Caldwell_Well Abandonment_20231006

. SEP 17 2023
WELL ABANDONMENT RECORD NC DIGligamigie ONLY:
This fa=can be used for san eormukiplewells Central Office
1.Well Contractor Information: WELL IO 3BANDOIENT DETAILS
MN ®
A KC let ✓ .vst.,f f-- s teI Vr AS 3 Ws' 7a.Number of n-eRs beitre abandoned:
Well on tarNnme(or=800maperaaillyabaat�sngazIl onbitttherptopem,) for mi tiro *Viral ar non-water :upn{r iw� ONL won the suer
corartatailabandorenma you can=bait°w fbm 1
NC Well Comreucr Cem&ratiouNombet
7b.Approximate volume of water remaining in well(s): tifig aL)
FOR.WATER SUPPLY WELLS ONLY:
CompanyName ej 7c Type of di9ntectant used:C L to✓t'^e b l e cc 4
2_Well Construction Permit ft. {0g 1 . rr�� �1
ZirraP espitm5letrc,:Pa•'np f a.Comm SYme Tmimpct btjaytiovi atcJ{Ibtmrn 7d-Amount of disinfectant used: /?'ilr �.l, A. O O dA
3.Well use(check well use):
Water Supply Well: 7e.SeaTmg materials pse41 sect all that apply:
rP ,f � ..,s� r..rr�^.�
OAgsi�al Oh4:unicipal/Public DNeu Cement Gmtip•-.� .(r,,• . \P18enttmt Chips or Pellets
O rmGeniheal(P TgfCoolmg Supply) �` T1 We=Supply(9crle) CI Send Cement Grout 6 p Dsy�y r
Crladnsnialr amine cial OResidemtal Water Supply(shared) 0 Gamete Grout 0 C T 0 20 i CuttinP
Dilatation O Specialty Gram O Gravel
----.------Non-Water Supply Well: - .-- - - - - O Beamntte Sltraiili;l IrC�n t'-3l' .`�CL?s'4c*.�l mtoule )
o ammtming OReco ery G`:`ir6�::i8OG
Injection Well: 7f.For each.material selected above,.provide amount of materials used:
=golfaRecharge OGaoundA'terRemetwnan S Vci S CO'Care k'
:AqufferStorage end Recovery OSeIiaityBatria 1
Dr-Aquifer TestDStanawn=Drainage '
Daperimmital Technology OSubaideace Control 7g_Provide a brief description of the abandonment procedure:
OGeot ennal(ClosedLoop) CiT accr Q T
MGeothetmal(RedingrCoolingRetrun) DOthet(explain=der 7g) —Re.iMC �✓� - Sec tt ' J V o., tcl"C Cc. '9
-(41'GyF ci i( pi..., /6;..,1 Cl,.i cl,S cc+^t!'J i.^ flee. f�1
Data
4.Dwel(s)abandoned: q ill i'3.3 Qt1le t o l is (h') (I)((i) , 0v^y C�rovnd 1<9.�CL^oj
5a.Well location: c'; Ilea so 1.1 e l i•4'� , J('c'A t t e 4-e.
I-JOvivilr I^ Av i../1 .---. -
Faalfy,+OunerName Finlay II (ifappiisbie) 8.Ce cation: .
309 S 1 eci M: Ra Hvalet- NC N \• V v v 9/I21 3.
Physical Add�.City,aniZta �-y(,S S Sig ama fCuasedWellCoaaaaort. '..._,, ` Dare
COI die II 2176 31 "Pi S.. ..
By signing this foray 1 hereby catty rhea rho'wa!!(s)ma(wow)abandoned in
Coma Parcel LtieaaficatitmNo.(PIN) accordance with ISA.NC,tC 02C.0100 or 2C_0200 Well Gbnsmtcrion Standards
and Mato copy gf'rht record hat been provided to the welt ottnor.
5b.Latitude and longitude in degreestmiantes+seconds or decimal degrees:
(fueellf eld we]uAongu den) 9.Site diagram or additional well details: '
Yon may use the back of this page to provide additional well site details or well
N W abandonment deffils_Yen zany also a=ch aadtiomal pages if necessary.
