WI0100108_Regional Office Physical File Scan Up To 9/14/2022

NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES (NCDENR)
APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR
INJECTION WITH A GEOTHERMAL HEAT PUMP SYSTEM FOR:
TYPE 50M WELL(S)
X New Permit Application OR Renewal (check one)
DATE: July 15 , 2010
PERMIT NO.\N I o� (leave blank if NEW permit application)
A. PROPERTY OWNER(S)/APPLICANT(S)
List each Property Owner listed on property deed (if owned by a business or government'agency, state name of
entity and a representative w/authority for signature): Biltmore Farms Homes, LLC
(1) Mailing Address: One Town Square, Suite #330, Attn: Bill de Bruin
City: Asheville State: NC Zip Code: 28803 County: Buncombe
Home/Office Tele No.: 828.209.2000 Cell No.: 828.230.0518
EMAIL Address: bdebruin(@biltmorefarmshomes.com
(2) Physical Address of Site (if different than above): 12 Ejaa TrTrac_ e Loop
City: Fairview State: NC Zip Code: 28703 County: Buncombe
Home/Office Tele No.: see above Cell No.: see above EMAIL Address: see above
B. AUTHORIZED AGENT OF OWNER, IF ANY (if the Permit Applicant does not own the subject property,
attach a letter from the. property owner authorizing Agent to install and operate UIC well)
Company Name: same as property owner in section A above
Contact Person: EMAIL Address:
Address:
City:
Office Tele No.:
State: Zip Code:
Website Address of Company, if any:,
C. STATUS OF APPLICANT
Private: X
State:
Federal
Municipal
GPU/UIC 5QM Well Permit Application (Revised 7/2008)
Commercial:
Native American Lands:
County:
RECEIVED I DENR / DWQ
Aquifer Protection Section
JUL 19 2010
Page I
I

D. WELL DRILLER INFORMATION
Company Name: AWD Services, Inc.
Well Drilling Contractor's Name: Larry Wells
NC Contractor Certification No.: 2603
Contact Person: Larry Wells EMAIL Address: [e-mail]
Address: 258 North Turkey Creek Rd.
City: Leicester Zip Code: 28748 County: Buncombe
Office Tele No.: 828.683.9223 Cell No.: 828.215.9334
E. HEAT PUMP CONTRACTOR INFORMATION (if different than driller)
Company Name: White and Williams Co. Inc.
Contact Person: Ted Lundsford EMAIL Address: tlunsford@a,wwhvae.com
Address: 514 Swannanoa River Road
City: Asheville Zip Code: 28805 County: Buncombe
Office Tele No.: 828.296.0267 Cell No.: 828.230.2189
F. INJECTION PROCEDURE (briefly describe how the injection well(s) will be used)
Wells will be used as part of a residential geothermal heating and cooling system.
G. WELL CONSTRUCTION DATA (Skip to Section H if this is a Permit RENEWAL)
(1) Proposed date to be constructed: when pennitted Number of borings: 2
Approximate depth of each boring (feet): 250
(2) Chemical additives to be used in closed -loop system (only those chemicals indicated have been approved):
R-22 propylene glycol ethanol other (other additives will need prior approval by
NCDENR before use)
(3) Type of tubing to be used (copper, PVC, etc): HDPE I" Libend
(4) Well casing. Is the well(s) cased? (check either (a.) YES or (b.) NO below)
(a) YES if yes, then provide casing information such as type (steel, PVC, plastic, etc.), diameter,
depth, and extent of casing appearing above ground:
(b) NO X
(5) Grout (material surrounding well casing and/or piping):
(a) Grout type: Cement Bentonite X Other (specify) pea gravel, top 20' solids
(b) Grout depth of tubing (reference to land surface): from 20 to 250 (feet)
If well has casing, indicate grout depth: from 0 to 20 feet)
H. INJECTION -RELATED EQUIPMENT
Attach a diagram showing the engineering layout or proposed modification of the injection equipment and exterior
piping/tubing associated with the injection operation. The manufacturer's brochure may provide supplementary
Information,
GPU/UIC 5QNl Well Permit Application (Revised 7/2008) Page 2

