HomeMy WebLinkAboutOnslow_Well Abandonment_20240624 (5) WELL-ABANDONMENT RECORD
ror Immil U-sr-ONLY,
"i-cibrin Can bo uSed for$h.)-9!e-6rww0pf0 well
Lyell 1coniractor-Information- AVVLLARA.NhQNMRNTP'_FTA
RICKY CENTRE ?a.Number Ow1bilIcin-vab ndinc :11
%Vell on hz0ber prowsk :tar 0111elople- r.1ftrif(w, �cw lmn-ilvir
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7h.Approv imate%,olume of linter IV
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14
SAEDACCO FOR NV.VFER SUPPIlY WELLS ONLY!
Convoy Kazt:
2-Well Coostrutlion Permit a,
7d.Amount of dlsinfeciant:uStd:
3.
Water Su plti Well.• 7c,501ing materials,used(check;'aq p
bki mic)pomW;
0,13c jolt
Ic,
136cothermal(tidausk)(colin Sipply) 1312cqdvilial Water SPp,4(,in�le) 'aCenica:Grout
d bly d-i-V
13 hidogrialiCkimin&cial. Dltccjdvjlial Water Supply tshaw4) O Conrrctc Geont b w"I i_pu t i i i!gg.
rj odict(C\plaiit order"g)
Nrqjon, ih- If Far eackMATerial-wlectcd above'pro idc amount of tuaterials.used:
Meat Cem.:4001b Wtr:70ga.1., Sand Cem.:Ib Wtr-gal.
tn,
brief red"
.,i(Mription nf(ki ab4ifitonincht pni, M:
Mothennal JCloscd Loop) Mmpe;
cr TRnM GROUT USING PORTIA= CEMENT.
5/2/24
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L. JUN 2 4-202A
ABC CLEANERS
F-aMit.t Lk,*
9.
328-294 TARAW BLVD, JACKSONVILLE,HC 28543 "le, 511212024
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ONSLOW
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9.Site diagram or Additional well de Milk
T0_0 jna�iiSerdie,baet of 111i5 ope i6-prof isle additional,%VU site.d;lfail§of lveIl
IV'
CONS'T R Iff-FION 0 MAILS S JIF'IN(;ABANDONED
suBmimm.
Ji4kfi well
v&ox L'y 1,A fiv.,wnsi t Agtpot,:ijnefi„�iic,
104. Ftir,All-Welh., Submit thwtfi'onn ivithin 30 dayj ot-coropletian of-,well
6j.%Vejt,tf1#-RWS-02 abandonfiten(to the fd!lonvi7ig-
Di4slon or WateiResources; Unit,
0b.Ttitaivrkil depth: 40
Ad iAoti'lo-'sviding tb-.,.*r0rI1t to l0a
6c.1110m,hole djAmejer.,4
601,Water level bdow'-pV mind surface: 17 28
163(,Mail Scrtice Center,Rilcigh.NC 276994636
10c.Far Walgr NIPPIV 5x-. 11ILext* In addition'to Ong the form to
.1 L
,;th(if two,%
Ge.Outer casing fen,
ibc-'address(CO above, also 6ubmi(i6ne copy of lid' from) within-36 days of
completion of ucil abaloo.unient t lim'courity healthdeparinwig of the countyat-ndibdoMd.'
4%S4&n length{if Mill,ti-fit). (ft.)
r4ofEnvitc ant mat Naluml R,��4umes Olt i5joncrWilL I Noah Czolhu DeMinx -not, 't te c rims