Mecklenburg_Well Abandonment_20230118 (2)

NVELL:ABANDONMENT'REC'O.RD. rQiltnrni,,t:w oN1 ::
• TT(i form ran�y u«d:fi?cstn�?t oi',nndttp[4ti::11s
1 VV'c1l'f actur 11-fikrnr:%t �V 1.1";ABANDONt11EN•I'DrTAtE -
Stefan Smith ?a Itluntber of udl king abodnned 1
1'c11+}}r�r+t;eiN�nt�tnrtiitllontxi. raa��ll} ilasrlaiun�u�1:5�1t ilii:prti{un}). t 'NuttrfG tn':�trr�rr .:a 1N1J-11wFyr Ir�.jJr x+Oir. ONLY u,rh '._;* ,ra,0
irmtrirctrt:r iw,arxf,atmrt!I,;yore r.e t,t7tt?nrt(Ole G,i'en..
3576A E C E i i/ ill.Appn►�Im itct itlunic of�t arer rematuntr to tl cllls}�1 cs,al.)
NCllcl3t" tiLri�lorC�.tlif�iU,}1;t mi9icr
SAEDACCO Inc JAN 1 5 23 >OR�v�rF>ii,��lrP�,titv�I.0 orlr:
Cbna�i inv l( rtic 7t `T}'p+of tltyufi•ctant uul::N/A _
Irtfcrtr�a:r�:t 'r.^.�ga sti3 Una -
2;1V'cllGiin4ritctftin:Peintit'Y:70003109,.. _Gi":`trt3fk�
U r<r�i-a a fts rG!e ur,l,�nrlh i,e:Ciur tj Ott z;l urht ti'r,1,iYi,ri,�.. lrt rf�t,r',ert
•.. rd.�itini�unt of di�rnfecl:�nl u+rtt:.; _ --
3 VYdt u+�(�hcckttdlutc);
tV atcr Stopply Well; 7c 5caltn�coati n tFt liscd(chct l all that app1+}
Q a ii�ullt�►it, �ihhnticip tUT'tlbt s; (a NC#i(cmcnE Gr+�ut; Q A�utotittc C hlps Ur f�ll�ls;
QGc itumbti St-tcatmiV(tb<)ltn '$uliply ❑12CS1drnh•11.W.,ttcr SnpTil} Icm�le);. Q'S:uisi tcnti tl C:riitit ,Q ll�CI t�
Qirufnstrial?Cbimitctc n) C3116id;:ndA Wit&Supph•(sliaivd). Q Co un to G iil t "17 DnItCulnji,
❑leri* lion' -:-d Sim,:wtV GipuE
Nnci VV`atcr'titipphtffi B.C00nitc Slutn Ialder^g)
CDh4uiatonn�<. i712itui•;;N
Injcctt4n ttidl�. 7F.'Rinreaihlitatcriitl tie1CCiCd adlGF�,pf•Lil'IdCantrytl[Et gf�Ili;Ifl.C1a15115Cd:
❑Ailtrfer(icclur$e_, QGrounu tt�s krurcdiriion.
Q 4gtttfer Storit.c atYl lZt,•40v rt� QSalnnij l3 tmcc
ra}ufcrles! QSlontiitatcrDtiit�t i Bentonite.:Aqua-guardlb ,Wtr:5gal.
Q
:.
Q�agntnuttei.TtlhnUl_vsti QSnbsicl�tt Coretrial 7 'I'irnultatincfdtScitptmu f.fhcat►an(mmncntprovpi ri:
UGiitTt�,mtal{Ctat�d T<OQj1) l7Traccr "� , - - _ ::.
IJG2tlt<nttal(Firlutt.;CouUvzRclurn} L101ticttc�plaitllnidtC::7r) pulled entire well and poured bentonite slurry.
4 Datr++rll(s}:abatilUirctl 12/15/2022
Sa Wdl titration:
Colwick Road Property
T7ci14iYr IVI►c*tait�`' laalu�ipr''(irtppl>able) GCrliRctUUll
4313 Colwick Rd. Charlotte, NC 28211 ..12/26/2022
I lii sti<at',liidtrt ;Clie,soil Zip -jell n ;..Celli1kil WY Court ii7t tit�'e,l th�_i'�r' 1)a;c'
Mecklenburg 15717222 13t �`s!rrrn 11'r-s firm .I.lutteh};r fr[t 11eni.ike slNIftJ xias(i:er�t',kaji oned in
L.n:uity {�t<<1]t1 ti�ifwltkiutti,,.{Pt\l_. a t�rtliritcuilif! Ii1 :+..-`14 64Ha ':'t fl2(ir)Ticll ati�rtzttr!t1n ktrttrrcl
Onddritract�rti'tT!llii�rcrnri lin.r}telrprtn�rltdtr+;llii+t11ozsricr.'.
ih Liflhtdc and Ton tt(rd+►n dcgrccsinti tutc�lccaindc or[Icclnt i(1M"?rci
(t!"ttT17.C.clr1 rill[Ld tnil�t�ant)i ttX} � Site d11tY:1111 Ur illtlitiUlT,tI`f4Cll d�t9I15:,
You nt q ine' balk�}f this ik►gc a,prod idv addr(iatial il:,dc(ail�iir+s'ell
35.178403 - 80.798937 fit' attdanntentr]r�at�; 1'ounta}.atso,att�cG:hfaldUll t[hr�tS'If1k�155t[%k
f UtcSlNll("(IO�.DE:'tAtf of 1tE.l l g-1 BFIN( AB"O' NF.D SlA!111TTATc1NS_TR[iCTi!)i�5.:.
