MO-4641_15664_CA_WR_19930427_Well Abandonment Records

CL ntM 01? RATS
✓c"ILL']C11L oZ nacurai resources and Cow.•-11ts Developme p R "SolfgQ'B AND
Division of Environmencal Management �XDFnQNT
j1= ABANDQNMERr P. 0. Box Z7687 - Raleigh, H. C. 27611
RECM
2.
3.
4.
5.
6.
7.
MAY 1 0 1993
IN1310R OF 1"IRORURTA-It MAAAGEAIE11
R REG NO 2NOWWRIGIgNAL OFFICE
W1.IDCATION: (Show a sketch of the location an back of fox=.)
Nearest Town: -�
�'. L , ! County jji7,_ ice,
Q,aadrangle No. 5 ry
Road QMMLMi.ty, Subdivision, Lot Nio.
Nbou
1t 33z WELL DIEM: Draw a detailed sketch of the
TOPOGFUMMdraw,..,slope, 2xLutop,valley,flat 'ill Irving total depth, depth and diameter
UM OP WEM-- 5' m �/� I1�ZZ: -3 .-C3 -�t2 Of screens
rem in the well, gravel
intervals of casing Perforations
TOTAL EEPTH: -7 , Imo: Zvi and depths and types of fill materials used.
feet
Z/
Neat cement
bags of cammt Z
gals. of water f
Other
Type material
{► Amour
diameter
Sand cement
bags of cement
yds. of sand
gala. of water
9- EnmuN XMWD OP EKPLAaDoW OF
C-"' s�--G-'/--' ` o5
�` r ✓r(
l 10. Chlorination X Chlorine
Remarks
I do hereby certify that this well
abandonment record is true and enact. c
CJ
-of Contractor or mat Date
;omit original to the Division of EnvironsigntALl management
, one copy to the Driller,
WA vas copy to the Order. x

MONITORING WELL INSTALLATION RECORD
1-n "p" IVa,1 "f, � zz I
JOB NAME Coltsgate Road Site JOB NUMBER 229-07757-03
WELL NUMBER MW-1 GROUND SURFACE ELEVATION N/A
LOCATION Coltsgate Road Charlotte, North Carolina
INSTALLATION DATE 3-13-92
STEEL PIPE
o
BOREHOLE
o
o
PVC PIPE / '57/
GROUT
BENTONITE SEAL J
PVC SCREEN
SAND BACKFILL/
7.5
END CAP
NOTE: ALL PVC PIPE JOINTS
HAVE SCREW CONNECTORS 1f27
LOCKABLE CAP
VENTED PVC CAP
STICK UP
), 1
1.5 Ft GROUND SURFACE
RESOURCM
_ (Tr�11rldI7'Y F3TT193
DEPTH TO BASE
OF GROUTSEAL �,MY i 0
11. Ft
10'r3iU14 fff I sa "`< 'sciilfll(
DEPTH TO TOP OF*0'1' .'I.I. i. 10614 ffffu
SAND BACKFILL
13 Ft
,4W_1 LAW ENGINEERING
CHAR LOTTE,NORTNCAROL INA
)EPTH
ELL
MONITORING WELL
INSTALLATION RECORD

A Q MPT- OF NATURA6
of naLurat r.eaourcem-i
s and Com•it5 Development v RIMIURGES AND
Division of environmental Management 6Ri1�iRS�Tti'1�1 �!�'d'%i1P1Hlrly'
WELL P. 0. Box z7667 - Raleigh, H. c. 27611 IrIVAY 1 01993
RECRD m e,--
Z' 0T ENVIRONMENTAL MANAGE1M S
REG. xn i �tlL-t1, AEGIONAL OFFICE
_
WML LOCATION: (Show a sketch of the location an hack of form.)
Nearest Town:
Pioad+ Cammmity, Subdivision, Lot No.
3 JELL DIAGRAM: Draw a detailed sketch of the
TOPOGRLi'H!C:draw, slope,hilltop,valley, flat wel.1 showing total depth, depth and diameter
II5E VEIL:2" of screens � em&i .� g im the well, gravel
'idt % DATE: �� c? interval, intervals of casing perforations, .
TOTAL TEPM: TER: �// and depths and types of fill materials used.
CA.SIM �DVEp:
f=
8. sEALIM
Neat cement
bags of cement-2
gala. of water -
go
Sand cement
bags of cement
Ids. of sand
gals. of water
Other -
Type materialij%c,c,
Amount 2!
EZPLUN 149TEtD op EKPLAmpeaT OF
. . . ..� . ... r. •0 r..
I IS
10. Chlorination X Chlorine Amount Used
r
Sabsdt original to the Division of Environ ental
gad one copy to the Order. tea+ me cOP7 to the Driller,

MONITORING WELL INSTALLATION RECORD
JOB NAME coltsgate Road Site JOB NUMBER 229-07757-03
WELL NUMBER Mw-2 GROUND SURFACE ELEVATION N/A
LOCATION Coltsaate Road Charlotte,North (arol ; na
INSTALLATION DATE 3-13-92
LOCKABLE CAP
VENTED PVC CAP
STEEL PIPE 4t7TSTICK UP GROUND SURFACE
If
BOREHOLE
� I
PVC PIPE I J
GROUT LL -_ i/ 1
BENTONITE SEAL i/fit
PVC SCREEN
SAND BACKFILL
END CAP Z
NOTE: ALL PVC PIPE JOINTS
HAVE SCREW CONNECTORS =�5
DEPTH TO BASE'"y'
OF GROUTSEAL
11 Ft LVISIO � fiv miWjnOeiec L
e r ._
XA ,�L
ADD
1993
OFFICE
)EPTH
ELL
Ft
LAW ENGINEERING
MONITORING WELL
Mw-2 `�2_ INSTALLATION RECORD
CMARLOTTE,NORTH CAROLINA