CONSTRUCTION DETAILS OF WELL(S)BEINC-ABANDONED S17B7<IITT4L INSTRUCTIONS
Arad lea conattcaton reard(s)ttmut7ahk. Fin andapda bjoriton or non-trtrsa supply
-- ' - waitOTanciP sm ph¢ eoropcmrtvnak5mrdocater.-nucalsubaaronejbrm:- 10a.Far All Well-: Submit this form within 30 days of camptenoa of well
6a Well ID T abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: (ft.) 1617 flail Service Center,Ralei h,NC27699-1617
•
10b.For injecion Wells: In addition to sending t1 form o the address m No
6c.Borehole diameter Apt cm.) above,also submit one Copy of this farm within 30 days of completion of well
abandonment to the following:
6d.Water level below ground surface: I O (ft) Division of Water Resources,Tindergnnnd Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer rasi length(if blown): (ft..) 10c.For Water Supply.0 Injection Wells: In addition to srimEn the foram to
the eddrets(es) above, also submit oar copy of this farm within 30 days of
completion of well abandonment to the county health department of the county
6f Inner casing/tubing length(if blown): (ft.) where abandoned'
6g.Screen length(if blown): (ft.)
FootGW-30 NoahCarolnaDepatmtmtofEnvaomrearandNaturalResomres-DidionofliYterResamres ItevisaiAttgut2013

WELL ABANDONNLENT RECORD For InIurnal.Dse ONLY:
_
--• --MIS form-ean be uscdIor single or muhiPte welLs1
i
Nk-A' WELL ABANDONMENT DETAILS
I.Well Cootraenor Informatitin: ,
1 ' .
Brian Ewing . 7a,Number of wells being abandoned:,
Weil eeltrictor Nome(Or'0.016%w:et i:.disihially1:iittatidchiliig i,14.611 litsilier prepcs'ny) For anfIapk. avectiow or .non-ita(04 suppi). wells. ONLY with am+ some
caaVritaiw.vvabatedonawat,ante can nitniirmejliriii,
4240-B
70.Approilmat olutne Of*atm.rent:titling in Well(sli 004
NC Well ConirdciorteitiricationNutiticr •• ! ' -
FOR WATER spppLy WELLS ONLY:
SAEDACCO 1 .. .
Coltman).Namo - 7c.,Type Of disinfectant tried:
1
2.Well Construction Permit 1/:
idiraii alipikable tie imraWiS(1.e.CIA1/11:}',4.1111g,riliiatite,litit'afon.,rie..)if harm
7d.Amount of,disinfectant userk. . .
3.Well,uii(eheeknell use): , . .
. .
Water Supply Well: . 76.Sealing materials usc'd.(cheek all that apply):
1:1AgOenlitual - itIMimicipal/Ftiblic• • -VI-,Ncat Cenient qtot _ o Bentonite Chips or Pellets..
i3Ocollternoll(Hcating/Ceoling Supply) 011esideritial Water Sopply(single) 1:1 Satid1Centrol Clitu4' -. (
... , . . ;1, , 9r.D.ry Clay
kr-. i----r? 11—ii -).. •: .
.0IndustrialiCommercial OResiciential Water Supply-Oliarcd) 13.COnctete-Grout to,ii...-'Li,a_,,, ki rEI3D,1111 Cnilltlg.s
• Elktijation • b•Specialty0pol b Gravel
Nott:AVater Supply Well: . ' El Bentonite Shiny OCT 0 , 2023 0.dther, i I(e;ip.aD niKi_er 7 g)
110Munitoring, • .Clitecovery.,
Injection Welk , 711.For each tdiiiiiiiirgekeiktPtiliiiiii-4eZatiCialitount-of ntaterials used:
1:3ActuiferRi:Chatge'. OGrOundWater gemediaticiir Neat Cem.:471b ,Wtr:3ga1. Sand Cem.:lb ,Wtr:gal-.
ifkkiptifi Storage uiriReCOvery • 1:1Saliiiity nattier•
DAiptifet Test OStaintWater tiraitiatie ------------.------ ------ ---• 1:1g.xpetintentel Technology 0guhsideireCentuil '7g:Priiiidia Wet tlisuiptiori,of the alp:Waimea.pirOiedurel. •
Mead:gni:al(closed Loop) . DTI:deer
tremie grouted from botttom to surface
.C1Geolliernial(Heation,Cooling Return)• . 0:Aber(explain under 7u). .
