WI0800206_Injection Event Record_20120329

ATC ASSOCIATES OF NORTH CAROUNA, P.C.
Engineering Individual Solutions
2725 East Millbrook Road
Suite 121
Raleigh, NC 27604
Tel: [phone]
Fax: [phone]
www.atcassociates.com
N.C. Engineering License No. C-1598
March 28, 2012
Mr. Michael Rogers
NCDENR Division of Water Quality
Aquifer Protection Section, UIC Program
1636 Mail Service Center
Raleigh, North Carolina 27699-1636
RE: Injection Event Record
Injection Permit WI0800206
Former Conoco Store #33051 (RM&R #6265)
2636 Castle Hayne Road
Wilmington, New Hanover County, North Carolina
ATC Project No. 45.75118.6265
Dear Mr. Rogers:
ATC Associates of North Carolina, P.C. (ATC), on behalf of ConocoPhillips, is submitting an Injection
Event Record per the requirements of Injection Well Permit W10800206 issued on January 27, 2011. The
injection event took place on February 29, 2012 and March 1, 2012. The event consisted of injection of
magnesium sulfate. Attachment 1 contains the Injection Event Record form. A separate report will be
submitted at a later date containing pre and post -injection groundwater monitoring data and additional
details regarding the injection activities.
If you have questions or require additional information, please do not hesitate to contact us at (919) 871-
0999.
Sincerely,
ATC Associates of North Carolina, P.C.
Ashley Winkelman, P.G.
Staff Geologist
Gabriel Araos, P, .
Project Manager
cc: Ed Kuhn — Contract Program Manager for ConocoPhillips
Deborah Mayo — NCDENR DWM-UST Section
Charles Stehman — Wilmington Regional Office
Attachments:
Attachment 1 — Injection Event Record
RECEIVED/DENR/DWQ
MAR 29201Z
Aquifer Protection Section

ATTACHMENT 1
INJECTION EVENT RECORD
RECENEDIDENRIDWQ
MAR 2 9 2012
Aqu'rfer Protection Section

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RECEIVEDIDENRIDWQ
INJECTION EVENT RECORD MAR 2 9 2012
North Carolina Department of Environment and Natural Resources — Division of AtietiOn Section
Permit Number WI 0 8 0 0 2 0 6
1. Permit Information
Mr. Steve Helfn, Eastern Regional Manager (ConocoPhillips)
Permittee
Former Conoco Store 433051
Facility Name
2636 Castle Hayne Road, Wilmington, New Hanover County, NC
Facility Address
2. Injection Contractor Information
ATC Associates of N.C., P.C.
Injection Contractor / Company Name
Street Address 2725 E. Millbrook Road, Suite 121
Raleigh NC 27604
City State Zip Code
( 919 ) 871-0999
Area code — Phone number
3. Well Information
Number of wells used for injection
Well names IW-1 through IW-6
6
Were any new wells installed during this injection
event?
❑ Yes ® No
If yes, please provide the following information:
Number of Monitoring Wells
Number of Injection Wells
Type of Well Installed (Check applicable type):
❑ Bored ❑ Drilled ❑ Direct -Push
❑ Hand -Augured ❑ Other (specify)
Please include two copies of form GW-1 b for each
well installed.
Were any wells abandoned during this injection
event?
❑ Yes 0 No
If yes, please provide the following information:
Number of Monitoring Wells
Number of Injection Wells
Please include two copies of the GW-30 for each
well abandoned.
4. Injectant Information
1,660 pounds of magnesium sulfate in 800 gallons of
water (20 weight percent)
Injectant Type
Concentration 2.075 pounds / gallon
If the injectant is diluted please indicate the source
dilution fluid. City of Wilmington
Total Volume Injected 800 gallons
Volume Injected per well_1W-3:
80 gal
50 gal
IW-5: 75 gal
5. Injection History
Injection date(s) 2/29/12 - 3/1/12
IW-2: 75 gal
IW-4: 200 gal
IW-6: 320 gal
Injection number (e.g. 3 of 5) 2 of 3
Is this the last injection at this site?
0 Yes ® No
I DO HEREBY CERTIFY THAT ALL THE
INFORMATION ON THIS FORM IS CORRECT TO
THE BEST OF MY KNOWLEDGE AND THAT THE
INJECTION WAS PERFORMED WITHIN THE
STANDARDS LAB7Ll THE PERMIT.
O 3f2� 11L
SIGNATURE OF INJECTION CONTRACTOR 1 ATE
Gabriel Araos, P.E.
PRINT NAME OF PERSON PERFORMING THE INJECTION
Submit the original of this form to the Division of Water Quality within 30 days of injection.
Attn: UIC Program, 1636 Mail Service Center, Raleigh, NC 27699-1636, Phone No. 919-733-3221
Form UIC-IER
Rev. 07/09

