WS-2403_2860_CA_LTTRPT_20230621_MW Abandon

WithersRavenel
Our People. Your Success. 

115 MacKenan Drive | Cary, NC 27511 
t: 919.469.3340 | f: 919.467.6008 | www.withersravenel.com | License No. F‐1479 
Asheville | Cary | Charlotte | Greensboro | Pittsboro | Raleigh | Southern Pines | Wilmington 

June 21, 2023 

State of North Carolina 
Department of Environmental Quality 
Division of Waste Management 
Underground Storage Tank Section 
Federal & State Lead Program 
1646 Mail Service Center 
Raleigh, North Carolina 27699‐1646 

Attn: Ms. Linda Blalock 

Reference:   Letter Report – Monitoring Well Abandonment 
Seats Country Store 
2513 Courtney‐Huntsville Road 
Yadkinville, Yadkin County, North Carolina 
Groundwater Incident Number: 2860 
UST Number: WS‐2403 
WR Project Number:  23‐0307‐EB 

Dear Ms. Blalock: 

WithersRavenel, Inc. (WR) has completed this Letter Report to document the abandonment of site 
monitoring wells MW‐1 through MW‐7. This event was described in our proposal numbered Task 
Authorization (TA)‐01, approved by the Federal & State Lead Program on May 12, 2023 under 
North Carolina Department of Environmental Quality (NCDEQ) Contract #N70522‐C. The 
enclosed report summarizes the results of the recently completed activities.   
Monitoring Well Abandonment 
WR mobilized a licensed North Carolina driller to the Seats Country Store site located at 2513 
Courtney‐Huntsville Road in Yadkinville, Yadkin County, North Carolina on May 25, 2023 for the 
purposes of abandoning monitoring wells MW‐1 through MW‐7. The general site location is 
depicted on Figure 1 and the locations of the site monitoring wells are depicted on Figure 2. 
Monitoring well construction information is included on Table B‐7. 
Bentonite pellets were poured into the well at a rate of 10 pounds per minute per the 
manufacturer’s recommendations.  Bentonite was used to fill the screen and casing until one foot 
from the top of casing. The remaining casing was filled with concrete until flush with surrounding 
grade. The manways were not replaced after abandonment. A photographic record is included in 
Appendix A and the well abandonment record is attached as Appendix B. 

WithersRavenel
Our People. Your Success. 

Seats Country Store (NCDEQ Incident # 2860)              Monitoring Well Abandonment    
June 2023  Page 2 of 2 
The well abandonment records and photographic documentation of the abandoned wells are 
included in the appendix. 
WR appreciates the opportunity to be of service to the Federal & State Lead Program.  Should you 
have any questions regarding the attached, please do not hesitate to contact us at (919) 469‐3340. 

Cordially, 

WithersRavenel
  Flora D’Souza, CHMM Elizabeth A. Allyn, P.G. 
Environmental Project Scientist II Environmental Project Geologist II 