1(tr.ri,tirrf crrctrucre�ttri'crtrrft) t:iitwfrn'f:;.;,lurtrtrtrii:rru�tcG��r ru' r r�irrrcr.:,fiftJt'
NtrLti;vz�Lt ii•rftliiJ". 4,Irt,1`U)tdhY"C'tlgitt tr4Utafl1rh4711-IrSU,'Cd4IOa:'Frlr All:''itlll�. Su6tiiil`ihi*r=fcru�-it•itlti►r',,(}'dit'5":rif°catitjilc(iun at�s-ell
�hatctounicnt o the follmttm>';
Ga.VV'cit lll€ti TMW-5
I1iri+t n:of�Yutcr tc:nurct ;dnlorm nProressin>,1Jnit.-
tl► Tntstl +;e11 dt ptlr'39 tft;)" "1Gi7 Jfail4nu c_Gcntcr;lialuLtl j\.fi 21Ci9!i-l(i17
TUL.=FUr in_i ltein't1ed1• In itlaltlroat sLtt.ln :tlkfani tq l(te 6j, irss ut tba
fc;,Rorl L�lc'diantMew.l tin,) abww rlstt stibinit onii'top+ ef'Cltts fopi _mthhu° O oaks,ul COS 1 �Kiqu or ir�ii
:tba6do►intcnt tot ij,rd lunnwg
Di+hinn:if ltaltct-'R��ou►rs,Uud� round fn�iitton_Cnntrul'Proram;
frd..Watcrleve b i -s tadndmir•ftcc; (ft:j 1636\tailScniie-Centct,Raict;.U; (_2709 1636
iU i
15 I(Ir;.1 rtr tS'31�';ilnnh .� iri[ 1+ru V Its In i�itlrUen 'S.tldtn*Ilm r6mt'.(o
_
f:
f~;Uutrccastnl,Icn;,tti cif laint+n). (t.) the`:iddressk%' vtiOve. 1T§0 si.ibnitt OgL:,I U(5l' of:Hits t�mt t+'Ithur.`3p d irs:::of'
eoniplcunu.;af;.+icil att:+suinnn n[to i.lic coitnl} li�:iltfi dai irtntcttl°of iltc cduiu�
i hzw 71iin46ik^i1,,
6t.1nnOrLa%inl ltuhinjv(e igih.(if tutu++nj: 'Aw
6g,$ rt 6;1101'01111f uIitIvn)20
F6UnClt�=ri Npitli'laci�lircg-f)cturtn>rnofH3isir.,nul;nl ttillVawriRcsawccs brsiiion�fV,;ttccltacurc�s Eiutsccflltt uaZi�l3.

,
WELL ABANDONMENT:RECORD ' lttil,it,rttil l« ONI,l:
This f6rni cairlic used fotsnilc oiitullipte } lls j '
l \ddi(.nupactor InFitrnran{in:; NVr.1a.-ABANDONMFNT=bETAIT:ti
Stefan Smith ?a ;qun Iler of mells 6uiik aban46n&i l
t ' t•rr r;!)rfGJh iflrh*cJ,AM� t1 r4i7�iitl(<ra�fis, Q.A'[,t' •aull
ti�111(t #11Ct@Ll`8F1k(orllt^tt0%%IZI.pd.6b1�11I, tt�71L11)Illl�l<L lu rh ilaipt s y
- � y r`L r<.rt-Ulitfrar<r,�z+filrAlm 711;ttu+E't r r n?lsrl rrri tirr n
3576A
NC ldcit Ca ttstcl9rGtt,i'iG:Unn t�n,i�f7er 11) Aliorsiumatcvolu tile of,%' . mpn�
� in
icl �'1 31-
)
JAN 18 2023
FUR�1'A1Eii;SUPPL)'V4`FLI:�4Oh1 Y::
SAEDACCO Inc
�Wsi'li:�nt�.lrS,lic' IitfG(Yi:`s�C1 1�•r<<^.C�'.-y<, tit.,
yl�.rQi3r - 7u-1's`Pcofdrsiufictantu+utrrl/A ..
