1804_1812_DukeMarshall_AbandonmentCompletionReport_FID1826674_20240122

DUKE
ENERGY
January 22, 2024
North Carolina Department of Environmental Quality
Division of Waste Management
Solid Waste Section
2090 U.S. Highway 70
Swannanoa, NC 28778
Attn: Ms. Sarah Moutos (submitted electronically)
Re: Piezometer and Monitoring Well Abandonment Completion Report
Dry Ash Landfill Phase II and Industrial Landfill No.1
Permit No.: 1804-INDUS-1983 and 1812-INDUS-2008
Marshall Steam Station
Terrell, North Carolina 28682
Dear Ms. Moutos:
525 S. Tryon St.
Charlotte NC, 28202
The Solid Waste Section approved Duke Energy's request for abandoning one monitoring well (MW-3) associated
with the Dry Ash Landfill Phase II (1 804-INDUS-1 983) in a letter dated October 6, 2023 as well as two
piezometers (CLF-301 and CLF-305) associated with Industrial Landfill No.1 (1812-INDUS-2008) Phases 3 in a
separate letter dated November 30, 2023.
Duke Energy is providing the well abandonment records for the one monitoring well and two piezometers in this
submittal. The abandonments were conducted by S&ME on December 13-14, 2023. Pre -abandonment
groundwater levels are included on Table 1 of the attached report.
Note, there are several ash basin groundwater monitoring wells that were approved for abandonment by the
NCDEQ Division of Water Resources (DWR) and abandoned during the same time as the solid waste monitoring
locations. Abandonment records for these locations are included in this submittal which will be provided to NCDEQ
DWR separately.
Abandonment records were submitted separately to the NCDEQ Information Processing Unit.
If you need additional information regarding this submittal do not hesitate to email or call me at Ashlev.Healy(a-).duke-
energy.com or [phone].
Respectfully submitted,
j4VAi
Ashley Healy, P.G.
Environmental Services
Attachments: Completion Report for Monitoring Well Abandonments (S&ME, January 2024)
cc (via e-mail): Claire Osborn, NCDEQ
Sherri Stanley, NCDEQ
Ed Mussler, NCDEQ
Dan Zakary, Duke Energy
Scott Saunders, Duke Energy
Chris Varner, Duke Energy
Tyler Hardin, Duke Energy
www.duke-energy.com Page 1 of 1

January 12, 2024
Duke Energy Marshall Steam Station
8320 NC Hwy 150 E
Terrell, North Carolina 28673
Attention: Ms. Ashley Healy, P.G.
EHS Waste and Groundwater Programs, Duke Energy
Reference: Completion Report for Monitoring Well Abandonments
Duke Energy Marshall Steam Station
Catawba County, North Carolina
S&ME Project No. 21410007, Ph. 02
Dear Ms. Healy:
S&ME, Inc. (S&ME) is pleased to present this Completion Report (hereafter, Report) for the abandonment of eight
(8) monitoring wells in support of the ash basin excavation and landfill construction at Duke Energy's Marshall
Steam Station (hereafter, Site), located at 8320 NC Hwy 150 E, in Catawba County, North Carolina. This Report
summarizes the well abandonment activities performed by S&ME at the Site in December 2023, as well as a
certification statement signed by a North Carolina licensed geologist, Julie Robertson, P.G, certifying that each
monitoring well was abandoned in compliance with the applicable standards and guidance as discussed in this
Report.
Background and Summary
The eight (8) monitoring wells addressed in this Report were abandoned by a North Carolina registered well driller
on December 131" and 141", 2023. Each of these monitoring wells were abandoned in accordance with the 75A
NCAC 02C Section .07 73 Standards for the Abandonment of Wells (hereafter, 02C Standards). S&ME personnel
provided support and oversight during the abandonment process for each monitoring well to ensure compliance
with the 02C Standards as mentioned above.
