WI0800156_GEO THERMAL_20020514

Beverly Eaves Perdue
Governor
AVA
~CDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Charles Wakild, P. E.
Director
May 14, 2012
Rene and Rebecca Scallan
216 East College Street
Bowdens, NC 28398
Subject: Notification of Rule Revisions Affecting
Closed-Loop Geothermal Injection Well Permit Holders
Permit Number: WI0800156
Dear Mr. and Mrs. Scallan:
Dee Freeman
Secretary
Our records indicate that you currently hold a permit for a closed-loop geothermal injection well
system. This letter is to inform you that on May I, 2012, the North Carolina Administrative
Code Title ISA Section 2C .0200 entitled "Well Construction Standards -Criteria and
Standards Applicable Injection Wells" were revised. These revisions affect all permits issued
for injection wells including geothermal wells.
This letter is also to inform you that your closed-loop geothermal injection well(s) have become
"permitted by rule." Therefore, you are no longer required to renew your current permit
and the permit will be valid indefinitely as long as the wells are active and are operated in
accordance with the revised rules referenced above. Please keep in mind that if you abandon
the wells, a record of abandonment must be submitted to the Division of Water Quality. You
may view the revised rules on our website at htt p://portal.ncdenr.org/web/wq/ap s.
If you have any questions regarding your current permit or the rule revisions, please feel free to
contact our underground injection control staff at (919) 807-63 00 .
Sincerely,
!I ~
Eric G. Smith, P.G.
Hydro geologist
AQUIFER PROTECTION SECTION
1636 Mail Service Center, Raleigh, North Carolina 27699-1636
Location: 512 N. Salisbury St., Raleigh, North Ca rolina 27604
Phone: [phone] \ FAX: [phone]
Internet: www.ncwaterguality.om.
An Equal Opportun ity \ Af!;rn1ative Action Employer
NOne 1 C 1. . ort1 aroma
/Vaturalllf
-�0� Yvnl�nh�
Michael F. Easley, Governor
�5 William G. Ross Jr., Secretary
`1 Nonh Carolina Deparunent of Environment and Natural resources
Cole= H. Sullins, Director
Division of Water Quality
Jane 13. 2009
Rene and Rebecca Scallan
216 E. College Street
Warsaw., NC 28398
Re: Issuance of Injection Well Permit
Permit No. W10800156
Issued to Rene and Rebecca Scallan
Dear Mr. and Mrs. Scallan:
In accordance with your application received May 30, 2008, 1 am forwarding Permit No.
Wl0800156 for the operation of a vertical closed -loop geothermal mixed -fluid heat pump
injection well system to be located 216 E. College Street, Warsaw. NC 28399. This permit shall
be effective from the date of issuance until May 31, 2013, and shall be subject to the conditions
and limitations stated therein.
Please pay special attention to the bolded language in the permit. In addition, please
submit copies of the Well Construction Completion form (GW-1) and site map after
construction as required in Part I paragraphs 8 and 9.
In order to continue uninterrupted legal use of this well for the stated purpose, you should submit
an application to renew the permit three months prior to its expiration date. As indicated in the
permit, this permit is not transferable to any person without prior notice to, and approval by, the
Director of the Division of Water Quality. If you have any questions regarding your permit or
the Underground Injection Control Program please call Mr. Qu Qi at [phone] or me at
[phone],
Best Regards,
}
Michael Rogers, Environmental Specialist
cc: Charlie Stelanian - Wilmingtion Regional Office
Central Office File - W10800156
Monte Jefferson - Home Energy, Inc.
Attachment(s)
Aquifer Protection section 1636 Mail Service Center Raleigh, NC 27699-1636
lntemet: http:liwww.ncwaterqua)itv.ore 2728 Capita) Boulevard Raleigh. NC 27604
An Equal opporlun4lAf lmtative Action Employer- 50%Recycledf10%Pest Consumer paper
No°� carolina
vVatura11,Y
Telephone; f919) 733-3221
Fax E [phone]
Fax 2: [phone]
Customer service: [phone]

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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
Rene and Rebecca Scallan
FOR THE CONSTRUCTION AND OPERATION OF 3 TYPE 5QM INJECTION WELLS,
defined in Title 15A North Carolina Administrative Code 2C ,0209(c)(3)(F), for the purpose of
operating a "direct expansion" type vertical closed -loop geothermal -mixed -fluid heat pump
system. This system is located at 216 E. College Street, Warsaw, Duplin County NC 28398, and
will be constructed and operated in accordance with the application received May 30, 2008, and
in conformity with the specifications and supporting data submitted, all of which are filed with
the Department of Environment and Natural Resources and are considered a part of this permit.
