUM GEOTHERMAL COMFORT SYSTEM
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COMPARE THE PERFORMANCE
WaterFurnace geothermal systems can
dramatically reduce your annual costs for
heating, cooling and hot water —by as much
as 60 percent per year. Smart homeowners
who purchase WaterFurnace E Series units
will experience significant energy savings
without sacrificing comfort. Ordinary
heating and cooling systems operate at a
fraction of the efficiency of geothermal
systems. And with skyrocketing costs of
natural gas, propane and fuel ❑il, future
savings from geothermal technology could
be even greater.
w
ANNUAL OPERATING
COST EXAMPLE
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The E Series is designed to provide you with
incredible energy savings —up to 60 percent
on monthly utility bills, compared to ordinary
systems —and features innovative technology that
enables amazing efficiency and performance. A
pioneer in the use of R-410A refrigerant,
WaterFurnace's E Series takes efficiency to an
even higher level and presents the best of both
worlds —clean, reliable comfort while protecting our
environment. When you consider the benefits of
geothermal technology, it just makes sense —and
dollars and cents.
ENERGY EFFICIENT: 1 unit of electricity
WaterFurnace systems are - ' _
Y T 4 units of heating
rated number one in ener- : 3 units of "free" r or cooling delivered
gy efficiency because they energy from the earth into home
can deliver an astounding
four units of energy for
every unit of electrical en-
ergy used. Compare that to even the best ordinary system that delivers less than one unit of
energy For every unit it consumes. That translates into an efficiency rating of 400 percent,
compared to the most efficient gas 'furnace, which rates nearly 94 percent.
COST EFFECTIVE: Because of the extraordinary efficiency of a WaterFurnace system,
any added investment related to installing a geothermal unit is usually more than offset by
your energy savings. In new homes, most homeowners will experience an immediate positive
return on their investment when the system cost is added to the mortgage. In replacement
installations, homeowners find that any added investment over the cost of an ordinary system
is generally recovered in energy savings within a few years,
COMFORTABLE: Capturing the relatively stable tern perature of the Earth to heat and cool
your home, WaterFurnace systems provide consistent, comfortable heating and cooling. You
can even regulate temperatures in different areas of your home.
RELIABLE: The WaterFurnace reputation for reliability has been earned by using only
the highest -quality components, design and workmanship. Computer run -testing after
assembly ensures that your unit performs flawlessly at start-up. And in the unlikely event of a
malfunction, WaterFurnace units are backed by the best warranties In the industry. Like your
refrigerator, your geothermal unit will provide many years of dependable operation.
QUIET: WaterFurnace systems don't require noisy outdoor units that can disturb your
peaceful surroundings or create unsightly additions to your home's appearance,
SAFE: Because natural gas, propane or oil is not required to operate a WaterFurnace unit,
there's no combustion, flames or fumes and no chance of carbon -monoxide poisoning.
FLEXIBLE: One compact WaterFurnace unit provides heating, central air conditioning and
domestic hot water. A variety of configurations and sizes are available for a wide range of
home applications, including newly constructed and existing homes. No matter what climate
you live in, your WaterFurnace system will deliver.
CLEAN: High -efficiency air cleaners found in WaterFurnace systems keep your indoor air
quality clean, removing dust and pollen so you can breathe easier.
ENVIRONMENTALLY FRIENDLY, The ground absorbs about 47 percent of the sun's
energy that reaches the Earth. WaterFurnace systems harness that free, renewable
energy and provide an environmentally friendly way to heat and cool your home. Installing a
WaterFurnace system is the environmental equivalent of planting 750 trees or removing two
cars from the road. And the WaterFurnace system doesn't burn fossil fuels, which means no
emissions or harmful greenhouse gases are released into the air.
E SERIES

THE E SERIES BENEFITS
R-410A REFRIGERANT
WaterFurnace geothermal systems feature advanced technology and
innovative components to provide a safe, clean way to heat and cool your
home. The E Series was the first geothermal heating and cooling system to
use R-410A, art environmentally safe, performance -enhancing refrigerant that
does not harm the Earth's ozone Layer,
DUAL CAPACITY COMFORT
Some sixes of E Series units feature dual capacity compressors. During mild
temperatures, the compressor runs in first stage. Compressor operation
automatically shifts to second stage (full capacity) on the coldest and hottest
days. You benefit by having better dehumidification in the summer, more even
and consistent temperatures throughout the home and increased energy
savings.