2.�5'cll C[rosti{ctuni Pe ni it-d:?0003109,, ,,
11 f<11uart�t +lt�i=,rrlf(hnrrA fl< irirl� 1r<ri'!'urtl,r c;Jrr�<<irrr� 7r r lit t reri
1(1.. lrn6inf of d1�iitfccE�nCu4stit1:'
3,Wetl u,�(�tcel.n ilf ut4j
R{tcrSupplv�lcll; ' 7s SGaltn�m.itCnticus'cd(cbccl ;allth�t"altpls)
:ultirril.: iakqunicip ilfiitbllcr; fl N ht Ccmcn..Grout: q IiLrga ittc Chtpc=cr P�ilit:;
Qfittatltcrns1.04cali OCbolill S11POl�. gltcsidriiii it.WaterSupple;(-mngc): O'SaiACctntru,Grirtit -
IIitldiisinalr(oinnlettial III{tsid-moral ldWOV,slipph.0,lr"{rd) ❑ Coiicnti t,ioitt D pill CutUtip
i7Trit^3tioit.; O,Sp<�talt� Grniit_ II Gracel
Nr�n4i'atcr41jpph' l[;;, i}Q Eiet{tonttt;5,lun}', !J OihL'r,'(e�pl7ittnxlcr^ j
tffihliiiittotne:;. IIIZCcits�.rt:
in3cctittn\Nell;.; +f:F6r cAlr'tii:ttahil.sdectc+l abuse,l r6ide.amoiiut of iiiatcrtals ti'w(
Q 4ipgifcr kccicirei., ❑Grouirduat�r ktiitcdia'666;
II aquifrr$tarsf:e ItId ftcv A crj� t7�a 11111v t3 imcr',.
Qra[l iCtr 1'st QStontititaltrUi itta a Bentonite.:Aqua-guardlb ,Wtr:5gal.
QCs�+nmi ui�l7��htiolt+ i DSnbstd�tr tuiNtnl 7h F'rim►ulc.i tinef elcriptttnn rifA 1C ah nitnnmct t,Proci urc
UGentii4rnaal{Clo��d f;aopl: i.mccr;
pulled entire well and poured bentonite slurry.
UGeatit4rt75{I.tNrsun, flic Return)' C 00),r,fes l 'i
d Dili sxll(s}tit►indorett: 12/15/2022"
Sa.��'tli;titatii►n:
Colwick Road Property
1 swlslrSt7++I>rlv;ilr4. 1a1:111t ID°(if tppl>.itilc fi GCIttTtitUOiY:
sc �
4313 Colwick Rd. Charlotte, NC 28211 - ��i�. mot, 12/26/2022
P1isiCat ilddsC ;Cu; a)iil Zlp tia+.flirt C oili A. ,) c31(s,n{r>`icir.)sr it 4;1{hs;alr: I?:?q
Mecklenburg 15717222 lli .tmult rJ rc:f�lm licTrt h� r IYftft [!sirs f4*ri cJ!(sr a qv(ic'er T Iihilirdran d pi
C<isn»r 1"11^,�l ld suit.ntxlu Nu,SI''iti`7'' arcs n7r str, ,s'rJtr 11 l 1C 4 02C, 01 f/0,rr or iJ?r?1 TI c JI C n» li�ti-f,C+r1 SfcrrlthlrrJ.S
rrncl tfrnt rr ca)tr:ajthis:r<?crtr<i lxrsh�rlr peen ftrerl lU lFre t+tlJ olrfcr.
�b X anhidc apd lnnhttt cRc+n dci!rres/mtt utccl,c. td,or ricrttn d,dec kf r( :
{1,W,UN".60,1 c,)>< Site diat!rant or addidonalwell daallc:"
You:ma) ine tt- ba F gf tlu,pagi Io pirorids,addrftetlsl�it11 sric d�tat[s or ss'ell
35.178769 80.798767 �bati:Ii}utnetit details. 1'ou mS�A.also.att<7rh•.tildmot>a1 Igcs tf ikc cs5:►rt'
C(*S R1l("TIOV pI.1 t►11 ()E\�pt l(ti113t 1h( AB 1NbONFD ;CU61iTTT<�i.i\STRLICTiQ` ;.
lttsr7r i,ra'arse!�tcJu�r¢n'rr rdtx rt uiwf tr,f< '.':f r<.r n rfrfpil uy chili,a ry n•ijitt,r rrJ'1 ,: :'
t,e feO1[t Iulisi'x .,rn<rruza,rnetiir+t,ar,ort,t�+<rx r.ura, dnrurtrrlsn,r_ 10.i:'For:411''�4dlc:"Suhtnit lht,5 fatiu i�ithiit:�0dits of-canipleteiin ot'si'cll
� ib itiaputricrit to thefollniiln .
ra.��:�u tDJ0:TMW-4 ..
Pi.vision of A
6b:T6txtti'dldclitb; it) atce lequrcct`Tuformati in 1iocc5srnl 'I°lnli,
1G17liplsnuct ttcr LsluthC =
`2 S fl7 ;
1Ub:.T r'Tnh lion 11rd1a Li`adaillou tose[ti[ne tl fottn;ii�ab add'ies uI IGa.
R i l ti } <ibo�e; iLw 3lbnul uni.,s�opirs�s_of llus.Coriit-y�tliw:>U'clt}s uf-eon}il Clio 11 u :ircll
ic. . d 1tcnto tl[a lollotra 1 frd:Wa1c�clbdnss= aunil.iiiFacc: tftJ Dhi,tuuofl�.urr`12c�oorrc Uudu httttitdInjc�ti
ter unCtuttvl:fictgrant,
1636.Atail 25 Scrsrce Cc ntcr,.TLs1eI2h,N�. G9'J.;IG3fi'
Tttc•rn r N%'�tct Gintils• In�v!gion W01 Tn"tiddidan tc;selxlms ing lonis lb.
6e.,0ptcri:.i•unglcn;;tti(iflainnri): 10 tft:') tb�.addr�ss{zs3 iGots....alsa subriitt oue cop7� qf.,hits-fi3rni tititthtu _?U dns"of`
cprnplcuon af;;ti��ll.ati:uulanircril'10 the caluu}''licall6 ci partmeitt of-the oitiltt•
, ticL•erc'itilttdatird" .. .. ..
bt.tnfier*Ca inV(tubut a>_ngj (Ijuunsn);. . tfI
G S.r&-n.10g,ti{if kiiitsi'n):?0 (ft)
}oIm CRr.:3ti. Ntrsih,lsta LN isial of`eaicr;kew um, Rya't ctl tu�usi'ii'I t.'
I.

NVELL>AB ANDO NIENT RECORD Fnrtm�rn:,l U ONLY
This Jb-`si t oir!Ilultiule Wells
( «'ell C nntr ictor lrtfgrnr ttuine, 1�ELL AB.ANfiONNiEM1 I nET:�lf ti
Stefan Smith 7 t:ivumht r of��t11,briny il►anlr,nut 1
\\ilt,("rt�laetti�ntctgrtiY t}uni rsnrc�tly;iil�7nla,u u�%ur9i;tt�rtlrc crt�1 Ft+': ,m,rnpl� fnlFtrior' +t ,tict-iiorcr ..yrEn1lr rrP4,.VNIX Wdl: "l :i.-,ta
f Fri#7IrtG��A C!rFrtt'l,H3Rhfitf;,}Y,rl a!�t c,7 vVf fAa frl^Jl
3576A
hC 11c11 Comaictbr CenlfikilrDn Nmvbcl s:'"� } I l 7b,,Aliprtt�tmatc�rtlumc of Zc ttici rcmainin„m ti>cll( 1 („al.)
SAEDACCO Inc FOR��`A iEft,�I1PR1,1'��rFl i S,Oi\1 1 is
Connan,,ht,iJAN7c.T}`pc of d�+intutanE u�uL Ti/A
2 4Yc11Cnnativ(tian Pcrnut 9:70003109�Yrn�r� �.�i?t ��3 �UM'.
Yxtr<ilI l,,,f Cw#1.5 r+rf1 w�nrrtJr i>e.�impJj �t<ta,a tin r s:,.t ec,�Ai1�{ ;jl�y}L .'.u' 1(I:Amount Uf' J►mfccYint pit'.tl:;
.. ...,.
3:IWOI U.C`(l lit Ck«III.rko:
«at(,r�upph Well, 7c Scaling nr rtcn ih utcd(chcc.l.alI th tr rink)
t7 t"ncnttttrt[. �i?�trintciP tlrPttb}ic: N6t CcmtnF,G it a B..-n aiin�Clnns or P�ltcts;,
o`Cxctyincrn�tc_(Hcnun.:�4.•otsiin; Sttt,ptS�j. 171t�stdrnntllt'3tcr:5upph�t�tn�le)" OSaei�tcntcitl-tUroitt _i7llr\(�Ln .
O3iuiirstnal( oinnicYcial ❑kc idviui;tl�Vnli i Sir�ptti jai t J? GOticrece Gigiit `D 15nI1 Cutltn„s
t]liii•�iiliiiii� _ ❑ Spe�i3th Gtiitit: ;:O Gct�cl
tin-li'atcr' u{tpl���'ct[::: 04 lieiitonitc.5`I.t►t Cl Qt11�[# �t?l7riurtd4rj
Cflhiunilann ❑lt�.4t'i'ry.
In)ccfi(tn��dl•,. rf.,l3orcaclt'ui;iicrial scltctciCabti�c,likivideiimo iiit OCIliat(rialsiiw:d:
❑Ailutfcr Hcrtiai Vic; C1Graui ciu dtr Okiltotii n
Agtnfcrtciar C au9 lttLos err_. CIS rltuifi l3 imcr
❑Aijinftr'lst 17S1oiiiiit,Iet UraiW4L'C
Bentonite.:Aqua-guardlb ,Wtr:5gal.
OCrperur1m11.ri:Tct,hu6lbe> OSubsidcti('Cs?iNtol 7x P►Ynulc t tirtcf dcicitpttnn r f tht at►apitnnmcnt.Dnicet uru:.
G<oth�rnial(Cto{cd isoori
pulled entire well and'. poured bentonite slurry.
d6e6 (iekiva,--c6oiin^Rclum) 001her,(011 plain under.'.) 71
t Date itcll(s)Almutit titctl; 12/15/2022
4a.11rell,[ocaiiiin:
Colwick Road Property
ri�iltt}tCtiti�i><r�?;iin4_ lr�.ihh it)«(iC,ippl>'ablc?; � Ccrtitic:iuUi}: 7::
4313 Colwick Rd. Charlotte, NC 28211 � <��Y;� Y 12/26/2022
PlicsiCnll+i3dm Ct1,,'atidZip �w_ tiii� �GL:ttftylWc](('�ntrtrrsir:vrWcll._wt r;
Mecklenburg 15717222 I3►;+ik,rrr 11ris.fi�Jm..I l,r?r�hp:cirl,Jt t!r{i_t4e sicll{s,�sqe(weal a5i>nr1�3r�d lr
( r.nili' iar:�l]d ntiFi�tkin his..{Pts') cict'�IYb lrct. ir.illr J�1 1� ((��'1'`(rl G(l.Ctr?+ 1)'itQ?it t 1i f cnUr tt r,Gn�,Sfarrtl rrrlS
crrtclYTrrlactjri;riflJrisrernrdlr i,lr�urpriirir'ar'Io1Cii}scil'oirrrtr.;
�b latrhtdc and tongttud(tn.dc2nresFniiiilrtccfcc.finds of ticrim it dcf:rres ,
{t!'xrl:Cv.ld trroi:Lr+l,u�tntJ,7}x}- � S►tc(6�t;raur or additinn-ti�tcll Ouz[IS:. ,.
S may:we t1a`b��i bf(Itt,E i t to prop (I�addition}i tier 0`srte(i t fits or,tell
35.178397 80.799154 ��`:, abaixlonnreiil,li t td�. S'uu itlay.alsa.tU.+cii nldititi,tal.[r tCcs rf it �c+s}n_
,eo Ns,i RIIC.-'I•IOV DF ,
`i41I ti(1M��1~[I�ti11iE`1K( ABAVUUhEU 5,11AAi1TTAT:.iNSTR(T("Tit)?YS:.
1(I,ItJ'f nrl Cr,r.'jYrtJ 1�arrrtcxra>!(dJ.i7rn.�t&a'i4 :r v'n-url.�:� rrt� cfitik re'rH r•iiitnr alrf•h'
>rcila f)11)trttL r'x Qu jw" acuur(irut r rr nr:l�t it +rr lGu CAt tt t cll fl Y rlh,t., jUJ''bOr:\1I.WCItt, Snhnui ilii 'foriu-,,,thin:�O=d ins of coiiililction of tail
Ga•11'tlt iU :TMw-1 ib it2�ountetiY,t 4 thc,follgiwnsz:.
Ui�`i,rnauf-lYrttcr licwnutrrs Infur•metinn 1'nices�tnt;Lrnit,=
fb:;T�ital,►dl'iltptlir'23 I61711alSuYrfc6htcr R.rlctth h.C'�7f914.67
1nU`.Ttir)ri i'Ctiari;%VClk bi 7dJitioo 16 k ii,Inig tli fi)iiii to lh Mdi ss ni 163..
J►Tf][i'>.tLtiU-stibntit At1C..cop tlf:tlii5,fOfllt:}tidtlll. Uf.lQr11y71.CtIUII Uf yell
tc,Buribol4 it rmcter:_1 (in:)_ abitidonntcnf iu thr follOwn,
Diu.rurt of 16OUrcw,Uudii�;n►und Injctliuu Cnntn}!Prugraiu;
(;cl.W rterlctcl bclosr`9VOpnd%U aCC` (ft) 1G36 Mail Sc y 11t �7-d9'1=1(3G
8 t0E rFnr�Vatc.r S�i�,,h A Tri a iun��`glk ire ii!diUan tti'SCIAIng"the tOnii.to.
Gc,Outc.rcasing1cn fli;fiflnionn):: fr:`) Iht.a(ldtcss{2 ). ibail;.alsa Sii�tiut ottG';Cupt c�f;i[tas t�tm ttidlnn_lp dns.'of`
cOttitiltpau pf jmr)l atia ulomn iii to lhc'catih health dcli:iitntcisf of the otti>t<
«1>rtc it"trtc}c,iti d:
df.inntr�isin}trurbrn}lui�+th(if lurutin)c:: . Ow
L :5 rttn.leayhL(if.la(r»n)#15 (ft:)
Fi}rniGl\�i[ Nonl,Lar�rluYtDeFti�Itrkt ofErl�ironul.11;�laaN:Ikur�fIZisOuxCs DISc,allofVitcrRmmr ; dAuCust .01i
I

1
I
'�' LL AB1-kND0\�1`I.ENT'RECO.RD , rl ,rn�t,�: ONLY'
?liia form man lii uue(l fgr.slttt or ntultip[4;tills
1 Rcll Cnnh'ii tnr hifa"rnt at , 1 F.LL:ARANDON.1Bi IA)l TMI S .
Stefan Smith 7.u.vumbu nf \tilltbciii>;vbtudctntyl l
1\C11CalettCtntlatllifdryiCII091xt.lkar,lu{1},tblritOUlJI �r��(lJlt Xk'It t ltN .RIUMPhr, Plrt#rMt7. ,t r,'hu lf,� '(if!j�i akll• Q.\!1.1 4rIfJ jl.t '$Ikl!i'.
�. ry i vlic f1tr1 r�aFStlrrinl it iron!ravlunrt rxtt mi.
3576Ale� i�r2..' 1
7b1 Aiipro\tinatc\nlunic of is ttcr ntnitininfi to�t ell(+)�1 (*al.)
lvCltcllCc+tilntiorCttl!fc[iU�t larlt cr JAN 1 S 2023
SAEDACCO Inc ^1❑r FOR�1`�rFR$UPPIl'�I'Pt, OBIY;'
Con in,;v�sliLr In#Or�rj
2 %'ell e6p ttvctttiti'P rinit N:70003109,
,J.r<r(i�'1�'�tY`��!(t!IF't 11��rrrrrl¢Il t:(,:irrr,I1 �tt}1,t f1r7LL L"'<,Ilt�t'ti/!fl'•;.i'ft 1�r�:l!r,4-(1'
7t1.�1linounf of ili�infcct:�nt u,etl; _-
3 1Vcilill tlbCCl.nel111wC�
Vlatlr�ul►plt Wcll:. rc 5calutg umt cn9lc uccd Cchci Ic all that apl►Ir)
❑ gT16litttt't1. ❑hittnlcJrxIiTtll iic:, �1 N��t Ccnlcnt:(I4.11. n Rentanitc Chips or Pcllcta,;;
<jC; titemiil(Hc trillC'a4hn�Srgipl}) C]F2c5id.nUal��'atcr Suprti isin�lci;. 6-5'iiid Ccrosnl Groot "❑lln t`.l iv
❑lt1(i115tfG1I(CQ[nI11CRaa1'- ❑Kfitlil$Illl,tl\4"81Cr Sllppl�'..I�halta}„ ❑C66cgc.tl,G qu[ II 17n11'Cu(hu ,
�ii i i3liti t. ❑SpLcialtr G otit:, ❑ Gciccl
N 671N1.00,14ipph 11,ct1,;: Iffi ierriointe5lttt�r}•..: :.0 Uth�rte�ltl+ii;tu�er''>j=
Q➢hloultunu�:: ❑kret try
Injcetign'\Volt:; 7f For'cac4 ntitLtiri;tl scicctciCalti(nc pir►iidc iinioun(of'tiintcrial;t►'sed:
❑Agm1cr iiedu1rec. ❑Gt ill'Oic Il�r Ftrnlcdl ltio].
_ 7
❑Atlulfcr Star:iite nii Etcc(I<riy. ❑5 dnntj 131trivr';
❑Atjiilfcr lrsi i7Slanti5\►IcrUritivz • Bentonite.:Aqua-guardl.b ,Wtr:5gal.
DCsp mulentat T«hiiploei t]Stitt�iilu>tl:Cuiel�yl ri!`Piii u&-a"We dcic plimi nCtlrc al►rndonlncat prrtrcdtire,
UG!othernml(Closc d f oop} !<1Trtccr.
pulled entire well and poured bentonite slurry.
L`lC�Oiikrllkll.(Hi;l(Itl.^.�coolia;Return)' �lUtla:r,(c�pl,iili tu►d`r'1;1 •
0atc.it(.[1 ii—I.i [ 12/15/2022,._ -
Kit.%��i@Il�ll)latll►n:
Colwick Road Property
T l�ilil;rChvii rNalre- i'a.thh if)i(Sr 1pplitblr). $ Ccttlfic:tltUll
4313 Colwick Rd. Charlotte, NC 28211 ,,, H.r� 12/26/2022
Pli:sKai'�lddmis.CtU;�1tif ZtD �v lli! Gc.fih ct V ell(_iut r);;ijmvt Sr 31(J.t:xr.: 1)iiic.
Mecklenburg 15717222 13t!,r{tarts d:`s J�11rt rehy certrt li:u7:Irr�vrlfffi; ticrr tirer�l ub.nulcrn�d tct
Cuantj', l',t`�tld >fif alr�r6Afu,.(fll) elee'Ciitrt!tct�t(!!t N `1( ll�(.,';111f1{)trr2- I)',?1}:`B�I1�ziii4lntttrGrr'SftmtfelrlS'
crncllluUartifi�rrrfrtttsrt;u1fc71r115timprUt;•n'ttltt?:lirt•ssFll'�ir:cr:=
{t► 1=atitt(dc and Innhlturtt in�tc�►res'nuinttcctcccindc or=dre►m tl dc>tr(\ -.:
{tt.te.L(atcl,tyt>v LII h»Ig se nlL.o=tX) % Site diitt;n I)nr tdditional1tcll(ktaH,.
}t 11'.111 11 t1iC[T} b tl`l bf EIIt?Ikla�'l(t pror)de 3� ii► 8iil gill iiG zbi13 t�F+r'e1I
35.178062 �< 80.798779 j�` abaloCttilliettt lztads.'1`ou nta�'.also.utaili ttldnlgnil lS.Icrs tf i�asitt\.
C()1\fir Itli[-.."1IOV.Ub:`CAII_S()f �tr EG1�5l[i1 l2\(.Ati,# iD()NFD $1]AAi1TT UINSTRLTCTtO'• :'
trG.strrtlrtf cri!.�!ruclruri'n�ci.!r<IrS1 JJ�iltfl!IA!rIt ;!dcv!!i!/lr�rt rr�tti+!i nrrNn=ii'ir!r•w)�ly' '
Ne71!w>CIVLYStlflrflk ttr)Itt <}fY„rL,ttii!t,rl UtuS�l fat+I1 Y'i:rl i�)!r ttrr Ailf1!r1xr�4 - 1Ua'''HnY`AiI.��CU�.'�Sl1h1Y1Ujlili„CfC(tll'111IN11L';�(};{ihGS'it)f�CQllll}�CliDti'Oft\'CiI
(st:Well iUli TMW-2
vb"(Wounit tt.l9lhc fCllntuns
lli►i+uin:of�l'utcrl(csmltr��s;lufotm:itiomPrtit:c+�tn1,Un1C,-.
1GlT1fai14nuc;Ccntt.i•;:12ak.It,b,hC �rG9J•=lG17
61►Totalr► I d6it1r;25 Lft.}'
701r Tyr lrii titiott«'ells lii!addthoo to sv�lil lnlg,tt firtnt tc�tll aJ[t'ress m [Ga .
f>c:;aiilrc6olc ilintuctcr:l (tt;) ubatt tls(t StcUnut.-Otte copy nP` llis:fonu>\culsill::a(4ul.wlitpl oil oLiiiell
. .. at►atdminknt�to t4e'lallo\>.lu��;
Di►i,tod of l'i`atir;Ri�+ouIYc,Ull tit roili inijeuio►/Cnntntl Pto rain:
CU Vatcele c1 belta gronncl ullr6ce ift;) 163e.Atait micc'Cen r le tlij 23Ci79=1636
Inc..Fnr y it ttrnlilv'S ink u►n 1`.Ili 1n:idtirtiolii�:x ttcluil :the f6ehl to_._
6c. butt rrasinl,lcn;tli iif 6von li) 15 (ft:) (iie`-.1 fvSS(CS) ,Iiruti .:.�lsu.sutrntlt ouv`cup 6 ibis 10611 wit lin
evniplcdnn•br\►cli ati:tiulpnni`nf to thc'cqurti 1►ci ttIt d r iiintcui':(�f tilt cgiiilty
\�'liic 11191t{Ink�d:
6f.>'lun�r t asiit�„Itultui _tut„n hi(f t,iy n); (;ft:)
6:,'SUecn.icnl;tli(rfaaiartt):10 (ftl
P4ItIiG«t-3ri, `1`j0•ltll;3[UIIrG i?�lYit111kY�4�EstS lLbStnt:t11"Ji ii iYi.lillf'3I T(�St?ILTt'S- QS4.15,1t7110rV IiCr t(cwtirm Atitscd At% ud i047 r,.

�1'FLL AB��►h,�DONMENT'RLCO.RD 1d�li�4 it � Nt:,
Th+afortilrairliyu4.dfgr:amNl;orrttultils(a \cl1s, - _
t NYrll(ouhyictor h�fprmdtu►R: IYEI.I.'ABANDt)NMFN`P-DF7',llI S
Stefan smith 7a Nutnbvr oC1\alls briny; illand rni:d
e - - ,•ru nhrin re "ltl(urrc++t,:.:0.r ,NIJ,iirRcr alrt^r't s+ fis. .O.\'!.Y `µif/!- •"tint. SA+fip.
Sl�1L(r�tanrtoi.t:am�rorictllott+Ar. +sa,ulltiLt�nloJiin�u IQt[htlCiliiop�nt}. 1'
cyxutcrichi J m'ca!SlrklnicgJf:,1'rxr c ur>vteiut cuJ T;irna'
3576A
d"i(,�k" � r e JIr ltn►umaic\+>funtc of\r t)c ninaininr in>itcll(sNl
NC 11 till Conlr��7or C�trific,Ito+i htui�Eitr j�, �„v 6�. r
SAEDACCO Inc 1OFt'11`AIFIt, I]PPI,Y'�1`FI,IE�OtiIX:'
Mirh.;,nC 7c:Tcpc of it.nfectant uset1:N/A
2 NVell Con�tiiietion pCrtislt a-70003109,)tttOr� =�?f sr„�cdC"r9 Litit :. _
+�J<!Fz l.rG'ltnrll kriiritttJc C:ivr Nr d:Nrluxi;ln rariJ .,cJr Jrrt
ttl`,lmouot of dlsinfc Rantu�cd::
3 }Felt uu(�hcd.�t t.lJ'i��)c" •
tit an�r Suppl+•'N dl; 7c �+GaUnr nr.ttcn ilcuscd(clia I;aIt th it�ppl\)'
i[ bkltntici tIR'+tGli :: l l Nczit Ccm6gt Grolli: t3 I3aUgtiuc cI i cr PvhCts
D�,tivultttr p
pCcltems iltHcahusYt::pplin ppl�'1` Dtcainrnh it l�'alcc SnpPlc tsrn,lc};'.' D S nul tctncist Grunt _D 17ry GIt�.
Dhidtistnall(oinntcccial 13❑Ilmdmilial Witcr$ii n [�tmInd)
D Coitctetc Grogr. 17till Cetttm
qo
❑Iiii��3tii7it'. D.Sp+;vraltr�,G4iil- D Gr.i�el
��a-lYatcr'Supplv c1t;;, OI Ftentaniti;.Sli►it}' l;1 Otitzt(explain u'Ad 7gj
QDhitltsdgmii,">. DRt:covery
InJcrfitrn�Yctl . 7kFoi cddt.ns►frrittl xcl�tfcCiititc,pivrvidaiimaiintoftiiatcnalsiesiil:'
❑Mlitifcr Itceluirge. ltculcdlutioll
D ar}tlfcr Stt)C1�c m.i Rt.�JLrt\�.: DS thnrtj 13 tmvr'�
f]rcyti►icr. Bentonite.:Aqua-guardl.b ,Wtr:5gal.
