WI-2058_2331_CA_LTRRPT_20230322_Well_Abandonment

220 Old Dairy Road
Wilmington, NC 28405
[phone]
www.CatlinUSA.com
Wilmington, NC | Raleigh, NC | Washington, NC | Atlanta, GA
ENVIRONMENTAL | CIVIL | GEOTECHNICAL

Wilmington, NC | Raleigh, NC | Washington, NC | Atlanta, GA | Charleston, SC
March 22, 2023
North Carolina Department of Environmental Quality Division of Waste Management UST Section
Attn: Mr. Scott Ryals
1646 Mail Service Center Raleigh, NC 27699-1646
Re: Letter Report – Well Abandonment
Fox Harbour #14 5338 US Hwy 70 W. Newport, NC 28570 Incident Number: 23331 Risk Classification: H224D
CATLIN Project No. 221166.04
Dear Mr. Ryals,
CATLIN Engineers and Scientists (CATLIN) is pleased to provide you with this letter report documenting well abandonment field activities performed in general accordance
with CATLIN proposal number 221166.4P, prepared February 16, 2023. Services were
authorized by the North Carolina Department of Environmental Quality (NCDEQ) Task Authorization (TA) #04, accepted February 16, 2023, and Contract Number N122019D. The approved scope of services for this Task Authorization included:
•Abandon seven (7) monitoring wells (MW-1D, MW-2R, MW-3R, MW-4, MW-5,MW-10, and MW-11); and
•Prepare a letter report documenting the site activities.
Monitoring Well Abandonment
On March 3, 2023, CATLIN personnel mobilized to the site and abandoned monitoring wells MW-1D, MW-2R, MW-3R, MW-4, MW-5, MW-10, and MW-11. Well construction
information and abandonment procedures for the wells are provided in the following table:
March 22, 2023Page 2 of 2
NCDEQ; 23331_Fox Harbour #14 CATLIN Engineers and Scientists
CATLIN Project No. 221166 March 2023
Well ID Well Type Well Depth (feet) Well Diameter (inches) Abandonment Procedure
MW-1D Deep 32.0 2.0 All well materials removed
MW-2R Shallow 11.5 2.0 All well materials removed
MW-3R Shallow 11.5 2.0 All well materials removed
MW-4 Shallow 13.0 2.0 All well materials
removed
MW-5 Shallow 13.0 2.0 All well materials removed
MW-10 Shallow 14.0 2.0 All well materials removed
MW-11 Shallow 14.0 2.0 All well materials removed
Monitoring wells MW-1D, MW-2R, MW-3R, MW-4, MW-5, MW-10, and MW-11 were abandoned under the direct supervision of a North Carolina Certified Well Contractor (CWC) according to guidance provided in the North Carolina Administrative Code (NCAC) Title 15A 02C .0113 (Abandonment of Wells). All well materials were removed, and the annular space was packed with bentonite chips to within four to six inches of the surface
while simultaneously pouring water to facilitate hydration. The remaining space was filled with concrete to the existing grade.
The well locations are shown on Figure 1 (Attachment A). The well abandonment records
were submitted to the NCDEQ Division of Water Quality on March 14, 2023; copies are provided in Attachment B. Photographs of the abandoned wells are included in Attachment C.
CATLIN Engineers and Scientists appreciates this opportunity to be of service. Should you have any questions or require additional information, please contact us at [phone].
Sincerely,
Benjamin J. Ashba, PG Project Manager
Attachments: A: Figure B: Well Abandonment Records C: Site Photographs
WI-2058_2331_CA_LTRRPT_20230322_Well_Abandonment
NCDEQ; 23331_Fox Harbour #14 CATLIN Engineers and Scientists
CATLIN Project No. 221166 March 2023
ATTACHMENT A
FIGURE
SITE LOCATIONUS HWY 70 W
OLD MURDOCH RDCopyright:© 2013 National Geographic Society, i-cubed
FIGUREPROJECTTITLE
1FOX HARBOUR #145338 US HWY 70 WEST
NEWPORT, NC SITE VICINITY MAP
2,000 0 2,000 4,0001,000
Feet
INCIDENT NO.JOB NO.DATE SCALE DRAWN BY/CHECKED BY23331221166MARCH 2023 AS SHOWN KMC/BJA
³
!(P !(P !(P !(P !(P
!(P
!(P
!(P
!(P
!(P
!(P
!(P
!(P
!(P!(P!(P !(P!(P !(P!(P!(P!(P!(P!(P !(P !(P
!>!>!>!>!>
!>
!>
!>!>!>!(>!(P
!(P
!(P
US HWY
7
0

