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Home My WebLink About8103_Rutherford_Central_CDLF_PiezAbandonment_FID1619927_20211025REPORT OF PIEZOMETER ABANDONMENT - PHASE 2 C&D EXPANSION RUTHERFORD COUNTY LANDFILL RUTHERFORDTON, NORTH CAROLINA C&D Landfill — Phase 2 Expansion Permit No. 8103-CDLF-2002 Prepared For: Rutherford County Solid Waste Dept. Rutherfordton, North Carolina BLE Project Number J21-13675-05 October 25, 2021 '`��yulrlrrrrr►►► NS �• 1 5 v�OLo4,� ►�rlrllrlll�� BLE North Carolina Business Licenses C-284 & C-1538 JJ IM IM BLJNNELL LAMMONS ENruNEERING 6004 Panders Court I Greenville, 5C 29615 864-288.1265 A 864,286.4330 a info@ble[orp.rom BLECORMOM it IM '13UNNELL LAMMONS ENGINEERING October 25, 2021 Rutherford County Solid Waste Department P.O. Box 1957 Rutherfordton, North Carolina 28139 Attention: Mr. James Kilgo Subject: Report of Piezometer Abandonment - Phase 2 C&D Expansion Rutherford County Landfill Facility Permit Number 8103-CDLF-2002 Rutherfordton, North Carolina BLE Project Number J21-13675-05 Dear Mr. Kilgo: Bunnell-Lammons Engineering, Inc. (BLE) is pleased to provide this report of piezometer abandonment to Rutherford County as part of the Phase 2 C&D landfill expansion. The purpose of this scope of service is to provide abandonment and reporting services as required in the facility's water quality monitoring plan (WQMP) and Rule 15A NCAC 2C .0113(b). This report includes a summary of the project information, scope of services performed, and results. Sincerely, BUNNELL LAMMONs ENGINEERING INC. Riley L. Blais, G.I.T. Staff Hydrogeologist CC: Mr. Pete Dickerson, P.E. — Odom Mr. Mark Cathey, P.E. — McGill v W Andrew W. Ale nder, P.G., RSM Consultant Hydrogeologist Registered, NC No. 1475kk ►►�"'A'■IR'�'+�.■� NSF 9 ': CLO W. A�►► 111111101 6004 Ponders Court, Greenville, SC 29615 (,864.288.1265 a 864.288.4430 Wg info@hleMrp.com BLECORP.COM 1s 1m 1i Report of Piezometer Abandonment — Phase 2 Expansion Rutherford County Landfill, North Carolina TABLE OF CONTENTS October 25, 2021 BLE Project No. J21-13675-05 1.0 PROJECT INFORMATION........................................................................................................1 2.0 SCOPE OF SERVICES PERFORMED......................................................................................1 3.0 RESULTS....................................................................................................................................... 2 4.0 QUALIFICATIONS OF REPORT.............................................................................................. 2 5.0 CLOSING.......................................................................................................................................2 Figures Figure 1 Site Location Map Figure 2 Piezometer Abandonment Map Appendices Appendix A NCDEQ Well Abandonment Records (Form GW-30) iofi 1s 1m 1i Report of Piezometer Abandonment — Phase 2 Expansion Rutherford County Landfill, North Carolina 1.0 PROJECT INFORMATION October 25, 2021 BLE Project No. J21-13675-05 The subject landfill site is located in Rutherford County, North Carolina, between the cities of Rutherfordton and Spindale with a physical address of 656 Laurel Hill Dr, Rutherfordton, North Carolina (Figure 1). Rutherford County owns and operates an inactive/closed MSWLF (Permit No. 8103-MSWLF- 1974) and an active C&D landfill (Permit No. 8103-CDLF-2002) consisting of one waste unit designated Phase 1. The county plans to construct a new C&D waste unit in an approximate 5.5-acre expansion area designated Phase 2. Eight (8) piezometers (LFG-6 [B-13], LFG-7 [B-17], B-36, B-40S, B-40D, B-41, B-42, and B-44) are located within the landfill's Phase 2 expansion area (Figure 2). It's noted that two of the piezometers, LFG-6 (B-13) and LFG-7 (B-17) were labeled as landfill gas monitoring wells but historically have been used for water level measurements and are not part of the landfill gas monitoring network. All eight (8) piezometers must be properly abandoned prior to construction of the waste unit. This piezometer abandonment report does not include documentation of abandonment of borings such as boring B-43 which was drilled