WI0100006_Complete File - Historical_20220308

ROY COOPER
Ic- Governor
MICHAEL S. REGAN
Secretary
Water Resources S.JAY ZIMMERMAN
Environmental Quality Director
May 12, 2017
Suzan McKay
Rainfall Mountains
141 Courtland Ct.
Lake Lure,NC 28746
Subject: Permit Rescission
UIC Permit No. WI0100006
Geothermal Heating/Cooling Water Return Well
Rutherford County
Dear Ms. McKay:
Reference is made to your request for rescission of the subject Geothermal Heating/Cooling Water
Return Well Permit located at the above referenced address. Staff from the Asheville Regional
Office has agreed that a permit is no longer required. Therefore, in accordance with your request,
Underground Injection Control (UIC)Permit WI0100006 is rescinded, effective immediately.
If in the future, you wish to operate a Geothermal Heating/Cooling Water Return Well injection
system, you must first apply for and receive a new permit. Operating a geothermal heat pump
injection system without a valid permit may result in the assessment of civil penalties and/or the
use of other enforcement mechanisms available to the state.
If it would be helpful to discuss this matter further, please do not hesitate to call Shristi
Shrestha at(919) 807-6406.
Sincerely,
(/ 46
Jay Zimmerman, P.G.,Director
Division of Water Resources
Attachment(s)
cc: Asheville Regional Office- WQROS RECEIVED
Central Files-PemutNo. WI0100006 Fmftater
�i°"°'walorRes°ur°a.
Rutherford County Environmental Health Dept.
WAY 23 2017
- ^Nothing Compares
State of North Carolina I Environmental Quality I Division of WateruaP
dyRegional Operationswater Quality se�anat Opendom Serdoo wile Re Tonal Office
1636 Mail Service Center I Raleigh,North Carolina 27699-1636
919-707-9129

s` t WELL ABANDONMENT RECORD DivsonawEterREDrces
y` North Carolina Department of Environment and Natural Resources-Division of Vater Quality
WELL CONTRACTOR CERTIFICATION# 1 I Ay 1
1.W��E�]L��L CONTRACTOR. S. WELL DETAILS:
111{(1/9 N0/ JMITI✓1 a.Total Depth:
�_ fltarta
Well Cymru(Indivulud)Namc —-�— Wa et r UU �pera;ions
//t' ' q r� b.Water Level(Below Mea wring PoiS nal Office
y71{(%�/V Ot✓/i OatI �fuge Measuring point is ._ above land s �
Well Connector Company Name/ Rn
STTR.EEFADDDRESS /, 7. grgf d 6. CASING: Length Diamcor
& �/C ReCk ^r C+ _ 'Z 97A4 a.Casing Depth(if known)' fL _ in.
City"Town State Zip code b.Casing Removed-
(fa )- G 93- 1z0o -----
Area code-Phone number 7. DISINFECTION:
2.WELL INFORMATION: (Amount of 65%-75%calcium hypoeblonte used)
SITE WELL ID#(if applicable) M g SEALING ATERIAL:
STATE WELL PERMIT#(if applicable). r)a((0(- cce Neat Ce-e_at Sand Cement
COUNTY WELL PERMIT#(if applicable)— Cement lb. Cce ')t Ib.Walcr gal. Walcr_
DWQ or OTHER PERMIT#(if applicable) Beotooite
WEI J.USE(Circle applicable use): Monitoring Residential
hlunic,pWPa _-yndustrial/Commercial Agricultural Beotonite lb.
Recovery IajUecuon Irrigation Type:Slmry Pellets_
Other(list me) Water_
ONer /I ,,//��
3.WELL LOCA70 f Typerrearnal DV-"-aFhC
COUNTY�JQ/2Ct QUADRANGLENAMP. C
NEARESTTOWN: ^h eg& Amamud 3:f�/t2[I .
(SucLRmd Name,NLM*a,Corremnny.SYddivimgLUNo.P>aud,ZTCo&) 9. EXPLIINMETHODOFEMPLAC?MENTOF MATERIAL:
TRAPHIC/LAND SETTING: .
qLaW Valley Flat Ridge Odter__ -__
(Circle appropriate/setting)) Q - --
LATITUDE r3�i 1`Z ) j�/ May be in dctr ,
mimnes,uemrd;m m a
LONGITUDE L91R // 19 Q(ki dermal tnmwt
18. WELL DIAGRAM:Draw a detailed sketch of the well of We back of this
Latitudellongitude source- 25 Topographic trap form showing Ids)depth,depth and diameter of smarts(if my)remaining
(Location ojwelf mast be shown on a USGS tope map and in the well,gravel interval,intervals of casing perf tudions,aid depth,and
attached to this form ijrml ming GPS) types of fill materials und.
4a.FACILIr V-The Does of the bisirs wb=the well is loosed.Cnsgdete4a arWb. e,
(If.residential well,skip 4a;complete4b,well owner infurnmfon only.) 11. DATE WELL ABANDONED
FACILITY ID#(if applicable) _
—— 100 HERESY CERTIFY THAT THIS WELL WAS ABANDONED IN ACCORDANCE
NAME OF FACILITY WH1i ISA NCAC 2C.WELL CON UCDON STANDARDS AND THAT A COPY OF
STREET ADDRESS TrnS RECORD HAS PRO ®TO THEW ELL OWNER. e^
City-Town Slate 1 `7 _11
lap Code SIG A OF CER7'1FTF.D WELL CONTRACTOR DA
4b.CONTACT PERSON/WELL OWNER
NAME rJ "A"' F SIGNATUREOF PRrYATF.U'Et OWNER ABANDONING THE WELL DATE
STREETADDRESS / / a1mtGFw �}' (Tbe Pdvato wea owner moat be ao ind;vidmiwM mswWlval,aodmshis,ler ressdevtal well
in acmdaae.th 15A NCAC 2C.0113.)
m tr L N� zy941
---
City wTown State ?�' (,ode PI1lN'i'ED NAME OF PERSON ABANDONING THE WELL
Area code-Phone number
Submit a copy to the owner and the original to the Division of Water Quaaty within 30 days. Form GW-30
Attn:Information Management,1617 Mail Senice Center-Raleigh,NC 27699-1617, Phone No.[phone] e:t 5611. Rev.51%

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Permit Rescission Form
Information to be filled out by Central Office:
Facility Name: Rainfall Mountains Inc.-SFR
Permit Number: WI0100006
Regional Office: Asheville
County: Rutherford
i
Date Rescission Requested: 02/23/2017
Received Original Request: 0 Central Office ❑ Regional Office
Form of Received Request: 0 Letter ❑ Signed Annual Fee Invoice X� Other form
Information to be filled out by Region:
Please Check Appropriately:
❑ Site Visit Performed ❑ Groundwater Concerns Addressed
Recommendations
❑ Rescind Permit Immediately
Reason for Approval
Require Renewal with Suspended Actions
Recommended Actions to be.Taken_ /c e ✓4 / wa!/
11-ce Jco' 1 74u /i� r1 �a llM 75(e t w�/l �[o� u ��s� �( � It
a,,&�okc AhL - d4e, ZOV gc07L,r - (y�// [•// �C LGFfQnid �
(,✓ *' 7K 4eyl- -4ew b�ti/'S,1r b✓/ {�/war's/ drat•+a/O�/K^t /ec P W 7(o La , e�l•e— /'acr•U,d
❑ Do Not Rescind/Recommend Renewal
Reason For Denial

Signatur of Certifier(WQROS Section):
Signature of Certifier:
Date Certified: 9iY /7o 1 7
Return Completed and Signed Form to the WQROS Section

DIVISION OF WATER RESOURCES
WQROS
February 27,2016
MEMORANDUM
To: Landon Davidson—Andrew Moore
From: Shristi Shrestha
WQROS
Re: Rescission Request
5A7 Geothermal Heating/Cooling Water Return Well
Permit No. WI0100006
Rainfall Mountains Inc. SFR
Rutherford County
The WQROS Central Office has received a permit renewal form indicating the permit be
rescinded. A Permit Rescission Form is attached. Please determine if a rescission should be
issued for this permit and return the completed Permit Rescission Form to this office.
If you have any questions,please contact me at(919) 807-6406.
Thank you for your cooperation.
Attachment(s) [ /�
omwon01'G�rr'ar�w
MAP 7
Water Oualtty Regiond Opw�Lorro
AstrevlXe R Tonal Otfic!

North Carolina Department of Environmental Quality—Division of Water Resources
APPLICATION FOR A PERMIT TO CONSTRUCT OR OPERATE INJECTION WELL(S)
In Accordance With the Provisions of 15A NCAC 02C.0224
GEOTHERMAL HEATING/COOLING WATER RETURN WELL(S)
These well(s)inject groundwater directly into the subsurface as part of a geothermal heating and cooling system
CHECK ONE OF THE FOLLOWING:
New Application Renewal*_Modification 1 Permit Rescission Request*
*For Permit Renewals or Rescission Request,complete Sections A thru E.and M(signature page)only
Print or Type Information and Mail to the Address on the Last Page. Illegible Applications Will Be Returned As Incomplete.
DATE: O(0 2012-- PERMIT NO. _ o � leave blank if New Application)
A. CURRENT WELL USE &OWNERSHIP STATUS(Leave Blank if New Well/Permit Application)
1. Current Use of Well
a. I wish to continue to use the well as❑ Geothermal Well ❑ Drinking Water Supply Well
❑ Other Water Supply Use-Indicate use (i.e.,irrigation,etc.)
b. Terminate Use: If the well is no longer being used as a geothermal injection well and you wish to
rescind the permit,check the box below. If abandoned, attach a coA3lip� a Well Abandonment
Record(GW-30). 01DWR
Yes,I wish to rescind the permit FEB 2 3 2017
2. Current Ownership Status' Water Quality Regional
Has there been a change of ownership since permit last issued? ❑YES O NO ns Section
If yes, indicate New Owner's contact information:
Name(s)
Mailing Address:
City: State: Zip Code: County:
Day Tele No.: Email Address
B. STATUS OF APPLICANT(choose one)
Non-Government: Individual Residence_ Business/Organization
Government: State_ Municipal_ County_ Federal
C. WELL OWNER(S)/PERMIT APPLICANT — For single family residences, list all persons listed on the
property de . Fora others,list me of b siness/agency and name of person d itle with delegated authority
to sign: N G I S G1 k<
Mailing Address: / �� , /
City: � L t�,¢�' StateN�Zip Code: County:
DayTeleNo.: H��� SS_��5� Cell No
EMAIL Address: Sri[ �9S�r(! /�lG . Fax No.:
Geothermal Water Return Well Permit Application Rev.4-15-2016 Page 1

D. WELL OPERATOR(if different from well owner)—For single family residences, list all persons listed on
the property deed. For all others,list name business/agency and name ofperson and title with delegated authority
to sign:
Mailing Address:
City: State:_Zip Code: County;
Day Tele No.: Email Address
E. PHYSICAL LOCATION OF WELL(S)SITE
(1) Parcel Identification Number(PIN)of well site:.1bo ?—OL/7 County:
(2) Physical Address(if different than mailing address):
City: County 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: 'Zip Code: State:_County:
Office Tele No.: Cell No.: Fax No.:
G. HVAC CONTRACTOR INFORMATION(if different than driller)
HVAC Contractor's Name:
NC HVAC Contractor License No.:
Company Name.-
Contact Person: EMAIL Address:
Address:
City: Zip Code: State:_County:
Office Tele No.. Cell No.: Fax No.:
H. WELL USE Will the injection well(s)also be us as the supply well(s)for the following?
(1) The injection operation? YES NO
(2) Personal consumption? YES NO
1. WELL CONSTRUCTION QUIREMENTS—As specified in 15A NCAC 62C .0224f :
(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 Rev.4-15-2016 Page 2

• V
r 1.
(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
(1) 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 diagram 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 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 groats areprohibitedfor seating water-bearing zones with1500
mg/L chloride or greater per 15.4 NCAC 02C.0107(fi(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 ERATING DATA
^ / (1) Injection Rate: Average(daily) gallons per minute(gpm).
,I`X1 (2) Injection Volume: Average(daily) gallons per day(gpd).
tVjl (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:
(1) All water supply wells,surface water bodies, and septic systems including drainfield,waste
application area, and repair area located within 250 feet of the injection well(s).
(2) Any other potential sources of contamination listed in 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 Retum Well Permit Application Rev.4-15-2016 Page 3

a . .
NOTE. Inmost 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,eta 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 .0211(e)requires that all permit applications shall be signed as follows:
I. for a corporation: by a responsible corporate officer;
2. for a partnership or sole proprietorship: by a general partner or the proprietor,respectively;
3. for a municipality or a state,federal,or other public agency: by either a principal executive officer
or ranking publicly elected official;
4. for all others: by all the person(s)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."
Signatare of ropert per/Applicant
L � ,
Print or Type Full Name had Ti le (*�i y2L
Signature of Property Owner/Applicant
Print or Type ull and Title ,
Oy/✓�L}/„i3 /C
Signature ofAuthoriz ent i
Print or Type Full Name and Title
Submit hvo copies of the completed application package to:
Division of Water Resources -UIC
Water Quality Regional Operations Section (WQROS)
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone [phone]
Geothermal Water Return Well Permit Application Rev.4-15-2016 _ Page 4

AQUIFER PROTECTION SECTION— GROUNDWATER PROTECTION UNIT
REGIONAL STAFF REPORT
Date: 04/26/2012 Permittee(s): Rainfall Mountains,Inc. Co Suzanne Mckay
Permit No.: WI0100006
To: APS Central Office County: Rutherford
Central Office Reviewer: Jonathan Stepu Project Name:
Regional Login No:
L GENERAL INFORMATION
1. This application is(check all that apply): ❑ SFR Waste Irrigation System ®UIC Well(s)
❑New ®Renewal
❑Minor Modification ❑ Major Modification
❑ Surface Irrigation❑ Reuse❑ Recycle❑High Rate Infiltration ❑ Evaporation/Infiltration Lagoon
❑ Land Application of Residuals ❑Attachment B included ❑ 503 regulated ❑ 503 exempt
❑ Distribution of Residuals ❑ Surface Disposal
❑ Closed-loop Groundwater Remediation ❑ Other Injection Wells(including in situ remediation)
Was a site visit conducted in order to prepare this report? ® Yes or❑No.
a. Date of site visit: 04/26/2012
b. Person contacted and contact information: Suzanne McKav
c. Site visit conducted by: Jonathan Stepp
d. Inspection Report Attached: ® Yes or❑No.
2. Is the following information entered into the BIMS record for this application correct?
®Yes or❑No. If no, please complete the following or indicate that it is correct on the current application.
For SFR Treatment Facilities:
a. Location:
b. Driving.Directions:
c. USGS Quadrangle Map name and number:
d. Latitude: Longitude: Method Used(GPS, GoogleTm,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):
b. Driving Directions: US64E to Lake Lure; left on Bills Creek: left on Buffalo Creek: right on Winesap
Blvd.: left on rourtland Court to 141 on left
c. USGS Quadrangle Map name and number:
d. Latitude: 35027146.33"N Longitude: 82"10'20.63"W Method Used (GPS, GoogleTm, etc.);
Goo leg Earth
APS•GPU Regional Staff Report(Sept 09) Page 1 of 8 Pages

AQUIFER,PROTECTION SECTION- GROUNDWATER PROTECTION UNIT
REGIONAL STAFF REPORT
H.. NEW AND MAJOR MODIFICATIONAPPLICATIONS Olds section not needed for renewals or minor
modifications,skin to next section)
Description of Waste System and Facilities
I. Please attach completed rating sheet. Facility Classification:
2. Are the new treatment facilities adequate for the type of waste and disposal system?
❑ Yes❑No ❑N/A. If no,please explain:
3. Are the new site conditions (soils, topography, 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:
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 new sites(hydraulic or nutrient)acceptable?
❑ Yes❑No ❑N/A. If no,please explain:
7. Are the new treatment facilities or any new disposal sites located in a 100-year floodplain?
ElYes ❑ No ❑ N/A. If yes, please attach a map showing areas of 100-year floodplain and please explain
and recommend any mitigative measures/special conditions in Part IV:
8. Are there any buffer conflicts (new treatment facilities or new disposal sites)? ❑ Yes or❑ 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? ❑ Yes ❑ No ❑ N/A. Attach map of existing monitoring well
network if applicable. Indicate the review and compliance boundaries. If No, explain and recommend any
changes to the groundwater monitoring program:
10. For residuals, will seasonal or other restrictions be required? ❑ Yes ❑No ❑N/A If yes, attach list of sites
with restrictions(Certification B?)
III. RENEWAL AND MODIFICATIONAPPLICATIONS(use previous section for new or niaior modification
systems)
Description of Waste System and Facilities
1. Are there appropriately certified ORCs for the facilities? ❑ Yes or❑No.
Operator in Charge: Certificate#:
Backup-Operator in Charge: Certificate#:
APS-GPU Regional Staff Report(Sept 09) Page 2 of 8 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? ❑ Yes or ❑No.
If no, please explain:
3. Are the site conditions (soils, topography, depth to water table, etc) maintained appropriately and adequately
assimilating the waste? ❑ Yes or❑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?
❑ Yes or❑No. If no, please explain:
6. Are the existing application rates (hydraulic or nutrient) still acceptable? ❑ Yes or ❑ No. If no, please
explain:
7. Is the existing groundwater monitoring program (number of wells, frequency of monitoring, monitoring
parameters, etc.) adequate? ❑ Yes ❑ No ❑ 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? ❑Yes ❑No ❑N/A If yes, attach list of sites
with restrictions(Certification B?)
9. Are there any buffer conflicts (treatment facilities or disposal sites)? ❑ Yes or ❑ 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? ❑
Yes or❑No. If no, please explain:
11. Were monitoring wells properly constructed and located? ❑ Yes or ❑ No ❑ N/A. If no, please explain:
12. Has a review of all self-monitoring data been conducted (GW,NDMR, and NDAR as applicable)? ❑ Yes or
❑No ❑N/A. Please summarize any findings resulting from this review:
13. Check all that apply: ❑ No compliance issues; ❑ Notice(s) of violation within the last permit cycle; ❑
Current enforcement action(s) ❑ Currently under SOC; ❑ Currently under JOC; ❑ 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? ❑ Yes
❑No ❑Not Determined ❑N/A.. If no, please explain:
15. Are there any issues related to compliance/enforcement that should be resolved before issuing this permit? ❑
Yes or❑No ❑N/A. If yes,please explain:
APS-GPU Regional Staff Report(Sept 09) Page 3 of 8 Pages

AQUIFER PROTECTION SECTION- GROUNDWATER PROTECTION UNIT
REGIONAL STAFF REPORT
IV. INJECTION WELL PERMITAPPLICATIONS(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:
® Heating/cooling water return flow(5A7)
❑ Closed-loop heat pump system(5QIvl/5QW)
❑In situ remediation(50
❑ Closed-loop groundwater remediation effluent injection(5LP Non-Discharge")
❑ Other(Specify:
2. Does system use same well for water source and injection? ® Yes ❑No
3. Are there any potential pollution sources that may affect injection?®Yes ❑No
What is/are the pollution source(s)?Rodent droppings. What is the distance of the injection well(s)from the
pollution source(s)?0 ft.
4. What is the minimum distance of proposed injection wells from the property boundary?—2 ft.
5. Quality of drainage at site: ❑ Good ®Adequate ❑Poor
6. Flooding potential of site: ® Low ❑Moderate ❑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 existing monitoring well network if applicable. If No, explain and recommend any changes to the
groundwater monitoring program:
8. Does the map presented represent the actual site(property lines,wells, surface drainage)?® Yes or❑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)?
❑Yes ❑No. If Yes, explain:N/A:Unable to sample the well because the owners are in Bermuda and
because the geothermal heating and cooling is currently non-operational. The house is being heated and cooled
using a conventional heat pump.
2. For closed-loop heat pump systems,has system lost pressure or required make-up fluid since permit issuance
or last inspection? ❑ Yes ❑No. If Yes, explain:
APS-GPU Regional Staff Report(Sept 09) Page 4 of 8 Pages

AQUIFER PROTECTION SECTION- GROUNDWATER PROTECTION UNIT
REGIONAL STAFF REPORT
3. For renewal or modification of groundwater remediation permits(of any type),will
continued/additional/modified injections have an adverse impact on migration of the plume or manaeement of
the contamination incident?❑Yes ❑No. If Yes,explain:
4. Drilling Contractor: Name: Green River Well and Pump Company
Address:
NC Certification number: 576
5. Complete and attach NEW Injection Facility Inspection Report,if applicable
V. EVALUATIONANDRECOMMENDATIONS
1. Provide any additional narrative regarding your review of the Application: Please see the attached photos
2. Attach new Injection Facility Inspection Form, if applicable
3. Do you foresee any problems with issuance/renewal of this permit? ❑Yes ®No. If yes, please explain
briefly.
4. List any items that you would like APS Central Office to obtain through an additional information request.
Make sure that you provide a reason for each item:
Item Reason
5. List specific Permit conditions that you recommend to be removed from the permit when issued. Make sure
that you provide a reason for each condition:
Condition Reason
Well seal needs repair Area around electrical wires needs to be calked and the area around
the return pipe needs to be sealed to prevent contaminants from
entering the well.
Well should be sampled Rodent droppings were present on top of the well head in the
for bacteria insulation. There is potential for the droppings to enter the well
around electrical wires and the return pipe.
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
The owner shall notify APS within 10 business Water samples were not collected at the time of
APS-GPU Regional Staff Report(Sept 09) Page 5 of 8 Pages

AQUIFER PROTECTION SECTION- GROUNDWATER PROTECTION UNIT
REGIONAL STAFF REPORT
days if the geothermal heating/cooling system this inspection because the system is currently
is returned use. non-operational.
The return pipe shall remain capped/sealed The return pipe may become a direct conduit to
while the geothermal heating and cooling groundwater
system is non-operational.
7. Recommendation: ❑ Hold,pending receipt and review of additional information by regional office; ❑ Hold,
pending review of draft permit by regional office; ❑ Issue upon receipt of needed additional information;
® Issue; ❑ Deny. If deny, please state reasons:
8. Signature of report Preparer(s): '`
Signature of APS regional supervisor:
Date: 6 ` - 2 -:;, 1 2
VI. ADDITIONAL INFORMATION AND SITE MAP(Sketch of site showing house and waste irrigation system,spray
or drip field,location of well(s),and/or other relevant information- SHOW NORTH ARROWI
APS-GPU Regional Staff Report(Sept 09) Page 6 of 8 Pages

A,;;A. RECEIVED
NCDENR y l0 2fi12
North Carolina Department of Environment and Natura Resour�t
Division of Water Quality Asheville Regional ffice
Beverly Eaves Perdue Charles Wakild, P.E. er pros eeman
Governor Director
May 4, 2012
Suzanne McKay
Rainfall Mountains,Inc.
141 Courtland Court
Lake Lure,NC 28746
Re: Issuance of Injection Well Permit
Permit No.WIOI00006
Issued to Rainfall Mountains
Rutherford County
Dear Ms.McKay:
In accordance with your application received February 27,2012, I am forwarding Permit No. WI0100006 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 April 30,2017,and shall be subject to
the conditions and limitations stated therein.
The Asheville Regional Office conducted an inspection of your geothermal system on April 26,2012. Per permit
conditions Part IV.1, 2,and 3,the following items need to be addressed and/or corrected in order to be in compliance with
your renewed permit:
• Since the system was not operational at the time of the inspection,the Permittee shall notify Jonathan Stepp or
Landon Davidson with the Asheville Regional Office(828-296-4500)within 10 days after the system becomes
operational again in order that samples can be obtained from the influent and effluent ports. After the laboratory
analytical results are received,the results will be forwarded to you by the regional office.
• The well head needs to be sealed around the electrical wires and return pipe in order to prevent surface
contaminants from entering the well.
• The well should be chlorinated prior to use as rodent droppings were observed on the well head and in the
installation.
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(919)807-6406.
AQUIFER PROTECTION SECTION
1636 Mail Service Center,Raleigh,North Carolina 27699-1636
Location:512 N.Salisbury St,Raigh,North Carolina 27604 One
Phone:919$07-64641 FAX:919A07-6496 Nlo Carolina
Internet www ncwatemuality.ora
An Equal Opportunity 1 AfFrmative Action Employer aturally

Best AARegards,
144,L
Michael Rogers,P.G.(NC & )
Environmental Specialist
cc: Landon Davidson, Asheville Regional Office
Central Office File, WI0100006
Rutherford County Environmental Health Dept.

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE CONSTRUCTION AND OPERATION70F 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
Rainfall Mountains, Inc.
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 beat pump effluent. This
injection well is located at 141 Courtland Court, Lake Lure;Rutherford County,NC 28746, and will be
constructed and operated in accordance with the application received February 27, 2012,and in conformity with
the specifications and supporting data, all of which are filed with the Department of Environment and Natural
Resources and are considered a part of this permit.
This permit is for operation 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 April 30, 2017, and shall be
subject to the specified conditions and limitations set forth in Parts I through VIII hereof.
Permit issued this the day of , 2012.
Charles Wakild, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission.
Permit#WI0100006 UIC/5A7 Page 1 of 5
ver.03/2010

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 ormell 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 lI—OPERATION AND USE GENERAL CONDITIONS
1. This permit is effective only with respect to the nature, volume of materials and rate of injection, as
described in the application and other supporting data.
2. This permit is not transferable without prior notice to, and approval by,the Director of the Division of
Water Quality (Director). In the event there is a desire for the facility to change ownership, or there is a
name change of the Permittee, a formal permit amendment request must be submitted to the Director,
including any supporting materials as may be appropriate, at least 30 days prior to the date of the change.
3. The issuance of this permit shall not relieve the Permittee of the responsibility of complying with any and
all statutes, rules,regulations, or ordinances, which may be imposed by other local, state, and federal
agencies, which have jurisdiction. Furthermore, the issuance of this permit does not imply that all
regulatory requirements have been met.
4. Continued operation of the injection system will be contingent upon the effluent not impacting
groundwater quality. The water quality of the effluent cannot be that of a lower quality than the influent,
which results in a degrading of water quality of the aquifer.
PART III—PERFORMANCE STANDARDS
1. The injection facility shall be effectively maintained and operated at all times so that there is no
contamination of groundwater that will render it unsatisfactory for-normal use. In the event that the
Permit#W10100006 UIC/50 - Page 2 of
ver.03/2010

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. Accordingly, the well head
needs to be sealed around the electrical wires and return pipe in .order to-prevent" surface
contaminants from entering the well.
2. Since the system was not operational at the time of the inspection on April 26, 2012, the Permittee
shall notify the Asheville Regional Office (828-296-4500) within 10 days after the system becomes
operational again in order that samples can be obtained from the influent and effluent ports.
3. The well should be chlorinated prior to use as rodent droppings were observed on the well head and
in the installation.
4. 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#W10100006 UIC/5A7 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 Raleigh Regional Office,.telephone number 919-791-4200, any of the following:
(A) Any occurrence,at 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 RENEWAL
In order to continue uninterrupted legal use of the injection facility for the stated purpose, the Permittee shall
submit an application to renew the permit 120 days prior to its expiration date.
PART VIH—CHANGE OF WELL STATUS
1. The Permittee shall provide written notification within 15 days of any change of status of an injection
well. Such a change would include the discontinued use of a well for injection. If a well is taken
completely out of service temporarily, the Permittee must install a sanitary seal. If a well is not to be used
for any purpose that well must be permanently abandoned according to 15A NCAC 2C .0213(h)(1), Well
Construction Standards.
2. When operations have ceased at the facility and a well will no longer be used for any purpose, the
Permittee shall abandon that injection well in accordance with the procedures specified in 15A NCAC 2C
.0214, including but not limited to the following:
(A) All casing and materials may be removed prior to initiation of abandonment procedures if
the Director fords 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 t0 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 NW10100006 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 cavify 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 Peimittee shall submit a Well Abandonment Record (Form GW-30) as specified in
15A NCAC 2C.0213(h)(1) within 30 days of completion of abandonmenf.
3. The written documentation required in Part VIII (1) and (2) (G) shall be submitted to:
Aquifer Protection Section-UIC Program
-DENR=Division of Water Quality — -
1636 Mail Service Center
Raleigh,NC 27699-1636
Permit#W10100006 UIC/5A7 Page 5 of 5
ver.03/2010

