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HomeMy WebLinkAboutEdgecombe_Well Abandonment_20240423 (3) WELL ABANDONMENT RECORD. For IrrlcmdUsdONLY; Tbis faim can be i sed fair singte or mtiliipt lV€Ils 1.Well Contractor Information: )NF.LL ARANnONM1IPNT DF:TAIt-C Brian Ewing lit,Number of wills heing abandoned: 1 wollcoutmaprNsaic pusortallyalias[orthi.-%wilbnI&IIicrpiupcny)• Fw- rkulapI& .vVewon. or, awa-unto �Crrpp fj• wells ONLY girl) Aw., .swjjc Mrixtrrrcfa[ur:a>U'atnhNtaaa'rrf,3wa rmr svtivittr le rail- 4240-B NC'Wc11 ConlrfdorG:ttitt�tiioti Nnrrbcr - 71t.Anpttiximatc v+rluirtr:of 3vat�v rtmuining iu trell(s}e (gul.) sAEnacco FOR WATER SUPPLY WELLS QNLY: Company Namc- 7e,Type of.di3infectont used: 2.Well Coustruction Permit l!: List rrll.a rpftc Ll�kr1J}xrmitr(ia!Cu�nm,State•!'nr4mce;Ir�rrGr�ir„�tcl ff Gut er: 7d,Amount of dlsinfMslat used: 3.Weu ua (ebeckn•cll use}: Water Supplr•Weil: 7c.Scaling materi;ds:used(cheer;all that apply-): I]itgricultttr ti. ' phlunici Mublic, M Neat Ccniccit Grout. Cl limonite Chips orPclicts ❑Gcothermd(Hsatirte)Cooliuo Stippty) ❑Residential%Voter Slipli -(single) ❑Sincf,Centeni Grout 0,My Clay ❑Ittild5trial/Cotfinicickil ❑lti sidenturl Water Suppl►•:(shared) Cgnctete Grout M Drill Cuttings ❑bti^[ion ❑SpeeiWly Grouf p Gravel Non-Water Supph•Wclt: ❑BentoniteSlutA Other(explain under7g) t9Matdtorirte ❑Recovers• to cetion FVcil; 7f,Foreach material-selected above;provide amo)ltifdf.ulatesialsu9ed: �AgtpfCtltecharge pGriinirdvruerRentedititiat� Neat Cem::471b ,Wti:3gal.. Sand Cem.:lb',Wtr:gal: []Aquifer Storage aid Recovety f]Saliuity Barrier C]AquiferTest OStonmgaterDnr[riage. pE>}tt riutenlal Tcvclluoloev OSubsidetre Corium. 7g.Provide a brief"description cif thi abandonment procedure: DGeothen»al(Ct!osed Loop) ❑Tracer TREMIE GROUT FROM THE BOTTOM TO�THE St1REACE;A; ❑Geotheolial(Heatinu•'Coolin Retum) ❑Othei'(ex lahlunder7a) , . . r —� d.Dafon'dl(s).abandoned: 3-28-24 APR G 2024 5a.WeR'lacntton: Former Edgecombe Genco Plant racilit Ahvmr Mow Ta:ility IDM(Fappli:abic) 8:CertlRrnliair: . � 6358.Battleboro,Rd., Battleboro,.NC 27809 fir'lar1_ 4/3/2024' Physical Address,City;andZip $i liriU(4(:eittredNVaillt0ow var",:'41140hvrvr Uate Edgecombe County Ry sigtring M&form,f hemhy ce.),fiA•rlraf the we11{sj it-as pve?e)ahautrfoned ur Couuty Parcel ldcntifti itiouNo.(PlNi t MVnIiilm idhlr MA l AC'02C.d100,.ur 2C:0200 moll: analirlctiaa Sfimdrtrils mrd l/ra►a crpj•offlris record 1whebt provid&ro'llre well mrher. 