LOCATION OF WELL(S)
Attach two copies of maps showing the following information:
(1) Include a site map (can be drawn) showing: buildings, property lines, surface water bodies, potential sources
of groundwater contamination and the orientation of and distances between the proposed well(s) and any
existing well(s) or waste disposal facilities such as septic tanks or drain fields located within 1000 feet of the
geothermal heat pump well system. Label all features clearly and include a north arrow.
(2) Include a topographic map of the area extending one mile from the property boundaries and
indicate the facility's location and the map name.
J. POTABLE WATER WELL(S)
Are there any potable water well(s) on the subject property or adjacent properties? YES X NO
If Yes, than indicate location on attached map(s).
K. CERTIFICATION
Note: This Permit Application must be signed by each person appearing on the recorded legal property deed.
"I hereby certify, under penalty of law, that I have personally examined and am familiar with the information
submitted in this document and all attachments thereto and that, based on my inquiry of those individuals
immediately responsible for obtaining said information, I believe that the information is true, accurate and complete.
I am aware that there are significant penalties, including the possibility of fines and imprisonment, for submitting
false information. I agree to construct, operate, maintain, repair, and if applicable, abandon the injection well and
all related appurtenances in accordance with t e approved spe ificat' ns and conditions of the ermit."
S nature of Property wne /App cant
t; � I & � i $
Print or Type Full Name slftnT
Signature of Property Owner/Applicant
Print or Type Full Name
Signature of Authorized Agent, if any
Print or Type Full Name
Please return two copies of the completed Application package to:
North Carolina DENR-DWQ
Aquifer Protection Section
UIC Program
1.636 Mail Service Center
Raleigh, NC 27699-1636
Telephone [phone]
RECEIVED / DENR / DWQ
Aquifer Protection Section
JUL 19 2010
GPU/UIC 5QM Well Permit Application (Revised 7/2008) Page 3

Local[- looks good. I noed to have you add a I— pointsF-
/_ o C-6� �'t� �� • `V V' il/O Ltl r a 1 I— n _ V (and a Iound.il
(/"'`/ W�'�� � Thanks, Bill.
O n �— �y EMAIL FROM ANDREA 3-19-2010:
-5�� — COMMUNITY AREA \ \.\ \ NI Barry.
We made a change to the right side of the foundation wall.
LOT 141 \ \.\ \ \ due to grace. Please repin accordingly.
cf)!— 25' 0.334 ACRES \ \ \\ �� Thanks,
c -4 14547 SQ. FT. \ \ '` \ Andrea
711 vp-
6787
\� \
O �L-
i � �/ ,,;. `•sB� 'sa
lei
20' WATER EASE
(PER PB 118 PG 74)`•\
65 �, 25"b l•/ boti /
80
y:
73o2724M 5�. / /v0
,..— E 1 f8.71, 78
LOT 140 I �\
U�
,\�� \ \ 20' SEWER EASE.
'`1""'v \ \ `�" (PER PB 112 PG 110)
SCALE V = 40'
-
NOT FOR RECORDATION,
40' 20' 0
40' 80,
120' SALES, OR CONVEYANCE
PLOT PLAN OF:
DATE:
2.01-10
�^+ D
1. BE��
SOUTH CLIFF - PH. 1
DRAWN BYOJECT ;
DRAWN BY:
0113
#1JBW
JBW
SSOCIATES, Y.A.
DRAWING NO.:
A-10-846
(LOT #141, PLAT BOOK 110 PAGE 36)
SCALE:
1"=40'
PROFESS1014AL LAND SURVEYING
Wallace S.McAbee,PLS Fax (828)02t1-1294
PIN:9677.42-3278 FAIRVIEW TOWNSHIP
Eric S. McAbee• PLS
3 McAbee Trail
Telephone (828) 82B-1295
Fairview North Carolina. 28730
ADDRESS: 12 PINEY TRACE BUNCOMBE COUNTY
www, mcabeesurvey.cam Firm License Number. C-694
LOOP NORTH CAROLINA

ra"o 1 Ul t
APUE i Notes
Map of 12 Piney Trace Loop
Fairview, NC 28730
All rights reserved. Use subject to License/Cop_yn ILt { Mao Legend
Directions and maps are informational only. We make no warranties on the accuracy of their content, road conditions or route usability or
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littp://www.mapquest.com/print 7/15/2010