Attachments: 
Figures 
Well Abandonment Record (GW‐30) 
Photographic Record 

FIGURES 

CBM
LA
DRAWN BY:
06/21/23 23-0307-EB
1
SUBJECT SITE
±2.00 ACRES
SCALE:FIGURE NO.:
PROJECT NO.:DATE:APPROVED BY:
SEATS COUNTRY STORE
TF-2860
2513 COURTNEY-HUNTSVILLE ROAD
YADKINVILLE, YADKIN COUNTY, NC
GENERAL LOCATION MAP
1"=1000 '
GRAPHIC SCALE
1 inch = 1000 ft.
0 1000500 2000
WithersRavenel
Engineers | Planners | Surveyors
115 MacKenan Drive | Cary, NC 27511 | t: 919.469.3340 | license #: F-1479
www.withersravenel.com
MW-3 (ABANDONED)MW-2 (ABANDONED)State MW(ABANDONED)MW-5(ABANDONED)FORMER SEATSCOUNTRY STOREGARAGERONNIESEATSRESIDENCESEATS ROADCOURTNEY-HUNTSVILLE ROADSW-2 (IRRIGATION)SW-3 (ABANDONED)COURTNEYELEMENTARYSCHOOLMW-6 (ABANDONED)MW-7 (ABANDONED)MW-1(ABANDONED)MW-4(ABANDONED)SW-1 (ABANDONED)UST-1CBMLADRAWN BY:06/21/2323-0307-EB2SCALE:FIGURE NO.:PROJECT NO.:DATE:APPROVED BY:SEATS COUNTRY STORETF-28602513 COURTNEY-HUNTSVILLE ROADYADKINVILLE, YADKIN COUNTY, NCSITE MAPWithersRavenelEngineers | Planners | Surveyors115 MacKenan Drive | Cary, NC 27511 | t: 919.469.3340 | license #: F-1479 | www.withersravenel.com1"=60 '6030120LEGENDTYPE II MONITORING WELL LOCATIONWATER SUPPLY WELL LOCATIONNOTES: 1.) 2013 AERIAL OBTAINED FROM THE LOCAL COUNTY GIS DEPARTMENT.UST

