WI0800266_GEO THERMAL_20120523

Beverly Eaves Perdue
Governor
&fA ;;;-;;--;,, ---------NCDEN R ___ _
North Carolina Dep~rrtment of Environment ~_n~_Natural Resources
Division of Water Quality
Charles Wakild, P. E.
Director
May 23, 2012
Deputy Director Public Works
Commanding Officer US Marine Corps -Camp Lejeune
1005 Michael Road
Camp Lejeune, NC 28547
Subject: Notification of Rule Revisions Affecting
Closed-Loop Geothermal Injection Well Permit Holders
Permit Number: WI0800266
To Whom it May Concern:
Dee Freeman
Secretary
Our records indicate that you currently hold a permit for a closed-loop geothermal injection well
system. This letter is to inform you that on May 1, 2012, the North Carolina Administrative
Code Title 15A Section 2C .0200 entitled "Well Construction Standards -Criteria and
Standards Applicable Injection Wells" were revised. These revisions affect all permits issued
for injection wells including geothermal wells.
This letter is also to infom1 you that your closed-loop geothermal injection well(s) have become
"pe1mitted by rule." Therefore, you are no longer required to renew your current permit
and the permit will be valid indefinitely as long as the wells are active and are operated in
accordance with the revised rules referenced above. Please keep in mind that if you abandon
the wells, a record of abandonment must be submitted to the Division of Water Quality. You
may view the revised rules on our website at http ://p ortal.ncdenr.org/web/wq /ap s.
If you have any questions regarding your current permit or the rule revisions, please feel free to
contact our underground injection control staff at [phone].
Sincerely,
t~~N~
Eric G. Smith, P.G.
Hydro geologist
cc: UIC Permit File
AQUIFER PROTECTION SECTION
1636 Mail Service Center, Raleigh, North Carolina 27699-1636
Location: 512 N. Salisbury St., Raleigh, North Carolina 27604
Phone: [phone] i FAX: [phone]
In te rnet: www.ncwaterquality.org
An E(lua! Oppor1unity \An ;rm ative Action Employer
One
North Carolina
Jvatttrall!f
Permit Number WI0800266
Program Category
Ground Water
Permit Type
Injection Mixed Fluid GSHP Well System (5QM)
Primary Reviewer
michael. rogers
Coastal SW Rule
Permitted Flow
Facility
Facility Name
USMC Camp Lejeune
Location Address
Nw Corner Of Intersection Of McHugh Blvd And
Cross St
Camp Lejeune NC 28542
Owner
Owner Name
USMC Camp Lejeune
Dates/Events
Scheduled
Orig Issue
12/12/11
App Received Draft Initiated Issuance
10/31/11
Central Files: APS_ SWP_
12/13/11
Permit Tracking Slip
Status
Active
Version
1.00
Project Type
New Project
Permit Classification
Individual
Permit Contact Affiliation
Major/Minor
Minor
Region
Wilmington
County
Onslow
Facility Contact Affiliation
Owner Type
Government -Federal
Owner Affiliation
Carl H. Baker Jr.
1005 Michael Rd
Camp Lejeune NC 285472521
Public Notice Issue
12/12/11
Effective
12/12/11
Expiration
11/30/16
Regulated Activities Re quested/Received Events -~----------------------
Heat Pump Injection RO staff report requested
RO staff report received
Outfal! I\IUL.L
Waterbody Name Stream Index Number Current Class
11/07/11
12/06/11
Subbasin
Permit Num ber WI0800266
Program Category
Ground Water
Permit Type
Injection Mixed Fluid GSHP Well System (5QM)
Primary Reviewer
michael.rogers
Coastal SW Rule
Permitted Flow
Facilit
Facility Name
USMC Camp Lejeune
Location Address
Nw Corner Of Intersection Of McHugh Blvd And
Cross St
Camp Lejeune NC 28542
Owner
Owner Name
USMC Camp Lejeune
Dates/Events
Orig Issue App Received Draft Initiated
10/31/11
Regulated Activities
Heat Pump Injection
Outfall NJLL
Scheduled
Issuance
Central Files: APS_ SWP_
12/07/11
Permit Tracking Slip
Status
In review
Project Type
New Project
Version Permit Classification
Individual
Permit Contact Affiliation
Major/Minor
Minor
Region
Wilmington
County
Onslow
Facility Contact Affiliation
Owner Type
Government -Federal
Owner Affiliation
Carl H. Baker Jr.