The eight (8) monitoring wells included in this Report (shown on Figure 1 in Attachment 1) were abandoned due
to their location within, or adjacent to, the grading and earthwork limits on Site supporting the excavation of ash,
as well as other various earthwork operations supporting the construction of the Industrial Landfill Future Phases
and construction of the geosynthetic cap for the closed 1804 Phase II Landfill. Per the 02C Standards, a well must
be permanently abandoned if it acts as a source or channel of contamination. Each of these wells were abandoned
prior to earthwork and grading operations to reduce the likelihood that the wells would act as a channel for
contaminants to reach groundwater once the well was removed during excavation and earthwork activities.
A summary of pertinent monitoring well information for each of the wells abandoned is located in Table 1 in
Attachment 11. As required by the 02C Standards, a Well Abandonment Record (GW-30 Form) was completed
and signed for each of the eight (8) wells abandoned. S&ME submitted these GW-30 Forms to the North Carolina
S&ME, Inc. 12016 Ayrsley Town Blvd., Suite 2-A I Charlotte, NC 282731 p 704.523.4726 1 www.smeinc.com

Completion Report for Monitoring Well Abandonments January 12, 2024
Duke Energy Marshall Steam Station Page 2
S&ME Project Number 21410007, Ph. 02
Department of Environmental Quality (NCDEQ) — Information Processing Unit, and they are included in
Attachment III as reference.
Each of the monitoring wells were abandoned following the general steps listed below:
If present, any dedicated tubing, pumps, or transducers were removed from the well and left on site with Duke
Energy personnel.
Depth to water from ground surface was measured using an electronic water level meter. The bottom of each
well was also tagged to ensure no discrepancies between recorded and actual well depth data exist.
The volume of water in the well was calculated based on the measured water level.
A bentonite slurry, Quik-Grout, was mixed with water (as noted in the Quik-Grout product specifications)
using a mechanical grouter before being placed via tremie method into the well to pump grout from the
bottom of the well upwards until the grout reached the top of the PVC well casing.
It should be noted that monitoring wells MA-2 and MA-3 were abandoned using coated bentonite
pellets (rather than Quik-Grout) in accordance with the general requirements of 02C Standards, as
access to these wells was very limited at the time of abandonment.
S&ME understands that the protective well covers and concrete pads will be removed from each of the eight (8)
abandoned well locations by the general earthwork contractor on Site.
Monitoring Well Abandonment Certification
Each of the eight (8) monitoring wells discussed in this Report were abandoned in general accordance with the
requirements of the 02C Standards by certified Well Drillers licensed in the State of North Carolina. Under the
supervision of an S&ME licensed geologist, an S&ME professional was on site to observe each well abandonment.
Closure
S&ME appreciates each and every opportunity to be of service to Duke Energy. Please contact us if you have any
questions regarding this report.
Sincerely,
S&ME, Inc.
1
Jasmine Tayouga, E.I.
Project Manager/Team Lead
[e-mail]
Attachments:
I — Figures
II — Tables
III — Well Abandonment Records/GW-30 Forms
Julie P. Robertson, P.G.
Vice President/Operations Manager
�[e-mail]
S&ME, Inc.

Attachments

Attachment I — Figures

Drawing Path: T:\Asheville-1410\Projects\2021\21410007 Duke Marshall CCP Closure On -Call Services Terrell NC\02_Well Abandonments\Dec2023\GIS\Draft_ WellAbandonments 20231215.mxd plotted byjtayouga 12-15-2023
4 \,' MW-3
Y. -
_ 4
l -CLF 301 - s
�t
;7
1
MA-2 .
)IN
k365 '
O
k4\
0 500 1,000
(FEET)
AB-145 ti� LEGEND
-(D- MONITORING WELLS ABANDONED 12/13/23 - 12/14/23
"REFERENCE:
$ THIS MAP IS FOR INFORMATIONAL PURPOSES ONLY. PREVIOUSLY ABANDONED AND/OR
I REMOVED MONITORING WELLS ARE NOT SHOWN ON THIS MAP. AERIAL IMAGERY DATE:
NOVEMBER 13, 2023. ALL FEATURE LOCATIONS DISPLAYED ARE APPROXIMATED. THEY ARE
NOT BASED ON CIVIL SURVEY INFORMATION, UNLESS STATED OTHERWISE.
