WI0300037_Complete File - Historical_20171231

1 wt
L neoI,,.Co• SR.40:15 Sp ir+gs Elem
C:\PF?RO\DATA\PFINDER\UIC.\st040619A.COR
Recs Mean Std Dev Minimum
Latitude
Longitude
Altitude
185 35%31'42.111"N 2.538
185 81%01'31.021"W 1.751
185 244.653 3.788
No velocity records in file.
No DOP records in file.
Start
End
GPS Week #795 on 04/06/95 at
GPS Week #795 on 04/06/95 at
Datum
Coordinate System
Altitude Mode
Altitude/Distance Units
Velocity Units
19:10:37
19:15:09
: WGS-84
: Latitude/Longitude
: Height Above Ellipsoid
: Meters
: Meters/Second
35M31'41.949"N
813401'31.151"W
=
238.459
Statistics Version 3.3
Maximum
35%31' 42. 219"N
81%01'30.881"W
251.639

7it +
C:\PF:PRO\DATA\PFINDER\UIC\k040620B.COR
Al W Cd4.11uti e.b ",a01.7E.4" L)hLce L+1.frt 1 '
Recs Mean Std Dev
Latitude 186_
Longitude 186
Altitude 186
35%31'42.132"N 0.362
81301'32.367"W 2.442
243.628 1.415
No velocity records in file.
No DOP records
in file.
Start GPS Week #795
End GPS Week #795
on 04/06/95 at 20:09:32
on 04/06/95 at 20:14:57
Datum
Coordinate System
Altitude Mode
Altitude/Distance Units
Velocity Units
: WGS-84
: Latitude/Longitude
: Height Above Ellipsoid
: Meters
: Meters/Second
k f` n col i Co, choors - rN'ocx 0pr/ s
L (efry 1i wJ
Statistics Version 3.3
Minimum
Maximum
35'31'42.111"N 35'31'42.167"N
81%01'32.546"W 81%01'32.246"W
241.866
249.906
MRO Files.
Duke Power Co., Mr. Jim Miller
Enclosures
P.O. Box 29535, Raleigh, North Carolina 27626-0535
An Equal Opportunity Affirmative Action Employer
Telephone [phone] FAX [phone]
50% recycled/ 10% post -consumer paper

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE CONSTRUCTION AND OPERATION OF A WELL SYSTEM 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
Lincoln County Schools
FOR THE CONSTRUCTION AND OPERATION OF AN INJECTION WELL SYSTEM for
the purpose of operating a vertical closed -loop heat pump system.
This well system, to be comprised of approximately 300 wells, will
be located at 3633 Highway 16 North, Denver, North Carolina, in
Lincoln County, and will be constructed and operated in accordance
with the application dated March 17, 1995, and in conformity with
the specifications and supporting data submitted, all of which are
filed with the Department of Environment, Health, and Natural
Resources and are considered a part of this permit.
This permit is for Construction and Operation only, and does
not waive any provisions of the Water Use Act or any other
applicable Laws, Rules or Regulations. Operation and use of an
injection well system shall be in compliance with Title 15 North
Carolina Administrative Code 2C, .0100 and .0200, and any other
Laws, Rules, and Regulations pertaining to well construction and
use.
This permit shall be effective, unless revoked, from the date
of its issuance until March 31, 2000, and shall be subject to the
specified conditions and limitations set forth in Parts I through
X hereof.
Permit issued this the 3G1 da arch, 1995.
7-9
T&d'L. Bush, Jr., Assistant Chief
Groundwater Section
Division of Environmental Management
By Authority of the Environmental Management Commission.
PERMIT NO. WI0300037

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
lockable cap.
6. Each injection well shall be afforded reasonable protection
against damage during construction and uSe.
7. Each injection well shall have permanently affixed an
identification plate.
8. A completed Well Construction Record (Form GW-1) must be
submitted for each injection well, to the Division of
Environmental Management (Division), within 30 days of
completion of well construction.
PART II - WELL CONSTRUCTION SPECIAL CONDITIONS
At least forty-eight (48) hours prior to constructing each
injection well, the Permittee shall notify the Groundwater
Section - Underground Injection Control (UIC), Central Office
staff, telephone number [phone].
PAGE 2 OF 7

PART III - OPERATION AND USE GENERAL CONDITIONS
1. This permit is effective only with respect to the nature,
volume of materials and rate of injection, as described in
the application and other supporting data.
2. This permit is not transferable without prior notice to, and
approval by, the Director of the Division of Environmental
Management (Director). In the event there is a desire for
the facility to change ownership, or there is a name change
of the Permittee, a formal permit amendment request must be
submitted to the Director, including any supporting materials
as may be appropriate, at least 30 days prior to the date of
the change.
3. The issuance of this permit shall not relieve the Permittee
of the responsibility of complying with any and all statutes,
rules, regulations, or ordinances which may be imposed by
other local, state, and federal agencies which have
jurisdiction. Furthermore, the issuance of this permit does
not imply that all regulatory requirements have been met.
PART IV - PERFORMANCE STANDARDS
1. The injection facility shall be effectively maintained and
operated at all times so that there is no contamination of
groundwaters which will render them 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 Environmental Management 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 groundwaters
resulting from the operation of this facility.
PAGE 3 OF 7

PART V - OPERATION AND MAINTENANCE REQUIREMENTS
1. The injection facility shall be properly maintained and
operated at all times.
2. The Permittee must notify the Division and receive prior
written approval from the Director of any planned physical
alterations or additions in the permitted facility or
activity not specifically authorized by the permit.
3. At least forty-eight (48) hours prior to the initiation of
the operation of the facility for injection, the Permittee
must notify by telephone the Groundwater Section -
Underground Injection Control (UIC) , Central Office staff,
telephone number [phone]. Notification is required so
that Division staff can inspect or otherwise review the
injection facility and determine if it is in compliance with
permit conditions.
PART VI - INSPECTIONS
1. Any duly authorized officer, employee, or representative of
the Division of Environmental Management 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 (see attached diagram).
PART Vil - MONITORING AND REPORTING REQUIREMENTS
1. Any monitoring (including groundwater, surface water, or soil
sampling) deemed necessary by the Division of Environmental
Management to insure surface and ground water protection,
will be established and an acceptable sampling reporting
schedule shall be followed.
PAGE 4 OF 7

c
2. The Permittee shall report by telephone, within 48 hours of
the occurrence or first knowledge of the occurrence to the
Mooresville Regional Office, telephone number [phone]
of any of the following:
(A) Any occurrence at the injection facility which
results in any unusual operating circumstances;
(B) Any failure due to known or unknown reasons, that
renders the facility incapable of proper injection
operations, such as mechanical or electrical
failures.
3. Where the Permittee becomes aware of an omission of any
relevant facts in a permit application, or of any incorrect
information submitted in said application or in any report to
the Director, the relevant and correct facts or information
shall be promptly submitted to the Director by the Permittee.
4. In the event that the permitted facility fails to perform
satisfactorily, the Permittee shall take such immediate
action as may be required by the Director.
PART VIII - PERMIT RENEWAL
The Permittee shall, at least six (6) months prior to the
expiration of this permit, request an extension.
PART IX - CHANGE OF WELL STATUS
1. The Permittee shall provide written notification within 15
days of any change of status of an injection well. Such a
change would include the discontinued use of a well for
injection. If a well is taken completely out of service
temporarily, the Permittee must install a sanitary seal•. If
a well is not to be used for any purpose that well must be
permanently abandoned according to 15 NCAC 2C .0113, 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 15 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
PAGE 5 OF 7

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.
(G) The Permittee shall submit a Well Abandonment
Record (Form GW-30) as specified in 15A NCAC 2C
.0213(h)(1) within 30 days of completion of
abandonment.
3. The written documentation required in Part IX (1) and (2) (G)
shall be submitted to:
Groundwater Section - UIC Staff
DEHNR - Division of Environmental Management
P.O. Box 29535
Raleigh, NC 27626-0535
PART X - OPERATION AND USE SPECIAL CONDITIONS
The fluid to be recirculated in the vertical closed -loop heat
pump system shall be potable water only.
PERMIT NO. WI0300037
PAGE 6 OF 7

ATTACHMENT 1
I •
1
•
I• �.'•.;;.
PERMIT NO. WI0300037
I
VERTICAL "CLOSED LOOP"
.` • INJECTION WELL, USING -
UNCASED BOREHOLE . • -
1

•
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MEMO.
TO: Lt/C h�
DATE
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SUBJECT V
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North Carolina Department of Environment,
Health, and Natural Resources °$ pent nRecycleGPapet
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State of North ( rolina
Department of 1, wironment,
Health and Natural Resources
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
GROUNDWATER SECTION
March 31, 1995
MEMORANDUM
A'7;ClrA
DEHNR
To: Peggy Findley
Groundwater Section
Mooresville Regional Office
From: Karen Harmon 90
UIC Group
Groundwater Section
Raleigh Central Office
Re: Permit No. WI0300037 issued to Lincoln County Schools for an
injection well system.
A new permit for construction and operation of an injection
facility has been approved by RCO-UIC. A copy of the
application, the required variance, and the permit are enclosed
for your UIC files.
Duke Power Company will be drilling a test well during a
training session at the site of the proposed injection well
system, Rock Springs Elementary School in Denver, NC, on Friday,
April 7, 1995. I plan to attend the training session. If you
were able to attend the session also, we could inspect the site
and complete the Preconstruction Injection Facility Inspection
Report (form A). Duke Power Company plans to construct 300
injection wells as part of this heat pump system, so it would be
practical for you to become involved at this early stage..
cc: UIC Files
RO Files
Enclosures
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

