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Home My WebLink AboutCumberland_Well Abandonment_20230227 . 1 i WELL ABANDONMENT RECORD Fat Internal Use ONLY: ... ThisTottn can he-uSeillar single.p f multi&wells I.Well Contraetbir InformatiOn: YC4)/ WELL ABANlifAMENT.DETAILS I I Chris Ruf fer '7a.Number of AV efts being abando!nel d: 3- ME C'euraclor kepi(or car‘llehneitpf.riiisinity.dMmicining%telt°a)ifsilierMaliarty) Fiw Ontlopk. Oifivicur or non-limit. Aral), wens. .ONLY L.,ith ilee .srme _ ofOritrocroonlohoirdomailoyao irate MAW ota2.)brea. 9223-A 1 - '7— ''''-;)'—'-'1'' '`''-'re, 7b.APpriftlin. ate‘olume uf wind.reinainiii in VIE110): ri 1- fir P.,..,,::•.; a.... (OA) NC WelleonitictOr toitIlimilion Niiiii:di Ric-:*.,,,L.1 'IL:-2—.1 - SASDACco Inc F-B 2 7 N-23 FOR WATER SUPPLY WELLS ONLY: °Javan).Name' 7e.Type of disinfectant Wed: II - 2.Well Con.structinii•Permit ti;„ lo13;:r.,-...`..iLirt 1..in.d. .. • Liit oil OplIctible.troll pvrodi*(ie.eyaray.Sonrc Faiiiirte.v.b0/214/4a(PiAddow 7(L Amount of.disinfectant used:. • 3.Well use(chedc Well use): Water Supply Well: 7c.Scaling materials used(theeg all that apPly): ' dAgrictilhiml. itiMunicipaliPublio 51•Neat Cement:90'ot . Cl Bentonite Chips or Peliels., .• 'Oeunhennal(Beating/C:101M;Sulapl ) bitesidantial Water Supply(sagle) 0'SO!ItiCrilkO.Gtnut El Di y Clay . . 0 bidustrial/Commacial ORcsiderdialWaler Supply-Ma/1A 0.Concrele'G rout • ' El Drill Collings Obrietion •. . .b-swoaitiOrput , i n Gravel Cltidier(explain poder 7g) -Nita-Watcr Simply Well: , Cl BentoniteSlum . .141v1indlorine.., Clitetovery • Injection Well: 71.For cacti material selected above,provide amount of materials used: ElAnniferfiecharge 1:30niniithWilei Re:mediation Neat cem.:941b. ,Wtr:5gal. Sand,Cod.:lb ,Wtr:gal. - OkinSiemge and Ree09,My EISalinify BarrIer• • DAtatifit Test -CIStoianivaler Dminane . - , • . 13Eximiiniental Technology bSuh.sldence COMM, 7g.PrOvide a brill diletiption;of thil'abaiidonment preeeddret i, ElOcotherinal(Closed Loop) dItacer t. Tremie grouted from bottom up ClGeotbennal(lizaina/Coolin.%Retum) Dither(explain under 7a) :... ii . 4.Bate will(s)altandoncd: 11923 ' II . • Sa.Weil location: Chemours 11 Facility/OW:M-14mo Facility RN tirapplicd S.Certification: blei . 22828 NC-87, Fayetteville, NC 28306 Chris Ruff et .,:. 1/19/2023 Physical Address,-ciiy.am e,.i Zip Sip lute of eint6e31.1tell eid'aiend Cir t./ell Omer 'I 1, • Cumberland fly signing this fama, 1 hereby ceiliktioe,the well(s)was(were)abandoned in, Cot* 'Parcel id:Mil/dada NO.