WI0600123_Geothermal Test_20140414

DEPARTMENT OF THE ARMY
US P►RMY INSTALLATION MANAGEMENT COMMAND
HEADQUARTERS,
UNITED STATES ARMY GARRISON, FT BRAGG
'
2175 REILLY ROAD, STOP A
I'
FORT BRAGG NORTH CAROLINA 28310
REPLY TO
- ATTENTION of
i
April 14, 2014
I �-
I j
Directorate of
Public
Works
-Attached are copies)
of GW-30 Form Well -Abandonment Recora. `Iris recora -,-:-
is in reference
to ipermit
_Nov, eothermal Test. Well ; and its
abandonment.
If you have
any' questions,concerning•this
matter, please contact Eric
Torres at 432-8450.
Enclosure
RECEIVED/CAE R/Di q
�t^R 2014`
Water Qu�iity hegioraai
t
Oi�er�t10CiS vEC;iot�
I
-
DENR-FR(
APR 2 9 20'.4 .
t
t
t
-
.

form can he rued for single or
I. We1i Contractor information:
Harry M.Sage -
VoIl Contractor'Nt me (orwell owm l;
2531-A
ENT RE, CORD Far tatutul Use ONLY,
1plewells
AVELL ABANIDQNMEN T DLTAR S
7o..Number of wells being abandoned:
dtyabandooae$tncllanldslfterpcoputy) Far aWIT le_ inj=on or Von -baler supply »rlls ONLY with the .same
I corutructfartlabanJomrrenl, y»p eansubm(t oncfomr.
VC \Yail Cunt ractorCeitificatioa Number
Applied resource Mariagei
Company Name
2• Well Construction Permit U.- N/A'
List aft opplincUL Uw1 permits (r c. Call"% state,
3. Well Use (checkwell use):.
P.C.
Water Supply Well:
❑Agricultural i Ohf
icipal/Public
❑Geothermal(Heating/Cooling Supply) ❑RlesidentialWaterSupply(single)
❑industrial/Commercial- ❑R,
identialIftl rSupp(y(Aared)
171rr1 tion
Noawater Supply Well:
ClMonitoring []Recovery
Injection Well:
17AquifecRcchargc ❑Crio
❑Aquif"Storage; Recovery ❑Salinity
undsaterRemediation
Barrier
and
❑Aqu'rferTest OStormwaterDminaga
t7EYpbdmcnWTechnology 13SubsidenceControl
MUcothermal (Closed Loop) ❑TrI
cer
❑Geothermal (Hcatin Conlin Reluih) ©Other(ea
lain under 7 )
4, Datevvell(s) abandoned: 3114114
5a. Well location:
Ft. Bragg
' FrscilitylOwnerNama
Enlister! Court, Ft. Bragg, NG
Firysical Address, City, and Zip
Cumberland
County
NIA
Facility 1DH (if2pplieable) 8• CCrfificatiilU:
!8310 �t ts,<�— 3117/14
siaaaturoorcati cdwe11Contractororwen ommi, Due
7b.Approximatevolumeofwalerremaining in'well(s):.N1A (gaL)
FORWATER SUPPLY WELLS ONLY-
76Typeofdisinfectantused; N/A
7d_AmountafdisinfectantUsed: NIA
7e. Staling materials used (ebeckall that apply). RECEIVEDlD��s� ®w
❑ NeatCemenrGrout
17 BentoniteChips orpellets
❑ Sand Cement Grout
n Dry Clay r�
APR 5 7
❑ Concrele Grout
❑ Mall Cuttings .1 01 q
El Spodalty.Grout
0 BantonitcStu"
❑ Gravel
❑ Other(explain Quality regional
nftr
' Operations section
W. Por each material selected abovq provide amomtt ofmaterials axed:
3 601-I3• BAGS
24 GALLON8150 LB
7g. provide a brief description of the abandonment procedure:
Geothermal Test well for Conductivity testing.
PN71900
Ntrecl Identification No. (FIN)
5b. Latitude and longitude in degreeslminuteslseconds or decimal degrees:
By slgturrg this form, I hereby certify dial the ivell(s) Spas (were) abandoned In"
aecordance svith.l5A NCAC 02C.0100 or 2C.0200 Well Cominiction Mandan*
and that a copy ofthis record has been provided to the iveil mvaer.
(ifwell Said, one latJtong is sufficient) 1 9.Site diagram or additional well details:
35 0917.8 79 0112.6 You may use the back of this page to provide additional well site details or welt
N W abandonment details. You may also attach additional pages if necessary-
CONSTRUCTIONDLTA"MWELL(S)BEINIG_ABANDONEB SS AMITTALINSTRUCTIONS
Aaaek urll eonttmellon rceordfs) irnvatlable. Tar rin4riple lmJeetion or uon-votar supply
wc1hONLYiddtthe same eonsfrucrtana6airJotnnen/ yoneansabmitone orni. lea. For All Wells. Submit this form within 30 days of completion of yell
6a. tiVclt IDII: NIA abandoiuncnt to the following:
Division di Water Resources, Information Processing Unit,
6b. To6l;wcll depths 260..(ft.) J 617 Alail Service Center, Raleigh, NC 27699-I617
I0b For Injection Wells: Tn addition to sending the form to the address in 10a
6 I above, also submit one copy of this form within 30 days of completion of ��cl1
6c. Borehole diameter. (in.) abandonment to the following.
6d. Water Ievcl below ground sTtrfneco NIA (ft) D)vision orwaterItrsources, Underground Injection Control Program,
t636 Mail Service Center, Raietgb, NC 27699-1636
II
6e. Outer rdsing Itngth (if tmocva): NIA i ({t) IUc. For Watcr Stippty & Infection Wells: In addition to striding the form to
the addmmCes) above, also submit one copy of this form within 30 days of
completion of well abandonment to tho county health department of the county
6Innlereosing/tubiriglength(tfknown):52DrHDPELaOPft)(where abandoned.
f_
6g. Screen length (if known): NIA V0
FormGW-30 Noek Carolina DapattmentofEavirvarlwnt arill Namral Hosourm — Division of%icr Resources Rev1$cdAugu&t2Rl3
1