•
, .
4.Date will(s)abandoned:.571 6'23 . .
.5i4 Well location:
. .
. . .
Former asi Bernhardt Mill •
. Faciltty/Owner Name Facility Inll.(iTapplkable0 13.Certiflartioin
is
1201 Steel Street. SW Lenoir, NC 28645 . . Brian EWing . 8/24/2023
Physical Adthoss,;City,.atid2ip Stknourc of Ceitillea W011eillar;U'aOk.fir l'i'4114:XVIVr DillN.
Caldwell . thy si5_,Titig MO frirni, 1 lietiqhy eertikthat the wellfs) was(were)abandoned in
. CoOnty - Patel blcutiff&aluit Na(FIN) 'iit.;00inte iiith 154. .1CciIC NC.:0100,or,?C'...0200 TrifIL CoraUructioci Stitockints.
'andthitt.a copy ofilti rectird ha!beeli profided tg:the fvell owner;
.5b.:Latitnde.and liwgitude.in degtresiminutestscironds.or decitual-degrecii
(itiliclircoki,oite latiking:fssolilelP1) 9.Site diagram or-additional weltdetails:
. , _- — ..
You.tuay Aso th'e back' of this page to piovole.adthnonal sell site details:or well
N • . • • • - - • •W •ahouilountent&tads:-You 414-alioattach additional pages it neceSsitty;
. ..
_,
CONSTRUCTION.DETAILS OF WELL(S)-BEING ABANDONED •SUBTWI1TAI.INSTRUCTIONS
Anode Ir,e41cuitwrocrion record()'if oiiiilaNr. liir nrulaple avitaale;or'11413.117.11et iiipply
11.07.4 diSir'iiiih*;%zute.eansirecaon/abigteknyritya.Jim cyy:sullirch ane fian. 10a. For-All Welts:- Submit this form Within 30 days of completion of well -
do,Well ID#:.TmII-.1 . , :ibandOnment to the'foliciviing:
•Divisia u of Water Rnsourets..InfortnatiOnPrOcessing Unit,
6b Total well depth: 15 (ft.)-
1617 Mail Service-Cetiree,Baleigli,N6 27699-1617
. . .
. 10h.For In iceflOn%Veils: In addition tri sending the frinitIo the address lit-WO
above,also submit one copy.of tills form withiir30 days of completion of well
6e.Borehole diameter: (hi.) ' abatulciunient In IlmicilInwing::
•
• Divislo.O.Of Water liesintries.i.Dodergropitifhtiretion Control Program,Gd;WaterleVel.belcor ground stirfacci (ft.) 1836 Mail Scrsice;Center,Raleigh,NC 27699-1636
I '
10c.For-Water Sontibr.,St•I101ection Wells: In addition to sending the form to
Ge.Outer casing length.(if known): (ft.) the address(es) obMre. also Suliinit.one copy of this than Within.30 days of
• conipletion of well abandonment to the county health'department of the county
i .
*hem abandoned..
6f.Inner easing/tubing length(IF known): 5 (11.4
6g.Screen length(If know 10:1° (ft.)
• .
