WI0800258_GEO THERMAL_20161025

PAT MCCRORY
(Jm•e,·iwr
DONALD R. VAN DER VAART
.)'ecretary
Water Resources
QUALITY
S. JAY ZIMMERMAN
Bradley and Donna Kuegel
402 Nelson Drive
Jacksonville, NC 28540
October 19, 2016
Subject: Geothermal well sampling results
Permit Number WI0800258
Onslow County
Dear Mr. and Mrs. Kuegel:
\'~ECEIVEDINCDEQ/DWR
OCT 2 5 2016
Water Quality Regional
Operations Section
f)trector
On September 27, 2016 staff from the Division of Water Resources sampled the influent and effluent
from your geothermal heat pump system's wells. The samples were analyzed by the Division's
laboratory for total and fecal coliform, total dissolved solids, metals, nitrates and other inorganic
constituents. No exceedances of the State Groundwater Standards were observed except for total
coliform. Coliform bacteria is present in the environment and was likely present at the hose spigots where
samples were taken, therefore it is unclear if the sample results are reflective of their presence in your
well water. A copy of the lab results are enclosed for your review.
Should you have any questions concerning this letter, please feel free to contact me at [phone] or
by email at [e-mail].
Enclosure: sample results
cc: DWR-WiRO files
Shristi Shrestha. DWR Central Office
Sincerely,
;{&Vt 144
Geoff Kegley
Water Quality Regional Operations Section
Wilmington Regional Office
Division of Water Resources, NCDENR
State of North.Carolina I Department of Environmental Quality I Division of Water Resources
127 Cardinal Drive Ext., Wilmington, NC 28405
910 796 7215
[�c1 e w '
AC32644 North Carolina Division of Water Resources Water Sciences
Section Laboratom Results
Loc. Dew.: W10600258 r Geother rsal Infection Wells)
County. Carteret Collector; G KEGL.EY Visiti0
Region: WIRD Report To W(RO Location ID: WIRO NLC
River Basin Collect Date: 0912712,91§ Priority ROOTIti6
Emergency Callecl Time: 11.110 Sample Matrix: GROUNDWATER
COC Yes/No Sample Depth Loc Type Water Supply
Final Report
Sample i0 AC32644
PO NumberSI
Date Received: 0912812016
Thpe Received: ae_�;au
Lahwarks Logine MSWIFT
Delivery Method NG Courser
Final Repoli Date: 10/12/16
Report Print Date' 10(1312016
If this report is labeled preliminary report, the results have not been validated. Do not use for Regulatory purposes.
CAS # Ana1yle Name POL
Sample temperature at receipt by lab
Result!
Qualifier
LAB
1.1
Units
Method Analysts
Reference Date Validated by
9/26/16 MSWIFT
MIC
Coiiform, MF Fecal in liquid 1
B2Q1 cFUrlooml
SM 9222 fJ 1997 91281i 6 ESTAFFOROI
Coiiform. MF Total in liquid 1 1300 Q1 CFU1100mi
SM 9222 B-1997 9/26115 ESTAFFORDI
NUT
K12+NO3 as N in liquid 0.02 0.02 U
mg/L as N
EPA 353 2 REV 2
9/30/16 CGREEN
Bromide 0.4
WET
6.4 U mgiL
EPA 300.0 rev2 1
9(28I16 CGREEN
Chloride
1.0 22
mg/L
EPA 300 0 rev2 1
9/28/16 CGREEN
Fluoride 0.4 0.50 mg/L
EPA 300.0 rev2 1
9126116 CGREEN
Sulfate 2.0 5.9 mg/L
EPA 300.0 rev2.1
9128/16 CGREEN
Total Dissolved Solids in liquid 12
472 mg1L
SM 2540 C-1997
104i/16 CGREEN
7440-22-4 Ag by ICPMS
1.0
MET
1.0 U
ugfL
EPA 200.8 Revs 4 1016116 ESTAFFORDI
7429.90-5 Al by ICP
50 50 U ug1L
EPA 200 7 Rev4 4 1015/16 ESTAFFQRD1
7440-36-0 Antimony by ICPMS
10 10 U ugfL
EPA 290.8 Rev5.4 10f6(16 ESTAFFOR01
7440-38-2 As by ICPMS
2.0 2.0 U
ug/L
EPA 200.8 Revs a
1016116 ESTAFFORD/
7440.38.3 Eta by ICP
10 10 U
ug/L
EPA200.7 Rev4.4 1015(18 ESTAFFORDI
7440-41-7 Be by ICP
5.0 5.0 U ug([.
EPA 200.I Rev4.4 1015(16 ESTAFFORD/
7440.70-2 Ca by ICP
0.10
52 mgfL
EPA 200.7 Rev4 4 10/5/16 ES TAFF OR D1
7440-3-9 Cd by ICPMS
0.50
0.50 U ug1L
EPA 200.8 Rev5.4 10/6/15 ESTAFFOR01
7440-48-4 Cobalt by ICP
50 50 U ug(L
EPA 200.7 Rev4.4 10(5/16 ESTAFFORD1
7440-7-3 Cr by ICPMS
5.0 5.0 U
ugrL
EPA 200.8 Rev6 4 1016116 ESTAFFORDI
7440-50-8 Cu by ICPMS
2 0 2.0 U u9IL
EPA 200.8 Rev5 4 10(6116 ESTAFFORD1
7439.69.6 Fe by ICP
50 50 U ug1L
EPA 200,7 Rev4.4 10/5/15 ESTAFF ORB,
7440-09-7 K by ICP
0.10 20
mg/L
EPA 200.7 Rev4.4 10/5/15 ESTAFFOR 01
7439-93-2 Li ICP
25 25 U ug1L
EPA 200.7 Rev4.4 10/5/16 ESTAFFOROI
743945-4 Mg by ICP
0.10 14
mg/L
EPA200.7 Rev4.4 10/5/16 ESTAFFORDI
7439-96-5 Mn by ICP
10 10 U ug1L
EPA 200.7 Rev4.4 10/5/15 ESTAFFORD1
7439-98-7
Mo by ICPMS
10
1 p U uglt
EPA 200.E Rev5.4 10/5/15 ESTAFFOR 0/
7440-23.5 Na by ICP
0.10
94 mg/L
EPA 200.7 Rev4.4 10/5(16 ESTAFFORD1
7440-02-0 Ni by ICPMS
2.0 2.0 U ug1L
EPA 200 8 Rev5.4 1016116 ESTAFFORD1
7438.92-1 Pb by tCPMS
2,0 2.0 U ug/L
EPA 200 8 Rev5.4 10/6116 ESTAFFORD1
7762-49-2 Se by ICPMS
1.0 1.0 U ugrL
EPA 200.E Rev5.4 10(6116 ESTAFFORDI
WSS Chemistry Laboratorps• 1623 Mail Service Center, Raleigh, NC 276994623 (8191 733.3906
"Not Detected" or "U" does not indicate the sample is analyze free Put that the anaiyle is not detected at or above she POL.
Page 1 of 2