This permit is for Construction and Operation only and does not waive any provisions of the
Water Use Act or any other applicable Laws, Rules, or Regulations, Operation and use of an
injection well shall be in compliance with Title 15A North Carolina Administrative Code 2C
.0100 and .0200, and any other Laws, Rules, and Regulations pertaining to well construction and
use.
This permit shall be effective, unless revoked, from the date of its issuance until May 31, 2013
and shall be subject to the specified conditions and limitations set forth in Parts I through IX
hereof.
Permit Issued this the day of , 2008
Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission.
Permit No. W10800156 Page 2

. l , ·'.
PART I -WELL CONSTRUCTION GENERAL CONDITIONS
1. The Permittee must comply with all conditions of this pemiit and with the standards and
criteria specified in Criteria and Standards Applicable to Injection Wells (15A NCAC 2C
.0200). Any noncompliance with conditions of this permit constitutes a violation of the
North Carolina Well Construction Act and is grounds for enforcement action as provided
for in N.C.G.S. 87-94.
2. This permit shall become voidable unless the facility is constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other supporting data.
3. Each injection well shall not hydraulically connect separate aquifers.
4. Each injection well shall not be located in an area generally subject to flooding. Areas that
are generally subject to flooding include those with concave slope, alluvial or colluvial
soils, gullies, depressions, and drainage ways.
5. Each injection well shall be secured to reasonably insure against unauthorized access and
use. Each well shall be permanently labeled with a warning that it is for injection purposes
and the entrance to each well must be secured with a locking cap.
6. Each injection well shall be afforded reasonable protection against damage during
construction and use.
7. Each geothermal well injection system shall have permanently affixed an
identification plate according to 2C .0213(g).
8. A completed Well Construction Record (Form GW-1) must be submitted for each injection
well to:
Aquifer Protection Section -UIC Staff
1636 Mail Service Center
Raleigh, NC 27699-1636
and
Aquifer Protection Section -Wilmington Regional Office
127 Cardinal Drive Extension
Wilmington, NC 28405
GW-1 s must be submitted within 30 days of completion of well construction. Copies of
-the GW-1 form(s) shall be retained on-site and available forinspection.
9 . Well construction records must also be submitted for the existing water supply wells on-
site as well as a site map showing any water supply wells on adjacent properties as
specified in NCAC .021 l(d)(l)(D).
Permit No. WI0800156 Page3
PART II -WELL CONSTRUCTION SPECIAL CONDITIONS
1. Prior to constructing the injection well system, the Permittee or his agent shall test the pH of
the soil at a depth of three feet at the planned well location. · If the resulting soil pH is less
than 6 standard units or greater than 11 standard units, the well system shall be equipped with
a compatible cathodic protection system. All testing results shall be kept on site available
for inspection.
2. At least forty-eight ( 48) hours prior to constructing system, the Permittee shall notify the
Aquifer Protection Section's Underground Injection Control (UIC) Program Central Office
staff, telephone number [phone] and the Wilmington Regional Office Aquifer
Protection Section Staff, telephone number [phone].
3. All underground tubing shall be refrigeration grade copper tubing.
4. Prior to installation, all tubing to be placed in boreholes ("loops") shall be checked for leaks
by pressurizing the loop to a gage pressure of at least 350 pounds per square inch (psig),
immersing the loop in water and examining it for leaks. Loops with leaks shall not be
installed.
5. Prior to installation, each loop shall be visually inspected for damage such as kinks, dents,
and scrapes. Each loop shall be checked to verify that the nitrogen charge applied to the loop
by the manufacturer before shipping is still present at a pressure of at least 300 psig. The
loop manufacturer shall be notified in the event of damage or pressure loss, and the
manufacturer's instructions shall then be followed. The nitrogen charge may be released
only when the loop is installed and ready to be connected to the manifold.
