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WithersRavenel
Our People. Your Success.
115 MacKenan Drive | Cary, NC 27511
t: 919.469.3340 | f: 919.467.6008 | www.withersravenel.com | License No. C‐0832
Cary | Greensboro | Pittsboro | Raleigh | Wilmington
January 15, 2020
State of North Carolina
Department of Environmental Quality
Federal & State Lead Program
Division of Waste Management‐Underground Storage Tank Section
1646 Mail Service Center
Raleigh, North Carolina 27699‐1646
Attn: Mr. Scott Ryals, PE
Re: Well Abandonment Letter Report
Former Paul’s Tire Service
7238 Market Street
Wilmington, New Hanover County, North Carolina
Groundwater Incident #43092
UST Number: Unassigned
WR Project Number: 02171214.29
Mr. Ryals:
WithersRavenel, Inc. (WR) has prepared this letter report for well abandonment activities
conducted at the Former Paul’s Tire Service site, located at 7238 Market Street in Wilmington,
New Hanover County, North Carolina. This report documents the abandonment of groundwater
monitoring wells MW‐1, MW‐2, MW‐3 and MW‐4 on January 9, 2020. Abandonment activities
were performed in association with TA‐03 for the site under NCDEQ Contract #N17005,
authorized by NCDEQ on December 31, 2019. Well abandonment records and a photographic
record are provided in the attachments.
Mr. Ryals, we appreciate the opportunity to be of service to the Federal & State Lead Program. If
you have questions or comments regarding this letter report, please contact Matthew James at
(919) 469‐3340.
Cordially,
WithersRavenel
G. Matthew James, PG
Senior Geologist
Attachments: Well Abandonment Records & Photographic Record
Well Abandonment Records
WELL ABANDONMENT RECORD
Form GW-30 North Carolina Department of Environmental Quality - Division of Water Resources Revised 2-22-2016
1. Well Contractor Information:
Well Contractor Name (or well owner personally abandoning well on his/her property)
NC Well Contractor Certification Number
Company Name
2. Well Construction Permit #:
List all applicable well construction permits (i.e. UIC, County, State, Variance, etc.) if known
3. Well use (check well use):
Water Supply Well:
□Agricultural □Municipal/Public
□Geothermal (Heating/Cooling Supply)□Residential Water Supply (single)
□Industrial/Commercial □Residential Water Supply (shared)
□Irrigation
Non-Water Supply Well:
□Monitoring □Recovery
Injection Well:
□Aquifer Recharge □Groundwater Remediation
□Aquifer Storage and Recovery □Salinity Barrier
□Aquifer Test □Stormwater Drainage
□Experimental Technology □Subsidence Control
□Geothermal (Closed Loop)□Tracer
□Geothermal (Heating/Cooling Return) □Other (explain under 7g)
4. Date well(s) abandoned:
5a. Well location:
Facility/Owner Name Facility ID# (if applicable)
Physical Address, City, and Zip
County Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
N W
CONSTRUCTION DETAILS OF WELL(S) BEING ABANDONED
Attach well construction record(s) if available. For multiple injection or non-water supply wells
ONLY with the same construction/abandonment, you can submit one form.
6a. Well ID#:
6b. Total well depth: (ft.)
6c. Borehole diameter: (in.)
6d. Water level below ground surface: (ft.)
6e. Outer casing length (if known): (ft.)
6f. Inner casing/tubing length (if known): (ft.)
6g. Screen length (if known): (ft.)
WELL ABANDONMENT DETAILS
7a. For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same
well construction/depth, only 1 GW-30 is needed. Indicate TOTAL NUMBER of
wells abandoned:
7b. Approximate volume of water remaining in well(s):(gal.)
FOR WATER SUPPLY WELLS ONLY:
7c. Type of disinfectant used:
7d. Amount of disinfectant used:
7e. Sealing materials used (check all that apply):
□Neat Cement Grout □Bentonite Chips or Pellets
□Sand Cement Grout □Dry Clay
□Concrete Grout □Drill Cuttings
□Specialty Grout □Gravel
□Bentonite Slurry □Other (explain under 7g)
7f. For each material selected above, provide amount of materials used:
7g. Provide a brief description of the abandonment procedure:
8. Certification:
Signature of Certified Well Contractor or Well Owner Date
By signing this form, I hereby certify that the well(s) was (were) abandoned in
accordance with 15A NCAC 02C .0100 or 2C .0200 Well Construction Standards
and that a copy of this record has been provided to the well owner.
9. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
abandonment details. You may also attach additional pages if necessary.
SUBMITTAL INSTRUCTIONS
10a. For All Wells: Submit this form within 30 days of completion of well
abandonment to the following:
Division of Water Resources, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
10b. For Injection Wells: In addition to sending the form to the address in 10a
above, also submit one copy of this form within 30 days of completion of well
abandonment to the following:
Division of Water Resources, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
10c. For Water Supply & Injection Wells: In addition to sending the form to the
address(es) above, also submit one copy of this form within 30 days of completion
of well abandonment to the county health department of the county where
abandoned.
For Internal Use ONLY:
George Matthew James
4164-C 0.0
WithersRavenel
~20 lbs of bentonite pellets
~15 lbs of concrete
1/9/2020
Bentonite Pellets were poured into the well in 1 ft lifts
until 1 ft from top of casing. A concrete cap was
applied from 1 ft to the surface.
Former Paul's Tire Service
7238 Market Street, Wilmington, NC
New Hanover
2357343.78 192686.57
MW-1, MW-2, MW-3 and MW-4
13
Unknown
6.3
N/A
N/A
10
1-15-20
Photographic Record
WithersRavenel
Our People. Your Success.
Former Paul’s Tire Service WR No. 02171214.29
Photographic Record January 2020
Frame No. 1
Description: View of MW‐1
Frame No. 2
Description: View of MW‐2.
WithersRavenel
Our People. Your Success.
Former Paul’s Tire Service WR No. 02171214.29
Photographic Record January 2020
Frame No. 3
Description: View of MW‐3
Frame No. 4
Description: View of MW‐4