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Home My WebLink AboutMecklenburg_Well Abandonment_20230828 (9) WELL ABANDONMENT RECORD For Iniem d Ust ONLY; •This f0im ea—d used for singte.or muliiple tv M I I.Well.Contractor lnrormutioni WFLL ABANDONNIENT DIZTAIL4 I Brian Ewing IL Number of wells being pbaudnneid: 1 WCitC'nnttacaurly�mr(orrarltu��rsij,c ,illy'.d,amto,rf,rauctl:o,ililstl,crptuticny� Few er,rlople 111jeuetr ar rOIAItftir sn1rph• wells ONLY 'Wrlb Mil sauc -. - constrtrcta•,'r.�oirrtam,,�.t•)nrr ctvts:r.arlta{ajnrni, 4240-B NC Well ConlrigorCcitif,catiorrNtinibcr 7b.Appiniciwatc volume of lyati�-tientaining inlsell(s)i (rnL) SAEDACCO FOR'WATER.SUPPLX WELCS.4NI,Y: Con,pattr.N.rms 7e.Type o(disinfivtrmt used: 2:Well Coustructiou Peradt 11:50000687, Lw rrll ajipli able. eil pirirrilr(i.,Carilu 6,.Sion!.6°r,Ptintc'e_JirJrrflurz_rtcl tf browrr 7d:ArllOtt[It of.dlsiufictant used: 3.�Vdl usr(0 dcwcll use): Water suppik Well 7a Scaling inatcrials used(theel;all that apply): l7rtgtirultttGil I7rittuiic pellPtililic 5d'NcatCcincrit.Groot to l3craoiiitc.Chips orPellets, pGco(hc HO(Hgatinr,f Coolingr Supply) pAcsidentol W;tter��ipnl}'L+�»glc] 0 Sand Centent Gmut - 13 D' Clay..- ❑hrdustrialfComntcrcial OResidendal\Voter Supply.(sbatcd), ' 0 oncrdd'Grout 0 17ri11 Callings ❑Ird •tion O-Spectiult}Ginui i b Gravel Noa-Water.Sapplg Well: 13 Bentotute Slurry C1.Other(explain m>der 7g) ®lvlouttodug-- ORtxoven• , Injection Well: 7f.For each material selected above.,provide amount of.materlals used: ❑Aqulfcr Kecttarge OCroundvialei ltentediation Neat Cem.•471b ,Wtr•3gal. Sand-Cem. 11Y Wtr•gal. ❑Atinifer 5ioiage,atxl Ret ocn, OSalinihr Banler i ❑AiiaWt Test OSloinnuter Uraitiaec OEVeiiuieuebl Taeltuo[ugy []SubsittetxaCtitgttil 7g:Pr6lidc a brief description oftlt�aWridnoment procedure-- Mothennal(CfosedLoop) 0Tmcer. ®GCOtbennal(Headq fC00l1n Return) ®t)ttn t i.es lalrk ll1FdC[7 ) -TREMIE GROUTED FROM BOTTOM TO SURFACE �' V Lj •t.Datctitcll(sj.al►andancds 7718-23 - ; Sa.Well location: AUG ` 8 -2023 i Motiva lrfft;ri�,8•t Wtt r�t^t5►r ?�l:rt 8..CertlQcatioic I , F;cilitylOnncrNmme I'xi18g Do(iEapplicabl6) l�u0J3lha 6851 Freedom Dr:' Charlotte, NC.28214 Brian E_YY I 7/28/2023 Physical Add,c&;City'and Zip S i�cvlrur or06tirrcd%Vcli(:nrurr,n}v- r:.:V(hrncr Date Mecklenbur4 Jfjr swilhig I. firpi,.!lienby,cei lift'•rb,tt th ae e11{s a ar firm)ahtu,daried in Couuiy f'tuecl lc$.njil7awi No.(pig) itctirliknwe*wilh 15.4_]-MCIC 02C,d100:or 2C.11200 TGell Consulitruori sta&krrcls and drat•a coprofiliis record has been provided la,lhe.ueU miner.' .5b,.;;aatiludeaud lim&ude in dcgreeslminmicslsceouds or dccim4% degncesi (it-1411 f4td,oru:tabyong is wit;c?cm) 9..Site diagram or additional well details: You.utay use tife back bf this pie to pio�•idd additional%vell se g decails:or 1se11 K W abantiotuuzutdetails You tut}also ttach:icitji[ional'poas if teecssan. t:ONSTRIIC'TIhN.DETAIL.0 OF WELU.