Rogers, Michael
From: Sent: Gabe Araos [e-mail]] To: Friday, February 24, 2012 2:18 PM .
Rogers, Michael
Subject: UIC Permit WI0800206 (Former Conoco #33051) Castle -Ha ne
y ,NC
Michael,
ATC will be performing the second injection event at the above referenced site on February 29, 2012.
second injection event ATC will evaluate the monitoring data and submit an interim evaluation report.
me if you have anyFollowing the
questions. p Please contact
Thanks
Gabriel Araos, P.E. (Senior Project Manager) ATC Associates of North Carolina, P.C.
[phone] direct I [phone] mobile
2725 E. Millbrook Road I Suite 121 I Raleigh, North Carolina 27604
[phone] tel [phone] fax 1 www_atcassociates.com
Please Note: This message, including any attachments, may include privileged, confidential
distribution or use of this communication by anyone other than the intended recipient is
ynlawful. If you are not the intended recipient, please notify the sender by replying to this messager inside information. Any
your computer, p strictly prohibited and may be
and then delete it from
Please consider the environment before printing this e-mail
1

YATC %TX
ATC ASSOCIATES OF NORTH CAROLINA, P.C.
Engineering Individual Solutions
June 27, 2011
Mr. Michael Rogers
NCDENR Division of Water Quality
Aquifer Protection Section, UIC Program
1636 Mail Service Center
Raleigh, North Carolina 27699-1636
RE: Injection Event Record
Injection Permit WI0800206
Former Conoco Store #33051 (RM&R #6265)
2636 Castle Hayne Road
Wilmington, New Hanover County, North Carolina
ATC Project No. 45.75118.6265
2725 East Millbrook Road
Suite 121
Raleigh, NC 27604
Tel: [phone]
Fax: [phone]
www.atcassociates.com
N.C. Engineering License No. C-1598
Dear Mr. Rogers:
ATC Associates of North Carolina, P.C. (ATC), on behalf Ccnocolzhillips, is submitting an Injection
Event Record per the requirements of Injection We ermit WI0800206 issued on January 27, 2011. Six
permanent injection wells (IW-1 through IW-6) were ' ,
Jfor th
injection event that took place on June 9, 2011. The even cons ste e oI' inject on11nd of magnesiwereum zed sulf tee
Attachment 1 contains the Injection Event Record form and Attachment 2 contains the injection well
construction records. A separate report will be submitted at a later date containing pre and post -injection
groundwater monitoring data and additional details regarding the injection activities.
If you have questions or require additional information, please do not hesitate to contact us at (919) 871-
0999.
Sincerely,
ATC Associates of North Carolina, P.C.
Justin C. Ballard, P.G.
Project Geologist
Gabriel Araos, P.E.
Project Manager
cc: Ed Kuhn — Contract Program Manager for ConocoPhillips
Deborah Mayo — NCDENR DWM-UST Section
Charles Stehman — Wilmington Regional Office
Attachments:
Attachment 1— Injection Event Record
Attachment 2 — Well Construction Records
RECEIVED / DENR / DWQ
Aquifer Protection Section
JUN 2 9 2011

ATTACHMENT 1
INJECTION EVENT RECORD
RECEIVED / DENR / DIMQ
Aquifer Protection Section
JUN 29 2011