THE E SERIES DESIGN:
WaterFurnace F Series products are designed to provide you with ultimate performance.
]� BLOWER MOTOR: A variable -speed ECM blower motor with up to 12
airflow selections allows the unit to provide enhanced comfort, quiet operation
and energy savings. Single -speed operation PSC motors are also available.
CABINET; The cabinet is made of heavy -gauge sheet metal finished with
durable powder -coat paint for long-lasting beauty and protection. Fully
insulated for quiet operation, it's available in vertical (upflow and downfIow)
and horizontal configurations.
COATED AIR COIL: The coated air coil resists corrosion and increases
equipment life. Its large size improves efficiency and dehumidification during
cooling,
DRAIN PAN: Electronic overflow protection is included to eliminate the
possibility of condensate flooding. Constructed of plastic, the drain pan is also
corrosion -proof.
HOT WATER ASSIST: During heating and cooling, the E Series preheats
your water and delivers it to your water heater. The longer the unit Operates,
the greater the amount of hot water generated. In the heating mode the
hot water is generated at the efficiency or the unit. In cooling, waste heat is
recovered and hot water is free!
V COMPRESSOR: Quiet, efficlent and very reliable, the dual capacity
compressors are available in several sizes to increase comfort and energy savings.
7� CONTROLS. Sophisticated microprocessor control sequence components
provide ultimate performance. Onboard diagnostics allow for easy service.
�$ LED STATUS LIGHTS: Externally mounted status lights indicate normal
operation or display faults and assist the technician in troubleshooting.
FACTORY QUALITY' WaterFurnace systems are the result of state-of-
the-art research and development. Dozens of quality checks are performed
throughout the assembly process, and computer -run testing is done on every
unit, ensuring flawless start-up and long-term reliability.
R-41OA: R-410A is an environmentally friendly, non -ozone -depleting
refrigerant that enhances efficiency and savings.
ARE CERTIFIED/ETL LISTED/ENERGY STAR RATED:
WaterFurnace systems are performance -certified by the Air Conditioning and
Refrigeration Institute. safety ilsted by ETL and exceed performance standards
for the ENERGY STAR rating,
u
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First Stage SKond Stage
H Unit EER COP UR COP
Naltapa(ityUnits 22.0-25.9 42-4.7 14.1-170 35-3.9
Single Speed Units 15.1-19.2 3.4-3.8
EER{rodirclrfixferYl�cS} cuvelv�6,pr�ennw.an7} arsea�yonrMineaAAlf{satitswsmunaw[Aaece

GEOTHERMAL LOOP TYPES
WaterFurnace dealers are trained to determine the best type of earth loop to use in any situation. The type of loop used is based on available
land space and installation costs for specific areas,
VERTICAL LOOP
Vertical loops are used when
space is limited. Holes are bored
using a drilling rig, and a pair
of pipes with special u-bend
Fittings is inserted into the holes.
A typical home requires three to
five bores with about a 15-foot
separation between the holes.
HORIZONTAL LOOP
Used where adequate land is
available, horizontal loops involve
one or more trenches that are dug
using a backhoe or chain trencher.
Polyethylene pipes are inserted,
and the trenches are backfilled. A
typical home requires 1/4 to 3/4
of an acre For the trenches.
POND LOOP
If an adequately sized body of
water is close to your home, a
pond loop can be installed. A
series of closed loops are coiled
and sunk to the bottom. A 1/2-
acre, 8-Foot-deep pond is usually
sufficient for the average home.
OPEN LOOP
An open loop is used where
there is an abundant supply of
quality well water. The well must
have enough capacity to provide
adequate Flow for both domestic
use and the WaterFurnace unit.
E series units require 3 - 10 GPM,
depending on size.
ACCESSORIES
WaterFurnace offers several innovative options and accessories to get even more out of your system. These features can increase your system's
value, simplify its operation and improve its efficiency.
iNTELLIZONE'"
With intelliZone technology,
you can control the temperature
setting in up to Four zones
throughout your home and
provide even more comfort.
IntelliZone provides precise
distribution of conditioned air to
each room.
WATERFURNACE—
_
a
u
THERMOSTATS
A variety of digital and
programmable thermostats are
available to ensure accurate
control of your systern's operation,
maintaining precise comfort levels
throughout your home.
l92.1=&4ZF,1:iia7=1*] 1.1Co7k
WaterFurnace is dedicated to providing you with safe, reliable and
energy -efficient haating and cooling systems that save you
money while helping protect our environment. Our engineers and
technicians work to create and build quality geothermal products that are
extensively tested to ensure the highest quality. An industry lead-
er and an innovator in geothermal technology—WaterFurnace.