• r •
DUCEICIOUI
Duke Power Company
Electric Center
P.O. Box 1006
Charlotte, NC 28201-1006
DUKE POWER
March 27, 1995
TO: Bob Cheek, Supervisor
Permits and Compliance Branch
FROM: Jim Miller, Cindy Hunter
Expanded Business Opportunities
SUBJECT: Variance to NORTH CAROLINA WELL CONSTRUCTION
STANDARDS Rule 15A NCAC 2C .0200 Rule 2C .0213 (d)(1)(A)
Rock Springs Elementary School
3633 Highway 16 North
Denver, N.C. 28037
Lincoln County
We request a variance to the referenced rule which requires that a well casing be installed which
extends from at least 12 inches above land surface to the top of the injection zone.
The injection well construction criteria described in Rule 2C .0213 (d)(1)(A) will not be possible
due to the engineering design of the vertical closed -loop heat pump system. The construction of
the injection wells will be as follows:
Each well will be drilled 110' deep. The grout pipe method recommended by the International
Ground Source Heat Pump Association (IGSHPA) will be followed. The closed -loop ground
heat exchanger (GHEX) loop is immediately inserted into the bore hole. Grout is placed in one
continuous operation by pumping, beginning at the bottom of the zone being sealed and
continued until it appears at the ground surface.
Grouting is an important aspect of the installation of a GHEX when used with a ground -source
heat pump system. Not only will it provide the proper heat transfer between the GHEX and the
ground necessary for the most efficient operation of the ground -source heat pump system, but it
will also provide groundwater protection.
P-r:ec 0': tecyciec Gem✓

This method of construction will prevent any fluids from entering the injection well at the
surface because all well heads will feed into a closed loop system that is underground and out of
view from the system users. In this particular application, the area where the ground field loop
system will be installed will be landscaped, allowing for a play area for the children at Rock
Springs Elementary School.
i Y Jilc-- ....
Jim Miller Cindy H er
Expanded Business Opportunities Expande Business Opportunities

FROM
03.13.1995 2:16
P. 2
NORTH CAROLINA '
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
AP'L1CATION FOR PE
MIT TO CONSTRUCT AND/OR USE A WELL FOR INJECTION
WITH A HEAT PUMP SYSTEM
Class 5 Wells
TO: DIRECTOR, NORTH CAROLINA DIVISION OF ENYIRONMENTALMANAGEMENT
DATE: M/ Chi 1-1 .,19 c15-
In accordance with the provision of Article 7, Chappte��r� 87; Article 21, Chapter 143, and regulations pursuant
thereto, 'APPLICATION is hest y made for a FERM=T to construct and/or use a well or well system as described
below and in any accompanying data submitted as part of this APPLICATION.
Please type or print clearly.
A, FiRMIT APPLICANT Name:
Addres>:
City:
County
Teleph ne:
B. S+Ai'[JS'OP APPLIC State f Private_
Public Commercial ______ Other
Native American Lands
C. PROPERTY OWNER (ifdifferentfrom applice t)) ��.�,�
Nunes
Addre s: ._.w�L� Zip code -
City: -
Count : i� '^
Telep one: 04 . � _ 1
D. •atAC1LTY ( SITE) DAT� (Fill out ONLY if the Status of Owner is Federal, State, Public or Commercial)
Name! of Business or Facility: gocg. SP121ma's S M
Zip code:
Addr ss:
City:
Coun y:
Te1e one:
Con ct Person:
E. HEATING CONTIRk R DATA
Nam
Ay ss: ip code:
Cou��ty:
Tele bone:
Con ct Person:
NGOL►�1 c i 7 t.10 L C 2DLtNAc
p code: IS DR 3
F. ;INJECTION PROCED ' = (Briefly describe h w the injection = well (s) will be used.)
Eta. trt~ . �_�� • 5r,
ssc. �. ,
• ...I..a b ■
G. WELL USE Will the njection well(s) also be used as the supply well(s) for either of the following:
(a) The injection otion7 YES
(b) Your personal •nsumption7
GW+57 HP (October 1 94) Page 1 of 4

,, FROM
83.13.1995 2:17
P. 4
•s-
K. :INJECTION -RELATED EQUIPMENT
Attach a diagram howing the engineering layout of the (1) injection equipment., and
(2) exterior piping/tubingpiping/tubing associated with the injection operation. The mar facturer's brochure, if
detailed, should a thsfy (1) above
�
L. TOPOGRAPHIC MAP
Attach a scaled to graphic map which extends one mile beyond the property boundaries of the
facility and indica
M. 1..00ATION OF WEL
Attach a detailed,
between the pro
waste) treatment,
and any other pot
direction and dis
wells) located wi
of each existing
on the map at le:
identify them by
clearly. Include a
, 4
es the location of the facility. (Q —es�1E "laxs E 1
s)
caled map of the site of the facility. showing the location of and distances
sed wells(s) (source wells and injection wells) and any waste (including hazardous
torage or disposal facilities; buildings; property boundaries; surface water bodies;
tial source of groundwater contamination. Additionally, indicate on the map the
ce to existing wells (injection wells, water supply wells, dry wells, abandoned
in 1,500 feet of the proposed injection well(s). Include with the map a description
ell, incorporating type, construction information, date drilled, and depth. Indicate
t two nearby reference points such ae roads, road intersections, streams, etc.. and
S, NC or SR (county secondary roads) numbers r name. Label all features
orth arrow on the reap to indicate orientation. wee Z*)
N. CERTIFICATION
"I. hereby certify, nder penalty of law. that I have personally examined and am familiar with the
information submi tee in this document and all attachments thereto and that, based on my inquiry of
those individuals i mediately 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 impri onment, for submitting false information. I agree to construct. operate, maintain,
repair, and if appl cable. abandon the injection well and all related appurtenances in accordance with the
approved specific4tions and conditions of the Permit."
aowl
(Signature of Owner or Autho " .1. gent)
PIease supply fetter signed byt e o hsvrSZ°ra+t
authorising the above agent, ((authorised agent is signer.
O. CONSENT OF PROP TY OWNER (Owner means any person who holds the foe or other property rights
.in the well being cons cted. A well is real property and its construction on land rests ownership in the
-land owner in the absertce of contrary agreement in writing.)
lithe property to owned by someone other than the applicant, the property owner hereby consents to
allow the apppli, nt to construct each injection well as oulined in this application and that it shall be
the responstbillt of the applicant to ensure that each injection well conforms to the Well
Construction S dards (Title 15A NCAC 2C .0200)
Name of Prope Owne3 (Print); _ CD an o
Mailing Addres . � -, !fix h cio
A.in n on C, aS0
(signature of Property Owner if Different
From Applicant)
GWt57 HP (October 1 .94) Page 3 of 4

DUKE POWER
March 17, 1995
Ms. Karen Harmon
North Carolina Department of Environment, Health
and Natural Resources
Division of Environmental Management
Groundwater Section, UIC Group
P.O. Box 29535
Raleigh, North Carolina 27626-0535
Subject: Duke Power Company
Geothermal Heat Pump Injection Well Permits
Dear Ms. Harmon:
Attached are two injection well permit applications and associated details for the
instaIIation of closed -loop, geothermal heat pump system injection wells for sites in
Lincoln and Gaston Counties in North Carolina.
•
Duke Power is proposing to install a training/test well, and approximately 300 closed-Ioop
injection wells, at the Rock Springs Elementary School on N.C. Highway 16 in Denver,
Lincoln County, North Carolina. These wells will serve as a closed -loop heat exchanger
for a geothermal (or ground -source) heat pump system planned for installation at the
school. These wells will be placed on a minimum 15 feet on -center grid, and bored to
approximately 110 feet deep by a typical 4 inch diameter auger. Upon completion of each
boring, a 1 inch diameter polyethylene pipe loop will be placed in the boring and charged
with water. The boring will then be grouted full -depth with a 18% to 30% bentonite-
cement grout. Casings, well screens, and gravel packs are not involved in the construction
of these wells. Lateral polyethylene piping will be placed approximately 6 feet below
ground and used to provide an interconnection between the wells. The completed system
will consist of the buried, closed -loop piping system charged with water for heat transfer,
a water -source (water to air) heat pump, and an air distribution system inside the school
building. The system will use water only as the heat transfer medium in a completely
closed -loop system. At no time will system water be in contact with groundwater, nor
will groundwater be withdrawn for use by the system.
The training/test well for the Rock Springs Elementary project is planned for installation
on April 6, 1995. This boring is being made as a test well for the overall project, and as
part of a geothermal heat pump system training program being conducted by IGSHPA

1 •., .!
(International Ground Source Heat Pump Association) certified trainers EWBANK &
Associates. This test well will serve as one of the production wells for the overall project
at Rock Springs Elementary, and will be temporarily capped until the remainder of the
wells have been installed. Installation of the remainder of the wells is scheduled to begin
April 30, 1995.
Duke Power is also proposing to install a training/test well on April 8, 1995 at the future
site of Gaston County High School on N.0 Highway 274 in Gaston County, North
Carolina. This boring is being made as a test well for a potential geothermal heat pump
system for the future high school, and is also being drilled as part of a geothermal heat
pump system training program being conducted by IGSHPA certified trainers EWBANK
& Associates. The installation details and procedures for this training/test well will be
identical to those for the Rock Springs Elementary project, however, this well be drilled to
approximately 300 feet deep. Following completion of this test well, the polyethylene
piping will be cut off below ground, and the well will be abandoned in accordance with
North Carolina state guidelines.
Attached are two completed permit application forms and associated site location maps
and typical detail drawings. Due to the nature of well installation techniques typically
employed for these closed -loop systems, references to "well casings", "screens", "gravel",
ti • "monitoring wells", and "injection fluid data" are not applicable. Also please note that the
heating contractor for the Rock Springs Elementary project has yet to be named, and that
details for the heat pump system will not be available until approximately March 24th.
Additional information is also attached from one potential heat pump system supplier.
Thank you for your time and assistance with this permitting effort. If you have any
questions, please contact me at [phone] or Mr. Jim Miller at [phone].
Furthermore, I believe that Mr. Bob Cheek in your Groundwater Section is familiar with
these systems, and is planning to attend the training/test well sessions at Rock Springs
Elementary on April bth.
Sincerely,
/4/N14-y_
Mark McGary, PE
Environmental Engineering
Attachments
xc w/att: J. B. Miller
xc w/o att: D. E. Sullivan

LII' ULn LUUIN 1 1 of-nuULJ .L J • (UzL (J94JL1
IVIHK ZZ ;Z( IN1J.VVI f' .Vl
March 22, 1995
P.O. Box 400, Lincolnton, NC 28093-0400 [phone]
Ms. Ell?at,eth Morey
Flo : CarcAi: F. OEHT' H-C EM
Post Office aflIX 29535
Dear Ms. Morwj/-
This 'titter isin response to your request regarding a recent application
for permit to construct andfor use a well for injection with a heat pump
system. Cd:.,-vnrd '.. Ha.tley. Associate Superintendent for Lincoln County
Schools, has signature authorization in my absence.
if ac1dltion l information is required, please let me knOw.
r
;;iIncer7(y,
�Iif r� /2///A74-721//'/->--
If r {
( +r . Martin A. Faddy
SUpBrintenciont
" Exrellcr.c'. our standard; learning, our goal."