SCALE: FIGURE NO.
DECEMBER 2023 MONITORING WELL ABANDONMENTS 1 " = 500 '
III E DUKE ENERGY - MARSHALL STEAM STATION
12-15-2023
CATAWBA COUNTY, NORTH CAROLINA PROJECT NUMBER
\ 21410007

Attachment II — Tables

Table 1: Summary of Monitoring Wells Abandoned in December 2023
Duke Energy - Marshall Steam Station
S&ME Project No. 27470007, Ph. 02
Well ID'
Total Well
2
Depth
(ft-toc)
Casing Stick -Up
Height
(ft-ags)
Total Well Depth
(ft-bgs)
3
Screened Interval
(ft-bgs)
4
Northing
(ft-NAD83)
4
Easting
(ft-NAD83)
Date
Abandoned
Depth to Water
Prior to
Abandonment
(ft-toc)
MW-3
30.2
4.3
25.9
15.9 to 25.9
685991.00
1415309.00
12/13/2023
7.3
MA-2
43.6
1.4
42.2
30.0 to 40.0
685644.55
1414728.46
12/13/2023
31.2
MA-3
48.0
2.5
45.6
35.0 to 45.0
685720.01
1414686.55
12/13/2023
36.6
AB-14S
23.2
3.0
20.2
6.0 to 21.0
683679.54
1412755.12
12/13/2023
20.1
AB-14DU
56.4
2.8
53.6
43.0 to 53.0
683658.34
1412768.38
12/13/2023
18.3
AB-14D
187.9
12.7
185.2
80.0 to 85.0
1 683676.24
1 1412767.69
1 12/13/2023
17.7
CLF-301
65.6
3.5
62.1
52.0 to 62.0
685838.40
1413513.30
12/14/2023
36.5
CLF22-305
18.9
2.9
16.0
6.0 to 16.0
685229.00
1413445.90
12/14/2023
18.7
Notes:
Each monitoring well consisted of 2-inch inner diameter inner polyvinyl chloride (PVC) casing.
2 Total Well Depth - prior to abandonment, the depth to the bottom of the screened interval was measured on each well.
3 Screened intervals were recorded from information on the well tag at each location.
4 Northing and Easting coordinates provided by Duke Energy.
ft: feet
bgs: below ground surface
ags: above ground surface
toc: top of casing

Attachment III - Well Abandonment Records/GW-30 Forms

WELL ABANDONMENT RECORD
1. Well Contractor Information:
Justin Marlowe
Well Contractor Name (or well owner personally abandoning well on his/her property)
4452-A
NC Well Contractor Certification Number
Phenom Geotech
Company Name
2. Well Construction Permit #: Not Applicable
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)
❑Industrial/Commercial
❑Residential Water Supply (shared)
❑hrri ation
Non -Water Supply Well:
RMonitoring
❑Recovery
Injection Well:
El Aquifer Recharge
❑Groundwater Remediation
El Aquifer Storage and Recovery
El Salinity Barrier
El 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: 1 2/1 3/2023
5a. Well location:
Duke Energy Carolinas Not Applicable
Facility/Owner Name Facility ID# (if applicable)
8320 NC Hwy 150, Terrell, NC 28673
Physical Address, City, and Zip
Catawba 461803426350
County
Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
35.617966 N-80.969412
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: Not Applicable
7b. Approximate volume of water remaining in well(s): 2. 0 (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
❑ Concrete Grout
❑ Specialty Grout
a Bentonite Slurry
❑ Dry Clay
❑ Drill Cuttings
❑ Gravel
❑ Other (explain under 7g)
7f. For each material selected above, provide amount of materials used:
7g. Provide a brief description of the abandonment procedure:
Coated bentonite pellets were slowly poured into
the well, and water was added to hydrate the
pellets, until it reached the top of PVC casing.