DC�g muint E'Tvtihuuhe�. DSubaitl:rt a CoiNrul. 7^=pritvid a brief dtuirptum r fthc abarictnnrncnt:prrictKlurc:
UCrotl►ernt•sl(C'tosvd Loop) UTrtccr .; . . ; ,
pulled entire well and poured bentonite slurry.
[7Gcatllvrnutl-lFirtnttit.tGooluir.Return) 0O(timja.� lain tinder 7g)
{ Difessi l{5j:}buulonctl, 12/15/2022.
{it.\�'c11.14:1.11 n
Colwick Road Property
T istlilj C1sc6.04 6, I'�:itn�ID"'(iE rlppli itilc)' GcrKtfil tldni.
4313 Colwick Rd. Charlotte, NC 28211 yJ " 12/26/2022
Plt%,sii:VAcIdtC& -iv.3ttd Zip ti ru�.tlst ./C;tsfit>sS 1}.c,I Cosstr>rgt.nt V1eit(h�txr D;i;4.
Mecklenburg 15717222 fjt.s?,Itt)r 1Jus:j,Jm I a, rehp:c ,trf} tlttrr rlr ut1lf�3 rtrrr(ii°er�),rJi grlr�n�3 iJi
Cumitj lX,ru11J litiCiralYsu Nu.:fE'41`{" cKCliillt cr it illr 1st 1t: it":r1'l:.OJ(Ji}.ir'?4 fJ'r7il Ti cl1 C C7111rJ?li l+art Srr rtit tr;l
crtrcllllc�t a cL�pip,cxJiliis:rcc.rirtllrJ,sh4trt:nrccr=iderdlo`tlri trill iix.t.rr':
�b l ahhtdc and longitude in dc�rcci.1i I te<Icccnndx oi:ilcrrni rl d rct ti:: -
{tr«w)i Cr<Id cJi>4 Ltt Ntns ,: ,+11i N thy- 9 Sitc drat grant 4r additional hill detdlls:.
1�u zit t} uoe t1r b�vl;of tlua page to prQi°idv addstiONi isti.11 sue do aits pi scell
35.177783 80.798455 �F' ..aGatnloil Item details; 1'oU OgeStf ;eeskir\
CUhtilItll("I I()\,DF`fiAll S}BEIR(.AiiAVDONVO $11A111TT,\T i\STR(tCTiQNS:
9(b i ss 1 i ri r7rN tr+i ri inrrl;K1'il: smf n'�li '..l ry r tr1(ei+ u�eciiiiit rJ rvfu ij:tur x3rj+fi
If eili`f)\IY ii ll�ttae cr7ba;fi+J+c�d'tE f1•i!t Op9ltcf�.JJ.�r r,t titl 5,tU drtiit"m Phnitr Itla�::l'br !�11..\�t.(t�• `"S'1117nlll`lI1I,5 fQR11 11'rtlli[3'fO.dt�5.0f'CQllt(AcCi lr-Ul"xv ll
abantionnicnt,tothcfollQ"\�tn;""
6a:\Vaal 1D*TMW-3
Ui+isnio tif" Yutcr Kcu,urr Infuttuati►al'mccssin Quit;
601 MailSmki`(cnt0,-Rrlct},b 11.C7i699461T
61►:;Tn1a1 jsell qkptli:,25
1Uh:.C!�O Inlid►nri Well In".Aditfuo to,�r>hUg tliv fotbi"to ilr KiCl i3s.iii"
abo'ec.j,u mtbiiu(one kbpti of-llns.forni_siitlsin.3t>da's ol-CoIllplCMiou Q1 csell
t>c,iiorcholc;iit imctcr;,1 fin:) ab andatfillelit1a(Ili IaIlOttltl4;':
Pi\iaion of lV:lterRc�ourr Undo*,Outid l'nlc.tiuu Coutrvl Prn:rain,
td,\Vatcricf�clbclon'groundiirfac.; (ff.) 1G3aAt it�cnicc cntcr..ltalet h 11(2769')=I63G'
lUc.Fnr«sZfcr'Cun�h'�C"Grj4, ton '-llc ]t5' iftlthou Y�``rKitn*>tlte fotn,tp.--
6c:Outer casing lcnctti;(if laion»): 15 aft> he ad¢rvss(s r <tbU�e: also kibitift:one i epv aIT this fotlll: uhut
cgniplcupu tit aicli ah:+tidonuicrit tQ tlic cpcust} tiyaltb dc}i rinscist oP the _oat Ay
6f:Innirta5inyytubin>:autynh;(if 6ttaiui);.:. (ft)
ti Ir1c tb tt„ialic
Gg:SCi4-.n.lc tLath(>f ki nib n)i i0 {ft:)
FilH00 F-lti. 'TJQrtIiL4tplimDLportincM6flin ii0nnrnt34N:uuralResniimes' Ulti`e.i�nof\' ri�r:rtts cnrr�s- R�VIKedAnCusi2011,