Rogers, Michael
From: Bill deBruin [[e-mail]]
Sent: Monday, August 02, 2010 4:05 PM
To: Rogers, Michael
Cc: Bill deBruin
;Subject: Geothermal 5QM well for Biltmore Farms Homes at SC#121
Michael,
Larry Wells intends to use Bentonite in the top 20 feet of the wells we intend to drill on 12 Piney Trace Loop, Fairview, NC.
Please do not hesitate to contact me with any questions.
Thanks.
Bill de Bruin
Director of Product Development
Biltmore Farms Homes
[phone] (0)
[phone] (Direct)
One Town Square, Suite #330
Asheville, NC 28803
bdebruinnn,biltmorefannshomes. com
� e
Please consider the environment before printing this e-mail.

HCDENR
North Carolina Department of Environment and Natura
Division of Water Quality
Beverly Eaves Perdue Coleen H: Sullins
Governor Director
July 23, 2010
Bill de Bruin
Biltmore Farms Homes LLC
One Town Square - Suite 330
Asheville, NC 28803
Subject: Acknowledgement of Application No. WI0100108
12 Piney Trace Loop
Injection Mixed Fluid GSHP Well System (5QM)
Buncombe
Dear Mr. de Bruin:
Resources
Dee Freeman
Secretary
The Aquifer Protection Section of the Division of Water Quality (Division) acknowledges receipt of your permit application
and supporting materials on July 19, 2010. 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 http://h2o.enr.state.nc.us/documentsidwo ortrchart.pdf.
PLEASE REFER TO THE ABOVE APPLICATION NUMBER WHEN MAKING INQUIRIES ON THIS PROJECT.
Sincerely,
uwk
for Debra J. Watts
Supervisor
cc: Asheville Regional Office, Aquifer Protection Section
AWD Services - Larry Wells, 258 North Turkey Creek Rd, Leicester, NC 28748
White & Williams Co., Inc, Ted Lundsford, 514 Swannanoa River Rd, Asheville; NC 28805
Permit Application File WI0100108
AQUIFER PROTECTION SECTION
1636 Mail Service Center, Raleigh, North Carolina 27699-1636
Location: 2728 Capital Boulevard, Raleigh, North Carolina 27604 One
Phone: [phone] FAX 1: 919-715-0588; FAX 2: 919-715.60481 Customer Service:1-877-623-6748 Nortl-iCarol.ina
Internet: www.ncwaterouality.oro
An Equal Opportunity 1 Affirmative Action Employer �a

P"r
i
Location looks goad. I nned to have you add a Iew pointsF-
(and a foundation wall). C�J-s��iY9�f7
Thanks, Bill. J
EMAIL FROM ANDREA 3-19-2010:
COMMUNITY AREA NI Barry.
We made a change to the dghl side of the loundolion wall.
LOT 141 \ \ \ due to grade. Please repin accordingly.
25' 0.334 ACRES \\ \
Thanks,
m` •Cn 145.47 SQ. FT. \,\ \ �.� Andrea
.`ass,,\ \�, \,\�,\
of �
fir/ �/ s` \\ \�•.
20' WATER EASE.
i r (PER PB 118 PG 74)�\
61
I Jr
7
118.71
78
r ^�
LOT 140
F � , ri h � \��/t�� \ �20'SEB112PWER 1
1�1.0 T{""I" rlli � \ �" (PER PB 112 PG 110)
SCALE 111= 40'
NOT FOR RECORDATION,
40' 20' 0 40' 80, 120' SALES, OR CONVEYANCE
PLOT PLAN OF: DATE: 2.01-10
0113
CABEE�, SOUTH CLIFF - PH. 1 DRAWN BYOJECT :
1i1JBW
DRAWN BY: JDW
SSOCIATES, Y.A. (LOT'4141, PLAT BOOK 1'10 PAGE 36) DRAWING NO.; A-10-846
PROFESSIONAL LAND SURVEYING SCALE: 1"=40'
Wallace S.McAbee,PLS Fax [phone] pIN:9677�2-3278 FAIRVIEW TOWNSHIP
Edc S, McAbee, PLS Telephone [phone]
3 McAbee Trail Fairview North Carolina, 28730 ADDRESS: 12 PINEY TRACE BUNCOMBE COUNTY
w . mcabeesurvey.com Firm License Number: C-694 LOOP NORTH CAROLINA
a