INJECTION EVENT RECORD
North Carolina Department of Environment and Natural Resources — Division of Water Quality
Permit Number WI0800206
1. Permit Information
Mr. Steve Selin, Eastern Regional Manager (Coillips)
Permittee
Former Conoco Store #33051
Facility Name
2636 Castle Rayne Road, Wilmington, New Hanover County, NC
Facility Address
2. Injection Contractor Information
ATC Associates of N.C., P.C.
Injection Contractor / Company Name
Street Address 2725 E. Millbrook Road, Suite 121
Raleigh NC 27604
City State Zip Code
9( 19) 871-0999
Area code — Phonenumber
3. Well Information
Number of wells used for injection 6
Well names IW-1 through IW-6
Were any new wells installed during this injection
event?
0 Yes
❑ No
If yes, please provide the following information:
Number of Monitoring Wells
Number of Injection Wells
6
Type of Well Installed (Check applicable type):
0 Bored ® Drilled
❑Direct -Push
0 Hand -Augured
0 Other (specify)
Please include two copies ofform GW-Ib for each
well installed.
Submit the original of this form to the Division of Water Quality within 30 days of injection.
Attn: UIC Program, 1636 Mail Service Center, Raleigh, NC 27699-1636, Phone No. 919-733-3221 y
"FINED / DP. Form UIC-IER
- quifer Protection S, Rev. 07/09
JUN 29 2011
Were any wells abandoned during this injection
event?
❑ Yes
a No
If yes, please provide the following information:
Number of Monitoring Wells
Number of Injection Wells
Please include two copies of the GW-30 for each
well abandoned
4. Injectant Information
1,660 pounds of magnesium sulfate in 800 gallons of
water (20 weight percent)
Injectant Type ----------
Concentration 2.075 pounds / gallon
If the injectant is diluted please indicate the source
dilution fluid. city of Wilmington
Total Volume Injected 800 gallons
Volume Injected per well Iw-1:
_IW-3
IW-5:
5. Injection History
Injection date(s) June 9, 2011
59 gal
60 gal
111 gal
Injection number (e.g. 3 of 5) 1 of 3
Is this the last injection at this site?
0 Yes ® No
IW-2: 240 gal
IW-4: 178 gal
IW-6: 152 gal
I DO HEREBY CERTIFY THAT ALL THE
INFORMATION ON THIS FORM IS CORRECT TO
THE BEST OF MY KNOWLEDGE AND THAT THE
INJECTION WAS PERFORMED WITHIN THE
STANDARDS LAID OUT IN THE PERMIT.
D
Justin C. Ballard, P.G-
PRINT NAME OF PERSON PERFORMING THE INJECTION

ATTACHMENT 2
WELL CONSTRUCTION RECORDS
RECEIVED / DENR / DWQ
Aquifer Protection Section
JUN 29 2011

RECEIVED / DENR / DWQ
NONRESIDENTI WELL CONSTRUCTION RECORD Aquifer Protection Section
North Carolina Department of Environment and Natural Resources- Division of Water Quality JUN 29 201
WELL CONTRACTOR CERTIFICATION # 3552
1. WELL CONTRACTOR:
VINCE FEDERLE
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
(704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# N/A
OTHER ASSOCIATED PERMIT#(itapplicable)_
SITE WELL ID #(ifapplicable)
3. WELL USE (Check One Box) Monitoring / Municipal/Public °
Industrial/Commercial ❑ Agricultural ❑ Recovery 0 Injection 0
irrigation° Other 0 (list use)
DATE DRILLED 06/06/11
4. WELL LOCATION:
2636 CASTLE HAYNE ROAD 28429
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: WILMINGTON COUNTY NEW HANOVER
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
°Slope ❑Valley ❑Flat °Ridge ❑Other,
LATITUDE _ " DMS OR
LONGITUDE — — — DD
DMS OR DD
Latitude/longitude source: OGPS [Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name. of the business where the well is located.)
RMR - 6265
Facility Name �—
2636 CASTLE HAYNE ROAD Facllriy 1D# (If applicable)
Street Address
WILMINGTON
City or Town NC 28429
State Zip Cade
CONOCO PHILLIPS
Contact Name
420 SOUTH KEELER AVENUE
Mailing Address
BARLE
City or Town OK 74006
State Zip Code
Ara code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 9.0 FEET
b. DOES WELL REPLACE EXISTING WELL?
YES ❑ NO ©/
c. WATER LEVEL Below Tap of Casing: i DRY
(Use "+n if Above Top of Casing) — —'
1'✓ 6tte,I etv Ice t eni
alei
Y•�„kt YyiM1� a.�i�+
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST_ N/A
f. DISINFECTION: Type N/A Amount N/A g. WATER ZONES (depth):
Top Bottom Top Bottom
Top Bottom Top Bottom
Top Bottom Top Bottom
7. CASING: Depth Thickness/
P Diameter Weight Material
Top 0.0 Bottom 4.0 Ft, 4 INCH SCH 40 PVC
Top Bottom Ft.
Top Bottom Ft.
8. GROUT: Depth
Top 0.0 Bottom 2.0 Ft.
Top Bottom Ft,
Top Bottom Ft.
Material
PORTLANO BENTONITE
Method
SLURRY
9. SCREEN: Depth Diameter Slot Size Material
Top 4.0 Bottom 9.0 Ft. 4.0 in. .010 in. PVC
Top Bottom Ft in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth
Top 3.0 Bottom 9.0
Top Bottom
Top Bottom
Size Material
Ft. 20-40 FINE SILICA SAND
Ft._____
Ft.
11, DRILLING LOG
Top Bottom Formation Description
0.0 / 1.0 ASPHALT/GRAVEL
1.0 / 9.0 GRAY CLAYEY SAND
12. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
yi
RECORD HAS BEEN PR • �ED TO WELL OWNER.
•
•
,ye
IFIED
06/08/11
VINCE FEDERLE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
nfAatton
aix14 r
rpcesstng'
5).!N
DATE
Form GW-lb
Rev. 2/09