'NC ,D'!-'J"}(_ .la6oratory Section •R.f.mfts/Sampl:e Comments/Quafifier <Definitions
Samole ID: AC32644
CAS# Analyte Name POL Result/ Method Analysis
Qualifier Units Reference Date Validated by
7440-28-0 Thallium (Tl) ICPMS 2.0 2_0 U ug/L EPA 200.8 Rev54 10/6/16 ESTAFFORD1
7440-62-2 V by ICP 10 10 U ug/L EPA 200. 7 Rev4.4 10/5/16 ESTAFFORD1
7440-66-6 Zn by ICPMS 10 10 U ug/L EPA 200.8 Rev5.4 10/6/16 ESTAFFORD1
WSS Chemistry Laboratory» 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone]
"Not Detecled" or "U" does not indicate the sample is analyte free but that the analyte is not detected at or above the POL.
Page 2 of 2
qr~w iv (k_ ,~&;--R(k\
AC 32643 North Carolina Division of Water Resources Water Sciences Section Laboratorv Results
Loe. Descr.; WI0800258 [ Geothermal ln [ection Wells ) Sample ID : AC32643
County: ~ Collect or: G KEGLEY Visi tlD PO Number#
Region : WIRO Report To WIRO Location ID: WIRO NLC Date Received : 09/28/2016
River Basin Collect Date : 09/27/2016 Priority ROUTINE iime Rece ived: 08:30
Emergency Collect Time : 11 :15 Sample Matrix: GROUNDWATER Labworks LoginlD MSWIFT
coc Yes /No Sample Depth Loe . Type : Water SUE!E!IJI Delivery Method NC Courier
Final Report Date: 10/12/16
Report Pr int Date : 10/13/2016
Final Re Qort
If this report is labeled preliminary report, the results have not been validated. Do not use for Regulatory purposes.
ResulU Units Method Anal~sis
CAS# AnaMe Name POL Qualifier Reference Date Va lidate d by
LAB
Sample temperature at receipt by lab 1.1 'C 9/28/16 MSWIFT
MIC
Coliform, MF Fecal in liquid 1 1 B2Q1 CFU/100ml SM 9222 D-1997 9/28/16 ESTAFFORD1
Coliform , MF Total in liquid 1400 Q1 CFU/100ml SM 9222 B-1997 9/26/16 ESTAFFORD1
NUT
NO2+NO3 as N in liquid 0 .02 0.02 U mg/Las N EPA 35 3 .2 REV 2 9/30/16 CGREEN
WET
Bromide 0.4 0.4 U mg/L EPA 300 .0 re v2.1 9/28/16 C GREEN
Chloride 1.0 22 mg/L EPA 300 .0 rev2 .1 9/28/16 CG REEN
Fluoride 0.4 0.50 mg/L EPA 300.0 rev2.1 9/28/16 CGREEN
Sulfate 2.0 5.9 mg/L EPA 300 .0 rev2.1 9/28/16 CGREEN
Total-Dissolved Solids in liquid 12 464 mg/L SM 2540 C-1997 10/3/16 CGREEN
MET
7440-22-4 Ag by ICPMS 1.0 1.0 U ug /L EPA 200 .8 Rev5 .4 10/6/16 ESTAFFORD1
7429-90-5 Al by ICP 50 50 U ug/L EPA200.7 Rev4.4 10/5/16 ESTAFFORD1
7440-36-0 Antimony by ICPMS 10 10 U ug /L EPA 200 .8 Rev5.4 10/6/16 ESTAFFORD1
7440 -38-2 As by. ICPMS 2.0 2.0 U ug/L EPA 200 .8 Rev5.4 10/6/16 ESTAFFORD1
7440 -38-3 Ba by ICP 10 10 U ug/L EPA 200 . 7 Rev4 .4 10/5/16 ESTAFFORD1
7440-41-7 Be by ICP 5.0 5.0 U ug/L EPA 200.7 Rev4.4 10/5/16 ESTAFFORD1
7440-70-2 Ca by ICP 0.10 53 mg/L EPA 200 . 7 Rev4.4 10/5/16 ESTAFFORD1
7440-43-9 Cd by ICPMS 0.50 0 .50 U ug/L EPA 200 .8 Rev5.4 10/6/16 ESTAFFORD1
7440-48-4 Cobalt by ICP 50 50 U ug/L EPA200 .7 Rev4 .4 10/5/16 ESTAFFORD1
7440-47-3 Cr by ICPMS 5 .0 5.0 U ug/L EPA 200 .6 Rev5.4 10/6/16 ESTAFFORD1
7440-50-8 Cu by ICPMS 2.0 2.0 U ug/L EPA 200 .8 Rev5.4 10/6/16 ESTAFFORD1
7439-89-6 Fe by ICP 50 50 U ug/L EPA 200 .7 Rev4 .4 10/5/16 ESTAFFORD1
7440-09-7 K by ICP 0.10 22 mg/L EPA 200 . 7 Rev4.4 10/5/16 ESTAFFORD1
7439-93-2 Li ICP 25 25 U ug/L EPA 200. 7 Rev4.4 10/5/16 ESTAFFORD1
7439-95-4 Mg by ICP 0.10 15 mg/L EPA 200 . 7 Rev4.4 10/5/16 ESTAFFORD1
7439-96-5 Mn by ICP 10 10 U ug/L EPA 200 . 7 Rev4 .4 10/5/16 ESTAFFORD1
7439-96-7 Mo by ICPMS 10 10 U ug/L EPA 200 .8 Rev5.4 10/6/16 ESTAFFORD1
7440-23-5 Na by ICP 0 .10 96 mg/L EPA 200 .7 Re v4.4 10/5/16 ESTAFFORD1
7440-02-0 Ni by ICPMS 2.0 2.0 U ug/L EPA 200.8 Rev5.4 10/6/1 6 ESTAFFORD1
7439-92-1 Pb by ICPMS 2 .0 2.0 U ug /L EPA 200.8 Re v5 .4 10/6/16 ESTAFFORD1
7762-49-2 Se by ICPMS 1 .0 1.0 U ug/L EPA 200.8 Rev5.4 10/6/16 ESTAFF0RD1
WSS Chemistry Laboratory>> 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone]
"Not Detected" or "U" does not indicate the sample is analyte free but that the analyte is not detected at or above the POL.
Page 1 of 2
NC 'D'Vl}q( £a6oratory Section (}?Jsufts/Samp(e Comments/QuafifierrDefinit10ns
Sample ID: AC32643
CAS# Anal yte Name POL Result/ Method Anal}'sis
Qualifier Units Reference Date Validated by
7440-28-0 Thallium (Tl) ICPMS 2.0 2.0 U ug/L EPA 200.8 Rev5.4 10/6/16 ESTAFFORD1
7440-62-2 Vby ICP 10 10 U ug/L EPA 200. 7 Rev4.4 10/5/16 ESTAFFORD1
7440-66-6 Zn by ICPMS 10 10 U ug/L EPA 200.8 Rev5.4 10/6/16 ESTAFFORD1
WSS Chemistry Laboratory» 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone]
"Not Detected" or "U" does not indicate the sample is analyte free but that the analyte is not detected at or above the POL.
Page 2 of 2
Permit Number
Program Category
Ground Water
Permit Type
WI0800258
Injection Heating/Cooling Water Return Well
Primary Reviewer
shristi.shrestha
Coastal SWRule
Permitted Flow
Facility
Facility Name
Bradley and Donna Kuegel SFR
Location Address
402 Nelson Dr
Jacksonville
Owner
Owner Name
Bradley
Dates/Events
Orig Issue
10/26/2011
NC
J
App Received
6/27/2016
Reg ulated Activities
Heat Pump Injection
Outfall
Waterbody Name
28540
Kuegel
Draft Initiated
Scheduled
Issuance Public Notice
Central Files: APS SWP
10/14/2016
Permit Tracking Slip
Status
In review
Version
Project Type
Renewal
Permit Classification
Individual
Permit Contact Affiliation
Major/Minor
Minor
Region
Wilmington
County
Onslow
Facility Contact Affiliation
Owner Type
Individual
Owner Affiliation
Bradley J. Kuegel
Owner
402 Nelson Dr
Jacksonville
Issue
10/15/2016
Effective
10/15/2016
NC 28540
Expiration
9/30/2021
Re quested /Received Events
RO staff report requested
RO staff report received
Streamlndex Number Current Class
6/30/16
10/7/16
Subbasin
PAT MCCRORY
Governor
DONALD R. VAN DER VAART
Water Resources
ENVIRONMENTAL QUALITY
Bradley and Donna Kuegel
402 Nelson Drive
Jacksonville NC 28540
Re: Issuance of Injection Well Permit
Permit No. WI0800258
October 15, 2016
Geothermal Heating/Cooling Water Return Well
Carteret County
Dear Mr. and Mrs. Kuegel:
Secretary
S. JAY ZIMMERMAN
Director
In accordance with your permit renewal application received November 30, 2015, and additional
information received June 27, 2016, I am forwarding Permit No. WI0800258 for the continued
operation of geothermal heating/cooling water return well(s) located at the above referenced address.
This permit shall be effective from date of issuance, until September 31, 2021, and shall be subject to
the conditions and limitations stated therein.
Please Note:
• Samples from the influent and effluent sampling ports of your geothernial well system
were collected on September 27, 2016 by Wilmington Regional Office. Laboratory
analytical results will be forwarded to you when it becomes available.
In order to continue uninterrupted legal use of this well for the stated purpose, you should submit an
application to renew the permit 120 days prior to its expiration date. As indicated in the permit, this
permit is not transferable to any person without prior notice to, and approval by, the Director of the
Division of Water Resources. ff you have any questions regarding your permit or the Underground
Injection Control Program, please call me at [phone].
Best Regards,
Shristi Shrestha
Underground Injection Control (UIC)-Hydrogeologist
Division of Water Resources, NCDEQ
Water Quality Regional Operations Section
State of North Carolina I Environmental Quality I Water Resources
1611 Mail service Center I Raleigh, North Carolina 27699-1611
919 707 9000
cc: Jim Gregson -Morella King Sanchez, Wilmington Regional Office
Central Office File, WI0800258
Carteret County Environmental Health Department
Page2 of2
NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENTAL QUALITY
RALEIGH, NORTH CAROLINA
PERMIT FOR THE USE 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
· Bradley and Donna Kuegel
FOR THE CONTINUED OPERATION OF ONE (1) GEOTHERMAL HEATING/COOLING WATER
RETURN WELL(S), defined in Title 15A North Carolina Administrative Code 02C .0224(a), which will be used
for the injection of heat pump effluent. The injection well(s) located at 402 Nelson Drive, Jacksonville, Carteret
County, NC 28540 will be operated in accordance with the application submitted Jun 27, 2016, and in conformity
with the specifications and supporting data, all of which are filed with the Department of Environmental Quality
and are considered a part of this permit.
This permit is for continued operation of an injection well shall be in compliance with Title 15A North Carolina
Administrative Code 2C .0100 and .0200, and any other Laws, Rules, and Regulations pertaining to well
construction and use.
This permit shall be effective, unless revoked, from the date of its issuance until September 31, 2021, and shall
be subject to the specified conditions and limitations set forth in this permit.
Permit issued this the 15th day of October 2016.
,l.8\. S. Jay Zimmerman, P.G.
\ Director, Division of Water Resources
By Authority of the Environmental Management Commission.
Pennit#WI0800258 UIC/5A7
ver. 11/15/2015
Page 1 of5
PART I-PERMIT GENERAL CONDITIONS
1. The Permittee shall comply with all conditions of this permit and with the standards and criteria specified
in Criteria and Standards Applicable to Injection Wells (15A NCAC 2C .0200). Noncompliance with
conditions of this permit constitutes a violation of the North Carolina Well Construction Act and is grounds
for enforcement action as provided for in N.C.G.S. 87-94
2. This permit is effective only with respect to the nature, volume of materials and rate of injection, as
described in the application and other supporting data [15A NCAC 02C .021 l(a)].
3. This permit shall become voidable unless the facility is constructed in accordance with the conditions of
this permit, the approved plans and specifications, and other supporting data [ISA NCAC 02C .0211(1)].
4. This permit is not transferable without prior notice and approval. In the event there is a desire for the facility
to change ownership, or there is a name change of the Permittee, a formal permit amendment request must
be submitted, including any supporting materials as may be appropriate, at least 30 days prior to the date of
the change [15A NCAC 02C .021 l(q)].
5. The issuance of this permit shall not relieve the Permittee of the responsibility of complying with any and
all statutes, rules, regulations, or ordinances, which may be imposed by other local, state, and federal
agencies, which have jurisdiction. Furthermore, the issuance of this permit does not imply that all
regulatory requirements have been met [ISA NCAC 02C .0203].
PART II -WELL CONSTRUCTION GENERAL CONDITIONS
1. The well supplying water for the geothermal heating and cooling system shall be constructed in accordance
with the requirements of rule ISA NCAC 02C .0107 except as required in Item #2 below.
2. Any injection well shall be constructed in accordance with the requirements of rule ISA NCAC 02C .0107
except that the entire length of the casing shall be grouted in such a way that there is no interconnection of
aquifers or zones having differences in water quality that would result in degradation of any aquifer or zone.
For screened wells, grout shall be emplaced from the top of the gravel pack to the land surface. For open-
end wells, the casing shall be grouted from the bottom of the casing to the land surface [ISA NCAC 02C
.0224(d)(2),(3)].
3. Bentonite grout shall not be used to seal any water-bearing zone with a chloride concentration equal to or
greater than 1,500 milligrams per liter. In areas where elevated chloride levels are known to exist or are
probable, such as coastal areas, chloride levels shall be verified in the field to determine existing conditions.
[15A NCAC .0225(g)(8)].
4. The injection well system shall be constructed such that a sampling tap or other collection equipment
approved by the Director provides a functional source of water when the system is operational. Such
equipment shall provide the means to eollect a water sample immediately after emerging from the water
supply well and immediately prior to injection into the return well [15A NCAC 02C .0224(d)(4)].
5. Each well shall be secured to reasonably insure against unauthorized access and use and shall be sealed
with a watertight cap or well seal as defined in G.S. 87-85(16).
6. Each well shall have permanently affixed an identification plate [15A NCAC 02C .0107(j)(2)].
Pennit#WI0800258 UIC/5A7
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Page 2 of5
7. A completed Well Construction Record (Form GW-1) shall be submitted as described in Part V.5 of this
permit.
PART ID-OPERATION AND USE CONDITIONS
1. The Permittee shall comply with the conditions of this permit and properly operate and maintain the
injection facility in compliance with the conditions of this permit and the rules of ISA NCAC 02C .0200,
even if compliance requires a reduction or elimination of the permitted activity [15A NCAC 02C .021 l(j)].
2. The issuance of this permit shall not relieve the Permittee of the responsibility for damages to surface water
or groundwater resulting from the operation of this facility. In the event that the facility fails to perform
satisfactorily, including the creation of nuisance conditions or failure of the injection zone to adequately
assimilate the injected fluid, the Permittee shall take immediate corrective actions that may be required,
such as the repair, modification, or abandonment of the injection facility [15A NCAC 02C .0206].
PART IV -INSPECTIONS [15A NCAC 02C .021 l(k)]
1. Any duly authorized officer, employee, or representative of the Division of Water Resources (DWR) may,
upon presentation of credentials, enter and inspect any property, premises, or place on or related to the
injection facility at any reasonable time for the purpose of determining compliance with this permit, may
inspect or copy any records that must be maintained under the terms and conditions of this permit, and may
obtain samples of groundwater, surface water, or injection fluids:
2. DWR representatives shall have reasonable access for purposes of inspection, observation, and sampling
associated with injection and any related facilities as provided for in N.C.G.S. 87-90.
3. Provisions shall be made for collecting any necessary samples of the injection facility's activities.
PART V -MONITORING AND REPORTING REQUIREMENTS
1. Records of well construction, repair, or abandonment shall be submitted within 30 days of completion of
such activities. Copies of such records shall be retained on-site and available for inspection [ISA NCAC
02C .0224(f)(2), (4)].
2. Monitoring of any well may be required to ensure protection of the groundwater resources of the State and
compliance with the groundwater quality standards specified in 15A NCAC 02L [15A NCAC 02C
.0224(f)(l)].
3. The Permittee shall report any monitoring or other information that indicates noncompliance with a specific
permit condition, that a contaminant may cause a violation of applicable groundwater quality standards, or
that a malfunction of the injection system may cause the injected fluids to migrate outside the approved
injection zone or area. As specified in rule ISA NCAC 02C .021 l(r), noncompliance notification shall be
as fol-lows:
(A) Oral notification shall be given within 24 hours of the occurrence, or first knowledge of the
occurrence, to the Wilmington Regional Office, telephone number 910-796-2004.
(B) Written notification shall be made within five days of the occurrence and submitted to the addresses
in Item #5 below.
Permit #WI0800258 UIC/5A7
ver. 11/15/2015
Page 3 of5
(C) The written notification shall contain a description of the noncompliance and its cause; the period of
noncompliance, including dates and times; if the noncompliance has not been corrected, the
anticipated time it is expected to continue; and any steps taken or planned to reduce, eliminate, and
prevent reoccurrence of the noncompliance.
4. The Permittee shall record the number and location of the wells with the register of deeds in the county in
which the facility is located. [15A NCAC 02C .0224(t)(3)].
5. All forms, reports, or monitoring results required by this permit shall be submitted to:
UIC Program Staff
Division of Water Resources
1636 Mail Service Center
Raleigh, NC 27699-1636
and
Water Quality Regional Operations Section
DWR Wilmington Regional Office
127 Cardinal Drive
Wilmington, NC 28405
PART VI -PERMIT RENEW AL [15A NCAC 02C .0224( c )]
As required by rule an application for permit renewal shall be made at least 120 days prior to the expiration
date of the permit. This permit condition does not apply if the Permittee chooses to discontinue operation
of the well for injection of effluent from the geothermal heating and cooling system associated with this
permit.
PART VII-CHANGE OF WELL STATUS [15A NCAC 02C .0240]
1. Procedures for temporarily or permanently abandoning a well are the same as those specified in rule 15A
NCAC 02C .0113. While some of those criteria are given below, the Permittee bears the responsibility of
complying with all applicable regulatory requirements.
2. If a well will no longer be used for any purpose, then it should be permanently abandoned according to rule
15A NCAC 02C .0113(b) in order to prevent the well from deteriorating and acting as a source or conduit
of contamination, which is prohibited by General Statute 87-88(c).
3. If a well is taken completely out of service temporarily, the Permittee shall install a water-tight cap or well
seal that cannot be removed without the use of hand or power tools.
4. When injection operations have ceased at the facility and a well will no longer be used for any purpose, the
Permittee shall permanently abandon that injection well in accordance with the procedures specified in 15A
NCAC 02C .0113(b), which include, but are not limited to, the following:
(A) All casing and materials may be removed prior to initiation of abandonment procedures if
such removal will not be responsible for, or contribute to, the contamination of an
underground source of drinking water.
(B) The entire depth of each well shall be sounded before it is sealed to insure freedom from
obstructions that may interfere with sealing operations.
(C) Each well shall be thoroughly disinfected prior to sealing in accordance with rule 15A
NCAC 02C .011 l(b)(l)(A), (B), and (C).
Pennit#WI0800258 UIC/5A7
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(D) Each well shall be completely filled with cement grout, which shall be introduced into the
well through a pipe which extends to the bottom of the well and is raised as the well is
filled.
(E) In those cases when a subsurface cavity has been created as a result of the injection
operations,. each well shall be abandoned in such a manner that will prevent the movement
of fluids into or between underground sources of drinking water.
(F) The Pennittee shall submit a Well Abandonment Record (Form GW-30) as specified in
15A NCAC 2C .0224(f)( 4) within 30 days of completion of abandonment.
5. The written documentation required in Part VII (4)(F) shall be submitted to the addresses specified in Part
V.5 above.
Permit #WI0800258 UIC/5A7
ver. 11/15/2015
Page 5 of5
North Carolina Department of Environmental Quality -.Division of Water Resources
WQROS REGIONAL STAFF REPORT FOR
UIC Program Support
··•-----------------
Permit No. WI0800258
Date: 9/27/2016
To: Shristi Shrestha
Central Office Reviewer
County: Carteret
Permittee/ Applicant: Brad & Donna Koegel
L GENERAL INFORMATION
1. This application is (check all that apply): D New [Z] Renewal
D Minor Modification D Major Modification RECEIVED/NCOl:.Q/DWR
a. Date oflnspection: 9/27/2016
b. Person contacted and contact information: Mr. Kue gel {910) 346-9534 OCT 012016
c . Site visit conducted by: Geoff Keg le y
d. Inspection Report Printed from BIMS attached: D Yes [Z] No.
Water Quality .
Regional Operations SediOn
e . Physical Address of Site including zip code: 402 Nelson Dr, Jacksonville, NC 28540
f. Driving Directions if rural site and/or no physical address: __
g. Latitude: 34 45 31 .45 N Longitude: 77 24 42.88 W
Source of Lat/Long & Accuracy (i.e., Google Earth, GPS, etc.):_ Google Earth
IL DESCRIPTION OF INJECTION WELL(S ) AND FACILITY
1. Type of injection system:
[Z] Geothermal Heating/Cooling Water Return
□ In situ Groundwater Remediation
D Non-Discharge Groundwater Remediation
D Other (Specify: )
2. For Geothermal Water Return Well{s ) only
a. For existing geothermal system only:
Were samples collected from Influent/Effluent sampling ports? [Z] Yes D No.
Provide well construction information from well tag:
b. Does existing or proposed system use same well for water source and injection? 0 Yes [Z] No
If No, please provide source/supply well construction info (i.e., depth, date drilled, well contractor,
etc.) and attached map and sketch location of supply well in relation to injection well and any other
features in Section IV of this Staff Report.
3. Are there any potential pollution sources that may affect injection? D Yes ~ No
What is/are the pollution source(s)? ________________________ _
What is the distance of the injection well(s) from the pollution source(s)? ___________ _
4. What is the minimum distance of proposed injection wells from the property boundary? ______ _
5. Quality of drainage at site: D Good ~ Adequate D Poor
6. Flooding potential of site: ~ Low D Moderate D High
WQROS Staff Report Rev. 4/15/2016 Page I
7. For Groundwater Remediation Injection Systems only, is the proposed and/or existing groundwater monitoring
program (number of wells, frequency of monitoring, monitoring parameters, etc.) adequate? El Yes ❑ No.
If No, attach map of existing monitoring well network if applicable and recommend any changes to the
groundwater -monitoring program.
8. Does the map included in the Application reasonably represent the actual site (property tines, wells, surface
drainage)? ® Yes ❑ No. ® N/A. If No, or no map, please attach a sketch of the site. Show property
boundaries, buildings, wells, potential pollution sources, roads, approximate scale, and north arrow.
9. For Non -Discharge Groundwater Remediation systems only (i.e., permits with WQ prefix):
a. Are the treatment facilities adequate for the type of waste and disposal system? ❑ Yes El No ❑ NIA.
If No, please explain:
b. Are the site conditions (soils, topography, depth to water table, etc.) consistent with what was reported by
the soil scientist and/or Professional Engineer? ❑ Yes ❑ No ❑ N/A, If no, please explain:
IIL EVALUATION AND RECOMMENDATIONS
1. Do you foresee any problems with issuance/renewal of this permit? ❑ Yes ® No. If Yes, explain.
2. List any items that you would like WQROS Central Office to obtain through an additional information request.
Make sure that you provide a reason for each item:
Item Reason
3. List specific special conditions or compliance schedules that you recommend to be included in the permit when
issued. Make sure that you provide a reason for each special condition:
Condition
Reason
4. Recommendation
❑ Deny. If Deny, please state reasons:
❑ Hold pending receipt and review of additional information by Regional Office
❑ Issue upon receipt of needed additional information
® Issue 4g.
5_ Signature of Report Preparer(s): /"72 -'
Signature of WQROS Regional Supervisor;
r
Date: d �� \`t `c 1, k
WQROS Staff Report Rev. 4/15/2016 Page 2