� ° Y
RCDEHR
North Carolina Department of Environment and Natu
Beverly Eaves Perdue
Governor
Bill De Bruin
Biltmore Farms Homes, LLC
One Town Square, Suite 330
Asheville, NC 28803
Dear Mr. De Bruin:
Division of Water Qua
Coleen H. Sullins
Director
August 16, 2010
20 2i�►�
�evidl� R 0raQ Rdi an,
Subject: Issuance of Injection Well Permit
Permit No. WI0100108
- Issued to Biltmore Farms Homes, LLC
Buncombe County
Dee Freeman
Secretary
In accordance with your application received July 19, 2010, and additional information received August
7, 2010, I am forwarding Permit No. WI0100108 for the construction and operation of a vertical closed -
loop geothermal mixed -fluid heat pump injection well system to be located at 12 Piney Trace Loop,
Fairview, Buncombe County, North Carolina 28730. This permit shall be effective from the date of
issuance until July 31, 2015, and shall be subject to the conditions and limitations stated therein.
Please pay special attention to the following sections in Part R of the permit:
Part,11.1- The geothermal wells shall be installed north of the drive on the east side of the house (on
the side of the house facing Piney Trace Loop) and at least 10 feet from the foundation.
Part H.2- The wells shall be grouted the entire length of each boring.
Part 11.3- At least forty-eight (48) hours prior to constructing system, the Permittee shall notify the
Aquifer Protection Section's Underground Injection Control (UIC) Program Central Office staff,
telephone number [phone], and Jonathan Stepp with the Asheville Regional Office Aquifer
Protection Section Staff, telephone number [phone].
Additionally, per Part VII.2 of the permit, submit copies of the Well Construction Completion form (GW-
1) within 30 calendar days of completion of installation of geothermal well(s).
In order to continue uninterrupted legal use of this well for the stated purpose, you should submit an
application to renew the permit 120 days prior to its expiration date. As indicated in the permit, this
permit is not transferable to any person without prior notice to, and approval by, the Director of the
Division of Water Quality. If you have any questions regarding your permit or the Underground Injection
Control Program please call me at [phone].
AQUIFER PROTECTION SECTION
1636 Mail Service Center, Raleigh, North Carolina 27699-1636
Location: 2728 Capital Boulevard, Raleigh, North Carolina 27604
Phone: [phone] \ FAX 1: 919-715-0588; FA>; 2: 919-715-6048 \ Customer Service: 1-877-623-6748
Internet: www.ncwaterguality.orq
An Equal Opportunity \ Affirmative Action Employer
One
No hCafOliiia
N%ny

cc: .Landon IDavd"son Ashe�nlle Regional Office
Central Office File — WI0100108
Buncombe County Environmental Health Dept.
Larry Wells — AWD Services, Inc.
Attachment(s)
Sincerely,
Michael Rogers, P.G. (NC & FL)
Environmental Specialist
OA