1005 Michael Rd
Camp Lejeune NC
Public Notice Issue Effective
Reauested/Received Events
RO staff report requested
RO staff report received
28547
Expiration
11/07/11
12/06/11
Waterbody Name Stream Index Number Current Class Subbasin
AT,A
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
December 12, 2011
Carl H. Baker, Jr., PE
USMC Camp Lejeune
1005 Michael Rd.
Camp Lejeune, NC 28547
Ref: Issuance of Injection Wen Permits WI0800266
Issued to USMC Camp Lejeune
Camp Lejeune, Onslow County, North Carolina
Dear Mr. Baker:
In accordance with the application received on October 31, 2011, I am forwarding permit number W10800266 for
the construction and operation of a vertical closed -loop geothermal mixed -fluid heat pump injection well system to
be located at the northwest corner of the intersection of McHugh Blvd. and Cross Street (Project P13I I), Camp
Lejeune, Onslow County, NC 28542_ This permit shall be effective from the date of issuance until November 30,
2016, and shall be subject to the conditions and limitations stated therein, including the requirement to install
well identification tags as specified in Part 11.4 and to submit copies of well construction records as specified
in Part VII.2. Be sure to read the entire permit to ensure that you are aware of all compliance requirements of the
permit.
NOTE: If temporary surface casing is left in the borehole during the drilling/installation process for longer
than 5 days, it shall be grouted in accordance with 15A 2C .0213(d).
You will need to notify this office at least 48 hours prior to beginning construction and operation of the injection
well system. in order to continue uninterrupted legal use of the injection facility for the stated purpose, you must
submit an application to renew the permit 120 days prior to its expiration date. This permit is not transferable to
any person without prior notice to and approval by the Director of the Division of Water Quality.
Please contact me at [phone] or michael.ro2ers« ncdenr.,ov if you have any questions about your permit.
Best Regards,
A 4 L£20 IF
Michael Rogers, P.G. (NC & FL)
cc: Charlie Stehman, Wilmington Regional Office
WI0800266 Permit File
Onslow County Environmental Health Department
Janice Scott. Midsouth Geothermal, LLC. 8275 Tournament Dr., Suite 185. Memphis, TN 38125
Chandra Malin, Daniels and Daniels Construction Company, 24 McHugh Blvd., Camp Lejeune, NC 28542
AQUIFER PROTZCTION SECTION
1636 Mai; nevi^ Gunter. Ralegri. Mart!! Caralina
Locatiari: 2728 Gspival Boulevard. Raeigh. North Camilla 276'3?
Phone:919•732i-3221 FAr. 919-715,1358B: FAX F-715-6045 c.usomerSerra. -r-6 +-525.674R
'itcarnet www-acwaterouaiitu,orc
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North Carolina
Natmrailit

NORTM CA ... (.OLINA
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
USMC Camp Lejeune
FOR THE CONSTRUCTION AND OPERATION OF 72 TYPE SQM INJECTION WELL(S), defined in Title
15A North Carolina Administrative Code 2C .0209( e)(3)(F), for the purpose of operating a vertical closed loop
geothermal mixed fluid heat pump system. This system is located at the northwest comer of the intersection of
McHugh Blvd. and Cross St. (Project P1311), Camp Lejeune, Onslow County, NC 28542, and will be
constructed and operated in accordance with the application received October 31, 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 permit is for Construction and Operation of an injection well and shall be in compliance with Title 15A of
the North Carolina Administrative Code 2C .0100 and .0200 plus any other applicable Laws, Rules , and
Regulations pertaining to well construction and use.
This permit shall be effective, unless revoked, from the date of its issuance until November 30, 2016, and shall
be subject to the specified conditions and limitations set forth in Parts I through IX hereof.
Permit issued this the 12th day of December, 2011.
,..('\coleen H. _Sullins, Director b Division of Water Quality
By Authority of the Environmental Management Commission.
Permit #WI0800266 ·u1c/SQM
ver. 03/2010
Page 1 of 5
3. The issuance of this permit shall not relieve th&~emifttee of the responsibility of complying with any and
all statutes, rules, regulations, or ordinances, which may be imposed by other local, state, and federal
agencies, which have jurisdiction. Furthermore, the issuance of this permit does not imply that all
regulatory requirements have been met.