IV. ADDITIONAL REGIONAL STAFF REVIEW COMMENTS/ATTACHMENTS (Optional I I f Needed)
This review was conducted for a permit renewal request for a geothermal injection well heat pump
system for the Kuegel residence . On September 27 , 2016, staff visited the home to inspect the well
system. Source well water and water prior to re-injection were sampled for Metals, Total and Fecal
Coliform, Nitrates, Chloride, Sulfate and Total Dissolved Solids. Sampling results will be forwarded to
the Central Office and owner when received from laboratory. System operation has been normal.
WQROS Staff Report Rev. 4/15/2016 Page3
WATER QUALITY REGIONAL OPERATIONS SECTION
APPLICATION REVIEW RE QUEST FORM
Date: June 30, 2016
To: Jim Gregson -Morella Sanchez-King
From: Shristi Shrestha, WQROS -Animal Feeding Operations and Groundwater Protection Branch
Telephone: [phone] Fax: [phone] E-Mail: [e-mail]
Permit Number: WI0800258
A. Applicant: Bradley & Donna Kuegel
B. Facility Name:
C. Application:
Permit Type: Geothermal Heating/Cooling Water Return Well
Project Type: Renewal
E. Comments/Other Information:
__ I would like to accompany you on a site visit.
Attached, you will find all information submitted in support of the above-referenced application for your
review, comment, and/or action . Within 30 calendar days, please return a com pleted W OROS Staff
Report.
When you receive this request form, please write your name and dates in the spaces below, make a copy of
this sheet, and return it to the appropriate Central Office Groundwater Protection Branch contact person
listed above.
RO-WOROS Reviewer: __________________ Date: _____ _
COMMENTS:
NOTES:
FORM: WQROS-ARR ver. 092614 Page 1 of 1
PAT M,CCRORY
Governor
DONALD R. VAN DER VAART
Secretary
Water Resources
ENVIRONMENTAL QUALITY S. JAY ZIMMERMAN
June 30, 2016
Bradley & Donna Kuegel
402 Nelson Drive
Jacksonville NC 28540
RE: Acknowledgement of Application No. WI0800258
Geothermal Heating/Cooling Water Return Well
Onslow County
Dear Mr. and Mrs. Kuegel:
The Water Quality Regional Operations Section (WQROS)acknowledges receipt of your
permit application and supporting documentation received on June 27, 2016. Your application
package has been assigned the number listed above, and the primary reviewer is Shristi Shrestha
Central and Wilmington Regional Office staff will perform a detailed review of the
provided application, and may contact you with a request for additional information.· To ensure
maximum efficiency in processing permit applications, the Water Quality Regional Operations
Section (WQROS) requests your assistance in providing a timely and complete response to any
additional information requests.
Please note that processing standard review permit applications may take as long as 60 to
90 days after receipt of a complete application. If you have any questions, please contact Shristi
Shrestha at 919-807-6406 or email at [e-mail].
cc: Wilmington Regional Office, WQROS
Permit File WI0800258
Sincerely,
For Debra J. Watts, Supervisor
Animal Feeding Operations & Groundwater
Protection Branch Division of Water
Resources
State of North Carolina I Environmental Qnality I Water Resources
1611 Mail •crvicc Center I Raleigh, North Carolina 27699-1611
919 707 9000
Director
NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
APPLICATION FOR A PERMIT TO CONSTRUCT OR OPERATE INJECTION WELLS
In Accordance With the Provisions of 15A NCAC 02C .0224
GEOTHERMAL HEATING/COOLING WATER RETURN WELL (S)
These well(s) inject groundwater directly into the subsurface as part of a geothermal heating and cooling system
CHECK ONE OF THE FOLLOWING:
__ New Application L Renewal* __ Modification __ Permit Rescission Request*
*For Permit Renewals or Rescission Request, complete Pages 1 and 4 (signature page) only
Print or Type Information and Mail to the Address on the Last Page. Illegible Applications Will Be Returned As Incomplete.
DATE: ________ ,20 __ _ PERMIT NO. ______ (leave blank if New Application)
A. CURRENT WELL USE AND OWNERSHIP STATUS (leave Blank if New Application)
B.
1. Current Use of Well 'V
a. Continue to use as _d_ Geothermal Well __ Drinking Water Supply __ Other Water
Supply
b. Terminate Use: If the well is no longer being used as a geothermal injection well and you wish to
rescind the permit, check the box below. If abandoned, attach a copy o~~~WR
Record (GW-30).
D Yes, I wish to rescind the permit
2. Current Ownership Status
Has there been a change of ownership since permit last issued? DYES
If yes, indicate new owner's contact information:
JUN 2 7 2016
Water Quality Regional
Operations Section
~NO
Name(s) --------------------------------
Mailing Address: ____________________________ _
City: __________ State: __ Zip Code: ______ County: _____ _
Day Tele No.: Email Address.:
STATUS OF APPLICANT (choose one)
Non-Government: Individual Residence_){_ Business/Organization __
Government: State Municipal __ County__ Federal
C. WELL OWNER(S)/PERMIT APPLICANT -For individual residences, list owner(s) on property deed. For
all others, list name of entity and name of person delegated authority to sign: __________ _
)2>~-A 'O l.. ,;--t O o 7V . r.J =: e,. ti L .
Mailing Address: '-t O ~ I; L.. 50 JV P., ) V E
City: J ~ C-J< 5tl /v V"' 1' t L n. State: >VL-,Zip Code: A 71' 5''-} L> County: 0 NS L Ou/
Day Tele No.: Cj 1 D ? y /? '1 '? J L._) Cell No.:
EMAIL Address: f?> ~ >"' 0 ),..(,Vt,: U-~ L, 8 Fax No.:
6-Y'1~iL. Ct7n,
Geothermal Water Return Well Permit Application (Revised Jan 2015) Page I
D. \VELL OPERATOR (if different from well owner) -For individual residences, list owner(s) on property
deed. For all others, list name of entity and name of person delegated authority to sign on behalf of the business
or agency: ______________________________ _
Mailing Address:---------------------------------
City: _____________ State: __ Zip Code:. _______ County: _____ _
Day Tele No.: ---------------~E=m=a=i~l A~d~dr~e~s~s-~: ___________ _
E. LOCATION OF WELL SITE -Where the injection wells are physically located:
(1)
(2)
Parcel Identification Number (PIN) of well site: __________ County: _____ _
Physical Address (if different than mailing address): ___ 5_y'4 __ VVJ ___ ~_:::.._ _________ _
City: ________________ State: NC Zip Code: _________ _
F WELL DRILLER INFORMATION
Well Drilling Contractor's Name: __________________________ _
NC Well Drilling Contractor Certification No.: _____________________ _
Company Name: ________________________________ _
Contact Person.~: _______________ EMAIL Address: ___________ _
Address:--~---------------------------------
City: --'---=•C'------· _______ Zip Code: _____ State: __ County: _________ _
Office Tele No.: _________ Cell No.: ________ Fax No ... · ________ _
G. HVAC CONTRACTOR INFORMATION (if different than driller)
HV AC Contractor's Name:
H.
NC HV AC Contractor License No.: _________________________ _
Company Name: ________________________________ _
Contact Person_: _______________ EMAIL Address: ___________ _
Address: ___________________________________ _
City: Zip Code: _____ State: __ County: _________ _
Office Tele No.: Cell No.: Fax No.: ---------------------------
WELL USE Will the injection well(s) also be used as the supply well(s) for the following?
(1)
(2)
The injection operation?
Personal consumption?
YES ___ _ NO ___ _
YES ___ _ NO ___ _
I. WELL CONSTRUCTION REQUIREMENTS-As specified in 15A NCAC 02C .0224 (d }:
(1) The water supply well shall be constructed in accordance with the water supply well requirements of
15A NCAC 02C .0107.
(2) If a separate well is used to inject the heat pump effluent, then the injection well shall be constructed
in accordance with the water supply well requirements of 15A NCAC 02C .0107, except that:
Geothermal Water Return Well Permit Application (Revised Jan 2015) Page2
NOTE: In most cases an aerial photograph of the property parcel showing property lines and structures can be
obtained and downloaded from the applicable county GIS website. Typically, the property can be searched by
owner name or address. The location of the wells in relation to property boundaries, houses, septic tanks, other
wells, etc. can then be drawn in by hand. Also, a `layer' can be selected showing topographic contours or elevation
data
M. CERTIFICATION (to be signed as required below or by that person's authorized agent)
15A NCAC 02C .02111e. requires that all permit applications shall be signed as follows:
1. for a corporation: by a responsible corporate officer;
2. for a partnership or sole proprietorship: by a general partner or the proprietor, respectively;
3. for a municipality or a state, federal, or other public agency: by either a principal executive officer
or ranking publicly elected official;
4. for all others: by all the person( si listed on the proper r. deed.
If an authorized agent is signing on behalf of the applicant, then supply a letter signed by the
applicant that names and authorizes their agent to sign this application on their behalf.
"I hereby certify, under penalty of law, that I have personally examined and am familiar with the information
submitted in this document and all attachments thereto and that, based on my inquiry of those individuals
immediately responsible for obtaining said infonnation, 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_"
Signatur .(Property Owner/Applicant
ap rf3)- Ls 1 c) 1}aci-r-zL
Print or Type FulI Name
C',t.,,t-i1 Q Q.
Signature of Property Owner/Applicant
4)0NNA Q-ru �2 I
Print or Type Full Name
Signature of Authorized Agent, if any
Print or Type Full Name
Submit two copies of the completed application package to:
Division of Water Resources
Water Quality Regional Operations Section (WQROS)
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone [phone]
Geothermal Water Return Well Perinit Application (Revised Jan 2015) Page 4

(a) For screen and gravel-packed wells, the entire length of casing shall be grouted from the top
of the gravel pack to land surface;
(b) For open-end wells without screen, the casing shall be grouted from the bottom of the casing
to land surface.
(3) A sampling tap or other approved collection equipment shall provide a functional source of water
during system operation for the collection of water samples immediately after water emerges from the
supply well and immediately prior to injection.
J. WELL CONSTRUCTION SPECIFICATIONS
(I) Specify the number and type of wells to be used for the geothermal heating/cooling system:
_____ *EXISTING WELLS ____ .PROPOSED WELLS
*For existing wells, please attach a copy of the Well Construction Record (Form GW-1) if available.
(2) Attach a schematic diagram of each water supply and injection well serving the geothermal
heating/cooling system. A single diagran1 can be used for wells having the same construction
specifications as long as the diagram clearly identifies or distinguishes each well from one another.
Each diagram shall demonstrate compliance with the well construction requirements specified in Part
H above and shall include, at a minimum, the following well construction specifications:
(a) Depth of each boring below land surface
(b) Well casing and screen type, thickness, and diameter
( c) Casing depth below land surface
( d) Casing height "stickup" above land surface
(e) Grout material(s) surrounding casing and depth below land surface
Note: bentonite grouts are prohibited for sealing water-bearing zones with 1500
mg/L chloride or greater per 15A NCAC 02C .0107(0(8)
(f) Length of well screen or open borehole and depth below land surface
(g) Length of sand or gravel packing around well screen and depth below land surface
K. OPERATINGDATA
(1) Injection Rate: Average (daily) gallons per minute (gpm).
(2) Injection Volume: Average (daily) gallons per day (gpd).
(3) Injection Pressure: Average (daily) pounds/square inch (psi).
(4) Injection Temperature: Average (January) ° F, Average (July) __ ·° F.
L. SITE MAP -As specified in 15A NCAC 02C .0224(b )( 4 ), attach a site-specific map that is scaled or otherwise
accurately indicates distances and orientations of the specified features from the injection well(s). The site map
shall include the following:
(I) All water supply wells, surface water bodies, and septic systems including drainfield, waste
application area, and repair area located within 250 feet of the injection well(s).
(2) Any other potential sources of contamination listed in 15A NCAC 02C .0107 (a }(2 ) located within 250
feet of the proposed injection well(s).
(3) Property boundaries located within 250 feet of the parcel on which the proposed injection well(s) are
to be located.
(4) An arrow orienting the site to one of the cardinal directions (north, south, west, or east)
Geothermal Water Return Well Permit Application (Revised Jan 2015) Page3
Water Resources
ENVIRONMENTAL QUALITY
June 16, 2016
CERTIFIED MAIL # 7015 1520 0000 7838 3910
RETURN RECEIPT REQUESTED
Bradley & Donna Kuegel
402 Nelson Drive
Jacksonville NC 28540
PAT MCCRORY
uovernar
DONALD R. VAN DER VAART
secrecy
S. JAY ZIMMERMAN
Direeror
Subject: Notice of Expiration (NOE)
Geothermal Water ReturnlOpen-Loop Injection Well
Permit No. WI0800258
Onslow County
Dear Mr. and Mrs. Kuegel:
The Underground Injection Control (UIC) Program of the North Carolina Division of Water
Resources (DWR) is entrusted to protect the groundwater quality and resources of the State of
North Carolina, and is responsible for the regulation of injection well construction and operation
activities within the state. Our records indicate that the above -referenced operating permit for the
geothermal injection well system located on your property at the above referenced address was
issued on October 26, 2011, and will expire on September 30, 2016. Per permit conditions and
requirements per 15A NCAC 2C .0224(c), the renewal application must be submitted at least 120
calendar days prior to expiration of the permit if you wish to continue operating the injection well
on your property.
If Your Geothermal Water Return Well is Still Currently Being Used for Injection:
In order to comply with the regulatory requirements listed under North Carolina Administrative
Code (NCAC) Title 15A, Subchapter 2C, Section .0211, you must submit the enclosed renewal
application (Application for a Permit to Construct or Operate Injection Wells — Geothermal
Heating/Cooling Water Return Wells), The form is also available on-line at our website
lrttp:llportal.ncdenr.orglweblwglapslgwprolpennit-applications.
If Your Geothermal Water Return Well is NO LONGER Being Used for Infection:
If the well is no longer being used for injection, you do not have to renew your permit. Check the
box in Part A of the attached renewal application that you wish to rescind the permit and indicate
the current status of the well (i.e., used as water supply well, irrigation well, inactive, plugged and
abandoned, etc.). If it is no longer being used for any purpose, it must be permanently abandoned
according to the regulatory requirements listed under NCAC Title ISA, Subchapter 2C, Section
_0240. When the well is plugged and abandoned, a well abandonment record (Form GW-30) must
be submitted to our office to certify that the abandonment was properly conducted.
Stale of North Carolina I Environmental Quality 1 Water Resources
1611 Mail service Curter I Raleigh, Nods Carolina 27699-10l
919 707 9000