8.. Certification:
1/5/2023
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
W abandonment details. You may also attach additional pages if necessary.
CONSTRUCTION DETAILS OF WELL(S) BEING ABANDONED
Attach well construction record(s) ifavailable. For multiple injection or non -water supply wells
ONLY with the same construction/abandonment, you can submit one form.
6a. Well ID#: MA-2
6b. Total well depth: 42.2 (ft.)
6c. Borehole diameter: 8.0 (in.)
6d. Water level below ground surface: 29.8 (ft.)
6e. Outer casing length (if known): Not Applicable (ft.)
6f. Inner casing/tubing length (if known): 30 (ft.)
6g. Screen length (if known): 10 (ft.)
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
loc. 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:
Justin Marlowe
Well Contractor Name (or well owner personally abandoning well on his/her property)
4452-A
NC Well Contractor Certification Number
Phenom Geotech
Company Name
2. Well Construction Permit #: Not Applicable
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)
❑Industrial/Commercial
❑Residential Water Supply (shared)
❑hrri ation
Non -Water Supply Well:
RMonitoring
❑Recovery
Injection Well:
El Aquifer Recharge
❑Groundwater Remediation
El Aquifer Storage and Recovery
El Salinity Barrier
El 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: 1 2/1 3/2023
5a. Well location:
Duke Energy Carolinas Not Applicable
Facility/Owner Name Facility ID# (if applicable)
8320 NC Hwy 150, Terrell, NC 28673
Physical Address, City, and Zip
Catawba 461803426350
County Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
35.618171 N-80.969558 W
CONSTRUCTION DETAILS OF WELL(S) BEING ABANDONED
Attach well construction record(s) ifavailable. For multiple injection or non -water supply wells
ONLY with the same construction/abandonment, you can submit one form.
6a. Well ID#: MA-3
6b. Total well depth: 45.6 (ft.)
6c. Borehole diameter: 8.0 (in.)
6d. Water level below ground surface: 34.1 (ft.)
6e. Outer casing length (if known): Not Applicable (ft.)
6f. Inner casing/tubing length (if known): 35 (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: Not Applicable
7b. Approximate volume of water remaining in well(s): 1 .9 (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
❑ Concrete Grout
❑ Specialty Grout
a Bentonite Slurry
❑ Dry Clay
❑ Drill Cuttings
❑ Gravel
❑ Other (explain under 7g)
7f. For each material selected above, provide amount of materials used:
7g. Provide a brief description of the abandonment procedure:
Coated bentonite pellets were slowly poured into
the well, and water was added to hydrate the
pellets, until it reached the top of PVC casing.
8. Certification:
��"`�`"_�Well
1/5/2023
Signature of r 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
loc. 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:
Justin Marlowe
Well Contractor Name (or well owner personally abandoning well on his/her property)
4452-A
NC Well Contractor Certification Number
Phenom Geotech
Company Name
2. Well Construction Permit #: Not Applicable
List all applicable well construction permits (i.e. UIC, County, State, Variance, etc) ifknown
3. Well use (check well use):
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
❑ Irrigation
Non -Water Supply Well:
El Aquifer Recharge
El Aquifer Storage and Recovery
El Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
El Groundwater Remediation
❑ Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under 7g)
4. Date well(s) abandoned: 1 2/1 3/2023
5a. Well location:
Duke Energy Carolinas Not Applicable
Facility/Owner Name Facility ID# (if applicable)
8320 NC Hwy 150, Terrell, NC 28673
Physical Address, City, and Zip
Catawba 461803426350
County Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
35.619145 N-80.967229
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: Not Applicable
7b. Approximate volume of water remaining in well(s): 3.7 (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
❑ Concrete Grout
❑ Specialty Grout
a Bentonite Slurry
❑ Dry Clay
❑ Drill Cuttings
❑ Gravel
❑ Other (explain under 7g)
7f. For each material selected above, provide amount of materials used:
7g. Provide a brief description of the abandonment procedure:
1 batch grout mix makes approximately 30 gal. grout
per Quik-Grout specs. (1 50 Ib. bag and 25 gal. water)
Grout pumped from bottom of well using 1" tremie
pipe until well is filled to top of PVC casing.