6. Boreholes shall be large enough to allow insertion of the loop plus a tremie pipe for grouting.
7. After insertion of the tubing into the boreholes, an approved grout (as defined in Title 15A
North Carolina Administrative Code 2C .0100) shall be pumped via tremie pipe into the
annular space of each borehole so as to completely fill it from bottom to top.
8. All tubing junctions shall be brazed using lead-free brazing material. The brazing material
shall have a galvanic potential as close as practicable to that of the tubing material.
9. Dry nitrogen shall be circulated through the tubing during brazing to prevent oxidation.
10. After installation and prior to operation of the system, a mechanical integrity test shall be
conducted by pressurizing the injection well system to 400 psig with dry nitrogen and
monitoring for leaks using an ultrasonic or other leak detector of equal sensitivity and
monitoring pressure in the system for at least 2 hours. Alternatively, an equivalent vacuum
test is acceptable. Any pressure fluctuation other than that due to thermal expansion and
contraction of the testing medium shall be considered a failed mechanical integrity test. Any
leaks shall be located and repaired prior to charging the system with refrigerant. This testing
data shall be recorded on the attached Mechanical Integrity Test Record Form and
submitted to the Aquifer Protection Section at least 24 (twenty-four) hours prior to the
Permit No. WI0800156 Page4
. initiation · of the operation of thfr facility for injection. A copy of this form shall also be
retained on-site for inspection.
11 . The location of each of the system manifolds shall be recorded by triangulation from two
permanent features on the site ( e.g., building foundation comers). The Permittee shall retain a
copy of the triangulation records. The Permittee shall also submit a copy of the
triangulation records to the Aquifer Protection Section within 30 days of completion of
well construction.
12. The written documentation r eq uired in.Part IL parasrraphs {1 0) and {1 1) shall be submitted to:
Aquifer Protection Section-DIC Staff
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
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 pirector 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.
PARTIV-PERFORMANCESTANDARDS
1. The injection facility shall be effectively maintained and operated at all times so that there
is no contamination of groundwater that will render it unsatisfactory for normal use. In the
event that the facility fails to perform satisfactorily, including the creation of nuisance
conditions or failure of the injection zone to adequately assimilate the injected fluid, the
Permittee shall take immediate corrective actions including those actions that may be
required by the Division of Water Quality such as the repair, modification, or abandonment
of the injection facility.
2. The Permittee shall be required to comply with the terms and conditions of this permit
even if compliance requires a reduction or elimination of the permitted activity.
Permit No. WI0800156 Pages
3. The issuance of this permit shall not relieve ~e Pe~ittee of the responsibility for damages
to surface or groundwater resulting from the operation of this facility.
PART V -OPERATION AND MAINTENANCE REQUIREMENTS
1. The injection facility shall be properly maintained and operated at all times.
2. The Permittee must notify~the Division and receive prior written approval from the
Director of any planned physical alterations or additions in the permitted facility or activity
not specifically authorized by the permit.
3. At least forty-eight (48) hours prior to the initiation of the operation of the facility for
injection, the Permittee must notify by telephone the Aquifer Protection Section's
Underground Injection Control (UIC) Program 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 Water Quality
may, upon presentation of credentials, enter and inspect any property, premises, or place
on or 'related to the injection facility at any reasonable time for the purpose of determining
compliance with this permit, may inspect or copy any records that must be maintained
under the terms and conditions of this permit, and may obtain samples of groundwater,
surface water, or injection fluids.
2. Department representatives shall have reasonable access for purposes of inspection,
observation, and sampling associated with injection and any related facilities as provided
for in N.C.G.S. 87-90.
3. Provisions shall be made for collecting any necessary and appropriate samples associated
with the injection facility activities.
PART VII -MONITORING AND REPORTING REQUIREMENTS
1. Any monitoring (including groundwater, surface water, or soil sampling) deemed
necessary by the Division of Water Quality to insure surface and ground water protection,
will be established and an acceptable sampling reporting schedule shall be followed.