with the Phase 2 expansion area. Boring B-43 was performed as part of the design hydrogeologic investigation and its abandonment was documented in the design hydrogeologic report. This report documents the abandonment services for piezometers as required in the facility's WQMP 2.0 SCOPE OF SERVICES PERFORMED Piezometer abandonment was performed by a licensed driller from SAEDACCO, Inc. of Fort Mill, South Carolina, under the supervision of a geologist from BLE. The eight (8) piezometers were abandoned between September 21-27, 2021, using a Diedrich D50 ATV -mounted drilling rig. The abandonment procedures for each piezometer consisted of the following: 1. Locate each piezometer in the field. 2. Measure the total depth and check for obstructions using a weighted tag line (each location was found to be not obstructed prior to abandonment). 3. Tremie grout the PVC casing continuously from the bottom of the casing to the ground surface. 4. Over -drill the location with hollow stem augers and center bit to the total depth of the piezometer or to the top of bedrock (auger refusal). 5. Backfill the resulting borehole with bentonite chips that were hydrated in lifts. A North Carolina well abandonment form (Form GW-30) for each piezometer is attached to this report (Appendix A). Piezometer locations are shown on Figure 2. 1 of 2 1s 1M 1i Report of Piezometer Abandonment — Phase 2 Expansion Rutherford County Landfill, North Carolina 3.0 RESULTS October 25, 2021 BLE Project No. J21-13675-05 Eight (8) piezometers have been permanently abandoned in or near the Phase 2 expansion area. The abandonment activities performed were in accordance with the WQMP and Rule 15A NCAC 2C.0113(b). The piezometers identified in this report which were within the footprint of the future Phase 2 area have been property abandoned in advance of landfill construction. 4.0 QUALIFICATIONS OF REPORT The activities and approaches used in this project are consistent with those normally employed for services of this type. Our services have been performed based on our understanding of the site and project information and the observations made during our work. This report has been prepared on behalf of and exclusively for the use of Rutherford County, North Carolina. This report and the findings contained herein shall not, in whole or in part, be used or relied upon by any other party (excluding the SWS) without BLE's prior written consent. 5.0 CLOSING We appreciate the opportunity to be of service to Rutherford County. Please contact us at (864) 288-1265 if you have any questions or comments. 2 of 2 FIGURES Saint) l pti Francis Episcopal p p K °moo ti 2 Ehurch'Cem q00 LU h w3RD West Memonal 6urck,em a a 0 a /1 N'couRr 221 J Sr � FzNa a oo 4GQBq�. `tTST �p q cT� URT ST �- ST o `� ?C�4 ST O --- - -- CSC 1 Bus H O �'. - J-W&T 4• Rutherfordton 74 Y1 oXFo 0 4pOp�1 =<v �O o LPARK'R� J ti �DUS7RIA V rG ti H y O Alt _ Q � o �oNE IyFDR O ^oo 0 — x ,.z C� COU,yTR` • \yF.p O ' � Op � i ''ci�aTIECUtt6r Gr ' _ QQ� �p\ \� moo �!`'� � ((//'�� m 'V A y`y�1 Bus «tip F s 7 j G221 U AarFRO O m s cc, �p � � 1 I1 0 O �. AAounYa�m� View`'Baphst 'Ch ru ch.Cem DQLFN,op o I I REFERENCES: USGS TOPOGRAPHIC MAP, 7.5 2000 1000 0 2000 4000 a7 TON MINUTE SERIES, RUTHERFORD17— APPROXIMATE SCALE IN FEET Z . _ SOUTH. NC. QUADRANGLE 2017 DRAWN: KLW DATE: 10-1-21 BUNNELL FIGURE IM LAMMONS M ENGINEERING 6004 Ponders Court, Greenville, SC 29615 Phone: (864) 288-1265 Fax: (864) 288-4430 SITE LOCATION MAP RUTHERFORD COUNTY LANDFILL RUTHERFORDTON, NORTH CAROLINA CHECKED: RLB CAD: RCLF-05SLM APPROVED: JOB NO: J21-13675-05 •• B-40 B-4 SS LFG-7 (I PHASE 2 C&D EXISTING C&D LANDFILL EXPANSION PHASE 1 0 4�\ 0� ,LFG-6 (B-13 XMI 9'>0 MONITORING LOCATION LEGEND LFG-9 LANDFILL GAS MONITORING WELL, SURVEYED BY MCGILL ASSOCIATES, 12/17/19 B-41 PIEZOMETER, SURVEYED BY MCGILL ASSOCIATES, 12/17/19 B-41 ABANDONED PIEZOMETER, SEPTEMBER 21-27, 2021 LFG-11 Ak TOPOGRAPHIC & GEOGRAPHIC LEGEND EXISTING 2' CONTOUR — LIDAR/ALS/MCGILL EXISTING 10' CONTOUR — LIDAR/ALS/MCGILL PHASE 1 EXISTING C&D LANDFILL BOUNDARY PHASE 2 C&D EXPANSION BOUNDARY GENERAL MAP REFERENCE I 100 50 0 100 200 APPROXIMATE SCALE IN FEET REFERENCES: 1. EXISTING TOPOGRAPHY OBTAINED FROM ELECTRONIC DRAWING TITLED, "19.00703 BLE 10-22-20" BY MCGILL ASSOCIATES ON OCTOBER 22, 2020. DRAWN BY: KLW DATE: 10-1-21 REVISIONS '= LAENrMMO Na 111. 