8. Certification:
1/5/2023
/ 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
W abandonment details. You may also attach additional pages if necessary.
CONSTRUCTION DETAILS OF WELL(S) BEING ABANDONED
Attach well construction record(s) ifavailable. For multiple injection or non -water supply wells
ONLY with the sameconsstruction/abandonment, you can submit one form.
6a. Well ID#: M V AV -3
6b. Total well depth: 25.9 (ft.)
6c. Borehole diameter: 6.0 (in.)
6d. Water level below ground surface: 3.0 (ft.)
6e. Outer casing length (if known): Not Applicable (ft.)
6f. Inner casing/tubing length (if known): 15.9 (ft.)
6g. Screen length (if known): 10 (ft.)
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
loc. 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:
Justin Marlowe
Well Contractor Name (or well owner personally abandoning well on his/her property)
4452-A
NC Well Contractor Certification Number
Phenom Geotech
Company Name
2. Well Construction Permit #: Not Applicable
List all applicable well construction permits (i.e. UIC, County, State, Variance, etc) ifknown
3. Well use (check well use):
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
❑ Irrigation
Non -Water Supply Well:
El Aquifer Recharge
El Aquifer Storage and Recovery
El Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
El Groundwater Remediation
❑ Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under 7g)
4. Date well(s) abandoned: 1 2/1 3/2023
5a. Well location:
Duke Energy Carolinas Not Applicable
Facility/Owner Name Facility ID# (if applicable)
8320 NC Hwy 150, Terrell, NC 28673
Physical Address, City, and Zip
Catawba 461803426350
County Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
35.6124606 N-80.9759188
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: Not Applicable
7b. Approximate volume of water remaining in well(s): 0. 5 (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
❑ Concrete Grout
❑ Specialty Grout
a Bentonite Slurry
❑ Dry Clay
❑ Drill Cuttings
❑ Gravel
❑ Other (explain under 7g)
7f. For each material selected above, provide amount of materials used:
7g. Provide a brief description of the abandonment procedure:
1 batch grout mix makes approximately 30 gal. grout
per Quik-Grout specs. (1 50 Ib. bag and 25 gal. water)
Grout pumped from bottom of well using 1" tremie
pipe until well is filled to top of PVC casing.
8. Certification:
�. .
Signature of Certified Well Contractor or Well Owner
1/5/2023
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
W abandonment details. You may also attach additional pages if necessary.
CONSTRUCTION DETAILS OF WELL(S) BEING ABANDONED
Attach well construction record(s) ifavailable. For multiple injection or non -water supply wells
ONLY with the same constructio
n/abandonment, you can submit one form.
6a. Well ID#: AB-14S
6b. Total well depth: 45.6 (ft.)
6c. Borehole diameter: 8.0 (in.)
6d. Water level below ground surface: 17.1 (ft.)
6e. Outer casing length (if known): Not Applicable (ft.)
6f. Inner casing/tubing length (if known): 6.0 (ft.)
6g. Screen length (if known): 15.0 (ft.)
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
loc. 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:
Justin Marlowe
Well Contractor Name (or well owner personally abandoning well on his/her property)
4452-A
NC Well Contractor Certification Number
Phenom Geotech
Company Name
2. Well Construction Permit #: Not Applicable
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)
❑Industrial/Commercial
❑Residential Water Supply (shared)
❑hrri ation
Non -Water Supply Well:
a Monitoring
❑Recovery
Injection Well:
El Aquifer Recharge
❑Groundwater Remediation
El Aquifer Storage and Recovery
El Salinity Barrier
El 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: 1 2/1 3/2023
5a. Well location:
Duke Energy Carolinas Not Applicable
Facility/Owner Name Facility ID# (if applicable)
8320 NC Hwy 150, Terrell, NC 28673
Physical Address, City, and Zip
Catawba 461803426350
County
Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
35.6124031 N-80.9758728
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: Not Applicable
7b. Approximate volume of water remaining in well(s): 6.2 (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
❑ Concrete Grout
❑ Specialty Grout
a Bentonite Slurry
❑ Dry Clay
❑ Drill Cuttings
❑ Gravel
❑ Other (explain under 7g)
7f. For each material selected above, provide amount of materials used:
7g. Provide a brief description of the abandonment procedure:
1 batch grout mix makes approximately 30 gal. grout
per Quik-Grout specs. (1 50 Ib. bag and 25 gal. water)
Grout pumped from bottom of well using 1" tremie
pipe until well is filled to top of PVC casing.