Driving Directions from 2090'Us 70 Hwy, Swannanoa,North Carolina 28778 to 141 Courtland C... Page 1 of 2
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Notes /
3S 02,�-"46 33
Trip to:
141 Courtland Ct $z° Cc 63 It
Lake Lure, NC 28746-9351
39.08 miles/56 minutes
2090 Us 70 Hwy, Swannanoa, NC 28778-8211
® 1.Start out going east on US-70 toward Walters Rd.Map 1.2 Mi
1.2 Mi Total
2.Turn right onto Patton Cove Rd.Mao 0.4 Mi
Patton Cove Rd is 0.1 miles past Old Patton Cove Rd 1.6 Mi Total
Lee's Food Stores is on the right
If you reach Welch Rd you've gone a little too far
3.Merge onto 1-40 E via the ramp on the left toward Black Mountain.Map 13.4 Mi
M `.►✓ If you'reach Buckeye Access Rd you've gone a little too far 15.0 Mi Total
m 4.Take EXIT 73 toward Old Fort.Mao 0.2 Mi
15.1 Mi Total
---------------- ----------- ----- --------- - ---- ----- - -- -
it 5.Stay straight to go onto Catawba River Rd. Mao 0.04 Mi
15_.2 Mi Total
6.Turn slight right onto Bat Cave Rd.Map 0.5 Mi
15.7 Mi Total
7.Turn slight left onto Old Fort Sugar Hill Rd.Map 8.9 Mi
Bethlehem Baptist Church is on the left 24.7 Mi Total
B.Turn right onto Montford Cove Rd.Mao 4.1 Mi
28.8 Mi Total
It 9.Montford Cove Rd becomes Cove Rd.Mao 1.2 Mi
30.0 Mi Total
10.Turn right onto Bills Creek Rd.MaD 7.1 Mi
37.1 Mi Total
11.Turn right onto Buffalo Creek Rd. Map 0.9 Mi
Buffalo Creek Rd is 0.2 miles past Landmark Dr 38.0 Mi Total
Dalton Store is on the left
If you are on Bills Creek Rd and reach Nowell Rd you've gone about 0.2 miles too far
12.Turn right onto Winesap Rd.Map - 0.8 Mi
IMnesap Rd is just past O Messetsmith Rd 38.8 Mi Total
If you reach Whitney Blvd you've gone about 0.4 miles too far
13.Turn slight left onto Winesap Blvd.Mai) 0.1 Mi
Winesap Blvd is just past Sheepnose Dr 38.9 Mi Total
` 14.Take the 2nd left to stay on Winesap Blvd. Mai) 0.1 Mi
-1 Winesap Blvd is just past Downing PI 39.1 Mi Total
If you reach the end of Vance PI you've gone a little too far
15.Turn slight left onto Courtland Ct.MaD 0.01 Mi
Couriland Ct is just past Downing PI 39.1 Mi Total
■ 16. 141 COURTLAND CT is on the left.Mai)
If you reach the end of Courtland Ct you've gone about 0.1 miles too far
141,Courtland Ct, Lake Lure, NC 28746-9351
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- 'Driving Directions from 2090 Us 70 Hwy, Swannanoa,North Carolina 28778 to 141 Courtland C... Page 2 of 2
Total Travel Estimate: 39.08 miles -about 56 minutes
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RECEIVED
AQUIFER PROTECTION SECTION
C APPLICATION REVIEW REQUEST FO M,4R 12 2C,2
Date: March 8, 2012 Asheville Regional Office
Aquifer Protection
To: ® Landon Davidson,ARO-APS ❑ David May, WaRO-APS
❑ Art Barnhardt, FRO-APS ❑ Morella Sanchez King, WiRO-APS
❑ Andrew Pitner,MRO-APS ❑ Sherri Knight, W-SRO-APS
❑ Jay Zimmerman,RRO-APS
From: Michael Rogers Groundwater Protection Unit
Telephone: [phone] Fax: [phone]
E-Mail: [e-mail]
A. Permit Number: WI 0100006
B. 011ner: Rainfall Mountains,Inc.
C. Facility/Operation:
❑ Proposed ® Existing ❑ Facility ❑ Operation
D. Application:
I. Permit Type: ❑ Animal ❑ SFR-Surface Irrigation❑ Reuse ❑ H-R Infiltration
❑ Recycle ❑ I/E Lagoon ❑ GW Remediation(ND)
® UIC—SA7 Open Loop 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:
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.
e When you receive this request forth, please write your name and dates in the spaces below, make a copy
m« of this sheet, and return it to the appropriate Central Office-Aquifer Protection Section contact person
_u listed above.
RO-APS Reviewer: Date:
FORM:APSARR 07/0 Page I of I
cna4t1ah _-Wff

ecelvcd�, 2 ?} �Z
NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
APPLICATION FOR A PERMIT TO CONSTRUCT OR OPERATE INJECTION WELLS
In Accordance With the Provisions of 15ANCAC 02C.0200
OPEN-LOOP GEOTHERMAL INJECTION NVELLS
These wells discharge groundwater directly into the subsurface as part of a geothermal heating and cooling system
(check one) - New Application Renewal* Modification
*For renewals complete Parts A-C and the signature page. -
Print or Type Information and Mail to the Address on the LastPage. Illegible Applications lill.Be Returned As Incomplete.
DATE: O y 20_
:J PERMIT NO. OODO 6 (leave blank if New Application)
STATUS OF APPLICANT choose -----
._ .. (- one)
Non-Government:' Individual Residence V Business/Organization
Government: State._ Municipal_ County_ Federal_
/_L IIl B. PERMIT APPLICANT— For individual residences, list each owner on property deed. For all others,
1 state nam ofentity and name of persoq delegated authorityto sign on behalf of the business or agency:
I � aLL
:. Mailing/Address: /lI �Ou I�YL,/asr�`/Cu
(3 City /� C f.G1�N State/!C Zip Code: County:
DayTele.No.:
I EMAIL
' C. LOCATION OF WELL SITE—Where the injection wells are physically located`
-�, (1)` _PazcelIdentificationNumbez(PIN)ofwell-site: County;_._ _. . : .._ .... __
(2) Physical Address(if different than mailing address):
City: State:NC Zip Code: .
I
D. WELL DRILLER INFORMATION
Well Drilling Contractor's Name:
NC WellDrilling Contractor Certification No.:
Company Name:
Contact-Person: EMAIL Address:
Address:
City._ Zip Code: State:_County:.
i
Office Tele No.: Cell No.: Fax No.:
GPUfWC 5A7 Permit Application(Revised 311 MG11).. Page l

J. 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; =f
4. for all others: by the well owner(which means all persons listed on the nronerty deed).
If an.authorized agent is signing on behalf of the applicant, then supply a;letter signed by,the e
applicant that namesand authorizes their agent to sign this application on their behalf.
111
"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 tine, accurate and -:t
complete. I am aware that there are significant penalties,including`thepossibility of fines and imprisonment, ;
for submitting false information. I-agree to construct;operate,maintain,repair;-and-if applicable,abandon the J
injection well and all related appurtenances in accordance with the approved specifications and conditions of
the Permit""
Sigpdmre of Property O ApplicantCK
?
''PrmC.6 .rh6 FIM Mini, - E
Signature of Property Owner/Applicant
Print or Type Full Name
i
Signature of Authorized Agent,if any
-. ._PrintorTypeFullName-. - -. .
3
a
Submit two copies of the completed application package to:
DWQ-Aquifer Protection Section F
1636 Mail Service Center
Raleigh,NC 27699-1636
Telephone[phone]
t
t
Application(Revised 3/18,2011) - Page?
d
SLY �4 }55l YJ. wy__ y�

State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STATUS OF INJECTION WELL SYSTEM
Permit Number:
Permittee Name:
Address:
Please check the selection which most closely describes the current status of your injection well system: -,
1) ❑ Well(s)still used for-injection activities,or may be in the future.
s-5
2) ❑ Well(s)not used for injection but is/are used for water supply or other purposes.
3} ITgeclion discominued and: a)❑Weli(s) temporarily abandoned ^=-
N�. :Il
b)❑Well(s)permanently abandoned -i
G}4ell(s)not abandoned
4) ❑ Injection well(s)never constructed
Current Use of Well
If you checked(2),describe the well use(potable water supply,irrigation,monitoring,etc),including pumping rate and other
relevant information.
Well Abandonment
If you checked(3)(a)or(3)(b),describe the method used to abandon the injection well. (Include a description ofhow the well
was sealed and the type of material used to fill the well ifpermanently abandoned):
Permit Rescission:
If you checked(2),(3),or(4)and will not use a well for injection on this site in the future,you should request rescission of the
permit.Do you wish to rescind the error
❑ Yes No
Certification:
"I hereby certify,under penalty of law,that I have personally examined and am familiar with the information submitted
in this document, and that to the best of my knowledge the information is true, accurate, and complete.'
all 97 L
Si Ka Date
g ,/V� -
Revised 5/05 GW/UIC-68

r
WCDERR
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 28,2012
Suzanne McKay
Rainfall Mountains,Inc.
141 Courtland Court
Lake Lyre,NC 28746
Subject: Acknowledgement of
Application No.WQD100006
Rainfall Mountains Inc.-SFR
Injection Heating/Cooling
Water Return Well (5A7)
System
Rutherford County
Dear Ms.McKay:
The Aquifer Protection Section acknowledges receipt of your permit application and supporting
documentation received on February 27, 2012. Your application package has been assigned the number
listed above, and the primary reviewer is Thomas Slusser.
Central and Asheville Regional Office staff will perform a detailed review of the provided
application, and may contact you. with a request for additional information. To'ensure. maximum
efficiency in processing permit applications, the Aquifer Protection Section requests your assistance in
providing a timely and complete response to any additional information requests.
Please note that processing standard review permit applications may take as long as 60 to 90 days
after receipt of a . complete application. If you have any questions, please contact
Thomas Slusser at(919)807-6412 or [e-mail].
Sincerely,
for Debra 7. s
Groundwater Protection Unit Supervisor
cc: Asheville Regional Office,Aquifer Protection Section
Permit File WI0100006
AQUIFER PROTECTION SECTION
1636 Mail Service Center,Raleigh,North Carolina27699.1636
Location:512 N.Salisbury St,Raleigh,North Carolina 27604 One: •: ;
Phone:[phone] FAK 919-807.6496 Nofthcar.ohna
Internet:www.nLwaterguality.ora -
An Equal OPporWntylAtfrmative Action Employe[ �i �� ���

RECEIVED
HCDE KIR Q1 2 12 ,,
North Carolina Department of Environment and Natural Rw*wft Regional Office
Division of Water Quality Aquifer Protection
Beverly Eaves Perdue Charles Wakild, P.E. Reenran
Governor Director Secretary
February 28,2012
Suzanne McKay
Rainfall Mountains,Inc.
141 Courtland Court
Lake Lyre,NC 28746
Subject: Acknowledgement of
Application No.WQ0100006
Rainfall Mountains Inc. -SFR
Injection Heating/Cooling
Water Return Well(5A7)
System
Rutherford County
Dear Ms. McKay:
The Aquifer Protection Section acknowledges receipt of your permit application and supporting
documentation received on February 27, 2012. Your application package has been assigned the number
listed above,and the primary reviewer is Thomas Slusser.
Central and Asheville Regional Office staff will perform a detailed review of the provided
application, and may contact you with a request for additional information. To ensure maximum
efficiency in processing permit applications, the Aquifer Protection Section requests your assistance in
providing a timely and complete response to any additional information requests.
Please note that processing standard review permit applications may take as long as 60 to 90 days
after receipt of a complete application. If you have any questions, please contact
Thomas Slusser at(919)807-6412 or [e-mail].
Sincerely,
for Debra J.
Groundwater Protection Unit Supervisor
cc: Asheville Regional Office,Aquifer Protection Section
Permit File WI0100006
AQUIFER PROTECTION SECTION
1636 Mad Service Center,Raleigh,North Carolina 27699-1636
Location:512 N.Salisbury St,Raeigh,North Carolina 27604 ' !�t•,,•e
Phone:[phone]\FAX:919a7ww $196 jvp FV'�,j'o11IIa
Internet:w .ncwateraualay.ora
An Equal Opportunity 1 Affirmative Action Employer ataullry

HCDEHR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director RECEIVED Secretary
December 2, 2011
C=C 0 6 2u i1 t/
Rainfall Mountains, Inc. [Asheville Regional Office
Suzanne McKay A uifer Protection
141 Courtland Court
Lake Lure,NC 28746
Subject: Notice of Expiration (NOE)
5A7 Geothermal Injection Well
Permit No. WI0100006
Rutherford County
Dear Ms. McKay:
The Underground Injection Control (UIC) Program of the North Carolina Division of Water
Quality (DWQ) is entrusted to protect the groundwater quality and resources of the State of
North Carolina, and is responsible for the regulation of injection well construction and operation
activities within the state. Our records indicate that the above-referenced operating permit for
the underground injection well system located on your property at 141 Courtland Court in Lake
Lure,NC, which was issued to you on May 15, 2007, and expires on April 30, 2012, is soon due
for renewal. If you wish to keep this permit and operate the injection well system, the permit
must be renewed and issued in your name.
If Your Iniection Well is Currently Inactive:
If the injection well system is no longer being used for any purpose, it must be permanently
abandoned according to the regulatory requirements listed under NCAC Title 15A, Subchapter
2C, Section .0214. When each well is plugged and abandoned, the well abandonment record
(Form GW-30) must be submitted to our office to certify that the abandonment was properly
conducted.
If there has been a change of ownership of the property, an Injection Well Permit
Name/Ownership Change Form must also be submitted. The GW-30 and Name/Ownership
Change forms can be found at httn://portal.nr-denr.or web/wg/aps/wr,pro/reportine-forms.
If Your Injection Well is Currently Active:
If the injection well system is still active and you wish to renew your permit, the renewal
application must be submitted within 120 calendar days of the expiration of your permit.
According to our records, you must submit your permit renewal by January 1,2012.
AQUIFER PROTECTION SECTION
1636(Vail Service Centw,Raleigh,North Carolma 27699-1636
uocamn.2728 Caoaal Boulevard.Rat-ah Norm Carolina 276604 Gn`
o _
Pnone'.9 ,,<32_'! Fh?.. .9?9-71�88.FAY2919-715-BM8lOustomerseivice'1-877-62"s-674,'Inte hIOT'tl1L.a1'Ol1Bu mei'w nrwateroua9R oro p
a.=aua. pconw .4fivmanveH vo,emoaae

In order to comply with the regulatory requirements listed under North Carolina Administrative
Code (NCAC) Title 15A, Subchapter 2C, Section .0211, you must submit one of the following
enclosed forms:
A. Application for Permit (Renewal) to Construct and/or Use a Well(s)for Injection with
Geothermal Heat Pump System for Type 5A7 Well($) if the injection well system on your
property is still active.
-OR-
B. Status of Injection Well System if the injection well system is inactive or has been
temporarily or permanently abandoned.
Please submit the appropriate forms to:
Aquifer Protection Section
Groundwater Protection Unit
UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Failure to submit these forms in a timely manner may result in the assessment of civil penalties
in accordance with North Carolina General Statute 87-94. For your convenience, a renewal
application and a UIC well system status form are attached along with a self-addressed envelope.
The above referenced forms are also available on-line at the DWQ website at
http•//portal nedenr ore/web/wa/aps/swpro/permit applications#2eothermAm .
Thank you in advance for your cooperation and timely response. If you have any questions,
please contact me by phone at(919) 715-6196 or by email at eric.s.smith0nedenr.eov.
Sincerely,
A,
Eric G. Smith, P.G.
Hydrogeologist
Enclosures
cc: Asheville Regional Office -APS w/o enclosures
APS Central Files - Permit No. WI0100006 w/o enclosures
2

\O � TQG Michael F.Easley,Governor
y William G.Ross Jr.,Secretary
r
North Carolina Department of Environment and Natural Resources
Alan W.Klimek P.E.Director
Division of Water Quality
May 15, 2007
Rainfall Mountains, Inc. RECEIVED
Attn: Ms. Suzanne McKay MAY 2 9
P.O. Box HM 1877 2007
Hamilton, Bermuda Asheville Regional Office
Re: Issuance of Injection Well Permit A uifer Protection
Permit No.WI0100006
Issued to Rainfall Mountains, Inc.
Dear Ms. McKay:
In accordance with your signed application received March 16, 2007, I am forwarding Permit
No. WI0100006 for the operation of a 5A7 geothermal underground injection (UIC) well heat
pump system located at 141 Courtland Court, Lake Lure, Rutherford County, North Carolina
28746. This permit shall be effective from the date of issuance until April 30, 2012, and shall be
subject to the conditions and limitations stated therein.
In order to continue uninterrupted legal use of this well for the stated purpose,you should submit
an application to renew the permit three (3) months prior to its expiration date. As indicated in
the permit, this permit is not transferable to any person without prior notice to, and approval by,
the Director of the Division of Water Quality. Also attached is a summary of the laboratory
sampling results from water samples collected from your geothermal well on April 10, 2007.
If you have any questions regarding your permit or the Underground Injection Control (UIC)
Program please call Mr. Qu Qi at [phone] or me at(919) 715-6166.
Best Regards,
Michael Rogers
Environmental Specialist H
GPU—UIC Control Program
cc: Landon Davidson—Asheville Regional Office
Central Office File
Attachment(s)
NOoe Carolina
j�gh
Aquifer Protection Section 1636 Mail Service Center Raleigh,NC 27699-1636 Telephone: [phone]
Internet:http'//www ncwatergualitv.ore 2728 Capital Boulevard Raleigh,NC 27604 Fax 1: (919)71M588
Fax 2: [phone]
An Equal Opportunity/A(Bnnalive Adon Employer-50%Recycled/10%Post Consumer Paper Customer Service: [phone]

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH,NORTH CAROLINA
PERMIT FOR THE CONSTRUCTION AND OPERATION OF A WELL FOR INJECTION
In accordance with the provisions of Article 7, Chapter 87; Article 21, Chapter 143, and other
applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
RAINFALL MOUNTAINS,INC.
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 141 Courtland Court, Lake Lure, North Carolina,
and will be operated in accordance with the application received March 16, 2007, and in
conformity with the specifications and supporting data submitted, all of which are filed with the
Department of Environment and Natural Resources and are considered a part of this permit.
This permit is for Operation only, and does not waive any provisions of the Water Use Act or
any other applicable Laws, Rules, or Regulations. Operation and use of an injection well shall
be in compliance with Title 15A North Carolina Administrative Code 2C .0100 and .0200, and
any other Laws, Rules, and Regulations pertaining to well construction and use.
This permit shall be effective, unless revoked, from the date of its issuance until April 30, 2012,
and shall be subject to the specified conditions and limitations set forth in Parts I through VIII
hereof.
y Permit issued this the day of yro+k 12007.
AAlan W. Klimek, Director
Division of Water Quality
By Authority of the Environmental Management Commission.
WI0100006 Page 2

PART I-WELL CONSTRUCTION GENERAL CONDITIONS
1. The Permittee must comply with all conditions of this permit and with the standards and
criteria specified in Criteria and Standards Applicable to Injection Wells (15A NCAC 2C
.0200). Any noncompliance with conditions of this permit constitutes a violation of the
North Carolina Well Construction Act and is grounds for enforcement action as provided
for.in N.C.G.S. 87-94.
2. This permit shall become voidable unless the facility is constructed in accordance with the
conditions of this permit,the approved plans and specifications, and other supporting data.
3. Each injection well shall not hydraulically connect separate aquifers.
4. Each injection well shall be constructed in such a manner that water from land surface
cannot migrate into the gravel pack or well screen.
5. Each injection well shall be secured to reasonably insure against unauthorized access and
use. Each well shall be permanently labeled with a warning that it is for injection purposes
and the entrance to each well must be secured with a locking cap.
6. Each injection well shall be afforded reasonable protection against damage during
construction and use.
7. Each injection well shall have permanently affixed an identification plate.
8. A completed Well Construction Record (Form GW-1) must be submitted for each injection
well to, DENR-Division of Water Quality, Aquifer Protection Section UIC-Staff, 1636
Mail Service Center,Raleigh,NC 27699-1636,within 30 days of completion of well
construction.
PART H-OPERATION AND USE GENERAL CONDITIONS
1. This permit is effective only with respect to the nature,volume of materials and rate of
injection, as described in the application and other supporting data.
2. This permit is not transferable without prior notice to, and approval by, the Director of the
Division of Water Quality(Director). In the event there is a desire for the facility to
change ownership, or there is a name change of the Permittee, a formal permit amendment
request must be submitted to the Director, including any supporting materials as may be
appropriate, at least 30 days prior to the date of the change.
3. The issuance of this permit shall not relieve the Permittee of the responsibility of
complying with any and all statutes,rules, regulations, or ordinances,which maybe
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.
WI0100006 Page 3

PART III- PERFORMANCE STANDARDS
1. The injection facility shall be effectively maintained and operated at all times so that there
is no contamination of groundwater, which will render it unsatisfactory for normal use. In
the event that the facility fails to perform satisfactorily,including the creation of nuisance
conditions or failure of the injection zone to adequately assimilate the injected fluid, the
Permittee shall take immediate corrective actions including those actions that maybe
required by the Division of Water Quality such as the repair, modification, or abandonment
of the injection facility.
2. The Permittee shall be required to comply with the terms and conditions of this permit
even if compliance requires a reduction or elimination of the permitted activity.
3. The issuance of this permit shall not relieve the Permittee of the responsibility for damages
to surface or groundwater resulting from the operation of this facility.
PART IV- OPERATION AND MAINTENANCE REQUIREMENTS
1. The injection facility shall be.properly maintained and operated at all times.
2. The Permittee must notify the Division and receive prior written approval from the
Director of any planned physical alterations or additions in the permitted facility or activity
not specifically authorized by the permit.
PART V-INSPECTIONS
1. Any duly authorized officer, employee, or representative of the Division of Water Quality
may,upon presentation of credentials, enter and inspect any property,premises, or place
on or related to the injection facility at any reasonable time for the purpose of determining
compliance with this permit, may inspect or copy any records that must be maintained
under the terms and conditions of this permit, and may obtain samples of groundwater,
surface water, or injection fluids.
2. Department representatives shall have reasonable access for purposes of inspection,
observation, and sampling associated with injection and any related facilities as provided
for in N.C.G.S. 87-90.
3. Provisions shall be made for collecting any necessary and appropriate samples associated
with the injection facility activities.
WI0100006 Page

PART VI-MONITORING AND REPORTING REQUIREMENTS
1. Any monitoring(including groundwater, surface water, or soil sampling) deemed
necessary by the Division of Water Quality to insure surface and ground water protection,
will be established and an acceptable sampling reporting schedule shall be followed.
2. The Permittee shall report by telephone,within 48 hours of the occurrence or first
knowledge of the occurrence, to the Asheville Regional Office, telephone number (704)
663-1699, any of the following:
(A) Any occurrence at the injection facility which results in any unusual
operating circumstances;
(B) Any failure due to known or unknown reasons, that renders the facility
incapable of proper injection operations, such as mechanical or electrical
failures.
3. Where the Permittee becomes aware of an omission of any relevant facts in a permit
application, or of any incorrect information submitted in said application or in any report to
the Director,the relevant and correct facts or information shall be promptly submitted to
the Director by the Permittee.
4. In the event that the permitted facility fails to perform satisfactorily, the Permittee shall
take such immediate action as maybe required by the Director.
PART VII-PERMIT RENEWAL
The Permittee shall, at least 120 days prior to the expiration of this permit,request an extension.
PART VIII- CHANGE OF WELL STATUS
1. The Permittee shall provide written notification within 15 days of any change of status of
an injection well. Such a change would include the discontinuation of use of a well for
injection. If a well is taken completely out of service temporarily,the Permittee must
install a sanitary seal. If a well is not to be used for any purpose that well must be
permanently abandoned according to 15A.NCAC 2C .0213(h)(1),Well Construction
Standards.
2. When operations have ceased at the facility and a well will no longer be used for any
purpose,the Permittee shall abandon that injection well in accordance with the procedures
specified in 15A NCAC 2C .0214, including but not limited to the following:
(A) All casing and materials may be removed prior to initiation of
abandonment procedures if the Director finds such removal will not be
responsible for, or contribute to,the contamination of an underground
source of drinking water.
WI0100006 Page 5

(B) The entire depth of each well shall be sounded before it is sealed to insure
freedom from obstructions that may interfere with sealing operations.
(C) Each well shall be thoroughly disinfected,prior to sealing, if the Director
determines that failure to do so could lead to the contamination of an
underground source of drinking water.
(D) Each well shall be completely filled with cement grout, which shall be
introduced into the well through a pipe,which extends to the bottom of the
well and is raised as the well is filled.
(E) In the case of gravel-packed wells in which the casing and screens have
not been removed, the casing shall be perforated opposite the gravel pack,
at intervals not exceeding 10 feet, and grout injected through the
perforations.
(F) In those cases when, as a result of the injection operations, a subsurface
cavity has been created, each well shall be abandoned in such a manner
that will prevent the movement of fluids into or between underground
sources of drinking water and in accordance with the terms and conditions
of the permit.
(G) The Permittee shall submit a Well Abandonment Record (Form GW-30)
as specified in 15A NCAC 2C .0213(h)(1)within 30 days of completion
of abandonment.
3. The written documentation required in Part VIH (1) and (2) (G) shall be submitted to:
Aquifer Protection Section-UIC Staff
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh,NC 27699-1636
WI0100006 Page 6

' s
LABORATORY ANALYTICAL RESULTS
5A7 GEOTHERMAL UNDERGROUND INJECTION CONTROL (UIC)WELL
PERMIT NO.: WI 0100006
PERMITTEE: Rainfall Mountains, Inc
REGIONAL OFFICEICOUNTY: Asheville/Rutherford
SAMPLE COLLECTED DATE: 4/10/2007
Coliform,total Coliform,fecal pH Chloride,Cl Sulfate Total Dissolved Solids Ammonia,NH3 TKN
1 CFU/100ml 1 CFU/100m1 units mg/L mg/L mg/L mg/L mg/L
MCL=1 MCL=1 MCL=6.5-835 MCL=250 MCL=250 MCL=500 MCL=nss MCL=nss
Influent 1.6 <2
Effluent 2.1 <2
NO2-+NO3-as N Phosphorus Nitrate Nitrite Silver,Ag Aluminum,At Arsenic,As Barium,Ba
mg/L mg/L mg/L mg/L pg/L g/L g/L ligil.
MCL=10 MCL=nss MCL=10 MCL=1 MCL=17.5 MCL=nss MCL=50 MCL=2000
Influent 0.07 <50
Effluent 0.1 <50
Calcium,Ca Cadmium,Cd Chromium,Cr Copper,Cu Iron,Fe Mercury,Hg 245.1 Potassium,K Magnesium;Mg
mg/L pg/L pg1l. g/L pg/L g/L mg/L mg/L
MCL=nss MCL=1.75 MCL=50 MCL=1000 MCL=300 MCL=1.05 MCL=nss MCL=nss
Influentl 29 <10 33 <50 2.8 3.4
Effluenti 26 <10 27 <50 2.7 3.4
Manganese,Mn Sodium,Na Nickel,Ni Lead,Pb Selenium,Be Zinc,Zn Fluoride
g/L mg/L pg/l. g/L pg/L pg/L mg/L
MCL=50 MCL=nss MCL=100 MCL=15 MCL=50 MCL=1050 MCL=2
Influent
<10 5.6 <10 <10 <10 <.4
Effluent <10 5.6 <10 <10 <10 <.4
MCL=Maximum Contamination Level per NCAC 2L.0200(GA Standards)
nss=no state standard
If no result(blank)=parameter not analyzed

North Carolina
GROUNDWATER FIELD/LAB FORM Department of Environment and Natural Resources
- DIVISION OF WATER QUALITY-GROUNDWATER SECTION
Location code_O 1 & QArrGA6L c4/a C? a SAMPLE TYPE SAMPLE PRIORITY
County_- 'eIzV ERFak,) X Water ® Routine . _ Lab Number /}5 15 39a
Q 1.uad No Serial No. Soil Emergency Date Received 4-/o-0y
/ F Time: 1440
(Lat' (Lon_. ❑ Other _ _ _ --Rec'd By:-V%S From:Bus, Courier an De
' ❑ Chain of Custody Other:
Report To'< cRO, MRO, RRO,WaRO,WiRO, Data Entry By: SMS Ck: +MS
WSRO, Kinston FO, Fed.Tru Central OH., Other: Date Reported: 5-/-07
.Shipped by:Bus, Courier and D , Other: - - Purpose: -
Collector(s): `r—it'uJ�ff Date 04 r Time /34.f Baseline, Complain ,. om lian LUST, Pesticide Study, Federal Trust, Other:
FIELD ANALYSES Owner 44t^(Afcc A4WS c- / eO a) Sj1*wWr n4rr4 C 44i)SOf- Zj/Z
PH 400 Spec. Ccnd.s4 at 25°C Location or Site A CovasLw eE Icr" '
.Temp:lb °C Odor Description of sampling point CM
r 4.4
Appearance _ Sampling Method t"01 Sample Interval
Fieid Analysis By: - - Remarks
LABORATORY ANALYSES (PumpiN ime.airtemP.,em.)
6OD 110 mg/L X Diss.Solids 70300 /3,D mg/L Ag-Silver 46566
u /L Or anochlodne Pesticides
COo High 340 mg/L Fluoride 951 mg/L Al-Aluminum 46557 u /L Organophosphorus Pesticides
'COD Low 335 mg/L Hardness:Total goo mglL As-Arsenic 46551 u /L Nitrogen Pesticides
Collform:MF Fecal 31616 18a /100m1 Hardness(noncarb)902 mg/L Ba-Barium 46558 u /L Acid Herbicides _
C0liform:MF Total 31504 f100ml Phenols 32730 ug/l Ca-Calcium46552 m /L PCBs _
TOC 680 mg/L Specific Cond.95 uMhos/cm Cd-Cadmium 46559 u /L
_- .Turbidity 76 - _ - ---NTU- - Sulfate 945 -- - — . 'mg/L Cr-Chromium 46559 u L
Residue.Suspended 530 mg/L Sulfide 745 mg/L Cu-Capper 46562 u /L
Fe-Iron 46563 u /L Semivolalile Or anim
Oil and Grease - mg/L Hg-Mercury 71900 u /L TPH-Diesel Range
pH 403 units K-Potassium 46555
m /L
Alkalinity to pH 4.5 410 mg/L Mg Magnesium 46554 m /L - - - -
Alkalinity to pH 8.3 415 mg/L Mn-Manganese 46565 u /L, Volatile Orpanics(VOA bottle)
Carbonate 445 mg/L NH,as N 610 mg/L NaSodium 46556 m /L TPH-Gasoline Range
Bicarbonate 440 mg/L TKN as N 625 mg/L Ni-Nickel a /L TPH-STEX Gasoline Range
Camon dioxide 405 _ mg/L NO,,+NO,as N 630 mg/L. Pb-Lead 46564 - u /L
.Chloride 940 mg/L P:Total as P 665 mg/L Se-Selenium u L
Chromium:Hex 1032 ug/L Nitrate(NO,as N)620 mg/L Zn-Zinc 46567 u /L
Color.True 80 Cu Nitrite(NO2 as N)615 mg/L LAB USE ONLY
Cyanide 720 - mg/L Temperature on arrival(°C): a,
Lab Comments
GW-54 REV.7/03 For Dissolved Analysis-submit filtered sample and write-DIS'm block