6004 Ponders Court, Greenville, SC 29515 Phone: (864) 288-1265 Fax: (864] 288-4430 MAP OT &DEXPANSIONAREA PHASE 2T C ABANDONMENT RUTHERFORD COUNTY LANDFILL RUTHERFORDTON, NORTH CAROLINA FIGURE 2 No. DESCRIPTION BY CHECKED BY. RLB FILE: RUTHERFORD-05BLP APPROVED BY: AWA JOB NO: J21-13675-05 APPENDIX A NCDEQ WELL ABANDONMENT RECORDS (FORM GW-30) WELL ABANDONMENT RECORD 1. Well Contractor Information: John Eisenman Well Contractor Name (or well owner personally abandoning well on his/her property) 4439-A NC Well Contractor Certification Number SAEDACCO, Inc. Company Name 2. Well Construction Permit #: NA List all applicable well construction permits (i.e. UIC, County, State, Variance, etc) ifknown 3. Well use (check well use): Water Supply Well: ❑ Agricultural ❑ Municipal/Public ❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single) ❑hidustrial/Commercial ❑Residential Water Supply (shared) ❑hri anon Non -Water Supply Well: e 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: 9/21 /2021 5a. Well location: Rutherford County Landfill 8103-CDLF-2002 Facility/Owner Name Facility ID# (if applicable) 656 Laurel Hill Dr, Rutherfordton, NC 28139 Physical Address, City, and Zip Rutherford Co. 1206280 County Parcel Identification No. (PIN) 5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees: (if well field, one lat/long is sufficient) 35021'5.39" N 81057-12.15" W CONSTRUCTION DETAILS OF WELL(S) BEING ABANDONED Attach well construction record(s) ifavailable. Formultiple injection or non -water supply wells ONLY with the same construction/abandonment, you can submit one farm. 6a. Well ID#: LFG-6 (B-13) 6b. Total well depth: 31.0 (ft.) 6c. Borehole diameter: 6.25 (in.) 6d. Water level below ground surface: 15 (ft.) 6e. Outer casing length (if known): NA (ft.) 6f. Inner casing/tubing length (if known): NA (ft.) 6g. Screen length (if known): 10 (ft.) For Internal Use ONLY: 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: 1 7b. Approximate volume of water remaining in well(s): NA (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 N Bentonite Chips or Pellets ❑ Sand Cement Grout ❑ Concrete Grout e Specialty Grout ❑ Bentonite Slurry ❑ Dry Clay ❑ Drill Cuttings ❑ Gravel ❑ Other (explain under 7g) 7f. For each material selected above, provide amount of materials used: Cement-Bentonite Grout: 5 gal Bentonite Chips: <1 bag 7g. Provide a brief description of the abandonment procedure: Tremie cement-bentonite grout from bottom of borehole to surface. Over -drill to 1 foot (auger refusal). Backfill to surface with bentonite chips. S. Certification: (� —4" :r 10/04/2021 future 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 Iniection 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 & Iniection 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. Form GW-30 North Carolina Department of Environmental Quality - Division of Water Resources Revised 2-22-2016 WELL ABANDONMENT RECORD 1. Well Contractor Information: Stefan Smith Well Contractor Name (or well owner personally abandoning well on his/her property) 3576-A NC Well Contractor Certification Number SAEDACCO, Inc. Company Name 2. Well Construction Permit #: NA List all applicable well construction permits (i.e. UIC, County, State, Variance, etc) ifknown 3. Well use (check well use): Water Supply Well: ❑ Agricultural ❑ Municipal/Public ❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single) ❑hidustrial/Commercial ❑Residential Water Supply (shared) ❑hri anon Non -Water Supply Well: e 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. 