%BEING ABANDONED SURAIT17AL INSTRUCTIONS :ttfarlr nrl!nurrrtruelicut ncvril(gr'if ovitilaGlc. Frirmultiplr iifrerltire•w•'imn•uatcr.wp�• ' melb ONLY uitlr Ilse svrtrecrnrstruarinttariarrthitm,er,t,irtucansuGim7aro i""- lOa:Far All Wrllr, $ubtnil tlfes.fann viithiu 3Q'da}:s of cotopletion of well 6a Weil IDS SP-8 pliandonmcut to ft follo}rin� I I)i�isioa of Water Resourers,Infarvtotiou Pr¢cvssin Unit, 6b.Total well depth: 25 (fe;) 1G17 tllail Smice Ceutcr,.ltaleil h,]rC 27699-1617 10b.ToItielW 'on-to -add i [ ress in [Oa 6c Borehole dlanietca:l ad.) -above.also sub»qt one copy_of 11iis fonti tivilhiit 30'days of comptetioit'of well abdi doumeut to the fallottiivat 6d.Watcrtcccl:bc[rmsrotiiatictirfacc� (£t:) Disisloti:gf3ValdrResout es UudeggroundInJI00lot/ControlProgratu, 1636 Mail Scnicc Ccute-•,Raleigh,NC 27691 1636 6e..Outer casirr len if known). . IOe.,Fnr Hater Smnnls.F.iaicctiun We11A: In addition to scodiug the form.to g length.(' (ft:) the:addresses) about. also submit.!one copy of this foam iiiliiin 30 days of complaian of well abandou ntnt to(tie count}•IrAlth department of itte county 6f.Inair casin„/tnbinr Irit(db(dleronn): (ft:) whet);atmndoncd. ? 6g.Streen length(if known): Font G%V-10 Nonh Camllha Dcpanm m a.tEndmoracot and Natural Rcs=res-CHsision of 4';•aterltesoltuces Rerecd Augwq 2013 I I i 1 I WELL ABANDONMENT RECORD Fatlaierruaus�olvL>; Tkia fainr rair be used far single or multip[diMls I.Well Contractor Infot mati6n: WELL ABANDONMENT DETAILS Brian Ewing 7a,Number of Wells heinj abdudon'd-.1 54'elfCeatracspiNan (or�icllo�rncrjkno�nllg:rlwi niaotitll.onlii4lllcr'prolrcrly� A r+�,rinp*.. .tr�ecuoir oi r�,ri�iitirter stlipb, walls .ONLY wlrb Mw swue '� - � ex+nxtnrcnat.�aintnima��eat,.�nriaior•r�,wnitaiej,rm, 4240-B NC Well Cvnlr�aorCoitificaliuu Natrbst ?b.Aliprosimate volume of lratcrirm:rinwg iu ticll(sj: (}tirL) { i FOR iVATERSUPPLY WELL S(1NLY. SAEDACCO Canryanl Hams: 7c.Tape ofdisinfivtaut wed: 2:`Yetl Constructian Permit d.50000087, _ Ltiradl dlipat bre tieflEar ir;Lp tip erwr,n:Sr w..Fariiinee,lirjrcLur,,c7c l if Grown 7d.AttiounI of.disinfectant micd:. ' 3.Well wk(ehe&"ell u:w)s Water Supply Well: 3a Scaling inattid ils use(cheek all thit apply):- 171tgri4nituntt• I]htiinicipalfit161ic lR:q6t CCatcri(:q.60t 0 Berko Rc Chips or Peltcts" ❑Grothcrm:rl(Hcatiit,,rlCoolitr supply) "Mkcsidentiul Water Supply(sitigie) ❑Sarin Cement Grout E3 Dly Clay ❑IndnstriallCocnmcroi:[1. ❑Residential Water Supply(shatrd) ❑.ib ncrti(d,6buI CI Drill Citltinp ❑hti lion b"SpWialty Gtuut b Gravel Naa-1Yatcr.5upplylYcll: G1 Eenionite5lutry 13 U[der(explain uwWr7g) . • ®tvlanitydng_ [7Rec:ateri' - i, ' injection Welt: X Far eadi tirateria selected above,provide a[nount of materials used., " ❑Aquifc�ltccGrrge ❑GrriuiidrialerRentcdialidtr. Neat Cem.•471b ,Wti 3ga1. Sand,Cem. lb ,Wtr gal. I7Ailuifer Storige;rrrJ RcYot'rry ❑Salinity Barber i ❑Ai16&i Test ❑Sliinrnvistor Unrirtilee ❑E.-•painietttal Teehadto y pSnbsideuce Cairtttu1 ?g;Piviide'a brief dLiciiptian aftbc•abaiidnnmenf pweeduri:- 00godwilml(CfoscdLoop) Mracer TREMIE GROUTED FROM BOTTOM TO SURFACE ®Geo[henualtHcntiait]Coaliu>;Return) •. ®Odt`r.(cstilaiaundcr7g) �- �/i6..t �► :l,Date ttcU(s):abandopcd: 7-18-23 i ;. ry+� {a,Well lacattrin: ` Motives IlrfilA+•%%C1?f:rGyto,�l.'{Z3( r3tilitclrhvncrNarnc Fa olily lPd(t'upplimb1®i S.CcrtiHcaiioil: . DI`Gl-t G 6851 Freedom Dr: Charlotte;' NC 28214 B ri a n_ Eviui n 7/28/2023 Physical Addrm.Cily;a id Zip Siyi iltuu 0f Csiiiliea 1Vc71 Lord,=Idi sc.;,::11 bi+car 4tue Mecklenburg f#.'vigning III is fine,,-I hemby certify-llmq n the •eII(s),was prere)abandoned hl Cminty furmcl ld;ni3rk�ii No.•iPI_Nj =4 ihlan a lrillr l!i4 1lL'iIC 00 010].ur 2C.0200-ITIM Evii.0hiulion Stimrkirds and drid.a mp),ofil is record has beivr prvt ia'ell(a Aresi•ell mt•irec"- SkJ l Wde and lbugttuita in degneeslitiimriestsccouds or decimal degtccs! (it+vcllt.tp,or.r4�tlimytssi cicra) 9.Siiedi:tgramoradditibuatueildet.ifs: . )tau.lttay uSe 6e back of ibis page to provide addit9anat ttirll site;Mails:oi bell N �Y atiaudowneuidecails You way aid:stocttaclditioiialixidesifnecessary CON14TRIICTION.DrrA1LS t1N wELLi51 BEING ABANDONED .SURNWrrAL 1iVSTRUCTl4YS .trrade well)carrtruclieua mwrd(s)j avr»IQLh ,Furin„lripte dyirririr:ar ron-will izlipph. ireils ONLY ii•idi r!?e svetc tn,rstrxrin,i ahafrcNiut�cru, +m ran snb,rat rare foim loa:•For All IVcllx:; Submit ibis.faun uilhiu 30 des}5 of completion of well Ga.�VFII ID0•SP-23 abirndontncbt to thdfvllotvina I„ Division of Waicr Rcsourzcs,lnfor inationProcessing Unit; 25 1617 Al tifScrvicc Ccnter,;Ralci{;+li,NC2769r1-1617 66.Total well ifeptb: 00 10b.Fstr inleclimi Wells: In addition to sending_ th> foenr to the address in IN Gc:Borchol�dlameter:l a11,) ?bo%,c-"also submit one cup}•.of this:forge%%itUur 30 days of completion af.mlt rtbdndomnen!to dtefollattiltq Itivislou.of WnterResounces,Uudergruund Lijecilan CO4t,W,I Prgbrutp, 6t1,Water lecel:belotr ground wrfacce (ft.) 1636 Mail Senice Ccntei,Ralci-h,NC:2709-1636 bc.Outer easing len th.(ifldrmra):.. . . (ft•) IOc..Fnr Water Gtnnh .F.iriiecttnn� 11>i:. In addition to kwing the fowl to the`address(es) gboye. also submit.one copy of this fotm ivilhia 30 days of completion of well abandoluMnt.to thc;eattnly Itralllr&Patvnerd of the county Gf.Liner caiinotilting kiiyrth.(if talown): (ft.) Ii here aMndoncd• { Gg,screed ient;W"(if known): (ft.) k1ml W-30 NanhCarotlm Dcp9mmi l of Endromnent aril Naltual Rcsoumscs-DNIsion of Waterlkcsotuces Re+died�#gusl 2013