Form GW-30 Wont of Ellii1011Elltla arii Natural Resell:us-Division of WatcrIftcsourees pelted August 20t3
1

1
WELL ABANDONMENT RECORD For lnicnudUscONLY:
This form cast be used.for single.oetttulliple.weUs
I.Wen Contractor Information: WELL ABANDONMENT DETAILS
Brian Ewing . 'lei,Number Of ii cib beIn(;olnindu1 net:.1
Weil'CouranbrMane'Orndloucei-Nts ttally`almoiiOnly;aoll.aaifiisltlr"propcnyl Rh, n+iilnplr hitcualt nr mutt-safer supit, walls- ONLY with t t some
NJtltructlowebavdon wat li'JNCW,aahiitlt W j`orsii
•
9240-B
7b.Aliprosimate`roluate of ii•atrr ictriaining in u'cll(s)t (gal.)
NC Well Conlydetorceniftc.Jtion Nantbci 1
• FOR WATER:SUPFLY WELLS;ONIN:
SAEDACCO .
Company Name 7c.Type of disinkctaut used: '
. 2.Well Construction Permit 0:, , •
L131141ulipJ11,41e ueflelaaiiltr(.e.Cdtirge,Siute,Aria/ice.Inlik ftaiketi:)ifkrot a- 7d.Amount of:disinfectant used:
3.Well usi:( iceli Well use):
Water Siippls Well: 7e.Sealing materials used(cliceli all that apply):
•f]r gticidjtttal. plvliinjcip h17i?thhlic• 6d Neat Cement it...-., -,.,� �l t1c,titonitc.Chips or Pellets'.
.a,-..g : trti e '
GlCieatltcritutl(Hcatir�GCaolti g•$trjtpl}) PRcsidontili[',Vater S�tipplg(single). ❑Sand Cement(tuiut,aM L,'CI:r V 0:1 l CL'ry
❑btdustrial/Commercial ❑Residential Water Supply(sliatcd) 0 Coucret. 'Grout •" Drill Cuttings
❑•'S tall Gr UCT 0;0-202 '
Dlntion peC`' } ou1 Gruel
RoaWatcrSupplyWell Cl BentapiteSltsna pr, gthr(explainander7g)
. 111INoultotiug,, DRecovety L}'a"
injection-Well: • . 71.For each material selectet�-above,provide amount'off.materials used:
DAgiiifer Recturgte DGrourldtptor Remedlatloii Neat Cem.•471b ,Wtr:3gel. Sand_Cem.•lb ,Wtr•gal.
❑Aquifer Storage turd Recovery. IOSalinity Barrier• '
❑Aijuifer Test• ❑Skim:ratterDniliutge .------ -------
-
DErpetinierual Techuolo r •Subsitfeuce COMM! 7 g:Proiide a brief description-of the abandonment procedure:
. . lJGeothemtal(Closed Loop) C11Yacer -
tremie grouted from botttom to surface
0Geothermal(Hcttine/CaolingRetur) . 0Otherdexplain under 71). .
.I.-Date well(s)•abandoned:8-16-23
Sit.Well location: . ,
•
Former JM Bernhardt Mill ,
Faeilttr/thvn rMimi Facility/IBM(ifapplicoblei S•Certi[Ic ilioit: ,
1201 Steel Street. SW Lenoir, NC 28645 Brian E! n. 8/29/2023.
Physical Addles,Ciiy,aiiilZip 5i ilnn;orceitiNd WcluCoilritc ::pr'uii .ft Omror pale
Caldwell • . • By slgttlr(}Ihtsftiqw,.I lrenby,•c0.rtrfj-thnr the ireE(s) was(mere)Oat:doned in .
County Parcel ldnnlifi&ttJnii No.(Plat) . 'rnxvriktnce tvfllr IA.'CiIC 02C;0100.or 24.0200 Well CaiuIrucfi9ri Standards
• 'and that a cap'ofthis record has been provided:/a'the Well o -wn-
Sb.Latittideand longitnee in degrceslittinutestsecoodsOrdeciival-degrees:
Orwell Ned,ow:lait/tonti s5iiIrlcigra) 9.Site di. ram or additional well details:
You.mag,use the baclt of this page to prOvide..addilionai well site details:or well
-Ii • • - - . . W abandonmeiudaits.et You twoy also.attach additional'pages if necessary...
.