r
L r ABANDONMENT RE, CORD Var rwccmal Use ONLY:
This form can he used iarsingle.or mulliplawel[s
L WelI Contractor information: '{YELL ABANkDOTVBiEM DETAILS
Harry M. Sage 7n.Number ofwelisbeing abandoned. 1
NYegConuadcrNnmc(orwellowncrw.07llyabandoomgwelton7uslherpmyaty) Far "to
;njcr�on. or non--rorer supply %sails ONLY with flit same
canrtnrertan�aEarfJonnrenr, yroa eaasubmAontfomr.
' 253'i-A i • '
t4C�t'cti-ontrnuarCutiGcatianNumbar 7b. Approximate volume ofwalerreenainiuginwetl(s): N!A &L)
Applied Resource Manaaement P.C. FOUNVATERSUP.PLYWELTSO LY.-
Company?keno !
2.WellConstructionPermitif: NIA
Lfs! aAappticoLlexr!! permits (%e. Cnnnt}; Siala,
3. Yell use (chtekwell use): i
❑Agricultural '
gGeothermal (licalingrcoaling Supply)
13[ndustrial/Commerctal
SupplylYell:
►nIacnan rrcu:
OAquifcr Recharge
OAquifer Storageand Recovery
❑Aquifer Test
EMxpemental Technology
OGcothwmal (Closed Loop)
13Gcothermat McatinrdCoolirnzRetum'
�. Datt tiveli(s) a6nndoned: 311411.4
50. Well location:
7aType ofdisinfectantused; N1A
'Id-Amountofdisinfectantased: NiA
fnjaalan.ara)rfAnoun
RECEIVEMENOY►'R
7e.Sealing materials used(checicall that
appiy�.
pal/Publio
11 NeatcementGrour
0 BcntoniteChips orPellets
atial WaterSupply (single)
13 Sand Cement Grout
17 Dry Clay APR j � 15 2014
atial WatorSnpply (shared)
'CI ConcreieGrout
0 Drill Cuttings
® 5pecialtyGrout J
O Gravel Water Qual y Regional .
13 BcatonlicSiurry
o other(cXpWDWMons Section
ry
7L li:or each material selected above; provide amount of materials used:
Itvater Remedialton
3 50LB BAGS
24 GALLON8I50 LB
naascrLrarnago ,
idencoControi 7g, Providea brief description of the abandonment procedure-
er Geothermal Test well for Conductivity testing.
r(explain under 7 )
Ft. Bragg
NiA
Fnaility/OwaerName •
Facility 108(ifappiimble)
8. Ccrtitication:
Enlisted Court, Ft. Bragg, NG
28310
3117i14
PlWstcalAddress,City, and Zip
SigaatuicorCai edwellconuaetor&xvc!iiow cr Date
Cumberland
PN71900
..
- By signing this jean„ I hrreby certify that lire wells) was {were) abandoned 1n'
County
Pxred Idcatilication No. (PIN)
accordance with 35A MAC 02C.O100 or 2C.0200 ihell Canstniction Standards
and that a copy ojlFi s record has been provided la theivell owner.
5b. Latitude and longitude in degrees!minutes/seconds
or decimal degrees:
(ifwcll Bald; ono tatltong is'sufficient)
I
9. Site diagram or ad&fonal well details:
35 0917.8 79 01 i
You miry use the backof.this page to provide additional well site details or -Mil
(q
NY
abandanmentdetails. You may also attach additional pages if necessary.
Arrach nnll construction raeord(s) ff avalla,
lVeRs ONLF"1Ji dw same consfraerlamnbar
6n. Witt IDII: N/A
6b, Told well depths 260
i
6c. Borabule diameter: 6
6d, Water level below ground surfaci-
NQ
BAN O ED SUBMITTAL INSTRUCTIONS
iple hJectlon or uon•imler supply
eanavhmiloriejorm. Itla. For All Wcllr. Submit this form ~within 30 days of completion of well
abandonment to the following:
6e. Oafer casing length (if known):
6E Innercasing/tubing length (if ]mown): 520 HOPE LOOP
6g, Scrten length (if known): NIA
Division olWafer Resources, information Pracming Unit,
1617 Mail Service Center, Raleigb, NC 276994617
IOb. Tor Inieelion Wells: In addition to sending the form to the address in 10a
above, also submit one copy of this form within 30 days of completion of well
abandonment to the following:
Division of Wateritrsuurces,underground injection Control Program,
1636 MR Service Center, Raleigh, MC 27699-1636
illc. Isar Water tip ntn v & Infection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this'fomt within 30 days of
completion of wail abandonment to tho county health department of the county
where abandoned.
Form Ma NertktlCarolina l3cpukneatofEavimamentand Natuml Resou=Zbiv;Sion ofWaurResources RovisedAusust20l3