COMPLAIN.GW
Request Complain Form
Namet of Caller:
Address:
Telephone:
Directions to Site:
*e f Complaint:
eceived By:
Date
Time:

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State o North Carolina
Department of Environment,
Health and Natural Resources
Division of Environmental Management
James B. Hunt, .Jr.. Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
MEMORANDUM
To:
From:
GROUNDWATER SECI'I©N
March 31, 1995
Karen Harmon!,�-
UIC Group
Groundwater Section
Raleigh Central Office
Nr,
�z ��icHi
E"GE
Re: Permit No. WI0300037 issued to Lincoln County Schools for an
injection well system.
A new permit for construction and operation of an injection
facility has been approved by RCa-UIC. A copy of the
application, the required variance, and the permit are enclosed
for your UIC files.
Duke Power Company w.1._ be drilling a. test well during a
training session at the site of the proposed injection well
system, Rock Springs Elementary School. in Denver, NC, on Friday,
April 7, 1995. I plan to attend the training session. If you
were able to attend the session. also, we could inspect the site
and complete the Preconstruction Injection Facility Inspection
Report (form A). Duke Power Company plans to construct. 300
injection wells as part of this heat pump system, so it would be
practical for you to become involved at this early stage,
cc: UIC Files
RO Files
Enclosures
R.a, Box 29536„ Pa1eigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirrcative Action Employer 50% recycled/ )0% post -consumer paper

Duke Power Company
Electric Center
P.O. Box 1006
Charlotte, NC28201.1006
.IP; DUKE POWER
March 27, 1995
TO: Bob Cheek, Supervisor
Permits and Compliance Branch
• FROM: Jim Miller, Cindy Hunter
Expanded Business Opportunities
SUBJECT: Variance to NORTH CAROLINA WELL CONSTRUCTION
STANDARDS Rule 15A NCAC 2C .0200 Rule 2C .0213 (d)(1)(A)
Rock Springs Elementary School
3633 Highway 16 North
Denver, N.C. 28037
Lincoln County
We request a variance to the referenced rule which requires that a well casing be installed which
extends from at least 12 inches above land surface to the top of the injection zone.
The injection well construction criteria described in Rule 2C .0213 (d)(1)(A) will not be possible
due to the engineering design of the vertical closed -loop heat pump system. The construction of
the injection wells will be as follows:
Each well will be drilled 110' deep. The grout pipe method recommended by the International
Ground Source Heat Pump Association (IGSHPA) will be followed. The closed -loop ground
heat exchanger (GHEX) loop is immediately inserted into the bore hole. Grout is placed in one
continuous operation by pumping, beginning at the bottom of the zone being sealed and
continued until it appears at the ground surface.
Grouting is an important aspect of the installation of a GHEX when used with a ground -source
heat pump system. Not only will it provide the proper heat transfer between the GHEX and the
ground necessary for the most efficient operation of the ground -source heat pump system, but it
will also provide groundwater protection.
Pnnted on recycled paper

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
GROUNDWATER SECTION
March 30, 1995
ZIA
�EHNR
Mr. Edward L. Hatley, Associate Superintendent
Lincoln County Schools
P.O. Box 400
Lincoln, NC 28093-0400
Dear Mr. Hatley,
In accordance with your application dated March 17, 1995, we
are forwarding Permit No. WI0300037 for the construction and
operation of an injection well system for the purpose of operating
a vertical closed -loop heat pump system in Lincoln County.
This permit shall be effective from the date of issuance
until March 31, 2000, and shall be subject to the conditions and
limitations stated therein, including the requirement to notify
this office by telephone 48 hours prior to initiation of operation
of the facility.
In order to continue uninterrupted legal use of this well
system for the stated purpose, you should submit an application to
renew the permit six months prior to its expiration date.
The variance requested by Mr. Jim Miller on behalf of Mr.
William H. Lindsay of Duke Power Company to Rule 2C .0213 (d) (1)
(A), which requires that a well casing be installed which extends
from at least 12 inches above land surface to the top of the
injection zone, has been approved and is attached, as it is a pre-
requisite for this permit to be issued.
If you have any questions regarding your permit please feel
free to contact me at (919) 733 - 3221, ext. 407.
Sincerely,
a. 4'a,z4i
A. Elizabeth Morey
Manager
Underground Injection Control Program
cc: UIC Files
MRO Files
Duke Power Co., Mr. Jim Miller
Enclosures
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
Duke Power Co.
P.O. Box 219
Seneca, SC 29679
Attn: Mr. William H. Lindsay
.A.vte"vA,
DEHNR
Subject: Request for Variance - NORTH CAROLINA WELL
CONSTRUCTION STANDARDS Rule 15A NCAC 2C
.0213(d) (1) (A) - Required extension of well casing
above land surface and depth of grout
Lincoln County School Property, 3633 Highway 16
North, Denver, NC
Dear Mr. Lindsay:
This is in response to the petition from Mr. Jim Miller,
on your behalf, requesting a variance from the referenced
Rule. Rule 2C .0213 (d)(1)(A) requires that a well casing be
installed which extends from at least 12 inches above land
surface to the top of the injection zone. Mr. Jim Miller
indicated in the letter dated March 27, 1995 that the
previously described injection well construction method would
not be possible due to the engineering design of the system.
Factors that would act to mitigate any potential problems
which could adversely affect human health and/or the effective
operation of this well, because of not meeting the regulatory
requirements, are as follows:
1. The well will be completely backfilled with a 18 -
30o bentonite-cement grout after installation of the
closed -loop piping in the well, as described in the
letter dated March 27, 1995 and illustrated in the
well construction diagram submitted with the permit
application. This construction method will provide
an adequate seal and prevent the vertical migration
of contaminants by way of the borehole.
2. The fluid to be circulated in the vertical closed -
loop heat pump system will be potable water.
P.O. Box 295315, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

Mr. William H. Lindsay
Variance to 15A NCAC 2C .0213
Page 2
Based on my review of the available information and
recommendations by our staff, it is my finding that the
combination of factors specified above are sufficient to
satisfy the conditions for approval of a variance from 15A
NCAC 2C .0213 (d) (1) (A) as defined in.15A NCAC 2C .0118. On
that basis, and with the additional requirement that you
notify the Mooresville Regional Office at [phone], at
least 24 hours before any well construction activities are
begun, the requested variance from Rule 15A NCAC 2C .0213
(d) (1) (A) is hereby granted.
The granting of this variance does not affect any of the
other requirements of the WELL CONSTRUCTION STANDARDS or of
the requirements of any other applicable laws or rules.
Sincerely,
DATE:
Zed L. Bush Jr., Assistant Chief
Groundwater Section
Division of Environmental Management
cc: UIC files
MRO
Duke Power, Mr. Jim Miller

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE CONSTRUCTION AND OPERATION OF A WELL SYSTEM 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
Lincoln County Schools
FOR THE CONSTRUCTION AND OPERATION OF AN INJECTION WELL SYSTEM for
the purpose of operating a vertical closed -loop heat pump system.
This well system, to be comprised of approximately 300 wells, will
be located at 3633 Highway 16 North, Denver, North Carolina, in
Lincoln County, and will be constructed and operated in accordance
with the application dated March 17, 1995, and in conformity with
the specifications and supporting data submitted, all of which are
filed with the Department of Environment, Health, and Natural
Resources and are considered a part of this permit.
This permit is for Construction and Operation only, and does
not waive any provisions of the Water Use Act or any other
applicable Laws, Rules or Regulations. Operation and use of an
injection well system shall be in compliance with Title 15 North
Carolina Administrative Code 2C, .0100 and .0200, and any other
Laws, Rules, and Regulations pertaining to well construction and
use.
This permit shall be effective, unless revoked, from the date
of its issuance until March 31, 2000, and shall be subject to the
specified conditions and limitations set forth in Parts I through
X hereof.
Permit issued this the
rch, 1995.
Td'L. Bush, Jr., Assistant Chief
Groundwater Section
Division of Environmental Management
By Authority of the Environmental Management Commission.
PERMIT NO. WI0300037

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
lockable cap.
6. Each injection well shall be afforded reasonable protection
against damage during construction and use.
7. Each injection well shall have permanently affixed an
identification plate.
8. A completed Well Construction Record (Form GW-1) must be
submitted for each injection well, to the Division of
Environmental Management (Division), within 30 days of
completion of well construction.
PART II - WELL CONSTRUCTION SPECIAL CONDITIONS
At least forty-eight (48) hours prior to constructing each
injection well, the Permittee shall notify the Groundwater
Section - Underground Injection Control (UIC), Central Office
staff, telephone number [phone].
PAGE 2 OF 7