.NON ONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
1. WELL CONTRACTOR:
VINCE FEDERLE
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
(704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# N/A
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL. ID #(if applicable) IW-2
3. WELL USE (Check One Box) Monitoring G' Municipal/Public ❑
Industrial/Commercial ❑ Agricultural 0 Recovery 0 Injection 0
Irrigation❑ Other 0 (list use)
DATE DRILLED 06/06/11
4. WELL LOCATION:
2636 CASTLE HAYNE ROAD 28429
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Coda)
CITY: WILMINGTON COUNTY NEW HANOVER
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
0 Slope 0 Valley 0 Flat DRidge °Other
LATITUDE
LONGITUDE
" DMS OR DD
"DMS OR DD
Latitude/longitude source: 03PS :Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
RMR-6265
Facility Name
2636 CASTLE HAYNE ROAD
Street Address
WILMINGTON NC 28429
City or Town State Zip Code
N/A
Facility ID# (if applicable)
CONOCO PHILLIPS
Contact Name
420 SOUTH KEELER AVENUE
Mailing Address
BARTLESVILLE OK 74006
City or Town State Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 9.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES 0
c. WATER LEVEL Below Top of Casing: DRY
(Use "+" if Above Top of Casing)
NOG(
FT.
RECEIVED / DENR / DWQ
Aquifer Protection Section
JUN 29 2011
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST_ N/A _
f. DISINFECTION: Type N'A Amount N/A
g. WATER ZONES (depth):
Top Bottom Top Bottom
Top Bottom Top Bottom
Top Bottom Top Bottom
7. CASING: Depth Thickness/
P Diameter Weight Material
Top 0.0 Bottom 4.0 Ft. 4 INCH sCH 4o PVC
Top Bottom Ft.
Top Bottom Ft,
8. GROUT: Depth Material Method
Top 0.0 Bottom 2.0 Ft, PORTLANOBENTONITE SLURRY
Top Bottom Ft.
Top Bottom Ft.
9. SCREEN: Depth Diameter
Top 4.0 Bottom 9.0 Ft. 4.0 in.
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 3.0 Bottom 9.0 Ft. 20-40
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
0,0 / 1.0 ASPHALT/GRAVEL
1.0 / 9.0 GRAY CLAYEY SAND
Slot Size Material
.010 in. PVC
FINE SILICA SAND
12. REMARKS:
BENTONITE SEAL FROM 2.0 TO 3.0 FEET
DO/HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
1NCAC 2C, WELL 4NST�l ST AND THAT A COPY OF THIS
R CORDORDtWS BE ROMO THE WE WN
06/08/11
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
VINCE FEDERLE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Etsmal"0 Pcacesstng
Form GW-lb
Rev. 2/09