9/27/2021 5a. Well location: Rutherford County Landfill 8103-CDLF-2002 Facility/Owner Name Facility ID# (if applicable) 656 Laurel Hill Dr, Rutherfordton, NC 28139 Physical Address, City, and Zip Rutherford Co. 1206280 County Parcel Identification No. (PIN) 5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees: (if well field, one lat/long is sufficient) 35021'6.55" N 81057-13.23" W CONSTRUCTION DETAILS OF WELL(S) BEING ABANDONED Attach well construction record(s) ifavailable. Formultiple injection or non -water supply wells ONLY with the same construction/abandonment, you can submit one farm. 6a. Well ID#: LFG-7 (B-17) 6b. Total well depth: 50.0 (ft.) 6c. Borehole diameter: 6.25 (in.) 6d. Water level below ground surface: 32 (ft.) 6e. Outer casing length (if known): NA (ft.) 6f. Inner casing/tubing length (if known): NA (ft.) 6g. Screen length (if known): 10 (ft.) For Internal Use ONLY: 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: 1 7b. Approximate volume of water remaining in well(s): NA (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 N Bentonite Chips or Pellets ❑ Sand Cement Grout ❑ Concrete Grout e Specialty Grout ❑ Bentonite Slurry ❑ Dry Clay ❑ Drill Cuttings ❑ Gravel ❑ Other (explain under 7g) 7f. For each material selected above, provide amount of materials used: Cement-Bentonite Grout: 12 gal Bentonite Chips: 11 bags 7g. Provide a brief description of the abandonment procedure: Tremie cement-bentonite grout from bottom of casing to surface. Over -drill to 32 feet (auger refusal). Backfill to surface with bentonite chips. S. Certification: ':5hcZ6� 10/04/2021 Signatu i 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 Iniection 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 & Iniection 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. Form GW-30 North Carolina Department of Environmental Quality - Division of Water Resources Revised 2-22-2016 WELL ABANDONMENT RECORD 1. Well Contractor Information: Stefan Smith Well Contractor Name (or well owner personally abandoning well on his/her property) 3576-A NC Well Contractor Certification Number SAEDACCO, Inc. Company Name 2. Well Construction Permit #: NA List all applicable well construction permits (i.e. UIC, County, State, Variance, etc) ifknown 3. Well use (check well use): Water Supply Well: ❑ Agricultural ❑ Municipal/Public ❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single) ❑hidustrial/Commercial ❑Residential Water Supply (shared) ❑hri anon Non -Water Supply Well: e 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. 9/27/2021 5a. Well location: Rutherford County Landfill 8103-CDLF-2002 Facility/Owner Name Facility ID# (if applicable) 656 Laurel Hill Dr, Rutherfordton, NC 28139 Physical Address, City, and Zip Rutherford Co. 1206280 County Parcel Identification No. (PIN) 5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees: (if well field, one lat/long is sufficient) 35021'3.62" N 81057-9.47" W CONSTRUCTION DETAILS OF WELL(S) BEING ABANDONED Attach well construction record(s) ifavailable. Formultiple injection or non -water supply wells ONLY with the same construction/abandonment, you can submit one farm. 6a. Well ID#: B-36 6b. Total well depth: 32 (ft.) 6c. Borehole diameter: 6.25 (in.) 6d. Water level below ground surface: 13 (ft.) 6e. Outer casing length (if known): NA (ft.) 6f. Inner casing/tubing length (if known): NA (ft.) 6g. Screen length (if known): 10 (ft.) For Internal Use ONLY: 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: 1 7b. Approximate volume of water remaining in well(s): NA (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 N Bentonite Chips or Pellets ❑ Sand Cement Grout ❑ Concrete Grout e Specialty Grout ❑ Bentonite Slurry ❑ Dry Clay ❑ Drill Cuttings ❑ Gravel ❑ Other (explain under 7g) 7f. For each material selected above, provide amount of materials used: Cement-Bentonite Grout: 5 gal Bentonite Chips: 6 bags 7g. Provide a brief description of the abandonment procedure: Tremie cement-bentonite grout from bottom of casing to surface. Over -drill to 16 feet (auger refusal). Backfill to surface with bentonite chips. S. Certification: 10/04/2021 Signatu 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 Iniection 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 & Iniection 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. Form GW-30 North Carolina Department of Environmental Quality - Division of Water Resources Revised 2-22-2016 WELL ABANDONMENT RECORD 1. Well Contractor Information: John Eisenman Well Contractor Name (or well owner personally abandoning well on his/her property) 4439-A NC Well Contractor Certification Number SAEDACCO, Inc. Company Name 2. Well Construction Permit #: NA List all applicable well construction permits (i.e. UIC, County, State, Variance, etc) ifknown 3. Well use (check well use): Water Supply Well: ❑ Agricultural ❑ Municipal/Public ❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single) ❑hidustrial/Commercial ❑Residential Water Supply (shared) ❑hri anon Non -Water Supply Well: e 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. 