PART III -.OPERATION AND USE GENERAL CONDITIONS
1. This permit is effective only with respect to the nature,
volume of materials and rate of injection, as described in
the application and other supporting data.
2. This permit is not transferable without prior notice to, and
approval by, the Director of the Division of Environmental
Management (Director). In the event there is a desire for
the facility to change ownership, or there is a name change
of the Permittee, a formal permit amendment request must be
submitted to the Director, including any supporting materials
as may be appropriate, at least 30 days prior to the date of
the change.
3. The issuance of this permit shall not relieve the Permittee
of the responsibility of complying with any and all statutes,
rules, regulations, or ordinances which may be imposed by
other local, state, and federal agencies which have
jurisdiction. Furthermore, the issuance of this permit does
not imply that all regulatory requirements have been met.
PART IV - PERFORMANCE STANDARDS
1. The injection facility shall be effectively maintained and
operated at all times so that there is no contamination of
groundwaters which will render them 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 Environmental Management 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 groundwaters
resulting from the operation of this facility.
PAGE 3 OF 7

PART V - OPERATION AND MAINTENANCE REQUIREMENTS
1. The injection facility shall be properly maintained and
operated at all times.
2. The Permittee must notify the Division and receive prior
written approval from the Director of any planned physical
alterations or additions in the permitted facility or
activity not specifically authorized by the permit.
3. At least forty-eight (48) hours prior to the initiation of
the operation of the facility for injection, the Permittee
must notify by telephone the Groundwater Section - .
Underground Injection Control (UIC) , Central Office staff,
telephone number [phone]. Notification is required so
that Division staff can inspect or otherwise review the
injection facility and determine if it is in compliance with
permit conditions.
PART VI - INSPECTIONS
1 Any duly authorized officer, employee, or representative of
the Division of Environmental Management 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 (see attached diagram).
PART VII - MONITORING AND REPORTING REQUIREMENTS
1. Any monitoring (including groundwater, surface water, or soil
sampling) deemed necessary by the Division of Environmental
Management to insure surface and ground water protection,
will be established and an acceptable sampling reporting
schedule shall be followed.
PAGE 4 OF 7

2. The Permittee shall report by telephone, within 48 hours of
the occurrence or first knowledge of the occurrence to the
Mooresville Regional Office, telephone number [phone]
of any of the following:
(A) Any occurrence at the injection facility which
results in any unusual operating circumstances;
(B) Any failure due to known or unknown reasons, that
renders the facility incapable of proper injection
operations, such as mechanical or electrical
failures.
3. Where the Permittee becomes aware of an omission of any
relevant facts in a permit application, or of any incorrect
information submitted in said application or in any report to
the Director, the relevant and correct facts or information
shall be promptly submitted to the Director by the Permittee.
4. In the event that the permitted facility fails to perform
satisfactorily, the Permittee shall take such immediate
action as may be required by the Director.
PART VIII - PERMIT RENEWAL
The Permittee shall, at least six (6) months prior to the
expiration of this permit, request an extension.
PART IX - CHANGE OF WELL STATUS
1. The Permittee shall provide written notification within 15
days of any change of status of an injection well. Such a
change would include the discontinued use of a well for
injection. If a well is taken completely out of service
temporarily, the Permittee must install a sanitary seal. If
a well is not to be used for any purpose that well must be
permanently abandoned according to 15 NCAC 2C .0113, 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 15 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
PAGE 5 OF 7

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.
(G) The Permittee shall submit a Well Abandonment
Record (Form GW-30) as specified in 15A NCAC 2C
.0213(h)(1) within 30 days of completion of
abandonment.
3. The written documentation required in Part IX (1) and (2) (G)
shall be submitted to:
Groundwater Section - UIC Staff
DEHNR - Division of Environmental Management
P.O. Box 29535
Raleigh, NC 27626-0535
PART X - OPERATION AND USE SPECIAL CONDITIONS
The fluid to be recirculated in the vertical closed -loop heat
pump system shall be potable water only.
PERMIT NO. WI0300037
PAGE 6 OF 7

ATTACHMENT 1
•
• .a •
PERMIT NO. WI0300037
• . • • : • • ••• • . . • : • .
. • . . . . • •
. .
. • •
•
HEAT
PUMP
VERTICAL "CLOSED LOOP"
INJECTION WELL, USING -
UNCASED BOREHOLE

This method of construction will prevent any fluids from entering the injection well at the
surface because all well heads will feed into a closed loop system that is underground and out of
view from the system users. In this particular application, the area where the ground field loop
system will be installed will be landscaped, allowing for a play area for the children at Rock
Springs Elementary School.
, 2g
Jim Miller
Expanded Business Opportunities
Cindy H er
Expande Business Opportunities

FROM
03.13.1995 12:16
P. 2
NORTH CAROLINA
ENVIONMENTAL MANAGEMENT COMMISSION
DEPARTMENT O = ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
APjL1CATION FOR PERMIT
O CONSTRUCT O HEAT PUMP D/01SYSTUSE A WELL FOR INJECTION
WITH
Class 5 Wells
TO: DIRECTOR, NORTH CAROIINA DIVISION OF ENVIRONMENTAL MANAGEMENT
DATE:_LAAec�i l7 —,19 5
In accordance
Article 21 Chapter 143, and regulations pursuant
with the Provisions of Article 7, Cliappt��er��87, ,
thereto, ikPPLICATION is heret'y made for a PERNIIT to construct and/or use a well or well system as described
below a#1d in any accompanying data submitted as part of this APPLICATION.
Please type or print clearly.
A. PiRMIT APPLICANT L �Gat,t.1 GeV oRT �'-c�I-t1�At
Name: .,.,
Address:Ci• - Zip code:
Coryu.n l.ir►�o rt �
Teleph ne:
8. SfATUS OF APP]IC
Fedex State f Private
Public
Native encan Lands
C. PROPERTY OWNER (if different from applicant)
Names t-. O t..P co V l.s'T"-(
Addeo s: P. 0, •. � A9 3
City:
Zip code. lA�q
Count : ' ^ - n r
Telep one: C44
D. •F?ACILITY SITE) DAT (Fill out ONLY if the Status of Owner is Federal, State, Public or Commercial)
Nam I of Business or Facility: go SPe1146 1� Mt-
ksi-
Addr ss: 36 33 Dr �i p code: 2S637
City:
Couny: inc
Te1e One: LDS f q r3 'r er
Con ct Person: e-r 9 fri
E. •
ATING CONTRtk R DATA ��p , t ,___) •
NNam :
Ad ss: Shy:
, ,,Zip code;
ty:
Tele hone:
ou
Con =ot Person:
F. INJECTION PROCED (Briefly describe h.w the
injection well(s)1Cbe used.)� as
5 171Pti
ELL, Lt- •L C- . • . MP 4T�/t
• r l G r S • � Lp+ An• ►1
Y e--,1�G-_J tED1uNt ga=fie1 t.- -nc?
• U51aEa 'PL1�t� W •'TES AGi �—
G. 'WELL USE Will the njection° well(s) also be used as the supply well(s) foreitherof the following:
NO
(a) The injection o eration? YESN� IC
(b) Your personal • nsumptlon? YES
GW+57 HP (October 1 ' 94) Page 1 of 4

FROM
03.13.1995 12.:16
H. k3ONSTRUCTION DATT (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 OW-1 (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,
tor'sName: T)Y Fox5oZ MtAr s '
Lion number: 92 t
Well Drilling Con
NC Driller Regis
i
Date to be consuu ted: + (Co /qc AND Approximate depth: 1 j 0 .
4/30195 ,4,�p �t�Z2c 7-;)Well casing:,. raja} to Arccon�1�%�-i.1Tl;.5E• 4 Lc
(a Tyke: GB]Va 11 lack stecl_Plastic Other(specify)
(b Inside diem er:
(c Casing dap From inches; Wall thickness inches or schedule i!
to_ft. (rem tb land surface)
Casing extezjds above ground inches (must be at least 12 inches)
stee
Cern ent grout: e LacE A-CcervteAk)'f0,5G-► i. 12 AN•10 v1&+)a—
(a) Around inn e or"primary" casing: Promto [o ft.
(b) Around out (pit) casing, if present: From
ft.
Screens (if apptic: 1 ): (- tacE P3-.5PAN- ' C-. k t�� Apt, FtG-zvRG 3'
(a)Type: ; Inner diameter: inches
(b) Depth: ro to feet below land surface
Gravel (if appiica.le): From tofeetbelow land surface NIA e o 116t7P &)
N.C. State Regul
provisions for m
pump) and efflut
(a) the influent
AGc.r7MP,406
tions (Title 15A NCAC 2C Section .0200) require the permitter. to make
boring well head processes. A faucet on both influent (groundwater entering heat
t (water being injected into the well) lines is required. Will there be a faucet on:
ine? yes no X (b) the effluent line? yes no Y.
NOTt: THE WELL DRIL i a CONTRACTOR CAN SUPPLY THE DATA POR EITHER EXISTING OR
PROPOSED WE S IF THIS INFORMATION IS UNAVAILABLE BY OTHER MEANS.
I.
PROPOSED OPERA G DATA JA:
(a) Injection za Average ((daily)
(b In action v.lume: Average (daily) f al
c) Injection p ssurre: Average ((daily)) !
(d) Injection to pasture: Annual Average N
J. iINJECTION FLUID D TA
gallons per minute m)
N a gallons per day. (gp
ounds/ inch ch si)
degrees FF
(1) Fluid source. If nderground, from what depth, formation and type of rack/sediment unit will the
fluid be drawn (e.g., granite, limestone, rand, etc.). [N !P )
Depth: Formation: Rock/sediment unit.
(a) SOURCE LL CONSTRUCTION INFORMATION (if different from injection well).
Attach a c9pyy of Form OW-1 (Well Construction Record). If Form GW-1 is not available,
provide th9 data in part H (1) through (7) of this application form to the best of your
knowledg
(2) Chemical Analy is of Source Water. The following chemical characteristics MUST accompany this
application: c 1 A�
H
hioride
otal hardness , ppm (parts per million or mg/1); Iron pppm:
ppm; Nitrate _ppm; Coliform bacteria counts/100m1,
NOTE: Assistance in determining these values may be obtained b contacting (a) our local or county
health offi a1, (b) a commercial water -testing laboratory, �nvtronment,�H�caith�ana contractor,
(d) the reg onal Hydrogeologist. NorthCarolinaP
Resources
GW-57 HP (October 1
94) Page 2 of 4