2. The Permittee shall report by telephone, within 48 hours of the occurrence or first
knowledge of the occurrence, to the Wilmington Regional Office, telephone number (910)
796-7269. any of the following:
(A) Any occurrence at the injection facility that results in any unusual operating
circumstances;
PermitNo. WI0800156 Page 6
' ' (B) Any failure due to known or unknown reasons that renders the facility incapable of
proper injection operations, such as mechanical or electrical failures;
(C) Any loss of refrigerant in the system, regardless of the origin of the loss;
(D) Any recharging of the refrigerant system.
3. Where the Permittee becomes aware of an omission of any relevant facts in a permit
application, or of any incorrect information submitted in said application or 'in any report to the
Director, the relevant and correct facts or information shall be promptly submitted to the
Director by the Permittee.
4. In the event that the permitted facility fails to perform satisfactorily, the Permittee shall
take such immediate action as may be required by the Director.
PART VIII -PERMIT RENEW AL
The Permittee shall, at least 90 days prior to the expiration of this permit, request an
extension.
PART IX-CHANGE OF WELL STATUS
1. The Permittee shall provide written notification within 15 days of any change of status of
an mjection 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 ISA 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.
Permit No. WI0800156 Page 7
(D)
(E)
Each well shall be completely filled with cement grout, which shall be
introduced into the well thro~gh a pipe which extends to the bottom of the
well and is raised as the well is filled.
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 IX (1) and (2) (G) shall be submitted to:
Permit No. WI0800156
Aquifer Protection Section-DIC Program
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
Page 8
Mechanical Integrity Test Record
(For SQM Geothermal Heat Pump Injection Well System)
Owner/Permittee Name: Permit Number: WI -------------------
Facility Address: ____________________________ _
Home Phone: Cell Phone:
Heat Pump Contractor Name: ________________________ _
Office Phone: Cell Phone: -----------------~~~~~---------
Tester Name: ______________ _cS i gn a tu.re: ____________ _
Date of Test: --------
Loop Initial Pressure (psi) Final Pressure (psi) Duration Pass (Yes or No)
(minutes)
1
2
j
4
5
6
7
8
9
10
11
12
13
14
15
Any additional loop testing add to back of this form
Comments: --------------------------------
Other Test Methods and Results:
This form must be filled out and signed by the tester. The record must be received by Aquifer Protection Section 24
hours prior to the initiation of the operation of the facility. You can send the form by mail: UIC Program, Mail
Service Center 1636, Raleigh, NC 27699 or by fax: [phone] .
. Permit No . WI0800156 Page9
Loop Initial Pressure (osi) Final Pressure (osi) Duration (minutes) Pass (Yes or No)
...
Permit No. WI0800156 Page 10
"NORTH CAROLINA
RECEIVED / DENR / DWQ
AQUJFER"PROTFCTION SECTION
MA~ 302008
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES (NCDENR)
APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR
INJECTION WITH A GEOTHERMAL HEAT PUMP SYSTEM FOR:
TYPE 5-0 M WELL (S)
_......,... ___ New Permit Application OR ____ Renewal (check one)
DATE: 9 M ~ . 20CJ8'
PERMIT NO. ________ (leave blank if NEW permit application)
A. PROPERTY OWNER(S)/APPLICANT(S)
List each Property Owner listed on property deed (if owned by a business or government agency, state name of
entity and a representative w/authority for signature): R fi # E, ~-Sc:.-/} A t..,?A/ £
le E l'J if ec 4 d s c & ~ .,t-# ,A/
(1) Mailing Address: .J lb Ii, ?P 1-L.E tf-15' s?;r
City: /(V,!JIZ«f ,f-/'V' State:g?Zip Code: J..J;_J ff' County: PII /',/4 / A/
Home/~TeleNo.: f lt'-..2.1,1 -2~tf t: Cell No.: ~e,,,.v£.
EMAIL Address: ~ ,-,v £ ,
(2) Physical Address of Site (if different than above): ______________ _
City: ________ State~!:?": _____ County: ____ _
Home/Office Tele No.: d/ ~ .. Cell No.:
EMAIL Address: ______ / ________ _
B. AUTHORIZED AGENT OF OWNER, IF ANY (if the Permit Applicant does not own the subject property,
attach a letter from the property owner authorizing Agent to install and operate UIC well)
Company Name: __________________________ _
Contact Person_: ________________ EMA--=--... IL=-A~ddre=s=s: ____________ _
Address: _____________________________ _
City: ________ State: __ Zip Code: _____ County: ______ _
Office Tele No.: Cell No.:
Website Address of Company, if any : _____________ _
\ __ .