PART IV-PERFORMANCE STANDARDS
1. The injection facility shall be effectively maintained and operated at all times so that there is no
contamination of groundwater that will render it unsatisfactory for normal use. In the event that the
facility fails to perform satisfactorily, including the creation of nuisance conditions or failure of the
injection zone to adequately assimilate the injected fluid, the Permittee shall take immediate corrective
actions including those actions that may be required by the Division of Water Quality such as the repair,
modification, or abandonment of the injection facility.
2. The Permittee shall be required to comply with the terms and conditions of this permit even if compliance
requires a reduction or elimination of the permitted activity.
3. The issuance of this permit shall not relieve the Permittee of the responsibility for damages to surface or
ground water resulting from the operation of this facility.
PART V -OPERATION AND MAINTENANCE REQUIREMENTS
1. The injection facility shall be properly maintained and operated at all times.
2. The Permittee must notify the Division and receive prior written approval from the Director of any
planned physical alterations or additions in the permitted facility or activity not specifically authorized by
the permit.
3 . At least forty-eight (48) hours prior to the initiation of the operation of the facility for injection, the
Permittee must notify by telephone the Aquifer Protection Section's Underground Injection Control (UIC)
Program Central Office staff, telephone number 919-715-6166. Notification is required so that Division
staff can inspect or otherwise review the injection facility and determine if it is in compliance with permit
conditions.
PART VI -INSPECTIONS
1. Any duly authorized officer, employee, or representative of the Division of Water Quality may, upon
presentation of credentials, enter and inspect any property, premises, or place on or related to the injection
facility at any reasonable time for the purpose of determining compliance with this permit, may inspect or
copy any records that must be maintained under the terms and conditions of this permit, and may obtain
samples of groundwater, surface water, or injection fluids.
2. Division 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.
· Permit #WI0800265 UIC/SQM
ver. 03/2010
Page 3 of 5
PART IX-CHANGE OF WELL STATUS
1. The Permittee shall provide written notification within 15 days of any change of status of an injection
well. Such a change would include the discontinued use of a well for injection. If a well is taken
completely out of service temporarily, the Permittee must install a sanitary seal. If a well is not to be used
for any purpose, then that well must be permanently abandoned according to 15A NCAC 2C .0213(h)(l).
Notification shall be submitted to the addresses given in Part VII.I of this permit.
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 I SA 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 that extends to the bottom of the well and is raised as the well is filled.
(E) In the case of gravel-packed wells in which the casing and screens have not been removed, the
casing shall be perforated opposite the gravel pack, at intervals not exceeding 10 feet, and grout
injected through the perforations.
(F) In those cases when, as a result of the injection operations, a subsurface cavity has been created,
each well shall be abandoned in such a manner that will prevent the movement of fluids into or
between underground sources of drinking water and in accordance with the terms and conditions
of the permit.
(G) The Permittee shall submit a copy of the Well Abandonment Record (Form GW-30) as specified
in 15A NCAC 2C .0213(h)(l) within 30 days of completion of abandonment. Copies shall be
submitted to the addresses given in Part VII. I of this permit.
Permit #WI0800266 UIC/SQM
ve r. 03 /2010
P.age 5 of 5
AQUIFER PROTECTION SECTION REGIONAL OFFICE STAFF REPORT
To: AQUIFER PROTECTION SECTION CENTRAL OFFICE
Central Office Reviewer: Michael Rogers
Application No.: WI0800266
Permittee: MCB Camp Lejuene
Regional Login No.: MCBCampLejuene
GENERAL INFORMATION
1. This application is (indicate all that apply):
Project Name: same
County: Onslow
X New Renewal Minor Modification Major Modification
Surface Irrigation Reuse
Evaporation/Infiltration Lagoon
503 Regulated 503 Exempt
Recycle
Land Application of Residuals
Distribution of Residuals
High Rate Infiltration
Attachment B included
Surface Disposal
Closed Loop Groundwater Remediation X Other Injection Wells (5QM)
2. Was a site visit conducted in order to prepare this report? X Yes No
a. Date of site visit: 11/21/2011
b. Person contacted and contact information: Donovan Brown (Daniels & Daniels Construction)
919-922-27 45 or 240-720-0225
c. Site visit conducted by: Jim Bushardt
d. Inspection report attached : Yes XNo
3. Is the following information entered into the SIMS record for this application correct? Yes No
If no, please complete the following information or indicate that it is correct on the current
application .