k
FROM
03.13.1995 12:17
P. 4
K. SECTION -RELATED
EQUIPMENT
Attach a diagram showing the engineering layout of the (1) injection equipment, and
(2) exterior piping/tubing associated with the injection operauon. The manufacturer's brochure, if
detailed. should s tisfy () above RE:: 3).
L. TOPOGRAPHIC MAP
Attach a scaled to graphic map which extends one mile beyond the property boundaries of the
facility and indica es the location of the facility. (R --E ..E IGvP. l
M. i.00ATION OF WEL S)
Attach a detailed,
between the prop
waste) treatment,
and any other pot
direction and disc
wells) located wit
of each existing v
on the map at lea
identify there by
clearly. Include a
N. CERTIFICATION
teased map of the site of the facility. showing the location of and distances •
sed wells(s) (source wells and injection wells) and any waste (including hazardous
storage or disposal facilities; buildings; property boundaries; surface water bodies;
ntial source of groundwater contain' ation. Additionally, indicate on the map the
nee to existing wells (injection wells, water supply wells, dry wells, abandoned
tin 1,500 feet of the proposed injection well(s). Include with the map a description
ell, incorporating type, construction information, date drilled, and depth. Indicate
tt two nearby reference points such aas� roads, road intersections. streams, etc., and
)S, NC or SR (county secondary roads) numbers or name. Label all features
north arrow on the map to indicate. orientation. tom[ G Vize 2•)
"I hereby certify, nder penalty of law, that 1 have personally examined and am familiar with the
information submi tcd in this document and all attachments thereto and that, based on my inquiry of
those individuals i mediately responsible for obtaining said information, 1 believe that the information
is true. accurate d complete. I am aware that there are significant penalties, including the possibility
of fines and imprionment, for submitting false information. I agree to construct, operate, maintain,
repair, and if appp1'cablc, abandon the inlection well and all related appurtenances in accordance with the
approved spectfic4tions and conditions of the Permit."
abol
(Signature of Owner or Auurtho gent)
Please
y a"ietter signed by the o net sirf . S""-
authorizing the above agent, if authorized agent is signer.
0. CONSENT OF PROPFtTY OWNER (Owner means any person who holds the fee or other property rights
:in the well being constricted. A well is real property and its construction on land rests ownership in the
land owner in the absence of contrary agreement in writing.)
If the property is owned by someone other than the applicant. the property owner hereby consents to
allow the appli = nt to construct each injection well as oulined in this application and that it shall be
the responstbilit of the applicant to ensure that each injection well conforms to the Well
Construction S dards (Mile 1SA NCAC 2C .0200)
-`
Name of Prope � Owner (Print): Zr ' � G 1rt CZ) ern r ao �
Mailing Addres p► o. x 400
A.1ncZ) n on C, aao-.3
(Signature o Property Owner if Different
From Applicant)
GW+57 HP (October I 94) Page 3 of 4

15' MIN ON CENTER
r s
SPACING
111=111=
111-III-
111=111=
III-111= - 111E 1 11_.
LATERAL LINES PLACED
APPROXIMATELY 8'DEEP
(-.
1-1
r
1" 0 CLOSED —LOOP
POLYETHYLENE PIPE
GROUTED FULL DEPTH
WITH 18% TO 30%
BENTONITE CEMENT
GROUT MIXTURE
" 0 BOVEHOLE
FIGURE 3
ROCK SPRINGS ELEMENTARY PROJECT
LINCOLN COUNTY
TRAINING/TEST WELL AND
GEOTHERMAL HEAT PUMP SYSTEM WELLS
TYPICAL ❑ETAIL

k \\
900
,••••"--'• C19•.,
4.96 2'30"
.3
. 0
0
SITE LOCATION
'97
t
v/
C/Y.
LIEU
FIGURE 1
3934
3933
32'30"
3932
3'331
39300000LN.
w
ROCK SPRINGS ELEMENTARY PROJECT
LINCOLN COUNTY
TRAINING/TEST WELL AND
GEOTHERMAL HEAT PUMP SYSTEM WELLS
SITE LOCATION MAP

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DUKE POWER
March 17, 1995
Ms. Karen Harmon
North Carolina Department of Environment, Health
and Natural Resources
Division of Environmental Management
Groundwater Section, UIC Group
P.O. Box 29535
Raleigh, North Carolina 27626-0535
Subject: Duke Power Company
Geothermal Heat Pump Injection Well Permits
Dear Ms. Harmon:
Attached are two injection well permit applications and associated details for the
installation of closed -loop, geothermal heat pump system injection weIIs for sites in
Lincoln and Gaston Counties in North Carolina.
L� r 5
cz
C.rt `r'
Duke Power is proposing to install a training/test well, and approximately 300 closed -loop
injection wells, at the Rock Springs EIementary School on N.C. Highway 16 in Denver,
Lincoln County, North Carolina. These wells will serve as a closed -loop heat exchanger
for a geothermal (or ground -source) heat pump system planned for installation at the
school. These wells will be placed on a minimum 15 feet on -center grid, and bored to
approximately 110 feet deep by a typical 4 inch diameter auger. Upon completion of each
boring, a 1 inch diameter polyethylene pipe loop will be placed in the boring and charged
with water. The boring will then be grouted full -depth with a 18% to 30% bentonite-
cement grout. Casings, well screens, and gravel packs are not involved in the construction
of these wells. Lateral polyethylene piping will be placed approximately 6 feet below
ground and used to provide an interconnection between the wells. The completed system
will consist of the buried, closed -loop piping system charged with water for heat transfer,
a water -source (water to air) heat pump, and an air distribution system inside the school
building. The system will use water only as the heat transfer medium in a completely
closed -loop system. At no time will system water be in contact with groundwater, nor
will groundwater be withdrawn for use by the system.
The training/test well for the Rock Springs Elementary project is planned for installation
on April 6, 1995. This boring is being made as a test well for the overall project, and as
part of a geothermal heat pump system training program being conducted by IGSHPA

(International Ground Source Heat Pump Association) certified trainers EWBANK &
Associates. This test well will serve as one of the production wells for the overall project
at Rock Springs Elementary, and will be temporarily capped until the remainder of the
wells have been installed. Installation of the remainder of the wells is scheduled to begin
April 30, 1995.
Duke Power is also proposing to install a training/test well on April 8, 1995 at the future
site of Gaston County High School on N.0 Highway 274 in Gaston County, North
Carolina. This boring is being made as a test well for a potential geothermal heat pump
system for the future high school, and is also being drilled as part of a geothermal heat
pump system training program being conducted by IGSHPA certified trainers EWBANK
& Associates. The installation details and procedures for this training/test well will be
identical to those for the Rock Springs Elementary project, however, this well be drilled to
approximately 300 feet deep. Following completion of this test weII, the polyethylene
piping will be cut off below ground, and the well will be abandoned in accordance with
North Carolina state guidelines.
Attached are two completed permit application forms and associated site location maps
and typical detail drawings. Due to the nature of well installation techniques typically
employed for these closed -loop systems, references to "well casings", "screens", "gravel",
"monitoring wells", and "injection fluid data" are not applicable. Also please note that the
heating contractor for the Rock Springs Elementary project has yet to be named, and that
details for the heat pump system will not be available until approximately March 24th.
Additional information is also attached from one potential heat pump system supplier.
Thank you for your time and assistance with this permitting effort. If you have any
questions, please contact me at [phone] or Mr. Jim Miller at [phone].
Furthermore, I believe that Mr. Bob Cheek in your Groundwater Section is familiar with
these systems, and is planning to attend the training/test well sessions at Rock Springs
Elementary on April 6th.
Sincerely,
/4%, t/f4
Mark McGary, PE
Environmental Engineering
Attachments
xc w/att:
xc w/o att:
J. B. Miller
D. E. Sullivan

LINLULF'l LUUN l Y bl.hiUUL !J : (U4 (Jb46 1
k
NHK 22'5 J 2( No.UU1 F.U1
MarVb 22, 1995
gWoLsi,
c/f41.d
P.O. Box 400, Lincolnton, NC 28093-0400 (704) '732-2261
Ms. Ell7aLetf, %/lore,/
Nora Carolina OEHNTH-D M
Post Office 2 535
Dear Ms. Morey:
This letter is in response to your request regarding a repent application
for permit to construct and/or use a well for injection with a heat pump
system. =-�w rd L , Hatley. Associate Superintendent for Lincoln County
Schools, has signature authorization in my absence.
If additional information is required, please let me know.
tr,inoer
f • I
'7
/ i , l
Or. Martin A. Faddy
S urlrintenU 'ft
"Exrellance, our Standard; learning, our goal."