M
01
DDM
F.
WELL DRILLER
Company
IMATION
Ia�V4:E� ��WEA106V. /NC
Well Drilling Contractor's Name: _ _ _ 2AV1 d _ L?D%d
NC Contractor Certification No.: 62L9 (0
Contact Person: r eg-Z ] G ME&& EMAIL, Address: &POM "W*O.W• ce"
Address: ACC BOX ?15 IF 34Da e 3r°
City: 1V6AJ,6F L Zip Code: a� County: Z:,4204A'V-
Office Tele No.: Q/ 9. 360�vs 0-P6 / Cell No.: _�I 4?- ??Zr.
HEAT PUMP CONTRACTOR INFORMATION (K ditlemnt than driller)
Company Name:.
Contact Person: EMAIL Address:
Address:
City:
Office Tele No,:
STATUS OF APPLICANT
Private: X Federal:
Zip Code: County:
Cell No.:
Commercial:
State: Municipal: Native American Lands:
INJECTION PROCEDURE (briefly describe how the injection well(s) will be used)
G. WELL CONSTRUCTION DATA (Sly to Section H if th% is a Permit RENEWAL)
(1) Proposed date to be constructed: n4, i J&46 Dom" Number of borings:
Approximate depth of each boring (feet): iS
(2) Chemical additives to be used in closed -loop system (only those chemicals indicated have been approved):
)(_R-22 propylene glycol ethanol other (other additives will
need prior approval by NCDENR before use)
(3) Type of tubing to be used (copper, PVC, etc):�f�lO�
(4) Well casing. Is the well(s) cased? (check either (a.) YES or (b.) NO below)
(a) YES if yes, then provide casing information such as tyRg (steel, PVC, plastic, etc.), diameter,
depth, and extent of casing appearing above ground:
(b) NO
(5) Grout (material surrounding well casing and/or piping) -
(a) Grout type: Cement Bentonite Other (specify)
(b) Grout depth of tubing (reference to land surface): from to - (feet]
If well has casing, indicate grout depth: from � _ to Jj (feet)

RECE a i OENR f DWQ
AOUIFFR WVFrTll1N gFcnoH
H. INJECTION -RELATED EQUIPMENT MAY 3 4 2M8
Attach a diagram showing the engineering layout or proposed modification of the injection equipment and exterior
pipingltubing associated with the injection operation. The manufacturer's brochure may provide supplementary
information.
1. LOCATION OF WELL(S)
Attach two copies of maps showing the following information:
(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 reap of the area extending one mile from the property boundaries and
indicate the facility's location and the map name.
J. CERTIFICATION
Note: This Permit Application must be signed by each person appearing on the
recorded legal property deed.
"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."
Signature ��
ofPropertyOwner/Applicant
Print or Type Full Name
Signature of Property Owner/Applicant
Print or Type Full Name
Signature of Authorized Agent, if any
Print or Type Full Name
Please return two copies of the completed Application package to:
North Carolina DENR-DWQ
Aqttifer Protection Section
UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone [phone]

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AQUIFER PROTECTION SECTION REGIONAL OFFICE STAFF REF(Aft 2 2008
To: AQUIFER PROTECTION SECTION CENTRAL OFFICE
Central Office Reviewer: Qu Qi
Application No.: W10800156
Permittee. Rene & Rebecca Scallan Project Name: same
Regional Login No.: County. Duplin
GENERAL INFORMATION
1. This application is (indicate all that apply):
X New Renewal Minor Modification Major Modification
Surface Irrigation Reuse Recycle
High Rate lnfiltration
Evaporation/Infiltration Lagoon Land Application of Residuals
Attachment B included
503 Regulated 503 Exempt Distribution of Residuals
Surface Disposal
Closed Loop Groundwater Remediabon
X Other Injection Wells
2. Was a site visit conducted in order to prepare this report? X Yes
No
a. Date of site visit: June 11, 2008
RECEIVEDIQ
b. Person contacted and contact information: Rebecca Scallan
Aquifrer+�•.,,,,��RIQ�
r
c_ Site visit conducted by: Charlie Stehman
d. Inspection report attached: Yes X No
3. Is the following information entered into the BIMS record for this application
correct? Yes No
If no, please complete the following information or indicate that it is correct on the current
application.