TABLE 

Well ID Date of 
Installation
Screened 
Interval 
(feet)
Total Depth 
(feet below ground surface)
Well Diameter 
(inches)
Top‐of‐Casing 
Elevation (feet)
Date Water Level 
Measured
Depth‐to‐LNAPL
(feet)
Depth‐to‐Water
Uncorrected(feet)
LNAPL Thickness
(feet)
Groundwater Surface
Elevation          
(feet)
9/11/2006 NM 26.90 NM 73.10
9/23/2012 NM 29.34 NM 70.66
4/12/2018 NM 12.40 NM 87.60
5/27/2020 NM 10.51 NM 89.49
6/25/2020 NM 11.22 NM 88.78
9/8/2020 NM 13.63 NM 86.37
4/26/2021 NM 12.85 NM 87.15
6/21/2021 NM 14.74 NM 85.26
4/18/2022 NM 11.23 NM 88.77
8/5/2022 NM 14.85 NM 85.15
2/16/2023 NM 9.37 NM 90.63
5/25/2023
9/11/2006 NM 25.95 NM 74.27
9/23/2012 NM 21.74 NM 78.48
4/12/2018 NM 11.22 NM 89.00
5/27/2020 NM 6.05 NM 94.17
6/25/2020 NM 8.56 NM 91.66
9/8/2020 NM 10.30 NM 89.92
4/26/2021 NM 9.58 NM 90.64
6/21/2021 NM 12.03 NM 88.19
4/18/2022 NM 7.99 NM 92.13
8/5/2022 NM 12.80 NM 87.32
2/16/2023 NM NM NM NM
5/25/2023
9/11/2006 NM 25.65 NM 74.21
9/23/2012 NM 30.34 NM 69.52
4/12/2018 NM 13.64 NM 86.22
5/27/2020 NM 9.54 NM 90.32
6/25/2020 NM 9.54 NM 90.32
9/8/2020 NM 11.87 NM 87.99
4/26/2021 NM 13.59 NM 86.27
6/21/2021 NM 16.04 NM 83.82
4/18/2022 NM 12.96 NM 86.89
8/5/2022 NM 16.60 NM 83.25
2/16/2023 NM 10.42 NM 89.43
5/25/2023
5/27/2020 NM 5.27 NM 95.16
6/25/2020 NM 7.09 NM 93.34
9/8/2020 NM 8.46 NM 91.97
4/26/2021 NM 7.99 NM 92.44
6/21/2021 NM 10.19 NM 90.24
4/18/2022 NM 5.52 NM 94.78
8/5/2022 NM 10.80 NM 89.50
2/16/2023 NM 4.27 NM 96.03
5/25/2023
5/27/2020 NM 6.97 NM 91.24
6/25/2020 NM 7.55 NM 90.66
9/8/2020 NM 8.12 NM 90.09
4/26/2021 NM 7.40 NM 90.81
6/21/2021 NM 9.42 NM 88.79
4/18/2022 NM 5.63 NM 92.57
8/5/2022 NM 10.10 NM 88.10
2/16/2023 NM 4.58 NM 93.62
5/25/2023
Abandoned
100.00
100.22
99.86
100.43
98.21
23 2
2
2
25
2
MW‐5 5/12/2020 10‐25
45
5/12/2020 8‐23
TABLE B‐7MONITORING WELL CONSTRUCTION INFORMATION AND LIQUID LEVEL DATA
Seats Country StoreIncident # 2860
2513 Courtney‐Huntsville Road
Yadkinville, Yadkin County, North Carolina
MW‐2 9/6/2006 15‐45 45
MW‐1
MW‐3 9/6/2006 15‐45 45
MW‐4
2
9/6/2006 20‐45
100.00
100.12
99.85
100.30
98.20
Abandoned
Abandoned
Abandoned
Abandoned
Page 1 of 2
Well ID Date of 
Installation
Screened 
Interval 
(feet)
Total Depth 
(feet below ground surface)
Well Diameter 
(inches)
Top‐of‐Casing 
Elevation (feet)
Date Water Level 
Measured
Depth‐to‐LNAPL
(feet)
Depth‐to‐Water
Uncorrected(feet)
LNAPL Thickness
(feet)
Groundwater Surface
Elevation          
(feet)
TABLE B‐7MONITORING WELL CONSTRUCTION INFORMATION AND LIQUID LEVEL DATA
Seats Country StoreIncident # 2860
2513 Courtney‐Huntsville Road
Yadkinville, Yadkin County, North Carolina
9/8/2020 NM 6.97 NM 92.70
6/21/2021 NM 10.58 NM 89.09
4/18/2022 NM 6.94 NM 92.62
8/5/2022 NM 11.25 NM 88.31
2/16/2023 NM 8.51 NM 91.05
5/25/2023
9/8/2020 NM 6.97 NM 85.32
6/21/2021 NM 3.79 NM 88.50
4/18/2022 NM 0.00 NM 92.29
8/5/2022 NM 4.35 NM 87.94
2/16/2023 NM 0.00 NM 92.29
5/25/2023
1)
2)3)Groundwater elevation adjusted for LNAPL is [Top of Casing Elevation ‐ Depth to Water] + [LNAPL Thickness * 0.8581]4)NM = Not Measured.
Prior Top of Casing (TOC) elevations and monitoring well construction information obtained from September 29, 2020 report prepared by S&ME, Inc.
LNAPL ‐ Light Non‐Aqueous Phase Liquid
20 2
20 2
MW‐6 9/3/2020 5‐20
9/3/2020 5‐20
Notes: 
MW‐7
99.56
92.24
92.29
99.67
Abandoned
Abandoned
Page 2 of 2

WELL ABANDONMENT RECORDS 
(GW‐30) 

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:
MW-1 (25 ft)MW-2,3 (30 ft)MW-4,5,6,7 (15 ft)
MW-1,2,3 (45 ft)MW-4 (23 ft)MW-5 (25 ft)MW-6,7 (20 ft)

PHOTOGRAPHIC RECORD 

 Photo 1:  
General site photograph facing north. 

 Photo 2:  
View of MW‐1 following the abandonment. 

  Photo 3:  
View of MW‐2 following the abandonment. 

 Photo 4:  
View of MW‐3 following the abandonment. 

  Photo 5:  
View of MW‐4 following the abandonment. 

 Photo 6:  
View of MW‐5 following the abandonment. 

  Photo 7:  
View of MW‐6 following the abandonment. 

 Photo 8:  
View of MW‐7 following the abandonment.