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Home My WebLink AboutWake_Well Abandonment_20230109 (7) WELL ABANDONMENT RECORD For Internal Use ONLY: 1.Well Contractor Information: WELL ABANDONMENT DETAILS 1i D.T. Chalmers 7a.For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same Well Contractor Name(or well owner personally abandoning well on his/her property) well construction/depth,only 1 GIN-30 is needed. Indicate TOTAL NUMBER of 4146-A wells abandoned: i NC Well Contractor Certification Number 7b.Approximate volume of water re;.ining in well(s): (gal.) CATLIN Engineers and Scientists:,==;e'tt--, FOR WATER SUPPLY WELLS ONLY: Company Name I n a 2.Well Construction Permit#: NA A U Q 2l'2J 7c.Type of disinfectant used: i List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)ifknoiin. 7r,^.:' 7d.Amount of disinfectant used: 3.Well use(check well use): Water Supply Well: 7e.Sealing materials used(check all that apply): ❑Agricultural ❑Municipal/Public ❑Neat Cement Grout N Bentonite Chips or Pellets []Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑Sand Cement Grout ❑Dry Clay ❑Industrial/Commercial El Residential Water Supply(shared) ❑Concrete Grout ❑Drill Cuttings ❑Irri ation ❑ Specialty Grout ❑Gravel Non-Water Supply Well: ❑ Bentonite Slurry e Other(explain under 7g) RMonitoring ❑Recovery Injection Well: 7E For each material selected above,provide amount of materials used: ❑Aquifer Recharge ❑GroundwaterRemediation Bentonite Pellets — 50 Ibs ❑Aquifer Storage and Recovery ❑Salinity Barrier ❑Aquifer Test ❑Stormwater Drainage TOPSOII 5 Ibs ❑Experimental Technology ❑Subsidence Control 7g.Provide a brief description of the abandonment procedure: ❑Geothermal(Closed Loop) ❑Tracer ❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g) Well abandoned in place with hydrated Bentonite pellets to top of well. Vault left in place and filled with nearby crushed 4.Date well(s)abandoned: 11/23/2022 concrete and topsoil to within 1 foot of surface and topped 5a.Well location: with concrete to existing grade. Vault cover put back in place. NCDEQ-Former Star Flite 52 Property NA Facility/Owner Name Facility ID#(if applicable) 8.Certification: 1904 St. Albans Dr., Raleigh, 27609 12/29/2022 Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date Wake NA 1. By signing this form, 1 hereby certif},that the ivell(s) was(were) abandoned in County Parcel Identification No.(PIN) accordance with I5A NCAC 02C.0100 or 2C.0200 Well Construction Standards and that a copy of this record has beer:provided to the ivell owner. Sb.Latitude and longitude in degrees/minutes/seconds or decimal degrees: (if well field,one Iat/long is sufficient) 9.Site diagram or additional well details: 35.834 N -78.606 W 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. CONSTRUCTION DETAILS OF WELL(S)BEING ABANDONED SUBMITTAL INSTRUCTIONS 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. 10a. For All Wells: Submit this form within 30 days of completion of well 6a.Well ID#: RW-2 abandonment to the following: Division of Water Resources,Information Processing Unit, 6b.Total well depth: 45 (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617 10b.For Iniection Wells: In addition to sending the form to the address in 10a 12.25 above, also submit one copy of this form within 30 days of completion of well 6c.Borehole diameter: (in.) abandonment to the following: i 6d.Water level below ground surface: NM (ft.) Division of Water Resources,Underground Injection Control Program, 1636 Mail Service Center,Raleigh,NC 27699-1636 1 6e.Outer casing length(if known): NA (ft.) 10c.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 6E Inner casing/tubing length(if known): 15 (ft.) abandoned. 6g.Screen length(if known): 30 (ft.) Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016 1 WELL ABANDONMENT RECORD For Internal Use ONLY: 1.Well Contractor Information: WELL ABANDONMENT DETAILSf D.T. Chalmers 7a.For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same Well Contractor Name(or well owner personally abandoning well on his/her property) well construction/depth,only I GIN-kiis needed. Indicate TOTAL NUMBER of 4146-A wells abandoned: NC Well Contractor Certification Number ' g V 7b.Approximate volume of water remaining aining in well(s): (gal.) Li CATLIN Engineers and Scientists FOR WATER SUPPLY WELLS ONLY: Company Name 7c.Type of disinfectant used: 2.Well Construction Permit#: NA List all applicable ivell construction permits rt.e.UIC,County,StatF;Vc rigtiaQ-q10 ifknoivn 7d.Amount of disinfectant used: 3.Well use(check well use): Water Supply Well: 7e.Sealing materials used(check all that apply): ❑Agricultural ❑Municipal/Public ❑Neat Cement Grout a Bentonite Chips or Pellets ❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑ Sand Cement Grout ❑ Dry Clay ❑Industrial/Commercial ❑Residential Water Supply(shared) ❑ Concrete Grout ❑ Drill Cuttings ❑Irri ation ❑Specialty Grout ❑ Gravel Non-Water Supply Well: ❑Bentonite Slurry e Other(explain under 7g) RMonitoring ❑Recovery Injection Well: 7E For each material selected above,provide amount of materials used: ❑Aquifer Recharge ❑GroundwaterRemediation Bentonite Pellets — 50 Ibs ❑Aquifer Storage and Recovery ❑Salinity Barrier ❑Aquifer Test ❑Stormwater Drainage TOpS011 5 Ibs ❑Experimental Technology ❑Subsidence Control 7g.Provide a brief description of the abandonment procedure: ❑Geothermal(Closed Loop) ❑Tracer Well abandoned in place with hydrated bentonite ❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g) pellets to top of well. Vault pulled and filled with a.Datewell(s)abandoned: 11/23/2022 nearby crushed concrete to within 1 foot of surface 5a.Well location: and topped with topsoil to existing grade. NCDEQ-Former Star Flite 52 Property NA Facility/Owner Name Facility ID#(if applicable) 8.Certification: �� 1904 St. Albans Dr., Raleigh, 27609 ��' 12/29/2022 Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date Wake NA By signing this form, !hereby certify that the tvell(s) was (were) abandoned in County Parcel Identification No.(PIN) accordance with I SA NCAC 02C.0100 or 2C.0200 Well Construction Standards and that a copy of this record has been provided to the ivell owner. Sb.Latitude and longitude in degrees/minutes/seconds or decimal degrees: (ifwell field,one lat/long is sufficient) 9.Site diagram or additional well details: 35.834 N -78.606 W 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. CONSTRUCTION DETAILS OF WELL(S)BEING ABANDONED SUBMITTAL INSTRUCTIONS Attach we//construction record(s)ifavailable.For multiple injection ornon-water supply wells ONLY with the saute construction/abandonment,you can submit one form. 10a. For All Wells: Submit this form within 30 days of completion of well 6a.Well ID#: RW-3 abandonment to the following: Division of Water Resources,Information Processing Unit, 6b.Total well depth: 50 (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617 10b.For Infection Wells: In addition to sending the form to the address in 10a 12.25 above, also submit one copy of this form within 30 days of completion of well 6c.Borehole diameter: (in.) abandonment to the following: 6d.Water level below ground surface: NM (ft.) Division of Water Resources,Underground Injection Control Program, 1636 Mail Service Center;Raleigh,NC 27699-1636 6e.Outer casing length(if known): NA (ft.) loc.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 611 Inner casing/tubing length(if known): 10 (ft.) abandoned. j i 6g.Screen length(if known): 40 (ft.) Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016 l �� A►EIN f10pE CI LURCH R N D '.. c� MW-27 (CNL) MW-34 • MW 8 M -12 (CNL) MW-25 SOS (CNL) E �P� • Mw-5 r!' MW-3 AS-2 AS=1 � MW� _ MW-26 RW-1 MW-16D ® MW-11 MW-9 9 (CNL) �NL) ■ ';MW,-10 RW-3 MW-31D MW-1 MW_2 (CNLr MW-15 ® -NL) (CNL) .. ■ RW-2 MW-20 MW-73� MW-33 W 4 MW 2D �0 MW-30®MW1- MW-294 ® Mw- 8 ® M W-2.2 LEGEND ®M W-21 1 ® Monitoring Well (Type 11) 0MW-2 ® Abandoned Monitoring Mw z3 — Well (Type 11) - O Monitoring Well ® MW-24 (Type 111) O Monitoring Well ' (Type III) O Abandoned Air Sparge Well Abandoned Recovery Well Q Parcel Boundary , e _ Approximate Location of Former Tank Basin star �eograP C he sefCommunity NOTES: 1. Well and tank locations were obtained from previous reports 80 40 0 80 160 prepared by other consultants and are approximate. 2. CNL=Could Not Locate Feet PROJECT TIME FIGURE FORMER STAR FLITE ATLIN52 PROPERTY SITE MAP 1904 ST ALBANS DR Engineers and Scientists RALEIGH, NC MCiDENTNO JOBNO DATE SCALE DRAWN BVICHECKED BV 6896 220333 DEC 2022 AS SHOWN KMC/SJO