For Treatment Facilities:
a. Location: 216 East College St., Warsaw, NC 28398
b. Driving directions: I-40 Warsaw exit I East on 24 to center of town 1 cross Hwy 11713"'
House on right 1 Elegant two story colonial
c. USGS Quadrangle number and map name: Warsaw South
d. Latitude: 34° 59' 59.18" N Longitude: 78" 05' 19.12" W
e. Regulated activities/type of wastes: (e_g., subdivision, food processing,
municipal
wastewater): Closed loop injection well using R-22

AQUIFER PROTECTION SECTION REGIONAL OFFICE STAFF REPORT
For Dis posal Sites:
(If multiple sites either indicate which sites the information applies to, copy and paste a new
section into the document for each site, or attach additional pages for each site)
a. Location(s):
b. Driving directions:
c. USGS Quadrangle map name and number:
d. Latitude: Longitude:
NEW AND MAJOR MODIFICATION APPLICATIONS (this section not needed for renewals
or minor modifications, skip to next section)
DESCRIPTION OF WASTE (S ) AND FACILITIES
1. Please attach a completed rating sheet. Facility classification:
2. Are the new treatment facilities adequate for the type of waste and disposal system?
Yes No N/A If no, please explain:
3. Are the new site conditions (soils, topography, etc.) consistent with what was reported by the
soil scientist and/or professional engineer? Yes No N/A
If no, please explain:
4. Does the application (maps, plans, etc.) represent the actual site (property lines, wells,
surface drainage)? Yes No N/A If no, please explain:
5. Is the proposed residuals management plan adequate and/or acceptable to the Division?
Yes No N/A If no, please explain:
6. Are the proposed application rates for the new sites (hydraulic or nutrient) acceptable?
Yes No NIA If no, please explain:
7. Are the new treatment facilities or any new disposal sites located in the 100 year floodplain?
Yes No N/A If yes, please attach a map showing the areas of
the 100 year floodplain and explain and recommend any mitigative measures/special
conditions in Part IV:
8. Are there any buffer conflicts (new treatment facilities or new disposal sites)? Yes No
If yes, plea$e 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 the proposed or existing groundwater monitoring program (number of wells, frequency of
monitoring, monitoring parameters, etc.) adequate? Yes No N/A Attach
map of monitoring well network if applicable. Indicate review and compliance boundaries.
If No, explain and recommend any changes to the groundwater monitoring program. Attach
map of existing monitoring well network, if applicable, indicating the review and
compliance boundaries.
AQUIFER PROTECTION SECTION REGIONAL OFFICE STAFF REPORT
10. For residuals, will seasonal or other restrictions be required? Yes
If yes, attach list of sites with seasonal restrictions (Certification B?)
No N/A
RENEWAL AND MODIFICATION APPLICATIONS (use previous section for new or
major modification systems)
DESCRIPTION OF WASTE(Sl AND FACILITIES
1. Is there an appropriately certified ORC for the facility? Yes No
Operator in Responsible Charge: Certificate # :
Back-up Operator : 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? Yes No If no, please explain:
3. Are the new site conditions (soils, topography, etc.) maintained appropriately and
adequately assimilating the waste? Yes No If no, please explain :
4. Has the site changed in any way that may affect the permit (drainage added, new wells
installed inside the compliance boundary, new development, etc.). Yes No
If Yes, please explain:
5. Is the residuals management plan adequate and/or acceptable to the Division?
Yes No If no, please explain:
6. Are the existing application rates (hydraulic or nutrient) still acceptable?
Yes No If no, please explain:
7. Is the existing groundwater monitoring program (number and location of monitoring wells,
frequency of monitoring, monitoring parameters, etc.) adequate?
Yes No N/A Attach map of existing monitoring well network if
Applicable. Indicate review and compliance boundaries. If No, explain and provide
recommended changes to the groundwater monitoring program:
8. Will seasonal or other restrictions be required for added sites? Yes
If yes, attach list of sites with restrictions (Certification B?)