DIVISION OF ENVIRONMENTAL MANAGEMENT
January 17. 1996
MEMORANDUM TO Arthur Mouberry
FROM: Barbara Christian
SUBJECT: Stanley Setzer Well Inspection Requests
I am writing, in response to Your November 14, 1995 letter to Elmer Newman, in witich you.
requested that I follow up with Stanley Setter and then report to you concerninghis requests for well
inspections, According to Mr.. Newman's Octobe,r 30 letter to you, Stanley Selzer has indicated that the
Moorewille Regional Office as not responsive to his requests for inspections. I agree that Mooresville
staff did not inspect either of these two wel.ls, 1 disagree, however. that Mooresville was not responsive,
On July 6, _fitly 2.4, and September 21, 1995, Stanley Setter called to discuss with me and Steve
Bograd the abandonment of a well located adjacent to the Cleveland County landfill, He stated that he
was bidding on a job to abandon the well Stanley reported that. the well was not grouted and a well tag
was not present He indicated that he wanted the Mooresville staff to inspect the well and enforce the
grout violation, thereby relieving hirn of that :responsibility (as the contractor abandoning the well).
Stanley thought that the well was constmeted perhaps by Junior Setzer. Steve Bograd and :I explained that
without definitive knowledge of the original well driller, the Mooresville staff could not proceed with
enfocernent or even a notice of violation.. We also explained that he could avoid the time and expense of
grouting the well by removing the easing Stanley, then asked that I send him a letter explaining the
.requirements for well abandonment, so he would have documentation to attach to his bid on the project.
which :I did. At the close of our last conversation on this well, and in a follow-up correspondence from
Stanley as a result of a clerical mix-up with attachments to my letter. I had every reason to believe that.
this case had been resolved to the satisfaction of both ofus, You can be sure I was quite surprised to read
about this well in Mr. Newman's letter,
During the July 6 telephone conversation between Steve Bograd and Stanley Setter about the
well abandonment, Stanley mentioned to Steve that near the landfill he saw a new ‘vell constructed only
about 15 feet from a building foundation. The well did not have a driller identification tag Stanley
suggested that Steve could inspcct the well when he inspected the landfill well, Since the inspection for
the landfill well 'became unnecessary and never took place, the second well likewise was not inspected.
Beyondthis brief mention of the second Welt in one conversation (I not remember nor do 1 have record.
that Stanley mentioned this welt to me), Steve did not realize that Stan„ley was actually requesting a well.
inspection,
Stewe did explain our hesitation to inspect a well where the request came from a party other than
the well owner, On our own initiative,. we decided to inspect wells drilled on the Crescent .Resources lots
this past summer where blanket variances were requested last year. The high degree of resentment and
general lack of cooperation shown us by the well owners, has made us just about give up this project.
Without the well owner's filll cooperation. we arc very reluctant to inspect a well..
I. apologize that this response is so late in being sent to you, but we did .not receive a copy of your
letter until over a rnonth after it was written.. We knew of the existence of the letter only after it had been
discussed at a North Carolina Ground Water Association meeting, and was reported to us by a driller who
was at the meeting 1 would ask that if you need me to take action and want to include it in a letter., as in
this case„ please have someone call me before the letter is sent, That Nvay I know to look for the letter. and
can act in a more timely' manner, Thanks,

•
. ' FROM
ftoe
12.19.1995 14129
11114
P. 4
•
October 30; 1995
Arthur No'
Chief, Citoi
Dept. of Ei
P.O. Box 2
North
Ca fir�a
and ter
i Writ? 4►
vironntdnt 1 Health 44 Natural Resources.
535
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eiir Mr; foubia
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I am writini on behalf 'of the North Carolina Ground W ter Association to express our concerns
regarding a'well codstrkiction project at the public school iin Denver. The project, which was begun is
August of this year,, in olves'the construction of 96 holes, each approximately 300 .feet deep, for the
purpose of Onstallin$ a lelosed loop heat pump system. As we understand it, .this is the first of a number of
large scale Oosed loop systenis'that will be installed throughout the state.
�t the ci struction of the wells in Which the loop•system will be placed. In view of
lis that will be drilled in this and i► similar projects, there is considerable danger
ination.' It is our understanding that such holes are included in the definition of
ction st 4 ndards. According to the definition, a well is ..."any excavation that is
tted, d'p or otherwise constructed for the purpose of locating, testing, developing,
any gto ndwater reservoirs or aquifer, or that may control, divert, or otherwise
water tram or into any aquifer.° Clearly, any hole that is 300 feet deep can
se may rent from or into an aquifer. In fact, one of our members observed one
oI prddicing 3 gallons of water per minute. In the Denver area, any hole that's
trough lit least one aquifer, most, if not all will pass through more than one.
In observing the well nstruction process at this school lroject, we noticed that there were several
We aro concerned abo
the large number of w
of groundwater contan
well in the well con to
cored, bored, drilled, jc
draining or!recharg(ng
cause the Movement oa
divert or otherwise eau
of the wells at the scbc
300 feet d p will do tl
rppa.mtc vi latldnn 10' he wa ldonsttuotion standards, Those violations include:-
a consticcction. of tit 1 fist 26 !!ells approximately 20 feet !from the footings of the school (the regulations
Call for 4 distance o at least 25 feet);
a removal lof casing • m at least some of the wells (sue wells create the opportunity for cross -aquifer
contamination); ! :
o construction of the Its in such a way that no well head will be above the ground (in fact, it is our
understq'nding that he entke 96 hole system will he wider asphalt and that there will be no indication
of the k cation o a wells;
a construction of the ells ivit lout the use of cement Out as required in the regulations;
use of b'entonite grout to fill up the inside of the well) in which the casing was not pulled;
AO, Box 982, New Markel, Virgin! 22844 " 1.703.140 3329

FROM
o construction oft e
grout ar and th c+
12.19.1995 14130 P. 5
i
yells without the required amount lof annular space, which is required in order to
ing in accordance with the regu1aiions; and,
o construe on of the 4vells bout contractor identification plates.
The types of violations we have cited are serious. They could lead to massive contamination of the
ground water. Considering the; urge number of such systems to be installed in North Carolina, we are
looting at a potentially. serlona roblem.
i
It is clear to us that a holes in these systems are wells. !Theymeet the conditions of the definition is
the well construction s andar+ds; With this in mind, we haie the following questions: .
o Have any of the'we$1s ever been inspected? If they huek when were they inspected and by whom?
o Have the wells beery constricted by a registered dole i? If so, who is the driller?
i WbQt.varianccas, ff, , htfivv'lseen gtaflted to the d'il1e for donstructipn of the wells?
o What permits' were btainO prior to the construction of the wells?
In asking these quat , we are especially concerned wi h the issue of enforcement. For that reason, I
must mentiOn two qth r wells that have been brought to he attention of a Groundwater Section regional
office. Recently, in the same p of the state where the heat pump project is located, one of our
members, Stanley Se r, asked the staff of Groundwater. Section's regional office in Mooresville to
inspect twa'wells that eemetl to be improperly constructOd. One of the wells was ungrouted and
untagged aid was iota ed in an area of known contatnina'tion, i.e., a solid waste dump. That well had
been cconstt'ucted in' 1 and Stanley had been asked by the owner to abandon the well so that the dump
could be ded. ' St niey did, not want to proceed ninth abandonment without an inspection by the
Groundwa r Section, ince tht# well was improperly conskructed.
The other Well was co tructed in the past six months; it 6d not been grouted and had no well tag. In
addition, it Was too 1c1 a to dui footings of the house; In neither case did the Groundwater Section
respond to the request for inspection. This type of non -response has bean reported in other sections of
the state,
the Assoc adonis kafl meeting, the membersat
pent 6 hours on the well construction
he regula ns ccnhanittee has just spent snot er 6 hours preparing recommendations on the
ring the ' io4is at the Fall meeting,' a n ber of participants expressed frustration tl"
were no being c orced. They argued, with some justification, that our efforts would be
Recently, a
standards.
standar1ds.1
the standar
•
ect ground water. When the members see
t their efforts are wasted.
g the school in Denver, and I hope that we can
work out a' way to get in better response from officials when they are made aware of potential problems.
a ifa eta cii int do f# 3ything it could do to e tee the standards. •Drillers that construct wells
r,Cnr ee with ds standarare at a disadvantage w en competing 4th drillers who do not comply
the st ndaids.
As President of the atioit, I am proud that we have consistently supported the licensing of drillers
and have wprked fir ell construction standards that pro
projects of the kind d' cussed iibove, they get concerned
I look forward to your responsC to our questions rega
Respec ly,•
<7---;7;)
er Newman
President
***END***

FROM
12.18.1995 15126 P. 2
S'�Cte cp f No th CairO a
Aejartment of Erg ironment,
Health and NatUr I Resources
Div sion of Enyironme, fa! Management
.ia es B. Hurt , Jr.,-$civernor
Jo athan B. Howes, Secretary
A. reston Howard, P.E., Director
•
•
• GROUNDWATER SECTION
November 14, 1995
Mr. D. liner Newinan
Preside t
North arolina G> ound W4ter Association
P.O. 982
New M ket, Virginia 22844
Subject: Geothe al HeatPump System at Rock Springs EIementary School in Denver,
Lincoln County, N rth Carlin
Dear Mr. Newmad,
hank you for expressing your concerns about the Geothermal Heat Pump System
at Rock Springs E ementary School in Denver, Lincoln County, North Carolina. The 96
borings which con ttie' losed loop system are classified as injection wells and regulated
under 'tie 15A, hapter 4, Subchapter 2C, Section .0200 of the North Carolina
•Adm' ' trative de. BotliL the state of North Carolina and the Environmental Protection
Agency define injection.We la as "...any excavation... used for the -injection of fluids or solids
into the subsurface or gro>ndwaters." Hence, the Well construction standards for water
supply ivells (2C, 0107) do not apply. Injection well permitting and regulation are handled
by the ndergrouid Injection Control Program (UIC) staffin the Raleigh Central Office.
our observed appirent violations of the water well construction standards (2C,
• .0107). ; addressed boloi'i:
1. Unlike the water supply well construction
s : dards (2C .0107); he injection well construction standards (2C .0218) do not
spe a mini aum dis ance from building footings, thus a variance was not required.
2. Coountrpct;� 'tho t� tie use of ce�mertt gi ut: As recommended by the International
Ground So Heat Piamp Association, all of the wells were backfilled with bentonite
gro t. As spe ified in the permit request, grout was placed in one continuous operation
by umping, beginning at the bottom of the well and continued until it appeared at the
gro nd surfae+. The type of bentonite grout used, Benseal, reportedly had the
un ticipated problom of substantial settling. This settling produced the appearance of
no ut in thi wells. To address this problem the wells have been topped off with more
gro t.
This characteristics and amount of settling of Benseal has been' investigated by UIC
1
P O. Box 2954 fideIgl .ilorlh Carolina 27626-0535 Telephone [phone]S FAX [phone]
An Equal,Opporlur4 Affirmative Action Employer EA% recycled/ In post•consumer paper