Page 2 of 2
If There has been a Change of Ownership of the Property:
If there has been a change of ownership of the property. an "injection Well Permit
Narne/Ownership Change" Form must also be submitted in addition to the renewal application.
This form is not enclosed but can be found at the website listed above. Please submit the applicable
forms to:
Division of Water Resources
UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Failure to submit the applicable forms in a timely manner may result in the assessment of civil
penalties in accordance with North Carolina General Statute A7-94. Thank you in advance for
your cooperation and timely response_ If you have any questions, please contact me by phone at
[phone] or by email at sluristi.shrestha({i ncdenr. i. ov,
Regards,
Shristi Shrestha
Hydrogeologist
Division of Water Resources
Water Quality Regional Operations Section
Enclosures
cc: Wilmington- Regional Office — WQROS w/o enclosures
Central Files - Permit No. W10800258 w/o enclosures

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SENDER: COMPLETE' THIS SECTION
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Bradley & Donna Kuegel
402 Nelson Drive
Jacksonville NC 28540
11111111111111111111111111111111111111111111
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North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, P.E. Dee Freeman
Governor Director Secretary
February 20, 2012
Bradley Kuegel
402 Nelson Dr.
Jacksonville, NC 28450
Subject: UIC sampling results
Permit Number W10800258
Onslow County
Dear Mr. Kuegel:
On December 12, 2011, staff from the Wilmington Regional Office of the Aquifer Protection
Section sampled the influent and effluent lines of your geothermal underground injection well
heat pump system. The samples were analyzed by the Division of Water Quality lab for
coliform, total dissolved solids, metals, nitrates and other inorganic constituents. A copy of the
lab results is enclosed for your review.
These results were forwarded to the central office in Raleigh. Should you have any questions
conceiving this letter, please fee] free to contact me at [phone] or by email at
Geof£Keglev ra ncdenr.cov.
Very Truly Yours,
Geoff Kegley
Hydrogeo]ogist
Enclosure: sample results
cc: Michael Rogers, APS Central Office
Wilmington Regional Office
127 Cardinal Drive Extension, Wilmington, North Carolina 28405
Phone' 910-796-72151 FAX: [phone] Customer Service:1-877-623-6748
Internet www.ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer
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Naturally

yr DWO Laooraiin Section Results
County: ONSLQW
River Basin
Report To WIROAP
Collector: G KEGLEY
Region: WIRO
Sample Matrix: GROUNDWATER
Loc. Type:
Emergency Yes/No
COC Yes/No
Location ID: W1ROAPNLC
VisitID
Loc. Descr.: pismotoi
Collect Date: 12/12/2011
Sample ID: AB79309
PO Number# 1101127
Date Received: 12/13/2011
Time Received: 07:50
Labworks LoginlD DLEAVITT
Report Generated: 2/2/12
Date Reported: 02/02/2012
Collect Time:
14:00
Sample Depth
CAS # Analyte Name
LAB
Sample temperature at receipt by lab
PQL
Result/
Qualifier
0.9
Units
eC
Method Analy iS Validated b�
Reference Date
12/13/11 DLEAVITT
MIC
Coiiforrn, MF Fecal in liquid 1 1 R2,L1 CFU/100rrtl APHA9222D-20th 12/13/11 MOVERMAN
Coliform, MF Total in liquid 1 1 B2,Q1 CFU/100m1 APHA9222B-20th 12/13/11 MOVERMAN
WET
Ion Chromatography _TITLE_ mg/L EPA 300.0 12/19/11 MOVERMAN
Chloride
1,0 56 mg/L EPA 300.0 12/19/11 MOVERMAN
Fluoride
0.4 0.6 mg/L EPA 300.0 12/19/11 MOVERMAN
Sulfate
2.0 3.7 mg/L EPA 300.0 12/19/11 MOVERMAN
Total Dissolved Solids in liquid 12 536 mg/L APHA2540C-18TH 12/13/11 MOVERMAN
NUT
No2+NC3 as N in liquid
0.02 0.02 U
mg/L as N Lac10-107-04-1-c 12/13/1; CGREEN
MET
7429-90-5 Al by ICP 50 501.1 uglL EPA 200.7 12/28/11 ESTAFFORD1
7443-70-2 Ca by ICP
0.10 52 mg/L EPA200.7 12J28/11 ESTAFFORD1
7440-47-3 Cr by ICPMS 10 10 U ugfL EPA200.8 1/13/12 ESTAFFORD1
744n-50.8 Cu by ICPMS 2.0 2.0 U ug/L EPA200.8 1/13/12 ESTAFFORD1
7439-89-6 Fe by ICP 50 50 U ug/L EPA 200.7 12/28/1' ESTAFFORD1
Hardness by Calculation
1.0 190 mg/L SM2340BEPA200,7 12/28/11 ESTAFFORDI
7440-09-7 K by ICP
0.10 23 mgl{. EPA 200.7 12/28/11 ESTAFFORDI
7439-95.4 Mg by ICP
0.10 15 mg/L EPA 200.7 12128/1' ESTAFFORDI
7439-96-5 Mn by ICP
10 10U ug/L EPA 200.7 12/28/1' ESTAFFORD1
7440-23-5 Na by ICP
0.10 140 mg/L EPA 200.7 12/28/1' ESTAFFORDI
744002-O Ni by ICPMS
2.0 2.0 U ug/L EPA 200.8 1/13/12 ESTAFFORD1
7439-92-1 Pb by ICPMS
2.0 2.0 U ug/L EPA 200.8 1/13/12 ESTAFFORD1
7440-66-6 Zn by ICP 10 10 U ug/L EPA 200.7 1/19/12 ESTAFFORD1
FEB 0 3 2012
Laboratory Section» 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone]
For a detailed desCriplion of the qualifier codes refer to httnvr,,ortal.nEdenrrow veetihreirial2/m inAhszolrs;sICraps4ifier Caries rdatablstaFMlWSechasxun
Page 1 of 1

GROUNDWATER F!ELD/LAB FORM
North Carolina
Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
Location code
County CD
Quad No_ Serial No.
Lat. Long.
Report To: ARO, FRO, MRO, RRO, WaRO iR•
WSRO, Kinston FO Fed. Trust, Central Off., Other:
Shipped by: Bus, Hand Del., Other:
Coilector(s): C 4L Y_
FIELD ANALYSES
pH aao
Temp.to
Appearance
Field Analysis By:
LABORATORY ANALYSES
SAME TYPE
rig Water
❑ Soil
❑ Other
0 Chain of Custody
SAMPLE PRIORITY
3 Routine
0 Emergency
) r be7 a�a3 '
Labab Number '1
Date Receive 1.6' 0-1 l T! - me4- 5 0
Rec'd By: From:Bus,• °urigr, Hand Del.,
Other:
Data Entry By: Ck:
Date Reported:
Purpose:
I� f :DO Baseline Complaint, Compliance, LUST. Pesticide Study, Federal Trust, Other O` 40.
Owner Itt.CEGFL [mrcle one)
Spec. Cond.sa at 25°C Location or Site W t 020b2S�
Odor Description of sampling paint ► itk -!' -7a 0 Jj.(
Sampling Method
Dateri
BOO 310
mplL
COD High 340
mg/L
COD Low 335
mgiL
Calfrorm: MF Fecal 31616
11 OOml
Coliform: MF Total 31504
1100m1
TOC 680
mg/L
Res
T idity 76
qlr, fnlal Suspended 530
NTU
mg/L
pH 403
units
Alkalinity to pH 4.5 41 a
mg/L
Time
u•ume. easier. we.%
Remarks
Sample interval
XC Diss, Solids 70300
mg/L
Fluoride 951
rng/L
}C Hardness: Total 900
mgiL
Hardness (non- arb) 902
rn91L
Phenols 32730
ugrl
Specific Cond. 95
pMhaslcm
Sulfate 945
Sulfide 745
mg/L
Oil and Grease
mg/L
(Pumping lime, air temp., ate,)
Ag-Silver 46568
uglL
x
AI -Aluminum 46557
ug/L
As Arsenic 48551
uglL
Ba-Barium 46558
ug1L
x
Ca-Calotum 46552
Cd-Cadmfum 46559
mg/I.
ug(L
x
Cr-Chromium 46559
ug1L
x
Cu•Copper46562
ug1L
Fe -iron 46583
ug/L
Hg•Mercury 71900
ug1L
Organochlorine Pesticides
Organoph05ph0rus Pesticides
Nitrogen Pesticides_
Acid Herbicides
PCBs
Semivolatile Organics
TPH-Diesel Range
x
K-Potassium 46555
mg1L
Alkalinity in pH 8.3 415
mg(L
Carbonate 445
mg/L
Bicarbonate 440
mg/L
Carbon dioxide 405
mg/L
Chloride 940
mg1L
Chromium: Hex 1032
uglL
Color. Tn.te 80
CU
Cyanide 720
mg/L
NH3 as N 610
mg/L
TKN as N 625
mg/L
NO2 +NO3 asN63i
mg/L
P: Total as P 665
Nitrate (NO3as N) 620
mg/L
mg/L
Nitrite (NO2 as N) 615
mg/
x
Mg -Magnesium 46554
mg1L
Mn-Manganese 46565
ug1L
Na-Sodium 46556
mg/L
x.
Ni-Nickel
Pb-Lead 46554
ugll
ug/L
Se -Selenium
uglL
an -zinc 46567
ug1L
Volatile OrganicsjVOA bottle)
TPH-Gasoline Range
TPH-BTEX Gasoline Range
LAB USE ONLY
Temperature on arrival (°C): o -
Lab Comments
GW-54 REV. 4106
For Dissolved Analysls-submit filtered sample and wrtte'DIS' in block.

(M410 Larorato1v.Se lion Results
County: ONSLOW
River Basin
Report To WIROAP
Collector. G KEGLEY
Region: WIRO
Sample Matrix: GROUNDWATER
Loc. Type:
Emergency Yes/No
COC Yes/No
Location ID: WIROAPNLC
Sample 1D: AB79308
a�� ER PO Number # 11°1126
Date Received: 12/13/2011
Time Received: 07:50
Labworks LoginI❑ ❑LEAVITT
Report Generated: 212112
Date Reported; 02r02/2012
V+sitUD
Loc. Descr.: SKI?�NER��
Collect Date: 12/12/2011
Collect Time:
14:20
Sample Depth
CAS # AnaMe Name
LAB
Sample temperature at receipt by lab
PQL
Result/
Qualifier
0.9
MIC
Coliform, MF Fecal in liquid
units
Method Analysis validated by
Reference Date
12/13/11 DLEAV1TT
1 1 B2,Q1 CFU1100rnl APHA9222D-20th 12/13/1' MOVERMAN
Coliform, MF Total in liquid
162,01 CFU1100ml APHA92228-20th 12/13/11 MOVERMAN
WET
Ion Chromatography
TITLE_
mg/L EPA 300.0 12/19/11 MOVERMAN
Chloride
1.0 56 mg/L EPA300.0 12/19/11 MOVERMAN
Fluoride
0.4 0.6 mg/L EPA 300.0 12/19/11 MOVERMAN
Sulfate
2.0 3.7 mg/ EPA 300.0 12/19/11 MOVERMAN
Total Dissolved Solids in liquid
12 546 mg/L APHA2540C-18TH 12/13/11 MOVERMAN
NUT
NO2+NC3 as N in liquid
0.02 0.02 U
mg/L as N Lac10-107-04-1-c 12/13/11 CGREEN
MET
7429-90-5 AI by 1CP
50 50 U ug/L EPA200.7 12/28/11 ESTAFFORD1
7440-70-2 Ca by ICP
0.10 52 mg/L EPA200.7 12/28/11 ESTAFFORD1
7440-47-3 Cr by ICPMS
10 10 U ug/L EPA 200.8 1/13/12 ESTAFFORDI
7440-50-8 Cu by ICPMS
2_0 2.0 U ug/L EPA200.8 1/13/12 ESTAFFORD1
7439-89-6 Fe by ICP
50 50 U ug/L EPA200.7 12/28/11 ESTAFFORDI
Hardness by Calculation
1.0 190 mg/L SM23408EPA 200.7 12128/11 ESTAFFORD1
7440-09-7 K by ICP
0.10 23 mg/L EPA 200.7 12/28/1' ESTAFFORD1
7439-95-4 Mg by ICP
0.10 15 mg/L EPA 200.7 12/28/1: ESTAFFORD1
7439-96-5 Mn by ICP
10 10 U
ug/L
EPA 200.7 12/28/1' ESTAFFORD1
7440-23-5 Na by ICP
0.10 140 mg/L EPA 200.7 12/28/1' ESTAFFORD1
7440-02-0 Ni by ICPMS
2.0 2.0 U ug/L EPA 200.8 1/13/12 ESTAFFORD1
7439-92-1 Pb by ICPMS
2.0 2.0 U ug/L EPA 200.8 1(13/12 ESTAFFORDI
7440-66-6 Zn by ICP
10 10 ug/L EPA 200.7 1/18/12 ESTAFFORD1
FEB 0 3 201z
Laboratory Section» 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone]
Fors detaiFed deScrfpf on of Y tetwallfier code6 rotor to Iotraloortal.nr.tfeornrpjtvttts4nvilait ara ifin folferhaxstData puaIiter CndessfntplilD03d1.fir,4+gnr,nrd/ti h�i iliabitialifiai hetF75sista
Page 1 of 1