Smarter from the Ground Up.
DEDICATED WATER
HEATING
For applications with large
demands for hat water, a
dedicated unit can be added
to your E Series system to
provide 100 percent of the
domestic hot water requirements.
These units operate at three to
four times the efficiency of an
ordinary water neater.
�i
AIR CLEANER
Dynamic electronic air cleaners
work hard to remove harmful
airborne pollutants, such
as smoke, odors, bacteria,
allergens, molds and pollen. It
fits conveniently in the unit's
filter rack for easy access.
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Smarter tram the Ground Ua' -
� - WF1489 waterturnace.com 1 (800) GEE -SAVE
4VatorFurt ce lntenetkv 1, In-- 500o Cunsarvarion Way- Fun Wayne, IN 46809-9194. WAWFum&ce has a poky at continual praduct research and
aCGtNCHAKGE 07/05 devMlop"t and resar tlta right to charge design and s"dficak a without notice. WaterFurnace fs a reai"md trademark of WaterFurnace hruMat7onal. krK•

GILMOR
SITE�7-
LAMONT
N WOOC
PARCEL ID 2221al
PIN 9766-16-1521.000
WADE ROOK MEACHAM ET AL a.
08 858/1059 N u
Ex. RR S80•
SPIKE—�%J7 15'16
73.4¢
6
PARCEL ID 2166
PIN 9756-97-2434.000
NEVIDA FARCLOTH El AL
DB 1228/782
GILMORE ROAD (5R1535)
EXISTING 60' PUBLIC RNV
LOT 2
3,99 AC.
RD
VICINITY MAP
NOT TO SCALE
EX. RR TIE EMI.
16$ 83 SPIKE S84'13'5g"E SPIKE
S89'34'39"E 363.62
CONTRO -
CORNER SOO737'341
40,01
q --
,f471
EXISTING
FOUNDA TIDN
106.9' MAY 30. 2006
361.45 PARCEL ID 2690
S89'22'46"W PIN 9766-14-0427.000
MARVIN MEACHAM
DID 456/550
PB 2004/23 LOT 1
NO TF 'A'
SUBSURFACE AND ENVIRONMENTAL CONDITIONS
WERE NOT EXAMINED OR CONSIDERED DURING
THIS SURVEY. ALL BUILDINGS, SURFACE AND
SUBSURFACE MIPROW04ENTS ON AND ADJACENT
TO THE SITE ARE NOT NECESSARILY SHOWN
HEREON. NO STATEMENT IS MADE CONCERNING
THE EXISTENCE OF UNDERGROUND CONTAINERS
WHICH MAY AFFECT THE USE OF THIS TRACT.
NOTE 'a-
TH£ LOCATION OF UNDERGROUND UAUTIES
AS SHOWN ARE BASED ON VISIBLE EWDENCE
AND DRAWINGS PRO14DED TO THE SURVEYOR,
LOCATION OF UNDERGROUND UT7UTIES AND
STRUCTURES MAY VARY FROM LOCA 17ONS
SHOWN HEREON, AND ADOITrONAL BURIED
UTILITIES MAY EXIST. CONTACT THE
APPROPRIATE UTILITY COMPANIES FOR
INFORMA77ON REGARDING BURIED UTILITIES.
NOTE C"
ALL DISTANCES ARE HORIZONTAL GROUND
AND AREA BY COORDINATE COMPUTATION.
SBO'47'45"E
1530.65
TIE TO EX, PK NAIL IN
INTERSECTION OF GILMORE RD,
AND POYTHRESS RD.
w
w
a PARCEL 1D 71703
'2 PIN 9766-15-2391.000
EMILY W. MEACHAM
OB 1081/509
N
PB 95/114
NOTE 10'
THIS SURVEY WAS DONE WITHOUT A TITLE
SEARCH AND IS BASED ON REFERENCED
INFORMATUX THERE MAY EXIST OTHER
OOCL#dENTS OF RECORD W01rCH COULD
AFFECT THIS PROPERTY
NOTE 'E.