For Treatment Facilities:
a. Location: Bldg 24 McHugh Blvd
b. Driving directions: Travel through main gate on Holcombe Blvd, right on Birch Street, right on
Mc Hugh Blvd. Communication Services Building and Base Telephone Building are located
on immediate left. Wells are located in front of the two buildings
c. USGS Quadrangle number and map name:Camp Lejeune ' .,, ,;6
d . Latitude: 34.40.y J,t, Longitude: 77.21 p
e. Regulated activities/type of wastes : (e.g ., subdivision, food processing, municipal
wastewater): geothermal noncontact wells
RECEIVED/ DENR / DWQ
Aquifer Protection Section
DEC O 6 2011
AQUIFER PROTECTION SECTION REGIONAL OFFICE STAFF REPORT
For Dis posal Sites:
(If multiple sites either indicate which sites the information applies to , copy and paste a new
section into the document for each site, or attach additional pages for each site)
a. Location(s):
b. Driving directions:
c. USGS Quadrangle map name and number:
d . Latitude: Longitude:
NEW AND MAJOR MODIFICATION APPLICATIONS (this section not needed for renewals
or minor modifications, skip to next section)
DESCRIPTION OF WASTE(S } AND FACILITIES
1. Please attach a completed rating sheet. Facility class ification:
2 . Are the new treatment facilities adequate for the type of waste and disposal system?
Yes No N/A If no, please explain:
3. Are the new site conditions (soils, topography, etc.) consistent with what was reported by the
soil scientist and/or professional engineer? Yes No N/A
If no, please explain:
4 . Does the application (maps , plans, etc.) represent the actual site (property lines, wells,
surface drainage)? Yes No N/A If no, please explain:
5. Is the proposed residuals management plan adequate and/or acceptable to the Division?
Yes No N/A If no, please explain:
6 . Are the proposed application rates for the new sites (hydraulic or nutrient) acceptable?
Yes No N/A If no, please explain:
7. Are the new treatment facilities ot any new disposal sites located in the 100 year floodplain?
Yes No N/A If yes, please attach a map showing the areas of
the 100 year floodplain and explain and recommend any mitigative measures/special
conditions in Part IV:
8. Are there any buffer conflicts (new treatment facilities or new disposal sites)? Yes No
If yes, 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 the proposed or existing groundwater monitoring program (number of wells, frequency of
monitoring , monitoring parameters, etc .) adequate? Yes No NIA Attach
map of monitoring well network if applicable. Indicate review and compliance boundaries.
If No, explain and recommend any changes to the groundwater monitoring program. Attach
map of existing monitoring well network, if applicable, indicating the review and
compliance boundaries.
AQUIFER PROTECTION SECTION REGIONAL OFFICE STAFF REPORT
10 . For residuals, will seasonal or other restrictions be required? Yes
If yes, attach list of sites with seasonal restrictions (Certification B?)
No NIA
RENEWAL AND MODIFICATION APPLICATIONS (use previous section for new or
major modification systems)
DESCRIPTION OF WASTE(S ) AND FACILITIES
1. Is there an appropriately certified ORC for the facility? Yes No
Operator in Responsible Charge: Certificate # :
Back-up Operator : Certificate # :
2. Is the design maintenance and operation (e.g. adequate aeration, sludge wasting, sludge
storage, effluent storage, etc.) of the treatment facilities adequate for the type of waste
and disposal system? Yes No If no, please explain:
3 . Are the new site conditions (soils, topography, etc.) maintained appropriately and
adequately assimilating the waste? Yes No If no, please explain :
4. Has the site changed in any way that may affect the permit (drainage added, new wells
installed inside the compliance boundary, new development, etc .). Yes No
If Yes, please explain :
5. Is the residuals management plan adequate and/or acceptable to the Division?
Yes No If no, please explain :
6. Are the existing application rates (hydraulic or nutrient) still acceptable?
Yes No If no, please explain:
7. Is the existing groundwater monitoring program (number and location of monitoring wells,
frequency of monitoring, monitoring parameters, etc.) adequate?
Yes No N/A Attach map of existing monitoring well network if
Applicable . Indicate review and compliance boundaries. If No, explain and provide
recommended changes to the groundwater monitoring program:
8 . Will seasonal or other restrictions be required for added sites? Yes
If yes, attach list of sites with restrictions (Certification B?)
No
9 . Are there any buffer conflicts (new treatment facilities or new disposal sites)?
NIA
Yes No If yes , attach a map showing the conflict areas or attach
any new maps you have received from the applicant to be incorporated into the permit:
10. Is the description of the facilities type and/or volume of waste(s) as written in the existing
permit correct?