GROUNDWATER FIELD/LAB FORM
North Carolina
Department of Environment and Natural Resources
❑fNISION OF WATER QUALITY -GROUNDWATER SECTION
Location code
1-4 0
County
Quad No Serial No.
Lat. Long.
Report To: ARO, FRO, MRO, RRO, WaRO, +� -
WSRO, Kinston FO, Fed. Trust, Central Off., Other:
Shippedb B �H dDel., Other:
SAMPLE TYPE
tg Water
0 Soil
❑ Other
❑ Chain of Custody
SAMPLE PRIORITY
Routine
❑ Emergency
Lab Number
/CIS
Date Recei v i_ 5.11- Tim 1 5 U
Reed ByDel., � From:Bus, r our'- , Hand
Other:
Data Entry By:
Date Reported:
Ck:
Y: us, an Purpose:
Collector(s): C>,. YE 6rLE`% Date J11121V Time it{: 2. Baseline, Complaint, Compliance, LUST, Pesticide Study, Federal Trust, Other: L.i_l Zs. -
FIELD ANALYSES Owner iC(7� L.t�ir°ie°"Bl
pH 400 Spec, Cond.94 at 25°C Location or Site IA/ f Dt6O ASS
Temp.ia °C Odor Description of sampling point "Wyk- . Lr- 50,/A
t
Appearance Sampling Method Sample Interval
Field Analysis By: Remarks ""m°' weer. e"'
LABORATORY ANALYSES
Boo 310
mg/L
COD High 340
mgfL
COD Low 335
mg/L
Colttorm: MF Fecal 31618
/100m1
Conform: MF Total 31504
1100m I
TOC 689
mg/L
Turbidity 76
NTt7
Residue, Total Suspended 530
mg/L
pH 403
units
Alkalinity to pH 4.5 410
mg/
Alkalinity to pH 8.3 415
mg(.
Carbonate 445
mg/L
Bicarbonate 440
mglL
Carbon dioxide 405
mglL
x
Chloride 940
mglL
Chromium: Hex 1032
ug/L
Color: True 80
CU
Cyanide 720
rng/L
Lab Comments
x
Diss. Solids 70300 mgii.
Fluoride 951 mglL
Hardness- Total 900 mglL
Hardness (non-carb) 902 mg/L.
Phenols 32730 ugi7
Specific Cond. 05 jMhoslcm
Sulfate 945 mg/L
Sulfide 745 mg/L
Oil and Grease rng?L
(Pumping [Imo, al temp-. elc.)
Ag-Silver 46566
ug/L
X AI -Aluminum 46557
As -Arsenic 46551
Ba-Barium 45658
j( Ca -Callum 46552
ug1L
uolL
ug/L
Mg/L.
Cd-Cadmlum 46569
uglL
jC Cr-Chromium 46559
ug/L
7( Cu-Copper 46562 ug/L
X Fe -Iron 46583
Hg-Mercury 71900
j[ K-Potassium 46555
ug/L
ug/L
mg/L
NH3 as N 610 mg/L
TKN as N 625 mglL
NO7 + NO3 as N 630 mgfL
P: Total as P 665 mg/L
Nitrate (NO3as N) 620 mglt.
Nitrite (NO2 as N) 615 mgfL
X Mg -Magnesium 46554
Mn-Manganese 46565
mg/L
ug/L
X Na-Sodium 46556 mg/L
j( NI-NIcket u41L
X Pb-Lead 46564
ug/L
Organochiorine Pesticides
Organophesphonis Pesticides
Nitrogen Pesticides
Acid Herbicides
PCes
Semivolatite Organics
TPH-Diesel Range
Volatile Organics iLVOA bottle)
TPH-Gasoline Range
TPH-BTEX Gasoline Range
Se -Selenium u9&_
%Ci Zn•Zinc46567 ug/L
LA5 USE ONLY
Temperature on arrival (°C): (
GW-54 REV. 4106 For Dissolved Analysis-submlt filtered sample and write "DIS' }n block.

Permit Number WI0800258
Central Files- APS SWP
10/31/11
Permit Tracking Slip
Program Category
Ground Water
Permit Type
Injection Heating/Cooling Water Return Well (5A7)
Primary Reviewer
michael.rcgers
Coastal SW Ruie
Permitted Flow
EFacilit•.
Status
Active
Project Type
New Project
Version Permit Classification
1.00 Individual
Permit Contact Affiliation
Facility Name
Bradley and Donna Kuegel SFR
Location Address
402 Nelson Dr
Jacksonville
Owner
NC 28540
Owner Name
Bradley
Dates/Events
Orig Issue
10/26/11
J Kuegel
App Received Draft Initiated
09/21/11
Regulated Activities
Heat Pump Injection
Outfall NULL
Scheduled
Issuance
Major/Minor
Minor
Region
Wilmington
County
Onslow
Facility Contact Affiliation
Owner Type
Individual
Owner Affiliation
Bradley J. Kuegel
Owner
402 Nelson Dr
Jacksonvilrie
NC 28540
Public Notice Issue Effective
10/26/11 10/26/11
Reauested/Received Events
RO staff report requested
RO staff report received
Expiration
09/30/16
09/2211 1
10/19/11
Waterbody Name Stream Index Number Current Class Subbasin

.407A
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen ti. Sullins Dee Freeman
Governor Director Secretary
October 26, 2011
Bradley and Donna Kuegel
402 Nelson Dr.
Jacksonville, NC 28540
Re: Issuance of Injection Well Permit
Permit No. WI0800258
Issued to Bradley and Donna Kuegel
Onslow County
Dear Mr. and Mrs. Kuegel:
In accordance with your application received September 21, 2011, I am forwarding Permit No.
WI0800259 for the operation of a 5A7 geothermal underground injection control (UIC) well heat pump
system located at the above referenced address. This permit shall be effective from the date of issuance
until September 30, 2016, and shall be subject to the conditions and limitations stated therein.
According to 15A NCAC 2C .0213(g) and Permit Condition Part 1.7, each geothermal injection well
shall have permanently affixed an identification plate. Please have a well plate affixed to the
geothermal well by a North Carolina Certified Well Driller within 30 days. Also, Geoff Kegley with
the Wilmington Regional. Office (910-796-7215) will be in contact with you to make arrangements to
collect water samples from your geothermal well.
In order to continue uninterrupted legal use of this well for the stated purpose, you should submit an
application to renew the permit 120 days prior to its expiration date. As indicated in the permit, this
permit is not transferable to any person without prior notice to, and approval by, the Director of the
Division of Water Quality. If you have any questions regarding your permit or the Underground injection
Control Program please call me at [phone],
Best Regards,
2
Michael Rogers, P.G. (NC & FL)
Environmental Specialist
cc: Art Barnhardt, Wilmington Regional Office
Central Office File, W10800259
Onslow County Environmental Health Dept.
AQUIFER PROTECTION SECTION '
1636 Mali Service Center. Raleigh, North Carolina 27699-1636
Location:2728 Capital Boulevard. Raieioh. North Carolina 27604
Phone.. 91g-733-3221 1 FAX [phone]; FAX 2:919-715-6046 I Customer Service. "-877-623-6748
i ntemer. www. ncwaiera ua1itvmin
Ong
NorthCaroiina
Entie c x[Jar F hfF; ;ranee i•mrIcvE

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE CONSTRUCTION AND OPERATION OF A WELL FOR INJECTION
In accordance with the provisions of Article 7, Chapter 87; Article 21, Chapter 143. and other applicable
Laws. Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Bradley and Donna Kuegel
FOR THE OPERATION OF A TYPE 5A7 INJECTION WELL, defined in Title 15A North Carolina
Administrative Code 2C .0209(e)(3)(A), which will be used for the injection of heat pump effluent. This
injection well is located at 402 Nelson Dr., Jacksonville, Onslow County, NC 28540, and will be constructed
and operated in accordance with the application received September 21, 2011, 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 peanit is fox operation of an injection well shall be in compliance with Title 15A North Carolina
Administrative Code 2C .0100 and .0200, and any other Laws, Rules, and Revelations pertaining to well
construction and use,
This permit shall be effective, unless revoked, from the date of its issuance until September 30, 2016, and shall
be subject to the specified conditions and limitations set forth in Parts I through VIII hereof.
Permit issued this theday of
CrColeen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission.
Permit #W[DS00258
[JIC/5A7
ver. 03/2010
, 2011.
Page 1 of 5

PART I -WELL CONSTRUCTION GENERAL CONDITIONS
1. The Permittee must comply with all conditions of this permit and with the standards and criteria specified
in Criteria and Standards Applicable to Injection Wells (15A NCAC 2C .0200). Any noncompliance with
conditions of this permit constitutes a violation of the North Carolina Well Construction Act and is
grounds for enforcement action as provided for in N.C.G.S. 87-94.
2. This permit shall become voidable unless the facility is constructed in accordance with the conditions of
this permit, the approved plans and specifications, and other supporting data.
3. Each injection well shall not hydraulically connect separate aquifers.
4. Each injection well shall be constructed in such a manner that water from land surface cannot migrate into
the gravel pack or well screen.
5. Each injection well shall be secured to reasonably insure against unauthorized access and use. Each well
shall be permanently labeled with a warning that it is for injection purposes and the entrance to each well
must be sealed with a water-tight cap or well sealed, as defined in G.S. 87-85(16).
6. Each injection well shall be afforded reasonable protection against damage during construction and use.
7. Each geothermal injection well shall have permanently affixed an identification plate according to 2C
.0213(g).
PART II -OPERATION AND USE GENERAL CONDITIONS
1. This permit is effective only with respect to the nature, volume of materials and rate of injection, as
described in the application and other supporting data.
2. Within 30 days of the well(s) becoming operational, Permittee must contact the Aquifer Protection
Section at the Wilmington Regional Office (910-796-7215) in order for staff to collect samples from the
influent and effluent sampling ports.
3. This permit is not transferable without prior notice to, and approval by, the Director of the Division of
Water Quality (Director). In the event there is a desire for the facility to change ownership, or there is a
name change of the Permittee, a formal permit amendment request must be submitted to the Director,
including any supporting materials as may be appropriate, at least 30 days prior to the date of the change.
4. 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.
5 . Continued operation of the injection system will be contingent upon the effluent not impacting
groundwater quality. The water quality of the effluent cannot be that of a lower quality than the influent,
which results in a degrading of water quality of the aquifer.
Permit #Wi0800258 UIC/5A7 Page 2 of 5
ver. 03/2010
PART III -PERFORMANCE STANDARDS
1. The injection facility shall be effectively maintained and operated at all times so that there is no
contamination of groundwater that will render it unsatisfactory for normal use. In the event that the
facility fails to perform satisfactorily, including the creation of nuisance conditions or failure of the
injection zone to adequately assimilate the injected fluid, the Permittee shall take immediate corrective
actions including those actions that may be required by the Division of Water Quality such as the repair,
modification, or abandonment of the injection facility.
2. The Permittee shall be required to comply with the terms and conditions of this permit even if compliance
requires a reduction or elimination of the permitted activity.
3. The issuance of this permit shall not relieve the Permittee of the responsibility for damages to surface or
groundwater resulting from the operation of this facility.
PART IV -OPERATIONS AND MAINTENANCE REQUIREMENTS
1. The injection facility shall be properly maintained and operated at all times.
2. The Permittee must notify the Division and receive prior written approval from the Director of any
planned physical alterations or additions in the permitted facility or activity not specifically authorized by
the permit.
PART V -INSPECTIONS
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 VI -MONITORING AND REPORTING REQUIREMENTS
1. Any monitoring (including groundwater, surface water, or soil sampling) deemed necessary by the
Division of Water Quality to insure surface and ground water protection, will be established and an
acceptable sampling reporting schedule shall be followed.
Permit #WI0800258 UIC/SA7 Page 3 of 5
ver. 03/2010
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 910-796-7215, any of the following:
(A) Any occurrence at the injection facility that results in any unusual operating circumstances;
(B) Any failure due to known or unknown reasons that renders the facility incapable of proper
injection operations, such as mechanical or electrical failures;
3. Where the Permittee becomes aware of an omission of any relevant facts in a permit application, or of any
incorrect information submitted in said application or in any report to the Director, the relevant and
correct facts or information shall be promptly submitted to the Director by the Permittee.
4. In the event that the permitted facility fails to perform satisfactorily, the Permittee shall take such
immediate action as may be required by the Director.
PART VII -PERMIT RENEW AL
In order to continue uninterrupted legal use of the injection facility for the stated purpose, the Permittee shall
submit an application to renew the permit 120 days prior to its expiration date.
PART VIII -CHANGE OF WELL STATUS
1. The Permittee shall provide written notification within 15 days of any change of status of an injection
well. Such a change would include the discontinued use of a well for injection. If a well is taken
completely out of service temporarily, the Permittee must install a sanitary seal. If a well is not to be used
for any purpose thatwell must be permanently abandoned according to ISA 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.
(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.
Permit #WI0800258 UIC/SA7 Page 4 of 5
ver. 03/2010
(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 VIII (1) and (2) (G) shall be submitted to:
Permit #WI0800258
Aquifer Protection Section-DIC Program
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
UIC/SA7
ver. 03/2010
Page 5 of 5
Permit Number W10800258
Program Category
Ground Water
Permit Type
Central Files: APS_ SWP_
10/24/11
Permit Tracking Slip
Status
In review
Version
Project Type
New Project
Injection Heating/Cooling Water Return Well (5A7)
Permit Classification
Individual
Primary Reviewer
michael.rogers
Coastal SW Rule
Permitted Flow
Facilitv
Facility Name
Bradley and Donna Kuegel SFR
Location Address
402 Nelson Dr
Jacksonville
Owner
Owner Name
Bradley
Dates/Events
NC
J
Orig Issue App Received
09/21/11
Repulated Activities
Heat Pump Injection
Outfall NULL
Waterbody Name
28540
Kuegel
Draft Initiated
Scheduled
Issuance
Permit Contact Affiliation
Major/Minor
Minor
Region
Wilmington
County
Onslow
Facility Contact Affiliation
Owner Type
Individual
Owner Affiliation
Bradley J. Kuegel
Owner
402 Nelson Dr
Jacksonville NC
Public Notice Issue Effective
\\) 124? \Zo\,,
Reouested/Received Events
RO staff report requested
RO staff report received
Stream Index Number Current Class
28540
Expiration
lt\~\~lD
09/22/11
10/19/11
Subbasin
Rogers, Michael
From: Kegley, Geoff
Sent: Wednesday, October 19, 2011 1:22 PM
To: Rogers, Michael
Cc: Barnhardt, Art
Subject: RE: Wt0800259 Skinner 5A7 permit application and also Kuegel
Attachments: Skinner Staff Report October 2011.doc; W10800259,pdf: Kuegel Staff Report October
2011 Am; W10800258.pdf; map to Nelson Drive UIC wells,jpg: Well locations - Nelson Dr.
U1Cs.jpg
Michael,
Attached are the staff reports, inspection reports & site maps for these UIC wells. I've placed hard copies in Art's inbox
for signature (he will be here tomorrow). Let me know if you have any questions.
-Geoff
Geoff Kegley
Hydrogeologist
North Carolina Department of Environment & Natural Resources
Division of Water Quality, Aquifer Protection Section
Wilmington Regional Office
htto://www. ncwaterquality.orp/
127 Cardinal Drive Extension
Millington, NC 28405
Phone: [phone]; lax; 010) 350-2OD4
[e-mail]
Email correspondence to and from this address is subject to
the North Carolina Public Records law and may be disclosed
to third parties unless the content Is exempt by statute or
other regulation.
From: Rogers, Michael
Sent: Tuesday, October 18, 2011 5:11 PM
To: Kegley, Geoff
Subject: FW: WI0800259 Skinner 5A7 permit application and also Kuegel
The below is also fine for -the Kuegel application also.
Michael Rogers, P.G. (NC & FL)
Environmental Specialist
NC Div of Water Quality- Aquifer Protection Section (APS)
1636 Mail Service Center
Raleigh, NC 27699-1636
Direct Line [phone]; Fax [phone] (put to my attn on cover letter)
http:J/portal. ncdenr.org/weblwglaps/awprolpermit-applications#cieotherrnApps
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parries
From: Rogers, Michael
Sent: Tuesday, October 18, 2011 10:50 AM
To: Kegley, Geoff
Subject: RE: WI0800259 Skinner 5A7 permit application