NON WELL CONSTRUCTION RECORD
RECEIVED
pro;p�,4� S/ D 4
North Carolina Department of Environment and Natural Resources- Division of Water Quality Section
WELL CONTRACTOR CERTIFICATION # 3552 JUN 2 9 2011
1. WELL CONTRACTOR:
VINCE FEDERLE
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
(704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# N/A
OTHER ASSOCIATED PERMIT#(ifapplicable)
SITE WELL ID #(If applicable) I W-3
3. WELL. USE (Check One Box) Monitoring Cil Municipal/Public °
Industrial/Commercial ° Agricultural ❑ Recovery 0 Injection 0
Irrigation Other ° (list use)
DATE DRILLED 06/07/11
4. WELL LOCATION:
2636 CASTLE HAYNE ROAD 28429
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: WILMINGTON COUNTY NEW HANOVER
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
°Slope ❑Valley ❑Flat °Ridge °Other
LATITUDE "DMS OR DD
LONGITUDE _ " DMS OR _ _ DD
Latitudeaongitude source: I:GPS propographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
RMR - 6265
Facility Name
2636 CASTLE HAYNE ROAD
Street Address
WILMINGTON
City or Town
CONOCO PHILLIPS
Contact Name
420 SOUTH KEELER AVENUE
Mailing Address
BARTLESVILLE
City or Town
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 9.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 131
c. WATER LEVEL Below Top of Casing: DRY
(Use "+" if Above Top of Casing)
N/A
Facility ID# (if applicable)
NC 28429
State Zip Code
OK 74006
State Zip Code
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A _
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom Top Bottom
Top Bottom Top Bottom
Top Bottom Top
Bottom
7. CASING: Depth Thickness/
P Diameter Weight Material
Top OA Bottom 4.0 FL 4 INCH SCH 40 PVC
Top Bottom Ft.
Top Bottom Ft.
8. GROUT: Depth
Top 0.0 Bottom,
Top Bottom
Material
2.0 Ft. PORTLAND BENTONIIE
Ft.
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size
Top 4.0 Bottom 9.0 Ft. 4.0 in. .010 in.
Top . Bottom Ft.
Top Bottom Ft.
10. SAND/GRAVEL PACK:
Depth
Top 3.0 Bottom 9.0 Ft.
Top Bottom Ft.
Top Bottom Ft.
in. in.
In. in.
Method
SLURRY
Material
PVC
Size Material
20-40
FINE SILICA SAND
11. DRILLING LOG
Top Bottom Formation Description
0.0 / 1.0 _ ASPHALT/GRAVEL
1.0 / 9.0 GRAY CLAYEY SAND
./
12. REMARKS:
BENTONITE SEAL FROM 2.0 TO 3.0 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A CAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF•THIS
RE RD HAS BEEN -OVI•. 0THE OWNE
•
CER IFIED WELL
VINCE FEDERLE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-lb
Rev. 2/09

of
.NONRESIDENTIAL WELL CONSTRUCTION RECORD RECEIVED / DENR / DWQ
AnUifBr PrptPt lOn lei
355 JUN 2 9 2011
Carolina Department of Environment and Natural Resources- Division of Water Quality
North
WELL CONTRACTOR CERTIFICATION
TION # 2
1. WELL CONTRACTOR:
VINCE FEDERLE
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE
City or Town
(704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# N/A
OTHER ASSOCIATED PERMIT#(ir applicable)
SITE WELL ID *Of applicable) 1W4
3. WELL USE (Check One Box) Monitoring Y'Municipal/Public 0
Industrial/Commercial 0 Agricultural 0 Recovery 0 Injection 0
Irrigation0 Other 0 (list use)
DATE DRILLED 06/06/11
4. WELL LOCATION:
2636 CASTLE HAYNE ROAD 28429
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: WILMINGTON COUNTY NEW HANOVER
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
°Slope °Valley °Flat °Ridge °Other
LATITUDE " DMS OR DD
LONGITUDE _ " DMS OR DD
Latitude/longitude source: COPS Dropograpl,ic map
(location of well must be shown on a L/SGS topo map andattached to
this form if not using GPS)
S. FACILITY (Name of the business where the well is located.)
RMR - 6265
Facility Name
2636 CASTLE HAYNE ROAD
Street Address
WILMINGTON
City or Town
CONOCO PHILLIPS
Contact Name
420 SOUTH KEELER AVENUE
Mailing Address
BARTLESVILLE
City or Town
NC 28625
State Zlp Code
N/A
Facility ID# (if applicable)
NC 28429
State Zip Code
OK 74006
State Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 9.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO q/
c. WATER LEVEL Below Top of Casing: DRY FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
*Top of casing terminated atlor below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A _
f. DISINFECTION: Type NIA _. Amount N/A
g. WATER ZONES (depth):
Top Bottom Top Bottom
Top Bottom Top Bottom
Top Bottom Top Bottom
7. CASING: Depth Thickness/
A Diameter Weight Material
Top 0.0 Bottom 4.0 FL 41NCH SCH 4o PVC
Top Bottom Ft.
Top Bottom Ft.
8. GROUT: Depth
Top 0.0 Bottom 2.0 Ft.
Top Bottom Ft,
Top Bottom Ft.
Material
PORTLANO BENTONITE
Method
SLURRY
9. SCREEN: Depth Diameter Slot Size Material
Top 4.0 Bottom 9.0 Ft. 4.0 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 3.0 Bottom 9.0 Ft. 20-40
Top,
Top
Bottom Ft.
Bottom Ft.
FINE SILICA SAND
11. DRILLING LOG
Top Bottom Formation Description
0.0 / 1.0 ASPHALT/GRAVEL
1.0 / 9.0 _ GRAY CLAYEY SAND
/
12. REMARKS:
BENTONITE SEAL FROM 2.0 TO 3.0 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15 CAC 2C, WELL CONSTR TION STANDARDS, AND THAT A COPY OF THIS
amt AS BEEN ROVIr =;�:a 0 THE f1 OWNS',.
/ • ,, �.�
SIGNATURE OF CERTIFIED WEL ~� - ®06/08/11 CT DATE
VINCE FEDERLE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-lb
Rev. 2/09