51).Latitudc antl longitude indeg[Cco/mintxtr sf5ccon+L4 nr dccitn;ll'degrccs: 1 (If yell meta,one.4tthottg is s111r;CW4) 7.Site diagram or additional well details: You ide additiotlal uefl site c[erails;or well A !V, .abaudountentdetails,You may a&ailach nddiGmrat pages if necMary.. COM.M1rMiON DFTAIt S OF W>LL1S)BEINC ABANDONED SUBhii•ITAL iNMUCTFOVS :lfhuh trp11 eunvrrearlfara mcvrzl(39!j nunilrerala. Fw molaplr drjeeiiwe'uv'rean•uYrtix.wfxiv uxlk ONLY u•lth the suna�erurstrcelfmca3nrrahuriari�it._izuiaarrLmit,wrrfprm la r For All Wclle• Submit this form within 30 days of completion of itrll 6a.Well ID3rTMN-6 abandonment to the rallptvanS: Di.�isitiu of WatcrResoui-ces,Iufotmatiun Prarce!.sting Unit,:, 61s.Totat.t►'cU depth: 18, ((t;) 1617 Mail Service Ccutcr,Raleigh,NC 27699-1617 lOb.For iti!Mlon Wells: :In addition to kading Ilse fornl;to the address[it.lOa 6c.Borehole diameter. (in.) above:tilso subnd(one copy of tltis faint withiir 30 days of'comptetioit of vi ell abiindonrrteru to the following: it fid.Water Icvcl.betoh j rrorrricl surface: (ft.) Divislott of Water Rcsourecs�Untletgruuud i�iject(onCoutrol Program, 1636 Mail Scrnicc Ccititcr,Raleigh,NC 23699 1636 Ge.Outc>casinglen�lh(ifhvovvn): (ft:) 10c.Fnr Warcr Surinly&Tiriectioro�d'ells: In addition tos�nding the foma io the addresses) above. also subnut'one copy of this form within 30 days of completion-of nrll abandainnent to the coruuy hrtlth depprintcut of the county 6f.Inner cusin;0uhiup te]itjah(if known): � ) vvhcrc atiandotrcd,. 6g,Semen length(if lut0110):10 - 00 i .Form 0111-30 Nonh Cam ltn Deporutxm ofEaviroom t and Nitnuat Resaeces-Divisron of Water Res ow!. Revised 4g"2013 i. AVELL ABANDONMENT RECORD FoilidetitalOwONLY; This foim can be used far sip*or nitdlipte itIls I 1.Well Contraetor Information: )YELL ABANDONRIENT"DETAlut Brian Ewing 7a.Number nfit'dlsbelugabandanoth 1 " wL-]r 3atmdorNnnie(or%%titt 6%v=ll 6omlly alianhnlag,ccll.oshisl iLr pra ny) Fw� w1flople. -Pr fecum, or mint-riufer )sup!f?c wells t),YLY with Nk smle LVh'trffifCUiNI�i7i+01P[IiNIN1�Rlf,1Y1Pn r2UP aztlnvrJfwle"JFJRII� 4240-B p NC Wdl Cbniraaor G:nlfi�tuotiN,tti#tcr � � '' "?Ir.Appmzlmate�nlume ufvrutr,Y•retttaiuing im q'ell(s}: (guL) " SAEDACCO FOR"WATER SUPPLYiVELIS.O.Ni.Y: Con+panyNaroi: 7c.Ty&of iliAnfectant used: 2.Well Construction Permlt 9:, _ Lisf till f�pptlauBle.u eB!<r�rriLr'ti.a Cvanfl,,Shwe,l'arlruxe ltrJdt4i7tr;rlcr If tnn+vrr . - - 7d.Amount of dislnf&tsint usrvl: 3.Wdi usi(cbccicn ell utry: i Water Supply Well, Id.Scaling mutc�als:tisc+!'(chcct;all that apply): pAfiticnititial I]Municipal/Riblid N Neat Cement Grout ElMmottitc Chips or Pellets IRCJeotltcpn:tt(13catinkt•1Coolirig"Stippty) ditcsiiiential Water$J,pp4-(single) LI'Sand'Ccntp.d Grout ❑Dry Clap ❑tndtistrialfCottunctr;ial" 13RC dentist Water Suppl},'(sltamd). ,I7.CtefoGroui, ! E3 Mill Callings DHoatian ❑5peeialty Grottl d Gravel Nap-Water Supply Well: CI Benfottile Slum 15 Odter(ex-plain under 7g) I9Mmittoriftg._ 011ccoeer? Injection Well: X For each material selettl above,pro%ide itmotiOt df.naiterials used: DAquiferRccbarg'e. 17Gr6undtralerRentediation Neat Cem.:471b ,Wtr:3gal. Sand Cem.:lb ,Wtr:gal. t74at r_Storilge aO Reeoven+ Malinitp Danicir Miluifer.Test i7Slonm}�tterDrattiage OPaperiutental Tcchnologn+. OSubstdettce Cofitml. 