'FROM
•G f
12.18.1995 15:27
L..g
P. 3
staff, who have .onfirme'd this problem. While not on site for all of the drilling
opera tlons, UIC stabhai,e used a count of the number of Benseal sacks to calculate the
app • ximate volume of backfill. The calculated volume of backfill is sufficient to have
filled all the we . The Settling problem can be avoided in the future by using a
diffe : nt type o bentbentimite grout.
8. f ,• _+.[ . , .1. , 2 Rule 2C.0213
(d) (1. (A), does : quire a casing and specifies the casingextend at least 12 inches above
land surface. owever, a variance to this rule was granted on March 81, 1995 (copy
atta + -(1). Mitigating faptors considered for this variance include: complete backfill of
the ells with 1,8.8O% bentonite grout (preventing vertical migration of contaminants
by w y of the b rehole) and circulation of potable water only i1 the closed loop system.
UIC taff have ocated the corners of the well field using Global Positioning System
to ology. In uded with the permit are detailed site drawings showing the location of
the ells wi the well field. The site will also be surveyed to show the exact locations
of allwells. Tr ring wire will also be installed in the trenches containing horizontal
Piping.
4. $em val of cpgi1g, creating the opportunity for Cross -aquifer contamination:. As
des bed in 8. ebove, a variance to the rule requiring casing was granted, and the
oppo 'ty for. cross-aq ' er contamination is. mitigated by complete backfill of the
wells with bentonite gro t. However, shallow temporary casing were used at the site.
The asings extend less han 6 foot below ground surface and are being excavated and
reemo ed when the substrface horizontal piping that connects the vertical loops is
installed. The clasings Were installed to aid in the grout topping of process described
under 2. above. The caskngs also provided a temporary way of marking the Wells so
that hey were rot disturbed by heavy equipment used for construction elsewhere on
the s .te.
5. 'Use
abov
grou
the
loop
pro
f bentonite grout i 011 up the inside of the wells with coin: Ae.describe d in 4.
the casings usedt the site were shallow and temporary. An 18.80% bentonite
is recomthended by the. international Ground Source Heat Pump Association and
IC Program. Bentbnite grout provides proper heat transfer between the closed
d the ground while preventing the vertical migration of groundwater and
r: g groundwaterotection.
• 6. - , _ _ e . : m . u _ +f .n u . _ _e. As previously described in 3. and
4. • : casings o served : t the site were temporary and are being removed. Annular
space around the closed oop pipe is filled with bentonite grout.
7. , . a .+ e : i+ : ;-s' Unlike the water supply well construction
sten ards (2C, .0107), t e current injection well construction Standards (2C .0200) do
not : quire con rector 1 entification plates. Proposed amendments to 2C .0200 will
reel : injectio well id ntification plates.
In response Ito your cither listed questions,- the wells have been inspected: UIC staff

'FROM
12.18.1993 15:28
•
P. 4
•
were pliesent for
Moorea!ville Regto
both U C staff an
and th site was
The we were co
reg. # 998). Perm
Schools for the co
describ d, a varia
above 1 d surfaci
he drill g of a test well during a training session on April 7, 1995;
gal 0111013 staff inspected the site. on August 28 and October 12, 1995;
I Mooresville Regional Office staffinspected the site on October 17, 1995;
gain visited by Mooresville Regional Office staff on October 26, 1995.
istructea by a registered driller,iAtlanta Testipg and Engineering (driller
[t numbor WI0300037 was issued on March 30, 1995 to Lincoln County
�structio and operation of a well system for injection. As previously
ice to Rile 2C .0213 (d) (1) (A), which requires casing to extend 12 inches
, was granted on March 31, 1995.
uke Pow r has ovirseen all drilling activities and is installing the heat pump and
associa d piping or LincOn County Schools. Cindy Hunter of Duke Power is speaking at a
meetin with a up of South Carolina well drillers this month and expressed a strong
interes in setting up a similar meting to present the details of geothermal heat pump
system ' stallatio with the North Carolina Ground Water Association, If your
organiz tion is interested she may be reached at [phone].
otherm heat pimp system installation could provide a Large market for well
drillers f North olina. IProperly installed closed loopgeothermal heat
should have ne lidible im ct to g pump Systems
g p groundwater while positively affecting the environment by
providing efficieneenergy saving heating and cooling. The' Groundwater Section
appreciates your concerns about potential improper installation and groundwater impact. I
believe I have adequately addressed these concerns.
•
•
I responsEi to your oncerns about the othe -tdvo wells for which an inspection was
rogues d. I am bway of his letter requesting Barbara Christian of the Mooresville
Region Office to rollow up with Mr. Stanley Setzer on this matter and to report back to
me.
6170 or
cc: Barb
Mari
f you should have any more questions please contact either myself at (919) 715.715-
Mark Milligan of the UIC Program at [phone].
Sincerely,
thur N,Iouberry, P.E.
Chief, Groundwater Section
ra Christian
Milligan
***E'JD **

PEON: Name:
FLA
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT, HEALTH, & NATURAL
RESOURCES
46miretiu.
MOORESVILLE E REGIONAL OFFICE
Division: 1 F-
Section:
919 North Main Street
Mooresville, NC 28115
Phone [phone]
FAX [phone]
FAX
Isis: 9L'-1 1,5 %h
FAX ER: Cr/V
SUBJECT : Ifr'F"1 ni ,(,L e ,`� - Xs..t-iti/-t ,l.(jeirZ.
A rlvi t 1414 Q c .a e_ d- c .d Garr► 20 ,G-e. CF11411tA,111,L%A
dn4:.&A,6 4 w-cie4 . Cie a. C,,aLdi/Le_ c v-
NOME= OF PAGES (Including Cover): I
t(k/A-L 4„Ait 44- i(j`t4tte. CrY-k-4Ut 1;LCrlA :(iWte:h
i&L44-lote_ ,txrua 7titAt,

5. USE OF WELL:
.&
6. TOTAL DEPTH: �R.
7. CASING REMOVED:
feet
_ '14.- Aka,.F L4•/
•
Department. of Environment; Health, & Natural Rest
Division of Environmental Management
Groundwater Section
P.O. Box 28687 - Raleigh, N.C. 27611
•
WELL ABANDONMENT RECORD
CONTRACTOR S 4z'ere �[oS :Tole
N.G. DEPT. O?
VlRONME.NT, I UL
ft?T
.
DEC 1 41995
pIVIS1011 OF Egitd .iFF��-
REG. NO . �4. 7l�4aE�M1'
�,0GAE5V4tLE RREGION.OfFIOE
1. WELL LOCATION: (Show a sketch of the location on back of form.)
Nearest Town: t 2, j
0.Z(� d' T.L. an See
(Road, Community, S
2. OWNER:(!eve +a cov41-7 5nl.d
3. ADDRESS:
4. TOPOGRAPHY: draw,
ivision, Lot. No.)
hilltop, valley, flat
(1�C iK v5i' DATE: ) 23•-9S
3 c,,5 _ DIAMETER: 4•
diameter
8. SEALING MATERIAL:
Neat cement Sand cement
bags of cement bags of cement �"
gals. of water yds. of sand side
gals. of water
Other
Type material
Amount
9. EXPLAIN METHOD EMPLACEMENT OF MATERIAL
f �/ 7 �1
U Se ! 1,•/..:DRof Qt� ; ns,`de tr7_ & e i � w Fri",e w r N
o Vt ykai /k-d p cJRe L S #v t yiveep etlreet
County
e ie vd 4,d
Quadrangle No.
WELL DIAGRAM: Draw a detailed
sketch of the well showing total
depth, depth and diameter of screen
remaining in the well, gravel
interval, intervals of casing
perforations, and depths and types
fill materials used.
Ce
Dep
eg..5 0, `1 I' 5.
eld de•-fred
co.,. e d e pth
we 1i pus, U #o,r,
td fihp,
4di c Hal- 3+1
c}r1an."+e
4 r -,60 i,e4 to TUiol.* ,.r %J.r '*a +iv ho5 we oLrizRexeried �n.0147 4-8�eus4+eaC
(� I do hereby certify that this well abandonment record is true and exact.
Signature of Contractor or Agent
WELL LOCATION.:
Date /o -, 3- 9 j'
Draw a location sketch on the reverse of this sheet, showing the
direction and distance of the well to at least two (2) nearby •
reference points such as roads, intersections and streams. Identify
roads with State Highway road identification numbers.
Submit original -to the Division of Environmental Management, one copy to the Driller,
and one copy to the owner.
GW-30