8. Certification:
1/5/2023
/ 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
W abandonment details. You may also attach additional pages if necessary.
CONSTRUCTION DETAILS OF WELL(S) BEING ABANDONED
Attach well construction record(s) ifavailable. For multiple injection or non -water supply wells
ONLY with the same construction/abandonment, you can submit one form.
6a. Well ID#: AB-14DU
6b. Total well depth: 53.6 (ft.)
6c. Borehole diameter: 6.0 (in.)
6d. Water level below ground surface: 15.5 (ft.)
6e. Outer casing length (if known): Not Applicable (ft.)
6f. Inner casing/tubing length (if known): 43.0 (ft.)
6g. Screen length (if known): 1 0.0 (ft.)
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
loc. 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:
Justin Marlowe
Well Contractor Name (or well owner personally abandoning well on his/her property)
4452-A
NC Well Contractor Certification Number
Phenom Geotech
Company Name
2. Well Construction Permit #: Not Applicable
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)
❑Industrial/Commercial
❑Residential Water Supply (shared)
❑lrri ation
Non -Water Supply Well:
a Monitoring
❑Recovery
Injection Well:
El Aquifer Recharge
❑Groundwater Remediation
El Aquifer Storage and Recovery
El Salinity Barrier
El 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: 1 2/1 3/2023
5a. Well location:
Duke Energy Carolinas Not Applicable
Facility/Owner Name Facility ID# (if applicable)
8320 NC Hwy 150, Terrell, NC 28673
Physical Address, City, and Zip
Catawba 461803426350
County
Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
35.6124522 N-80.9758763
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: Not Applicable
7b. Approximate volume of water remaining in well(s): 11 .5 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
❑ Concrete Grout
❑ Specialty Grout
a Bentonite Slurry
❑ Dry Clay
❑ Drill Cuttings
❑ Gravel
❑ Other (explain under 7g)
7f. For each material selected above, provide amount of materials used:
7g. Provide a brief description of the abandonment procedure:
1 batch grout mix makes approximately 30 gal. grout
per Quik-Grout specs. (1 50 Ib. bag and 25 gal. water)
Grout pumped from bottom of well using 1" tremie
pipe until well is filled to top of PVC casing.
8.Certi�fica/tion:
Alig7naturc
1/5/2023
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
W abandonment details. You may also attach additional pages if necessary.
CONSTRUCTION DETAILS OF WELL(S) BEING ABANDONED
Attach well construction record(s) ifavailable. For multiple injection or non -water supply wells
ONLY with the same construction/abandonment, you can submit one form.
6a. Well ID#: AB-14D
6b. Total well depth: 85.2 (ft.)
6c. Borehole diameter: 7.9, 4.9 (in.)
6d. Water level below ground surface: 15.0 (ft.)
6e. Outer casing length (if known): 72.0 (ft.)
6f. Inner casing/tubing length (if known): 80.0 (ft.)
6g. Screen length (if known): 5.0 (ft.)