1. WELL CONTRACTOR:
VINCE FEDERLE
1
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
3552
WELL CONTRACTOR CERTIFICATION #
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Welt Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
(704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# N/A
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID Of applicable) IW-5
3. WELL USE (Check One Box) Monitoring Il Municipal/Public ❑
Industrial/Commercial 0 Agricultural 0 Recovery 0 Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 06/06/11
4. WELL LOCATION:
2636 CASTLE HAYNE ROAD 28429
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: WILMINGTON COUNTY NEW HANOVER_
TOPOGRAPHIC 1 LAND SETTING: (check appropriate box)
❑Slope ❑Valley ❑Flat ❑Ridge ❑Other
LATITUDE _ _ "DMS OR DD
LONGITUDE i " DMS OR _ DD
Latitude/longitude source: COPS Qr'opographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
RMR - 6265 N/A
Facility Name Facility 1D# (if applicable)
2636 CASTLE HAYNE ROAD
Street Address
WILMINGTON NC 28429
City or Town State Zip Code
CONOCO PHILLIPS
Contact Name
420 SOUTH KEELER AVENUE
Mailing Address
BARTLESVILLE
City or Town
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 9.0 FEET
OK 74006
State Zip Code
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO
ci
c. WATER LEVEL Below Top of Casing: DRY FT.
(Use "+" if Above Top of Casing)
riQ►13t)fe
RECEIVED / DENR / DWQ
Aquifer Protp. fi0n Section
JUN 29 2011
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST
f. DISINFECTION: Type N/A Amount
g. WATER ZONES (depth):
Top Bottom Top
Top Bottom Top
Top Bottom Top
7. CASING: Depth Diameter
Top 0.0 Bottom 4.0 Ft. 4 INCH
Top Bottom Ft.
Top Bottom Ft.
8. GROUT: Depth Material
Top 0.0 Bottom 2.0 Ft. PORTrANDBENmNTE
Top Bottom Ft.
Top Bottom Ft.
N/A
N/A
Bottom,
Bottom
Bottom
Thickness/
Weight Material
SCH 40 PVC
Method
SLURRY
9. SCREEN: Depth Diameter Slot Size
Top 4.0 Bottom 9.0 Ft. 4.0 in. .010 in.
Top Bottom Ft in, in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 3.0 Bottom 9.0 Ft. 20-40
Top Bottom Ft.
Top Bottom Ft
11. DRILLING LOG
Top Bottom
0.0 / 1.0
1.0 / 9.0
Material
PVC
FINE SILICA SAND
Formation Description
ASPHALT/GRAVEL
GRAY CLAYEY SAND
12. REMARKS:
BENTONITF SEAL FROM 2.0 TO 3.0 FEFT
I D HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
1 NCAC 2C, WELL CONST TION ST DARDS, AND THAT A COPY OF THIS
ECORD HAS a PRO TO THE OWN -R.
SIGNATURE OF CERTIFIED WELL CR DATE
06/08/11
VINCE FEDERLE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
iio code siri" Y tl�t - F
�%aw.s�tizv°=•Y"iyy?t
Form GW-lb
Rev. 2/09