EXCEPT AS SP£CInCALLY STATED OR SHOWN,
THIS SURVEY DOES NOT REPORT ANY OF
THE FOLLOWING: EASEMENTS, OTHER THAN
THOSE VISIBLE DURING FIELD EXAMINA 770N,
BUILDING SETBACKS, RESTRICTIVE COVENANTS
ZONING OR LAND USE RECULA17ONS AND ANY
FACTS MWCiH A TITLE SEARCH MAY DISCLOSE
NOTE F•
WETLAND$ JURISDICTIONAL WATERS OR OTHER
CONDITIONS WCH MAY BE REGULATED BY
FEDERAL OR STATE OR LOCAL AGENCIES WERE
NOT 1NVESS77GA TED DURING THIS SURVEY,
RIPARIAN BUFFERS AND OTHER RESTRICOONS
ON DEVELOPMENT MAY BE REQUIRED.
_PARCEL 8106 7 _ PIN #9766-15-0451- 000 J08 # 06- T 95
SCALE 7" = 100' DRAWN BY JWS ^CHECKED BY EWP
I, EDMUND W. PURCELL, PLS NO, 4335, CERTIFY THAT THIS MAP
WAS DRAWN FROM AN ACTUAL FIELD SURVEY AND CORNERS
WERE SET OR RECOVERED AS NOTED. THIS MAP DOES NOT
CONFORM WITH G.S. 47-30 AS AMENDED.
WITNESS MY HAND AND SEAL THIS FIRST DAY OF JUNE, 2006.
CONTROL
P
NOTE 'G"
SEE PLAT 'PROPERTY SURVEYED FOR KEVTN
O'DELI. & ANGELA BURTON' BY WILLIAM N.
MCCARTHY, Q., PLS. FATED SEPTEMBER 24,
2DO3, AND RECORDED rN PET 2004/23.
NOTE 'H,
FLOOD ZONES OR BASE FLOOD ELEVARONS HERE
NOT INVESTIGATED DURING THIS SURVEY
N07E J'
THIS SURVEY IS FOR LOAN AND T77LE
PURPOSES ONLY, DECLARATION IS MADE TO
ORIGINAL PURCHASER OF THE SURVEY ONLY,
IF IS NOT TRANSFERABLE TO ADDITIONAL
OWINERS.
'���u�srlirlr►I.I..
sLIRA-,G
off f,,,r7I I r�!<11 14 ` "N:N�,
PROPERTY SURVEYED FOR O
KE VI.N O DELL IRON PIN SET
0 SUMMIT
BALDWIN TWP, CHATHAM CO., NORTH CAROLINA EXfSTI � IRON Consulting Engineers
FIELD WORK PERFORMED ON DATE MAY P4, 2006 MA THEMA TICAL POINT 1000 Corporate Dr., Suite 101
PROPERTY AS DESCRIBED IN D.B. 1081/512 Hiilsbaraugh, NC 27278-8551
STANDINC IN THE NAME OF `rlD Voice: [phone] Fax: t919j 732-6676
KEVIN O'DELL AND MFF ANGELA BURTON UTILITY POLE vvwwsummit-eTtigineer.a❑m

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Page 1 of 2
Ch h at am C ounty M ap
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95-114 ' (0: U>• I ~ 361.45 ...._., I
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' ' ' ' I I
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PIN I 9766-15-0451. 000 ~-2
Parcel Number(AKPAR) I 81067 L
Tax Year jl 2007 Township II 2
Fire District II 107 OwnerlDl! 1019170 I
Deed Name ll oDELL KEVIN C ETUX ANGELA BURTON Deed Book ll 1os1 I
Deed Page ll 0512 Deed Year!! 2004 I
Plat Book II 2004 Plat Page II 0023
Legal De scrip II M 1-9A • 2 II Land FMvll 67400
Improvement FMV 1311502 II Deeded Acres 11 3. 99
Physical Address 1411 GILMORE RD II PIN Map 11 9766
PIN Submap 01 I PIN Map Block II 15
PIN Parcel 10451 II PIN Subparcel I
Billing Name I ODELL KEVIN CHARLES II Billing Name2 !I BURTON ANGELA ANNETTE I
Billing Name3 Billing Address ll 9905 OAK HOLLOW RD I
Billing Address2 Billing Address3 I
Billing Address4 Billing City II CHAPEL HILL I
Billing State NC 1; Billing Zip 11275165976 I
Watershed lws-Iv PA Census Tract [I 020100 I
Disclaimer: This map is prepared for the inventory of real property found within lllis jurisdiction
and is compiled from recorded deeds, plats, and other public records and data. Users of this
Map Scale
1 inch • 142 feet
Grid based on the North n
http://www.chathamgis.com/printPreview.aspx?PrintOptData=Chatham%20County%20M... 8/28/2007