Yes that's fine. In your staff report, you can request that the permit condition will be that sampling ports will be installed
and The Permittee is to contact you when they are installed for you to come and sample. We usually give them 30 days
to install the sampling ports and notify you to sample.
Michael Rogers , P.G. (NC & FL)
Environmental Specialist
NC Div of Water Quality-Aquifer Protection Section (APS)
1636 Mail Service Center
Raleigh , NC 27699-1636
Direct Line [phone]; Fax [phone] (put to my attn on cover letter)
http ://po rtal.ncdenr.org/web/wq /aps/gworo/permit-aoplications#geothermApps
E-mail correspondence to and from this address may be subject to the No11h Carolina Public Records Law and may be disclosed to third parties
From: Kegley, Geoff
Sent: Tuesday, October 18, 2011 10:22 AM
To: Rogers, Michael
Cc: Barnhardt, Art
Subject: RE: WI0800259 Skinner SA7 permit application
Michael,
I am headed there today, I should be able to get the staff report to you this afternoon or tomorrow via email. In
speaking with Mr. Skinner, I am doubtful that the appropriate sampling taps are available for sampling, however since
the system is not working correctly, I'd like to get them their permit asap before cold weather sets in. Apparently, the
contractor will not install the replacement system until the permit is issued. Perhaps we can issued the permit and I can
sample later.
-Geoff
-------------------------------------------------------------
Geoff Kegley
Hydrogeologist
North Carolina Department of Environment & Natural Resources
Division of Water Quality, Aquifer Protection Section
Wilmington Regional Office
http://www.ncwaterquality.org/
127 Cardinal Drive Extension
Wilmington, NC 28405
Phone: [phone]; Fax: [phone]
[e-mail]
Email correspondence to and from this address is subject to
the North Carolina Public Records Law and may be disclosed
to third parties unless the content is exempt by statute or
other regulation.
From: Bushardt, Jim
Sent: Tuesday, October 18, 2011 9:57 AM
To: Kegley, Geoff
Subject: FW: WI0800259 Skinner SA7 permit application
From: Rogers, Michael
Sent: Monday, October 17, 2011 4:49 PM
To: Barnhardt, Art
2
Cc: Bushardt, Jim
Subject: WI0800259 Skinner SA7 permit application
Art-
I received a voicemail from Joe Skinner asking about the status of his SA7 permit. I need to call him back tomorrow and
give him some kind of status report. How long do you think it will take to get the staff report over to me? After I receive
the SR, the normal turnaround is 5 to 7 days. If you would like to call him, his phone number is 910-347-4786.
Thanks
Michael Rogers, P.G. (NC & FL)
Environmental Specialist
NC Div of Water Quality-Aquifer Protection Section (APS)
1636 Mail Service Center
Raleigh, NC 27699-1636
Direct Line [phone]; Fax [phone] (put to my attn on cover letter)
http://portal.ncdenr.org/web/wq/aps/gwpro/permit-applications#geothermApps .~ ,
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties
3
·AQUIFER PROTECTION SECTION -GROUNDWATER PROTECTION UNIT
REGIONAL STAFF REPORT
Date: October 19. 2011
To: APS Central Office
Central Office Reviewer: Michael Rogers
Regional Login No: Geoff Keglev
Permittee(s): Brad & Donna Kuegel
Permit No.: WI0800258
County: Onslow
Project Name: Kue gel 5A7
L GENERAL INFORMATION
1. This application is (check all that apply): D SFR Waste Irrigation System X UIC Well(s)
X New D Renewal
D Minor Modification D Major Modification
D Surface Irrigation D Reuse D Recycle D High Rate Infiltration D Evaporation/Infiltration Lagoon
D Land Application of Residuals
D Distribution of Residuals
D Attachment B included
D Surface Disposal
D 503 regulated D 503 exempt
D Closed-loop Groundwater Remediation D Other Injection Wells (including in situ remediation)
Was a site visit conducted in order to prepare this report? IX! Yes or D No.
a. Date of site visit: October 18, 2011
b. Person contacted and contact information: Mr. Kuegel [phone]
c. Site visit conducted by: Geoff Kegley
d. Inspection Report Attached: IX! Yes or D No.
2. Is the following information entered into the BIMS record for this application correct?
D Yes or IX! No. If no, please complete the following or indicate that it is correct on the current application.
For SFR Treatment Facilities:
a. Location:
b. Driving Directions: __
c. USGS Quadrangle Map name and number: __
d. Latitude: Longitude: __ Method Used (GPS; Google™, etc.); __
e. Regulated Activities/ Type of Wastes (e.g., subdivision, food processing, municipal wastewater): __
For UIC Injection 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): 402 Nelson Ave .. Jacksonville. NC 28540
b. Driving Directions: From Wilmington take Hwy 17 North to Jacksonville, stay on US-17 Business/N.
Marine Blvd. into Jacksonville, tum right onto Onslow Dr., tum left onto Nelson Dr.
c . USGS Quadrangle Map name and number: __
d. Latitude: 34 45 31.35 Longitude: 77 24 42.69 Method Used (GPS, Google™, etc.); Goo2le Earth
APS-GPU Regional Staff Report (Sept 09) Page I of 6 Pages
AQUIFER PROTECTION SECTION -GROUNDWATER PROTECTION UNIT
REGIONAL STAFF REPORT
IL NEW AND MAJOR MODIFICATION APPLICATIONS (this section not needed fo r renewals or minor
modifi cations1 skip to next section )
Description of Waste System and Facilities
1. Please attach completed rating sheet. Facility Classification: __
2. Are the new treatment facilities adequate for the type of waste and disposal system?
D Yes D No D N/A. Ifno, please explain: __
3. Are the new site conditions (soils, topography, depth to water table, etc) consistent with what was reported by
the soil scientist and/or Professional Engineer? D Yes D No D N/ A. If no, please explain: __
4. Does the application (maps, plans, etc.) represent the actual site (property lines, wells, surface drainage)? D
Yes D No D N/ A. If no, please explain:. __
5. Is the proposed residuals management plan adequate and/or acceptable to the Division. 0Yes 0No D
NI A. If no, please explain: __
6. Are the proposed application rates for new sites (hydraulic or nutrient) acceptable?
D Yes D No D N/ A. If no, please explain: __
7. Are the new treatment facilities or any new disposal sites located in a 100-year floodplain?
D Yes D No D N/ A. If yes, please att~ch a map showing areas of 100-year floodplain and please explain
and recommend any mitigative measures/special conditions in Part IV: __
8. Are there any buffer conflicts (new treatment facilities or new disposal sites)? D Yes or D No. If yes, please
attach a map showing conflict areas or attach any new maps you have received from the applicant to be
incorporated into the permit: __
9 . Is proposed and/or existing groundwater monitoring program (number of wells, frequency of monitoring,
monitoring parameters, etc.) adequate? D Yes D No D N/A. Attach map of existing monitoring well
network if applicable. Indicate the review and compliance boundaries. If No, explain and recommend any
changes to the groundwater monitoring program: __
10. For residuals, will seasonal or other restrictions be required? D Yes D No D N/ A If yes, attach list of sites
with restrictions (Certification B?)
IIL RENEWAL AND MODIFICATION APPLICATIONS (use previous section fo r new or maior modification
systems)
Description of Waste System and Facilities
1. Are there appropriately certified ORCs for the facilities? D Yes or D No.
Operator in Charge: __ Certificate #: __
Backup-Operator in Charge: __ Certificate #: __
APS-GPU Regional Staff Report (Sept 09) Page 2 of6 Pages
~ AQUIFER PROTECTION SECTION -GROUNDWATER PROTECTION UNIT
REGIONAL STAFF REPORT
2. Is the design, maintenance and operation ( e.g. adequate aeration, sludge wasting, sludge storage, effluent
storage, etc) of the treatment facilities adequate for the type of waste and disposal system? D Yes or D No.
If no, please explain: __
3. Are the site conditions (soils, topography, depth to water table, etc) maintained appropriately and adequately
assimilating the waste? D Yes or D No. If no, please explain: __
4. Has the site changed in any way that may affect permit (drainage added, new wells inside the compliance
boundary, new development, etc.)? If yes, please explain: __
5. Is the residuals management plan for the facility adequate and/or acceptable to the Division?
D Yes or D No. Ifno, please explain: __
6. Are the existing application rates (hydraulic or nutrient) still acceptable? D Yes or D No. If no, please
explain: __
7. Is the existing groundwater monitoring program (number of wells, frequency of monitoring, monitoring
parameters, etc.) adequate? D Yes D No D N/ A. Attach map of existing monitoring well network if
applicable. Indicate the review and compliance boundaries. If No, explain and recommend any changes to the
groundwater monitoring program: __
8. Will seasonal or other restrictions be required for added sites? D Yes D No D N/ A If yes, attach list of sites
with restrictions (Certification B?)
9. Are there any buffer conflicts (treatment facilities or disposal sites)? D Yes or D No. If yes, please attach a
map showing conflict areas or attach any new maps you have received from the applicant to be incorporated
into the permit: __
10. Is the description of the facilities, type and/or volume of waste(s) as written in the existing permit correct? D
Yes or D No. If no, please explain: ____ _
11. Were monitoring wells properly constructed and located? D Yes or D No D N/A. If no, please explain:
12. Has a review of all self-monitoring data been conducted (GW, NDMR, and NDAR as applicable)? D Yes or
D No D N/A. Please summarize any findings resulting from this review: __ _
13. Check all that apply: D No compliance issues; D Notice(s) of violation within the last permit cycle; D
Current enforcement action(s) D Currently under SOC; D Currently under JOC; D Currently under
moratorium. If any items checked, please explain and attach any documents that may help clarify
answer/comments (such as NOV, NOD etc): ____ _
14. Have all compliance dates/conditions in the existing permit, (SOC, JOC, etc.) been complied with? D Yes
D No D Not Determined D N/A.. If no, please explain: __
15. Are there any issues related to compliance/enforcement that should be resolved before issuing this permit? D
Yes or D No D N/ A. If yes, please explain: __
APS-GPU Regional Staff Report (Sept 09) Page 3 of6 Pages
AQillFER PROTECTION SECTION -GROUNDWATER PROTECTION UNIT
REGIONAL STAFF REPORT
IV. INJECTION WELL PERMIT APPLICATIONS (Complete these two sections for all systems that use injection
wells, including closed-loop groundwater remediation effluent injection wells, in situ remediation injection wells, and heat
pump injection wells.)
Description of Well(s) and Facilities -New, Renewal, and Modification
1. Type of injection system:
[gl Heating/cooling water return flow (5A7)
D Closed-loop heat pump system (5QM/5QW)
D In situ remediation (51)
D Closed-loop groundwater remediation effluent injection (5L/''Non-Discharge")
D Other (Specify: )
2. Does system use same well for water source and injection? D Yes [gl No
3. Are there any potential pollution sources that may affect injection? D Yes [gl No
What is/are the pollution source( s )? ___ ._Wh __ a_t _is_t_h_e_d_is_tan_c_e_o_f_th_e_in_i_ec_t_io_n_w_el_l(~s~) _fr_o_m_t_h_e ___ p_o_ll_u_ti_o_n
source(s)? ft.
4. What is the minimum distance of proposed injection wells from the property boundary? 25+ ft.
5. Quality of drainage at site: D Good [gl Adequate D Poor
6. Flooding potential of site: [gl Low D Moderate D High
7. For groundwater remediation systems, is the proposed and/or existing groundwater monitoring program
(number of wells, frequency of monitoring, monitoring parameters, etc.) adequate? D Yes D No. Attach
map of existing monitoring well network if applicable. If No, explain and recommend any changes to the
groundwater monitoring program: __
8. Does the map presented represent the actual site (property lines, wells, surface drainage)? [gl Yes or D No. If
no or no map, please attach a sketch of the site. Show property boundaries, buildings, wells, potential pollution
sources, roads, approximate scale, and north arrow.
Injection Well Permit Renewal and Modification Only:
1. For heat pump systems, are there any abnormalities in heat pump or injection well operation (e.g. turbid water,
failure to assimilate injected fluid, poor heating/cooling)?
D Yes !ZI No. If ves . explain:
2. For closed-loop heat pump systems, has system lost pressure or requi,red make-up fluid since permit issuance
or last inspection? D Yes D No. If yes . explain:
3. For renewal or modification of groundwater remediation permits (of any type). will
continued/additional/modified in jections have an adverse impact on mie:ration of the plume or management of
the contamination incident? D Yes D No. If ves . explain:
APS-GPU Regional Staff Report (Sept 09) Page 4 of 6 Pages
AQUIFER PROTECTION SECTION -GROUNDWATER PROTECTION UNIT
REGIONAL STAFF REPORT
4. Drilling Contractor: Name: Donald Sweeting, A & D Drilling
Address: out of business
NC Certification number: Deceased
5. Complete and attach NEW Injection Facility Inspection Report, if applicable
V. EVALUATION AND RECOMMENDATIONS
1. Provide any additional narrative regarding your review of the Application:
This review was conducted for a permit application for an UIC permit 5A 7 for the Kue gel
residence. This injection well system has been installed since ~1985, but was never permitted.
The heat pump system was recently replaced and the building inspector informed the owner that a
permit was needed for the UIC wells. On October 18, 2011, staff visited the home to inspect the
well system. No setback buffer issues were observed. A sampling tap is installed, however no
samples were taken during this inspection. Staff will return to the residence to take samples in
the near future. No well tag was installed and the well driller is now deceased. The owner stated
that the 4" supply well was approximately 200' deep. The depth of the 2" return well is
un.lmown. The well head for the return well was completed below ground. An inspection report
and a map of the site with well locations are attached.
2. Attach new Injection Facility Inspection Form, if applicable
3. Do you foresee any problems with issuance/renewal of this permit? D Yes r2J No. If yes, please explain
briefly. __ .
4. List any items that you would like APS Central Office to obtain through an additional information request.
Make sure that you provide a reason for each item:
Item Reason
5. List specific Permit conditions that you recommend to be removed from the permit when issued. Make sure
that you provide a reason for each condition:
Condition Reason
APS-GPU Regional Staff Report (Sept 09) Page 5 of 6 Pages
AQUIFER PROTECTION SECTION -GROUNDWATER PROTECTION UNIT
REGIONAL STAFF REPORT
6. List specific special conditions or compliance schedules that you recommend to be included in the permit when
issued. Make sure that you provide a reason for each special condition:
Condition Reason
7 . Recommendation: 0 Hold, pending receipt and review of additional information by regional office; 0 Hold,
pending review of draft permit by regional office; D Issue upon receipt of needed additional information; IZJ
Issue; D Deny. If deny, please state reasons: __
8. Signature of report Preparer(s): ______________________ _
Signature of APS regional supervisor: ____________________ _
Date: ______ _
VI. ADDITIONAL INFORMATION AND SITE MAP (Sketch o f site showing house and waste irrigation
s 1>stem, s pra y or dri p field. location o f well(s). and/or other relevant information-SHOW NORTH ARROW)
APS-GPU Regional Staff Report (Sept 09) Page 6 of 6 Pages
AQUIFER PROTECTION SECTION -GROUNDWATER PROTECTION UNIT
REGIONAL STAFF REPORT
Date: October 19, 2011
To: APS Central Office
Central Office Reviewer: Michael Ro gers
Regional Login No: Geoff Ke gley
Permittee(s): Brad & Donna Kue gel
Permit No.: WI0800258
County: Onslow
Project Name: Kue gel 5A7
L GENERAL INFORMATION
1. This application is (check all that apply): D SFR Waste Irrigation System X UIC Well(s)
X New D Renewal
D Minor Modification D Major Modification
D Surface Irrigation D Reuse D Recycle D High Rate Infiltration D Evaporation/Infiltration Lagoon
D Land Application of Residuals
D Distribution of Residuals
0 Attachment B included
D Surface Disposal
D 503 regulated O 503 exempt
D Closed-loop Groundwater Remediation D Other Injection Wells (including in situ remediation)
Was a site visit conducted in order to prepare this report? ~ Yes or D No.
a. Date of site visit: October 18 , 2011
b. Person contacted and contact information: Mr. Kuegel [phone]
c. Site visit conducted by: Geoff Kegley
d. Inspection Report Attached: ~ Yes or D No.
2. Is the following information entered into the BIMS record for this application correct?
D Yes or ~ No. If no, please complete the following or indicate that it is correct on the current application.
For SFR Treatment Facilities:
a. Location:
b. Driving Directions: __
c. USGS Quadrangle Map name and number:
d. Latitude: Longitude: __ Method Used (GPS, Google™, etc.); __
e. Regulated Activities/ Type of Wastes (e.g., subdivision, food processing, municipal wastewater): __
For UIC Injection Sites:
(If multi ple sites either indicate which sites the information a pp lies to . co py and paste a new section into the
document for each site . or attach additional pa ges for each site )
a. Location(s): 402 Nelson Ave., Jacksonville , NC 28540
b. Driving Directions: From Wilmington take Hwy 17 North to Jacksonville, stay on US-17 Business/N.
Marine Blvd. into Jacksonville, turn right onto Onslow Dr., tum left onto Nelson Dr.
c. USGS Quadrangle Map name and number: __
d. Latitude: 34 45 31.35 Longitude: 77 24 42.69 Method Used (GPS, Google™, etc.); Goo gle Earth
RECEIVED/ OENR / owa
AQU\J:FR·PROiECilON SECTION
OCT-24 2011
APS-GPU Regional Staff Report (Sept 09) Page I of 6 Pages
AQUIFER PROTECTION SECTION -GROUNDWATER PROTECTION UNIT
REGIONAL STAFF REPORT
IV. INJECTION WELL PERMIT APPLICATIONS (Complete these two sections for all systems that use injection
wells, including closed-loop groundwater remediation effluent injection wells, in situ remediation injection wells, and heat
pump injection wells.)
Description of Well(s) and Facilities -New, Renewal, and Modification
I. Type of injection system:
C8J Heating/cooling water return flow (SA 7)
D Closed-loop heat pump system (5QM/5QW)
D In situ remediation (51)
D Closed-loop groundwater remediation effluent injection (SL/"Non-Discharge")
D Other (Specify: )
2. Does system use same well for water source and injection? D Yes C8J No
3. Are there any potential pollution sources that may affect injection? D Yes C8J No
What is/are the pollution source( s )? --~Wh~=a~t =is~t=h~e ~d=is~ta=n~c~e~o=f ~th=e~•=· n.,_je~c~ti~o=n~w_e~l~l(~s)~f1~ro~m~t~h~e .... o~o_ll~ut~io~n
source{s}? ft.
4. What is the minimum distance of proposed injection wells {rom the property boundary? 25+ ft.
5. Quality of drainage at site: D Good C8J Adequate D Poor
6. Flooding potential of site: C8J Low D Moderate D High
7. For groundwater remediation systems, is the proposed and/or existing groundwater monitoring program
(number of wells, frequency of monitoring, monitoring parameters, etc.) adequate? D Yes D No. Attach
map of existing monitoring well network if applicable. If No, explain and recommend any changes to the
groundwater monitoring program: __
8. Does the map presented represent the actual site (property lines, wells, surface drainage)? IZ! Yes or D No. If
no or no map, please attach a sketch of the site. Show property boundaries, buildings, wells, potential pollution
sources, roads, approximate scale, and north arrow.
Injection Well Permit Renewal and Modification Only:
1. For heat pump systems, are there any abnormalities in heat pump or injection well operation (e.g. turbid water,
failure to assimilate injected fluid, poor heating/cooling)?
D Yes IZI No. If ves . explain:
2. For closed-loop heat pump systems, has system lost pressure or required make-up fluid since permit issuance
or last inspection? D Yes D No. If yes , explain:
3. For renewal or modification of g roundwater remediation permits (of anv tvp e), will
continued/additional/modified in jections have an adverse im pact on migration of the plume or management of
the contamination incident? D Yes D No. If yes , explain:
APS-GPU Regional Staff Report (Sept 09) Page 4 of 6 Pages
AQUIFER PROTECTION SECTION -GROUNDWATER PROTECTION UNIT
REGIONAL STAFF REPORT
4. Drilling Contractor: Name: Donald Sweeting, A & D Drillin g
Address: out of business
NC Certification number: Deceased
5. Complete and attach NEW Injection Facility Inspection Report, if applicable
V. EVALUATION AND RECOMMENDATIONS
1. Provide any additional narrative regarding your review of the Application:
This review was conducted for a permit application for an UIC permit SA 7 for the Kuegel
residence. This injection well system has been installed since ~ 1985, but was never permitted.
The heat pump system was recently replaced and the building inspector informed the owner that a
permit was needed for the UIC wells. On October 18, 2011, staff visited the home to inspect the
well system. No setback buffer issues were observed. A sampling tap is installed, however no
samples were taken during this inspection. Staff will return to the residence to take samples in
the near future. No well tag was installed and the well driller is now deceased. The owner stated
that the 4" supply well was approximately 200' deep. The depth of the 2" return well is
unknown. The well head for the return well was completed below ground. An inspection report
and a map of the site with well locations are attached.
2. Attach new Injection Facility Inspection Form, if applicable
3. Do you foresee any problems with issuance/renewal of this permit? D Yes [8J No. If yes, please explain
briefly. __ .
4. List any items that you would like APS Central Office to obtain through an additional information request.
Make sure that you provide a reason for each item:
Item Reason
5 . List specific Permit conditions that you recommend to be removed from the permit when issued. Make sure
that you provide a reason for each condition:
Condition Reason
APS-GPU Regional Staff Report (Sept 09) Page 5 of 6 Pages
AQUIFER PROTECTION SECTION -GROUNDWATER PROTECTION UNIT
REGIONAL STAFF REPORT
6. List specific special conditions or compliance schedules that you recommend to be included in the permit when
issued. Make sure that you provide a reason for each special condition:
Condition Reason
7. Recommendation: D Hold, pending receipt and review of additional information by regional office; D Hold,
pending review of draft permit by regional office; D Issue upon receipt of needed additional information; cgj
Issue; D Deny. If deny, please state reasons: __
lo-/1-ZOI I 8. S'.gnatureofreportP~parer(s):. ~~
Signature of APS regmnal supervisor:, ~--------~--U------........ t .... o_-_ru __ -.. Wft ............... __ _
Date: ______ _
VL ADDITIONAL INFORMATION AND SITE MAP (Sketch o f site showing house and waste irrigation
s pstem, s pra r or drip fi eld, location o f well(s ), and/or other relevant in formation-SHOW NORTH ARROW)
APS-GPU Regional Staff Report (Sept 09) Page 6 of 6 Pages
Permit: Wl0800258
SOC:
County: Onslow
Region: Wilmington
Effective:
Effective:
Contact Person: Bradley J Kuegel
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On-Site Representative(s):
Related Permits:
Inspection Date: 10/18/2011
Primary Inspector: Geoff Kegley
Secondary lnspector(s):
Reason for Inspection: Routine
Compliance Inspection Report
Expiration:
Expiration:
Title:
Owner: Bradley J Kuegel
Facility: Bradley J Kuegel SFR
402 Nelson Dr
Jacksonville NC 28540
Phone: [phone]
Certification: Phone:
Entry Time: 02:30 PM Exit Time: 03:30 PM
Phone:
Inspection Type: Compliance Evaluation
Permit Inspection Type: Injection Heating/Cooling Water Return Well (5A7)
Facility Status: ■ Compliant O Not Compliant
Question Areas:
■Wells ■ System Operations
(See attachment summary)
Page: 1
Permit: WI0800258
Inspection Date: 10/18/2011
Owner • Facility: Bradley J Kuegel
Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
This inspection was conducted as part of the review for a permit application for an UIC permit 5A7 for the Kuegel
residence. This injection well system has been installed since ~1985, but was never permitted. The heat pump system
was recently replaced and the building inspector informed the owner that a permit was needed for the UIC wells. On
October 18, 2011, staff visited the home to inspect the well system. No setback buffer issues were observed. A sampling
tap is installed, however no samples were taken during this inspection. Staff will return to the residence to take samples
in the near future. No well tag was installed and the well driller is now deceased. The owner stated that the 4" supply
well was approximately 200' deep. The depth of the 2" return well is unknown. The well head for the return well was
completed below ground.
System Operation
Is same well used as source well and injection well?
Is injection well capable of assimilating injected fluid?
Injection flow rate at time of inspection (gpm)
Has system owner/operator noticed any abnormalities (turbidity, air in system, poor heating/cooling, etc) in
system operation?
Comment on system operation
Is system operation and construction consistent with that described in application?
Describe inconsistencies between application and observed operation/construction
Comment:
Yes No NA NE
□•□□
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A QUIFER PROTECTION SECTION
APPLICATION REVIEW REQ UEST FORM
Date: Se pt ember 22 . 2011
To: D Landon Davidson, ARO-APS
0 Art Barnhardt, FRO-APS
0 Andrew Pitner, MRO-APS
D Jay Zimmerman, RRO-APS
0 David May, WaRO-APS
IZ! Charlie Stehman, WiRO-APS
□ Sherri Knight, W-SRO-APS
From: Michael Ro gers Groundwater Protection Unit
Telephone: [phone] Fax: [phone]
E-Mail: Michael.Rogers (ro,n cmail.net
A. Permit Number: WI 0800 258
B. Owner: Kuegel.
c: Facility/Operation:.-·. __
D Proposed ~ Existing 0 Facility D Operation
D. Application:
1. Permit Type: D Animal D SFR-Surface Irrigation□ Reuse D H-R Infiltration
D Recycle D 1/E Lagoon D GW Remediation (ND)
IZ! UIC -5A 7 Well
For Residuals: D Land App.
0 503
0 D&M
D 503 Exempt
0 Surface Disposal
D Animal
2. Project Type: IZ! New D Major Mod. D Minor Mod. D Renewal D Renewal w/ Mod.
E. Comments/Other Information: 18]
NOTE: Evidently well is installed, and injecting without permit. Please provide site map in staff
report showing actual location of the well in relation to the house. Also, check well tag for construction
information. Thanks.
Attached, you will find all information submitted in support of the above-referenced application for your
review, comment, and/or action. Within, please take the following actions:
~ Return a Completed APSARR Form and attach laboratory analytical results, if applicable .
D Attach Well Construction Data Sheet.
D Attach Attachment B for Certification by the LAPCU.
D Issue an Attachment B Certification from the RO.*
* Remember that you will be responsible for coordinating site visits and reviews, as well as additional
information requests with other RO-APS representatives in order to prepare a complete Attachment B for
certification. Refer to the RPP SOP for additional detail.
When you receive this request form, please write your name and dates in the spaces below, make a copy
of this sheet, and return it to the appropriate Central Office-Aquifer Protection Section contact person
listed above.
RO-APS Reviewer: Date: -------------------------
FORM : APSARR 07/06 Page 1 of 1
NCDENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Bradley J. Kuegel
Donna R. Kuegel
402 Nelson Dr.
Jacksonville, NC 28540
Dear Mr. Kuegel:
Division of Water Quality
Coleen H. Sullins Dee Freeman
Director Secretary
September 21, 2011
Subject Acknowledgement of
Application No. WI4800258
Bradley J Kuegel SFR
Injection Heating/Cooling
Water Return Well (5A7)
System
Onslow County
The Aquifer Protection Section acknowledges receipt of your permit applicationand supporting
documentation received on 09/21/2011. Your application package has been assigned the number listed
above, and the primary reviewer is Michael Rogers.
Central and Wilmington Regional Office staff will perform a detailed review of the provided
application, and may contact you with a request for additional information. To ensure maximum
efficiency in processing permit applications, the Aquifer Protection Section requests your assistance in
providing a timely and complete response to any additional information requests.
Please note that processing standard review permit applications may take a long as 60 to 90 days
after receipt of a complete application. If you have any questions, please contact Michael Rogers or
[e-mail].
.erely,
-A
for Debra Watts
Groundwatel= Protection Unit Supervisor
cc: Wilmington Regional Office, Aquifer Protection Section
Logan Sosa (Comfort Heating & Cooling, 501 Edwards Rd., Jacksonville, NC 28540)
Pe gait File WIOS00255
AQUWER PROTECTION SECTION
1536 Ma I+ Service Cerner, Raleigh, North Carolina 27699.1636
Lcatlion. 2728 Capital Boulevard, Raleigh. North Carolina 27604
Prime! 919-733.3221 \ FAX'- 919-715-958E: FAX 2: 919-715.60481 Customer Service. 1•877-B23-6748
interne. www.ncwaternualir
F,7 CQUc CI3iort3r. • llrfli' it Vr. Ifo;1 [rn FroyeT
One
NorthCarolina
7aturaiij

NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
APPLICATION FOR A PERMIT TO CONSTRUCT OR OPERATE ~JECTION WELLS
In Accdrdance· With" the Provisions of 15A NCAt 02C' .0200 •
OPEN-LOOP GEOTHERMAL INJECTION WELLS
These wells discharge groundwater direcdy into the subsurfac;.e as part of a geothermal heating ap.d qooling system
• ,. • I ,.-•i, .. I j I, -0 )_ , ' ~ •,
(check one) L New Applitation . Renewal* -. ' ;_._·_-_Modification
* For renewals complete Parts A-C and the signature page.
Print or Type Infonnation and Mail to the Address on the Last 'f age. Illegible Applications Will Be Returned As Incomplete.
DATE: ______ _, 20
REC_EIVED I DENR / DWQ
Aquifer Prote1-ion Section PERMIT NO. rf 8 !ffhs'B (leave blank ifNew Application)
SEP f5 2011 A. STATUS OF APPLICANT (choose one)
Non-Government: Individual Residence _X_ " 2,,\ d--_);v' Business/Organization __
Government: State Municipal __ County__ Federal
B. PERMIT APPLICANT -For individual residences, list each owner on property deed. For all others,
state name of entity and name of person delegated authority to sign on behalf of the business or agency:
6:raA}...,I ~ ~ Ku.-i¥f
...bo ,J tJ P. R._ -l<-LA.-~
Mailing Address: 4-o J.. tJ Ll So A'.! h. IL
City: J ~Onl) i l) .e.-State~ Zip Code~~ 5. 4-'0 County: '.l! 1l S LO i..J
Day~eleNo.: C\tD-34-lP--Df5.3'-f CellNo.:ci)5"g -didq • .s.~ I/
EMAILAddressclr k:::u ~e..L @ e.c.-I Yr. lnvl-FaxNo.: -
C. LOCATION OF WELL SITE -Where the injection wells are physically located:
(1) P ~el Identifieation Number (PIN) of well site. County: -=--
(2) Physical Address (if different than mailing address): _______________ _
City: _______________ State: NC Zip Code: ________ _
D. WELL DRILLER INFORMATION
Well Drilling Contractor's Name: .O r2-j L.L£ '2-$'E i'<..V I C...t
NC Well Drilling Contractor Certification No.: ___________________ _
Company Name: ______________________________ _
Contact Person_: ______________ E_MA __ I_L_A~d~dr_e~s~s=~----------
Address: ________________________________ _
City: _________ Zip Code: ____ State: __ County: ________ _
Office Tele No.: Cell No.: "-'Fa=x'-'N'--'-o""".-'-: _______ _
GPU/UIC 5A7 Permit Application (Revised 3/18/2011) Pagel
E.
F.
G.
HEAT PUMP CONTRACTOR INFORMATION (if different than driller)
Company Name: C.o M-to r + J+to..>J..c:.nj ti-C..ool In~
Contact Person: loj ll..n 6 o..sa-EMAIL Address: C,/)mfo r:+ C.o n-l-Y'a...~ +o Y-~ @
Address: .Sol lcc:1.wo....n;J~ ~cl... ~l'Y'IC&.i..l' C-OV\
City: J ~ 0 f\. v ·1 l l-t-Zip Code~S-IJ.,i) State:l\JL County: btv.S La,J
Office Tele No.: q1p •'-l&S .. I 40 ~ Cell No.: 'h 0-:.'t>'1 .. '2? 4 Ui I Fax No.: ~ IO · °?J<+CP ~ q q O 3
WELL USE Will the injection well(s) also be used as the supply well(s) for the following?
(1)
(2)
The injection operation?
Personal consumption?
YES )r ----NO ___ _
YES ----NO _..,,_Y.,___
WELL CONSTRUCTION DATA
PROPOSED Well(s) to be constructed for use as an injection well. Provide the data in (1) through ----
(1)
(2)
(6) below as PROPOSED construction specifications. Submit Form GW-1 after construction.
____ EXISTING Well(s) being proposed for use as an injection well. Provide the data in (1) through (6)
below to the best of your knowledge. Attach a copy of the Well Construction Record (Form
GW-1) if available. ~
Well Construction Date: q-,.... I+-() lp Number ofborings: _/___ ~
Depth of each boring (feet): d D:() -', _ ~ ~ v-{ l ,-Jr, ·r '} t>? • ) ul).
Well casing type: Galvanized steel __ Black steel_•_ Plastic_'_·_ Other (specify) __ , ___ _
Casing thickness (in.): __ Diameter (in.): __ _
Casing depth: from: ___ to: ___ feet b~low
0
land surface'
· • -Casing extends above ground ____ inches ..
(3) Grout materiat surrounding well casing:
(a) Grout type: Cement__ Bentonite* Other (specify) ______ _
"By selecting bentonite grout, a variance is hereby requested to ISA NCAC 2C .0213(d)(l)(A), which requires a cement type grout.
(b) Depth of grout around well casing (relative to land surface): from ___ to ___ feet
(4) Well Screen or Open Borehole depth (relative to land surface): from ____ to ____ feet
(5) N.C. State Regulations (Title 15A NCAC 2C .0200) require the Permittee to make prov1S1ons for
monitoring wellhead processes. A faucet on both Influent (groundwater entering heat pump) and Effluent
(water being injected back into the well) lines is required. Is there a faucet on:
(a) Influent line? Yes No (b) Effluent line? Yes No
(6) Source Well Construction Information. If the water source well is a different well than the injection
well, attach a copy of the well construction record (Form GW-1 ). If Form GW-1 is not available, provide
the following data, ·
From what depth, formation, and type of rock/sediment units will the groundwater be withdrawn? (e.g.
granite, limestone, sand, etc.)
Depth: Formation: Rock/sediment unit: ----------------------
NOTE: THE WELL DRILLING OR HEAT PUMP CONTRACTOR CAN HELP SUPPLY THE DATA IF THIS
INFORMATION IS OTHERWISE UNAVAILABLE.
GPU/UIC 5A'J Permit Application (Revised 3/18/2011) Page 2
H. OPERATING DATA
(1) Injection Rate: Average (daily) gallons per minute (gpm).
(2) Injection Volume: Average (daily) gallons per day (gpd).
(3) Injection Pressure: Average (daily) pounds/square inch (psi).
(4} Injection Temperature: Average (January) ° F, Average (July) __ ° F.
I. WELL LOCATIONS-Maps must be scaled or otherwise accurately indicate distances and orientations of
features located within 1000 feet of the injection well(s). Label all features clearly and include a north arrow.
(1) Attach a site-specific map showing the locations of the following:
* Proposed injection wells * Buildings * Property boundaries
* Surface water bodies * Water supply wells
* Septic tanks and associated spray irrigation sites, drain fields, or repair areas
* Existtng or potential sources of groundwater contamination
. "I. ,. ~. • ~ ~ .,
(2) Attach '-a topographic map of the area extending 1/4 mile from the injection well site that indicates the
facility's location and the map name.
NOTE: In most cases, an ae;lal photograph o/the property parcel showing property lines and structures can be
obtained and downloaded from the applicable county GIS website. Typically, the property can be searched by
owner name or address. The location of the wells in relation to property boundaries, houses, septic tanks, other
wells, etc. can · then be drawn in by hand. Also, a 'layer' can be selected showing topographic contours or
elevation data. · " · · .\ · ' • ·, .
. .
GPU/UIC 5A 7 Permit Application (Revised 3/18/2011) Page 3
J. CERTIFICATION (to be signed as required below or by that person's authorized agent)
15A NCAC 02C .021 1(b) requires that all permit applications shall be signed as follows:
1. for a corporation: by a responsible corporate officer;
2, for a partnership or sole proprietorship: by a general partner or the proprietor, respectively;
3. for a municipality or a state, federal, or other public agency: by either a principal executive
officer or ranking publicly elected official;
4. for all others: by the well owner (which Means all persons listed on the property' deed).
If an authorized agent is signing on behalf of the applicant, then supply a letter signed by the
applicant that names and authorizes their agent to sign this application on their behalf.
"I hereby certify, under penalty of law. that I have personally examined and am familiar with the information
submitted in this document and all attachments thereto and that, based on my inquiry of those individuals
immediately responsible for obtaining said information, I believe that the information is true, accurate and
complete. I am aware that there are significant penalties, including the possibility of fines and imprisonment,
for submitting false information. I agree to construct, operate, maintain, repair, and if applicable, abandon the
injection weli and all related appurtenances in accordance wi the approved specifications and conditions of
the Permit_"
jog
i
Signature of Pro
erty ner/Applicant
r'a ,' eAi3 1'{-[ e -e•4
Print or Type lull Name
Signature of Property Owner/Applicant
Print or Type Full Name
Signature of Authorized Agent, if any
Print or Type Full Name
Submit two copies of the completed application package to:
DWQ - Aquifer Protection Section
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone [phone]
RECEIVED/ pENR / 0WQ
Aquifer Protection Section
SEP 15 2011
GPCU/UIC 5A7 Permit Application (Revised 3/18/2Oi 1] Page 4