91 NC 1�'W GadoratoSection esuCts
Loc.Descr.: RAINFALL MTNS,INC INF Q t 0000 Sample ID: 15459
7G
PO Number# 7G0234
Location ID: 01 RURAINFALL04100701 VisitlD
County: RUTHERFORD OF V4ApER
a (} Collect Dale: 04/10I2007
River Basin
`O G Report To AROAP Collect Time:: 13:45
Date Received:ARO
�i � � A
Collllector: T MINNICK p _ Y V�\\� Time Received: 08:30/2007
Sample Matrix: GROUNDWATER Labworks LoginlD MMA
Loc.Type: WATER SUPPLY
Sample Depth Date Reported: 0 5/0 212 0 0 7
Emergency Yes/No
COC Yes/No
Sample Qualifiers and Comments
Routine Qualifiers
For a more detailed description of these qualifier codes refer to www.dwqlab.org under Staff Access
A-Value reported is the average of two or more determinations
N3-Estimated concentration is<POL and>MDL
Bl-Countable membranes with<20 colonies; Estimated
NE-No established PQL
B2-Counts from all filters were zero.
B3-Countable membranes with more than 60 or 80 colonies; Estimated P-Elevated PQL due to matrix interference and/or sample dilution
64-Filters have counts of both>60 or 80 and<20: Estimated Qt-Holding time exceeded prior receipt at lab.
B5-Too many colonies were present;too numerous to count(TNTC) Q2-Holding time exceeded following receipt by lab
J2-Reported value failed to meet QC criteria for either precision or accuracy; Estimated PQL-Practical analyzed
forth Limit-subject to change due to instrument sensitivity
U-Samples analyzed for this compound but not detected
J3-The sample matrix interfered with the ability to make any accurate determination; Estimated
J6-The lab analysis was from an unpreserved or improperly chemically preserved sample; Estimated X1-Sample not analyzed for this compound
Nl-The component has been tentatively identified based on mass spectral library search and has an estimated value
Laboratory Section>>1623 Mail Service Center, Raleigh, NC 27699-1623 [phone] Page 1 of 3

Sample ID AB15459
NC DWQ Laboratory Section Results
Location ID: OIRURAINFALL04100701 Collect Date: 04/10/2007
Loc.Descr.: RAINFALL MTNS,INC INF Collect Time:: 13:45
Visit ID
Analyte Name PQL Result Qualifier Units AnalystiDate Approved By/Date
LAB
Sample temperature at receipt by lab 0.3 C DSAUNDERS MMATHIS
Method Reference 4/12/07 4/12/07
WET
Chloride 1.0 1.6 mq/L MIBRAHIM MOVERMAN
Method Reference EPA 300.0 4/19/07 4/24/07
Fluoride 0.4 0.4 U mq/L MIBRAHIM MOVERMAN
Method Reference EPA 300.0 4/19/07 4/24/07
Sulfate 2.0 2.0 U mq/L MIBRAHIM MOVERMAN
Method Reference EPA 300.0 4/19/07 4/24/07
NUT
NO2+NO3 as N in liquid 0.02 0.07 mq/L as N MAJAYI CGREEN
Method Reference L8c10-107-04-1-c 4/12107 4/17/07
MET
7429-90-5 Al by ICP 50 50 U uq/L JJURGEVICH ESTAFFORD
Method Reference EPA 200.7 4/23/07 5/1/07
7440-70-2 Ca by ICP 0.10 29 mq/L JJURGEVICH ESTAFFORD
Method Reference EPA 200.7 4/23/07 6/1/07
744047-3 Cr by ICPMS 10 10 U uq/L PGAUTHIER ESTAFFORD
Method Reference EPA 200.8 4/26/07 5/1/07
7440-50-8 Cu by ICPMS 2.0 33 uq/L PGAUTHIER ESTAFFORD
Method Reference EPA 200.8 4/26/07 5/1/07
7440-48-4 Fe by ICP 50 50 U uq/L JJURGEVICH ESTAFFORD
Method Reference EPA 200.7 4123/07 511107
7440-09-7 K by ICP 0.10 2.8 mq/L JJURGEVICH ESTAFFORD
Method Reference EPA 200.7 4/23/07 5/1/07
7439-954 Mg by ICP 0.10 3.4 ma/L JJURGEVICH ESTAFFORD
Method Reference EPA 200.7 4123/07 5H/07
7439-96-5 Mn by ICPMS 10 10 U uq/L JJURGEVICH ESTAFFORD
Method Reference EPA 200.8 4/23/07 511107
7440-234 Na by ICP 0.10 5.6 mq/L JJURGEVICH ESTAFFORD
Method Reference EPA 200.7 4123/07 5/1/07
7440-02-0 Ni by ICPMS 10 10 U uq/L PGAUTHIER ESTAFFORD
Method Reference EPA 200.8 4126/07 5/1/07
7439-92-1 Pb by ICPMS 10 10 U uq/L PGAUTHIER ESTAFFORD
Method Reference EPA 200.8 4/26/07 5/1/07
Laboratory Section>>1623 Mail Service Center,Raleigh,NC 27699-1623 [phone] Page 2 of 3

NC DWQ Laboratory Section Results SampleAB15459
Location ID: 01RURAINFALL04100701 Collect Date: 04/1012007
Loc.Descr.: RAINFALL MTNS, INC INF Collect Time:: 13:45
Visit ID
CAS# Analyte Name PQL Result Qualifier Units nays ate Approved By/Date
7440-66-6 Zn by ICP 10 10 U ug/L PGAUTHIER ESTAFFORD
Method Reference EPA 200.7 4124/07 511/07
Laboratory Section 1623 Mail Service Center,Raleigh,NC 27699-1623 [phone] Page 3 of 3

v:C /T�rr� # �r of 00006 Polyo51
North Carolina
GROUNDWATER FIELD/LAB FORM Department of Environment and Natural Resources
DIVISION OF WATER QUALITY-GROUNDWATER SECTION
Location code 01 AtAiwiFALI. 04100 0 1 SAMPLE IYPL
SAMPLE PRIORITY /�
County QfIFiCFOr�� O.Watef X Routine Lab Number V
Quad No Serial No. ❑ Soil ❑ Emergency q
Lat. 3S z 7 .9 Long. 2 10 ❑ Other Date Received�T-( Tim _
Rec'd By: bt 5 From:Bus our' r and Del.,
❑ Chain of Custody Other:_ Y�-�
Report To FRO, MRO, RRO,WaRO,WiRO, Data Entry By: Ck:
WSRO, Kinston FO Fed.Trust, Central Off., Other: Date Reported:
Shipped by: Bus, ouri Hand Del.,Other. Purpose:
Collector(s): T Llm(� ,C,r Date to seoZ Time 4 Baseline, Complaint, om lianc LUST, Pestic�St"dy, Federal Trust, Other:
FIELD ANALYSES Owner NF,4LG M)M i I �eZ:54t '.-`I°,�°tfs+�nr�y �fyjKfjl 7Ri/
PH 400 —�' Spec. Cond.e at 25°C Loratlon or Site /41 CwF7iwK0 UfT
Temp.lo /Z °C Odor Description of sampling point. f 7^0
Appearance Sampling Method Sample Interval
Field Analysis By: Remarks tl 013.0 ec
LABORATORY ANALYSES (Pumping I.,
BOD 310 rrg/L Din.Solids 70300 mglL AgSilver 46566 i !L O anachlanne Pesticides
COD High 340 mg/L Fluoride 951 mg/L Al-Aluminum 46557 uq1L Onationhostihcrus Pesticides _
COD Low 335 mg/L Hardness:Total 900 mg/L As-Arsenic 46557 Nitrogen Pesticides
Colifortn:MF Fecal 31616 f100m1 HarOness(non-carb)902 mg/L Ba-Sanum 46558 L Acid Herbicides
Colifonn:MF Total 31504 '100ml Phenols 32730 u90 Ca-Catdum 46552 PCBs
TOC 690 mwt Specific Coed.95 uMhosfcm Cd-Cadmium 46559 UgIL
Turbidity 76 NTU Su6ab 945
mg/L X Cr-Chromium 46559 fL
Residue,Suspended 530 mg/L Sulfide 745
mg/L A Cu-Copper 48562
Fe-Iron 46563 UnILSemivolable O anics
Oil and Grcasa mgfL �( Hg-Mercury 71900
L TPH-Diesel Range
PH 403 units K-Potassium 46555
L
Alkalinity to pH 4.5 410 rrg/L )( Mg-Magneslum 46554 rrML
Alkalinity 10 pH 8.3415 m9fL Mn-Manganese 46565 u /L _Volatile Omanics(VOA bonle)
Carbonate 445 mg/L NH,as N 610 mg/L N"Idlum 46558 IngTPH-Gasoline Range
Bicarbonate 440 mgfL TKN as N 625 /L mg X Ni-Nickel ug/L TPH-STD(Gasoline Range
Carbon dioxide 405 mg& NO,.NO3 as N 630 mg/L Pb-Lead 46564 UgtL
Chloride 940 M91L P:Total as P 685 mg/L Se-Selenium
Chromium:Hex 1032 uglL Nitrate(NO,as N)620 mg/L Zn-Zinc 46567
u
Color True 60 Cu Nitrite(NO,as N)615 mgtL LAB USE ONLY
Cyanide 720 - mg/L Temperature on arrivaITC)
,
Lab Comments
GW-54 REV.7103 Far Dissolved Analysis-submit filtered sample and write'DIS'in block
o.tC "'17

NC rDZV Laboratory Section esufts
Sample I AB16399
Loc.Descr.: RAINFALL MTNS,INC INF PO Number
er# ARO
Location ID: OIRURAINFALL04100701 - VisitlD
County: RUTHERFORD pF WATF9 Collect Date: 04/10/2007
River Basin \Qa �G n Collect Time:: 13:46
Report To AROAPCO
v
Date
Region:
lector: TMINNICK Y J��\\�^ Time Received: 1 /2007
4:40 Col
Sample Matrix: Groundwater �f
Loa Type: Influent Late Reporks rteLogd: D JSM
Date Reported: 05101l2007
Sample Depth
Emergency Yes/No
COC Yes/No
Sample Qualifiers and Comments
Routine Qualifiers
For a more detailed description of these qualifier codes refer to www.dwqlab.org under Staff Access
A-Value reported is the average of two or more determinations
N3-Estimated concentration is<PQL and>MDL
B1-Countable membranes with<20 colonies; Estimated
NE-No established PQL
82-Counts from all filters were zero. P-Elevated PQL due to matrix interference and/or sample dilution
B3-Countable membranes with more than 60 or 80 colonies; Estimated
B4-Filters have counts of both>60 or 80 and<20;Estimated Q1-Holding time exceeded prior t
Q2-Holding time exceeded following receipt by lab
65-Too many colonies were present;too numerous to count(TNTC)
PQL-Practical Quantdation Limit-subject to change due to instrument sensitivity
J2-Reported value failed to meet QC criteria for either precision or accuracy; Estimated
U-Samples analyzed for this compound but not detected
J3-The sample matrix interfered with the ability to make any accurate determination; Estimated Xl-Sample not analyzed for this compound
J6-The lab analysis was from an unpreserved or improperly chemically preserved sample; Estimated
Ni-The component has been tentatively identified based on mass spectral library search and has an estimated value
Laboratory Section>>1623 Mail Service Center,Raleigh,NC 27699-1623 [phone] Page 1 of 2

` NC DWQ Laboratory Section Rpults Sample A615399
I
Location D: 01 RURAINFALL04100701 Collect Date: 04/10I2007
Loc.Descr.: RAINFALL MTNS,INC INF Collect Time:: 13:45
Visit ID
Analyte Name PQL Result Qualifier Units Analyst/Date Approved By/Date
ARO
Sample temperature at receipt by lab 2.0 °C JSMITH MMATHIS
Method Reference 4110107 4/12/07
Coliform, MF Fecal in liquid 1 1 B2 CFU/100m1 JSMITH CGREEN
Method Reference APHA9222D-20th 4/10/07 4117/07
Coliform, MF Total in liquid 1 1 CFU/100m1 JSMITH CGREEN
Method Reference APHA92228-20th 4/10/07 4117/07
Total Dissolved Solids in liquid 10 130 mp/L JSMITH CGREEN
Method Reference APHA254OC-18TH 4/16107 5/1/07
Laboratory Section>>1623 Mail Service Center,Raleigh, NC 27699-1623 [phone] Page 2 of 2

Wr 61 e000re
North Carolina
GROUNDWATER FIELD/LAB FORM Department of Environment and Natural Resources
DIVISION OF WATER QUALITY-GROUNDWATER SECTION
Location code b 1 gm RArelAatt 04/d e7 OI SAMPLE TYPE SAMPLE PRIORITY
County C U7 WaF 1I _ a Water ® Routine _ Lab Number A3 1539q
Quad No Serial No. ❑ Soil ❑ Emergency
❑ / F Date Received 4-fo-off Time: 1440
Other
t Rec'd By: ?AtS From:Bus, Couner an e
❑Chain of Custody Other:
Report TDtR YRO,MRO, RRO,WaRO,WiRO, Data Entry By: Ck:
WSRO, Knston F0, Fed.T entral Off., Other: Date Reported:
Shipped by: Bus, Couner and D , Other: Purpose:
Collector(s): T..fMali Date W'Q' M Time �54 Baseline, Complain , am lia LUST, Pesticide Study, Federal Trust, Other:
FIELD ANALYSES Tom'- OwnerA61w/FwK A4rg$ T t as : I StIOPW1 ► tireo&r (I��� 715
PH 400 Spec. Cond.94 at 250C Location or Site 141 ulgawrvD Ctlrlaar 6F GULF
�f+ rtipnr* aC Odor Description of sampling point .✓
Appearance Sampling Method KA"Arp Sample Interval
Field Analysis By: Remarks `
LABORATORY ANALYSES (Pumpinaom�.x bmP.,a .)
1800310 MWL Disc.Solids 70300 rtglL Ag-Silver 48566 u /L Organochlonne,Pesticides
COD High 340 mart Fluoride 951 mg/L AI-Aluminum 46557
L O_rganopnospharus Pesticides
COD Low 335 mgfL Hardness:Total 900 mg/L As-Arsenic 48551
rL Nitrogen Pes9cides
Collfov0:MF Fecal 31616 /100m1 Hardness(non-barb)902 mart Ba-Barium unit. Acid Herbicides _
Coliform:MF Total 31504 .'loom[ Phenols 32730 u9A Ca-Calcium 48552
mqlL PCBs
TOC 880 nrg/L Spedfic Cond.95 uMhos/aa Cd-Cadpsum 46559
Turbidity 76 NTU Sulfate 945 mg/L Cr-Chromium 46559
L
Residue.Suspended 530 mg/L Sulfide 745 m9/L Cu-Copper 46562
Fe-Iron 46563 unit. Semivolafile Oromics
Oil and Grease m91L Hg-Mercury 71900
troll. TPH-Diesel Range
pH 403 units K-Potassium 46655
Alkalinity to pH 4.6 410 mg/L Mg-Magneslum 46554 Mort-
ort-
Alkalinity to pH 8.3 415 mWL Mn-Manganese 46665 u L Volatile Organics(VOA bottle)
Carbonate 445 mg/L NH3 as N 610 mg/l Na-sotllum 46568
m TPM-Gastllne Range
Bicarbonate 440 rrr4& TKN as N 625 m0/L Ni-Nidml uar. TPH-STE1t Gasoline Range
Carbon dioxide 405 mart NO,.NO,as N 830 mg/L Pb-Lead 46564
Chloride 940 mgrL P:Total as P 865 ngfL ScSelenium
Chromium:Hex 1032 ugrL Nitrate(NO,as N)820 mg/L Zn-Zinc 46567
Color:True 80 Cu Nlbft(NO2 as N)615 ma/L LAB USE ONLY
Cyanide 720 - mg/L Temperature on arrival M): �, Q
Lab Comments
GW-54 REV.7103 For Dissolved Analysis-submit filtered sample and wnte'DIS'in block
L n

' ;• 'w CJ�C �cr-+w)%� /�tl TOIOOOOC
North Carolina
GROUNDWATER FIELD/LAB FORM Department of Environment and Natural Resources
DIVISION OF WATER QUALITY-GROUNDWATER SECTION
Location code Ot - /NFAu 61(/0 07 OL SAMPLE TYPE SAMPLE PRIORITY
County a Water Routine . Lab Number A1315•+00
Quad No Serial No. ❑ Soil ❑ Emergency Date Received H'-10•07
Time: /`+`�9
t-Lat:_+ 6rlb.'�; ❑ —��
_. _ Other Rec'd By: ,iMb From:Bus, Courier and Cel.
'❑ Chain of Custody Other:_
.Report Tc AR RO, MRO, RRO,WaRO,WiRO, Data Entry By: 3^'LS Ck: T-'wS
WSRO, Kinston FO, Fed.Trust Central Off., Other: Dale Reported: S'-/-o 7
Shipped by: Bus, Couriergo
and D , Other: Purpose:
Collector(s): 77WA(Art Date /0 ZOtI Time 7#C0 Baseline, Com aint, omplianc LUST, Pesticide Study, Federal Trust, Other:
FIELD ANALYSES Owner �S .in/ °"� tAr✓!E M�lw 4�r SGf-7161 _
pH 400 Spec. Cond.94 at 25°C Location or Site Cdt-S LAFr�
;Temp.fo °C Odor Description of sampling pot �r _
Appearance Sampling Method �iIMPQ Sample Interval
Field Analysis By: Remarks ""°' 'a' 1.°
LABORATORY ANALYSES (Pumpin9rlmdafrr
BOO 310 _ mg/L Diss.Solids 70300 1,90 mg/L Ag-SilJer 46566 u /L Or anachlorine Pesticides
COD High 340 mglL Fluoride 951 mglL AI-Aluminum 46557 u /L Organophosphorus Pestcides
COD Low 335 mg/L Hardness:Total 900 mg/l As-Arsenic 46551 u /L Nitrogen Pesticides
Colifonn:MF Feral 31616 80 /100m1 Hardness(noncarb)902 mg/L Ba-Barium 46558 u /L Acid Herbicides
Colifoan:MFTctal 31504 ) q :looml Phenols32730 ug/I Ca-Calcium 46552 m /L PCBs
TOC 680 - mg/L Specific Cond.95 uMhos/cm Cd-Cadmium 46559 u /L
Turbidity 76-- - - NTU - Sulfate 945 - - - -- -mg/L- Cr-Chromium 46559 u /L
Residue,Suspended 530 mg/L Sulfide 745 mg/L Cu-Copper 46562 u /L
Fe-Iran 46563 u /L Semivolatile Organics _
Oil and Grease mglL Hg-Mercury 71900 u /L TPH-Diesel Range
pH 403 - units - K-Potassium 46555 m /L
Alkalinity to pH 4.5 410 mg/L Mg-Magnesium 46554 m fL
Alkalinity to pH 8.3 415 mg/L Mn-Manganese 46565 u /L Volatile Organics(VOA bottle) -
Carbonate 445 mglL NH3 as N 610 mg/L Na-Sodium 46556 m IL TPH-Gasollne Range
Bicarbonate 440 mg/L TKN as N 625 mg/L Ni-Nickel u /L TPH-STEX Gasoline Range
Camon dioxide 405 mg/L NOz+NO3 as N 630 mg/L Pb-Lead 46564 u /L
Chloride 940 mglL P:Tctal as P 665 mgfL Se-selenium u /L
Chromium:Hex 1032 ug/L Nitrate(NO,as N)620 mg/L Zn-Zinc 46567 u /L
Color.True 80 Cu Nitrite(NO2 as N)615 mg/L LAB USE ONLY ^
Temperature on arrival(°C): d
Cyanide 720 - m L r
Lab Comments
GW-54 REV.7103 For Dissolved Analysis-submit filtered sample and write'DIS'in block

N D Laboratory Section suits
Loc. Descr.: RAINFALL MTNS,INC EFF L 1 000v Sample ID: AB16460PO Number# 7GO235
Location ID: 01 RURAINFALL04100702 VishlD
County: RUTHERFORD OF WATF9 River Basin Collect Date: 04/1 OI2007
a Q
Report To AROAP
�� G Collect Time:: 14:00
r� �
Region: ARO - �" CI A Date Received: 0411212007
Collector T MINNICK Y r,�v\�J Time Received: 08:30
Sample Matrix: GROUNDWATER �v+!-� Labworks LoginlD MMA
Loc.Type: WATER SUPPLY ")
Sample Depth Date Reported: 0 5/0 212 0 0 7
Emergency Yes/No
COC Yes/No
Sample Qualifiers and Comments
Routine Qualifiers
For a more detailed description of these qualifier codes refer to www.dwqlab.org under Staff Access
A-Value reported is the average of two or more determinations
61-Countable membranes with<20 colonies; Estimated
N3-Estimated concentration is<PQL and>MDL
82-Counts from all filters were zero.
NE-No established PQL
83-Countable membranes with more than 60 or 80 colonies; Estimated
P-Elevated PQL due to matrix interference and/or sample dilution
134-Filters have counts of both>60 or 80 and<.20; Estimated Qi-Holding time exceeded prior to receipt at lab.
135-Too many colonies were present;too numerous to count(TNTC)
Q2-Holding time exceeded following receipt by lab
J2-Reported value failed to meet QC criteria for either precision or accuracy; Estimated PQL-Practical Quantitation Limit-subject to change due to instrument sensitivity
J3-The sample matrix interfered with the ability to make any accurate determination; Estimated U-Samples analyzed for this compound but not detected
J6-The lab analysis was from an unpreserved or improperly chemically preserved sample;Estimated X1-Sample not analyzed for this compound
NI-The component has been tentatively identified based on mass spectral library search and has an estimated value
Laboratory Section>>1623 Mail Service Center,Raleigh,NC 27699-1623 [phone] Page 1 of 3

- TrC 1�WQ Laboratory Section 12esuCts Sample ID ABIS46O
Locaticr 10: 01RURAINFALL04100702 Collect Date: 04/10/2007
Loc.Descr.: RAINFALL MTNS, INC EFF Collect Time:: 14:00
Visit ID
Analyte Name PQL Result Qualifier Units Analyst/Date Approved By/Date
LAB
Sample temperature at receipt by lab 0.3 C DSAUNDERS MMATHIS
Method Reference 4/12/07 4112107
WET
Chloride 1.0 2.1 mq/L MIBRAHIM MOVERMAN
Method Reference EPA 300.0 4/19/07 4124/07
Fluoride 0.4 0.4 U ma/L MIBRAHIM MOVERMAN
Method Reference EPA 300.0 4119/07 4124107
Sulfate 2.0 2.0 U mq/L MIBRAHIM MOVERMAN
Method Reference EPA 300.0 4/19107 4/24/07
NUT
NO2+NO3 as N In liquid 0.02 0.10 mglL as N MAJAYI CGREEN
Method Reference Lac10-107-04-1-c 4/12107 V17/07
MET
7429-90-5 At by ICP 50 50 U ua/L JJURGEVICH ESTAFFORD
Method Reference EPA 200.7 4123107 5/1/07
7440-70-2 Ca by ICP 0.10 26 mq/L JJURGEVICH ESTAFFORD
Method Reference EPA 200.7 4/23/07 511/07
744047-3 Cr by ICPMS 10 10 U uq/L PGAUTHIER ESTAFFORD
Method Reference EPA 200.8 4/26/07 5/1/07
7440-50-8 Cu by ICPMS 2.0 27 uq/L PGAUTHIER ESTAFFORD
Method Reference EPA 200.8 4/26107 5/1/07
7440-48-4 Fe by ICP 50 50 U ua/L JJURGEVICH ESTAFFORD
Method Reference EPA 200.7 4/23/07 511/07
7440-09-7 K by ICP 0.10 2.7 mq/L JJURGEVICH ESTAFFORD
Method Reference EPA 200.7 4/23107 5/1107
7439-954 Mg by ICP 0.10 3.4 mq/L JJURGEVICH ESTAFFORD
Method Reference EPA 200.7 4/23107 511/07
7439-96-5 Mn by ICPMS 10 10 U uq/L JJURGEVICH ESTAFFORD
Method Reference EPA 200.8 423/07 5/1107
7440-23-4 Na by ICP 0.10 5.6 mq/L JJURGEVICH ESTAFFORD
Method Reference EPA 200.7 4/23/07 5/1107
7440-02-0 Ni by ICPMS 10 10 U uq/L PGAUTHIER ESTAFFORD
Method Reference EPA 200.8 4/26/07 5/1/07
7439-92-1 Pb by ICPMS 10 10 U uq/L PGAUTHIER ESTAFFORD
Method Reference EPA 200.8 4/26/07 511/07
Laboratory Section 1623 Mail Service Center,Raleigh,NC 27699-1623 [phone] Page 2 of 3

TrC WQ Laboratory Section 12esufts amps AB15460
Location ID: 01RURAINFALL04100702 Collect Date: 04/10/2007
Loc.Descr.: RAINFALL MTNS,INC EFF Collect Time:: 14:00
Visit ID
Analyte Name PQL Result Qualifier Units nays ate Approved By/Date
7440-66-6 Zn by ICP 10 10 U u0/L PGAUTHIER ESTAFFORD
Method Reference EPA 200.7 4/24/07 511/07
Laboratory Section>>1623 Mail Service Center, Raleigh,NC 27699-1623 [phone] Page 3 of 3

(1Tc PGL-A417— 6/ 66606 Qth� JNIW
1 orth
GROUNDWATER FIELD/LAB FORM Department ofEnvirronm nttandaNaturalRe' urces
DIVISION OF WATER QUALITY�ROUNDWATER SECTION
Location code O/ ' rn(�A6� 04/6 61 62- SAMPLE TYPE SAMPLE PRIORITY n
County Rll Water X Routine Lab Number��T 2�Quad No Serial No. Soil Emergency Date Received'-(2 Ti-O/ m - •r J6
Lat. Long. 2 / Other Rec'd By: 05 From:BUS Du Hand Del.,
❑ Chain of Custody Other:
Report T ARO R0, MRO, RRO,WaRO,WiRO, Data Entry ey: Ck:
WSRO, Kinston F Fey Trust, Central Off., Other. Date Reported:
Shipped by: Bus, un Hand Del.,Other: Purpose:
Collector(s): i"rr,t_X— Date a Time Baseline, Complaint, om lian , LUST, Pesticide Study, F carat Trust, Other:
FIELD ANALYSES Owner GL _L ci t.}'ya
pH 400 S-A.r Spec. Cond." at 25°C Location or Site ¢ UrA r
Temp.loh-4C Odor Description of samplin"oint
Appearance Sampling Method Mrm
Sample Interval
Field Analysis By: Remarks
LABORATORY ANALYSES mwv wn.,wamp.,a e)
BOD 310 mg/L Diss.Solids 70300 mg/L Ag-S9ver 46566 u L O anochlorine Pesticides
COD High 340 mg/L Fluoride 957
rtKi/L AI-Aluminum 46557 U011. 0�ophosphorus Pesticides
COD Low 335 mglL Hardness:Total 900 mgll. ;Arsenic 46551 L NbNen Pesticides
Coldorm:MF Fecal 31516 Mond Hardness(ran-carh)902 mglL Ba-Banum 46558 ualL Acid Herbicides
Coliform:MF Total 31504 1 cond Phenols 32730 ugd Ca-Callum 46552 was
TOC fiB0 mg/L Specific Cord.95 uMhos/cm Col-Cadmam 48559 L
Turbidity 78 NTU Sulfate 946 mg/L Cr-Chromium 48559 uQ1L
Residue,Suspended 530 mg/L Sulfide 745 mg/L Cu pper 46562
Fe-Iron 46563 ugil- Semivolafile O anics
Oa and Grease M91L H"ercury 71900
L TPH-Diesel Ra
Al 403 units K-Potassium 46555 L
Alkalinity to pH 4.5 410 mg/L Mg-Magnesium 48554 tL
Alkalinity to pH a.3415 mall- Mn-Manganese 46565 _Volatile Organics(VOA bottle)
Carbonate 445 mg/L NH.as N 610
Bicarbonate 440 mg/L TKN as N 625 mg/L Na-Sodium 46558 TPH-Gasoline Ronde
Ni-Nkicd
M91L UcUL TPH-BTE(Gasoline Range
Carbon dioxide 405 mg/L NO2+NO,as N 830 mg/L PDLead 46584 ug/L
Chloride 940 mg/L P:Total as P 665 M91L Se-Selenium
L
Chromium:Hex 1032 ug/L Nitrate(NO,as N)620 mg/L Zn-Znc 46567 udfi
Color.True eB Cu NitnM(NO2 as N)615 myL LAB USE ONLY
CyaNde 720 - "Kill. Temperature on arrival
Lab Comments
GALS4 REV.7/03 For Dissolved Analysis-submit filtered sample and write'DIS•in bock

NC D Laboratory Section Wesufts
Sample ID: AB16400
Loc. Descr.: RAINFALL MTNS,INC EFF
PO Number# ARO
Location ID: 01RURAINFALL04100702 VisitlD
County: RUTHERFORD �� WA7F9
River Basin Oa qG Collect Date: 04 0I2007
y Collect Time:: 14:00
Report To AROAP
Region: ARO —I Q,� \U Date Received: 04110/2007
Collector: T MINNICK �\'� Time Received: 14:40
Sample Matrix: Groundwater Labworks LoginlD JSM
Loc.Type: Effluent
Date Reported: 05/01/2007
Sample Depth
Emergency Yes/No
COC Yes/No
Sample Qualifiers and Comments
Routine Qualifiers
For a more detailed description of these qualifier codes refer to www.dwqlab.org under Staff Access
A-Value reported is the average of two or more determinations
N3-Estimated concentration is<PQL and>MDL
131-Countable membranes with<20 colonies;Estimated
NE-No established PQL
132-Counts from all fitters were zero.
P-Elevated PQL due to matrix interference and/or sample dilution
B3-Countable membranes with more than 60 or 80 colonies; Estimated
64-Filters have counts of both>60 or 80 and<20;Estimated of-Holdingtime exceeded prior
65-Too many colonies were present;too numerous to count(TNTC) Q2-Holding time exceeded following receipt by lab
to receipt at lab.
PQL-Practical Quantitation Limit-subject to change due to instrument sensitivity
J2-Reported value failed to meet QC criteria for either precision or accuracy; Estimated
U-Samples analyzed for this compound but not detected
J3-The sample matrix interfered with the ability to make any accurate determination;Estimated X1-Sample not analyzed for this compound
J6-The lab analysis was from an unpreserved or improperly chemically preserved sample;Estimated
N1-The component has been tentatively identified based on mass spectral library search and has an estimated value
Laboratory Section>>1623 Mail Service Center,Raleigh,NC 27699-1623 [phone] Page 1 of 2