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
loc. 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:
Justin Marlowe
Well Contractor Name (or well owner personally abandoning well on his/her property)
4452-A
NC Well Contractor Certification Number
Phenom Geotech
Company Name
2. Well Construction Permit #: Not Applicable
List all applicable well construction permits (i.e. UIC, County, State, Variance, etc) ifknown
3. Well use (check well use):
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
❑ Irrigation
Non -Water Supply Well:
El Aquifer Recharge
El Aquifer Storage and Recovery
El Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
El Groundwater Remediation
❑ Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under 7g)
4. Date well(s) abandoned: 1 2/1 4/2023
5a. Well location:
Duke Energy Carolinas Not Applicable
Facility/Owner Name Facility ID# (if applicable)
8320 NC Hwy 150, Terrell, NC 28673
Physical Address, City, and Zip
Catawba 461803426350
County Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
35.6167546 N-80.9736988
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: Not Applicable
7b. Approximate volume of water remaining in well(s): 0. 04 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
❑ Concrete Grout
❑ Specialty Grout
a Bentonite Slurry
❑ Dry Clay
❑ Drill Cuttings
❑ Gravel
❑ Other (explain under 7g)
7f. For each material selected above, provide amount of materials used:
7g. Provide a brief description of the abandonment procedure:
1 batch grout mix makes approximately 30 gal. grout
per Quik-Grout specs. (1 50 Ib. bag and 25 gal. water)
Grout pumped from bottom of well using 1" tremie
pipe until well is filled to top of PVC casing.
8. Certification:
1/5/2023
A`Egnature 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
W abandonment details. You may also attach additional pages if necessary.
CONSTRUCTION DETAILS OF WELL(S) BEING ABANDONED
Attach well construction record(s) ifavailable. For multiple injection or non -water supply wells
ONLY with the same construction/abandonment, you can submit one form.
6a. Well ID#: CLF22-305
6b. Total well depth: 16.0 (ft.)
6c. Borehole diameter: 6.0 (in.)
6d. Water level below ground surface: 1 5. 8 (ft.)
6e. Outer casing length (if known): Not Applicable (ft.)
6f. Inner casing/tubing length (if known): 6.0 (ft.)
6g. Screen length (if known): 1 0.0 (ft.)
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
loc. 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:
Justin Marlowe
Well Contractor Name (or well owner personally abandoning well on his/her property)
4452-A
NC Well Contractor Certification Number
Phenom Geotech
Company Name
2. Well Construction Permit #: Not Applicable
List all applicable well construction permits (i.e. UIC, County, State, Variance, etc) ifknown
3. Well use (check well use):
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
❑ Irrigation
Non -Water Supply Well:
El Aquifer Recharge
El Aquifer Storage and Recovery
El Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
El Groundwater Remediation
❑ Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under 7g)
4. Date well(s) abandoned: 1 2/1 4/2023
5a. Well location:
Duke Energy Carolinas Not Applicable
Facility/Owner Name Facility ID# (if applicable)
8320 NC Hwy 150, Terrell, NC 28673
Physical Address, City, and Zip
Catawba 461803426350
County
Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
35.6184322 N-80.9735128 W
CONSTRUCTION DETAILS OF WELL(S) BEING ABANDONED
Attach well construction record(s) ifavailable. For multiple injection or non -water supply wells
ONLY with the same construction/abandonment, you can submit one form.
6a. Well ID#: CLF-301
6b. Total well depth: 62.1 (ft.)
6c. Borehole diameter: 8.0 (in.)
6d. Water level below ground surface: 33.0 (ft.)
6e. Outer casing length (if known): Not Applicable (ft.)
6f. Inner casing/tubing length (if known): 52.0 (ft.)
6g. Screen length (if known): 1 0.0 (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: Not Applicable 7b. Approximate volume of water remaining in well(s): 4.8 (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
❑ Concrete Grout
❑ Specialty Grout
a Bentonite Slurry
❑ Dry Clay
❑ Drill Cuttings
❑ Gravel
❑ Other (explain under 7g)
7f. For each material selected above, provide amount of materials used:
7g. Provide a brief description of the abandonment procedure:
1 batch grout mix makes approximately 30 gal. grout
per Quik-Grout specs. (1 50 Ib. bag and 25 gal. water)
Grout pumped from bottom of well using 1" tremie
pipe until well is filled to top of PVC casing.
8. Certification:
1/5/2023
/eSignature�ofCertified�Wellor 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
loc. 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