9/21 /2021 5a. Well location: Rutherford County Landfill 8103-CDLF-2002 Facility/Owner Name Facility ID# (if applicable) 656 Laurel Hill Dr, Rutherfordton, NC 28139 Physical Address, City, and Zip Rutherford Co. 1206280 County Parcel Identification No. (PIN) 5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees: (if well field, one lat/long is sufficient) 35021'4.17" N 81057-14.57" W CONSTRUCTION DETAILS OF WELL(S) BEING ABANDONED Attach well construction record(s) ifavailable. Formultiple injection or non -water supply wells ONLY with the same construction/abandonment, you can submit one farm. 6a. Well ID#: B-40S 6b. Total well depth: 46 (ft.) 6c. Borehole diameter: 6.25 (in.) 6d. Water level below ground surface: 23 (ft.) 6e. Outer casing length (if known): NA (ft.) 6f. Inner casing/tubing length (if known): NA (ft.) 6g. Screen length (if known): 10 (ft.) For Internal Use ONLY: 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: 1 7b. Approximate volume of water remaining in well(s): NA (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 N Bentonite Chips or Pellets ❑ Sand Cement Grout ❑ Concrete Grout e Specialty Grout ❑ Bentonite Slurry ❑ Dry Clay ❑ Drill Cuttings ❑ Gravel ❑ Other (explain under 7g) 7f. For each material selected above, provide amount of materials used: Cement-Bentonite Grout: 10 gal Bentonite Chips: 9 bags 7g. Provide a brief description of the abandonment procedure: Tremie cement-bentonite grout from bottom of casing to surface. Over -drill to 25 feet (auger refusal). Backfill to surface with bentonite chips. S. Certification: 10/4/2021 S ature 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 Iniection 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 & Iniection 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. Form GW-30 North Carolina Department of Environmental Quality - Division of Water Resources Revised 2-22-2016 WELL ABANDONMENT RECORD 1. Well Contractor Information: John Eisenman Well Contractor Name (or well owner personally abandoning well on his/her property) 4439-A NC Well Contractor Certification Number SAEDACCO, Inc. Company Name 2. Well Construction Permit #: NA List all applicable well construction permits (i.e. UIC, County, State, Variance, etc) ifknown 3. Well use (check well use): Water Supply Well: ❑ Agricultural ❑ Municipal/Public ❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single) ❑hidustrial/Commercial ❑Residential Water Supply (shared) ❑hri anon Non -Water Supply Well: e 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. 9/21 /2021 5a. Well location: Rutherford County Landfill 8103-CDLF-2002 Facility/Owner Name Facility ID# (if applicable) 656 Laurel Hill Dr, Rutherfordton, NC 28139 Physical Address, City, and Zip Rutherford Co. 1206280 County Parcel Identification No. (PIN) 5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees: (if well field, one lat/long is sufficient) 35021'4.17" N 81057-14.57" W CONSTRUCTION DETAILS OF WELL(S) BEING ABANDONED Attach well construction record(s) ifavailable. Formultiple injection or non -water supply wells ONLY with the same construction/abandonment, you can submit one farm. 6a. Well ID#: B-40D 6b. Total well depth: 76 (ft.) 6c. Borehole diameter: 6.25 (in.) 6d. Water level below ground surface: 26 (ft.) 6e. Outer casing length (if known): NA (ft.) 6f. Inner casing/tubing length (if known): NA (ft.) 6g. Screen length (if known): 10 (ft.) For Internal Use ONLY: 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: 1 7b. Approximate volume of water remaining in well(s): NA (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 N Bentonite Chips or Pellets ❑ Sand Cement Grout ❑ Concrete Grout e Specialty Grout ❑ Bentonite Slurry ❑ Dry Clay ❑ Drill Cuttings ❑ Gravel ❑ Other (explain under 7g) 7f. For each material selected above, provide amount of materials used: Cement-Bentonite Grout: 15 gal Bentonite Chips: 9 bags 7g. Provide a brief description of the abandonment procedure: Tremie cement-bentonite grout from bottom of casing to surface. Over -drill to 25 feet (auger refusal). Backfill to surface with bentonite chips. 8. Certification: ge�'� (10/04/2021 S ature of Ce tified 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 Iniection 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 & Iniection 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. Form GW-30 North Carolina Department of Environmental Quality - Division of Water Resources Revised 2-22-2016 WELL ABANDONMENT RECORD 1. Well Contractor Information: Stefan Smith Well Contractor Name (or well owner personally abandoning well on his/her property) 3576-A NC Well Contractor Certification Number SAEDACCO, Inc. Company Name 2. Well Construction Permit #: NA List all applicable well construction permits (i.e. UIC, County, State, Variance, etc) ifknown 3. Well use (check well use): Water Supply Well: ❑ Agricultural ❑ Municipal/Public ❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single) ❑hidustrial/Commercial ❑Residential Water Supply (shared) ❑hri anon Non -Water Supply Well: e 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. 9/27/2021 5a. Well location: Rutherford County Landfill 8103-CDLF-2002 Facility/Owner Name Facility ID# (if applicable) 656 Laurel Hill Dr, Rutherfordton, NC 28139 Physical Address, City, and Zip Rutherford Co. 1206280 County Parcel Identification No. (PIN) 5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees: (if well field, one lat/long is sufficient) 35021'3.26" N 81057-13.11" W CONSTRUCTION DETAILS OF WELL(S) BEING ABANDONED Attach well construction record(s) ifavailable. Formultiple injection or non -water supply wells ONLY with the same construction/abandonment, you can submit one farm. 6a. Well ID#: B-41 6b. Total well depth: 35 (ft.) 6c. Borehole diameter: 6.25 (in.) 6d. Water level below ground surface: 25 (ft.) 6e. Outer casing length (if known): NA (ft.) 6f. Inner casing/tubing length (if known): NA (ft.) 6g. Screen length (if known): 10 (ft.) For Internal Use ONLY: 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: 1 7b. Approximate volume of water remaining in well(s): NA (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 N Bentonite Chips or Pellets ❑ Sand Cement Grout ❑ Concrete Grout e Specialty Grout ❑ Bentonite Slurry ❑ Dry Clay ❑ Drill Cuttings ❑ Gravel ❑ Other (explain under 7g) 7f. For each material selected above, provide amount of materials used: Cement-Bentonite Grout: 9 gal Bentonite Chips: 8 bags 7g. Provide a brief description of the abandonment procedure: Tremie cement-bentonite grout from bottom of casing to surface. Over -drill to 22 feet (auger refusal). Backfill to surface with bentonite chips. S. Certification: '! t&z4z4f' '7�ynZ6� 10/04/2021 S igilatuVof 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 Iniection 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 & Iniection 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. Form GW-30 North Carolina Department of Environmental Quality - Division of Water Resources Revised 2-22-2016 WELL ABANDONMENT RECORD 1. Well Contractor Information: John Eisenman Well Contractor Name (or well owner personally abandoning well on his/her property) 4439-A NC Well Contractor Certification Number SAEDACCO, Inc. Company Name 2. Well Construction Permit #: NA List all applicable well construction permits (i.e. UIC, County, State, Variance, etc) ifknown 3. Well use (check well use): Water Supply Well: ❑ Agricultural ❑ Municipal/Public ❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single) ❑hidustrial/Commercial ❑Residential Water Supply (shared) ❑hri anon Non -Water Supply Well: e 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. 