(PIN) aecokiktrater with 1.;1..4:Ncile OZG:0100 or 2C.0200 Trollabalivviion_Starrekirds anchhiO a copy of iliii record hile beEli provided 4,1he well owier:- .51).1,atilidc and hingiMdc'in degrecslininitesfseionds lir deciinal degrees: I/ ; Orwell field,one Willing:is tofficipal 9.Site diagram oradditiOnal well details: You may use the back of thispage(6'primitie additional well site,details or well N W abandonment details,'You tuay ago attach its1ditionafpages if neeessiity. '. .. _ CONSTRUCTION.BETAlLS OF WELLfS)BEING ABANDONED SUBMITTAL INSTRUCTIONS Attack rill corignici.idu ftcord(s).4f nif al.,'le_ Fiir oruffillb•in:re:coati 6r-ion-Hut&a ppb. tre,,tiv ily4Y:Ott:/hp svmerodskektadildiegukd.mem.pig 9;y1:strial we firm ' 10a.For All %Veils:- Subunit this ram-Within 30 days of Completion-of well 6:t.•Wen 111#:Pmw-.05P . . abamddoment 03 the following: ; • Division of Water Ilesnortinformation-PrOceising Unit, • 6h.Total well depth: 60 (IL) 1: 1611 Maill'Service Onter,,Baleigli,NC 27699-1617 - - . -ltib.For In lecti6n WelIM-In addition to sending diefOrnt.to the dildre.ss in Ica • above,also subunit one copy of tliis,Ilinn within 30 days•of cortinte1ion of well 6c.-Borchnic diameter:0.75 . .Cluj nbatitionnient lb the fallowing: I: • • Divisinti.of Witter Risourii4;Underground'hijection Control Pnigratit, Gd.Water level:bet*ground suifacei (ft.) 1634 Mail Service C`ciliter,Raleigh,NC 27699-1636 10c.For Water,Stinnlv Si hilection Welk: In addition-to'sending the form to 6e.Outer easing length liflomwo): . A/ the.-address(es) aboye. also Sub:0111one copy of this thou Within 30 days of completion of well abandonment:to the county health depargemni of the county where abandoned. (if.InnerCasidgi.tobing length(if!mown): (ft.) ' 6g.Screed length(If Imown):15 (ft.) • Fern:GW-30 Notth CaroilM•Deparucom of Emironment and Nodal Resources-Division of Wok:Tito:sources ficvted August 2013 • i; i WELL ABANDONMENT RECORD For!denial Usd ONLY: r I This form can be used far single.or multipte wells 1.Well Contractor information: WELL ABANDONMENT DETAII 4 Chris Ruffer '7at,Number ofivelis being abaada ied: 1- Welt C'ouracrbrNacite(or WO.il%t pctsanally.abarcion[niuellanEs';krpreperfy) For trutlopei anle<'1;'ajr or rwaigvinacr supgh. teens .ONLY vtrh Ilm .some c+oarstrrtcttoriltoirdo ent,3nri MR.57.111111 aizforrn 9223-A . r,-n. Tl ii—'' F?. ,Z'�J I 4:"' " L 6 V r 71,.A rnAiin to volume of tnmainin• in w•i�ll a: (01.) NC Well CominsiorEeitifrsation Nmnbei ' 's.-- r �' pl. I I {)� sAEDAcco Inc FEB ' 7 2023 FOR WATER.S_UPPLY WELLS ONLY: Company Name ,_� Una ?e,Type of disinfectant used; I' Ir,asar: �Pr., �� Z.Welt Cottatniction Permit lic, , 1-A Qi%O ' Let diapplaeabteiicIllarurit,'.(%dCrnuuy,S'oee.Variaftee-lifriitory,etci J,Guiiiirr 7tL Amount of'disinfectant used: • 3.Wdt use(check Well use): P Water Supply Well: 7c:Scaling maferiulsu sstl(Creek:all Britt apply): D,4gri'cultural ❑Mitnicipal/Public, l3.Ncat Centetit.Otuart to Hertonite Chips or Pellets., IDCacothcrmat(Hcating/Caolina Supply) pltesidential-1Vater Supply(single) n San4:Certte111 Gmut El Dry Clay ❑htdrrstrial/Cemmereial ❑Residential Water Supply(sharcd) ❑.Conimti Groat ' El brill Collings ❑itti'gation ' ❑Specially Gt(tut b Gravel Nmi-Watcr Supply Well: til BentoniteSlimy .El Other(exalainunder7g) . DlMnnlloriug._ . ❑Recoceiy