7g Prtirldc u IrrIcf dcserIption of thc,ulrtndnnmcnt pmci dun: 13G9011temial(Closed Loop) ❑Tracer TREMIE GROUT FROM.THE BOTTOM.TO.M1q._PURFACE ®Geothermal(HearjaglCooiinR Retum) ®Odtertex- lain under 7g) d.Dafen'elt(s).abandoned. 3-28-24 APR G :• �n�4 8a.Well location: b .,..a Former Edgecotnbe Genco Plant. • '- La':'v�J;`�w - racility/Chmt Natue ra ilita IDs 6fupplicabls) ti:CertiQ61116it: 6358 Battleboro.Rd., Battlebo'ro, NC 27809 B ri an' • Ewing 4/3/2024 PhysicalAddtess.City,and Zip- Siregl,�t11or4eitiGCd 1V¢fl C n,uyrtor<,c r.�.11 O,e,tir D2te Edgeeombe County 11 gi21Pg this form,.1 hereby certify thim dw irellfsj wmg(trerr)vhevidoned rre Cti,amy Pane]1ilctgiCte3daa No.(PINj actyMance irrth 15A.CAC"02C,'0100.ur 2C.0260 itrell`Gotis'lrtfctrun StrirrrkJrcls and drat acrpvoftlifsre�-ord liar bee)r provided to'the well otMer.' " S64 ttitudeand longitude in ftm .91011outeslseconds'ordecim;d dcgrem. (firwell Mtd,otte Wa Itg is s ifficiom') '9.Site diagram or additional well del'mu's: ' You tua}�_tne ilie bac3:of Ibis pEige[p:proy'ide.additiottgl tc>:Il site details:oricial N W .abandoiuucut&tails. You tnay also.attacb adtGtional pages if necessaty_- CbNSTRtiCT10N DETAILS OF WELLM BEING ABANDONED CURb1117TAi,INSTRUCTIONS :11LJrlr,irll,airrslrJrliart nevrillsl Ij ovnllra4la. Fur°ircullipfr itjrefiUti a'raun•uvrer�rpp1P - ttefls ONLY u'Jfh Qre atn.arbmft wre fimte l' 10u.-Nor All-Wcllc: Suhinit-this-fatttt xtiithia 30 da}`S of catnptetion"of trial abandonment to the follotiving: Gst.\YdCID_ ffhT�-7 I ' Di.vision of Water Rt ciiuccLs.,Informatiou Proct mug Unit, 23. 1617 Mail Seiirice-C&tcri Raleigfi,NC 27699-1617 6b.Total rrlt dep(h: (R.) lOb.For inleellon Webs' In addition to sending lite fomt to the pddiess in-103 6c.Borehole dlatmetcr.1 (in.) abom tilso snbntit erne copy of this;Conn within 30'days of completion of well. abitndonntrtd to the tollolviritg: fd,Water le�cl.bclon ground sttrfaec: (ft.) Division of Water Resoutrtcs U'udcrgroumd itijecttou Couttol Progratu, 1636(Hail Scrricc Ccn`tcr'Raleigh,KC 276'J9-1636 6m Outer casing lcngth(iflmnn-n): (f�) loc.SmrmWater surinh•'A-fillection tYene:, In addition tosending the fomt to . the address(es) above. also submit gone copy of this'fomt mtbin'30 days of conipletioti"of AvCII abattdaiuncnt to ltite eotudy It it depunntetd of the county, GG •�t Inner easinuhin•ttn b if Im vv nn• wlierc alrtndaitcd.. 