Yes No If no, please explain:
11 . Were monitoring wells properly constructed and located? Yes No NIA
If no, please explain:
12 . Has the review of all self-monitoring data been conducted (GW, NDMR, and NDAR as
applicable)? Yes No Please summarize any findings from the review :
Compliance
AQUIFER PROTECTION SECTION REGIONAL OFFICE STAFF REPORT
13. Check all that apply: No compliance issues
Notices of violation within the last permit cycle
Current enforcement action(s)
Currently under SOC
Currently under JOC
Currently under moratorium
If any items are checked, please explain and attach any documents that may help clarify
answer/comments (such as NOV, NOD, etc.).
14. Have all compliance dates/conditions in the existing permit, SOC, JOC , etc. been
complied with? Yes No N/A If no, please explain :
15 . Are there any issues related to compliance/enforcement that should be resolved before
issuing this permit? Yes No If yes, please explain :
INJECTION WELL PERMIT APPLICATIONS (Complete these two sections for all systems that
use injection wells, including closed loop groundwater remediation effluent injection wells, in situ
remediation injection wells, and heat pump injection wells.
Descri ption of well {s ) and Facilities -New , Renewal , and Modification
1. Type of injection system :
Heating/cooling water return flow (5A7)
X Closed-loop heat pump system (5QM/5QW)
In situ remediation (51)
Closed-loop groundwater remediation effluent injection (5L nondischarge)
Other (specify)·
2. Does the system use the same well for water source and injection? Yes X No
3. Are there any pollution sources that may affect injection? Yes X No If yes,
what are the pollutant source(s) and distance(s) from the closest injection well :
4. What is the minimum distance of proposed injection wells from the property boundary?
Wells are located on a Marine Corps Base with no property line issues
5. Quality of drainage at the site : X Good
6. Flooding potential of site : X Low
Adequate
Moderate
Poor
High
7. For groundwater remediation systems, is the proposed and/or existing groundwater
monitoring program (number of wells, frequency of monitoring , monitoring parameters,
etc.) adequate? Yes No Attach map of monitoring well network if
applicable. If no, explain and recommend any changes to the monitoring program.
8. Does the map presented represent the actual site (property lines, wells, surface
drainage)? Yes X No If no, or no map , please attach a map of the site
showing property boundaries, buildings , wells, potential pollution sources, roads,
approximate scale, and north arrow. See additional drawing excerpts
AQUIFER PROTECTION SECTION REGIONAL OFFICE STAFF REPORT
In jection Well Permit Renewal And Modification Onl y :
1. For heat pump systems, are there any abnormalities in the heat pump or injection well
operation (e.g. turbid water, failure to assimilate injected fluid, poor heating/cooling)?
Yes No If yes, please explain:
2. For closed loop heat pump systems, has the system lost pressure or required make-up
fluid since permit issuance or last inspection? Yes No If yes, please
explain:
3. For renewal or modification of groundwater remediation permits , will
continued/additional/modified injections have an adverse impact on migration of the
plume or management of the contamination incident? Yes No If yes ,
please explain :
4. Drilling contractor: Name
Address
Certification Number
5. Complete and attach well construction data sheet:
EVALUATION AND RECOMMENDATIONS
1. Provide any additional narrative regarding your review of the application. This report is
being provided based upon a request to permit two 5QM geothermal well systems (one
system located at the Base Telephone Building and the other system located at the
adjacent Communication Services Building). Since the application package was
somewhat incomplete, I have forwarded you a couple of email files that contain the civil
drawings. Also, I have attached a few drawing package excerpts that depict well
placement at the Communications Services Building and at the Base Telephone Building
(Sheets C-201 & C-204), the typical Geothermal Well Detail (Sh M-504), the Mechanical
Site Plan & Piping Detail (Sh M301), and the Well Piping System Control Diagram (Sh M-
802). Each well system will be composed of 36 wells to 305 ft depth BLS . The system
design is recirculating, noncontact geothermal wells using a mixture of water (from area-
wide potable water supply) and propylene glycol. NCAC 02C . 02(d)(1)(F) requires the
injection rate to be known. Based upon review of the drawing package, the
water/propylene mixture injection rate is controlled via variable frequency drive pumps
(max pump rating is 80 gpm). The propylene glycol feed rate will be variable and
controlled by needle valve adjustment. There will be two¾" HOPE pipes, connected in a
loop, and placed into a 5" bore hole. The wells will be constructed of HOPE pipe (3" and
2 " manifolds and¾" wells). Each well loop will be grouted with bentonite for full well
length (-5 ft BLS to -305 ft BLS). No well casings will be used. Wells will terminate into
supply/return piping manifolds (using pressure fittings) that are located 5 feet below
ground surface . The well systems will be located under parking lots. Since this package
includes two separate geothermal well systems at adjacent locations , the writer would
suggest the issuance of two separate well permits. Additionally, the writer will note that
the well heads will be below ground, and that the applicant defaulted to request a
variance to 2C .0231 (d)(1 )(A) by selecting bentonite (thermally conductive) grout.