•
• - NC 1n'iNQ Laboratory Section 12,esuCts amp AB15400
Location ID: 01RURAINFALL04100702 Collect Date: 04/10/2007
Loc.Descr.: RAINFALL MTNS, INC EFF Collect Time:: 14:00
Visit ID
Analyte Name PCL Result Qualifier Units nays ate Approved Ty/Date
ARO
Sample temperature at receipt by lab 2.0 °C JSMITH MMATHIS
Method Reference 4/10/07 4/12/07
Coliform, MF Fecal in liquid 1 1 B2 CFU/100ml JSMITH CGREEN
Method Reference APHA9222D-20th 4/10107 4117/07
Coliform, MF Total in liquid 1 1 B2 CFU/100ml JSMITH CGREEN
Method Reference APHA92228-20th 4110/07 4/17/07
Total Dissolved Solids In liquid 10 120 mu/L JSMITH CGREEN
Method Reference APHA254DC.16TH 4/16/07 5/l/07
Laboratory Section>>1623 Mail Service Center,Raleigh,NC 27699-1623 [phone] Page 2 of 2

• � cl C f�E?-�r,i'''` �,tJ 7-a a0006
North Carolina
GROUNDWATER FIELD/LAB FORM Department of Environment and Natural Resources
DIVISION OF WATER QUALITY-GROUNDWATER SECTION
Location code_Q '667 QL SAMPLE TYPE SAMPLE PRIORITY
County Qlrtk-Arzy-�-) C,Water 1W Routine Lab Number A815400
Quad No Serial No. ❑ Soil ❑ Emergency Date Received It-10-07
Time: IV4o
t -Y ❑ Other Rec'd By: TMa From:Bus, Courier and Ce
❑ Chain of Custody Other:
Report Tod��RO, MRO, RRO,WaRO,WIRO, Data Entry By: Ck:
WSRO, Kinston FO, Fed.Trust entral Off.,Other. Date Reported:
Shipped by: Bus, Courie and Other. Purpose:
Collector(s): IV t Date Time Baseline, Com aint omplianc LUST, Pesticide Study, Fedest, Other.
FIELD ANALYSES Owner f Z ral Trut:AYr6 'ray
ype. ,.,
H.�,4d.o, Spec. Cond.g, at 250C Location or Site
.11 °C Odor Description of sampling poirg oV7iiDF TAW
Appearance Sampling Method ii*f m - Sample Interval
Field Analysis By: Remarks — i�.bade 0I.A —
LABORATORY ANALYSES (Pumping ume,sir ump.,Ncl
BOD 310 IT D ss.Solids 70300 mg/L Ag-Silver 46566
Oryanotlnlorine Pest es
COD High 340 mglL Fluonde 951 mg/L AI-Aluminum 46557 ugIL Organophospnonls PesOWes
COO Low 335 mg/L Hardness:Total goo mg/L As-Arsenic 46551 u L Nitrogen Pesticides
Coliform:MF Fecal 31616 H00ml Hardness(non-carb)902 mglL Ba-Sanum 46558 ugn. Add Hermes
Colifonn:MF Total 31504 Arland Phenols 32730 ugA Ca-Caldurn 46652
PCBs
TOC 680 IT Specific Cord.95 uMhoslcm Cd-Cadmium 46559
uqA
Tumklity 76 NTLI Sulfate 945 men- Cr-Chmmium 46559 u L
Residue,Suspended 530 rng/L. Sulfide 745 mg/L Cu-Copper 46562 uqtL
Fe-Iron 46563 UQILSernivolable Organics
Od and Grease M94. Hga lercury 71000 L TPH-Diesel Range
PH 403 units K-Potassium 45555
Akalimty,to pH 4.5 410 m9IL Mg-Magnesium 46554 m
Alkalin0y to pH 8.3 415 M91L Mn-Manganese 46565 /L Volatile Organics(VOA bo81e
Carbonate 445 m91L NHs as N 610 m9rL Na-Sodium 46556 molt. TPH-Gasoline Ran
ge
Bicarbonate 440 mglL TKN as N 625 mg/L Ni-Nickel uQfL TPH-BTEX Gasoline Range —
Carbon dioxide 405 mg& NOz+NOs as N 630 mg/L PDLead 46564 L
Chloride 940 mglL P:Total as P 665 mg/L Se-Selenium uWL
Chromium:Hex 1032 ug/L Nitrate(NO3 as N)820 mg/L Zn-Zinc 46567
uqfL
Color.True 80 Cu Nibble(NO2 as N)615 mg/L LAB USE ONLY }�
Cyanide 720 - moll. Temperature on arrival(°C): d r 0
Lab Comments
GW-54 REV.7103 For Dissolved Analysis-submit filtered sample and wnte'DIS'in block.

�0ti WATF90 Michael F.Easley,Governor
�0 �i William G.Ross Jr.,Secretary
fq. r North Carolina Department of Environment and Natural Resources
Alan W.Klimek,P.E.Director
Division of Water Quality
February 23, 2007
Suzanne McKay
Rainfall Mountains, Inc. ^g 2 tg 2���
P.O. Box HM 1877
Hamilton, Bermuda HM HX
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
7006 2150 0003 5465 0457
Subject: Notice of Expiration
Injection Heating/Cooling Water Return Well (5A7) Permit
UIC Permit No. WI0100006
Rainfall Mountains, Inc. - SFR
Rutherford County
Dear Ms. McKay:
The Underground Injection Control (UIC) Program of the Division of Water Quality is
responsible for the regulation of injection well construction and operation activities within the
state of North Carolina. Our records show that the operating permit referenced above for the
geothermal heat pump injection well system on your property at 141 Courtland Court in Lake
Lure,North Carolina will expire on June 30, 2007. In addition, our records do not indicate that
the injection well system has been abandoned.
In order to comply with the regulatory requirements listed under North Carolina Administrative
Code (NCAC) Title 15A, Subchapter 2C, Section .0211, you must take one of the following
actions:
A. Submit the form RENEWAL APPLICATION FOR PERMIT TO USE WELL(S)FOR INJECTION WITH A
HEATPUMP SYSTEM(form GW/UIC-57 HPR) if the injection well system on your
property is still active;
B. Submit the form STATUS OFINJECTION WELL SYSTEM(form GW/UIC-68) if the injection
well system is inactive or has been temporarily or permanently abandoned.
If the injection well system is no longer being used for any purpose, it must be permanently
abandoned according to the regulatory requirements listed under NCAC Title 15A, Subchapter
2C, Section .0214. If the injection well system is to be permanently abandoned,the well
abandonment record(s) must be submitted to our office to certify that the abandonment was
N,am�s`ttrCur-701
arol na
dvat
Aquifer Protection Section 1636 Mail Service Center Raleigh,NC 27699.1636 Telephone: [phone]
Internet:www.ncwaternualitv.ore Location: 2728 Capital Boulevard Raleigh,NC 27604 Fax 1: (9I9)715-0588
Fax 2: [phone]
An Equal Opportunity/Af8m love Action Employer-50%Recyded1100h Post Consumer Paper Customer Service: [phone]

Suzanne McKay
Rainfall Mountains,Inc.
February 23,2007
Page 2 of 2
properly conducted. If the injection well system is still active, a renewal application is to be
submitted at least 3 months prior to the expiration of this permit.
Please submit the appropriate form(s) within 30 calendar days of the receipt of this letter. If you
have any questions regarding the permit or injection well rules, or if you would like assistance
completing these forms please call Qu Qi at [phone], or email him at au.gina,ncmail.net.
Sincerely,
Jesse Wiseman
Aquifer Protection Section
Enclosures
1. GWMIC-57 HPR
2. GW/UIC-68
cc: Asheville Regional Office-APS w/o enclosures
APS Central Files -Permit No.WI0100006 w;o enclosures

North Carolina Department of Environment and Natural Resources
Division of Water Quality- Groundwater Section
Y +
INJECTION FACILITY INSPECTION REPORT - FORM B
INJECTION WELL PERMIT NO. WTQ/ 00006 DATE 1.1 / cd,7
/n�� �—
NAME OF OWNER 4rfCalt MoG"\r A tnl5., J,vr
ADDRESS OF OWNER [Xiec LU2t 141 Ca-e-i2AivLJ Ccu.CF—
(Street/road or lot and subdivision, county, town)
LOCATION OF INJECTION WELL (and source well(s), if applicable)
(Street/road or lot and subdivision, county, town, if different than owner's address,plus description of location on site)
t
Potential pollution source ( i'r ect%•t-ac Distance from well Z
Potential pollution.source Distance from well
Potential pollution source Distance from well
Minimum distance of well from property boundary = Z t Quality of drainage at site 4�1ctAzW- Flooding potential of site /ad
(goodadequatepoor) (high,moderate,low)
GPS Data:
Latitude: 3�° 7-7'46.3 '" Longitude:
DRAW SKETCH OF SITE (Showproperty boundaries, buildings, wells,potential'pollution sources, roads, approximate scale, a
north arrow.)
DESCRIBE INJECTION SYSTEM (vertical closed loop, uncased borehole or cased water well;separate source well and
injection well;combination source and injection well;or other description as applicable)
EoNtc3,Nti�otJ S3t/2ccr tN �rc�cJ cnlC-b-
Ver.3/01 GW/UIC-2

r
INJECTION FACILITY INSPECTION REPORT-FORM B (CONTINUED) ®•
WELL CONSTRUCTION
Date constructed 071 / 9�`/
I
Drilling contractor: Name 6 4SF/J Q11rr7L t"�c2c Co
Address o za-x Zt4
C. ck± 4C4f T(G ZSIZ6
Certification number. -#-596 ( P Zazal
Total depth of well Total depth of source well 5411.1E
(if applicable)
Inspection point Measurement Meets minimum standards Comments
Yes No `
Casing
Depth � ✓
Diameter �o/a ✓
Height (A.L.S.) ` c�
Grout
Depth
Screens
Depth(s) CIA
Length(s)
I.D. Plate i!
Static water level
Well yield. Sr��PM
Enclosure
Enclosure floor _
(concrete)
Sampling port 3r tF C� � �h7lJ
(labeled)
Water tight pipe entry
Well enclosure entry ✓
Vent ✓
Functioning of heat pump system (Determine from the owner if heat pump functions properly.)
INSPECTOR 1� --�lw Office N51, 0
WITNESS as- .-rc pem+ Address ,F- .Y><t3clL .
WITNESS Address
Ver.3/01 GW/UIC-2

AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
Date: M lG 2607 County: OIL-
To: Aquifer Protection Section Central Office Permittee:
Central Office Reviewer: Project Name: Atiw,gMle irn✓s
Regional Login No: Application No.: AZ O%00004
L GENERAL INFOMMATION -
1. This application is (check a0 that apply): ❑New Z Renewal
❑ Minor Modification ❑ Major Modification
❑ Surface Irrigation ❑ Reuse ❑ Recycle ❑ High Rate Infiltration❑ Evaporation/Infiltration Lagoon
❑ Land Application of Residuals ❑Attachment B included ❑ 503 regulated ❑ 503 exempt
❑ Distribution of Residuals ❑ Surface Disposal
❑ Closed-loop Groundwater Remediation 5&Other Injection Wells (including in situ remediation)
Was a site visit conducted in order to prepare this report? 'Z Yes or❑No.
a. Date of site visit: O U0I
b. Person contacted and contact information: ©_ tAfArF— 11/ (Clclff31V- 4-44rfr AA M (P) 62:i=0l7
c. Site visit conducted by:
d. Inspection Report Attached: ®,Yes or❑No.
2. Is the following information entered into the BIMS record for this application correct?
®Yes or❑No. If no, please complete the following or indicate that it is correct on the current application..
For Treatment Facilities:
a. Location:
b. Driving Directions:
c. USGS Quadrangle Map name and number:
d. Latitude: Longitude: _
e. Regulated Activities/Type of Wastes (e.g.,subdivision, food processing, municipal wastewater):
For Disposal and Infection 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 paces for each site)
a. Location(s): J41 Cc+1Y`nar/'� L rXt L U/zE Fur-m e W Wtlelcw
b. Driving Directions: iJ564ti, © eJ �rcu L v 1314, 0 aJ S,Lf36Y,0 C.'/ Cc oRirt) er-
c. USGS Quadrangle Map name and number:
d. Latitude: 3i L'74G-3 Longitude: ,yLid 'tc•$
II. NEWAND MAJOR MODIFICATIONAPPLICATIONS(this section not needed for renewals or minor
modifications, skin to next section)
Description Of Waste(S) 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?
FORM: Documentl I

t
AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
❑ Yes ❑No ❑N/A. If no,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? ❑ 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 new sites (hydraulic or nutrient) acceptable?
❑Yes ❑No ❑N/A. If no, please explain:
7. Are the new treatment facilities or any new disposal sites located in a 100-year floodplain?
❑ Yes ❑ No ❑ N/A. If yes, please attach a map showing areas of 100-year floodplain and please explain
and recommend any mitigative measures/special conditions in Part IV:
8. Are there any buffer conflicts (new treatment facilities or new disposal sites)? ❑ Yes or❑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? ❑ Yes ❑ No ❑ N/A. Attach map of existing monitoring well
network if applicable. Indicate the review and compliance boundaries. If No, explain and recommend any
changes to the groundwater monitoring program:
10. For residuals, will seasonal or other restrictions be required? ❑ Yes ❑ No ❑N/A If yes, attach list of sites
with restrictions (Certification B?)
III RENEWAL AND MODIFICATIONAPPLICATIONS Luse previous section for new or major modification
systems)
Description Of Waste(S) And Facilities
1. Are there appropriately certified ORCs for the facilities? ❑Yes or❑No.
Operator in Charge: Certificate
Backup- Operator in Charge: _ Certificate
2. Is the design, maintenance and operation (e.g. adequate aeration, sludge wasting, sludge storage, effluent
storage, etc) of the treatment facilities adequate for the type of waste and disposal system? ❑ Yes or ❑ No.
If no, please explain:
3. Are the site conditions (soils, topography, depth to water table, etc) maintained appropriately and adequately
assimilating the waste? ❑ Yes or❑No. If no,please explain:
FORM: Documentl 2

tf
AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
4. Has the site changed in any way that may affect permit (drainage added, new wells inside the compliance
boundary, new development, etc.)? If yes,please explain: /V 6
5. Is the residuals management plan for the facility adequate and/or acceptable to the Division?
❑ Yes or❑No. If no,please explain:
6. Are the existing application rates (hydraulic or nutrient) still acceptable? ❑ Yes or ❑ No. If no, please
explain:
7. Is the existing groundwater monitoring program (number of wells, frequency of monitoring, monitoring
parameters, etc.) adequate? ❑ Yes ❑ No ❑ 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? ❑ Yes ❑No ❑N/A If yes, attach list of sites
with restrictions(Certification B?)
9. Are there any buffer conflicts (treatment facilities or disposal sites)? ❑ Yes or ❑ 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? ❑
Yes or❑No. If no,please explain:
11. Were monitoring wells properly constructed and located? ❑ Yes or ❑ No ❑ N/A. If no, please explain:
12. Has a review'of all self-monitoring data been conducted (GW,NDMR, and NDAR as applicable)? ❑ Yes or
❑No ❑N/A. Please summarize any findings resulting from this review:
13. Check all that apply: ❑ No compliance issues; ❑ Notice(s) of violation within the last permit cycle; ❑
Current enforcement action(s) ❑ Currently under SOC; ❑ Currently under JOC; ❑ 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? ❑ Yes
❑No ❑Not Determined ❑N/A.. If no, please explain:
15. Are there any issues related to compliance/enforcement that should be resolved before issuing this permit? ❑
Yes or❑No ❑N/A. If yes, please explain:
FORM: Documentl 3

r
AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
IV. INJECTION WELL PERMIT APPLICATIONS(Complete these two sections for all systems that use injection
wells, including closed-loop groundwater remediation effluent injection wells, in situ remediation injection wells,and heat
pump injection wells.)
Description Of Well(S) And Facilities—New Renewal,And Modification
1. Type of injection system:
❑ Heating/cooling water return flow (5A7)
❑ Closed-loop heat pump system(SQM/5QW)
❑In situ remediation(51)
❑ Closed-loop groundwater remediation effluent injection(5L/"Non-Discharge")
❑ Other(Specify:
2. Does system use same well for water source and injection? ❑ Yes ❑No
3. Are there any potential pollution sources that may affect injection?❑Yes ❑No
What is/are the pollution source(s)? What is the distance of the injection well(s) from the pollution
source(s)? ft.
4. What is the minimum distance of proposed injection wells from the property boundary? ft.
5. Quality of drainage at site: ❑ Good ❑ Adequate ❑Poor
6. Flooding potential of site: ❑Low ❑ Moderate ❑ 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 existing monitoring well network if applicable. If No,explain and recommend any changes to the
groundwater monitoring program:
8. Does the map presented represent the actual site(property lines,wells, surface drainage)? ❑ Yes or❑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.
Iniection 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)?
❑ Yes g No. Imes, explain:
2. For closed-loop heat pump systems,has system lost pressure or required make-up fluid since permit issuance
or last inspection? ❑ Yes ❑No. If yes, explain:
3. For renewal or modification of groundwater remediation permits (of any type),will
continued/additional/modified injections have an adverse impact on migration of the plume or management of
the contamination incident?❑ Yes ❑No. If yes, explain:
4. Drilling contractor: Name:
FORM: Documentl 4

AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
Address: Ey /3fe
�� n�L 2d9Z(o
E,FCli 7-� i
Certification number: ��lv
5. Complete and attach Well Construction Data Sheet.
FORM: Documentl 5

AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
V. EVALUATIONAND RECOillilIENDATIONS
1. Provide any additional narrative regarding your review of the application.:
2. Attach Well Construction Data Sheet-if needed information is available
3. Do you foresee any problems with issuance/renewal of this permit? ❑ Yes NLNo. If yes,please explain
briefly.
4. List any items that you would like APS Central Office to obtain through an additional information request.
Make sure that you provide a reason for each item:
Item Reason
5. List specific Permit conditions that you recommend to be removed from the permit when issued.•Make sure
that you provide a reason for each condition:
Condition Reason
6. List specific special conditions or compliance schedules that you recommend to be included in the permit when
issued. Make sure that you provide a reason for each special condition:
Condition Reason
7. Recommendation: ❑ Hold,pending receipt and review of additional information by regional office; ❑ Hold,
pending review of draft permit by regional office; ❑ Issue upon receipt of needed additional information;
Issue; ❑ Deny. If deny, please state reasons:
8. Signature of reportpreparer(s):
C
Signature of APS regional supervisor:
Date: b / zw
ADDITIONAL REGIONAL STAFF REVIEWITEPIS
FORM: Documentl 6

Compliance Inspection Report
Permit: WI0100006 Effective: 06/27/02 Expiration: 06/30/07 Owner: Rainfall Mountains Inc .
SOC: Effective: Expiration: Facility: Rainfall Mountains Inc.-SFR
County: Rutherford 141 Courtland Ct
Region: Asheville
Lake Lure NC 28746
Contact Person: Suzanne McKay Phone:[phone]
Directions to Facility:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On-Site Representative(s):
Related Permits:
Inspection Date: 04110/2007 Entry Time: 01:10 PM Exit Time: 01:35 PM
Primary Inspector: Harold E Minnick Phone:[phone]
Secondary Inspector(s):
Reason for Inspection: Routine Inspection Type:Compliance Evaluation
Permit Inspection Type: Injection Heating/Cooling Water Return Well(5A7)
Facility Status: ■Compliant 0 Not Compliant
Question Areas:
Wells
(See attachment summary)
Page: 1

i
I
I
i
Permit:WI0100006 Owner-Facility: Rainfall Mountains Inc
I
Inspection Date: 04/10/2007 Inspection Type:Compliance Evaluation Reason for Visit:Routine
Inspection Summary:
permit renewal inspection--no violations noted
I
i
Page: 2

IX �. 408 Cot, fl A C III Lek.-emu. NC ,
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jogice
AQUIFER PROTECTION SECTION NAR 2 GAPPLICATION REVIEW REQUEST FORM;; ,�,,,1, , e€o
Date: March 21,2007
To: Landon Davidson,ARO-APS ❑ David May,WaRO-APS
❑ Art Barnhardt,FRO-APS ❑ Charlie Stehman,WiRO-APS
❑ Andrew Pitner,MRO-APS ❑ Sherri Knight,WSRO-APS
❑ Jay Zimmerman,RRO-APS
From: Michael Rogers , Groundwater Protection Unit
Telephone: [phone] Fax: [phone]
E Mail: Michael.Rogers(@ncmail.net
A. Permit Number: WI 0100006
B. Owner: Rainfall Mountains,Inc. (Contact Suzanne McKay)
C. Facility/Operation:
❑ Proposed ® Existing ❑ Facility ❑ Operation
D. Application:
I. Permit Type: ❑ Animal ❑ SFR-Surface Irrigation❑ Reuse . ❑ H-R Infiltration
❑ Recycle ❑ I/E Lagoon ❑ GW Remediation(ND)
® UIC-(5A7) open loop geothermal
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: ® I would like to accompany you on a site visit.
If possible,I would like to accompany you on the inspection
Attached, you will find all information submitted in support of the above-referenced application for your
review,comment, and/or action. Within 21 calendar days,please take the following actions:
® Return a Completed APSARR Form.
❑ Attach Well Construction Data Sheet.
❑ Attach Attachment B for Certification by the LAPCU.
❑ Issue an Attachment B Certification from the RO.* -
* Remember that you will be responsible for coordinating site visits and reviews, as well as additional
information requests with other RO-APS representatives in order to prepare a complete Attachment B for
certification. Refer to the RPP SOP for additional detail.
When you receive this request 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: 9W703 2-6
FORM: APSARR 07/06 Page 1 of 1

NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT,HEALTH,AND NATURAL RESOURCES
RENEWAL APPLICATION FOR PERMIT TO USE WELL(S) FOR INJECTION WITH A
HEAT PUMP SYSTEM
Type 5A7 and 5QM Wells
In accordance with the provisions of NCAC Title 15A: 02C.0
complete application and mail to address on the back page,
TO: DIRECTOR,NORTH CAROLINA DIVISION OF WATER QUALITY i MAR 2 6 2007
DATE: /�/� ,20_ Asheville Regional Office
Aquifer Protection
A. PERMIT APPLICANT Permit Number:
7 rry 0/&OCC 6p (WIO######,listed at the bottom of each
�page
�of your pemut)
Name: ��/,/2///!�/!�� G�1"',, chi'✓ i� p��'/'✓/I/ZC� /'/ /!�S /✓C—
Address: ��• / �(�77
State: Zip code:
� Telephone: SO 5 — 75 6
B. PROPERTY OWNER(if different from applicant)
Name:
Address:
City: State: Zip code:
County: Telephone:
RECEIVED I DENR!DWO
C. STATUS OF APPLICANT AQUIFPP PP0Tr:f TI N SECTION
Private: � Federal: Commercial: State: Public: MAR16 200Z'
Native American Lands:
D. FACILITY(SITE)DATA(Fill out ONLY if the Status of Owner is Federal, State,Public or Commercial).
Name of Business or Facility:
Address:
City: State: Zip code:
County: Telephone:
Contact Person:
Standard Industrial Code(s)which describe commercial facility:
Revised 7/06 GW/UIC-57 HPR Pagel of 3

E. INJECTION PROCEDURE (specify any modifications to the injection procedure since the issuance of the
previous injection permit)
F. WELL USE Is(are)the injection well(s) also used as a so Ill well(s)for-either of the following?
(1) The injection operation? YES V h N0_
(2) Your personal consumption? YES_ f°1MNOJetf'
G. CONSTRUCTION DATA
(1) Specify any and all modifications to the well casing, grout or screens since the issuance of the previous
injection permit.
(2) NC. State Regulations (15A NCAC, 2C, Section .0200) require the permittee to make provisions for
monitoring well head processes. A faucet on both influent (groundwater entering heat pump) and
effluent(water being injected into tlp well)lines is required. Is there a faucet on:
(a) the influent line? YES t/ NO—
(b) on the effluent line? YES NO—
H. CURRENT OPERATING DATA
(1) Injection rate: Average(daily) gallons per minute(gpm)
(2) Injection volume: Average(daily) gallons per day(gpd) Z;gc'L-s C"'/ Lon vy/
(3) Injection pressure: Average(daily) a� pounds per square inch(psi) r
(4) Injection temperature: Annual Average degrees Fahrenheit,(°F)
I. INJECTION-RELATED EQUIPMENT
Attach a diagram showing any modifications to injection equipment since the issuance of the previous injection
permit including the engineering layout of the (1) injection equipment, and (2) exterior piping/tubing associated
with the injection operation. The manufacturer's brochure,if detailed,should satisfy(1).
J. LOCATION OF WELL(S)Attach a map
Include a site map(can be drawn) showing: the orientation of and distances between the injection well(s) and any
existing well(s) or waste disposal facilities such as septic tanks or drain fields located within 1000 feet of the
ground-source heat pump well system;include buildings,property lines,surface water bodies,any other potential
sources of groundwater contamination. Label all features clearly and include a north arrow to indicate
orientation.
K. PERMIT LIST: Attach a list of all permits or construction approvals, received or applied for by the applicant
that are related to the site. Examples include:
(1)Hazardous Waste Management program permits under RCRA
(2)NC Division of Water Quality Non-Discharge permits
(3)Sewage Treatment and Disposal Permits
L. OTHER MODIFICATIONS: Indicate any other modifications to the injection well system (equipment, fluid,
operation, etc.) that have occurred since the issuance of the previous injection permit and have not been noted
elsewhere on this application.
Revised 7/06 GW/UIC-57 HPR Page 2 of 3

M. CERTIFICATION
"I hereby certify, under penalty of law, that I have personally examined and am familiar with the information
submitted in this document and all attachments thereto and that, based on my inquiry of those individuals
immediately responsible for obtaining said information, I believe that the information is true, accurate and
complete. I am aware that there are significant penalties, including the possibility of fines and imprisonment, for
submitting false information. I agree to 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."
ayxf
(Signah of Well weer i uthorized Agent)
If authorized agent is acting on half of the well owner,
please supply a letter signed by the owner
authorizing the above agent.
N. CONSENT OF PROPERTY OWNER(Owner means any person who holds the fee or other property rights in the
well(s). A well is real property and its construction on land rests ownership in the land owner in the absence of
contrary agreement in writing.)
If the property is owned by someone other than the applicant, the property owner hereby consents to allow the
applicant to operate an injection well(s)as outlined in this application and that it shall be the responsibility of the
applicant to ensure that the injection well(s) conform to the Well Construction Standards (Title 15A NCAC
Subchapter 2C.0200)
(Signature of Property Owner if Different From Applicant)
Please return the completed Application package to:
A€9�IVED 1 DENR 1 D1NQ
UIC Program AQV!FPP'PRnr-rr'Tlnl`RFLT'OM
Aquifer Protection Section MAR 16 2007:
North Carolina DENR-DWQ
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone: [phone]
Revised 7/06 GW/UIC-57 HPR Page 3 of 3

�oF warF9O Michael F.Easley,Govemor
.,0 G William G.Ross Jr.,Secretary
CO
r North Carolina Department of Environment and Natural Resources
p Alan W.Klimek,P.E.Director
Division of Water Quality
March 20,2007
Suzanne McKay
Rainfall Mountains,Inc.
PO Box HM 1877
Hamilton,Bermuda HM HX
Subject: Acknowledgement of Application No.WI0I00006
Rainfall Mountains,Inc. SFR
Injection Heating/Cooling Water Well Return(5A7)
Rutherford
Dear Ms. McKay:
The Aquifer Protection Section of the Division of Water Quality(Division)acknowledges receipt of your permit
application and supporting materials on March 16,2007.This application package has been assigned the number
listed above and will be reviewed by Michael Rogers.
The reviewer will perform a detailed review and contact you with a request for additional information if necessary.
To ensure the maximum efficiency in processing permit applications,the Division requests your assistance in
providing a timely and complete response to any additional information requests.
Please be aware that the Division's Regional Office,copied below,must provide recommendations prior to final
action by the Division.Please also note at this time,processing permit applications can take as long as 60-90 days
after receipt of a complete application.
If you have any questions,please contact Michael Rogers at 919-715-6166,or via e-mail at
[e-mail]. If the reviewer is unavailable,you may leave a message,and they will respond
promptly.Also note that the Division has reorganized.To review our new organizational chart,go to
httt)://h2o.enr.state.ne.us/documents/dwq orgchart.t)df.
PLEASE REFER TO THE ABOVE APPLICATION NUMBER WHEN MAKING INQUE1UES ON THIS
PROJECT.
Sincerely, /, )
for Deb J. atts
Supervisor
cc: Asheville Regional Office,Aquifer Protection Section
Permit Application File WI0I00006
IQ���`rCarolina
�vatur I
Aquifer Protecton Section 1636 Mail Service Center Raleigh,NC 27699-1636 Telephone: [phone]
Internet:w .ncwateroualitv.oro Location: 2728 Capital Boulevard Raleigh,NC 27604 Fax 1: [phone]
Fax 2: [phone]
An Equal Opportunity/Affirmative Action Employer-50%Recycled110%Post Consumer Paper Customer Service: [phone]

DIVISION OF WATER QUALITY
GROUNDWATER SECTION
June 28, 2002
MEMORANDUM
To: Landon Davidson, L.G., Regional Groundwater Supervisor
Groundwater Section
Asheville Regional Office
From: Mark Pritzl '1Q [e-mail]
Hydrogeological Technician Il
UIC Group
Groundwater Section
Raleigh Central Office
Re: Issuance of a Open-Loop Geothermal Injection Well System(Type 5A7.):
Permit Number WI0100006 to operate a well for the injection of an open-loop
ground-source heat pump system has been issued to Rainfall Mountains Inc., Suzanne McKay,
Lake Lure,North Carolina. This is a renewal permit and the Underground Injection Control
Group appreciates ARO's assistance with the inspection and review tasks. Please retain the
application and paper work for the ARO-UIC files. If you have any questions regarding this
permit or the UIC program,please contact me at [phone].
p
cc: CO-UIC Files JUL - 2 2002
D
Enclosures
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