CONCORD OFFICE
P.O. BOX 508
CONCORD, N.C. 28025
To Order Concrete:
Concord 782-4186
Kannapolis 933-2737
.Salisbury 636-1642
MERS COPY
PRODUCT CO
SL
CHARLOTTE OFFICE
P.O. BOX 5247
CHARLOTTE, N.C. 28225
Office: 372-2930 Dispatch : 372-7500
THIS SALE 15 SUBJECT TO THE TERMS AND CONDITIONS OF THE STANDARD
CONCRETE SUPPLY CO. QUOTATION; COPY AVAILABLE UPON REQUEST.
IMPORTANTI read reverse side before using cement products.
CPU NO. j CU • ' RME
I :f;::.i"::!..:::. :il..:J 3 .. :I:l'i+:::..it..;,.i2OD— k:;l_3.1...>:->r:.
ORDER NO. CUSTOMER NO.
:I, l,'l
JOB ADDRESS/SPECIAL INSTRUCTIONS
�. ,...i... 41 l.. .s'Il' 1`� �(J13; '', CI' ,.1`,)N ,Si`' :I: .
GASTONIA OFFICE
P•Q. BOX 600
DALLAS, N.C. 28034
To Order Concrete:
Gastonia
Kings Mountain
Shelby
Lincolnton
922-8638
739-7471,
487-8558
735-2278
N.C. Toll Free [phone]
PROJECT NO. TICKET NO. .
PURCHASE ORDER NO.
CASH i:lhit_..`r•
OW( ,. ....A ,; T ,. R ONTO HWY.., :I. 8#.! (lf'i .�1• I...S.,i3ll::. ., j .,
TO
TOWARDS EARL, GO TO LAVENDER ROAD . i.... ., GO
.--:fir,,._ .. r4.-7,r,, ;•i 7 -'� r} y'-• till-
y--
_ .. .-'�'•�!. �t�. ,�.F1 :1 ..�.:Li !��',W I::. I{ l,Ji`1 11-�I L:. �k. .i. i.ii�l•1 r.
'
LOAD $$II CUMULAT IV I. OR DE Ft P.9.0. PRODUCT
Q1 ANT1TY4 QUANTIT a ,O ANTITY -V47, CORE
PRODUCT DESCRIPTION
:.i(:{()) GROUT
i'
DRIVER NO.-__---
L .,
•
UNIT
OF
MEASURE
UNIT
,RICE.,-.
E DISPATCHErIME FUSE
., . -. ,.•
1.
TESTCYLINDER -_..-�--- i1�- ��
J •J 0 YES I) `it ' r • .
i J—I.,� -
ARRIXE JOB r...,, I COUNTER READING
/ -. • 0 / I START: ), ,r 7
LEAVE JOB --- -1 ' GAL WATER ADDD --- ;EAT IRST
CUSTOMER REQUEST ,,--/ /
• ARRIVE PLANT I REMARKS
NO
COUNTER READING
FINISH:
MIDDLE
PLEASE RATE OUR PERFORMANCE.
WE VALUE YOUR OPINION!
TAX CODE
AUTHORIZED'BY
:a" t A N
AMOUNT
RECEIVED'BY
Service
Excellent
Average
Poor
Quality
Driver Courtesy
Comments:

State of North Carolina
Department of Environment,
Health and Natural Resources
Mooresville Regional Office
James B. Hunt, Jr., Governor
Jonathan 8. Howes, Secretary
Linda Diane Long, Regional Manager
DIVISION OF ENVIROI
August 21, 1995
Stanley K. Setzer
Setzer Bros., Inc.
Post Office Box 280
Claremont, North Carolina 28610
RE: We
Dear Mr. Setzer:
Abandonment Requ
or Drilled Wells
A EMENT
ements
On. July 17, 1995, you requested information on the proper
procedures for abandoning wells in accordance with North Carolina
rules and general statutes. In addition to what is outlined below,
I have attached a copy of the portion of the well construction
rules addressing well abandonment. 15A NCAC 2C .0114(b)(1)
requires that any person abandoning any well shall submit a record
of the abandonment to this Department on forms provided by the.
Department within a period of thirty (30) days after completion of
the abandonment.
15A NCAC 2C .0113 (a)(2) requires that drilled wells
be abandoned in accordance with the following procedures:
(1) The entire depth of the well shall be sounded before it
is sealed to insure freedom from obstructions that may
interfere with the sealing operation.
(2) The well shall be thoroughly disinfected prior to
sealing.
(3) The well may be filled with cement, sand or gravel
opposite the zones of consolidated rock, The top of the.
sand or gravel fill shall be at least five feet below the
top of the consolidated rock. The remainder of the well
shall be filled with cement grout only.
919 North Main Street, Mc re i e. North Carolina 28115 Telephone [phone] FAX [phone] Equal Opportunity Affirmative Action Employer 50% recycled/ 1O% post -consumer paper

Stanley K. Setzer
August 21, 1995
Page Two
(4) The outer well casing must be grouted to a minimum depth
of 20 feet or removed prior to abandonment.
I have enclosed a well abandonment record form and a chlorina-
tion table for your use in the abandonment of the well. Should you
have further questions regarding well abandonment, please do not
hesitate to call me at [phone].
Sincerely,
16TUIdtalut- A CIV"'C°-/i31
Barbara S. Christian, P.G.
Regional Groundwater Supervisor
Enlosures: Chlorine Table
Well Abandonment Form
15A NCAC .0113
BSC/js

State of North Carolina
Department of Environment,
Health and Natural Resources
Mooresville Regional Office
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Linda .Diane Long, Regional Manager
DIVISION OF ENVIRONMENT
August 22, 1995
Stanley K. Setzer
Setzer Brothers, Inc.
Post Office Box 280
Claremont, North Carolina 28610
RE: Well Abandonment
Dear Mr. Setzer:
A
On August 21, 1995 Staff of theGroundwater Section of the
Mooresville Regional Office sent information to you regarding
well abandonment. Enclosed are the attachments which should have
been included with that letter.
I apologize for any inconvenience this may have caused.
Sincerely,
Karen W. Connell
Hydrogeologist
Enclosures: Chlorine Table
Well Abandonment Form
15A NCAC .0113
KWe/sc
919 North Main Street, ire e, North Carolina 28115 Telephone 7od-663-1699 FAX [phone]
Ari Equoi Opportuntry Atturnotrve Action Ernptoyer 50% recycled! 10% post -co %surne► PoPer

30" & 24" Boring
Pumps Installed
SERER BROTH RS INC.
BA Dam and Boring
P.O. Box: 28Q CLAREMONT, N. C. 20610
WILLIE SETZER 17043 241-2734 CATAWBA, N. C.
Barbara S. Christian
Regional Groundwater Supervisor
RE: Well Abandment Request
Dear Miss Christian :
I have been informed by Robert Cheek that Solid Waste Div,
has control concerning anything inside a landfill, including
Wells and there abandonment. So now I,m waiting for their
instructions on now they want me to abandon the well in question.
1 would like to T}ikNK YOU for your time in dealing with
this matter.
Also inclosed in this letter is your travel expellee reim-
bursement form which you sent by mistake. You can tell your hoss
I approved it. HA! HA!
SyL Sete
SetterSetzer23ros. Inc.
6" Drilling
Pumps Sold

f OCF-lA
7/1/95
DEPARTMENT OF ENVIRONMENT, HEALTH AND NATURAL RESOURCES File: Travel.wpd
TRAVEL EXPENSE REIMBURSEMENT FORM - SUMMARY PAGE
PLEASE INDICATE: X TRAVEL _MOVING NON -STATE EMPLOYEE OTHER
INSTRUCTIONS TO CLAIMANT: Submit one original to Office of the Controller, Travel Section. Attach all necessary original receipts and other
supporting documents to this form, including any prior written approval of excess registration, lodging and out-of-state travel. Retain one (1) copy for
your records. Please complete amount, company, account, and center fields. File no later than 30 days after month in which travel ends. Prepare
in ink or type. Make all corrections by drawing line through erroneous data and entering correct data. Do not use white -out Initial all corrections or
revisions.
Social Security No. (9 digits) 1 get — 413- `1 ? 6 4-1 I New Employee or Address
Payee's Name (First, Middle, Initial, Last)
$ orb also S . Gig Ifs j 4- avl
Payee's Address (Street)
161 Catalwia Drive_
Division/Section:
Env. 41gt- 1Groundaailer
Title: ,ariaj Ent/. Supv. i
Headquarters (City)
Katei'g lei
(City, State, Zip)
Moo(&W i lie-) /IBC
Duty Station (If different than Headquarters)
Moo re,svi 11Ie_
Period Covered by this Request
From: 5L J y 4) (99 To: -./T4 I y
Under penalties of perjury 1 certify this is a true and emirate statement of
the city of !edging, expenses end allowances Mooned in the service of the
State.
(Clarnani)
(fie)
t have examined this reimbursement request end artily that funds ere
available in the proper accounting s to pey this claim. Further
authorization (d required) shouldsled end dated.
(Date)
NOTE: Original signature and dates are required tor processing.
AMOUNT
CR
COMPANY
ACCOUNT
CENTER
CA crul
ale
1099
!2a 1tc
1
s
of
5
3la�
i
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1
s-5
-11
1
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ill
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551
1 OD 100
1
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0
6
3 to
7
2-
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1
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1
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7
a
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1
1
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0
6
31
1
1
1
1
1
6
0
6
1
31
1
1
1
11
1
1 •
1
1
1
6
0
6
3 1
1
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1
1
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5
31
1
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1
1
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5
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31
1
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1
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ti
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Total Expenses •
.
0
1
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6
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7.
®I'I"
-I"I'
I I i III I
I I
Travel
Advance
.
308 I 5-0
Reimbursement
'
A1P Initials
Date:
PLEASE USE BLUE PAPER

7/1/95
DEPARTMENT OF ENVIRONMENT, HEALTH AND NATURAL RESOURCES File: Travel.wp
TRAVEL EXPENSE REIMBURSEMENT FORM - ITINERARY
Empioyee Name:-6arbara S • orris iav, - Social Security Number: 199 y�''77b�
Date: g /7/) RC -
Page j of 1
Travel
Trensportatlon
Subsistence
Other Expenses
Day
Frorn
To
1
S
In -State
Out-ofState
2
In -State
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3
Explanation
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LEGEND:
(1) Mode of Travel
P - Private car
R - Rental Car
(2) Type of Subsistence:
a - Breakfast
L - Lunch
D - Dinner
- Motel
(3) Other Expanse,
Taxi. parking, baggage,
telephone, or registration
NOTE: Daily total for subsistence not to
e xceed authorized amount for instate
or outofsute travel.
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