No
9. Are there any buffer conflicts (new treatment facilities or new disposal sites)?
N/A
Yes No If yes, attach a map showing the 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 of waste(s) as written in the existing
permit correct?
Yes No If no, please explain:
11. Were monitoring wells properly constructed and located? Yes No N/A
If no, please explain:
12. Has the review of all self-monitoring data been conducted (GW, NDMR, and NDAR as
applicable) ? Yes No Please summarize any findings from the review:
Compliance
AQUIFER PROTECTION SECTION REGIONAL OFFICE STAFF REPORT
13. Check all that apply: No compliance issues
Notices of violation within the last permit cycle
Current enforcement action(s)
Currently under SOC
Currently under JOC
Currently under moratorium
If any items are 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? Yes No N/A If no, please explain:
15. Are there any issues related to compliance/enforcement that should be resolved before
issuing this permit? Yes No If yes, please explain:
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.
Descri ption of well {s ) and Facilities -New, Renewal , and Modification
1. Type of injection system:
Heating/cooling water return flow (5A7)
X Closed-loop heat pump system (5QM/5QW)
In situ remediation (51)
Closed-loop groundwater remediation effluent injection (SL nondischarge)
Other (specify)
2. Does the system use the same well for water source and injection? Yes X No
3. Are there any pollution sources that may affect injection? Yes X No If yes,
what are the pollutant source(s) and distance(s) from the closest injection well:
4. What is the minimum distance of proposed injection wells from the property boundary?
5. Quality of drainage at the site: X Good
6. Flooding potential of site: XLow
Adequate
Moderate
Poor
High
7. For groundwater remediation systems, is the proposed and/or existing groundwater
monitoring program (number of wells, frequency of monitoring, monitoring parameters,
etc.) adequate? Yes No Attach map of monitoring well network if
applicable. If no, explain and recommend any changes to the monitoring program.
8. Does the map presented represent the actual site (property lines, wells, surface
drainage)? Yes No If no, or no map, please attach a map of the site
showing property boundaries, buildings, wells, potential pollution sources, roads,
approximate scale, and north arrow.
AQ UIFER PROTECTION SECTION REGIONAL OFFICE STAFF REPORT
In jection Well Permit Renewal And Modification Only :
1. For heat pump systems, are there any abnormalities in the heat pump or injection well
operation (e.g. turbid water, failure to assimilate injected fluid, poor heating/cooling)?
Yes No If yes, please explain:
2. For closed loop heat pump systems , has the system lost pressure or required make-up
fluid since permit issuance or last inspection? Yes No If yes, please
explain :
3. For renewal or modification of groundwater remediation permits , will
continued/additional/modified injections have an adverse impact on migration of the
plume or management of the contamination incident? Yes No If yes,
please explain:
4. Drilling contractor: Name David Boyd (Home Energy Inc.)
Address P.O. Box 238, Wendell, NC 27591
Certification Number 2106
5. Complete and attach well construction data sheet:
EVALUATION AND RECOMMENDATIONS
1. Provide any additional narrative regarding your review of the application. Applicant
proposes to construct three thermal transfer wells to serve two 2½ Ton units and
one 5 Ton unit. Other than a functioning home heating oll tank there are no ·
pollution sources on the property. There are two closed out UST incidents
situated two blocks from the site on Hwy 117 at Hwy 24.
2 . Attach well construction data sheet, as needed information is available . Not needed .
3. Do you foresee any problems with issuance/renewal of this permit? Yes X No
If yes, please explain:
4. List any items that you would like the APS Central Office to obtain through additional
information request. Please provide a reason with each item. None
5. List specific permit conditions that you recommend to by removed from the permit when
issued . Please provide a reason for each recommendation.
6. List specific special conditions or compliance schedules that you recommend to be
included in the permit when issued. Please provide a reason for each recommendation.
