WS-2854_7121_CA_WR_20221130

Arcadis G&M of North
Carolina, Inc.
3540 Toringdon Way
Suite 220
Charlotte
North Carolina 28277
Phone: [phone]
www.arcadis.com
1/1
Mr. Gene Mao
Hydrogeologist
Environmental Health Division
Guilford County Department of Health and Human Services
400 West Market Street, Suite 300
Greensboro, North Carolina 27401
Date: November 30, 2022
Our Ref: 30091981
Subject: Permit Application Package
Former Piedmont Natural Gas, Inc. Operations Center
1029 Winston Street, Greensboro, Guilford County, NC
Incident Number: 7121, Risk Classification: Intermediate
Dear Mr. Mao,
Arcadis G&M of North Carolina, Inc. has prepared the enclosed monitoring well permit application package, on
behalf of Piedmont Natural Gas Company, Inc. (PNG), for the Former PNG Operations Center located at 1029
Winston Street in Greensboro, Guilford County, North Carolina (the site). The site is approximately 1.55 acres in
size, and historical operations included fueling and maintenance activities associated with PNG’s service vehicles.
The site is currently owned by The North Carolina A&T Real Estate Foundation, Inc., and is zoned as Industrial. On
October 4, 2022, Parratt-Wolff, Inc. installed one monitoring well, MW-3R, as a replacement to previous monitoring
well MW-3. Additionally, on October 10 and 11, 2022, JG Drilling, LLC completed the abandonment of 32 monitoring
wells (MW-5, MW-12, MW-14D, MW-15, MW-16, MW-17D, MW-19, MW-20D, RH-21D, RH-22D, RH-23D, MW-
24D, MW-25, RH-26D, MW-27D, MW-28M, RH-29D, MW-30D, MW-33D, MW-34, MW-35D, MW-37, MW-38, MW-
39, MW-41, MW-42, MW-44, MW-45, MW-46D, MW-47D, MW-47M, and MW-48D) in accordance with North
Carolina Administrative Code 15A 02C.0100 standards. Although intended for abandonment, monitoring well MW-43
was unable to be located, despite multiple efforts, including georeferencing and probing. Monitoring well MW-43
shall be considered unable to be located and, therefore, abandoned. There are 11 monitoring wells remaining at the
facility following completion of these referenced installation and abandonment activities.
If you have any questions or comments regarding the permit application, please feel free to contact me at 864-
987-3922.
Sincerely,
Arcadis G&M of North Carolina, Inc.
Jonathon H. Ball, P.E.
Certified Project Manager
Email: [e-mail]
Direct Line: 864 987 3922
CC. Christopher Gilbert, PNG
Enclosure: Application for Installation of Groundwater Monitoring Well, Air Injection Well, Air Sparging Well, or
Recovery Well
GUILFORD COUNTY DEPARTMENT OF PUBLIC HEALTH
DIVISION OF ENVIRONMENTAL HEALTH
APPLICATION FOR INSTALLATION OF GROUNDWATER MONITORING WELL,
AIR INJECTION WELL, AIR SPARGING WELL, OR RECOVERY WELL
Date: __11/7/2022___________New: £
Amendment: £ Existing Permit Number: 052-05-MW47-RW0
In accordance with the provision of the Guilford County Well Rules, application is hereby made for a well installation permit.
1.Site Name: ____________________________________________________ Incident #: __________
2.Address of Well(s): ___________________________________________________________________
3.Type and Number of wells to be constructed: Monitoring __ Air Injection __ Air Sparging __ Recovery __
4.Name of Well Owner: _________________________________________________________________
5.Name of Contact Person: _________________________________________ Telephone:
____________
6.Mailing Address of Well Owner: _____555-A Brevard Road_________________________________City: _Asheville__________ State: __NC___ Zip: _28806_____
7. Property Owner (if different from well owner): _____________________________________________
8. Property Owner’s Mailing Address: ______________________________________________________
9. Reason for Well Installation: ____________________________________________________________
(e.g. non-discharge permit, suspected contamination, environmental assessment, etc.)
10. Type of Facility for which the well is needed: ______________________________________________
(e.g. non-discharge facility, waste disposal site, landfill, underground storage tank, etc.)
11. Contaminant Type (if known): _________________________________________________________
(e.g. nutrient, organics, petroleum, heavy metals, etc.)