of nacurai resources and Commmity Development A. Q IDES O$ igATVM,
Division of Environmental Management RESOURM ANDC0AIF'-yJFI7I Y 9DEVE ZOp
AW
WELL ABANDONMIM
REMRD /-74 C,,,-
3
2.
3-
4.
5.
6.
7.
P. 0. —X 27687 - Raleigh, H. C. 27611
MAY I:01993
--- f, ' i,RM, Np "" t't5l�z!3%iEt)7Ai MAflA6EMEq
ilEtI LOCA=ClN: (Show a sketch of the .location on hack of Sons.) . • R
Nearest Town: !'' , / Conrnty
0�dran8le No.
��+ Commmi.ty, Subdivision, Lot No.
C e
AICF=:
WIML DIAGRAM: Draw a detailed sketch of the
TOPOGRLPIMdrag,slope, hilltop,va11eT,flat well showing total depth, depth and diameter
II5E OF imL: t� � �I g of scree m rem In in the well, gravel
I >l7A / HAZE: � / 3 � interval, intervals of casing Perforations, .
TOTAL : a j ' Z // and depths and types of fin materials used.
CASIM REMOVE):
feet diameter
8. SEAT G
Neat Cement
bags of cangnt Z
gals. of water "7
Sand cement
bags of cent
yds. of sand
gals. of water
Other -
T7Pe material
Amount Z
�-�jDate
611Retmark
orination
I do hereby certify that this wkxxwnt rec ord is tXUe and en
tore of Caatraator or Agent
Chlorine I Amount
Sadcit original to the Division of Envir+oomental
amd one co" to the Order. 'IV One One c'OP7 to the Driller,

MONITORING WELL INSTALLATION RECORD
JOB NAME Coltsgate Road site JOB NUMBER 229-07757-03
WELL NUMBER
MW-3
GROUND SURFACE
ELEVATION
LOCATION
Coltsgate Road
Charlotte, North
Carolina
INSTALLATION DATE 3-13-92
STEEL PIPE
BOREHOLE
PVC PIPE -
GROUT
BENTONITE SEAL =--'
PVC SCREEN
SAND BACKFILL-
END CAP 5,
NOTE: ALL PVC PIPE JOINTS
LOCKABLE CAP
VENTED PVC CAP
STICK UP
1.5 Ft
DEPTH TO BASE
OF GROUTSEAL
5 Ft
HAVE SCREW CONNECTORS�� S
MW-3 LAW ENGINEERING
"l CMARLOTTE,NORTM CAROLINA
N/A
GROUND SURFACE
-, % (
R. Q ]DEPT. ®p XATrM
PX'SOUt Axe
COMAR)AUTy DZIULOPMEM
Wy I n on
t,IrlUAGEMENT
OFFICE _
)EPTH
ELL
Ft
MONITORING WELL
INSTALLATION RECORD

of naLu:ai resources and Cow.• -city Development
Division of Environmental Management
2.
3-
k.
5•
6.
7•
P. 0. Box Z7687 - Re leigh, H. C. 27611
G Dtra; OF Nast
RESOURCES AND
COADIUNJITY DEW, IF ""
MAY 1, 01993
WEU IDC =CN: (Show a sketch of the location on back of form.) NOWS111"LLE ROM[
Nearest Tbun: .c�'-,. G /
C / _ Q.isdrangle No. ZZTC
Road, CommLmity, Subdivision, Lot No. l
AtCRESs:
MP0GRAPfff:draw, slope. b:LUtop, valley, flat
USE OP HELL: �' -W I
TOTAL IEPTEI:
CASING REMOVED. -
feet
'2j/
8. SFAIJM MAIL:
Neat cement
bags of cement
gala. of water_
Amount 3 4 8
diameter
-Zi/
Sand cement
bags of cement
yds. of sand
gals. of water
9. MUM MOM= OF Expuamcm op
r
WE= LIIAGRAM: Draw a detailed sketch of the
well snowing total depth, depth and dimr
Of screens remaimi••� g in the well, gravel
interval, =tes'vals of ca-v ng perforations, .
and depths and types of fill materials used.
,Sr
10. Chlorination X Chlorine
7
11.
I d0 hereby certify that this well Remarks
Abandkxctment rr �
record is true and enact. _ lr
/f.27
;abwlt original to the Division of Envirounwtal msnaaen.,t, one to the Driller,
nd me copy to the Owner. � COS ,

MONITORING WELL INSTALLATION RECORD
JOB NAME Coltsgate Road Site JOB NUMBER 229-7757-Q3
WELL NUMBER MW-4 GROUND SURFACE ELEVATION— N/A
Colts ate Road Charlotte, North Carolina �t
LOCATION g
INSTALLATION DATE 3-17-92 Co -L TY��«�OPRf
MAY 1 01993
LOCKABLE CAP PVC CAP
bl�O;iiSYI?L� IIE�I'IIfi�� Qt'F�F
GROUT SEAL GROUND
STICKUP 1.5 Ft SURFACE
BOREHOLE 8 inch
4" PVC PIPE
2PVC PIPE
CEMENT- BENTONITE
GROUT SEAL
BENTONITE SEAL
BOREHOLE
PVC SCREEN
SAND BACKFILL
END CAP
NOTE: ALL PVC PIPE JOINTS
HAVE SCREW CONNECTORS
DEPTH TO BASE
OF GROUT SEAL
36.5 Ft
Mw-4 LAW ENGINEERING
C HARLOTTE, NORTH CAROLINA
Monitoring Well
Installation Record