6g.Screen length(if hllotsn):10 (ft.) . Fomt MNI-30 Nooth Carotim Dcpann?m ofEm7ronment and Naumt Rcsotmes-Division of Watuftes aws Rci-scd AKgLw 2013 " I ' 1 ; NALL ABA"ONNIEN.T-RECORD For lydcnwlU.Q;MY; { This_foim can be used lbr single or multiple ivells 1.Well Contrilctor Information:' 1t+ELL ABAN55N6IENT DETAK f Brian.Ewing 7a.Number of treks being a li bandanei :l 1VeltCatYeaceorName(of kvdi6%%nL7pcaanatly mtilnple frfeetfa( Or Min-+infer +sl&ry wells ONLY 'wah .t1,+e some crnufrrrcli+whzbatr+hx4ni��u,irrn aur.vnluittf't?naf run NC iycll Conlradorr�.nlTtc�iioti Nuri:6ci - 71r.Anprn`ximatc vnlume of tFat�rrcr�n.+ining in�sdl(s}:. _ (;�rl.j l sAEDAcco FOR WATER.SUPPLY WELLS ONLY: ontirm y Name 7e T�7tc of disinfietunt used: 2:WellConstr'uction Permit 0: LL4dlapj.4uable.uvilpernrav fie.CuvnhtStse,11hrimnce:Irfcciiar;.rlc} ,Gwen - 7(LAutouof 'fdLiinfEctdnt;llSlYl• 3:Well use(eheckn•ell. %c} Water Supply Well; 7b.ScAliftg matetiiticttsc+i(cUccl,"all:that apply): 1-lAocniti ram [INtanicipidlhlblie, I&Neat Cement Grant ®Bcntonitc Chips orPcllcts AGeothctin7l(Hcatiuof iroolirio Supply) [3kesWarial l ater Snppb.(Sint lc) 17 Sand Celnenl Grout ❑Dry Clay ❑IndusltiallCommercial ❑itcsidcntial%VatcrSupply`(shared) ❑ConEtele'Grout ❑DrillCultin�;s ❑Teti tion ❑Specialty,Grout , ❑Gravel Non-Water Supply Wcil: ❑Bentouke Slurry Ci Other(explain under 7g). 119Mauitodne. ❑Recover Injection Well: X For'caeh tuaterial selccted'abore;pro%idq amotnitdf.tu:iterials nscd: ❑Aquiferltechargb Renttdialion Neat Cem.:471b. ,Wtr:3gal. Sand Cem.:lb ,Wtr:gal. ClArinifer Sttsmbe and Recot't*' Maliniti°Harrier ❑AOifer Test ❑$1onm�uter braimiage ❑Erperiu►amal Technology pSubsidenca Control. ?g Provide a brIcf dcscriptian cif the ui►andnnrncai pnecitiltrrr: ❑Geothennal(Ciosed Loop) . [Tracer TREMIE GROAT FROM THE BOTTOM TO_THg-,SII,RFFCIr.,_ ®Geothenual(fi6tingtoolin Retum) ®Other( lain under 7g) era^`d ice.�.,'.1,.•.i �1 g.�,a.>, 4.Dafewell(s).abandonctt: 3-28-24' APR 2 c.2024. - iF!`.:' - .:, 7,-.C:rw';,;•�%.)roc' Former Edgecombe Genco Plant. , ✓•4i}rr4r��".�d rhdIity Chvrn:r Nwnc Faciliti IDtJ(fappliwblc) S.Cerliltcadah; ' 6358.Battleboro,Rd., Battleboro, NC '27809 B.ri_a n_ E ng 4/3/2024 Pitysical'Addre�i,City.and Zip Sigminh+irceitino NVOI Co+urrti+ro,•r.1.114:hvmr. bale Edgecombe County ljyr signing fhly ftrrmi I hemby cerfifj!1hal the Irell(s)ryas 6rex)ohandoned ire tln+iimy I'alid likWjfii itinuNo.(PIN) fx-vidanve With I54 1'C1IC'O.' ,01PO.or 2C.0200 Well Cinistrrtction Stinukurls andtkirt,acoguoft7rise¢curdkasbeeirprmio'erlto7kerrellotffier. Shi:l»ttitttdr and longitude iri dc�mcesrnrimittestsecontls ire dccim;al.ilet�rcess � . (ifuell mold,om L•lvl mg is s tlHeicii). 9..Site diagram or additional m-ell detalis: you tun}use.tliebacl:of tl►is page to provide additiotlal cell site dztnils'or'uell abaudonntem de'tails...You may also attach additional tmg�s if necessary. CONSTRiiCTION DETAILS OF WEL,LLJSI HKING ARAN6ONED- SURILT=AT,TNSTRUC nOVS , .