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
Biltmore Farms Homes, LLC
FOR THE CONSTRUCTION AND OPERATION OF 2 TYPE 5QM INJECTION WELL(S), defined in Title
15A North Carolina Administrative Code 2C .0209(e)(3)(F), for the purpose of operating a vertical closed loop
geothermal mixed fluid heat pump system. This system is located at 12 Piney Trace Loop, Fairview, Buncombe
County, NC 28730, and will be constructed and operated in accordance with the application received July 19,
2010, and in conformity with the specifications and supporting data received August 7, 2010, all of which are
filed with the Department of Environment and Natural Resources and are considered a part of this permit.
This permit is for Construction and Operation of an injection well and shall be in compliance with Title 15A of
the North Carolina Administrative Code 2C .0100 and .0200 plus any other applicable Laws, Rules, and
Regulations pertaining to well construction and use.
This permit shall be effective, unless revoked, from the date of its issuance until July 31, 2015, and shall be
subject to the specified conditions and limitations set forth in Parts I through IX hereof.
Permit issued this the 16t' day of August 2010.
-
Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission.
Permit W10100108 UIC/5QM Page 1 of 5
ver. 03/2010

PART I - WELL CONSTRUCTION GENERAL CONDITIONS
�11
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 not be located in an area generally subject to flooding. Areas that are generally
subject to flooding include those with concave slope, alluvial or colluvial soils, gullies, depressions, and
drainage ways.
5. Each injection well shall be afforded reasonable protection against damage during construction and use.
She
PART II — WELL CONSTRUCTION SPECIAL CONDITIONS
1. The geothermal wells shall be installed north of the drive on the east side of the house (on the side
of the house facing Piney Trace Loop) and at least 10 feet from the foundation.
2: , The wells shall be grouted the entire length of each boring.
3. At least forty-eight (48) hours prior to constructing system, the Permittee shall notify the Aquifer
Protection 'Section's Underground Injection Control (UIC) Program Central Office staff, telephone
number [phone], and the Asheville Regional Office Aquifer Protection Section Staff, telephone
number [phone].
4. The location of each of the system manifolds shall be recorded by triangulation from three permanent
features on the site (e.g., building foundation corners) and shown on an updated Site Map. The Permittee
shall retain a copy of this record on site.
5. One well identification tag per grouping or `cluster' of wells shall be permanently affixed to the heating
and cooling unit or other nearby permanently fixed location in accordance with 15A NCAC 2C .0213(g).
PART III — OPERATION AND USE GENERAL CONDITIONS
1. This permit is effective only with respect to the nature, volume of materials and rate of injection, as
described in the application and other supporting data.
2. This permit is not transferable without prior notice to, and approval by, the Director of the Division of
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.
Permit W10100108 UIC/5QM Page 2 of 5
ver. 03/2010

The issuance of this permit shall not relieve the Permittee of the responsibility of complying with any and
all statutes, rules, regulations, or ordinances, which may be imposed by other local, state, and federal
agencies, which have jurisdiction. Furthermore, the issuance of this permit does not imply that all
regulatory requirements have been met.
PART IV — PERFORMANCE STANDARDS
1. The injection facility shall be effectively maintained and operated at all times so that there is no
contamination of groundwater that will render it unsatisfactory for normal use. In the event that the
facility fails to perform satisfactorily, including the creation of nuisance conditions or failure of the
injection zone to adequately assimilate the injected fluid, the Permittee shall take immediate corrective
actions including those actions that may be required by the Division of Water Quality such as the repair,
modification, or abandonment of the injection facility.
2. The Permittee shall be required to comply with the terms and conditions of this permit even if compliance
requires a reduction or elimination of the permitted activity.
3. The issuance of this permit shall not relieve the Permittee of the responsibility for damages to surface or
ground water resulting from the operation of this facility.
PART V — OPERATION AND MAINTENANCE REQUIREMENTS
1. The injection facility shall be properly maintained and operated at all times.
2. The Permittee must notify the Division and receive prior written approval from the Director of any
planned physical alterations or additions in the permitted facility or activity not specifically authorized by
the permit.
3. At least forty-eight (48) hours prior to the initiation of the operation of the facility for injection, the
Permittee must notify by telephone the Aquifer Protection Section's Underground Injection Control (UIC)
Program Central Office staff, telephone number [phone]. Notification is required so that Division
staff can inspect or otherwise review the injection facility and determine if it is in compliance with permit
conditions.
PART VI - INSPECTIONS
1. Any duly authorized officer, employee, or representative of the Division of Water Quality may, upon
presentation of credentials, enter and inspect any property, premises, or place on or related to the injection
facility at any reasonable time for the purpose of determining compliance with this permit, may inspect or
copy any records that must be maintained under the terms and conditions of this permit, and may obtain
samples of groundwater, surface water, or injection fluids.
2. Division representatives shall have reasonable access for purposes of inspection, observation, and
sampling associated with injection and any related facilities as provided for in N.C.G.S. 87-90.
3. Provisions shall be made for collecting any necessary and appropriate samples associated with the,
injection facility activities.
Permit W10100108 UIC/5QM Page 3 of 5
ver. 03/2010