12.Are there any existing recovery wells? ____________________________________________________
If yes, how many? _______________________ Permit Number: ________________________
13.Distance to a known waste or pollution source: ___0____________ feet
14.Are there any wells located less than 500 feet from the proposed well? ______
If yes, give the distance: ___75____ feet
Fee: $ __________
Date: ___________
15.Well Driller: __Parratt-Wolff, Inc.___________________________
16.Registration Number: ___4473______________________________
17.Well Driller Address: ____501 Millstone Drive_________________
Receipt #: _________
Received by: ______
__Hillsborough, NC 27278________________
Telephone: ____919-644-2814___________________
Additional Information
1.Attach a map showing the location of the following:
(a) Proposed well(s)
(b) All existing wells and test boring within the property boundary
(c) All water supply wells (if any) within 500 feet of the well
(d) At least two reference points (e.g. numbered roads, intersections, streams, etc.)
2. Provide a well construction information and diagram for each well (separate pages).
The Well Owner hereby agrees that the proposed well(s) will be constructed in accordance with specifications
and conditions set forth in Guilford County Well Rules and accepts full responsibility for compliance with
these rules.
__________________________________________________________
Signature of Well Owner Title
Address: ____________________________________________________________________
Telephone: ________________________________
If the property is owned by someone other than the well owner, the property owner hereby consents to allow the
well owner to construct wells as outlined in this application and that it shall be the responsibility of the
well owner to ensure that these wells confirm to the Guilford County Well Rules.
____________________________________________
Signature of Property Owner (if different the well owner)
(Attach agreements)
CW Professional
526 S. Church Street, Mail Code EC13K, Charlotte, North Carolina 28202
828-713-0097
MW-3R
MW-2
MW-7
MW-13
MW-32
MW-36D RH-21D
RH-29D
MW-34
MW-24D
MW-33D
MW-37
MW-39MW-47 M/D
MW-11D
MW-20DMW-17D MW-14DMW-30D
MW-4
MW-5
MW-16RH-22D
MW-15
MW-19
MW-25
MW-26D
MW-41
MW-43*
MW-46 D
MW-45
MW-42
MW-44
MUDDY CREEKE. WENDOVER AV
E
OFF RAMPHUFFMAN STREETMW-9
MW-10
MW-18
MW-35D
MW-38
WINSTON STE.BESSEMER AVETUCKER STFORMER PIEDMONT
NATURAL GAS
SERVICE OPERATIONS
CENTER
MW-6
MW-12
MW-3 MW-1
MW-8
MW-27D
MW-28M
MW-28D
MW-48D
FIGURE1
C:\Users\tfatto\ACCDocs\Arcadis\AUS-DUKE ENERGY-FORMER GREENSBORO MGP-GREENSBORO North Carolina\Project Files\2022\01-In Progress\01-DWG\GEN-SITE LAYOUT.dwg LAYOUT: 2 SAVED: 10/19/2022 9:29 AM ACADVER: 24.2S (LMS TECH) PAGESETUP: ---- PLOTSTYLETABLE:
PLTFULL.CTB PLOTTED: 10/19/2022 9:30 AM BY: FATTO, TRACEY
Former Tank Basin
Parcel Boundaries
LEGEND
Monitoring Well Location
Stream
SITE LAYOUT
PIEDMONT NATURAL GAS COMPANY, INC.FORMER SERVICE OPERATIONS CENTER
1029 WINSTON STREET, GREENSBORO, NORTH CAROLINA
Surface Water Flow Direction
Bedrock Monitoring Well Location
0 180'90'
GRAPHIC SCALE
MW-36D
MW-10
SOURCES:
AERIAL IMAGE FROM © 2022 Microsoft Corporation
© 2022 Maxar © CNES (2022) Distribution Airbus DS
PARCEL INFORMATION FROM
https://www.nconemap.gov/pages/parcels, Guilford
County dataset, July 2022
Monitoring Well Location (Abandoned)
Bedrock Monitoring Well Location
(Abandoned)MW-35D
MW-38
Could Not Locate Monitoring WellMW-43*
LAND SURFACE
8 inch diameterdrilled hole
Well casing,
inch diameter,
Schedule 40 PVC
Backfill
X Grout Portland cement
ft*
Bentonite slurry
ft*X pellets
ft*
Well Screen.
inch diameter
,0.010 slot,
Gravel Pack
X Sand Pack
Formation Collapse
ft*
ft*
Measuring Point isTop of Well CasingUnless Otherwise Noted.
* Depth Below Land Surface
Sch. 40
pre-pack
20
20
2
6
8
10
2
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:
Certification:
ature of Certified Well Contractor or Wel
Jeffrey Grant
4328-B One
11
JG Drilling, LLC
N/A
N/A
Neat Cement 7 gallons
Bentonite 95 pounds
Oct(10th&11th)2022
Grouted well in place.
Piedmont Natural Gas Company.
1029 Winston Street, Greensboro, 27405 10-12-22
Guilford
MW-5
25
4
7.9
15
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 wellabandonment 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: