HomeMy WebLinkAbout__20230113 . WELL ABANDONMENT RECORD For Internal Use ONLY: i
I ,
1.Well Contractor Information: WELL ABANDONMENT DETAILS '
Kevin White 7a.For Geoprobe/DPT or Closed-L I p Geothermal Wells having the same
Well Contractor Name(or well owner personally abandoning well on his/her property) well construction/depth,only I GW 130 is needed. Indicate TOTAL NUMBER of
2973 wells abandoned:1
I16
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): . _ (gal.)
I' '
Parratt-Wolff, Inc. FOR WATER SUPPLY WELLS ONLY: .. '
Conipany Name R"):, :.^` _•--
7c.Type of disinfectant used: tt' t_
K
2.Well Construction Permit#: J..AA �a }�,;•b;i'1
List all applicable well construction permits(i.e.UiC.County,State.Variance.etc.)ifknotpi N/V -ti 4.,
7d.Amount of disinfectant used: 7n. _
3.Well use(check well use): �l).n-..- -
Water Supply Well: 7e.Sealing materials used(check all that apply): ,-1;.' '
❑Agricultural ❑Municipal/Public ❑ Neat Cement Grout PIBentonite Chipsr o`Pellets'"• '
❑Geothermal(Heating/Cooling Supply) ['Residential Water Supply(single) ❑ Sand Cement Grout 0 Dry Clay
❑Industrial/Commercial ❑Residential Water Supply(shared) ❑Concrete Grout I ❑ Drill Cuttings
❑Irrigation ❑ Specialty Grout 0 Gravel
Non-Water Supply Well: 0 Bentonite Slurry 0 Other(explain under 7g)
❑Monitoring •Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation 2.85
❑Aquifer Storage and Recovery ❑Salinity Barrier I
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology ❑Subsidence Control
7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer
['Geothermal(Heating/Cooling Return) 0 Other(explain under 7g)
•
4.Date well(s)abandoned: 1 2-1 3-22
5a.Well location:
Kinder Morgan LLC River Road
Facility/Owner Name Facility ID#(if applicable) 8.Certification: Q
3340 River Road, Wilmington y ' -' I . 1O • a 3
Physical Address,City,and Zip Sib ature of Certified ell Contractor or Well Owner Date
New Hanover
By signing this form, I hereby certy5 that the well(s) was (were)abandoned in
County Parcel Identification No.(PIN) accordance with 15A NCAC 02C.0/00 or 2C.0200 Well Construction Standards
and that a copy of this record has been provided to the well owner.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one latllong is sufficient) 9.Site diagram or additional well details:
34.178966 N -77.951940 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 ornon-water supply wells
ONLY with the sane construction/abandonment,you can submit one forts.
10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: RW-30 abandonment to the following:
•
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 18.5 (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617
10b.For injection Wells: In addition to sending the form to the address in IOa
6c.Borehole diameter: 8 (in.) above,also submit one copy of tliis'form within 30 days of completion of well
abandonment to the following:
6d.Water level below ground surface: 6 (ft.) Division of Water Resources,Underground Injection Control'Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
i
6e.Outer casing length(if known): (ft.) 10c.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
6f.Inner casing/tubing length(if known): 3.5 (ft.) abandoned.
6g.Screen length(if known): 15 (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016
WELL ABANDONMENT RECORD For Internal Use ONLY: I
1.Well Contractor Information: WELL ABANDONMENT DETAILS
Kevin White 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 GW I30,is needed. Indicate TOTAL NUMBER of
2973 wells abandoned:'
NC Well Contractor Certification Number 7b.Approximate volume of water',remaining in well(s): 8.82 (gal.)
Parratt-Wolff, Inc. FOR WATER SUPPLY WELLS ONLY:
Company Name
7c.Type of disinfectant used:
2.Well Construction Permit#:
List all applicable well construction permits(i.e.U/C,Counny,State, Variance,etc.)ifknown l ° !!", ,
7d.Amount of disinfectant used:
3.Well use(check well use): t7;L- = 4 ue3
Water Supply Well: 7e.Sealing materials used(check all that apply):
tYi 9e •
❑Agricultural ❑Municipal/Public ❑Neat Cement Grout IN Bentonite Ch1ps.tiF PelVts I /
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑ Sand Cement Grout • ❑Dry Clay
❑Industrial/Commercial ❑Residential Water Supply(shared) ❑ Concrete Grout • I I 0 Drill Cuttings
❑Irrigation ❑ Specialty Grout ❑Gravel
Non-Water Supply Well: ❑ Bentonite Slurry ❑Other(explain under 7g)
❑Monitoring PI Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation 2.29 •
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology ❑Subsidence Control
7g.Provide a brief description of the abandonment procedure:
OGeothermal(Closed Loop) ❑Tracer
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g)
4.Date well(s)abandoned: 1 2-1 3-22
5a.Well location:
Kinder Morgan LLC River Road
Facility/Owner Name Facility ID#(if applicable)
8.Certification:
3340 River Road, Wilmington r - a3
Physical Address,City,and Zip Signature of Certified Well Contractor or'�ell Owner Date
New Hanover
By signing this form, I hereby certify that the well(s) was(were) abandoned in
County Parcel identification No.(PIN) accordance with 15A NCAC 02C.0i00 or 2C.0200 Well Construction Standards
and that a copy of this record has been provided to the well owner.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one latllong is sufficient) 9.Site diagram or additional welbdetails:
34.179008 N -77.951948 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-31 • abandonment to the following:
C Division of Water Resources,Information Processing Unit,
6b.Total well depth: 1 8.`� (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617
10b.For Injection Wells: In addition to sending the form to the address in l0a
6c.Borehole diameter: 8 (in.) above,also submit one copy of tliiis form within 30 days of completion of well
abandonment to the following:
6d.Water level below ground surface:.5 (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): (ft.) IOc.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
6f.Inner casing/tubing length(if known): 3.5 (ft.) abandoned. i t
6g.Screen length(if known): 1 5 (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resource i Revised 2-22-2016
{
WELL ABANDONMENT RECORD For Internal Use ONLY: I
1.Well Contractor Information: WELL ABANDONMENT DETAILS
r
Kevin White 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 GW-30 is needed. Indicate TOTAL NUMBER of
2973 wells abandoned:'
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): 8.82 (gal.)
I.
Parratt-Wolff, Inc. FOR WATER SUPPLY WELLS ONLY: l
Company Name 'nr
7c.Type of disinfectant used: % ..i', .1- ,�:71 ,+-
2.Well Construction Permit#: ,I '• s i_N,,'
List all applicable well construction permits(i.e.UUC'.County.State.Variance.etc.)ifknown JA AI 1 r
7d.Amount of disinfectant used: 4 2023
3.Well use(check well use): I r^•'C>rt,•-,.;cn
mi.,,
Water Supply Well: 7e.Sealing materials used(check all that apply): w•:e Q,, L3�; 1:-'3 1-1.1
❑Agricultural ❑Municipal/Public ❑Neat Cement Grout I'Bentonite Chips or Pellets
OGeothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑ Sand Cement Grout ❑Dry Clay •
❑Industrial/Commercial ❑Residential Water Supply(shared) ❑ Concrete Grout I I 0 Drill Cuttings
❑Irrigation ❑ Specialty Grout ' ❑ Gravel
Non-Water Supply Well: ❑ Bentonite Slurry 0 Other(explain under 7g)
❑Monitoring I Recovery
Injection Well: 7f.For each material selected above,provide amount of-materials used:
❑Aquifer Recharge ❑Groundwater Remediation 2.29 •
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage
❑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) -
4.Date well(s)abandoned: 1 2-1 3-22
5a.Well location:
Kinder Morgan LLC River Road - - - - - - -- - --
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
3340 River Road, Wilmington i _ 0..9,, 1 • lv• a-S
Physical Address,City,and Zip Signature of Ceniifie3 Well Contractor or Well Owner Date
New Hanover _ .
By signing this form, 1 hereby certify that the well(s) was(were) abandoned in
County Parcel Identification No.(PIN) accordance with 15A NCAC 02C.0100 or 2C.0200 Well Construction Standards
and that a copy of this record has teen provided to the well owner.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees: i i
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.179047 N -77.951958 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 nwell construction record(s)ifasailable. For multiple injection ornon-water supply wells '
ONLY with the same construction/abandonment.you can subtriit,one form.
10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: RW-32 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth 18.5 (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617
10b.For Injection Wells: In addition to sending the form to the address in 10a
6c.Borehole diameter: 8 (in.) above, also submit one copy of flits'form within 30 days of completion of well
abandonment to the following: I
6d.Water level below ground surface: 5 (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): (ft.) 10c.For Water Supply&Infection 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
6f.Inner casing/tubing length(if known): 3.5 (ft.) abandoned.
6g.Screen length(if known): 15 (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016
I .
. Il
WELL ABANDONMENT RECORD For Internal Use ONLY: I
1.Well'Contractor Information: WELL ABANDONMENT DETAILS
Kevin White 7a.For Geoprobe/DPT or Closed ILoop Geothermal Wells having the same •
Well Contractor Name(or well owner personally abandoning well on his/her property) well construction/depth,only 1 GW,30 is needed. Indicate TOTAL NUMBER of
2973 wells abandoned:' I
8
NC Well Contractor Certification Number 7b.Approximate volume of wateri remaining in well(s). .82 (gal.)
Parratt-Wolff, Inc. FOR WATER SUPPLY WELLS'ONLY: b . i,A ..,r,:::. ' "s,
Company Name • s
7c.Type of disinfectant used: i h i N
2.Well Construction Permit#: `� .?a?? ..
List all applicable well construction permits(i.e.U1C County,State.Variance,etc.)if known t"''i'iv:• -'F,
7d.Amount of disinfectant used: • {"`'`-f?r-.-
3.Well use(check well use): '`'' Cry,;
Water Supply Well: • 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public ❑Neat Cement Grout a Bentonite Chips or Pellets
OGeothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑ Sand Cement Grout 1 0 Dry Clay
• ❑Industrial/Commercial ❑Residential Water Supply(shared) ❑ Concrete Grout I . ❑Drill Cuttings .
❑Irrigation 0 Specialty Grout i 0 Gravel
Non-Water Supply Well: ❑Bentonite Slurry ❑ Other(explain under 7g)
❑Monitoring In Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
['Aquifer Recharge 0 Groundwater Remediation 2.29 •
❑Aquifer Storage and Recovery 0 Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology 0 Subsidence Control
7g.Provide a'brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer
0 Geothermal(Heating/Cooling Return) ❑Other(explain under 7g)
- 4.Date well(s)abandoned: 12-1 3-22
5a.Well location: •
Kinder Morgan LLC• River Road
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
3340 River Road, Wilmington I .
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
New Hanover ii
By signing this form, I hereby certify that the well(s) was(were)abandoned in
County Parcel Identification No.(PIN) accordance with 15A NCAC 02C.0100 or 2C.0200 Well Construction Standards
and that a copy of this record has bleet�n provided to the well owner.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees: I
(if well field,one lat/long is sufficient) 9.Site diagram or additional well'details: ,
34.178847 N -77.951964 `,l, 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-hater supply wells 1 .
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-32 abandonment to the following: ''
Division of Water Resources,Information Processing Unit,
18.5 1617 Mail Service Center,Raleigh,NC 27699-1617
6b.Total well depth: (ft.) 1,
lOb.For Injection Wells: In addition to sending the form to the address in 10a
6c.Borehole diameter: 8 (in.) above,also submit one copy of this'form within 30 days of completion of well
abandonment to the following:
6d.Water level below ground surface: 5 (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
I
6e.Outer casing length(if known): (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
6f.Inner casing/tubing length(if known): 3.5 (ft,) abandoned.
6g.Screen length(if known): 15 (ft.)
Form OW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016
WELL ABANDONMENT RECORD For Internal Use ONLY:
t
1.Well Contractor Information: WELL ABANDONMENT DETAILS
Kevin White
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 GW 30 is needed. Indicate TOTAL NUMBER of
2973 wells abandoned:' l I
NC Well Contractor Certification Number 7b.Approximate volume of waterjremaining in well(s): 8.82 (gal.)
Parratt-Wolff, Inc. FOR WATER SUPPLY WELLS:ONLY:
Company Name •
7c.Type of disinfectant used: f"
2.Well Construction Permit#: tiP ^�
List all applicable well construction permits(i.e.UIC,County,State.Variance,etc.)ijlmmo; '''-a G o ')
7d.Amount of disinfectant used: r.
3.Well use(check well use): 1�1 iv i r
Water Supply Well: 7e.Sealing materials used(check all that applrk)SCr;aY„,n r)r
❑Agricultural ❑Municipal/Public ❑Neat Cement Grout I Bentonite Clip.set;lleti:i;9`t
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Thy Clay
❑IndustriallCommercial ' OResidential Water Supply(shared) 0 Concrete Grout '' ❑Drill Cuttings
❑Irrigation ❑ Specialty Grout 1 0 Gravel
Non-Water Supply Well: ❑Bentonite Slurry ❑Other(explain under 7g)
❑Monitoring !Recovery
Injection Well: If.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation 2.29
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology ❑Subsidence Control
7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer
❑Geothermal(Heating/Cooling Retum) ❑Other(explain under 7g) •
4.Date well(s)abandoned: 1 2-1 3-22
5a.Well location:
Kinder Morgan LLC River Road
Facility/Owner Name Facility ID#(if applicable) 8.Certification: 0 3340 River Road, Wilmington :...sa_
. /•(O .2
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
New Hanover
By signing this form, I hereby certify that the well(s) was (were) abandoned in
County Parcel identification No.(PIN) 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.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees: 1 1
(if well field,one Iatllong is sufficient) 9.Site diagram or additional welll'details:
34.179189 N -77.951856 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 cmrsnvction/abandonment,you can submit one form. 10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: RW-34 abandonment to the following:
Division of Water Resources,Information Processing Unit,
1617 Mail Service Center,Raleigh,NC 27699-1617
6b.Total well depth: 18.5 (ft)
lOb.For Injection Wells: In addition to sending the form to the address in l0a
6c.Borehole diameter: 8 (in.) above, also submit one copy of this form within 30 days of completion of well
abandonment to the following:
6d.Water level below ground surface: 5 (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): (ft.) 10c.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
6f.Inner casing/tubing length(if known): 3'5 (ft.) abandoned.
6g.Screen length(if known): 15 (ft.)
Form OW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-20I6
i I
i
WELL ABANDONMENT RECORD For Internal Use ONLY:
I ;
1.Well Contractor information: WELL ABANDONMENT DETAILS
11
Kevin White 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 GW i30 is needed. Indicate TOTAL NUMBER of
2973 wells abandoned:' I '
NC Well Contractor Certification Number 7b.Approximate volume of waterPremaining in well(s): 8'82 (gal.)
l
Parratt-Wolff, Inc. FOR WATER SUPPLY WELLS'ONLY:
Company Name
7c.Type of disinfectant used:
2.Well Construction Permit#:
List all applicable well construction permits(i.e.UK',County,State.Variance,etc.)if known ''- '>~' T.,.
7d.Amount of disinfectant used: `'�> _-P-- 77„
3.Well use(check well use): ,q '-" "''a )
Water Supply Well: 7e.Sealing materials used(check all that apply): - N 2023
❑Agricultural ❑Municipal/Public 0 Neat Cement Grout II BentorigChips.or, ellets
....-
❑Geothermal(Heating/Cooling Supply) OResidential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay Er.,,,,-,.,,• -..-.., t
• 4io"o.G 'Li C,T.,i
❑Industrial/Commercial ❑Residential Water Supply(shared) 0 Concrete Grout i 0 Drill Cuttings
❑Irrigatiori ❑ Specialty Grout 0 Gravel
Non-Water Supply Well:
PP Y 0 Bentonite Slurry ❑Other(explain under 7g)
❑Monitoring IRecovery •
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation 2.29
❑Aquifer Storage and Recovery 0 Salinity Barrier .
❑Aquifer Test ❑Stormwater Drainage ;
•
❑Experimental Technology ❑Subsidence Control
7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) OTracer
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g)
•
4.Date well(s)abandoned: 12-13-22
5a.Well location:
Kinder Morgan LLC - River Road
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
3340 River Road, Wilmingtonii, IvU - a3
•
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
New Hanover By signing this form;I hereby certfy that the well(s) was(were) abandoned in
County Parcel Identification No.(PIN) accordance with 15A NCAC 02C.0100 or 2C.0200 Well Constructions Standards
and that a copy of this record has been en provided to the well owner.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one Iat/long is sufficient) 9.Site diagram or additional welidetails:
34.178969 N -77.952003 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 nve!!construction record(s)ifavailable. For multiple injection or non-water supplyuellr - -
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-33 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 18.5 (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617
10b.For Injection Wells: in addition to sending the form to the address in 10a
6c.Borehole diameter: 8 (in.) above,also submit one copy of this form within 30 days of completion of well
abandonment to the following:
6d.Water level below ground surface: 5 (ft.) Division of Water Resources,Underground Injection Control Program, -
1636 Mail Service Center,Raleigh,NC 27699-1636
I
6e.Outer casing length(if known): (ft.) 10c.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
6f.Inner casing/tubing length(if known): 3.5 (ft.) abandoned.
6g.Screen length(if known): 15 (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016
WELL ABANDONMENT RECORD For Internal Use ONLY:
1
1.Well Contractor Information: WELL ABANDONMENT DETAILS
Kevin White ate 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 GW I30 is needed. Indicate TOTAL NUMBER of
2973 wells abandoned:' 1 1
7b.Approximate volume of water!'remaining in well(s): 1 0'1 2 (gal.)
NC Well Contractor Certification Number i
Parratt-Wolff, Inc. FOR WATER SUPPLY WELLS ONLY:
Company Name r
7c.Type of disinfectant used:
2.Well Construction Permit#: } L; y"�'r
List all applicable well construction permits(i.e.U!C,County,State,Variance,etc.)if known JAAj am=ta
7d.Amount of disinfectant used: 7n3�
3.Well use(check well use): iii,:^; ,°t
Water Supply Well: 7e.Sealing materials used(check all that apply): �� -, y .
❑Agricultural ❑Municipal/Public ❑Neat Cement Grout I Bentonite Chips or Pellets`fit` Ltr"'
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout ❑Dry Clay
❑Industrial/Commercial OResidential Water Supply(shared) ❑ Concrete Grout 0 Drill Cuttings . --
I r
❑Irrigation ❑ Specialty Grout 0 Gravel
Non-Water Supply Well: 0 Bentonite Slurry 0 Other(explain under 7g)
❑Monitoring URecovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation 1.63
:Aquifer Storage and Recovery ❑Salinity Barrier .
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology 0 Subsidence Control
7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer
❑Geothermal(Heating/Cooling Retum) ❑Other(explain under 7g)
4.Date well(s)abandoned: 1 2-1 3-22
5a.Well location:
Kinder Morgan LLC River Road .
Facility/Owner Name Facility ID#(if applicable) 8.Certification: �`
3340 River Road, Wilmington . fD . a3
Physical Address,City,and Zip Sign• re of Well Contractor or Well Owner Date
New Hanover By signing this form, I hereby certify that the well(s) was(were) abandoned in
County Parcel Identification No.(PIN) accordance with ISA NCAC 02C.0100 or 2C.0200 Well Construction Standards
and that a copy of this record has been provided to the well owner.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees: I. I
(if well field,one Iatllong is sufficient) 9.Site diagram or additional well details:
34.179209 N -77.951864 N, 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)lfavailable. For multiple injection or non-water supply wells - -
ONLY with the same construction/abandonment,you can submit one fora.
10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: RW-1 9 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 1 7.5 (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617
10b.For Injection Wells: In addition to sending the form to the address in 10a
8 above, also submit one copy of tliis form within 30 days of completion of well
6c.Borehole diameter: (in.)
abandonment to the following: 1
6d.Water level below ground surface:
3 (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
1
i
6e.Outer casing length(if known): (ft.) 10c.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
6f.Inner casing/tubing length(if known): 2.5 (ft.) abandoned. I
i
6g.Screen length(if known): 15 (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resource) Revised 2-22-2016
1I
4
f
WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS .
I
Kevin White 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 GW J30 is needed. Indicate TOTAL NUMBER of
2973 wells abandoned:' I I NC Well Contractor Certification Number 7b.Approximate volume of waterireinaining in well(s): 8.82 (gal.)
Parratt-Wolff, Inc. FOR WATER SUPPLY WELLS'ONLY:
Company Name
7c.Type of disinfectant used:
2.Well Construction Permit#:
List all applicable well construction permits(i.e.U/C,County.State,Variance,etc.)if known
7d.Amount of disinfectant used: iR
3.Well use(check well use): -- s,,, . E j?•v
Water Supply Well: 7e.Sealing materials used(check all that apply): J1411 1 ""'i .
❑Agricultural ❑Municipal/Public ❑Neat Cement Grout a Bentonit�Chips or PeVllets ` 2023
OGeothermal(Heating/Cooling Supply) :Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay 1?j ti-,_
C1,.,.• .,.
❑Industrial/Commercial ❑Residential Water Supply(shared) ❑Concrete Grout �I ❑Drill Cuttings _ '���.G "'�2_t;,ir_
_ ❑Irrigation ❑ Specialty Grout 0 Gravel
Non-Water Supply Well: ❑ Bentonite Slurry ❑Other(explain under 7g)
❑Monitoring ' IN Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
DAquifer Recharge ❑GroundwaterRemediation 2.29
❑Aquifer Storage and Recovery 0 Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage
•
❑Experimental Technology 0 Subsidence Control 7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g)
4.Date well(s)abandoned: 1 2-1 3-22
5a.Well location:
Kinder Morgan LLC River Road
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
3340 River Road, Wilmington /sr) - j I
Physical Address,City,and Zip Signature of Certified Well Contractor or Well caner Date
New Hanover By signing this form, I hereby certify that the well(s) was (were) abandoned in
County Parcel Identification No.(PIN) 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.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.179169 N -77.951853 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-34 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 18.5 (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617
lOb.For Injection Wells: In addition to sending the form to the address in 10a
6c.Borehole diameter: 8 (in,) above, also submit one copy of this form within 30 days of completion of well
abandonment to the following: I,
5 Division of Water Resources,'Underground Injection Control Program,
6d.Water level below ground surface: (ft.)
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): (ft.) 10c.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
6f.Inner casing/tubing length(if known): 3.5 (ft.) abandoned.• 4
6g.Screen length(if known): 1 5 (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016
I .
PI
WELL ABANDONMENT RECORD For Internal Use ONLY:
I
1.Well Contractor Information: WELL ABANDONMENT DETAILS
,
Kevin White °
7a.For Geoprobe/DPT or Closed-L'otip Geothermal Wells having the same
Well Contractor Name(or well owner personally abandoning well on his/her property) well construction/depth,only I GW-30!is needed. Indicate TOTAL NUMBER of
2973 wells abandoned:I
•
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): 8.82 _ (gal.)
Parratt-Wolff, Inc. FOR WATER SUPPLY WELLS ONLY:
Company Name
• 7c.Type of disinfectant used: re...
2.Well Construction Permit#: rSr 1 ,---,
• List all applicable well construction permits(i.e.U!C,County,State.Variance,etc.)ifknowrr �;,
7d.Amount of disinfectant used: +_
3.Well use(check well use): • I ��Ijy, `,I
r,.s -I .1.,'2p --
Water Supply Well: 7e.Sealing materials used(check all apply --�'�+�;;-`..� . 23 .
❑Agricultural ❑Municipal/Public 0 Neat Cement Grout a Bentonite Gliij o �?ellets
`-'l)..r.
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay t'--0 : ;;p 1,,
❑Industrial/Commercial ❑Residential Water Supply(shared) ❑Concrete Grout El Drill Cuttings
❑Irrigation 0 Specialty Grout ❑Gravel
Non-Water Supply Well: 0 Bentonite Slurry 0 Other(explain under 7g)
❑Monitoring URecovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑GroundwaterRemediation 2.29
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage '
❑Experimental Technology ❑Subsidence Control 7g.Provide a brief description of the abandonment procedure:
OGeothermal(Closed Loop) ❑Tracer
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g)
4.Date well(s)abandoned: 1 2-1 3-22
5a.Well location: ,
Kinder Morgan LLC River Road
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
3340 River Road, Wilmington ,/a • v .
Physical Address,City,and Zip Signature of Certified Well Contractor or Well caner Date
New Hanover
By signing this form, I hereby certify that the well(s) was (were) abandoned in
County Parcel Identification No.(PIN) accordance with 15A NCAC 02C J0100 or 2C.0200 Well Construction Standards
and that a copy of this record has been provided to the well owner.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one lat/long is sufficient)
9.Site diagram or additional well details:
34.178870 N -77.951891 `,l, 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 recor (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-32 abandonment to the following:
• Division of Water Resources,Information Processing Unit,
6b.Total well depth: 1 8.5 (ft) 1617 Mail Service Center,Raleigh,NC 27699-1617
10b.For Injection Wells: In addition to sending the form to the address in 10a
6c.Borehole diameter: 8 (in.) above, also submit one copy of this form within 30 days of completion of well
abandonment to the following: 1
i
6d.Water level below ground surface: 5 (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service,Center,Raleigh,NC 27699-1636
1
6e.Outer casing length(if known): (ft.) 10c.For Water Supply&lniection Wells: In addition to sending the form to the
address(es)above,also submit one dopy of this form within 30 days of completion
of well abandonment to the county health department of the county where
6f.Inner casing/tubing length(if known): 3.5 _(ft.) abandoned.
6g.Screen length(if known): 15 (ft.) 1
•
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016