PART VII — MONITORING AND REPORTING REQUIREMENTS
1. All required documentation shall be submitted to:
Aquifer Protection Section — UIC Program Aquifer Protection Section
DENR — Division of Water Quality Asheville Regional Office
1636 Mail Service Center and 2090 US Highway 70
Raleigh, NC 27699-1636 Swannanoa, NC 28778
Ph# 919-715-3221 [phone]
2. A completed Well Construction Record (Form GW-1) for each injection well must be submitted to the
Aquifer Protection Section Central Office and the Asheville Regional Office within 30 days of completion
of well construction. Copies of the GW-1 form(s) shall also be given to the Permittee and retained on site
to be made available for inspection.
3. A copy of the site map updated with manifold locations required in Part II.2 of this permit shall. be
submitted to the Aquifer Protection Section Central Office and the Asheville Regional Office within 30
days of completion of well construction. 1,
4. 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.
5. 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 [phone] any of the following:
(A) Any occurrence at the injection facility that results in any unusual operating circumstances;
(B) Any failure due to known or unknown reasons that renders the facility incapable of proper
injection operations, such as mechanical or electrical failures;
(C) Any loss of refrigerant in the system, regardless of the origin of the loss;
(D) Any recharging of the refrigerant system.
6. 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.
7. In the event that the permitted facility fails to perform satisfactorily, the Permittee shall take such
immediate action as may be required by the Director.
PART VIII — PERMIT RENEWAL
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.
Permit WIOIQ0108 UIC/5QM Page 4 of 5
ver. 03/2010

VT IX - CHANGE OF WELL STATUS
1. The Permittee shall provide written notification within 15 days of any change of status of an injection
well. Such a change would include the discontinued use of a well for injection. If a well is taken
completely out of service temporarily, the Permittee must install a sanitary seal. If a well is not to be used
for any purpose, then that well must be permanently abandoned according to 15A NCAC 2C .0213(h)(1).
Notification shall be submitted to the addresses given in Part VII.1 of this permit.
2. When operations have ceased at the facility - and a well will no longer be used for any purpose; the
Permittee shall abandon that injection well in accordance with the procedures specified in 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.
(B) The entire depth of each well shall be sounded before it is sealed to insure freedom from
obstructions that may interfere with sealing operations.
(C) Each well shall be thoroughly disinfected, prior to sealing, if the Director determines that failure
to do so could lead to the contamination of an underground source of drinking water.
(D) Each' well shall be completely filled with cement grout, which shall be introduced into the well
through a pipe that extends to the bottom of the well and is raised as the well is filled. .
(E) In the case of gravel -packed wells in which the casing and screens have not been removed, the
casing shall be perforated opposite the gravel pack, at intervals not exceeding 10 feet, and grout
injected through the perforations.
(F) In those cases when, as a result of the injection operations, a subsurface cavity has been created,
each well shall be abandoned in such a manner that will prevent the movement of fluids into or
between underground sources of drinking water and in accordance with the terms and conditions
of the permit.
(G) The Permittee shall submit a copy of the Well Abandonment Record (Form GW-30) as specified
in 15A NCAC 2C .0213(h)(1) within 30 days of completion of abandonment. Copies shall be
submitted to the addresses given in Part VII.1 of this permit.
Permit WI0100108 UIC/5QM Page 5 of 5
ver. 03/2010