F NJ ATF Michael F.Easley,Governor
0 9oG William G.Ross Jr.,Secretary
North Carolina Department of Environment and Natural Resources
7 Alan W.Klimek,P.E.Director
>_ .y Division of Water Quality
June 21, 2002
Ms. Suzanne McKay
Rainfall Mountains Incorporated
P.O. Box HM 1877
Hamilton,Bermuda HM HX
Dear Ms. McKay:
In accordance with your renewal application dated December 3, 2001, we are forwarding Permit
No. WI0100006 for the operation of a geothermal heat pump injection well at 141 Courtland
Court, Lake Lure, in Rutherford County, North Carolina. A copy of the laboratory test results of
water samples collected on February 4,2002 is also enclosed.
This permit shall be effective from the date of issuance until June 30, 2007, and shall be subject
to the conditions and limitations stated therein. In order to continue uninterrupted legal use of
this well for the stated purpose,you should submit an application to renew the permit three
months prior to its expiration date.
If you have any questions regarding your permit please contact Mark Pritzl at [phone].
Sincerely,
W—Evan O. Kane
Hydrogeologist
UIC Program Manager
JUL
cc: CO-UIC Files
ARO-UIC Files
closures
NO
NO
Customer Service Division of Water Quality / Groundwater Section
1 800 623-7748 1636 Mail Service Center Raleigh,NC 27699-1636
Phone: [phone] Fax: [phone] Internet: http://gw.ehnr.state.nc.us

' 1VINORANDUM June 21, 2002
To: Ms. Suzanne McKay
From: Mark Pritzl tel. [phone]
Re: Groundwater Sampling Results from February 4, 2002
Influent Water Sample Effluent Water Sample
Coliform, total <1/100ml Coliform, total <1/100ml
Coliform, fecal <1/100m1 Coliform, fecal <1/100m1
pH 7.5 pH 8.1
Chloride, Cl 4 mg/L Chloride, Cl 4 mg/L
Dissolved Solids 76 mg/L Dissolved Solids 66 mg/L
NOZ+NO3 as N 0.23 mg/L NOZ+NO3 as N 0.23 mg/L
NH3 as N ns NH3 as N ns
TKN as N ns TKN as N ns
Cadmium, Cd <2.0 ug/L Cadmium, Cd <2.0 ug/L,
Chromium, Cr <25 ug/L Chromium, Cr <25 ug/L
Copper, Cu 29 ug/L Copper, Cu 77 ug/L
Iron Fe <50 ug/L Iron, Fe <50 ug/L,
Mercury, Hg <0.2 ug/L Mercury,Hg <2.0 ug/L
Potassium,K 2.3 mg/L Potassium, K 2.4 mg/L
'Magnesium,Mg 3.0 mg/L Magnesium, Mg 3.0 mg/L
Manganese,Mn <10 ug/L Manganese,Mn <10 ug/L
Sodium,Na 4.9 mg/L Sodium,Na 5.0 mg/L
Nickel,Ni <10 ug/L Nickel,Ni <10 ug/L
Lead, Pb <10 ug/L Lead, Pb <10 ug/L
Selenium, Se <5.0 ug/L Selenium, Se <5.0 ug/L
Zinc, Zn 17 ug/L Zinc, Zn 30 ug/L

State Groundwater Quality Standards:
Classifications and Water Quality Standards Applicable To The Groundwater's of North Carolina
(North Carolina Administrative Code Title 15A: 02L.200)
Coliform, total <1/100 ml
Coliform, fecal <1/100 ml
Chloride <250 mg/L
Total Dissolved Solids <500 mg/L
NOZ+NO3 as N <10 mg/L
Cadmium <5.0 ug/L
Chromium, Cr <50 ug/L
Copper, Cu <1,000 ug/L
Iron, Fe <300 ug/L
Manganese,Mn <50 ug/L
Nickel,Ni <100 ug/L
Lead,Pb <15 ug/L
Zinc, Zn <21100 ug/L
Arsenic,As <50 ug/L
Mercury, Hg <l.l ug/L
Barium,Ba <2,000 ug/L
Zinc, Zn <2,100 ug/L
mg/L=milligrams per liter=parts per million (1gram/1,000grams)/1,000grams
ug/L=micrograms per liter=parts per billion (1gram/1,000,000grams)/1,000grams
1,000 ug/L= 1 mg/L
ns =not sampled
t

r, NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH,NORTH CAROLINA
PERMIT FOR THE 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
RAINFALL MOUNTAINS INCORPORATED
FOR THE OPERATION OF A TYPE 5A7 INJECTION WELL(S), 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 system is located at 141 Courtland Court, Lake Lure, in Rutherford County,
North Carolina, and will be operated in accordance with the application received on December 3,
2001, and in conformity with the specifications and supporting data submitted, all of which are
filed with the Department of Environment and Natural Resources and are considered a part of
this permit.
This permit is for Operation only, and does not waive any provisions of the Water Use Act or any
other applicable Laws,Rules, or Regulations. Operation and use of an injection well shall be in
compliance with Title 15A North Carolina Administrative Code 2C .0100 and .0200, and any
other Laws,Rules, and Regulations pertaining to well construction and use.
This permit shall be effective, unless revoked, from the date of its issuance until June 30, 2007,
and shall be subject to the specified conditions and limitations set forth in Parts I through IX
hereof.
Permit issued this,the r , day of 2002.
Ted L. Bush, Jr., Assistant Chief
�U Groundwater Section
Division of Water Quality
By Authority of the Environmental Management Commission.
Permit No.WI0100006 Page 1 of 5
ver.3/01 GW/UIC-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 secured with a locking cap.
6. Each injection well shall be afforded reasonable protection against damage during
construction and use.
7. Each injection well shall have permanently affixed an identification plate.
PART II- OPERATION AND USE GENERAL CONDITIONS
1. This permit is effective only with respect to the nature, volume of materials and rate of
injection, as described in the application and other supporting data.
2. This permit is not transferable without prior notice to, and approval by, the Director of the
Division of Water Quality(Director). In the event there is a desire for the facility to
change ownership, or there is a name change of the Permittee, a formal permit amendment
request must be submitted to the Director, including any supporting materials as may be
appropriate, at least 30 days prior to the date of the change.
3. The issuance of this permit shall not relieve the Permittee of the responsibility of
complying with any and all statutes,rules, regulations, or ordinances which may be
imposed by other local, state, and federal agencies which have jurisdiction. Furthermore,
the issuance of this permit does not imply that all regulatory requirements have been met.
Permit No.WI0100006 Page 2 of 5
ver.3/01 GW/UIC-5

PART III-PERFORMANCE STANDARDS
1. The injection facility shall be effectively maintained and operated at all times so that there
is no contamination of groundwater which will render it unsatisfactory for normal use. In
the event that the'facility fails to perform satisfactorily, including the creation of nuisance
conditions or failure of the injection zone to adequately assimilate the injected fluid, the
Permittee shall take immediate corrective actions including those actions that maybe
required by the Division of Water Quality such as the repair,modification, or abandonment
of the injection facility.
2. The Permittee shall be required to comply with the terms and conditions of this permit
even if compliance requires a reduction or elimination of the permitted activity.
3. The issuance of this permit shall not relieve the Permittee of the responsibility for damages
to surface or groundwater resulting from the operation of this facility.
PART IV- OPERATION AND MAINTENANCE REQUIREMENTS
1. The injection facility shall be properly maintained and operated at all times.
2. The Permittee must notify the Division and receive prior written approval from the
Director of any planned physical alterations or additions in the permitted facility or activity
not specifically authorized by the permit.
PART V- INSPECTIONS
1. Any duly authorized officer, employee, or representative of the Division of Water Quality
may, upon presentation of credentials, enter and inspect any property,premises, or place on
or related to the injection facility at any reasonable time for the purpose of determining
compliance with this permit, may inspect or copy any records that must be maintained
under the terms and conditions of this permit, and may obtain samples of groundwater,
surface water, or injection fluids.
2. Department representatives shall have reasonable access for purposes of inspection,
observation; and sampling associated with injection and any related facilities as provided
for in N.C.G.S. 87-90.
3. Provisions shall be made for collecting any necessary and appropriate samples associated
with the injection facility activities.
Permit No.WI0100006 Page 3 of 5
ver.3/01 GW/UIC-5

PART VI-MONITORING AND REPORTING REQUIREMENTS
1. Any monitoring (including groundwater, surface water, or soil sampling) deemed necessary
by the Division of Water Quality to insure surface and ground water protection,will be
established and an acceptable sampling reporting schedule shall be followed.
2. The Permittee shall report by telephone, within 48 hours of the occurrence or first
knowledge of the occurrence, to the Raleigh Regional Office, telephone number(919) 571-
4700, any of the following:
(A) Any occurrence at the injection facility which results in any unusual
operating circumstances;
(B) Any failure due to known or unknown reasons, that renders the facility
incapable of proper injection operations, such as mechanical or electrical
failures.
3. Where the Permittee becomes aware of an omission of any relevant facts in a permit
application, or of any incorrect information submitted in said application or in any report to
the Director, the relevant and correct facts or information shall be promptly submitted to
the Director by the Permittee.
4. In the event that the permitted facility fails to perform satisfactorily, the Permittee shall
take such immediate action as may be required by the Director.
PART VII- PERMIT RENEWAL
The Permittee shall, at least three (3) months prior to the expiration of this permit,
request an extension.
PART VIII- CHANGE OF WELL STATUS
1. The Permittee shall provide written notification within 15 days of any change of status of
an injection well. Such a change would include the discontinued use of a well for
injection. If a well is taken completely out of service temporarily, the Permittee must
install a sanitary seal. If a well is not to be used for any purpose that well must be
permanently abandoned according to 15A NCAC 2C .0213(h)(1), Well Construction
Standards.
2. When operations have ceased at the facility and a well will no longer be used for any
purpose, the Permittee shall abandon that injection well in accordance with the procedures
specified in 15A NCAC 2C .0214, including but not limited to the following:
Permit No.WI0100006 Page 4 of 5
ver.3/01 GW/UIC-5

(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) The 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) Drilled wells shall be completely filled with cement grout;which shall be
introduced into the well through a pipe which extends to the bottom of the
well and is raised as the well is filled.
(E) In the case of gravel-packed wells in which the casing and screens have
not been removed, neat-cement shall be injected into the well completely
filling it from the bottom of the casing to the top.
(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 VHI(1) and (2) (G) shall be submitted to:
Groundwater Section-UIC Staff
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh,NC 27699-1636
PART IX- OPERATION AND USE SPECIAL CONDITIONS
None
Permit No.WI0100006 Page 5 of 5
ver.3/01 GW/UIC-5

� � V�
�q_S9 _�tG � ��
s�a s
-ZQ1oZ � �0
�� _ --J��

Request for Exception to Purchase/ Contract
Division: _Division of Water Quality — Groundwater Section — ARO
Amount Requested:
Funding Source: _1655
Type of Funding:
Items to be purchased:
i. Item #M37037011 - TONER for DC-2055,2254,2255,2285 copiers - $21.55 /
each
The DC-2254 copier is a non-administrative supported copier and used by UST and GW
Sections. Costs for toner are shared between Sections. The copier is not on a service
Contract and will be sent to salvage when it breaks. Only one administrative copiers is availab
in the whole building.
2. Item #HP 92298A, CARTRIDGE TONER, LASERJET 4 Plus Printer - O
each
$82.95 * 1= $82.95
3. Estimated shipping charges and tax:
$7.57 + $10.00 = $17.57
Analysis of Need:
Support equipment necessary for printer and copier to carry on everyday function of regional
Section office. This is the only printer available to GW Section staff on the third floor. This is
the only copier available to GW Section staff on the third floor and only the second available f
GW Section staff in the whole building.
Signed:
Division Director
Approved Disapproved Div. P & S
Approved Disapproved Div. BPA
Approved Disapproved Secretary

!�n NC DENR/DWQ Chemistry Laboratory
Report to: l r) Sample Anomaly Report(SAR) //---- �
Lab Number: '�.c,-ila i 3 Sample lD: F'�C� n /lS� >/J '
Station Location: County: Region:
Sample Type: 1 Priority: Collector: Q<.n )AQLk4
Date collected: 1,[ ,'Date
rereceived
n n/�/ �(1�Date analyzed:
Affected Param eter(s): t o f .I�� r,f / Jti 11 F t
Analytical Area(check one):
❑ WCH ❑ METALS ❑ VOA Cl SVOA
❑ NUT ❑ MICRO ❑ PEST
The following anomalies occurred(check all that apply):
❑ Samples ❑ Quality Control
❑ Improper container used ❑ Instrument failure—no reportable results
❑ VOA vials with headspace ❑ Analyst error—no reportable results
❑ Sulfide samples with headspace ❑ Surrogates
❑ Samples not received,but listed on fieldsheet ❑ None added
❑ Samples received,but not listed on fieldsheet ❑ Recovery outside acceptance limits
❑ Mislabeled as to tests,preservatives,etc. ❑ Spike recovery
❑ Holding time expired ❑ None added
❑ Prior to receipt in lab ❑ Recovery outside acceptance limits
❑ After receipt in lab ❑ Failed to meet criteria for precision
❑ Insufficient quantity for analysis ❑ Internal standards
❑ Sample exhibits gross non-homogeneity ❑ Blank contamination
❑ Sample not chemically preserved properly ❑ QC data reported outside of controls(i.e.QCS,LCS)
❑ pH out of range(record pH): ❑ Incorrect procedure used
O Improper chemical ❑ SOP intentionally modified with QA and Branch Head
Cl Residual chlorine present in sample approval
❑ Color interference Cl Invalid instrument calibration
❑ Heavy emulsion formed during extraction ❑ Elevated detection limits due to:
❑ Sample bottle broken in lab-no reportable results ❑ Insufficient sample volume
❑ Other(specify):
Comments:
Corrective Action:
❑ Samples were rejected by DWQ Lab. Authorized by: Date:
❑ Accepted and analyzed after notifying the collector or contact person and determining that another sample could not be secured.
❑ Sample(s)on hold until:
Sample reported with qualification.Data qualification code used:
Other(explain):
Notification Required(circle one)? Yes No
Person Contacted: Date:
Form completed by:
Lead Chemist Review(t itial): D
9 BIOCHEM ❑ PEST- ❑ SV
METALS_ ❑ VOA- APR i O 2002
Branch Head Review(initia
QA/QC Review (initi ): Logged mo da base by(initial):
QAT.U.b.Wly'SAR GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

NC DENR/DWQ Chemistry Laboratory
Report to: �—)n U Sample Anomaly Report(SAR) ^
Lab Number:_ 1 �5L Sample I((D��: \'1 Q �1 f1., .fin n!1
Station Location: County:V� Region:
rJ
Sample Type: .D QA5A-x Priority: Collector:
Date collected:- '!Q / ate received: Date analyzed:
Affected Parameter(s): l .vv .CYV Qn� t r Jt�M
Analytical Area(check one):
❑ WCH ❑ METALS ❑ VOA ❑ SVOA
❑ NUT ❑ MICRO ❑ PEST
The following anomalies occurred(check all that apply):
Cl Samples ❑ Quality Control
❑ Improper container used ❑ Instrument failure—no reportable results
❑ VOA vials with headspace ❑ Analyst error—no reportable results
❑ Sulfide samples with headspace ❑ Surrogates
❑ Samples not received,but listed on fteldsheet ❑ None added
❑ Samples received,but not listed on fteldsheet ❑ Recovery outside acceptance limits
❑ Mislabeled as to tests,preservatives,etc. ❑ Spike recovery
❑ Holding time expired ❑ None added
❑ Prior to receipt in lab ❑ Recovery outside acceptance limits
❑ After receipt in lab ❑ Failed to meet criteria for precision
❑ Insufficient quantity for analysis ❑ Internal standards
❑ Sample exhibits gross non-homogeneity ❑ Blank contamination
❑ Sample not chemically preserved properly ❑ QC data reported outside of controls(i.e.QCS,LCS)
❑ pH out of range(record pH): ❑ Incorrect procedure used
Cl Improper chemical ❑ SOP intentionally modified with QA and Branch Head
❑ Residual chlorine present in sample approval
❑ Color interference ❑ Invalid instrument calibration
❑ Heavy emulsion formed during extraction ❑ Elevated detection limits due to:
❑ Sample bottle broken in lab-no reportable results ❑ Insufficient sample volume
❑ Other(specify):
Comments:
—1 — 1 O ¢J p 6
Corrective Action:
❑ Samples were rejected by DWQ Lab. Authorized by: Date:
❑ Accepted and analyzed after notifying the collector or contact person and determining that another sample could not be secured.
❑ Sample(s)on hold until:
Sample reported with qualification.Data qualification code used: ZY
Other(explain):
Notification Required(circle one)? Yes No
Person Contacted: Date:
Form completed by: dL�I�_ 'rip- Date:
Lead Chemist Revi (i 'a]): D v 0 u
BIOCHEM D ❑ SVOA
METALS A Aoo �N1 f
Branch Head Review(initia ' AF 11 1 O LVOL
QA/QC Review (initia Logged into database by(initial):
QA1.U.b..YSAR GROUNDWATER SECTION i0Z7/Ot�
ASHEVILLE REGIONAL OFFICE

NORTH CAROLINA
GROUNDWATER FIELD/LAB'FORM Depoi tMeet of Ettvion.Md and N itvol Resources
DIVISION OF WATER QUALITY - GROUNDWATER SECTION
112
�wa{4CA�.r6` Sample Tvoe. Sample Priority Lab Number
County Dote Received
Quad No. Serial No. Water Routine
``// �>> Rec'd by: From:B Courie Hand Del.
Lot. .y�DL 1`f'0n9 pc.. Z3533 Soil Emergency
/ Other
Other Ck.
.q- Chain of CustodyDota Entry by
Report To: `�oarSbHS AR O,Oilier)
Shipped by e,.(i er (Bus.C union Nord Del_Other) /
Collectorts): 'rww of So>~S Date-. q•
z• Date Reposed:
Time:
Purpose. (Baseline,Complain Complian UST,Pesticide Study,Federal Trust,Ot er):
r<r<k uel Owner �G.ti p\\ �'\ONM AaKS TY,.C- .
Pwoo �9 $ Spec Cord.q. 9z•0(I of 250C Location or site µ{�Q„{ pV d CO
°C Odor �mu.,Qr Descriptmnof sampling point
QO.+ VaNrl %%k Q�� G 1V'Qti 'taue.a
Temp�a I s. Sample Interval:
Sampling Method rGb
Appearance pep( - - '
Field Arolysis by: a KQ C'f�o hS
Remarks
LABORATORY ANALYSIS Ag-Silver 46566 ug/I Organochlorine Pesticides
mg/I as.Solids 70300 mg/I /I Orgamphosphoru9 Pesticides
5 AI-Aluminum 46557 u9
COD High 340 "A luoride 951 m9/I /l Nitrogen Pesticides
araness: Iotal 900 mg/I As-Arsenic 465 b u9
COD Low 335 mg/I Acid Herbicides
Coliform:MP Fecal 31616 /100ml Hardness:(non-curb)902 mg/I Ba-Barium 4 6 58 ug/I PCB's
Coliform'.MF Total 3I504 /100m1
Phenols 32730 ug/I Ca-Calcium 46552 mg/I
TOC 680 mg/I Speciiic Cond.95 u.,.os,c.^.. C_Cadmium 46559 ug/
Turbidity 76 NTU ulfate 945 mg/I Cr-Chromium 46560 ug/l
s/
6562 ug/I
Residue.,Suspended 530 mg/I Sulfide 745 rig/1 Cu-Copper 4 Semi o ati a Organics
Fe- run 46563 ug/
Oil a Grease mg Hg-Mercury 71900 u9
TPH-blue Ronge
PH 403
units C. K-Potassium 46555 mg/l
Alkalinity to pH 4.5 410 mg/I ✓Mg-Magnesium 46554 mg
Mn-Manganese 46565 ug/I
Alkalinity to PH 8.3 415 mg/I No-S ium 46556 mg/ Volati c Organic(VOA bolt e
5
Carbonate 5 mg/ NH3 as N 625 mg/ /l TPH-Gasolin Range
Bicarbonate 440 mg/1 TKN as N 625 m9 Pb-Lead q Ni-Nickel u9 ug/I TPH.BTEX Gasoline Range
Carbon dioxide 405 Mg/I NO2.NO3 as N 630 mg/I
46564
1/' Chloride 940 "A P:Total as P 665 mg/1 S< A
Chromium:Hex 1032 ug/I
Color:True 80 CU
Cyanide 720 "A -�� APR 1 0 2002
LAB C011101 TS : I
6W-54 For Nnol ed Are",-submit fitted maple and rrttte'DIS•in block

North Carolina
GROUNDWATER FIELD/LAB FORM Departmentof EDQUALleOland Natural Resources
DIVISION OF WATER QUALITYGROUNDWATER SECTION
`� _ AMP TYPE AS MPLEPRIORITY /� �i
County ' cZ,A k1kc��0y m,Water J Rotmne Lab Number A-©Z©f-5 O
r3
(a�4a �r✓G Serial No. b Soil -' Emeroencv Date Racal, ad SO 2 Time: Z� >O
Quad No - From:Bus,Courier an ,
Lat, _ Long.— El Other Other By: 1n.
❑Chain of Custody Other:
Report To:ARO FRO,MRO, RRO,WaRO, W R0, Date Entry By: I� Ck:
Data
WSRO,Kinston FO, Fed.Trust,Central OH.,Other: Reported: 12 t
Shipped by:Bus,Courjer d Del.,Other: Purpose:
Collector(s): a. ✓5 V s_ Date Z' oZ Time aseline Complaint, om lien ,LUST,1 Pesticide Study,Federal Trust,Othec_ _
r2 9 Owner ;&! ,OtAhJ 'WS
pH am ��_ Spec.C°nd gi 7-7 at 250C Location or Site .wt or d C.0 � ,.4' r v —
Temp.n I -�° °C Odor Nto7u¢ Description of sampling�oint Sample Interval_
Appearance C:Icm' x o tw RemaSamprks Method crab
�S SOltiS s mo. er.Stg.i
Field Analysis By �raarr tPumomgama.ee�.w..etc.)
QR6TQRY 8NALY=
lCerbondinoxideM91L
10 mg/L Dias.Solids 70300 mp/L Ag-Sllver 46586 ug/L Or enochlonne PealiUdes
High 340 ri Fluoride 951 mg/L N-Muminum 46557 ug/L 0 anopbgapna➢s Past
Low 335 mg/L Hardness'.Total 900 mg/L As-Arsenic 46551 u /L Namgen Pesticides
Mom:MF Fecal 31816 Z 1100m1 Hardness(non-acid 902 mg/L ea-Banum a655B u /L Acid Herbicides
nn•MF Total 31504 L It00mI Phenols 32730 ugn Ga-Caicium 46552 ni PCBs
680 m9!L Specific Cond.95 uMnoslcm Cd-Cadmium 48559 ug/L
ity 76 NTU Sulfate 945 ni Cr-Chmmlum 46559 ug/L
ue,Suspended 530 mg/L Su01tle 745 mg)L Cu-copper 46582 uglL
Fe--:^n 48563 u 0. Semrvolatile Organics
Oil and Grease mg/L Hg-Mercury 71900 uyL TPH-Diesel Range
3
units K.Potassium 48555 m /L
nity to pH 4.5 410 ari MgMegnesium 46554 m /L
inity to pH 0.3 415 mg/L Mo-Mangenese 46565 u /L Volatile Organics(VOA bottle)
onate 445 mg/L NH3 as N 610 mg/L NaSodium 46556 r IL TPH.Gasolme Range
bonate 440 ni TKN as N 625 mg!L Ni-Nickel u /L TPH-8TEX Gasoline Raripe
on dioxide 405 mg/L NO,F Nos as N 630 mg/L Pb-Lead 46564 ug/L
Chloride 940 mg1L P.Total as P 665 mgiL Se-Seienmm uglL
Chromium:Hex 1032 ug/L ZnZnc 46567 u L
LAB USE QNQ
Carr.True e0 DO Temperature on arrival:
Cyanide 720 mg/L
Lab Comments
GW-64 REV.12/87 For Dissdvad Analysis-submit filtered Sample and was DIS'in biocK. FEB - I
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

North Carolina
Department Environment t and Natural Resources
GROUNDWATER FIELD/LAB FORM
DIVISION OF WATER QUALITY-GROUNDWATER SECTION
AMP TTPF SAMPLEP I Z O
County--- gl ��4�e�Y� W8t8r ❑ Routine ` Lab Number r
Soil ❑ Emercencv L Time: S
L _ Serial No.� C Date Receive wJ� From:Bus,Cour Courier, and De.
Quad No — v Omer Rec'd By:
Lat. Long.
_ J Chain of Custody Other:
Report To:ARC)FRO,MRO,RRO,WaRO,WiRO, Data Entry By: � Ck: &�X
, Data
WSRO,Kinston
FO,Fed.Trust, Central Off., Other: Reported: w'
Shipped by:Bus, o. r Hand Qy Other: Purpose:
Collector(s): Tt� T'w so` S Date Z' 'IL Time_-,^Baseli Complaint, lia .LUST,)Pesticitle Study,Federal Trust,Other:___
Owner. Kath a,"-u1tA
PH
Spec.Cond 91 277 at 25°C Location or Site_ �.;'..Lr +er c >'• —
Temp.1 '(r eC Odor_ Nvv-e� Description of samplingoint Sample Interval
Appearance Sampling Method arC-b am
Field Analysis By: Remarks left (Pwnpmyeme.aKtmro..ek.,
RATORY ANAL
a00 310 mglL Dias.Sobas 7030: mg/L AggSilver 46566 u lL Orgenachlgrine Pe6ticides
COD High 340 mg/L Fluodde 95+ mg/L AI•AlaminUm 46557 u /L amphosphgrus Pestiddes
COD Low 335 mg/L j Hardness:Tors'.9O: mglL As-Amenlc 46551 u /L Nor an Pesticides
Colttorm:MF Fecal 31616 /100ml Hardness Ino,-cam 902 mg/L Ba-Barium 46558 ug/L Acid Herbicides
Coliform:MF Total 31504 nuoml Pranols 3273f ug/I Ca-Calcium 48552 mg/L PCBs
TOG 680 mg/L Soecilic Cont.95 uMnos/cm b Cd-Cadmium 46559 ug/L
Turbidity 76 NTU Sulfate 945 mg/L Cr-Chromium 46558 ug/L
Residue,suspended 530 mg/L Sulfide 745 mg/L Cu-Copoer 46562 ug]L
Fe iron A6563 un/L $emivolaue Organics
Oil and Grease mg/L t1t5i Hg-Mercury 71900 ug/L TPH-Dimal Rome
PH 403 units �.�a K-Potassium 46555 mall
Alkalinity to PH 4.5 410 mg/L n+<. Mg-Magnesium 46554 m /L
Alkalinity to bH 6.3 415 mg/L �.,-� Mn-Manganese 46565 u /L Volatile Organics(VOA bottle)
Carbonate 445 mg/L NH,as N 61: mg/L (�tS Na-Sodium 46556 mg/L TPH-Gasoline Ran e
Bicarbonate 440 mg/L TKN as N 62` mg/L <'. Ni-Nickel ug/L TPH-STEX Gasoline Ran e
Carbon dioxide 405 mg/L NO;+NO.as N 63: mg/L Pb-Lead 46564 ug/L
Chloride W mg/L P:Total as P 66'_ mg/L '}!;', Se-selenium ug/L
Chromium:Hex 1032 ug/L y Zn-Zinc 46667 ug/L
N Y
Color:Two 80 Cu Temperature
Cyanide 720 mg/L
Lab Comments
GW-54 REV.12187 For Dissolved Analysis-Submit filtered samwe ar^_wrae'OIS"In ologK.
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

L 5ed
DIVISION OF WATER QUALITY
Chemlstry Laboratory Repar,I Crouad Water Oudlry Lab Number 2GO213
Date Received 20n002
COUNTY : RUTHERFORD SAMPLE PRIORITY Time Received : 9:30 AM
QUADNO: ROUTINE EMERGENCY Received By US
REPOR
COLI.F TTO : ARO RcRinnalORnr CHAIN OF CUSTODY
CI-OR(s) : ] PARSONS E �Released'B� TR�
DATE'
COLLIf 2AUM W❑ SAMPLE TYPE Date reported: 3/ZR12002
'DME:
PURPOSE: Owner: RAINFALL 51OUNTAINS INC
Location or Site:
Description of sampling paint
Sampling Method:
Remarks:
LABORATORY ANALYSIS
ROD 310 _ m /L X Dlss.Solids 70300 66 m /L X A -Silver 46566 5.OU u L Orgurnachlenine Pesticides
COD High 340 m /L X Fluoride 931 0.1 m /L X AI-Aluminum 46537 50U u L Or no h horus Pesticides
COD Low 335 m L X Hadnea:meal 900 30 m L % As,Ananic 46551 IOU a /L Nitrogen Pesticides
Coliform:MF Fecal 31616 /100ml Hardness: rmncarb)901 m L X Ba-Darium 46558 130 u /L
Coliform:MP Iou131504 /loom) Phenols32730 u /L X CaCalcium 46552 7.2 m /L Acid Herbicides
10C MR/1 Specific Cond.95 umhos/cm2 X CdCadium 46559 2.01.1 a 1.
I urbifity N7U X Sulfate 51.1 m L X CrnChromium 46560 25U ug/L Senivulatiles
% Residue,Suspended 530 2.5 U m /L Sulfide 745 m L X Cu-Co per 1042 77 a /L TPH-Diesel Range
Tool Suspended solids m /L IMBAS m L X Fe-Iron 1045 5OU u L
Oil am Grease m /1. X II Mrrcu 71900 0.2U a /1. lVolafflc Or nits VOA boulu)
_LI 8.1 unit% X Silica 38 m /l. X K-Poonsiusn 46555 2.4 tortall.
Alkalinity to till4.5 32 J2 nilill. Bonin X I Mx Ma nnium927 3.0 m L I'I Ill I.Gasoline Ram ,
Alkalinity to Fil18.3 1 U.J2 n, /L Ivrmeldth de m L % Mrl.Man anese 1055 IOU u /L 11 PH.BTEX Gasoline Range
X Carbonate I U,J2 mg/L NI13 as N 610 m /L X Na.Sodium 929 5.0 m /L
X Bicarbonate 32 J2 m /L TKN a N 625 m /L X Ni-Nickel IOU a /L
Carbon dioxide m L X NO2*NO3a n630 0.23 m L X I'b-Lead 46564 IOU u /L
X Chloride 4 en /L P:Total as P 665 m /L X Se-Seknium 5.OU u /L
Chromium:Hex 1032 a /L PO4 m L X Zn Zinc 46567 30 u /L
Color:True 80 c.u.
C amide 720 m L
C'OJIMENTS:
[if 11
APR 1 0 2002
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
an9219.ah