2. Attach well construction data sheet, as needed information is available. Not needed .
AQUIFER PROTECTION SECTION REGIONAL OFFICE STAFF REPORT
3. Do you foresee any problems with issuance/renewal of this permit? Yes X No
If yes, please explain:
4. List any items that you would like the APS Central Office to obtain through additional
information request. Please provide a reason with each item. None
5 List specific permit conditions that you recommend to by removed from the permit when
issued. Please provide a reason for each recommendation. None
6. List specific special conditions or compliance schedules that you recommend to be
included in the permit when issued. Please provide a reason for each recommendation.
None
AQUIFER PROTECTION SECTION REGIONAL OFFICE STAFF REPORT
7 Recommendation:
Hold, pending receipt and review of additional information by the regional office;
Hold, pending review of draft permit by the regional office;
X Issue
Deny If denied, please state reasons
Signature of report preparers
Signature of APS regional supery
Date: le 1 / / 11
ADDITIONAL REGIONAL STAFF REVIEW ITEMS
none
jb:ab:MCBCanripLe;uene.n 11
cc: Wilmington Well Permit File (WI0800266)

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pECE1VED
AQUIFER PROTECTION SECTION
APPLICATION REVIEW REQUEST FORM
Date: November 7. 2011
To: ❑ Landon Davidson, ARO-APS
❑ Art Barnhardt, FRO-APS
❑ Andrew Pitner, MRO-APS
❑ Jay Zimmerman, RRO-APS
From: Michael Rogers Groundwater Protection Unit
Telephone: [phone]
E-Mail: Michael.Roszersra ncrnail.net
A. Permit Number: WI 0800266
B. Owner: USNIC Camp Leieune
C. Facility/Operation:
❑ Proposed ® Existing
woe
❑ David May, WaRO-APS
® Charlie Stehman, WiRO-APS
❑ Sherri Knight, W-SRO-APS
Fax: [phone]
❑ Facility ❑ Operation
D. Application:
1. Rermit'T,ppe: 0 Animal ❑ SFR-Surface Irrigation❑ Reuse ❑ H-R Infiltration
❑ Recycle E J/E Lagoon ❑ GW Remediation (ND)
• UIC SQM Groundwater Geothermal'Well
For Residuals: ❑ Land App. ❑ D&M ❑ Surface Disposal
❑ 503 ❑ 503 Exempt ❑ Animal
2. Project Type: ® New ❑ Major Mod_ ❑ Minor Mod. ❑ Renewal ❑ Renewal w/ Mod.
E. Comments/Other Information: ❑
NOTE: This is a govern nentalproperty, therefore, we will need -a staff -report.
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.
❑ Attach Well Construction Data Sheet.
❑ Attach Attachment B for Certification by the LAPCU.
❑ Issue an Attachment B Certification from the RO.*
* Remember that you will be responsible for coordinating site visits and reviews, as well as additional
information requests with other RO-APS representatives in order to prepare a complete Attachment 13 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: s: Date:
FORM: APSARR 07/06 Page 1 of 1

AQUIFER PROTECTION SECTION
APPLICATION REVIEW REQUEST FORM
Date: November 7. 2011
❑ Landon Davidson, ARO-APS
❑ Art Barnhardt, FRO-APS
❑ Andrew Pitner, MRO-APS
❑ Jay Zimmerman, RRO-APS
From: Michael Rovers Groundwater Protection Unit
Telephone: l 919 l 715 -616 6
E Marl: Michael.Roeers avncmail.net
❑ David May, WaRO-APS
Charlie Stehnian, WiRO-APS
❑ Sherri Knight, W-SRO-APS
Fax: [phone]
A. Permit Number: WI 0800266
B. Owner: USMC Camp Leteune
C. Facility/Operation:
❑ Proposed ® Existing
❑ Facility ❑ Operation
D. Application:
1. Permit Type: ❑ Animal ❑ SFR-Surface Irrigation❑ Reuse ❑ H-R Infiltration
❑ Recycle ❑ I/E Lagoon ❑ GW Remediation (ND)
• UIC —50M Groundwater Geothermal Well
For Residuals: ❑ Land App.