9/21 /2021 5a. Well location: Rutherford County Landfill 8103-CDLF-2002 Facility/Owner Name Facility ID# (if applicable) 656 Laurel Hill Dr, Rutherfordton, NC 28139 Physical Address, City, and Zip Rutherford Co. 1206280 County Parcel Identification No. (PIN) 5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees: (if well field, one lat/long is sufficient) 35021'6.29" N 35021-6.29" W CONSTRUCTION DETAILS OF WELL(S) BEING ABANDONED Attach well construction record(s) ifavailable. Formultiple injection or non -water supply wells ONLY with the same construction/abandonment, you can submit one farm. 6a. Well ID#: B-42 6b. Total well depth: 44 (ft.) 6c. Borehole diameter: 6.25 (in.) 6d. Water level below ground surface: 13 (ft.) 6e. Outer casing length (if known): NA (ft.) 6f. Inner casing/tubing length (if known): NA (ft.) 6g. Screen length (if known): 10 (ft.) For Internal Use ONLY: 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: 1 7b. Approximate volume of water remaining in well(s): NA (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 N Bentonite Chips or Pellets ❑ Sand Cement Grout ❑ Concrete Grout e Specialty Grout ❑ Bentonite Slurry ❑ Dry Clay ❑ Drill Cuttings ❑ Gravel ❑ Other (explain under 7g) 7f. For each material selected above, provide amount of materials used: Cement-Bentonite Grout: 10 gal Bentonite Chips: 5 bags 7g. Provide a brief description of the abandonment procedure: Tremie cement-bentonite grout from bottom of casing to surface. Over -drill to 18 feet (auger refusal). Backfill to surface with bentonite chips. 8. Certification: 10/04/2021 S ature 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 Iniection 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 & Iniection 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. Form GW-30 North Carolina Department of Environmental Quality - Division of Water Resources Revised 2-22-2016 WELL ABANDONMENT RECORD 1. Well Contractor Information: Stefan Smith Well Contractor Name (or well owner personally abandoning well on his/her property) 3576-A NC Well Contractor Certification Number SAEDACCO, Inc. Company Name 2. Well Construction Permit #: NA List all applicable well construction permits (i.e. UIC, County, State, Variance, etc) ifknown 3. Well use (check well use): Water Supply Well: ❑ Agricultural ❑ Municipal/Public ❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single) ❑hidustrial/Commercial ❑Residential Water Supply (shared) ❑hri anon Non -Water Supply Well: e 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. 9/27/2021 5a. Well location: Rutherford County Landfill 8103-CDLF-2002 Facility/Owner Name Facility ID# (if applicable) 656 Laurel Hill Dr, Rutherfordton, NC 28139 Physical Address, City, and Zip Rutherford Co. 1206280 County Parcel Identification No. (PIN) 5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees: (if well field, one lat/long is sufficient) 35021'5.96" N 81057-7.28" W CONSTRUCTION DETAILS OF WELL(S) BEING ABANDONED Attach well construction record(s) ifavailable. Formultiple injection or non -water supply wells ONLY with the same construction/abandonment, you can submit one farm. 6a. Well ID#: B-44 6b. Total well depth: 39 (ft.) 6c. Borehole diameter: 6.25 (in.) 6d. Water level below ground surface: 21 (ft.) 6e. Outer casing length (if known): NA (ft.) 6f. Inner casing/tubing length (if known): NA (ft.) 6g. Screen length (if known): 10 (ft.) For Internal Use ONLY: 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: 1 7b. Approximate volume of water remaining in well(s): NA (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 N Bentonite Chips or Pellets ❑ Sand Cement Grout ❑ Concrete Grout e Specialty Grout ❑ Bentonite Slurry ❑ Dry Clay ❑ Drill Cuttings ❑ Gravel ❑ Other (explain under 7g) 7f. For each material selected above, provide amount of materials used: Cement-Bentonite Grout: 8 gal Bentonite Chips: 12 bags 7g. Provide a brief description of the abandonment procedure: Tremie cement-bentonite grout from bottom of casing to surface. Over -drill to 39 feet (auger refusal). Backfill to surface with bentonite chips. S. Certification: li75&11 �'� 10/04/2021 Signatu 1 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 Iniection 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 & Iniection 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. Form GW-30 North Carolina Department of Environmental Quality - Division of Water Resources Revised 2-22-2016