DIVISION OF WATER QUALITY
Chemlatry Labonrory Repun/Ground Ware,Quality Lab Number 2GO212
Date Received 2/7/I002
COUNTY RUTHERFORD SAMPLE PRIORITY
Time Rettived : 9:30 AM
QUAD NO: ROUTINE EMERGENCY Rettived By IDS
REPORTTO ARO Regional Once CHAINOFCUSTODY ��''////II� �/6
COLLECTOR(S) TPARSONS I �eleased'B AR
DATE: 2L4= W❑ SAMPLE TYPE Date reported: 3/20/2002
TIME:
PURIN)SE 0..,: RAINFALL MOUNTAINS INC
Location or Site:
Description of sampling point
Sampling Method:
Remark:
LABORAT011Y ANALYSIS
R0f1310 /L X Uiss.Solids 70300 76 m /L X All-Silver 46566 5.0U u /L Orgarsochlorme Pesticides
COD I ligh 340 m /L X Fluoride 951 0.2 m /L X AI-Aluminum46557 SOU u /I. Or no hot hmus Pesticides
COO Low 335 m t/L X I lardnrn:tout 900 30 m L X As-Awmc 46551 IOU u A. Nitrogen Pesticides
Colitis:m:MF Fecal 31616 /10Um1 Ilardness: mmrvcarb 902 m /L X Ila-Ilaoum 46559 130 a /L
Colifmm:MF'1'uut 315D4 /IWmI Pherwh 32730 u /L X Ca-Calcium 46552 7.2 m /L Acid Herbicides
1'0C m /I Specific Cond.95 umhos/cm2 X Cd-Cadium 46559 2.01.1 u /L
Turbitity Nl'U X Sulfate 5U m /L X Cr-Chromium 46560 25U a /L Sernnoutiles
X Residue.,Suspended 530 2.5 U m L Sulfide 745 m /L X Cu.Copper 1042 29 u /L TPII.Dieml Range
'foul Sus ndcdsolids /L MDAS m /L X Fe.Iron 1045 SOU u /L
Oil and Grease m /L X 11 -Mercusty 71900 0.2U u /L IVolafile Or nies VOA bottle)
II 7.5 units X Silica 38 m /L X K-Potassium 46555 2.3 m /L
Alkalinit to 114.5 36 J2 m /L Boron X MR-Ma nesium 927 3.0 m /L ITPIIGasoline Range
Alkalinit to II 8.3 I U,J2 mg/1- Formaldehyde m /L x Mn-Man nose 1055 IOU a /L TPH-BTEX Gasoline Ran
X IC.rbonate I U,J2 m /L NIB a N 610 m 11. X Na-Sodium 929 4.9 m /L
X Bic,stbonaw 36 J2 m /L 'rKN a N 625 m /L X Ni-Nickel IOU u /L
Carbon dioxide m /L X N01+NO3 a n 630 0.23 m L X Ph Lead 46564 IOU u L
X Chloride 4 m /L P:lout as P665 m L X SeSeIrmum 5.OU u /L
Chromium:Hex 1032 u /L PO4 en /L X Zn Zinc 46567 17 u /L
Color:Toe 80 C.U.
C amde 720 m /L
COaIMENI-S:
APR 10 2W2 [Uj
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE 200212 xia

NORTH CAROLINA
GROUNDWATER FIELD/LAB FORM Department of Environment and Natural Resources
1 DIVISION OF WATER QUALITY - GROUNDWATER SECTION
County �<A�v..a,V �oYG� Sample Type Sample Priority Lab Number � a
Quad No. Serial No. ` Water Routine Date Received 7 Ti
Lot. 3S,thip'Z g. $L•1�•T.3$330 Soil Emergency Ret'd by: From;Bus, punt r • and Del.
•� Other Other
Report To: "� `p YSpH.S AR O,Other) Chain of Custody yy Data Entry by: Ck:
Shipped by (2p%wi e Y' (Bus.C urier Hand Del.Other)
Collector(s): �t.e� o($OkS Dote: ,7< ��•d� Dote Reported.
Time: 1 T=rT.«'�•
Purpose: (Baseline,Complain Complian UST,Pesticide Study,Federal Trust,Of er): `AA
FIELD ANALYSES I<"<k �A� a`� "\o1A.�Il 4�MS T Y�•C
pHson �• p _ _ 5pec.Condo, 9T..q a �L' � � �o< ion s µ{�,<F OYd CO
Tempi; IS .(;' "C Odor Y40 M.ee Description a ing point ea'4 IA% A,, tN o3it¢.. 1- G 1ve.•A. 11v4_,N
Appenrance Cjppe APR S Me �ra p Sample Interval:
1 0-- -- 2� T, rn,-crTC— -- —
rield Analysis by: \ v�C.��O{'OhS Remarks �'S AS -rk'40a wleW-.-' `S•�i G.o. I-tlt\fc-Ae'
AT TION
LABORATORY ANALYSIS GROUND REGIONAL _
gm-'3a — mg/I iss. mg Ag-Silver 46566 ug/1 Organochlorine Pesticides
COD High 340 mg/I Fluoride 951 mg/1 AI-Aluminum 46557 ug/1 Organophosphorus Pesticides
COD Low 335 mg/ Hardness: Total 900 mg/1 As-Arsenic 46551 ug/1 Nitrogen Pesticides
Coliform:MF Fecal 31616 /loom, Hardness:(non-curb)902 mg/I So-Barium 46556 ug/1 Acid Herbicides
Coliform:MF Total 31504 /loom, Phenols 32730 ug/1 Ca-Calcium 46552 mg/I PCB's
TOC 680 mg/l u os cm C -Cadmium 46559 ug/
Turbidity 76 NTU Sulfate 945 mg/I ,/ Cr-Chromium 46560 ug/I
Residue.,Suspended 530 mg/I Sulfide 745 mg/I Cu-Copper 46562 ug/I
Fe-Iron 46563 ug Semivo ati a Organics
OtT a Grease mg Hg-Mercury 71900 ug/1 TTH_D_1"_e1 Range
pH 403 units tLA K-Potassium 46555 mg/1
Alkalinity to pH 4.5 410 mg/1 Mg-Magnesium 46554 mg/I
Alkalinity to pH 8.3 415 mg/1 Mn-Manganese 46565 ug/l
Carbonate 445 mg/1 NH3 as N 610 mg/ a-So l 46556 mg/ Volatile Organics(VOA bottle)
Bicarbonate 440 mg/I TKN as N 625 mg/1 Ni-Nickel ug/l TPH-Gasoline Range
Carbon dioxide 405 mg/I V NO +NO3 as N 630 mg/1 Pb-Lead 46564 ug/l TPH-BTEX Gasoline Range
Chloride 940 mg/l P:Total as P 665 mg/1 Se-Selenium ug/l
Chromium:Hex 1032 ug/I n-Zinc 46567 ug/l
Color: True 80 CU
Cyanide 720 mg/I
LAB COMMENTS
GW-54 For Dissolved Analysis-submit filtered(ample and wrlte'DIS'In block. _

F \NATF Michael F. Easley,Governor
William G.Rosa Jr.,Secretary
��. North Carolina Department of Environment and Natural Resources
Uj 1 r Gregory J.Thorpe,Ph.D.
> Acting Director
Division of Water Quality
To: Mark Pritzl
Hydrogeological Technician II
NCDENR/DWQ/GW/UIC
RCO
From: Tina Parsons {(�
UIC/Resource Evaluation/Incident Management
NCDENR/DWQ/GW
ARID
Through: G. L. Davidsoa(2
Region Supervisor
NCDENR/DWQ/GW
ARO
Re: WI0100006
UIC Permit Renewal
Rainfall Mountains Inc.
Lake Lure NC
Rutherford County
Date: 12 February 2002
On 4 February 2002, 1 performed a routine inspection and sampling of Rainfall Mountain Inc.'s
geothermal injection well system. This is the home of Alan and Suzanne McKay in the community of Lake
Lure, adjacent to the golf course.
The well is located at the back of the house and sits adjacent (<2')from the golf course. Potential
contaminates include nitrates from the golf course. I obtained influent and effluent samples and submitted
them to our labs for analysis. I found nothing out of the ordinary and recommend re-issuance of the
permit.
attachments
Akn
FdF11r7r i
Customer Service Division of Water Quality / Groundwater Section
1 800 623-7748 1636 Mail Service Center Raleigh,NC 27699-1636
Phone: [phone] Fax: [phone] Internet: hdp://gw.ehnr.stale.nc.us

North Caroliud nelinf rent of Environment rind Ndta'ral IlesoUrces
Division of Wader Quality - Gr'oundwatet•Section
INJECTION CACILITI INSPECTION RC PORT - FORM B
3µS 'k ZbN
INJECTION KrF,I,I, PF,RMI'I' NO. WI01660b DATE Z ' lZ•6.Z ct!mz •o'�•o
NAM1IF OF OWNFR :. - ....
ADDRESS OF OWN ER d0'x
(,Street/rnad or Mt and snhrlivision, r•onnQt fovv)
LOCATION OF INJECTION WELL, (and source well(s), if applicable)
--2t_ E o cam\_ cowl S4.
(Streit/rnrrrl or lot rrnrl snhdiri.cinn , rnunll'. Imrn, (fdr,'lrcrent than owner's n(lrlress,pills description of location oil site)
Potential pollulion source_ C F Lbw St_. _ Distance from well - Z
Potential pollu n tio source_ _�_ _ _ _- Distance from well
Polcntial pollution sourcc __. . Distance from well
f
Minimum distance of•wcll from prolicrty boundary
(Quality of drainage it site Ade.�kblelclooding potential orsite_—
(good,adrguate,poot) (high.modernfe,low)
UPS Uata:
i,tftitntle: as :'+tDz9�/yS�i�( Longitude: Sz• 1 3333tAf
DRAW SKETCll OF SITE (Show property houndaiies, buildings, wells,potential polhrfinn solaces, roads, approximate scale. a
north arrow.) 1
DESCRIBE INJECTION SVSTEM (iwrtical clo.red loop, unrased borehole or cased water well;separate source well and
ityertion well; rgmhin/a-tinn snrn•rr and injer•finn uv: I; or other dewription ns nl plienble)( l
�_e a•L�pW' CR. •�- I "1jc.GT 'a� L1G�1 .
V er.3/01 C W/UIC-2

~ INJECTION..<CILITV 119SPF.CTION REPORT-FORM I.tCONTINUED)
WELL CONSTRUCTION
Pate consttucted
Drilling contractor: Nail»e�de eti�i uer` l�t\\ �� i
Address
Certification number
1
Total depth of well `� g8 'Total depth of source well S
--- (iJ'npldicr+hlel
Inspection point Mensorcnncot I'd eels minimum standards Comments
Yes No
Casing
3St
Diameter —
Hcight (A.L.S.) J115 —
Grout ,
Depth —
§cteetns
Depth(s) _ N I\ —
Length(s)I.D. Plate 00 00
Static water level _ _ —
Well yield '5W iw —
Encloshre it coork�e-c( t-3 -,y
Phelostire floor - vkot-m _
(concrete)
Sampling port - tJe la4a►Qun� —
(labeled) _ , , be k�- �^ 1+.n r1_�
. C'c>f c S
Water tight pipe entry CA ✓ —
Well enclosiure entry 1`
Vent HA- —
t"llfieIlollIIIgo f heat pump system (Uetern+ine jinn+the awner lfheat pnn+p f actions properly.)
INSPECTOR ► T� _ Officc AT �
WITNESS Jo\�vCNA\ Addres% s - to"vve�oY WoJk •�b�
W 1'1'NF,SS Address
Ver.3/01 G W/UIC-2

North Caroli— Department of Environment and N..,,-.-al Resources
Division of Water Quality - Groundwater Section
INJECTION FACILITY INSPECTION REPORT - FORM B
INJECTION WELL PERMIT NO. W(�I 0 166001a DATE Z ' t z•o Z-
NAME OF OWNER
ADDRESS OF OWNER -'1 •O. 'DO'X �\P`\ lSY+
vim:%lteti An tky,
Ti EQvV�y.
(Street'road or lot and subdivision, county, town)
LOCATION OF INJECTION WELL(and source wcll(s),(if applicable)
atC
(Street/road or lot and subdivision, county, town, if different than owner's address,plus description of location on site)
Potential pollution source !uC4 c-d`^r%C- Distance from well =Z
Potential pollution source Distance from well
Potential pollution source Distance from well
i
Minimum distance of well from properrtLty boundary !L Za
Quality of drainage at site /ode !ia Flooding potential of site
(good,adequatepoor) (high,moderate,low)
GPS Data:
Latitude: SS.`}�zg`IYS�/� Longitude: 6X- l Z3J3j
DRAW SKETCH OF SITE (Show property boundaries, buildings, wells,potential pollution sources, roads, approximate scale, a
north arrow.)
DESCRIBE INJECTION SYSTEM (vertical closed loop, uncased borehole or cased water well;separate source well and
injection well;combination source and injection we 1;or other description as applicable)
b/�arl (eap �ow% b�w. �o� 3oW eo t tnicG? 'a�t 4YL��.
Ver.3/01 GW/UIC-2

INJECTIW "MITY INSPECTION REPORT-FORM , :ONTINUED)
WELL CONSTRUCTION
Date constructed �kl�, I
Drilling contractor: Name �ree►���ve�r l,�}i\\ '7
Address
Certification number
t s �
Total depth of well Total depth of source well
(if applicable)
Inspection point Measurement Meets minimum standards Comments
Yes No
Casing
Depth o- 351
Diameter l.o .XS11 Tts _
Height (A.L.S.) I ' S
Grout ,
Depth / 9 ' 'J
Screens
Depth(s) N A
Length(s)
I.D. Plate tJ O O
Static water level Alk
Well yield 5 ►w
Enclosure Wctl cov"4LJ to (31`00 �� rock ke vq_r�
Enclosure floor — vwi,.& _
(concrete)
Sampling port — n10 1ph.Qao�
(labeled) _
Water tight pipe entry C� ✓
Well enclosure entry y
Vent NA-
Functioning of heat pump system (Determine from the owner if heat pump functions properly)
INSPECTOR 'S Office ATt
WITNESS Joyw T � Ve, $Z �LAddressl
V...„•M_ }e./ 'jam �c�0.�' •
WITNESS Address
Ver.3/01 GW/UIC-2

WI0100006 UIC Inspection of Rainfall Mtn pics.doc
}
Injection well and cover.
4(
o'er k
3gPa^ yyw .s. 4 � N
✓, r•4
Injection well is just to the left of picture. The
End.
TParsons Page 1 2/13/2002

?� � y
;;�: _
.� -x'= - ,
.�,

WI0100006 Rainfall Mtn. Inc.
Lake Lure NC
WI0100006
� N
�r Wf
0 0.2 Miles S

CAWLD"
.c-rC�� bwwtmetaf am-mom tied hoturw 4Leswrees
;RDl7N�Wt4TfR TjE Z11AB�DRM N o Dr4L9IO AVAM QUAISTY - 6ROUNDWAT6t secrsoH
�LL� �O'CO` coal Tvce Sample Priorm Water pate Recrned
outtYAwo Routine From:Buz,Curer,Hard Del.
?trod Sena)tuo. Roc d b{.
V�Tp^9 R-• L3S Soil Emergency other
at. •y - Other Y CI`.
Data Entry by
'To: +T� K5 AR O,Other) Chain of Custody
zeporr, aaY50
Slipped by' sAfit� (Bus. user and Del.,Other) Date Reported'.
e6 Dote: Z•'��oz'
Time:
Purpose (Bnsel,ne.Comilla. Comohan UST,Pesticide Study,Federal Trust.Oi er)- sM kN atKS =�C
Owmer �a,M o�� ��W 'e.
FT VA Y 5 p, of 25aC Location or site µ{�Q.r OYd
Spec.Catdy. gX• l
p�00 — Deamptton of sampling point ec µtAA.
cC Odor t4v ✓4� SamPlc Irttcrvo!-
Temptcc_ �� Sompliro MethodQ p
APpearortcz. _'c � .= �5.0 ` ` \S 5:1; C� N t'�t/�.�e-•
Remarks
Fuld Aetalysts by:
LABORATORY 4NALYS15 F�LW.
46566m
ptyarochionm PesnraaC �
ma/I Sol.as 70300 MCI Or9ntgphosph1W Pesnndes
Name 951 mg/1 m 6551 Nttro9en PestlnGe$
COD Hiah 340 mo/I c 46551
ma/I artiness.Total 90C mg/I And Herotctaes
COD Low 335 - 4655EPCs's
/100m, Inororrss:Inon-garb)90e ma/I 46552
I ICoiiionn:MF Fecoi 3i61c 11 D 15 52730 W/1
IColifatm:MF Total 31504 iiv0m; �� ,�,;,� ua/I
ypociftc Ca .9� u...�as. �/'===
TOC 680 mo/I fate 945 "/I Cr-Cnra,m m 46560 "p/I
Tu'bidity 76 NTU SuFfide 745 mg/I Cu-Copper 46562 uo/1
anrvo Slatile Otoatscz
R,.adue,,Sup oed 530 "/I Fe-Iron 46563 ug/1 Ra,�
/ H9A'�- T 1900 1
re
0"ad& nse K-Potmaun46555 mg/1
PH 403 urm 5 LA C. Ma_- un46554 e9/1
Mmiiaity to PH4.5410 n9/I Mn-Wtmattsc 46565 W. Volatile OrWme (VOA Dottie
AymWityto pH 8.3415 mg/I NH3 as N610 mg/1 No-Saaun 46556 M/I TpH,Gmdme PAM
C,rbotmte445 wgll Nia ltdvl +9A
gi�botmte 440 W411 TIN as N 62.5. mt9ll Ni-McktJ � TPH-BTEX AIM�10c
NO2.NO3 as N 630 "A WI
mtg/I F.Total as P665 a9/1 Se-Sekruun
�ChImide 940 =/I Zunr46567 u9"
Ovanaim:Hex 1032 WA
CDbr:TnmaO CU
Cy,r,de720
-AS 5
--- f«t..a..,I+ts-QLS.Sabek

NORTH C�T►+A
txpww W of Err.er.+M.d Naltovl Rwrai"
WDUNDWATER�ILAS FORM nlvisON OF��ATER QUAL ' w"�`s�
jjjMFja� U _'^` � Lob Number Time
T�f mole Tyoe Sample Priority Dee Reserved
Canty �4l Water Routine From:Bus.Lamer.Hard Del.
Serial No. Read by
Lhnd W. Long. Qy7.(}L S�S3lJ soil Emergency Oder
Lai. 3S.-6 Other Ck:
Data Entry by
�� Aa 0,Other) Chain of Custody
Report To: aY56K�
Shipped bY- �rf •C-Y' (Bus. umer Hard/Del.,Other) Dot,Repomed-
Coikctor(s). ��w OrSo� Date. Z•�'�z'
Trme-
Purpose. (Bose Im,Campiai Comphon us-.P viade Study,Feaer of TTrtut,
incw.el Or+r1[r "Q.� a�\ •'\OMK O.r V•S �T.0
M lA Y S 9z 6l at 25 oC Location or ste µ��'1C.'f OV d
SPec.Cond.9.
PH�o �9•�
`C etm
am
` Dptron of sPhrg point `+ V' Somolc Tnterwl:
T OderonPi. .`�— 1Vm samplim Method lib
Appeora� _i� �'IC 4 a,��1�d uvl cA S
kemarks rjNo.=
Field AMiys6 by
Ao-Setter 46566 uo/I OroarprlydnrK Pe51rtlM3
UBORA70RY-ANALYSIS ma/I prss-5ohas 7030G rro/I Oroonophosphorut Pestiadcs
s - mo/I AL-Ahnumm 46557 ua/I
/I �Fknride 951 u?/I Nrtroaen Pasrrcides
COD High 340 Haraness. Total 900 mg/I D As-Arstmc 46551 �/ And Herbiaats
COD Low 335 na Bo-esatun 46556
C RTarm:MF Fecal 3161c /lOOml IHoronus iron-curb)902 mo/I ma/I PCBs
IPherols 32730 uo/I Ca-Calnum 46552 J
I Colitam:MF Total 315<K ;.•.rV... i �:.nh 4659 _
TOC 680 mo/I {&peat¢ 45 'v5 ro/i
Sulfate 945 mp/I Cr{nroadum 46560
Turbidity 76 NiL Cu-Copper 46562 w!I
sidue..Sru9erocd 530 ma/I Sulfide 745 n5/' to/i Senrvolatile Orpomcs
Re
Fe-Iron 46563 -
Oil H9-Mw>ry 1900 ua/i
Oil and Grrasc K-peahen 46555 "/I
pH403 units Mg-Moorrueen 46554 "A
Abmlinity to PH 4.5410 VV/I +16565 u9/1
M- - Vokrtile Or9amrs(VOA bottic
Alidintty to pH 8.3 415 n5/I No-Sodaen 46556 1A°/I
Caraorrdte 5 mg/I NH3 as N 610 n9/I uo/I TPH-6am1rw kon9e
TKN m N 625 wg/l Ab 4,eW 46564 TPH-STEX Ea Wlm Raaoe
NO2 NO3 as N 630 m9/I
grmborutc 440 m9/I pb-Lead ua/i
. as/l
Gabon drxiu oe 405 mg/I P:Total as P 665 mg/I Se-�' -
Lhlaidc940 iro/1 p1 ZNZtnc46567 u9/i
Qaamown:Hex 1032 u9/I
Coca'Troe 80 Cu
Cy,we 720 ni9/I
-LAB COMOWT5 .
_..._. c...rr�Arm1�-ssmrrflhavd+aiR�,vdwite'DISmblsd�

NORTH CAROLINA
GROUNDWATER FIELD/LAB FORM Department of Ermrmr.rcrit and Natural Resources
,�y�,�, `\ DIVISION OF WATER WALITY - GROUNDWATER SECTION
�µ� �pYG` Sample Twe Sample Priority Lab Number
County Time
Serial No. Water Routine Dote Received
Quad No. ` Rec'd by From:Bus,Courier,Hnnd Del.
Lai. 'SIT Long. SL•F�'T•.SS'S8� Soil Emergency
Other Other
Report To: '[�wY,5pK5 AR 0,Other) Chain of Custody
Data Entry by Ck'
Shipped by tdi a Y" (Bus,C urier and Del,Other)
�� Date. O Date Reported
Collector(s): \•t"� Of SOKS Z'
Time: -�^'•
Purpose. (Baseline,Complain Complian UST,Pesticide Study,Federal
Tr�ust,Ot er).
(.rak arc) Owner 1�aa.N ft\\ •'�P1AsA, ockl ir1.
F ANA YS 5 yAre-
5
D eov l9• Spec Cond_9a1 9Z• i of 25aC Location or site µ��,Q,d OV d O L� `
cC Odor Fvm MC. Description of sampling point ee.'4 i1AMA, 1M 0�xe G 1�7Qk `t�'�
Tempe., S. Sample Interval:
Appearance �'�rpY Sampling Method `` ro1b
T Remarks (�'�• T S• �Ott1� 214`5 %S•
Field Armiysis by. \ eM4�CY'OtAS „g.,,,r,u,..e+¢r;.. }
LABORATORY ANALYSIS M.r
ochlorine Pesticides
/I boss,Solids 70300 mg/I Ag-Suvcr 46566 ug/l
mg ho horns Pesticide
COD High 340 mg/1 Fluoride 951 mg/1 AI-Aluminum 46557 u9/1 P sp
g As-Arsenic 46551 ug/1 en P"Ticides
COD Low 335 mg/1 Hcronew Total 900 mg/1 erbicides
Coliform:MF ieccl 31616 /100m1 Nartlness:(non-curb)902 mg/I So-Barium 46558 ua/I
Coliform:MF Total 31504 /100ml Phenols 32730 ug/l Ca-Calcium 4 ma/I
TOC 680 mg/l Specitic Coed.95 as,s C_a-fadmium 4652 559 uo/
Turbidity 76 NTU 'Sulfate 945 m9/1 Cr-Chromium 46560 ug/I
Residue.,Suspended 530 mg/I Sulfide 745 mg/I Cu-Copper 46562 ug/l
Fe-Iron 46563 u9 Semivolatile Organics
i a Grease m5 Hg-Mercury 1900 t9 H-Dice Range
pH 403 units (,.1 G K-Potassium 46555 mg1l
Alkalinity to pH 4.5410 mg/I Mg-Magnesium 46554 mg
Alkalinity to pH 8.3 415 mg/I Mn•Matgonese 46565 ug/l
-Sodium 46556 mg/ Volatile Organic(VOA bolt e
Carbonate 45 "A NH3 as N 630 mg/I TPH-6asohm
BBicarbonatee 440 m9/I TKN as N 625 mgll Ni-Nickel u9/l Plange
Carbon dioxide 405 mtg/I
NO2-NO3 as N 630 mg/I Pb-Lead 46564 ug/1 TPH-STEX Gasoline Range
Chloride 940 mg/I P:Total as P 665 m5/I Se-Selenium t9/I
Chromium:Hex 1032 *1 n-Zinc 46567 u9/I
Color:True 80 CU
Cyanide 720 "A
LAB COMMENTS
5W-54 For Dissolved Analysis.wbnii filtered sampk ord wr+tc'DI5'in bbck

�psyrwNefE.+,wr,rndiJ.n.dlMawew � - i ., �}
re
6RDvmWATfR 71s�BFFDRIN WMWNofWAMSTY-;Wp1MWAMSS=N >
s9wLab Nuttier
mmjisty-��+ON�o•C� T c�nnnle Priority Date Reccncd Time
County Serial No. Water Routine ,d Ftnm:&u,Cana+er,Hand Del.
Qt� Other Emert!<ncYOther
by-
Lat. 35.4_ b .Laiq $Z- -'z3S�� Data
'•'� [main of Custody Data Entry by
-UVOrt7o: 'T TpYSbK� AR O.Dihv)
(D
5hRPed by' ;qeAr (Bus. cr ud Del-Other) Dote Reported
zollector(s). Or'�.a0� Date: 2..q,07—
Time: •+�•�•
Purpose (Bosel,W.Compiw Comphan UST,Pesticide 5tudy,Federal Trust,Ot er): �,�A
¢.ck...) OwrerC.t41S Z+f�
El t�S , at 25pC Location or site yi{>�,{ OVt� Ley 'e
5pec.Coady. tM � � i �V2+ti �tuC:S
Description of sampling point
Oda* y - eb� 1►N'L �eT� l,.
T"m as• `1w Smnoling Method 'rol•y ` 1
Appearance -'C-i
Field Amiysis 6Y: Ewa or'C�S _ n10r1`s L nuC•= '[5$
Pestnciaes
LABORATORY.ANALYW5 5uwr46566 u9/1 Pttticides
o "A Fluoride
Sohas 70300 tn9/I � �
Fluoride 951 -"A Ai_A 11113m46557 u9/1
COD High 340 m9/1 H=nCIS Total 900 "A AS-Arsenic 46551 ug/I Acid Herbicides
COD Low335 �/ � Ir,troness:lroa-carb)902 mg
Ipiwmis 32730 u9/� 52/I 8o-Banun 46558 t9/l
PCB's
Cohrortn:MF Feca:31616 Co-Cdcium 52 465 in9/I
to/I
ILoliform:MF 7otci 315v- /I 5pcttnc iare.95 +^� -
TOC 680 46560 u9/I
,ydfote 945 m9/1
tiTll 46562 ag/I
TRetidn¢..75 5OrPonics
30 W411 Suffdc 745 *t9/l Fe-Z 3 � Senutelatdeamp
6trara 109 Hr*Arc*y
K-Potmaran4 555 m9/l
PH emts M4_iAogrewn46554 wg/1
AYodintyto pH4.5410 -"/I A\n4Amn9encsw�46565 Volatile Ot9mecs(VOA Pattie)
AynlerW vH8.3415 TMtJ/1 No-Sodm46 1
C,.b,mte445 tag/ NH3 asN610 'm9/l lit4•Bdarl 419/1 TM1.6aadioeRage
pnoyypnarc440 /l T7Jw N625 -mg/I pt,-Lw d46564 Ag/I TPH-gTDCbmdlheikinge
Ca,bandntade405 ttg/I NO2•NO30SN630 wg/I
P:Totai P b65 tin/I Se-Seletcum 49/1
Otluridc 940 'm9/1 7s-Zmc46567 49A
C, mi w Hex 1032 AS/I
Color.Tt ue90 Ql
Cymide720 mJ/1
y48TOMA1EN1'S ° \

W A Michael F.Easley,Governor
\OHO 9Q(r William G.Ross Jr.,Secretary
North Carolina department of Environment and Natural Resources
co r Gregory J.Thorpe,Ph.D.
j Acting Director
Division of Water Quality
December 11, 2001
Ms. Suzanne McKay, Vice-President
Rainfall Mountains Inc.
P.O. Box HM 1877
Hamilton,Bermuda HM HX
Dear Ms. McKay:
Your renewal application for a permit to use a well for the injection of geothermal heat
pump effluent has been received and is under review. The Groundwater Section appreciates your
timely response to our written inquiry regarding the status of your geothermal heat pump system.
A member of the Groundwater Section's Asheville Regional Office staff will be contacting you
to arrange an inspection of the injection well and collect water samples as part of the review.
If you have any questions regarding the permit or injection well rules please contact me at
[phone] or Evan Kane at [phone].
Sincerely,
Mark Pritzl
Hydrogeological Technician
Underground Injection Control Program
cc: CO-UIC Files
ARO-UIC Files
nNrN
ENR
Customer Service Division of Water Quality / Groundwater Section I
1 800 623-7748 1636 Mail Service Center Raleigh,NC 27699-1636
Phone: [phone] Fax: [phone] Internet: http://gw.ehnr.state.nc.us