Ct3NS'rRUC TIttN.DETAiLS ON WELLS)iIEINC ABANDONED •SURM1iiTTAI,INSTRUCTIONS
:Wadi irdl cariytrnclidt'vim-ats)'if oiiiitaile. Frir noJnplr iilrctitirt rir twin-water supple
wefts ONLY ii!/i Me wine€oar ert(0 ipykkotin rt.,Yitt[Yn7 Siflurt l me I0,i: For All Welts: Submit iliis;fcrm within 30•days of completion of rimll , .
bandoomcnt to the following:
Ga.•Weil ID§:TMW-2 ,
•
Dislikin of Water Resooriccs,lnformatiou-Pivicessing Unit;
'1617bfttil-Scrsiee C.riter,.RalcigIi,NC27699-1617
Gb.•Total well depth: 18 - (ft.)
10b.Jrnrinleetlon Wells:-In addition-to sending the forat to the-address in l0a
6e 8orcltolc dianuter: pn;y above:also submit:one Copy/of this.form within-30 days-of comptetioit of well'
abanidoument to the following. 1
Divislon.ef Water Resources;:Uudergroundinjection Control Pitigram,
6d.Water teyelbcion•grotinrl surfae:. - (ft:) 1636 Mail Scrsice'Ccntcr,Raleigh,NC 27699-1636 •
Gc.Outer casing,lenhth.(if known); (ft.) 10c,Fur Water snouts-&Lifi$tjon Wells:. In addition to sending the form to
tbe;:oddress(esl,aboee. also submit.one copy of-this fomt Within 30 days of
compaction of well abandannieni to the county health-deportment of the county '
6f.Inner easing/tubing length.(if known):5 (ft.)
*hero abandoned,
6g.Sireen length(if lworr n):10 (ft.)
Pam)GW-30 Noah Camlli a Dcpuoa>rni of Environment and Nattaat Resoterci-Division of Water Rosoaizes Revised August 20t3
i

i
WELL ABANDONIVIEN.T RECORD For(demi(Ad ONLY:
ThiS Pim mitt heuSeillor singre.or multitil wtlls
l 1
1.WeII 0100400r IttfortnatiOnc WELL ABANDONMENT DETAILS
Brian Ewing . . . '7a.Number of wells being abandoned:.1
Welt emicartorMainelnir u.O,llCakirskinallinhan411.ni;vroll.ou lifsiUrlireicriy) Ftir trittlopk &break* tir aoa-titer uppi tolls ONLY with Um some
cOtiltrucooilloltaidoilment,)wri cyln.vabnat 4a.efirral.
424 0-B I '
• Th.Approilmate voluine Of trater;iintaining inwell(a): (OW
NC Well Contractor Coalliqaionthiniacf
SAEDACCO •
FOR WATE R.SUPPLY WELLS'ONLY:
.
Company Kam: .
7c.Tyjie tifdisinfeciant used:
2.Well Construction•Fertolt IS;,
Lh pliogile kW/perara*au.Conroy.Stay.Vilililtke,lirjecliotkettli if kituUlt
7d.Amount of.disinfectaultised:
3.Well uii(check Ayellusit):
Water Supply Well: 7..e.,Sealing Materials Osed,(cbecklill that apply):•
ElAgticulturat i,
0 ds'
Mitnicipa(Albite Neat Cement.Cactig7 . El Bentonite Chips or Pellets.
...,,., . i'---f••".:. •'-''t% 6-, ..,,,,_
1:104,0dianNli(BC(1140C.00lifig,Surtply) . Ottesidentiral Water Supply(.5itigic) 13 Sil1rifirCe11141t1',*.l. v,t-..,:--r‘,...,i::::i;i \if-0iy,i1.13, •
,.,..; : •
.Ellndustrial/Cornmerelal OResidential Water Supply.(shared) -EI.Ccinekte'Grout El Doll Culling
A 're•1
" o Speciallygrour OCT V 0 LO2E1 Gravel
Elltription :_ .. ,
— - -- — .