7. Recommendation :
Hold, pending receipt and review of additional information by the regional office;
Hold, pending review of draft permit by the regional office;
X Issue
Deny If denied, please sta ~eas °(1 s
Signature of report preparer: ~-~
Signature of APS regional superviso ~ ~ ~-
Date: 06 /u / O e, I ,
c
Warsaw, N Carolina
aY�l
M, - e...' E,e all %75711

AQUIFER PROTECTION SECTION
APPLICATION REVIEW REQUEST FORM
Date: June 5. 2008
To: ❑ Landon Davidson, ARO-APS ❑ David May, WaRO-APS
❑ Art Barnhardt. FRO-APS ® Charlie Stela an, WiRO-APS
❑ Andrew Pitner, MRO-APS ❑ Sherri Knight, W-SRO-APS
❑ Jay Zimmerman, RRO-APS
From: Michael Rogers Groundwater Protection Unit
Telephone: [phone] Fax: [phone]
E Mail: Michael.Rogersrii"ncmail.net
A. Permit Number: WI 0800156
B. Owner: Rene and Rebecca Scallan
C. Facility/Operation:
® Proposed ❑ Existing ❑ Facility ❑ Operation
D. Application:
1. Permif Type: ❑ Animal ❑ SFR-Surface Irrigation❑ Reuse ❑ H-R Infiltration
❑ Recycle ❑ I/E Lagoon ❑ GW Remediation (ND)
® UIC - (5QM) closed loop mixed fluid geothermal
For RaOduals: ❑ Land App. ❑ D&M ❑ Surface Disposal
❑ 503 ❑ 503 Exempt ❑ Animal
Z Project Type: ® New ❑ Major Mod. ❑ Minor Mod. ❑ Renewal ❑ Renewal w/ Mod.
E. Comments/Other Information: ❑ I would like to accompany you on a site visit.
NOTE:
Attached, you will find all information submitted in support of the above -referenced application for your
review, comment, and/or action. Within 14 calendar days, please take the following actions:
® Return a Completed APSARR Form.
❑ Attach Well Construction Data Sheet.
❑ Attach Attachment B for Certification by the LAPCU.
❑ Issue an Attachment B Certification from the RO.*
* Remember that you will be responsible for coordinating site visits and reviews, as well as additional
information requests with other RO-APS representatives in order to prepare a complete Attachment B for
certification. Refer to the RPP SOP for additional detail.
When you receive this request farm, 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 47106 Page I of I

Michael F. Easley, Governor
William G. Ross Jr„ Secretary
North Carolina Department of Environment and Natural Resources
Coleen H. Sullins Director
Division of Water Quality
June 3.2008
Rene' & Rebecca Scallan
216 E. College Street
Warsaw, NC 28398
Subject: Acknowledgement of Application No. WI0800156
Injection Minted Fluid GSHP Well System (5QM)
Duplin
Bear Mr. & Mrs. Scallan:
The Aquifer Protection Section of the Division of Water Quality (Division) acknowledges receipt of your permit
application and supporting materials on May 30, 2008. This application package has been assigned the number listed
above and will be reviewed by Mike Rogers.
The reviewer will perform a detailed review and contact you with a request for additional information if necessary
To ensure the maximum efficiency in processing permit applications, the Division requests your assistance in
providing a timely and complete response to any additional information requests.
Please be aware that the Division's Regional Office, copied below, must provide recommendations prior to final
action by the Division. Please also note at this time, processing permit applications can take as long as 60 - 90 days
after receipt of a complete application.
If you have any questions, please contact Mike Rogers at 919-715-6166, or via e-mail at mike..rogers @ncmail.net.
If the reviewer is unavailable, you may leave a message, and they will respond promptly. Also note that the Division
has reorganized. To review our new organizational chart, go to
htt .L/Uo.enr.state nc.us/documents/d_wq_nrachart pd .
PLEASE REFER TO THE ABOVE APPLICATION NUMBER WHEN MAKING INQUIRIES ON THIS
PROJECT,
Sincerely,
7
for Debra .1. Watts
Supervisor
cc: Wilmington Regional Office, Aquifer Protection Section
Home Energy, Inc.
Permit Application File W10800156
Aquifer Protection Section 1636 Mail Service Center
Internet-, nL".ncwate ualit ,a Location: 2728 Capita$ Boulevard
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Avurally
Raleigh, NC 27699-1636 Teiephone: [phone]
Raleigh, NC 27604 Fax 1: [phone]
Fax 2: (919) 715-6M
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