NON ONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
1. WELL CONTRACTOR.
VINCE FEDERLE
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
(704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# N/A
STATESVILLE
City or Town
NC 28625
State Zip Code
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) IW-6
3. WELL USE (Check One Box) Monitoring (1 Municipal/Public °
Industrial/Commercial 0 Agricultural 0 Recovery° Injection °
Irrigation° Other 0 (list use)
DATE DRILLED 06/07/11
4, WELL LOCATION:
2636 CASTLE HAYNE ROAD 28429
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: WILMINGTON _ COUNTY NEW HANOVER
TOPOGRAPHIC / LAND SETTING: (check appmpiiate box)
❑Slope °Valley °Flat °Ridge ❑Other
LATITUDE DMS OR DD
LONGITUDE " DMS OR DD
Latitude/longitude source: 03PS Dropographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
RMR - 6265 N/A
Facility Name
2636 CASTLE HAYNE ROAD
Street Address
WILMINGTON NC 28429
City or Town State Zip Code
Facility ID# (if applicable)
CONOCO PHILLIPS
Contact Name
420 SOUTH KEELER AVENUE
Mailing Address
BARTLESVILLE
City or Town
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 9.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES 0
, c. WATER LEVEL Below Top of Casing: DRY
(Use "+" if Above Top of Casing)
OK 74006
State Zip Code
NOc
FT.
RECEIVED / DENR / DWQ
Aquifer Protection Section
JUN 29 2011
d. TOP OF CASING IS 0.0 _ FT. Above Land Surface*
"Top of casing terminated ator below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom Top Bottom
Top Bottom Top Bottom
Top Bottom Top Bottom
7. CASING: Depth Diameter
Top 0.0 Bottom 4,0 Ft. 4 INCH
Top Bottom Ft.
Top Bottom Ft.
8. GROUT: Depth
Top 0.0 Bottom 2.0 Ft.
Top Bottom Ft,
Top Bottom Fi.
Thickness/
Weight Material
SCH 40 PVC
Material
PORTLAND BENTONITE
Method
SLURRY
9. SCREEN: Depth Diameter Slot Size Material
Top 4.0 Bottom 9.0 Ft. 4.0 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 3.0 Bottom 9.0 Ft. 20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
0.0 / 1.0 ASPHALT/GRAVEL
1.0 / 9.0 GRAY CLAYEY SAND
/
12. REMARKS:
BENTONITE SEAL FROM 2.0 TO 3.0 FEET
DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
i5A NCAC 2C, WELL CO -UCTIO NDARDS, AND THAT A COPY OF THIS
RECORD HAS P' :ED TO T E LL O NER.
e�9�hs�� • A.tf_
SIGNATURE OF CERTIFIED WELL CONTRACTOR 06 DATE
VINCE FEDERLE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-lb
Rev. 2/09

Rogers, Michael
From: Gabe Araos [[e-mail]]
Sent: Thursday, June 02, 2011 10:51 AM
To: Rogers, Michael
Cc: Mayo, Deborah
Subject: Notification of Injection Event Permit # WI0800206 Applicant ConocoPhillips
This email -is providing notification of the injection well installation on June 6-7, 2011, and the injection event on June 9-10,
2011, at the former Conoco #33051 located at 2636 Castle-Hayne Road, Wilmington, NC. Please contact me if you have
any questions.
Thanks
Gabriel Araos, P.E. (Senior Project Manager! ATC Associates of North Caroiina, P.C.
[phone] direct I [phone] mobile
2725 E. Millbrook Road I Suite 121 I Raleigh, North Carolina 27604
[phone] tel [phone] fax ( www.atcassociates.com
Please Note: This message, including any attachments, may include privileged, confidential and/or inside information. Any
distribution or use of this communication by anyone other than the intended recipient is strictly prohibited and may be
unlawful. If you are not the intended recipient, please notify the sender by replying to this message and then delete it from
your computer
1