Google Maps
Page 1 of 1
RECEIVED; DEN I DWG
AQUIFFR'PRl1TFCTl(1N SECTION
`yr ` maps SEP 21 2011
To see all the details that are visible on the
screen, use the "Print" Zink next to the map.
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Google Maps Page 1 of 1
RECEIVED / DENR / DWQ
AQUIFPR PROTFCTIoN SECTION
maps SEP 21 2011
To see all the details that are visible on the
screen, use the "Print" link next to the map.
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4" and 6" SUBMERSIBLE PUMPS
OWNER'S MANUAL
E1467
3/05
INSPECT THE EQUIPMENT
Examine the pump when it is received to be sure
there has been no damage in shipping. Should any be evident,
report it immediately to the dealer from whom the pump was
purchased. Please check the pump package to see that it includes
pump, motor, and motor leads (if your pump purchase includes
a motor). These units will include either a built-in or external
mounted check valve with the discharge head. Three -wire,
single-phase pumps should include a control box which has
to be purchased separately and matched to the pump motor.
Example: Franklin Control Box for Franklin motors. Make
certain that your available voltage corresponds to that of your
motor,
INSTALLATION RECORD
It is a good idea to keep an accurate record of your
installation. Be sure to record the data below: Ct y
Purchased from fir i 11-e r Jr-�6�+fc- `�
Date of installation it-- /'/ g
Pump ModeI No,* TE L'f le' 9 —5'-
Pump Date Code* ei
Well Inside Dia. (in/mm) 'r7'
.11
Depth of Well (ft/m) a
Depth of Water (ft/m) 30
Pump Setting (ft/in) to 1.
Drop Pipe Size f "
Wire Size (From pump to control box) I - 2-
Wire Size (Control box to power source)
Horizontal Offset (Between well and house) 2 6
*Make of Motor - Amps 0d HPF Volts ?,7cPh /
Make of Control Box - HP .r Volts --
Power Supply - Volts ;,'30 Ph / HZ
Pressure Switch (PSI) Cutin '/6 . Cutout
*This information is on your pump or motor tag. It will help
us identify your pump in case of later inquiries.
RECEIVED 1 DENR / DWQ
Aquifer Protection Section
SEP 15 lan

September 14, 2011
DWQ-Aquifer Protections Section
1636 Mail Service Center
Raleigh, NC 27699-1636
To Whom It May Concern,
Enclosed are the two applications for well construction pern1its. This is the only
information we have concerning the well. Please contact us if you need further
assistance.
Thank You,
/kQJ).
Bradley J. Kuegel
402 Nelson Drive
Jacksonville, NC 28540
910-346-9534
RECEIVED I DEN
Aquifer Protect· RI DWQ ion Section
SEP ~ 2011
.· 2l c\~·