FA-704_12745_CA_WR_20231006_MWsAaband

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 

October 6, 2023 

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

Attn: Mr. Hassan Osman 

Reference:   Letter Report – Monitoring Well Abandonment 
 Del & Ruby’s 
6545 & 6547 Faison Highway 
Faison, Sampson County, North Carolina 
Groundwater Incident Number: 12745 
UST Number: FA‐704 
WR Project Number:  23‐0307‐BD 

Dear Mr. Osman: 

WithersRavenel, Inc. (WR) has completed this Letter Report to document the abandonment of site 
monitoring wells MW‐1 through MW‐12 with MW‐2 and MW‐8 already being destroyed. This 
event was described in our proposal numbered Task Authorization (TA)‐02, approved by the 
Federal & State Lead Program on July 17, 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 Del & Ruby’s site located at 6545 & 6547 
Faison Highway in Faison, Sampson County, North Carolina on September 8, 2023 for the 
purposes of abandoning monitoring wells MW‐1, MW‐3, MW‐4, MW‐5, MW‐6, MW‐7, MW‐9, 
MW‐10, MW‐11, and MW‐12. 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 replaced after abandonment at locations that were in walkable areas of 
the site. The well abandonment record is attached as Appendix A and the photographic record is 
included in Appendix B. 

WithersRavenel
Our People. Your Success. 

Del & Ruby’s (NCDEQ Incident # 12745)              Monitoring Well Abandonment    
October 2023  Page 2 of 2 

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

Cory Nobles, P.G. Elizabeth A. Allyn, P.G.  
Environmental Geologist II Environmental Project Geologist II  

Attachments: 
Figures 
Table 
Appendix A ‐ Well Abandonment Record (GW‐30) 
Appendix B ‐ Photographic Record 

FIGURES 

KBB
LA
DRAWN BY:
06/20/2023 23-0307-BD
1
SUBJECT SITE
±1.16 ACRES
(CALCULATED)
SCALE:FIGURE NO.:
PROJECT NO.:DATE:APPROVED BY:
DEL & RUBY'S
(TF#12745)
6545 FAISON HIGHWAY
FAISON, SAMPSON COUNTY, NC
GENERAL LOCATION MAP
1"=1000 '
1000500 2000
WithersRavenel
Engineers | Planners | Surveyors
115 MacKenan Drive | Cary, NC 27511 | t: 919.469.3340 | license #: F-1479
www.withersravenel.com
0
GRAPHIC SCALE
1 inch = 1000 feet
MW-6(ABANDONED)MW-9(ABANDONED)
MW-2
(DESTROYED)MW-1(ABANDONED)
TW-2
(ABANDONED)
MW-12(ABANDONED)
MW-3(ABANDONED)
MW-5(ABANDONED)MW-7(ABANDONED)
TW-1
(ABANDONED)
MW-11(ABANDONED
DIESEL UST BASIN
GASOLINE UST BASIN
KEROSENE
UST BASIN
ORPHAN UST
SW-1
(INACTIVE)
KEENER ROAD FAISON HIGHWAYMW-4 (ABANDONED)
MW-10(ABANDONED)
MW-8
(DESTROYED)
LEGEND
TYPE II MONITORING WELL LOCATION
WATER SUPPLY WELL LOCATION
NOTES:
1.) 2021 AERIAL OBTAINED FROM NC ONE MAP.1 inch = 50 ft.
5025 100
GRAPHIC SCALE
0
KBB
LA
DRAWN BY:
1"=50 '
10/06/2023 23-0307-BD
2
SCALE:FIGURE NO.:
PROJECT NO.:DATE:APPROVED BY:
WithersRavenel
Engineers | Planners | Surveyors
115 MacKenan Drive | Cary, NC 27511 | t: 919.469.3340 | license #: F-1479
www.withersravenel.com SITE MAP
DEL & RUBY'S
(TF#12745)
6545 FAISON HIGHWAY
FAISON, SAMPSON COUNTY, NC