W
MW-4
MW-11
MW-10 MW-9
MW-3R MW-6(CNL)
MW-1D
MW-7(CNL)
MW-8
MW-2RMW-5
WSW-3
FORMER USTS
FORMER ASTFORMER DIESEL DISPENSER
FORMER GASOLINE DISPENSER
WSW-1
WSW-2OLD MURDOCH RDSource: Esri, Maxar, Earthstar Geographics, and the GIS User Community
FIGUREPROJECTTITLE
2FOX HARBOUR #145338 US HWY 70 WEST
NEWPORT, NC SITE MAP
50 0 50 10025
Feet
INCIDENT NO.JOB NO.DATE SCALE DRAWN BY/CHECKED BY23331221166MARCH 2023 AS SHOWN KMC/BJA
NOTES: 1. Well and tank locations were obtained from previous reportsprepared by other consultants and are approximate.2. CNL = Could Not Locate
Parcel Boundary
Approximate Location
of Former UST System
Monitoring Well(Type II)!>
LEGEND
Active Potable
Water Supply Well!(P
Abandoned Monitoring
Well (Type III)!(>Abandoned PotableWater Supply Well!(P
³
Abandoned Monitoring Well (Type II)!>
NCDEQ; 23331_Fox Harbour #14 CATLIN Engineers and Scientists
CATLIN Project No. 221166 March 2023
ATTACHMENT B
WELL ABANDONMENT RECORDS
220 Old Dairy Road
Wilmington, NC 28405
[phone]
www.CatlinUSA.com
Wilmington, NC | Raleigh, NC | Washington, NC | Atlanta, GA
ENVIRONMENTAL | CIVIL | GEOTECHNICAL

Wilmington, NC | Raleigh, NC | Washington, NC | Atlanta, GA | Charleston, SC
March 14, 2023
North Carolina Department of Environmental Quality
Division of Water Quality
Information Processing
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Re: North Carolina Well Abandonment
NCDEQ – Fox Harbour #14
5338 US Hwy 70 West
Newport, North Carolina 28570
Incident Number: 23331
CATLIN Project No.: 221166
To Whom it May Concern,
CATLIN Engineers and Scientists (CATLIN) recently abandoned seven (7) monitoring
wells at the above referenced site. Attached to this letter are the completed North
Carolina Well Abandonment Records with associated Attachments for the site in
Newport, North Carolina.
If you have any questions or require additional information, please feel free to contact
us at [phone].
Sincerely,
Benjamin J. Ashba P.G. Corey D. Futral, CWC
Project Manager Project Geologist
Attachments
Well Abandonment Records and Site Map
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:
Corey D. Futral
4300-B
CATLIN Engineers and Scientists
NA
Bentonite Pellets
Concrete
~25lbs
~ 12.5 lbs
03/03/2023
Bentonite used to fill to ~5" below land surface.
Bentonite was hydrated to create seal and concrete was
used to bring the opening to grade.
NCDEQ - Newport, NC 00-0-0000025120
5338 US HWY 70 West, Newport, NC 28557 3/14/23
Carteret 6356.06.48.7344000
34.742423 -76.820116
MW-1D
32
8.25
4.30
NA
27
5
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:
Corey D. Futral
4300-B
CATLIN Engineers and Scientists
NA
Bentonite Pellets
Concrete
~ 16.7 lbs
~ 12.5 lbs
03/03/2023
Bentonite used to fill to ~5" below land surface.
Bentonite was hydrated to create seal and concrete was
used to bring the opening to grade.
NCDEQ - Newport, NC 00-0-0000025120
5338 US HWY 70 West, Newport, NC 28557 3/14/23
Carteret 6356.06.48.7344000
34.742423 -76.820116
MW-2R
11.5
8.25
2.45
NA
1.5
10
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:
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:
Corey D. Futral
4300-B
CATLIN Engineers and Scientists
NA
Bentonite Pellets
Concrete
~ 16.7 lbs
~ 12.5 lbs
03/03/2023
7g. Provide a brief description of the abandonment procedure:
Bentonite used to fill to ~6" below land surface.
Bentonite was hydrated to create seal and concrete was
used to bring the opening to grade.
NCDEQ - Newport, NC 00-0-0000025120
5338 US HWY 70 West, Newport, NC 28557 3/14/23
Carteret 6356.06.48.7344000
34.742423 -76.820116
MW-3R
11.5
8.25
3.20
NA
1.5
10
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:
Corey D. Futral
4300-B
CATLIN Engineers and Scientists
NA
Bentonite Pellets
Concrete
~ 16.7 lbs
~ 12.5 lbs
03/03/2023
Bentonite used to fill to ~4" below land surface.
Bentonite was hydrated to create seal and concrete was
used to bring the opening to grade.
NCDEQ - Newport, NC 00-0-0000025120
5338 US HWY 70 West, Newport, NC 28557 3/14/23
Carteret 6356.06.48.7344000
34.742423 -76.820116
MW-4
13
8.25
2.69
NA
3
10
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:
Corey D. Futral
4300-B
CATLIN Engineers and Scientists
NA
Bentonite Pellets
Concrete
~ 12.5 lbs
~ 12.5 lbs
03/03/2023
Bentonite used to fill to ~4" below land surface.
Bentonite was hydrated to create seal and concrete was
used to bring the opening to grade.
NCDEQ - Newport, NC 00-0-0000025120
5338 US HWY 70 West, Newport, NC 28557 3/14/23
Carteret 6356.06.48.7344000
34.742423 -76.820116
MW-5
13
8.25
2.30
NA
3
10
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:
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:
Corey D. Futral
4300-B
CATLIN Engineers and Scientists
NA
Bentonite Pellets
Concrete
~ 16.7 lbs
~ 12.5 lbs
03/03/2023
7g. Provide a brief description of the abandonment procedure:
Bentonite used to fill to ~6" below land surface.
Bentonite was hydrated to create seal and concrete was
used to bring the opening to grade.
NCDEQ - Newport, NC 00-0-0000025120
5338 US HWY 70 West, Newport, NC 28557 3/14/23
Carteret 6356.06.48.7344000
34.742423 -76.820116
MW-10
14
8.25
2.58
NA
2
12
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:
Corey D. Futral
4300-B
CATLIN Engineers and Scientists
NA
Bentonite Pellets
Concrete
~25lbs
~ 12.5 lbs
03/03/2023
Bentonite used to fill to ~6" below land surface.
Bentonite was hydrated to create seal and concrete was
used to bring the opening to grade.
NCDEQ - Newport, NC 00-0-0000025120
5338 US HWY 70 West, Newport, NC 28557 3/14/23
Carteret 6356.06.48.7344000
34.742423 -76.820116
MW-11
14
8.25
2.19
NA
2
12
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US HWY
7
0