{ffratlr tir1J caasiraciimt tiiwdls/(f rrtrulruld Ftir ttmlfiple irlrciion w•rv.!n•utilu'.wfplp o ells 01VLY'utih rl svutgcw❑ttsrrtin!c4zbn rrhutbtcaf.it u mnsubmit wee junit lam For All Wells:- Submit Ih,;fort uith.in 30 days of completion of ur11 6;L Well ID#:TMW-e ibtindomucat to the following: Dtyiyinn of Water Resonl'r ,Information Procm§ing Unit, 18 1617 Alai1_Sciviee Centeri Raleigh,XC,2769971617 6b e.1al fell depth: A) 10h.Ror Tniecllon Wells: 41 addition to settling the fortn'to the aidtm in-10a Gc•Borehole dlanleter:l (iu.y above•also submit one copy of 111is forta within 30 days of comptetion of a ll abiindomneitt Iti tit¢falloyYitig: :Di�is[on of W>,tcr Rcsout�cLs;Uuticrgttwnd itij��Ylou Control Progrutn; fd.Water lcv,cl bclosr ground surface: (ft.) 1636 t1l:til Scndcc'Ccntcr,Ilalcighi KC 27699-1636 10c.rnr•W:iter Sunnh•&Thieetinti►Yells: In addition t6.sending the form to . 6e.Outer rtsinglength(iflmon-n): 00 the,addresses) 0 We. also subunjubrie copy of this fort twit iin Sly days of comptetian,of«fell abandoiunent to the cotuuy health department of the county 6L Inner casinWtnbin°twigth if linown° �}']uro afnrtdoned, i i i 6g.Screen length(if loton'n):10 -A) i , Farm GLY=30 Nonli Carollm DcpJnnxm of Envlron 'ni mid Natural Rcsotaccs-blvisioan of Water Rol wins Revised Auggrn 20l$ k ' • r 1 1 AVELL ABANDONMENT RECORD FoTImcmallls6ONLY; j This form can be used for single or iuhipte%rsells I 1,Weil Contractor Information: Wlr"..LL ARANDONMENT DCTAIL.S ' i Brian Ewing !a6 Ntimber of iv is being almnduncil:t1 R'clfCour�elorNattic(artirlloor�permn�ll}_nlia>titutdnoactl.onhistliertualicny) Fnr 'FOOple 11yLeum .or nov-iiwe'r ;aupf.Vy wells ONLY wt[b N,c .same • crnufnrcbcua!a6m}rhuiva�nif,}rtn ccueaah�nitiun;jFrrur, 4240-B t 71r•Arptn'-imxtc%nlnint uftxat -rem�inuig in t(dl(s)Z .. (cad.) NC Well Cbnlm�orG:plfi�liotrNmidtci . � FOR OR WAITER SUMPI.Y NVt:US,UNIX. Convany Name 7n Trip of disinfectant used: 2.}Yell Constructimr Pcrrtilt fl:,' , 11sttdl,?pphMJ&-%w11lnr Av(Lr_G.mnn-,Shoo.l�Hrur�:tr�eclinrr rrcliJtrmwn ?d.Awonntofdislnfectsint"Used: 3:Well"Si.(dtecksscll."use}: Water suppl well: 7e.Seating materials-uscd(chcch'ali heat apply): - i7Agticultit(al t]MrmicipvUPuhlic M Neat Cement Grout ❑Mmonitc Chips or Pcticts 13Gcothenn7l(Hcatin�rJCaolioo Srrppt}} 1:312csidm4d Watt:r.Sopp$•(m81c).. ❑Sand Cantept Grout 13.Dry•ClAy . pintttishia]lContmctcial ❑ResidentialWatcrSupply(§hated).. M CgncrcloGrout, .13 DrillCuttitigs ❑irti tion ❑Spe<;ialkVGrout )3 Gravel Non-WaterSuppty�VcU; d BentouiteSlum' d Other(explain ur►der7g) Imhlanitorhrg_, 13Recovem Injection Well; 7f,1Fo.r each_tu:ttertalselected above,pro�idc autontitaf-nt itetiats n'sctl: ❑AgitlferIiCcharge OGriitrnd%�ileriterrtediiuian Neat Cem::471b ,wtr:3gal. Sand Cem.:lb ,Wtr:gal. . DA'gnifer Siotagt and Recovery [iSaliitily Barrier ❑Aquifer Test DStorut water.Drairiage. PF-Verinteulal Technology . ]Subsidencz&Id.rdl 7g Provide a brief description of Ilk atrandonment pmeCtilum: DGeodw(inal(Closed Loopy dTtaccr TREMZE GROUT FROM THE BOTTOM.TO THE SURFACE .136eothertmiffl6lin 'Coolin Return) ®Other(ex laiiiunder7,) [,a= �-,4 ��• 9 4.Datcw'cll(s).abandoned: 3-28-24 APR 2 5a Nell9aca[ton: Former Edgecombe Genco Plant 11r`.'Jir;�sr,':f r� ;.^ ✓; 3 UeN . FactlityAhv cr Nmuc Facility fUb 6fitpplicablc) $:'CenilIi�tlioil: G`.Tc 6:y"y�v - r y�.i I 6358 Battleboro Rd., Battleboro,.NC 27809 B.rJ'a�_.-EViF 11), 4J3/2024 Plt}'sical'Address,Citp.a,idzip sig anrr.orr,'citificulb'CllCnru'raotartrr.'.ItOirn:r Dim Edgecombe County 13jr ci�rrltrg rlris forr?r,I lremby rectify rlmr the troll{.v}n'os prerel a andoned in Corwiy Nud 1&'mfr56llat1 No.(Pit) :trCtutYlmatc with I M XCAC 02C,01OO.ar 2C.O2O0 tt7elf:CriJfsrrucriun'Sfrrnrkrrxls acid rlrar a crpy of ibis record has•r etar pr ovidcd to lfre well owner. M Utitude m(d longitude in degtreslmiantes/seconds or dechu tl d cgr eq.. (if�eC11 Fq ttl,Ork 411111i1gig.11tlictCr9) 9.Site diagram or addlilonat •ell detaUS:. You rm}use the bad:ofthi§.page to'prot.ide:addiiiomt%tell site details.or►cell" N W .abandaiuuent details..I'iau snap alw attach adriitioml pages if.rrecessan'. CONSTRIt(Tl1)11 DETAILS ON WELLS)REM.ARANDIINED $[1RTIii7'i AT,i1VSTRi1C FfiINS ,llfun'r srdl cvrz+•lrui7ieut r¢ivrdfsi!j avnilrariFa Fcu inulhplr irleciiun"w•trun•iru(ir aupplp ' i _ ne11rONL1 irirfidx svmrrrursrrrxrwrc!a5arrh�remeruy+!u�nnxrLrrrilwrefunq ' 10:1:'Nor All Submit thus fomt xvithin 30 days;,of'6rtiplction of urll 6a 1VeIl ID�:T -g abandonment to�k faliolmg; i . . 1 Division Infor nation Proceming Unit, 61► Total dcplh: 18 1617 Mail Scc Colter,Raleiati,XC 27699-1617 . (ft:) e.M ' 101t.Tor Inicctlon Wells: hi addition to sending the font to the addr>s4 in I a 6c.13orchole dtaructer 1 fin,} above;also subadt one copy of thisiforut%citbiu 30 days of coruptetion of►iell abutidonntent to tite follatviug: j 6d.\Vatcr lc%cl.bclois nurid surface. ft.) Division of WaterResourees,Under'gnmad Injection Coutrui PrOgratui ( 1636 Hail Service Ceratcr,'Italcirh,NC 27659-1636 P , 10c.Fnr WatcrSumth'Rr.liriccriaro Welts; In addition'lo:sending the fonts to 6c ()user easing length(if Imo%%v); (ft) tfie 5ddress(es) oboe e,"also sti4mit!ane copy of this fbrtti }violin 30 days of wmpledan-of m-M abanduranent to�Ihe county health dep{irt' id of ttm eourrtV 6f.fnncr castor;ftnbing[citi*th if Waavva)i (D;) Micro abandoned.. I' dl 6g.Screen length([f ktia%u):10 (ft.) I Fornr GlV-30 Ndnti Carolltn I?epuurxm ofEnvlroornenl utd Niataat liesotuecs-131t'fsioa of Nau rR�ow s Raised AuFus130 13 i