D [ �[ UCH
DIVISION OF WATER QUALITY Q DEC 12 2001 ;
GROUNDWATER SECTION
December 11, 2001
MEMORANDUM
To: Landon Davidson, L.G., Regional Groundwater Supervisor
Groundwater Section
Asheville Regional Office
From: Mark Pritzl rlp. [e-mail]
Hydrogeological Technician II
Underground Injection Control Group (UIC)
Central Office (CO) ^ o
Re: Permit renewal#WI0100006 f4JinSlly under Ralph Clum; request for inspection and
routine sampling of Rainfall Mountain's geothermal injection well system. This system
is located at 141 Courtland Court, Lake Lure, NC 28746.
1. Please review the injection well permit renewal and submit any comments to the CO-UIC.
Retain the application for your UIC files.
2. Inspect the injection well site to verify that the location and construction plans submitted in
the application are accurate and the NCAC Title 15A 2C .0200 standards are being complied
with, using the enclosed Injection Facility Inspection Report(form B) as appropriate.
3. Collect samples from the influent and effluent sampling ports and submit the results to
the CO-UIC.
You are requested to return the completed Injection Facility Inspection Report (form B) to the
CO-UIC by January 30,2002. If the inspection can not be accomplished by this date, please
inform the CO-UIC. The UIC group greatly appreciates Asheville Regional Office's
assistance with this review. If you have any questions regarding this review or the UIC
program, please contact me at(919) 715-6166.
cc: CO-UIC Files
Enclosures

01/28/2002 11:44 4412955524 DIVERSIFIED SERVICES PAGE 01
FAX TRANSMISSION
DmR5IFIED SERVICES BERMr1r1A LTD.
-P.O.Box HM 1877
Hamilton,HM HX Bermuda
441-295-9253
Fax:[phone]
To: NC Water Authority Date: January 28, 2002
Fax#: [phone] Pages: 1, including this cover sheet.
From: Alan J.McKay
Subject: Well&Heat Pump
For the arm of Noss Tina Parsons
Good Morning Miss Persons,
With reference to your call this morning regarding the inspection of the above at our house in
Lake Lure,we have instructed the contractor presently working on the house to make contact
with you and arrange a suitable visit to site.
The gentleman's flame is,
John Bittle Tel No 828-625-9341
Should you have any problems in this regard please do not hesitate to contact the undersigned.
Yours sincerely,
A"J. y

State of North Cc Ina
Department of Environment,
Health and Natural Resources ` •
Division of Environmental Management
James B. Hunt,Jr., Governor p E H N IR
Jonathan B. Howes,Secretary
A. Preston Howard, Jr., P.E., Director
GROUNDWATER SECTION
November 29, 1994
MEMORANDUM
To: Chris Hite
Groundwater Section
Asheville Regional Office
From: Karen Harmon
UIC Group
Groundwater Section
Raleigh Central Office
Re: Issuance of injection well permit .
Permit No. WI0100006 to use a well for injection has been
issued to Mr. Ralph Clum; a copy of the permit is enclosed for
your files.
CC : UIC Files nGr�ou�ndwater
U I
ARO Files
Enclosures
P.O.Box 295M,Raleigh,North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50%recycled/10%post-consumer paper

State of North Cqigina
Department of trEllonment,
Health and Natural Resources `4 •
Division of Environmental Management
James B. Hunt,Jr., Governor p E H N IR
Jonathan B. Howes,Secretary
A. Preston Howard,Jr., P.E., Director
GROUNDWATER SECTION
November 29, 1994
Mr. Ralph Clum
408 Courtland Court
Lake Lure, NC 28746
Dear Mr. Clum,
In accordance with your application dated August 11, 1994, we
are forwarding a permit for the Operation and Use of a well, for
the purpose of injecting heat pump effluent, in Rutherford County.
This permit is a renewal of Permit No. 80 - 0128 - WO - 0001,
which was issued on October 3, 1989 . This permit shall be
effective from the date of issuance until November 30, 1999, and
shall be subject to the conditions and limitations as specified
herein. This permit, Permit No. WI0100006, replaces and shall also
supersede Permit' No. 80 - 0128 - WO - 0001. Please note that the
permit numbering system has been revised so that your permit has a
new number.
In order to continue uninterrupted legal use of this well for
the stated purpose, you should submit an application to renew the
permit six months prior to its expiration date.
If you have any questions regarding your permit please feel
free to contact me at (919) 733 - 3221, ext . 407 .
Sincerely,,
A. Eliza th More
Manager
Underground Injection Control Program
P.O.Box 29536,Raleigh,North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50%recycled/10%post-consumer paper

. Y
NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE 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
Ralph Clum
FOR THE OPERATION OF AN INJECTION WELL for the purpose of injecting
heat pump effluent. This well is located at 408 Courtland Court,
Lake Lure, North Carolina, in Rutherford County, and will be
operated in accordance with the application dated August 11, 1994,
and in conformity with the specifications and supporting data
submitted, all of which are filed with the Department of
Environment, Health, and Natural Resources and are considered a
part of this permit.
This permit is for Operation only, and does not waive any
provisions of the Water Use Act or any other applicable Laws, Rules
or Regulations . Operation and use 'of an injection well shall be in
compliance with Title 15 North Carolina Administrative Code 2C,
. 0100 and' _ 0200 and any other Laws, Rules, and Regulations
pertaining to well construction and use.
This permit is a renewal of Permit No. 80 - 0128 - WO - 0001
which was issued on October 3, 1989, and shall be effective, unless
revoked, from the date of its issuance until November 30, 1999, and
shall be subject to the conditions and limitations specified in
Parts I through VIII herein. This permit replaces and shall also
supersede Permit No. 80 -, 0128 - WO = 0001 .
Permit issued this the 9 day of November, 1994 .
L. Bush, Jr. , Assistant Chief
Groundwater Section'
Division of Environmental Management
By Authority of the Environmental Management Commission.
PERMIT NO. WI0100006

r"
PART I - 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 (15 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.
87-91 .
2 . This permit is effective only with respect to the nature,
volume of materials, and rate of injection described in the
application and other supporting data.
3 . This permit is not transferable without prior notice to, and
approval by, the Director of the Division of Environmental
Management (Director) . In the event there is a desire for
the facility to change ownership, or there is a name change
of the Permittee, a formal permit amendment request must be
submitted to the Director, including any supporting materials
as may be appropriate, at least 30 days prior to the date of
the change.
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 .
PART II - PERFORMANCE STANDARDS
1. The injection facility shall be effectively maintained and
operated at all times so that there is no contamination of
groundwaters which will render them unsatisfactory for normal
use. In the event that the facility fails to perform
satisfactorily, including the creation of nuisance conditions
or failure of the injection zone to adequately assimilate the
injected fluid, the Permittee shall take immediate corrective-
actions including those actions that may be required by the
Division of Environmental Management (Division) 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.
PAGE 2 OF 6

3 . The issuance of this permit shall not relieve the Permittee
of the responsibility for damages to surface or groundwaters
resulting from the operation of this facility.
PART III - OPERATION AND MAINTENANCE REQUIREMENTS
1 . The injection facility shall be properly maintained and
operated at all times .
2 . The Permittee must notify the Division and receive prior
written approval from the Director of any planned physical
alterations or additions in the permitted facility or
activity not specifically authorized by the permit .
PART IV - INSPECTIONS
1. Any duly authorized officer, employee, or representative of
the Division of Environmental Management may, upon
presentation of credentials, enter and inspect any property,
premises, or place on or related to the injection facility at
any reasonable time for the purpose of determining compliance
with this permit, may inspect or copy any records that must
be maintained under the terms and conditions of this permit,
and may obtain samples of groundwater, surface water, or
injection fluids .
2 . Department representatives shall have reasonable access for
purposes of inspection, observation, and sampling associated
with injection and any related facilities as provided for in
N.C.G.S. 87-90 .
3 . Provisions shall be made for collecting any necessary and
appropriate samples associated with the injection facility
activities (see attached diagram) . .
PART V - MONITORING AND REPORTING REQUIREMENTS
1. Any monitoring (including groundwater, surface water, or soil
sampling) deemed necessary by the Division of Environmental
Management to insure surface and ground water protection,
will be established and an acceptable sampling reporting
schedule shall be followed.
2 . The Permittee shall report by telephone, within 48 hours of
the occurrence or first knowledge of the occurrence to the
Groundwater Section Staff, Asheville Regional Office,
PAGE 3 OF 6

telephone number (704) 251-6208, of any of the following:
(A) Any occurrence at the injection facility which
results in any unusual operating circumstances;
(B) Any failure due to known or unknown reasons, that
renders the facility incapable of proper
injection operations,, such as mechanical or
electrical failures .
3 . Where the Permittee becomes aware of an omission of any
relevant facts in a permit application, or of any incorrect
information submitted in said application or in any report to
the Director, the relevant and correct facts or information
shall be promptly submitted to the Director by the Permittee.
4 . In the event that the permitted facility fails. to perform
satisfactorily, the Permittee shall take such immediate
action as may be required by the Director.
PART VI - PERMIT RENEWAL
The Permittee shall, at least six (6) months prior to the
expiration of this Permit, request an extension.
PART VII - CHANGE OF WELL STATUS
- 1. The Permittee shall provide written notification within 15
days of any change of status of an injection well. Such a
change would include the discontinued use of a well for
injection. If a well is taken completely out of service
temporarily, the Permittee must install a sanitary seal. If
a well is not to be used for any purpose that well must be
permanently abandoned according to 15 NCAC 2C . 0113, Well
Construction Standards.
2 . When operations have ceased at the facility and a well will
no longer be used for any purpose, the. Permittee shall
abandon that injection well in accordance with the procedures
specified in 15 NCAC 2C . 0214, including but not limited to
the following:
(A) All casing and materials may be removed prior to
initiation of abandonment procedures if the
Director finds such removal will not be
responsible for, or contribute to, the
contamination of an underground source of drinking
water.
PAGE 4 OF 6

(B) The entire depth of each well shall be
sounded before it is sealed to insure freedom from
obstructions that may interfere with sealing
operations .
(C) Each well shall be thoroughly disinfected, prior
to sealing, if the Director determines that
failure to do so could lead to the contamination
of an underground source of drinking water.
(D) Each well shall be completely filled with cement
grout, which shall be introduced into the well
through a pipe which extends to the bottom of the
well and is raised as the well is filled.
(E) In the case of gravel-packed wells in which the .
casing and screens have not been removed, the
casing shall be perforated opposite the gravel
pack, at intervals not exceeding 10 feet, and
grout injected through the perforations .
(F) In those cases when, as a result of the injection
operations, a subsurface cavity has been created,
each well shall be abandoned in such. a manner that
will prevent the movement of fluids into or
between underground sources of drinking water and
in accordance with the terms and conditions-.of the
permit.
(G) The Permittee shall submit a Well Abandonment
Record (Form GW-30) as specified in 15A NCAC 2C
. 0213.(h) (1) within 30 days of completion of
abandonment .
3 . The written documentation required in Part VII (1) and (2)
(G) shall be submitted to:
i
Groundwater Section - UIC Staff
DEHNR - Division of Environmental Management
P.O. Box 29535
Raleigh, N.C. 27626-0535
PART VIII - SPECIAL CONDITIONS
NONE
PERMIT NO. • WI0100006
PAGE 5 OF 6
I

ATTACHKENT 1 ,
PERIKIT NO. WI0100006
Sanitary Well Seal Sampling Tap
(Influent) HEAT
Casing must extend-min.
of 12 inches above PUMP
land surfaces — W
cc mp Sampling Tap
(Effluent) p4 �f' )C�C S':r:I.I;r':,r,.-o;••:Ary.,,:ti.J lt:,.� �;.(•.l:r;.[:..-\.lri.fr::i.,.�, i.••y:l.i:l. •I�'•.44V•r�..l ! U .�: -:4:' •,,1L. lil•y.rR•f u+:'Js;A•,r.T!: rr..{{1• .1 9•" „r_ J:,rr.Y..,•.•:.'l'l..:?�.'� e h�.r • Tf�'I.i�ir�1 4:';.r r•.'iJ.•5 .:r r<(,1
N111. : .r!, vt I
7 :� 1! a� ..,.r,
;:rr1 . +�ry}�$S,T71:1�!•;7.�2'�i:' .:JS�•1S� r7�y.C),:•,':Y•qCi�•SLY �:Y>�3 �; {. a;7•. �
:r�\ter fl•• [•• iv h: 'C.d..y.:;' W .!• r.�. i•..•.h;,a,:rt'i:fll:hlr.l ya. �rr..i•...yr:: 1. � 1•.Y^.•f......,y .VI�.,:-.:.'l..:![r' rrr:+`,. : •.i1:1�+'�
�;r:; :�Sv �J t. �L, is '�J . L:t Y.•:`:��:l::ii' �:rl:, ..J: r.•.Y: ;f'n:'•':ir. \.;
t•'•
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w
a COMBINATION . SOURCE . . :'
- E AND INJECTION WELL L�
t1j ,
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.� -:/_.1 ��' `� M1`. .L' i_ J„/� ��_...t- `�G!C - /i.!%.tl/\�/!ll'�\ I�\\,�-�111 ,I.I '�J! -0n:/•� I. � ^. ..

L' NATURAL RESOURCES AND COP, .4 DEV41AWMC 1
LaVISION 0; IMVIRO1QMAL
YELL AND PUMP INSPECTION REPORT 89
/ Dat
Well location L� Ly2 ., Area
Town, Corm.. Subdivision and, Lot No. County RutAe/'{�,�(
Owner _ --4 gt y•' CdtfAf -
Road/Street Cr,*,,x
Address t� J3oK '32o 71e�ye 104b Quad No. OQ-;L
Sarial ,No.
YELL CONSTRUCTION Lat. Look--
Driiiing•Contractor, C!gA/ Aes-2. A,/ € AAA.0 Co p&ft z64 gz
Name Address 6-AtAr Raab. Reg. i
- zY7z6
Meets Min. -Standards
Meisure Yes No Remarks
Permit ;,f
Diitaice from
Pollution-source- -
Other location standards ' ✓ j
Tatal Depth APO
Casing
Depth y✓ ✓
Diameter
Weight/thickness, ✓
Height
Drive shoe ?
Exception approved by owner nT
Grout: -/
Tye
Thickness (/
Depth y
Screens
Develo MEI ��In ( IZ
I ,
1. D. "Plate
Abandonment (temporary/permanent) p✓p,
Water level
Well test G�UUGyL
Chlorination i
Cutting A14
Reports
(appearance) ,

?uri. 'iaataiiar �� �_<Ici✓C�- WEGG Z �(JAtY
Name Address Reg. U
Meets Min. Standards
Measure Yes No Remarks
Enclosure „(�4 -•c,:
Enclosure floor
Casing' heiRht
t
Valved flow
Water tight Dine entry
Well entry _
Vent ., ,!
Hose bib _ Z Cos— r ,
r <,../
Tee (iet)
Suctim •line � ~
Chlorination ?
Temporary Aband.
Date Well Constructed G ��E•%
Date Pump Installed 7 Q� ` •-�
i
„, Signature "
Witness
Name Address Type j
Name Address Type jl
IV
1
Oro
E _
O �• `gi.1D 1
0e.1
v

RAINFALL MOUNTAINS INC.
P.O. Box HM 1877
Hamilton HM HX
BERMUDA
Phone: [phone]
Fax: [phone]
November 26, 2001 o
UIC PROGRAM
Ground Water Section r
North Carolina DENR-DWQ
yc
1636 Mail Service Center �o
Raleigh
North Carolina 27699-1636 w �A
USA w z
ATTENTION: MARK PRITZL
Dear Mark,
Further to our telephone conversations, please find enclosed the completed Renewal
Permit Application for the heat pump system at 141 Courtland Court, Lake Lure.
Please do not hesitate to call me if you have any questions.
Many thanks for your assistance.
Yours sincerely,
Suzann McKay
Vice-President
Rainfall Mountains Inc.

Oct 23 01 04: 45p „ RE1 im REFFL'TY t82 "•25-2478 p. 3
NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT;HEALTH,AND NATURAL RESOURCES
_ —
APPLICATION FOR PERMIT RENEWALT.0 USE A WELLS) IraR INJECTION WITH
A 11EAT PUMP SYSTEM
o 0
LJ10i o6pue Type 5A7.and'5QM Wells' o a
f�rn� iU� M �..
ql�, In accordance with the provisions of NCAC Title 15A:02C.0200
complete application and mail to address on thebackpage., w {
3 am
TO: . DIRECTOR,NORTH CAROLINA DIVISION OF WATER QUALITY ma
cn
DnTF `•-November' L' ;20'O1 w —'
w o
A. SYSTEM CLASSIFICATION: Does'the system re-circulate only potable water without any additives such as .
corrosion inhibitors or antifreczesiu continuous piping which isolates the fluid from the environment?
YES If yes,du not complete this form.. A form SOW-57 CL,(Notification Of Intent To Construct A
Closed-Loop Geothermal-Water-Only Inicetion Well System),should be completed.
/ .
NO V If no,then continue completing this form.
B. PERMIT APPLICANT
Name:_RAINFALL MOUNTAINS INC.— C/O SUZANNE MCKAY
P.O. BOX HM 1877
Address: _—City: —
HAMILTON State: BERMUDAZipcode: HM HX —
----
County: BERMUDA _ Telephone: [phone] (Daytime)
C. PROPERTY OWNER(if different from applicant)
Name:
Address. _
Crty::' State:.... Z. code:
Colony: __-- Telephone:----- —...-..—
D. STATUS OF APPI ICAN'r
Private: Feduah_ Commercial: _. Stale:_ Public:
Native American Lands: —
F. FACILITY (SITE)DATA(Pill out ONLY if the Status of Owner is Federal,Stale,Public or Commercial).
Name of Business or Facility:_ 2AINEATL MOi1NTA �TS_7SLC.._- --
Address:___141_ C_our_tland_Court____
City:
Lake Lure State: NC Zipcade:28746 _
y_� _.._..----------- --"._
Coon b: USA�t.i gG Telephone: [phone] Contact Person: Suzanne McKay
Standard Industrial Codes)which describe conmrcrcial facility:
PRIVATE HOUSE
ver3/01 OW/UIC-5711PR Pagel oF3

Oct 23 01 04: 46p RE, --N REnLTY (6 ICY—1 25-2476 lo. 4
F. INJECTION PROCEDURE (specify any modifications to the injection procedure since the issuance of the
previous injection permit)
G, WELL USE Is(are)the injection well(s)also used as the i1pply well(s)for either of the following?
(1) The injection operation? YES_ ✓ NO
(2) Your personal consumption? YES_
H. CONSTRUCTION DATA
(1) Specify any and all modifications to the well casing, grout or screens since the issuance of the previous
injection permit.
(2) NC. State Regulations (15A NCAC, 2C, Section .0200) require the pernriuce to make provisions for
monitoring well head processes. A faucet on both influent (groundwater entering heat pump) and
effluent(water being injected into the well)lines is required, Is there a faucet on:
(a) the influent line? yes_ ✓ no
(b) on the effluent line? ycs no_
I. CURRENT OPERATING DATA
(1) Injection rate: Average(daily).gallons per minute(gpin)
(2) Injection volume: Average(daily)kCDOgallons per day(gpd)
i
(3) Injection pressure: Average(daily)_ per square inch(psi)
(4) Injection temperature: Aimual Average degrees'Fahrenheit(°F)
INJECTION-RELATED EQUIPMENT
Attach a diagram showing any modifications to injection equipment since the issuance of the previous injection
permit including the engineering layout of the (1) injection equipment, and(2) exterior piping/tubing associated
with the.injection operation. The.manufacturer's brochure,if detailed,should satisfy(1).
LOCATION OF WELL(S)Attach a map
Include.a,site map (can be drawn) showing: the orientation of and distances between the injection well(s) and
any existing wells)or waste disposal,facilities such as septic tacks or drain fields located within loco feet of the
ground-source heat pump well system; in buildings,property lines,surface water bodies,any other potential
sources of groundwater contamination. Label all features clearly and include a north arrow to indicate
orientation.
PERMIT LIST: Attach a list of all permits or construction approvals, received or applied for by the applicant
that are related to the site.
Examples include:
(1)Hazardous Waste Management program permits under RCRA
(2)NC Division`of Water Quality Non-Discharge Perini
(3)Sewage Treatment and Disposal Permits
f3
OW/UIC-57 HPk - page 2 o

Oct 23 01 04. 46p REV' 7,N REnLTY (82; "`�25-2476 p. 5
OTHER MODIFICATIONS: Indicate any other modifications to the injection well system
(equipment,fluid,operation,etc.)that have occurred since the issuance of the
previous injection permit and have not been noted elsewhere on this application.
1.7i CERTIFICATION
"I hereby certify, under penalty of law, that I have personally examined and am familiar with the information
submitted in this document and all attachments thereto and that, based on my inquiry of those individuals
immediately responsible for obtaining said information, I believe that the information is true, accurate and
complete. I am aware that there arc significant penalties,including the possibility of fines and imprisonment,for
submitting false information. I agree to 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"
SU EHAL OF RAINFALL MOUNTAINE
Signature o Well Omrr Authorized Agent) INC.
Ifanthorized agent is acting on behaljojthe well omvrler,
please,supply a letter signed by the uivner
authorizing the above agent.
O. CONSENT OF PROPERTY OWNER(Owner means arty person who holds the fee or other property rights in the
well(s). A well is real property and its construction on land rests ownership in the land owner in the absence of
contrary agreement in writing.)
If the property is owned by someone other than the applicant, the property owner hereby consents to allow the
applicant to operate an injection well(s)as outlined in this application and that it shall be the responsibility of the
applicant to ensure that the injection well(s) conform to the Well Construction Standards (Title 15A NCAC
Subchapter 2C.0200)
(Signature of Properly Owner if Different From Applicant)
Please return the completed Application package to:
UIC Program
Groundwater Section
North Carolina DENR-DWQ
1636 Mail Service Center
Raleigh,NC 27699-1636
(Telephone: [phone])
vcr.3/01
OW/UIC-57 HPR Page of

Oct 23 01 04: 46p REI1 ' I REALTY (82(; '25-2478 p. 6
NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY, GROUNDWATER SECTION
STATUS OF INJECTION WELL SYSTEM
Dale: NovelIIk7er 26 . 2001 Permit Number; WY /,0000
Name: RAINFALL MOUNTAINS INC.
Address: P.O. Box HM 1877, Hamilton BERMUDA HM HX
Please check the selection which most closely describes the current status of your injection well.
In addition, please provide the requested information.
1) f/ Well is still used for injection activities.
2) _ Well is used for water supply.
3) — Injection discontinued;
a) _Well temporarily abandoned b)_ Well permanently abandoned
Describe the method used to properly abandon the injection well. (Include a description of how the well
was sealed and the type of material used to fill the well if permanently abandoned): If you checked two
(2), report the pumping rate and what the water is used for.
Certification: (For well abandonment)
"I hereby certify, under penalty of law,that I am personally responsible for the proper abandonment
of any Injection well as required in Title 15A NCAC 2C.0214 Criteria and Standards Applicable to Injection
Wells."
(Signature)
Certification: (For information verification)
"I hereby certify, under penalty of law, that I have personally examined and am familiar with the
Information submitted In this document, and that to the best of my knowledge the information is true,
accurate, and complete:"
SU VE/C4 BEHALF OF RAINFALL MOUNTAINS
( ignatu INC.
ver.3/01 GW/UIC-68

North Carolina
Department of Environment,Health,and Natural Resources
GROUNDWATER FIELD/LAB FORM
/ // DIVISION OF ENVIRONMENTAL MANAGEMENT-GROUNDWATER SECTION
County N 1 _ Lab Number
Quad No l'rx? 11W Serial No. _ _ QAMPLE PRIORITY Date Rec ' ed l` Time
Lat. Long. — _ ROUTINE EMERGENCY Rec'd by: From: Bus oun , Hand Del.,
CHAIN OF CUSTODY Other:
Report T ARO, RO,MRO, RRO,WaRO,WiRO, Data Entry By: 1 Ck
WSRO, Kinston O, Fed.Trust, entral O ., Date Reported:
Shipped by: But, ourie Hand Del.,Other
Purpo:: :
Collector(s): t'1//s `/�p Date � % ��� Time ��� S l Baseyl' :,Complaint,Compliance(LUST,Pesticide Study,Federal Trust,Other:
FIELD ANALYSES /�a/ZZI /I/
t ai,A7i
/� 11`. Owner /,Z. ' e /
1400 i., Spec. Cond.94 � �� at 25o C Location or site '14 a r t n,�, ,— =� _ r - a a �• %./
.. mp.10 '% 0C Odor Description of sampling point
Appearance c'ha/ Sampling Method -oG Sample Interval
Field Analysis By: Remarks ------_ t 'M"°`°t°t
LABORATORY ANALYSES \, �^w^u°^"•=r"^ met
BOD 310 m : Diss.Solids 70300 mail A -Silver 46566 u cyl
Or anochtorine Pesticides
_COD High 340 mg/I Flouride 951 mcvl At-Aluminum 46557 ugil Organophosphorus Pesticides
COD Low 335 m Hardness:Total 900 m I As-Arsenic 46551 uqA Nitrogen Pesticides
�Coliform:MF Fecal 31616 /100ml Hardness non-carb 902 mq1I Ba-Barium 46559 uqA
Coliform:MF Total 31504 /100ml Phenols 730 uQA Ca-Calcium 46552 MgtI Acid Herbicides
TOC 660 MCO Specific Cond.95 uMhos/cm2 d-Cadmium 46559 uqA
Turbidity 76 NTU Sulfate 945 m Cr-Chromium 46560 u /1 Semivolatile Organics
Residue.,Suspended 530 mg/I Sulfide 745 u-CO en 46562 �' u I
Fe• Iron 48563 < u
H -Mercury 71900 U911 Volatile Organics(VOA bottle)
pH 403 unit K-Potassium 46555 m 1
Alkalinity to pH 4.5 410 mgA M -Ma nesium a6551 ; j m 1 TPH-Gasoline Range
Alkalinity to pH 8.3 415 mg/I V /' ��-� Mn-Manganese 46565 <Z. : uqA TPH-BTEX Gasoline Range
Carbonate 445 mg/I NH as N 6100.0 3 mail Na-Sodium 46556 maji
Bicarbonate 440 I TKN as N 62s mcVI vI Ai - Nickel -,�/O ucyl
Carbon dioxide 405 m91I NO +NO as N 630 0, 05 m I Pb- Lead 46564 < ' u I
Chloride 940 matt P:Total as P 665 m I Se-Selenium u I
Chromium:Hex 102 u Zn-Zinc 46567 3 u
Color:True e0 Pt-Co
Cyanide 720 mg/I
Lab Comments: Groulldvratgr Section
GW-54 REV.6/93 For Dissolved Analysis-submit filtered sample and write"DIS"in block.

North Carolina
GROUNDWATER FIELD/LAB FORM Department of Environment,Health,and Natural Resources
/ DIVISION OF ENVIRONMENTAL MANAGEMENT-GROUNDWATER SECTION
County .r /W _ Lab Number qC2 3
Quad No Serial No. -_ SAMPLE PRIORITY Date Received -9 Time1 G
Lat. � iOUTINE EMERGENCY Long. _" Rec'd by: From: Bus, o� Hand Del.,CHAIN OF CUSTODY Other: ) ,
Report To: RO, RO, MRO, RRO,WaRO,WiRO, Data Entry By: Ck:
WSRO, Kinston FO, Fed.Trust,Central ,Of e /�� - !���N��'�'f° F', Date Reported:
Shipped by: Bus,1CZ!WW Hand Del.,Other —�
,�/� �C� Purpose:
Collector(s): 4'Xi'%f 151/P Date 7 ° Time Baseline,Com laint,?Compliance( LUST, Pesticide Study,Federal Trust,Other:
FIELD ANALYSES iy/ '1� /7 ( /t;,r '
Owner
.� '6p, - r a 1 ���
A400 / Spec.Cond.94 G�' at 25o C Location or site y/ ' > /c' /�/ ' - /�� / �
.amp.70 .'!+ oC Odor Description of sampling point
Appearance C/Fcy Sampling Method /c;7� f 4� Sample Interval
Field Analysis By: �� '' fr Remarks — gyp' `mil
LABORATORY ANALYSES (pumpvp lime,arc temp.WC.)
BOD 310 m , Diss.Solids 70300 m A A -Silver 46566 uqA Or anochlorine Pesticides
COD High 34o mgA Flouride 951 mqA Al-Aluminum 46657 ugA Organophosphorus Pesticides
COD Low 335 mgA Hardness:Total goo MQII As-Arsenic 46551 uco Nitrogen Pesticides
Coliform:MF Fecal 31616 /100ml Hardness non-cart 902 m_qA Be-Barium 46558 UqA
Coliform:MF Total 31504 /1 ooml phenols 32730 UCIA Ca-Calcium 46552 Acid Herbicides
TOC 6e0 m9A Sp2cific Cond.95 uMhos/cm' Cd-Cadmium 46559 u
Turbidity 76 NTU Sulfate 945 mCVI 4 Cr-Chromium 46560<5 _ ugA Semivolatile Organics
Residue.,Suspended 530 mgA Sulfide 745 mqA vj Cu-Copper 46562 u I
Fe-Iron 46563 u I
H -Mercury 71909 u A Volatile Organics(VOA bottle)
PH 403 unit K- Potassium 46555 m9A
Alkalinity to pH 4.5 410 mgA Mg- Ma nesium 46554:;, TPH-Gasoline Range
Alkalinity to pH 8.3 415 mg/I 1/ f ^tP Mn-Manganese 46565<d 0 ugA TPH -BTEX Gasoline Range
Carbonate 445 mgA NH as N 610 O 3 mo
JI Na-Sodium 46556 maA
Bicarbonate 440 Ni-Nickel <! uciA
Carbon dioxide 405 mgA +NO as N 630 D, 0' MgjI Pb- Lead 465M / uqA
Chloride 940 mgA P:Total as P 665 m I Se-Selenium U011 `' I _
Chromium:Hex 1032 UgA Zn-Zinc 46567 .j(c uqA
Color:True 6o Pt-Co
Cyanide 720 mgA L 061
Lab Comments:
we
GW-54 REV.6193 For Dissolved Analysis-submit filtered sample and write"DIS"in block.

