HomeMy WebLinkAboutIredell_Well Abandonment_ WELL ABANDONMENT RECORD For ItoemilU'W-OKY!
Tads forth canto used Or single or mulliple sye%
1.Well Cautractor Information: WRLL ABAYDOTsiNWNT DETAILS
Robert Miller 7a.Number of steps being abandoned: 1
Vs�etf t or±tac or tvatm (ar;ell o;�mrr{xrsolcttll al>a r3anirtg weal an hn%l r prapcm l }i N atr FnT itL vl ccrteri ru WN-..finer ,sUV(V -444 D:'QV WWJ lhke r01111•
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2675
NC 1�cil C4itlstsanr t anitr Ilion Number71r.Approximate volume of wratel remaining Ill ss'CIl(s)N/A (2a1.)
SAEDACCO Inc FOR tY#1 FI2 SUPPLY IVELt 4 ON1,X: JJ
d k b
Catrtlpsnr l wltr 7e.Ttitle of disinfectant used: JUN 7-1
2.Well Construction Permit 'r
tact rL7 r,Jl f•' rf,)c rt ll ytrrri�+.a fi. (`rr�rzlr STv:r,l uridrresc ln+s cT_+rin.adt ItElm rrr 7d,Amount of dhinfectant aseYl...
3.Well usr(check:still use): ✓.::.ri'c�
.WaterSapply Well: 714Scaling materials uscai-(clr t;411-th:t0lipht-
QAgrieulttuld ❑14Lttniciliwl.Q'ttblie 0 New Cement[drain 0 Dornonite Chips or POIcts
DUeotlmerm:tl(Hcatin&'f`noling Supply] 0RcFidcrn4,t1 Wat+:r.Supply O Sund Cenunt Grout 11 Dry Clan
Ctludustaialf(:omntt rci ll ❑Residential Water Supply(rb:ered) O Concrete Grout O Drill Cuttings
❑lard tiau ❑Specialty Grout ❑Gravel
Non-Water Supply well: M Bentollile Slorn, rj Other(explai11 under fig)
119manilrrute ORct cts n
Injection Well: 7T For each material selected above,provide amonat of material`used:
DAquifer Recluirge Ofirundssatet Iteutedimion
OAquiFer Storage and Rccovery DSalinin Darner
❑Agaufct Test 0Statntesatcr t7rr{nlaLe
Bentonite.:501b ,Wtr:7gal.
OEaprrtintaatal Tec a atogy OSubsidence Caimtol 7g.Provide a brief description of the abandonment procedure:
0Gwthdruusl(Closed Loop} ClTtacer
Pour from surface.
OG ITte[uvtl(la ttitb>w+Conlin Return} 00dier(plain undo 7stt
d.i1 ttc svcll(sl iibandoned: 5-27-2022
aa.Well location:
Trane
Vu6J t)+'0cvwr Name F:s lity 1DM car;tppli:ahkc S.Certification:
2022
800 Beaty St. Davidson, NC 28036 5/31� /
sisal Addrm,0%;,mud Zits Daze
Iredell FIy s:<:.r:uu this fiarrn. I hereby cr;rrfjv Mat td a sreUpsi wax n eY rrhmid oyied rat
Cil:a ly I'accl lJ rtii?vltinn?Ju.WIN) acrvalanci tcitlr MA A.4C,02 .4l100 sir 2 .0,'00 frill T,'onstrur--Arvin SiamrAmct!s
mid-drat a r_npp.nj'Ais-record 1.a+.l ewlprovidlefla 11fers•.eld owner.
Sb.Latitude and tonotu.de in&gm fminrttesf'c=n&or decimal deg" a:
(irnill('wK*a,h0ima is ma;wo) 9.Site diagram or additional well details:
You tying rue ih back of this Fee to provide additiotual weli site details or sell
W stbattdauntettiderails. YOU tua}also:>gwclt Afclitiarlul Pages ifmcessafV-
COIs NTI'Ri1C IQN DETAILS(IN WEUI-S1 BEING ABANDONED SURAiTTTAi f�S7 RLTI Tifl�i5
Afft?er'r wd+cotainict+rjr:rravr tv of atrilcz.'rle. 1`or mtrlopk aijechm or
rrcr•rrarrr�}plr -— - ---
{rrlr3airl'iti8rrt eauacrfn,;rrurr„n"t r;ri;ti,:{rrrt_i rrten::.sntyrit:rumrirnz l9a.For All %Wllm. Submit thin Coati within+0 dyes of completion of sell
6a.Well to#'MW-3 abandonmea;to the fililowing:
itiivlsiotrofl4'ateritesituITLS;ItafoltitlatiatTProciscia, Unit;
6b.Total well depth: 20 C 00 1617.51ail Service Center,Raleigh.XC 27fi99-1617
10b. fit addition to sending twat forin to time address io lira
GC.Borehole diameter;?" above.21sa subinit one copy of this force within.10 dsys of t;otnpl;:ti€n of well
(iu.} abandatuncul to the fallaniug:
6d Water Icscl beano round surface: (ft.} Division of Water Resources,Underground Injection Control Program,
1636 Mail Serice Center,Ralci2h,NC 27699-1636
fie.Outercrninn length-(if-Irnown): 10 fft loc.Fnr W:etjr Sunnls'&-lisle one
Cil To addition io sodding tbia font to
We addmss(es) itbos'e. also xibutin cue copy of this fonu i
within _0 days of
Completion of well ahandamr.nt to the Count% Its-with deparmtent of the count
(it.Inner ca9inp,+tubiag.knyKb(if known): (fw)
where ahandoited,.
6g.Screen length(if knot*n):10
Faint 6W-.'Io Nanti Carolina Detnntuccn cif Enumanu:at all]Natural Resouxes-Di;istan of Warer vesountis Re%5Cd Aitgusi 21)1 i