injection Well: 7f.For each material selected above,provide amount otmaterials wed: ❑AgiiiferRecharge ❑GroundnalerRemedial* Neat Cera--1881b ,Wtr•12ga1. Sand Cem--lb ,Wtr•gal. DAhui1 w Storage and Rei_jovery DSalinily Darrier Bentonite.:21b ,Wtr:gal'. ❑Ailuifer Test ❑Stommvter Diii1Oge —_ ❑Espeiipienlal Tech ltuotoev DSnbsideuce Corrtml 7g:Pravidc a lirirf description of the al►andnnmcnt pnteitilumc CDGeotherinal(CinsedLoop) Clliacer 1, GIGeothertual(iieotiillU'Cooling Return) ❑Otherl.e.Cplain under 7g) Tremie grout in with pump. Pulled pad and topped off with grout." I! . 1-29-2023 I. 4.Uatc�cll(s).abandoned. 5a.Wei location: I Cumberland Off-Site Well Facilityr'Utc•rsr Name Fa:ility iDs(irappliable} 8.CCiiIflc tloit: 14011 Hwy 210, Roseboro, NC 28382 Chris Ruffer. 1/24/2023 • Physical Address;City;aria Zip Signature of Certified Wen Catantelor or Well Oivn:r Dam Cumberland 8v sipnitkg this firmr/hernhy certify-that the welt(s)oars(were.)ahtmdotied itr Corinfy Pared"hienligefittatt No.(PIN) raceaitlataia with 1.a.4:1 C:4C 026';9160"or 2C'-0200 Well Coirsti•uctiuri Sfariekird$ and ihal a cnpp of this record hos been pravidedia the*ell owner.• Sb:.lt.ntitude•and lrlugitilllein thwees/nitnutes/seconds or decimal degrees li ' (it*rll fold,oli latilopa:is sulhetrq) 9.Site diagram or additional well details: You may..use the back of this page to proside.addilionai well.site details:or well 34.8636267 N -078.5391507 W abatnionuiertidetails"Yon rtray:lLsil attach;ultiitioitaipagesifnece`csary. • CONSTRiJI TION.UETAiLS OF WELLfS)BEING ABANDONED .SURMiTTAT.iNSTRUCTiONS :ttlad,neN coriarrnciiarr r curillsa•ifm-iailabf. Frir multiple iirtigirni or mdanrater.aipphv II r miens ONLY n1 hi dv wore aaoitstir.+OO/ki iOltdriratteraa,ilia can tirbitot ore"irmdays ForAll Wells: Submit ttrLS film within 30 of completion of well 6a.Well fill:Cumberland-5-D ab;indonment to the follaiving: Divisiirn of Water Recilurcts,Infor mation•Pivicessing Unit; 6h. otut well depth: 57 (ft) '1617 MhilSenice Ce iter,_Raleigh,NC 27699-I617 • lOb.For infection WetlS: In addition to sending the fotin to the address in 19a Gc.Borehole dLrnictcr:2 above_also submit.one cope"of this"form withiit"30'days of completion of well Un`, abandonment to thefolhorting: II ' i Disislottni Water Resources.Undergruuud Lijecttpu Cotrtrel Fragratu, Gd.Water fevel.belms ground surface: (ft.) i636 Mail Ser ite it:cntcr•,Raleigh NC 27699-163G Ge..Outcr casing length(if!Mown): (ft.) the Fnr Water Sunnli ,,cc.Infection I Wells: In addition lei sending the form to the address(es) above. also submit.one copy of this fomt within 30 days of completion of welt ahandomirent to the county health department of the comity 6f.Inner easing tubing length(if tarown): 52 (ft.) where abandoned. 6g,Screen length(If kuo*Fn):5 _(ft.) • Fano GW-)0 North Carolina Departmcm of Entiroonicnt at><t Natural Resources-Division of Water Roc axes Revised August 2013