Not •WOter.Sti pp ly,Well: Cl Bente:lite Slimy . . , Cl Oilier(explain under 7g)
'Irtf3Tir.:24T.n Proc.I.44-,,!?,..-g 11171
IMMiiidtorine.. Elitecovety
'Injection Well: . .
• 7f.For each material sclecaligiaqawide amount of materials used:
. . ElAnuifer Itethaqe., pGrOtuidnater Rentediation Neat Cem.:471b. ,Wtr:3gal. Sand Cem.:lb ,Wtr:gal.
0Aguied*nage and Reeiwery DSalinity Barrier•
ElAnnifer Test. . EIS lei-miner Drainage — _ _ ___ _ _
Eigsperintental Tecluntiodv EISubsidetteeCOnlytil 7g;Praide a brief deAcription of tilk abandonment procedure:
ElGembermal(Closed Loop) ElTracer
tremie grouted from botttom to surface
ElGeothertnat(floating/Cooling Return) 1:10tIter(explain under 7g).
___ ____
• • ,
• . ,
4.Date wel10.ahaindoned: 8-16-23
. .
•
.5a;Well location:
•
. . . . ;
Former 3M Bernhardt Mill
• Fatilityierarcr N111110 Faciliiy IDIJ(ifapplkabld) 8.CertifIcatioitt
•
1201 Steel Street.SW Lenoir,_ NC_ 28645 " • Brian Ewint 8/24/2023
. Physical Addross;City,-atid Zip Sikri.linrc or Ciiiipon ed Welt Cuircrot,.:.?r,rl.:11 Owner Dalt
,
Caldwell . liv,SIVilkg dits fiimn,.I herchy•ceitif,0 dim!the 14.44 st.c...y fiverg)aliondoned in
County Parca litalifLEaloit NO.(PIN) demi-dance utilh 1..-4:AVAC 02C,19.100.or 3C.0200 TPW1.04iStrucliwi Sloodords
onaVrai a nopyoflhis record has be en prol:ided.lo-dre feel/&viten- '
511:1,atitude And langitntle.in degreeslifilintestscinudsOr deciMnidegrcen:
(itijr111 Aoki,ono latilung Is farlftel9r* 9.Site diagram oraddltioual well details:
• . You may use theha.cit of this page to pros additional well.Siti.deraikor•well
• . N • • . . - W ahandornuent•tkails: You mayraLSOitnach additional'pages if tteceisaty. . •
ceiNsTRuctioNt.iirrmas OF WELL(S)BEING ABANDONED SUBMITTAL INSTRUCTIONS
:tooth 11.ep raristructiuu recuraYsilf oiitilable. 1,1ir multiple ifyrilicur'or isin.water supply ' .
we/Le oArLY.with fire slynr.ccon-stradon-latiOudreqaot.you cati iirlirot tote farm. Itla, For-All Waits: Submit this form Within 30 days of completion of well .
,W • •ID#:P114-3 abandonment to the folio-wing; t
6aell
• •
Division of WatciResuurcm,InformationTermessing Unit,
• 1611 MailService teriter,;Raleigh,NC 276994617
6b.Total well depth: 15 010
th.Frir Inlection Wells: In addition,to sending the fortitto the address in COO
••above,-aLio submit one copy of lids,form within-30•days.of contPletion of well
tie,..Elo relit*diameter: . _(in.) abandonment to the following:
- -
• (viSioalif Winer Resoureciluderrottatilitiercitou ContrOl Ptligratn,
6il:Water level below' 1
ground surface:. • (ft.) .1636;Mail Scrvice Center,Raleigh,NC:27699-1636
I '
10e.For Water gamily&Infection Wells: In addition to sending the form to
6c..Outei casing length.(if known): (ft.) the.address(es) above. also shlitnit„one copy of this bon Within 30 days of
conipletion of well ahandonnient to the county health department of the counqr
wlicic abanclonad,
61.Inner easing/tubing length(if known): (ft.) I •
• 1
6g.Screen length(if known):I-° •(D)
• •
Form GW-30 North Carollro Departiona of Enviromnent=I Natural Rcsoturces-Division of Water 1olaces Revised August 20(3