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)
11/16/2007 NM 3.13 NM 93.37
9/15/2010 NM 3.50 NM 93.00
5/6/2013 NM 2.80 NM 93.70
1/6/2015 NM 0.90 NM 95.60
2/5/2018 NM 0.86 NM 95.64
3/5/2019 NM 0.73 NM 95.77
5/14/2020 NM 1.69 NM 94.81
5/11/2021
9/8/2023
MW‐2 12/12/1992 2‐12 12 2 96.02 9/15/2010
9/15/2010 NM 2.69 NM 92.55
5/6/2013 NM 1.60 NM 93.64
1/6/2015 NM 0.40 NM 94.84
2/5/2018 NM 0.00 NM 95.24
3/5/2019
5/14/2020 NM 0.90 NM 94.34
5/11/2021 NM 0.80 NM 94.44
5/23/2023 NM 1.58 NM 93.66
9/8/2023
9/15/2010 NM 2.84 NM NS
5/6/2013 NM 2.51 NM NS
1/6/2015 NM 1.60 NM NS
2/5/2018 NM 1.14 NM NS
3/5/2019 NM 0.00 NM NS
5/14/2020 NM 2.24 NM NS
5/11/2021 NM 2.20 NM NS
5/23/2023 NM 2.61 NM NS
9/8/2023
11/16/2007 NM 4.33 NM 91.69
9/15/2010 NM 5.41 NM 90.61
5/6/2013 NM 4.20 NM 91.82
1/6/2015 NM NM NM NM
2/5/2018 NM 2.57 NM 93.45
3/5/2019 NM 2.67 NM 93.35
5/14/2020 NM 3.54 NM 92.48
5/11/2021 NM 3.90 NM 92.12
5/23/2023 NM 4.08 NM 91.94
9/8/2023
11/16/2007 NM 2.42 NM 95.08
9/15/2010 NM NM NM NM
5/6/2013 NM NM NM NM
1/6/2015 NM NM NM NM
2/5/2018 NM NM NM NM
3/5/2019 NM NM NM NM
5/14/2020 NM NM NM NM
5/11/2021 NM NM NM NM
5/23/2023 NM NM NM NM
9/8/2023
11/16/2007 NM 2.33 NM 91.77
9/15/2010 NM 3.90 NM 90.20
5/6/2013 NM 2.60 NM 91.50
1/6/2015 NM NM NM NM
2/5/2018 NM 0.15 NM 93.95
3/5/2019 NM 0.25 NM 93.85
5/14/2020 NM 2.23 NM 91.87
5/11/2021 NM 2.40 NM 91.70
5/23/2023 NM 2.69 NM 91.41
9/8/2023
MW‐7 7/29/2002 2‐12 12 2
MW‐4 8/30/1994 2‐12 12 2
MW‐5 8/30/1994 2‐12 12 2
Faison, Sampson County, North Carolina
MW‐1 12/12/1992 96.50
MW‐3 8/30/1994 2‐12 12 2
97.50MW‐6 7/30/2002
TABLE B‐7MONITORING WELL CONSTRUCTION INFORMATION AND LIQUID LEVEL DATA
Del & Ruby'sIncident # 12745
6545 & 6547 Faison Highway
12
95.24
2‐12
Destroyed
2‐12 12 2
Not Surveyed (NS) 
96.02
94.10
Well Under Water
Abandoned
2
Not Located
Abandoned
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)
Faison, Sampson County, North Carolina
TABLE B‐7MONITORING WELL CONSTRUCTION INFORMATION AND LIQUID LEVEL DATA
Del & Ruby'sIncident # 12745
6545 & 6547 Faison Highway
11/16/2007 NM 2.75 NM 94.41
9/15/2010 NM 3.39 NM 93.77
5/6/2013 NM 2.75 NM 94.41
1/6/2015 NM 0.90 NM 96.26
2/5/2018 NM 1.55 NM 95.61
3/5/2019 NM 0.25 NM 96.91
5/14/2020 NM 1.04 NM 96.12
5/11/2021 NM 1.30 NM 95.86
5/23/2023
11/16/2007 NM 2.63 NM 98.73
9/15/2010 NM 3.09 NM 98.27
5/6/2013 NM 2.77 NM 98.59
1/6/2015 NM NM NM NM
2/5/2018 NM 0.75 NM 100.61
3/5/2019 NM 0.00 NM 101.36
5/14/2020 NM 0.94 NM 100.42
5/11/2021 NM 1.00 NM 100.36
5/23/2023 NM 2.78 NM 98.58
9/8/2023
11/16/2007 NM 3.25 NM 94.81
9/15/2010 NM 4.07 NM 93.99
5/6/2013 NM 3.39 NM 94.67
1/6/2015 NM 2.10 NM 95.96
2/5/2018 NM 1.81 NM 96.25
3/5/2019 NM 1.91 NM 96.15
5/14/2020 NM 2.97 NM 95.09
5/11/2021 NM 2.56 NM 95.50
5/23/2023 NM 3.59 NM 94.47
9/8/2023
11/16/2007 NM 4.42 NM 91.45
9/15/2010 NM 3.31 NM 92.56
5/6/2013 NM 1.85 NM 94.02
1/6/2015 NM NM NM NM
2/5/2018 NM 0.30 NM 95.57
3/5/2019 NM 0.16 NM 95.71
5/14/2020 NM 1.64 NM 94.23
5/11/2021
5/23/2023
9/8/2023
11/16/2007 NM 4.42 NM 93.49
9/15/2010 NM 2.17 NM 95.74
5/6/2013 NM NM NM NM
1/6/2015 NM 1.40 NM 96.51
2/5/2018 NM 1.13 NM 96.78
3/5/2019 NM 0.88 NM 97.03
5/14/2020 NM 1.91 NM 96.00
5/11/2021 NM 1.36 NM 96.55
5/23/2023 NM 3.09 NM 94.82
9/8/2023
1)
2)
3)4)
Abandoned
Not Located
Abandoned
MW‐9 7/30/2002 2‐12 12
MW‐10
MW‐11 1/7/2003 2‐10 10
7/29/2002 2‐12 12
MW‐12 4/9/2011 2‐12 12 2
MW‐8 7/29/2002 25‐35 35 6/2 (Type III)
Notes: Top of Casing (TOC) elevations and monitoring well construction information obtained from July 1, 2020 report prepared by S&ME, Inc and files available on NCDEQ Laserfiche.
LNAPL ‐ Light Non‐Aqueous Phase Liquid
Groundwater elevation adjusted for LNAPL is [Top of Casing Elevation ‐ Depth to Water] + [LNAPL Thickness * 0.8581]
NM = Not Measured.
97.16
95.87
97.91
2 101.36
Destroyed
Abandoned
2
2 98.06
Not Located
Abandoned
Page 2 of 2

APPENDIX A 

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:

APPENDIX B 

PHOTOGRAPHIC RECORD 

 Photo 1:  
General site photograph facing southwest. 

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

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

 Photo 4:  
View of MW‐4 following the abandonment (lid was removed after photo). 

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

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

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

 Photo 8:  
View of MW‐9 following the abandonment (lid was removed after photo). 

  Photo 7:  
View of MW‐10 following the abandonment. 

 Photo 8:  
View of MW‐11 following the abandonment. 

  Photo 7:  
View of MW‐12 following the abandonment (lid was removed after photo).