❑ 503
❑ D&M
❑ 503 Exempt
❑ Surface Disposal
❑ Animal
2. Project Type: ® New ❑ Major Mod. ❑ Minor Mod. ❑ Renewal ❑ Renewal w/ Mod.
E. Comments/Other Information: ❑
NOTE: This is a governmental property, therefore, we will need a staff report.
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.
❑ Attach Well Construction Data Sheet.
❑ Attach Attachment B for Certification by the LAPCU.
❑ Issue an Attachment B Certification from the RO.*
* Remember that you will be responsible for coordinating site visits and reviews, as well as additional
information requests with other RO-APS representatives in order to prepare a complete Attachment B for
certification. Refer to the RPP SOP for additional detail.
When you receive this request 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

AVA
MC DEMR
North Carolina Department of Environment and Natural Resources
·Division of Water Quality
Beverly Eaves Perdue
Governor
Carl H. Baker, Jr. -PE
Marine Corps Base
1005 ;Michael Rd.
Camp Lejeune, NC 28547
Dear Mr. Baker:
Coleen H. Sullins
Director
November 4, 2011
Dee Freeman
Secretary
Subject: Acknowledgement of
Application No. WI0800266
Project P 1311 -McHugh Blvd.
Injection Mixed Fluid GSHP
Well System (SQM) System
Onslow County
The Aquifer Protection Section acknowledges receipt of your permit application and supporting
documentation received on 10/31/2011. 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 ensur~ maximum
efficiency in processing permit applications, the Aquifer Protection Section requests your assistance in
providing a timely and complete response to any additional information requests.
Please note that processing standard review permit applications may take as long as 60 to 90 days
after receipt of a complete application. If you have any questions, please contact
Michael Rogers at [phone] or [e-mail] .
S~cere. ly, . n , .. ~¼~~70
for Debra ~atts
Groundwater Protection Unit Supervisor
cc: Wilmington Regional Office, Aquifer Protection Section
Janice Scott -(Midsouth Geothermal, LLC, 8275 Tournament Dr., Ste. 185, Memphis, TN
38125)
Permit File WI0800266
AQUIFER PROTECTION SECTION
1636 Mail Service Center, Raleigh, North Carolina 27699-1636
Location: 2728 Capital Boulevard, Raleigh, North Caroiina 27604
Phone: [phone] I FAX 1: 919-715-0588; FAX 2: 919-715-6048 I Customer Service: 1-877-623-.6748
Internet: www.ncwaterquality.org
An Equa! Qpportun:•y I Affirmative Action Employer
None. C 1. orth 'aroma
,?vat11rallu
NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
APPLICATION FOR A PERMIT TO CONSTRUCT OR OPERATE INJECTION WELLS -` -
O
In Accordance With the Provisions of 15A NCAC 02C .0200
CLOSED -LOOP MIXED -FLUID GEOTHERMAL INJECTION WELLS , 5
These wells circulate fluids other than potable water as part of a geothermal heating and cooling system
(check one) x New Application Renewal* Modification
Pratt or Type Information and Mail to the Address on the Last Page_ Illegible Applications Will Be Returned As Incomplete.
DATE: September 29 , 2011
PERMIT NO. 45.?1` (leave blank if New Application)
A. STATUS OF APPLICANT (choose one)
Non -Government: Individual Residence Business/Organization
Government: State Municipal County Federal x
B. PERMIT APPLICANT — For individual residences, list each owner on property deed. For ail others,
state name of entity and name of person delegated authority to sign on behalf of the business or agency:
?VIA/2.14E PO!Ps MEJ CAW LES kJ6
Mailing Address: 1005 Michael Road
City: Camp Lejeune
State: NC Zip Code: 28547 County: Onslow
Day Tele No.: 910-451-2213 Cell No.:
EMAIL Address: carl.h.bakeryrusmc.mil Fax No.:
C. LOCATION OF WELL SITE — Where the injection wells are physically located:
(I)
(2) Physical Address (if different than mailing' ddress): l3uildi 24_ McHugh Blvd.