North Carolina
GROUNDWATER FIELD/LAB FORM Department of Environment, Health,and Natural Resources
DIVISION OF ENVIRONMENTAL MANAGEMENT-GROUNDWATER SECTION
County u Lab Number / 07 -2 t�
Quad No Serial No. AMPLE PRIORITY Date Received 9- 2-5y Time 3.3 0
Lat. Long. - E, ROUTINE EMERGENCY Rec'd by: s` From: Bus,Couri , Hand Del.,
CHAIN OF CUSTODY Other:
Report T AR FRO,MRO, RRO, W O,WiRO, L,, Data Entry By:. S Ck: �'
WSRO, Kinston FO, Fed. Trust entral er: //OLtj,'J'Wf el- �r�i n74 - �it!1�C Date Reported: 9 ,2 7- ° U
Shipped by: BusAA ourie , Hand De.,Othepr ,Purpose:
Collector(s): ( �l/�i S . .� Date / 9 Time �' �� Baseline,gomplaint,C7 pli7 e(.LUS., Pesticide Study,Federal Trust,Other:
FIELD AN Owner /
pHa� L f�SpeC Cond.94 9� NA O aS
t 250 C Location or site D 4 F' P / LIG
Temp.10 39 OC Odor — Description of sampling point
Appearance le ^ Sampling Method in✓ _Sample Interval
Field Analysis By: _ "%3' 411? Remarks
LABORATORY ANALYSES pempny 6ma,airwmp.W.)
BOD 31 o RICO Dies.Solids 70300 m I A -Silver 46566 uc Or anochlorine Pesticides
COD High 34o M94 flouride 951 mqA Al-Aluminum 46557 ugA Organophosphorus Pesticides
COD Low 335 Hardness:Tot 00 As-Arsenic 46551 u /I Nitrogen Pesticides
COliform:MF Fecal 31616.4 1 /100ml Hardness non-cart 902 mco Be-Barium 46558 uco
ColBorm:MF Total 37504 G I /t 00m1PhenolS 32730 uciA C -Calcium 46552 I Acid Herbicides
TOC 6so m I Specific Cond. 95 uMhos/cm2 d-Cadmium 46559 ucyl
Turbidity 76 NTU Sulfate 945 m Cr-Chromium 46560 u I Semivolatile Organics t
Residue.,Suspended 530 mg/I Sulfide 745 moll Acu-Copper 46562 u /I
Fe- Iron 46563 u
H -Mercury 71900 UgA Volatile Organics(VOA bottle)
PH 403 ,1 unit K-Potassium 46555
Alkalinity to pH 4.5 410 mg/I -Ma nesium 46554 mall TPH-Gasoline Range
Alkalinity to pH 8.3 415 m �' / EQ.v,I� Mn-_Man anese 46565 u TPH-BTEX Gasoline Range
Carbonate 445 mg/1 NH as N 610 m Na-Sodium 4:66 m I
Bicarbonate 440 mco TKN as N 625 mnA I Ni- Nicke uoyl
Carbon dioxide 405 mgA NO +NO as N 630 moil Pb- Lead 46564 uco
Chloride 940 mgA P:Total as P 665 m Se-Selenium uqA
Chromium:Hex 1032 U911 Zn-Zinc 46567 uqA
Color:True 80 Pt-Co
Cyanide 720 mg/i
'2
Lab Comments:
GW-54 REV."3 For Dissolved Analysis-submit filtered sample and write"DIS"in block.

North Carolina
GROUNDWATER FIELD/LAB FORM Department of Environment, Health,and Natural Resources
// DIVISION OF ENVIRONMENTAL MANAGEMENT-GROUNDWATER SECTION
County -If t!f 1 '� Lab Number !5 7 S
Quad No 4 Lug Serial No. SAMPLE PRIORITY Date Received 9 - - 9 Y Time 3 30
Lat. Long. Rec'd by: �� From: Bus,Courier, and Del.
® OUTINE EMERGENCY
OCHAIN OF CUSTODY Other:
Report To RO, MRO, RRO W RO WiRO, /_ LL Data Entry By: S'— Ck: �
WSRO, Kinston FO, Fed.Tru , Central O theT"}�1C' /'iaat.1"1'1h/� SCe aP( Date Reported: 9-� �-`) `)
Shipped by: Bus,
L ouri , Hand De., ther
Collector(s): �17s f''/e Date 9�Time �' �l Baseline,C Plaint, Cor�liance LUST, Pesticide Study, Federal Trust,Other:
FIELD ANALYSES u��os Owner < i� � Na�)
pH400 '7 Spec. Cond.94 ✓ at 250 C Location or site uo
Temp.10 oC Odor Description of sampling point 7� �
Appearance el Sampling Method 109e ZIASample Interval
Field Analysis By: tl rr/S i Remarks Marv,Naar,sic.
'Naa`at`
LABORATORY ANALYSES (pemµng ima,air temp.ala.)
BOD 310 MCJA Diss. Solids 70300 7(a mciA A -Silver 46566 uco Or anochlorine Pesticides
COD High 340 mgA Flourida 951 m9A Al-Aluminum 46557 ugli Organophosphorus Pesticides
COD Low 335 mgti Hardness:Total g o 219 mco As-Arsenic 46551 uqjI Nitrogen Pesticides
Coliform:MF Fecal 31616 C 1 A 00ml Hardness non-cart 902 Be-Barium 46556 uqA
Coliform:MF Total 31504 < 1 /100m1 Phenols 32730 uco Ca-Calcium 46552 I Acid Herbicides
TOC s60 m I Specific Cond. 95 umhosIce d-Cadmium 46559 u
Turbidity 76 NTU Sulfate 945 m r-Chromium 46560 UCO Semivolatile Organics
Residue.,Suspended 530 mg/I Sulfide 745 m I V Cu-Copper 46562 u I
Fe- Iron 46563 \ UgA
H -Mercury 71900 u 1 Volatile Organics(VOA bottle)
pH 403 6.3 unit - Potassium 46555 m I
Alkalinity to pH 4.5 410 m9A M -Ma nesium 46564 m I TPH-Gasoline Range
Alkalinity to pH 8.3 415 mgA 1 male O AA Mn-Man anese 46565 uqA TPH-BTEX Gasoline Range
Carbonate 445 m9A NH as N 610 a-Sodium 46656
Bicarbonate 440 i-Ni eluoA
Carbon dioxide aos m NO +NO as N 630 Pb-Lead a65s4 uaA
Chloride Sao a mgA P:Total as P 665 e-Selenium uoA
Chromium:Hex 1032 u I Zn-Zinc 46567 u I
Color:True 60 Pt-Co
Cyanide 720 mgA
Lab Comments:
WWI
GW-54 REV.693 For Dissolved Analysis-submit filtered sample and write"DIS"in block.

DIVISION OF ENVIRONMENTAL MANAGEMENT
GROUNDWATER SECTION
September 8, 1994
NEMORANDUM
TO: Karen Harmon, Hydrogeological Technician II
Underground Injection Control Program, Ground Water Section
THROUGH: Don Link, Regional Groundwater Supervisor
Asheville Regional Office
FROM: Chris Hite, Hydrogeological Technician II
Asheville Regional Office
SUBJECT: Injection Well Permit No. WI0100006
Mr. Ralph Clum
408 Courtland Court
Lake Lure, Rutherford County, North Carolina
I have sampled and inspected the referenced injection well facility as
required for the renewal of injection well permit no. WI0100006. Please find a
copy of the completed Injection Facility Inspection Report attached to this
memorandum. The DEM lab has been requested to send a copy of the Groundwater
Field/Lab Report to RCO-UIC.
If you have any questions, please call me.
Attachment

INJECTION Fi 'p Y INSPECTION REPOR -FORM B (CONTINUED)
WELL CONSTRUCTION y
Date constructed
Drilling contractor: Name
Address
Registration number S7!>
Total depth of well 1�
P '�� 8 � Total depth of source well
(if app71cab7e)
Inspection point Measurement Meets minimum standards Comments
Yes No
Casing /
Depth
Diameter
Height (A.L.S. )
Screens *e4 klelm/e //fd sCl'ee4 /
Depth(s) N 14
Length(s)
I.D. Plate
Static water level �f .r(pa3Kr
Well yield ✓ `/
Enclosure /
Enclosure floor
(concreted)
Sampling port
(labelled)
Water tight pipe entry
Well enclosure entry
Vent
Functioning of heat pump system (Determine from the owner if heat pump functions proper7y.)
INSPECTOR e'/= ✓� e� Office /7.Sf%P//r//
WITNESS f/
Address 41&1 r / Lae Z,41e 97Yal
WITNESS .
Address
JULY, 1'994

North Carolina Department of Environment, Health, and Natural Resources
Division of E 'onmental Management - Groundw Section
INJECTION FACILITY INSPECTION REPORT - FORM B
INJECTION WELL PERM�IITT NO. WWII0/0000.4 DATE 9 7
NAME OF OWNER
ADDRESS OF OWNER !{D 1'-Ija 'rlad
f at Ap „oP . Iff ;?R 7v
(Street/ road or lot and suddivision, county, town)
LOCATION OF I}��CTION WELL (and source w ll(s) , if applicable)
/�o/w/PSS. / �r� /ink9P� is a/P9zL 1 ao/yeeauI'se use vo a v �d�
(Streetl road or lot and suddivision , county, town, if different than owner's address, plus description of location on site)/
Potential pollution source,`/ �tdd Distance from well Oo w.t9�'ad;eq-f
Potential pollution source Distance from well \
Potential pollution source Distance from well
Minimum distance of well from )
property boundary � �I1aceill leqo1744 C06f/s�
Quality of drainage at site Sod
Flooding potential of site 2611✓
(good,adequate,poor) (high,moderate, low)
DRAW SKETCH OF SITE (Show property boundaries, buildings, wells, potential pollution sources, roads, approximate
scale, and north arrow.)
��� C°�--- l✓��e�/no�PfP�,d�
y
DESCRIBE INJECTION SYSTEM (vertical closed loop, uncased borehole or cased water well; separate source well and
injection well; combination source and injection well; or other description as applicable)
L'arih �a� 'n.t so.rrrp a�� /I ;'asall A/'4

State of North �,,Urolina
Department of Environment,
WA
Health and Natural Resources •
Division of Environmental Management A&V*A
James B. Hunt, Jr., Governor �
Jonathan B. Howes, Secretary ID E H N F1
A. Preston Howard,Jr., P.E., Director
GROUNDWATER SECTION
August 16, 1994
MEMORANDUM
To: Chris Hite
Groundwater Section
Asheville nRegional Office
From: UIC Group l d•N(tA�w
Groundwater Section
Raleigh Central Office
Re: Request for review of renewal injection well permit
application and for routine sampling/inspection of the facility.
An application for the renewal of injection well Permit No.
WI0100006 by Mr. Ralph Clum has been received by this office.
1 . Please review the application and submit any comments to
RCO-UIC by August 31 , 1994. Retain the application for your UIC
files .
2. Please inspect the injection well facility to visually
determine the integrity of wellhead construction, the presence
and accessibilty of effluent and influent taps, and other
requirements for compliance with the NCAC T15A: 02C. 0200
standards, using the enclosed Injection Facility Inspection
Report (form B) as a guide.
3. Please sample the influent and effluent using the
Sampling/Inspection Procedure for Injection Wells as a guide.
Complete the enclosed Groundwater Field/Lab Report ( form GW-54) .
Please sample and inspect the injection well facility by
September 9, 1994. ( If sampling and inspection cannot be
accomplished by this date, please inform RCO-UIC promptly. ) Send
a copy of the completed Injection Facility Inspection Report
( form B) to RCO-UIC and request the DEM lab to send a copy of the
Groundwater Field/ Lab Report ( form GW-54) to RCO-UIC.
The permit will be issued upon receipt of satisfactory
reports . The current permit expires on September 30, 1994, but
it is unlikely that the analytical results will be released by
that date.
"919733-2496
P.O. Box 29535,Raleigh,North Carolina 27626-%35 Telephone 919-733
An Equal Opportunity Affirmative Action Employer 50%recycled/ 10%post-consumer paper

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT,HEALTH,AND NATURAL RESOURCES
APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL FOR INJECTION
WITH A HEAT PUMP SYSTEM
Class 5 Wells
TO: DIRECTOR,NORTH CAROLINA DIVISION OF ENVIRONMENTAL MANAGEMENT
DATE:IL 4 19.
In accordance with the provisions of Article 7,Chapter 87;Article 21,Chapter 143,and regulations pursuant
thereto,APPLICATION is hereby made for a PERMIT to construct and/or use a well or well system as described
below and in any accompanying data submitted as part of this APPLICATION.
Please type or print clearly.
A. PERMIT APPLICANT
Name: / ✓v-
Address: A A 1, cc
City: a r' Zip code: - .J- ?4/!
ar
County: <✓ rn
Telephone:
crn
B. STATUS OF APPLICANT C o F"n
Federal State Private
Public Commercial Other a rn
Native American Lands
C. FACILITY(SITE)DATA (Fill out ONLY if the Status of Owner is Federal,State,Public or CommaWial.cn-
a` rn
Name of Business or Facility:
Address:
City: Zip code:
County:
Telephone:
Contact Person:
D. HEATING CONTRACTOR DATA
Name: 1v
Address:
City: Zip c e: 9
County:
Telephone: B19C fS
Contact Person:
E. INJECTION PROCEDURE (Briefly describe how the Von well(s)will
Corm na cvl f L� � t' /-44 El ,fLyAgl Titer- �C
f & of U-i d)-7
F. WELL USE Will the injection well(s)also be used as the supply well(s)for either of the following?
(a) The injection operation? YES k NO
(b) Your personal consumption? YES NO
POW
GW-57 HP (April 1994) Page 1 of 4 t 9
a{er SecOn 4

G. CON'ST/RUCTION DATA (CHECKONE)
" EXISTING WELL being proposed for use as an injection well.,Attach a copy of Form GW-1
(Well Construction Record)and furnish(7&8)below. If Form GW=1 is not available,furnish the data in
(1)through(8)below to the best of your knowledge.
,for use as.an injection well. Furnish the data in(1)
below as PR49P98 truction specification's:
(1) Well Drilling Contractor's Name:: (! r f ✓1 w), 4o lJ
I J /��=t.r
NC Driller Registration number.
(2) Date to be constructed: S Approximate depth:_Ji
(3) Well casing:
(a) Type:Galvanized s eel ✓Black steel_Plastic_Other(specify)
(b) Inside diameter. ,,S�inches; Wall't�jzkness inches or schedule#'
(c) Casing depth: . From C7��/t/o��� ft.'(reference to land surface)
�
Casing extends aboveground—inches(must be at least 12I inches)
(4) Cement grout
(a) Around inner or"primary"casing: From 1. to 5 ft.
(b) Around outer(pit)casing,if present From to ft
(5) Screens(if applicable): }�
(a) Type: N/Ifider diameter. inches
.(b) Depth: From to r /fed below land surface
(6) Gravel(if applicable): From e' (!' feet below land surface
(7) -N.C.State Regulations(15A NCAC,2C,Section.0200).require the permittee to make provisions for
monitoring well head processes. A faucet on both influent(groundwater entering heat pump)and
effluent(water being injected into 114e well)lines is required. Will there be a- f et on:
(a) the influent line? yes_vnc_ (b) the effluent line? yes no_
(8) Attach a diagram showing the location of the injection well and sampling faucets relative to primary
building on property.
H. PROPOSED OPERATING DATA
(a) Injection rate: Average(daily) = gallons per minute(gpm)
(b) Injection volume: Average(daily) o���,7�gallows per day(gpd)
(c) Injection pressure: Average(daily)__QKQ_pounds/square inch(psi)
(d) Injection temperature: Annual Average degrees F
I. INJECTION FLUID DATA
(1) Fluid Source. If underground,from what depth,and what type of rock/sediment does the fluid to be
injected derive(e.g.,granite,limestone,sand). ? r- '
75 � L'4ti1Q. f
(2) Chemical Analysis of S urce-Water. The following chemical characteristics MUST accompany this
application: N�
Total p l hardness ppm(parts per million or mg/1);Iron ppm;
hloride ppm; Nitrate ppm;Colifonn bacteria counts/100ml
NOTE: Assistance in determining these values may be obtained by contacting(a)your local or county
health offical,(b)a commercial water-testing laboratory,(c)your well drilling contractor,or
(d)the regional Hydrogeologist,North Carolina Dept.of Environment, Health,and
GW-57 HP (April 1994) Page 2 of 4

Natural Resources.
J. INJECTION-RELATED EQUIPMENT
Attach a diagram showing the engineering layout of the(1)injection equipment,and
*(2)exterior piping/tubing associated with the injection operation. The manufacttuees brochure,if
detailed,should satisfy(1)above
K LOCATION OF WELLS)
Attach a detailed map showing the orientation of and distances between the proposed well(s),any
existing well(s)that will in any way be involved in the injection operation,and at least two(2)
nearby reference points such as roads,road intersections,streams,etc. The roads should be
identified by US,NC or SR(county secondary roads)numbers,and streams should be named. In
addition,the diagram should show the direction and approximate distance to any existing water-
supply and/or injection wells within 1,000 feet of the proposed injection well.
L.. CERTIFICATION
"I hereby certify,under penalty of law,that I have personalty 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"
• J
(Signal a of Owner or Authorized Agent)
Please supply a letter signed by the owner
authorizing the above agent,if authorized agent is signer. -
M. CONSENT OF PROPERTY OWNER(Owner means any person who holds the fee or other property rights
in the well being constructed.A well is real property and its construction on land rests ownership in the
land owner in the absence of contrary agreement in writing.)
If the property is owned by someone other than the applicant,the property owner hereby consents to
allow theapplicant to construct an injection well(s)as oulined in this application and that it shall be
'the responsibility of the applicant to ensure that the injection well(s)conform to the Well
Construction Standards(Title 15A NCAC Subchapter 2C.0200) .
Name of Property Owner(Print):
Mailing Address:
(Signature of Property Owner if Different
From Applicant)
GW-57 HP (April 1994) Page 3 of 4

I i4
----------

COUNTY � N.C. DEPARTMENT OF NATURAL RESOURCES LAB NUMBER ,
QUAD NO. —SERIAL NO. & COMMUNITY DEVELOPMENT DATE RECE�EDU
LAT" LONG. DEM Rec'd by: From: ..
GROUNDWATER FIELD/LAB FO 0 Other
Report 1 . AR RO. MRO, RRO, WaRO, WiRO,
SAMPLE PRIORITY DATA ENTRY BY: CK: r"
WSRO, Xinsloo FO Other 1
�. ROUTINE ❑ EMERGENCY DATE REPORTED:
Shippetl by: Bus. JCjpyri er, Other
//
COILLCTOR(S): "•yAWIC DATE TIME PURPOSE: BASELINE, COMPLAINT COMPLIANC LUS-:, OTHER
/^+ n � /1�� ��-�pp (circle i
FIELD ANALYSES Owner ( 7�y 4 ^'^fe` �
ptt4o0 Spec. CoM.94_ at250C Location or site
Temp-1O °C Odor Description of sampling
/!utl nwtA
Appearance Taste Sampling Method ` �,v`��+'� Sample Interval GrpUn1yrater Section
(pump. bailer, etc.) 4Shevifle Reeianal Of6ip -
Field Analysis By: Remarks �,r/' I
�j C fY�(puniping ti . air temp. etc-) jf &._7V (pumping 11 . air temp. etc-) j
LABORATORY ANALYSES C-L/C/Y
8005 310 MA Disc Solid, T0300 aeon At -sil.0 1077 win Or9aoo<Alorim poaOdid.s
COD Mass Sa0 m911 Fluofido 951 ma/1 At -Aluminum 1105 .0/1 0,9aoophosp..r.. P.socide.
COD Low 795 m9/1 nardlmacTaMl 909 mgn ea- aariom 100T tit
CPlilam:MF Focal 31696 /oKmd H.rdn.as Inofrcarb) 902 an Ca - Calcl.m 916 m911 Acid Hardlcidos -
C.I11prm:MF Total 31504 1100m1 PMnolc 32130 -an CO -C.dmi.m 1027 up/1
TOC Sao m9/I spocllic Coal.95 ~.s/cm2 Chromiem:Total 1034 ua/1 gag / 1laotial Exoacrabt. 0,oanio.
Torbiall, 76 Ulu SWIM,9a5 mgn Ca - co".. 1042 dgIf Acid Ei lractabfe Oryanid.
Spllido 145 m911 Fe - Non 1045 ."1
"a - Marc., 71900 VO/l P.19oabl. 01941n11aa(VOA adult)
OH 403 .niM a -Palossitvn 937 awl
Atka I1Mq to PH 4.5 A 10 m41 119- 41a9roti. 927 mqJ[ 1,2 -Olb.omwlba Pa MOB)
AlaalWtr to PH 5.3 s IS m9/I Mn-Madan!" 1055 11911
C.rb000to 4a5 mgn No - Sod{.. 929 mgn
9i9arl O.ale 440 mall NH7 as N 610 moll Ni - Nickel 1061 uaJl
Arsenic:Total 1002 a9/1 TIEN a. N 625 mgJl Pb - L..d IDS1 ."I
C.Nan dl..ioa 405 mg1l M02♦NO3 as N a" mgn So - Sal.nium 11.7 VO/1
Chldfid."a Z n W1 P:T oUd as P 665 mq/I In-1)dc 1092 sign _
Chmasiun:Hac 1032 ugll
CMocTnr as PIC.
Cy.ai do T20 -off
Lab COmmen75: asiaris i =:•y'
`f ndwatel Serai n -rl �
_ I
GW-54 Revised 7/E5 For Dissolved Analysis - su ai[ tipMtt¢Ql„ 'a))8'"-irli to -()IS' in block
While copy - Headquarters COPY - Region Yellow copy - Lab

.,nm. i N.C. DEPARTMENT OF NATURAL RESOURCES LAB NUMBER 8 _l -3 �7�
ounv No. SERIAL No. & COMMUNITY DEVELOPMENT DATE RECE Vy EO Q1 Time L�
LA7. LONG. DEM Rec'd by: ,_.yf['j-,$U�_ From: Bus-Courier
Report t . AR RO. MRO. RRO, WaRO, WiRO, GROUNDWATER FIELD/LAB FORM Other f r
WSRO, Kinston FO Other SAMPLE PRIORITY DATA ENTRY BY:—�a_Y_CK:
ROUTINE ❑ EMERGENCY DATE REPORTED 606-�Y Atl
- Shipped by: Bus, Courier, Other -- �
COLLECTOR(S): AfM UATE � TIME PURPOSE: BASEMNE, COMPLArN COMPLIA E UST, OTHER
(circle o
FIELD ANALYSES Owner r.,orlAI&4 r
l
P/la Col Spec. rond.,,,1 112SOC LDCalron or site
Temp.10 oC Odor Description of sampling 9) at WF_u-
ADPea ranee lasre Samptine Method — � o� Sample Imerval J
(pump, bailer, etc.) b= Irt9IPf SPf�Bn
Field Analysis By: Remarks a fteviHeReAiona1Office {
N�aEA'� (panp/Iq e, air temp. e1GJ
LABORATORY ANALYSES
GODS 310 mq/1 Diss. Solids 703o0 man A9 -Silrer 1077
NA Dr9arrochl orim Pealic files
COD Klgl 340 mp/1 Flued De 951 mgA Ai -Alw,elm„n IIoS
e9/1 Or9enoOfiOSpAOrwi POflr[Idef
COD Ear ]JS m9/1 X HeNrmaTOml gee mall Be-Ba]I,rn, rag]
Pan
Coal om:eK Fecal]1616 /Tounil Narace la (.,feat/)902 la1gA Ca -Calei. 916 m r
W Acld NerdiCidee
Calilmm:MF TOW]tS01 lloOml PMnols 32]3o WA Cd - Cadmium 1027 "A
TOC ago all Specirm Cood. 95 eDPcg,cPs2 Clrpmpao:Tolal 1034 all
Bass l 1NV Ka1 ESte.clolb 0,9eniea
TvrDidi}T 76 NTU Su11am 945 mwl CO- Cooper 1942
0911 Aci4 Eafiaple Dle Organics
Sulfide ]e5 09/1 Fe - Iron lass .914
N9 - Yettwl 71900 all Purvealle Organics (voA come)
OH 403 enih K -Pomas4m, 237
Alkal,nlly b PN e.5 e10 mgA _ mat!
Kq -INmmelum 827 mp/i 1.2 - O,DromOwthane iEDS)
AIY aHWIT IP PH 8.3 I13 m9lr Mn-yan9aAae 1955
Carpoeale MS mYA W/t
Na - Sodlam 829 man
BiuNONi® 140 m9/1 KH3 ae N 610 all Ni - Nickel 1067 OY]1
Ataenic:Toia1 1002 uq/r TKN of K 625 m9/! PD -lead lass wail -
Calton 0loslde 406 mill, K02 a NO9 as N 630 mall Se - Selenium 1 ts]
Chloride 9sq n9ll P:Total as P "s m911 Zn -Zinc 1D92
Chtgmlwn:Hef le]2 all �g
Calms.0o Pl-Ca f i G
Cyanide 720 mall I 11 / /,
-
c
Lab Comments- � C � ( �'.tL iDA ,n � Sri,
' —ATOM Q—.i t1 ("fv} JVn
For Dissolved Analysis - Submit filtered sampte and write 'DIS" in block
White COPY - Headquarters Pink copy - Region Yellow copy - Lab

rl'
� North Carolina
'yEnvironmental Management Commission
�4Department of Environment, Health & Natural Resources
Groundwater Section
STATUS OF INJECTION WELL SYSTEM
1
Date: IZ9 Permit # : N u - G/,;2- / -WO- c- D D
r
Name: U nl( _
Address : ' u
Co/ee 'Vc- D
Please check the selection which most closely describes the
current status of your injection well. In addition, please
answer the appropriate questions in the space provided.
1 ) f// Well is still used to inject heat pump return flow.
2 ) Injection discontinued; well temporarily not being
used.
Why? :
How long out of service? :
Is the well sealed shut? :
Intended use:
Projected date of re-use:
3) Injection discontinued; well used as water supply
well.
Why? :
4) Injection discontinued; well permanently abandoned.
Why? :
How long out of service? :
Is the well filled or open? :
Who performed abandonment? :
Certification:
"I hereby certify, under penalty of law, that I have
personally examined and am familiar with the information
submitted in this document, and that to the best of my
knowledge the information is true,
/ accurate and complete.. "
V y� (Signature
Gw-sa f1B 19 �
U
�y�y�$ecticnre
Ito P. -..

.-gate of North Awa
Department of Environment, `�
Health and Natural Resources
Division of Environmental Management M f
L
James B. Hunt, Jr., Governor E '---�
Jonathan B, Howes, Secretary
A. Preston Howard, Jr., P.E., Director
GROUNDWATER SECTION
May 3, 1994
Mr. Ralph Clum
Rte. 1 ; P.O. Box 320
Lake Lure, NC 28746
Dear Mr. Clum,
our records show that the operating permit for the heat pump
injection well on your property will expire on September 30,
1994. In addition, our records do not indicate that the well has
been abandoned. In order to comply with the regulatory
requirements for permitted injection facilities ( 15 NCAC 2C
. 0211 ) , it is imperative that you either submit the enclosed
application for permit renewal or submit the enclosed Status of
Injection Well System form that certifies that the injection
facility is no longer in use. If the well is no longer to be used
for any purpose, it must be permanently abandoned according to
the regulatory requirements (15A NCAC 02C . 0113) , and you must
submit the enclosed Well Abandonment Record form. The appropriate
form(s) should be forwarded to us by April 18, 1994 . A copy of
the previous application is also enclosed for your reference.
If you have any questions regarding your permit please feel .
free to contact me at (919) 733 - 3221 , ext. 431 .
Sincerely, 1
Karen A. Harmon
Hydrogeological Technician II
Underground Injection Control Program
Groundwater Section
cc: UIC Files
ARO Files
Enclosures
P.O. Box 29535,Raleigh.North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer ' 50%recycled/10%post-consumerpaper

- lbfate of North c droL. J �} Department of Environment,
Health and Natural Resources 1AL*�A�
Division of Environmental Management James B. Hunt,Jr., Governor
Jonathan B. Howes, Secretary ® FEEN F1
A. Preston Howard, Jr., P.E., Director
GROUNDWATER SECTION
July 25, 1994 3
Mr. Ralph Clum
Rte. 1 . P .O. Box 320 '
Lake Lure, NC 28746 _
Dear Mr. Clum,
On May 3, 1994, this office notified you in writing that the
operating permit for the heat pump injection well on your
property would expire on September 30 , 1994, and requested that
you submit either the enclosed Application for Permit to
Construct and/or Use a Well for Injection (form GW-57HP) or the
enclosed status of Injection Well System' ( form GW=68) certifing
that the injection facility was no longer in use . You were
advised that if the well were no longer used for any purpose, the
well was to be abandoned according to the regulatory requirements
(15A NCAC 02C . 0113 ) and the enclosed Well Abandonment Record
( form GW-30) was to be submitted. However, our office has
received no forms from you.
Please note that if you use the injection facility without a
permit, you are in violation of the regulatory requirements for
permitted injection facilities ( 15 NCAC 2C . 0211 ) . I again
enclose forms to facilitate your application for permit renewal;
the completed form(s) must be submitted to this office by August .
13, 1994 .
If you have any questions regarding your permit please feel
free to contact me at (919 ) 733 - 3221 , ext. 431 .
Sincerely,
� r
Karen A. Harmon
Hydrogeological Technician II
Underground Injection Control Program
Groundwater Section
cc: UIC Files
ARO Files
Enclosures
P.O. Box 29535,Raleigh,North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50%recycled/ 10%post-consumer paper