W
MW-4
MW-11
MW-10 MW-9
MW-3R MW-6(CNL)
MW-1D
MW-7(CNL)
MW-8
MW-2RMW-5
WSW-3
FORMER USTS
FORMER ASTFORMER DIESEL DISPENSER
FORMER GASOLINE DISPENSER
WSW-1
WSW-2OLD MURDOCH RDSource: Esri, Maxar, Earthstar Geographics, and the GIS User Community
FIGUREPROJECTTITLE
1
FOX HARBOUR #145338 US HWY 70 WEST
NEWPORT, NC SITE MAP
50 0 50 10025
Feet
INCIDENT NO.JOB NO.DATE SCALE DRAWN BY/CHECKED BY23331221166MARCH 2023 AS SHOWN KMC/BJA
NOTES: 1. Well and tank locations were obtained from previous reportsprepared by other consultants and are approximate.2. CNL = Could Not Locate
Parcel Boundary
Approximate Location
of Former UST System
Monitoring Well(Type II)!>
LEGEND
Active Potable
Water Supply Well!(P
Abandoned Monitoring
Well (Type III)!(>Abandoned PotableWater Supply Well!(P
³
Abandoned Monitoring Well (Type II)!>

NCDEQ; 23331_Fox Harbour #14 CATLIN Engineers and Scientists
CATLIN Project No. 221166 March 2023

ATTACHMENT C SITE PHOTOGRAPHS

ATTACHMENT C SITE PHOTOGRAPHS – MARCH 3, 2023
NCDEQ; 23331_Fox Harbour #14 CATLIN Engineers and Scientists
CATLIN Project No. 221166 March 2023
Fox Harbour #14 MW-2 Abandoned
Fox Harbour #14 MW-1D Abandoned
ATTACHMENT C SITE PHOTOGRAPHS – MARCH 3, 2023
NCDEQ; 23331_Fox Harbour #14 CATLIN Engineers and Scientists
CATLIN Project No. 221166 March 2023

Fox Harbour #14 MW-5 Abandoned
Fox Harbour #14
MW-3R
Abandoned
ATTACHMENT C SITE PHOTOGRAPHS – MARCH 3, 2023
NCDEQ; 23331_Fox Harbour #14 CATLIN Engineers and Scientists
CATLIN Project No. 221166 March 2023

Fox Harbour #14
MW-10
Abandoned
Fox Harbour #14 MW-4 Abandoned
ATTACHMENT C SITE PHOTOGRAPHS – MARCH 3, 2023
NCDEQ; 23331_Fox Harbour #14 CATLIN Engineers and Scientists
CATLIN Project No. 221166 March 2023

Fox Harbour #14 MW-11 Abandoned