The URL can be used to link to this page

Home My WebLink AboutGW1-2021-03032_Well Construction - GW1_20210622 WELL CONSTRUCTION RECORD For Internal Use ONLY: This form can be used for single or multiple wells 1.Well Contractor Information: v ,5d Norman Travis Costello (S s' ) " FR WATER ZONES FROM TO DESCRIPTION Well Contractor Name ✓� 021 ft. ft. 2251-A ft ft NC Well Contractor Certification Number rr 10�v�glta 15.OUTER CASING for multi-eased'wells OR LINER if a hcable S&ME, Inc. I icttrOt �1 car r,Y10 FROM To DIAMETER1a 1HIC[f7dESS MATERIAL Company Name 16.INNER CASING OR TUBING eother al closed-too 2.Well Construction Permit III!: N/A Cleveland County, N.C. FROM fL TO DIAMETER THICKNESS MATERiAI List all applicable well construction permits(i.e.County,State,Variance,etc) ft. ft. in. 3.Well Use(check well use): 17.SCREEN Water Supply Well: FROM TO DIAMETER SLOT SIZE .THICKNESS MATERIAL- ❑Agricultural ❑Municipal/Public 30.0 ft 40i0 ft. 2.0 0.01 in. 0.154 in. PVC ❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ft I ft. in• ❑lndustrial/Commercial ❑Residential Water Supply(shared) 1&GROUT FROM TO MATERIAL EMPLACEMENT METHOD&AMOUNT ❑hTi ation 0.00 ft' 25.0 ft. NEAT CEMENT . TREMIE,8.7 C.f. Non-Water Supply Well: ❑Monitoring ❑Recovery 25.0 ft- 28.0 fL BENTONITE TREMIE, 1.0 C.f. Injection Well: ft ft ❑Aquifer Recharge ❑Groundwater Remediation 19.SAND/GRAVEL PACK if applicable) FROM TO -MATERIAL. EMPLACEMENT METHOD ❑Aquifer Storage and Recovery ❑Salinity Barrier 28.0 ft- 40.0 ft. SAND/GRAVEL TREMIE ❑Aquifer Test ❑Stormwater Drainage ft. ft. ❑Experimental Technology ❑Subsidence Control 20.DRILLING LOG attach additional sheets if necessa ❑Geothermal(Closed Loop) ❑Tracer FROM TO DESCRIPTION color,hardnes soil/rock type,grain d7x,eta ❑Geothermal(Heating/Coohng Return) i70ther(explain under#21 Remarks) 0.0 ft- 0.30 it. CRUSHED STONE 4.Date Well(s)Completed: November 5, 2015 0.30 ft. 23•2 ft- FILL:SILTY SAND(SM)-REDBROWN,FINE TO MEDIUM,DRY 23.2 f• 24,0 f• ASH FILL:SANDY SILT(ML)-DARK GRAY,FINE,MOIST 5.Well Location: 24.0 ft' 28.0 ft' FILL:SANDY SILT(ML)-TAN/ORANGE,COARSE TO FINE,MOIST Duke EnergyCarolinas, LLC James E.Rogers Energy Complex 28.0 fL 40.0 ft- FILL SILTY SAND ISM)-aROAMORIWGERAN,COARSE TO FINE TO MEDIUM,MOIST Facility/Owner Name Facility ID#(if applicable) ft. ft 573 Duke Power Road, Mooresboro, N.C. 28114 ft ft. Physical Address,City,and Zip 21.REMARKS Cleveland County 1574840445 Well is only for monitoring groundwater levels and elevations. County Parcel Identification No.(PIN) Well not to be used for water quality measurements 5b.Latitude and Longitude in degrees/minutes/seconds or decimal degrees: 22.Certification: (if well field,one latAong is sufficient) 545343.0640 N 1178002.1530 W 12/2/2015 Signature of Certified Well Contractor Date 6.Is(are)the well(s): 2Permanent or ❑Temporary By signing this form,I hereby certify that the well(s)was(were)constructed in accordance with 15A NCAC 02C.0100 or 15A NCAC 02C.0200 Well Construction Standards and that a 7.Is this a repair to an existing well: ❑Yes or BNo copy of this record has been provided to the well owner. If this is a repair,fill out known well construction information and explain the nature of the repair under#11 remarks section or on the back of this form. 23.Site diagram or additional well details: one(l) You may use the back of this page':to provide additional well site details or well 8.Number of wells constructed: construction details. You may also attach additional pages ifnecessary. For multiple injection or non-water supply wells ONLY with the same construction,you can submit one form. 24.Submittal Instructions: 9.Total well depth below land surface: 40'0 (ft.) 24a. For All Wells: Submit this'form within 30 days of completion of well For multiple wells list all depths ifdierent(example-3@200'and 2@I00') construction t0 the following: 8 10.Static water level below top of casing: 25. (ft.) Division of Water Quality,Information Processing Unit, If water level is above casing,use"+" 1617 Mail Service Center,Raleigh,NC 27699-1617 11.Borehole diameter- 8.0 (in.) 24b.For Injection Wells: In addition to sending the form to the address in 24a Hollow-Stem Auger above, also submit a copy of this form within 30 days of completion of well 12.Well construction method: construction to the following: (i.e.auger,rotary,cable,direct push,etc.) Division of Water Quality,Underground Injection Control Program, 13.FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center,Raleigh,NC 27699-1636 i 13a.Yield(gpm) Method of test: 24c.For Water Suonly&Geothermal Wells: In addition to sending the form to the address(es) above, also submit one copy of this form within 30 days of 13b.Disinfection type: Amount: completion of well construction to the county health department of the county where constructed. I I Form GW-1 North Carolina Department of Environment and Natural Resources-Division of Water Quality Revised Jan.2013 r i I June 14, 2021 Division of Water Resources, Information Processing Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617 Attention: Division of Water Resources Reference: Abandonment of One(1) Monitoring Well Duke Energy Carolinas, LLC Rogers Energy Complex(Cliffside Steam Station) Mooresboro, North Carolina_ S&ME Project No.71.26-20-059 To Whom It May Concern: As requested by Sequoia Services; LLC(Sequoia Services),S&ME, Inc: (S&ME) has abandoned one(1) monitoring well located at the Duke Energy Carolinas, LLC's Rogers Energy Complex(Cliffside Steam Station) in Mooresboro, North Carolina. The monitoring well was abandoned by S&ME on June 4,2021 This letter includes a brief description of the work performed by S&ME,the Well Abandonment Record (Form GW-30),and historical well construction information. Monitoring Well, MW-1,was abandoned in general accordance with the North Carolina Administrative Code Title 15A,Department of Environment and Natural Resources Division of Water Quality Subchapter 2C,Section.0100 Well Construction Standards. If you have any questions, please contact our office. Thank you for your assistance and consideration of this information. Sincerely, S&ME, Inc. Frank Morris, P.E. Project Engineer-Manager V Attached. Form GW-30 . Historical Well Construction Information i S&ME,Inc. 48 Brookfield Oaks Drive,Suite F i Greenville,SC 296071 p 864.297.9944 wwwsmeinc.com h p Abandonment of One(1) Monitoring Well June 14, 2021 Division of Water.Resources, Information Processing Unit Page 2 s E i FORM GW-1 y i i o S&ME, Inc. i