Pe,c,rccr— F1311 CAAL 14
Parcel Identification Number (PIN) of well site: County: Onslow
City: Camp Lejeune State: NC Zip Code: 28542
D. WELL DRILLER INFORMATION
Well Drilling Contractor's Name: Tim Hamby
NC Well Drilling Contractor Certification No.: NC 3118A
Company Name: Midsouth Geothermal. LLC
Contact Person: Janice Scott EMAIL Address: jscotttwmidsouthgeothermal_com
Address: 8275 Tournament Drive, Suite 185
City: Memphis Zip Code: 38125 State: TN County: Shelby
Office Tele No.: _901-748-9095
Ce11 No.: N/A — Fax No.: 901-748-9097
CPUIUIC 5QM Permit Application (Revised 1124/2011) Page 1

E. HEAT PUMP CONTRACTOR INFORMATION (if different than driller) l>
Company Name: Midsouth Geothermal, LLC
Contact Person.,_: ....;J=a=n=ic=e~S=co=t'-'-t _______ ___;E=MA~=I=L'-"-A-=-d=d=r=e=ss=:_1=· s=co=t=t{i=u-=,m=i=d=s=ou=t=h,..g=eo=-t=h=e=rm=al=.c=o=m~--
Address: 8275 Tournament Drive Ste. 185
City: Memp his Zip Code: 38125 State: TN County: ~S=h=el=b...,__y _____ _
Office Tele No.: ~90=1~-~74~8~-9~0~9~5 ______ Cell No.: _NIA~ Fax No.: 901-748-9097
S::i,
C> =R~ ~m n -o-
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F. WELL CONSTRUCTION DATA
(1) Number of borings to be constructed*: 72 Depth of each boring (feet): __ 2_5_0~' ____ _
* If existing water supply wells will be used then provide the information in item (4) below.
(2) Chemical additives to be used: R-22 __ _ Propylene glycol _x_ Ethanol __ _
Other _________ ( other additives will need prior approval by NCDENR before use)
(3) Type of tubing to be used (copper, PVC, etc): HDPEPipe
( 4) Well casing. If the well( s) will use casing then provide the ~ ( steel, PVC, plastic, etc.), diameter, depth,
and extent of casing appearing above ground: __________________ _
(5) Grout (material surrounding well casing and/or piping):
(a) Grout type: Cement__ Bentonite** -1L Other (specify) _______ _
o,:, By selecting bentonite grout, a variance is hereby requested to 15A NCAC 2C .0213(d)(l)(A), which requires a cement type grout.
(b) Grout depth of tubing (reference to land surface): from __ o~• __ to _25_0_' __ (feet)
If well has casing, indicate grout depth: from ____ to _____ (feet)
G. WELL LOCATIONS -Maps must be scaled or otherwise accurately indicate distances and orientations of
features located within 1000 feet of the injection well(s). Label all features clearl v and include a north arrow.
(1) Attach a site-specific map showing the locations of the following:
* Proposed injection wells * Buildings * Property boundaries
* Surface water bodies * Water supply wells
* Septic tanks and associated spray irrigation sites, drain fields, or repair areas
* Existing or potential sources of groundwater contamination
(2) Attach a topographic map of the area extending 1/4 mile from the injection well site that indicates the
facility's location and the map name.
NOTE: In most cases, an aerial photograph of the properly parcel showing properly 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 properly 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 SQM Permit Application (Revised 1/24/2011) Page 2
A. CERTIFICATION (to be signed as required below or by that person's authorized agent)
15A NCAC 02C .0211(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 well and all related appurtenances in accordance with the approved specifications and conditions of
the Permit."
ature o1 Property Owner/Appli
_Carl H. Baker. Jr.. PE
Print or Type Fuli Name
r
/°L cJos
v A
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]
GPU/UIC 5QM Permit Application (Revised 1/2412011) Page 3

11
DAHIELSGRUNLEY
DANIELS
_AM! jEtijCDC k:
October 12, 2011
Attn: Carl Baker
Building on Tradition
Enclosed is the Application for Permit to Construct or Operate Injection Wells, please
sign and return to Daniels & Daniels/ Grunley.
Also included is the Permit Drawings for the Geothermal Wells.
If you have any questions please feel free to contact me or my Project Manager.
Chandra Malin
24 McHugh Blvd
Camp Lejeune NC 28542
240-720-0225
[e-mail]
Jeremiah Daniels
240-720-0289
Jereini
Thanks so much,
Chandra S. Malin
Administrative Assistant
Daniels & Daniels Construction Co.
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