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Home My WebLink AboutCumberland_Well Abandonment_20240119 i WELL ABANDONMENT RECORD For Internal Use ONLY: i . 1 1.Well Contractor Information: WELL ABANDONMENT DETAILS , Matt Steele 7a.For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same Well Contractor Name(or well owner personally abandoning well on his/her property) well construction/depth,only 1 GW-30 is needed. Indicate TOTAL NUMBER of 4548Awells abandoned:I well NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): - _ (gal.) Geological Resources, Inc. FOR WATER SUPPLY WELLS ONLY: Company Name 7c.Type of disinfectant used: 2.Well Construction Permit#: List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)if known I' 7d.Amount of disinfectant used: 3.Well use(check well use): Water Supply Well: 7e.Sealing materials used(check all that apply): ❑Agricultural ❑Municipal/Public •Neat Cement Grout •Bentonite Chips or Pellets ❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay 0 Industrial/Commercial ❑Residential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings 0 Irrigation 0 Specialty Grout I 0 Gravel 1. Non-Water Supply Well: 0 Bentonite Slurry 0 Other(explain under 7g) •Monitoring ❑Recovery Injection Well: 7f.For each material selected above,provide amount of materials used: ❑Aquifer Recharge . ❑GroundwaterRemediation 10 lbs cement ❑Aquifer Storage and Recovery ❑Salinity Barrier ❑Aquifer Test ❑StormwaterDrainage 48 lbs hole plug ,• ❑Experimental Technology 0 Subsidence Control 7g.Provide a brief description of the abandonment procedure: 0 Geothermal(Closed Loop) ❑Tracer 0 Geothermal(Heating/Cooling Return) ❑Other(explain under 7g) 7/11/2023 -u 4.Date well(s)abandoned: � ��'��.�^�,.�i% `Et 5a.Well location: JAN 1 9 2024 _ - Short Stop 45 00-0-0000030246 8.Certification: `Isliv"Yr'cid27I s">-:5"r :';j lJFIi Facility/Owner Name Facility ID#(if applicable) D d'vJ:`ki'..x3,` 3408 Murchison Road, Fayetteville, 28311 I ' 7/11/2023 Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date Cumberland 0429-50-2545 By signing this form,I hereby cert.&that the well(s) was(were) abandoned in County Parcel Identification No.(PIN) accordance with 15A NCAC 02C.0100 or 2C.0200 Well Construction Standards and that a copy of this record has,been provided to the well owner. 5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees: I: (if well field,one lat/long is sufficient) 9.Site diagram or additional well'details: 35.097810 N 78.915328 W You may use the back of this page to provide additional well site details or well abandonment details. You may also attach additional pages if necessary. CONSTRUCTION DETAILS OF WELL(S1 BEING ABANDONED SUBMITTAL INSTRUCTIONS Attach well construction record(s)if available.For multiple injection or non-water supply wells ONLY with the same construction/abandonment,you can submit one form. 10a. For All Wells: Submit this form within 30 days of completion of well `/�, 6a.Well ID#: M V V-1 abandonment to the following: Division of Water Resources,Information Processing Unit, 6b.Total well depth: 34.24 (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617 10b.For Injection Wells: In addition to sending the form to the address in 10a 6c.Borehole diameter: 6 (in.) above, also submit one copy of this form within 30 days of completion of well abandonment to the following: ; . I' I 6d.Water level below ground surface: 30.96 (ft.) Division of Water Resources,Underground Injection Control Program, 1636 Mail Service Center,Raleigh,NC 27699-1636 6e.Outer casing length(if known): 0 (ft.) 10c.For Water Supply&Injection Wells: In addition to sending the form to the address(es)above,also submit one copy of this form within 30 days of completion of well abandonment to the county health department of the county where 6f.Inner casing/tubing length(if known): 20 (ft.) abandoned. I 6g.Screen length(if known): 10 - - (ft.) I• l Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016 WELL ABANDONMENT RECORD For Internal Use ONLY: 1.Well Contractor Information: WELL ABANDONMENT DETAILS Frank Beecher 7a.For Ceoprobe/DPT or ClosedlLoop Geothermal Wells having the same Well Contractor Name(or well owner personally abandoning well on his/her property) well construction/depth,only 1 GW-30 is needed. Indicate TOTAL NUMBER of 3225-A wells abandoned:N/A NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): 1•71 (gal.) AECOM Technical Services of North Carolina,Inc. FOR WATER SUPPLY WELLS ONLY: Company Name N/A 7c.Type of disinfectant used: 2.Well Construction Permit#: N/A r List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)if known 7d.Amount of disinfectant used:i NSA 3.Well use(check well use): Water Supply Well: 7e.Sealing materials used(check'all that apply): ❑Agricultural 0 Municipal/Public 0 Neat Cement Grout ' C Bentonite Chips or Pellets ❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout i, 0 Dry Clay ❑Industrial/Commercial ❑Residential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings - -❑Irrigation - -- -❑ SpecialtyGrout --- 0 Gravel - - - - - Non-Water Supply Well: 0 Bentonite Slurry 0 Other(explain under 7g) UMonitoring ❑Recovery Injection Well: 7f.For each material selected above,provide amount of materials used: ❑Aquifer Recharge ❑GroundwaterRemediation Bentonite Chips-34,Ibs ❑Aquifer Storage and Recovery ❑Salinity Barrier ❑AquiferTest ❑StormwaterDrainage Water-1.0 gallons ❑Experimental Technology ❑Subsidence Control 7g.Provide a brief description of;the abandonment procedure: ❑Geothermal(Closed Loop) ❑Tracer i' Slowly added bentonite chips and ensured there was no bridging ❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g) taking place.Then added water to hydrate bentonite chips. 4.Date well(s)abandoned: 01.05.2024 The well was abandoned in ac�ortia ee,; #M.�,15A GAC 5a.Well location: 02C .0113. t c1 .s i 1.' I Speedway 6992 00-0-0000011818 JAN 1 9 2024 Facility/Owner Name Facility iD##(if applicable) 8.Certification: 101 South Eastern Blvd, Fayetteville, 28301 " ,.,� . -cam nfori-ar ien P ,, n t �` D VQ l3V,I. f5.024 Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date Cumberland 0447024246000 By signing this form, T hereby certify that the well(s)was(were)abandoned in County Parcel Identification No.(PIN) accordance with 15A NCAC 02C.0100 or 2C.0200 Well Construction Standards and that a copy of this record has been provided to the well owner. 5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees: I. (if well field,one lat/long is sufficient) 9.Site diagram or additional well details: 35.04704 N -78.86511 `,I, You may use the back of this page to provide additional well site details or well - abandonment details. Yon may also attach additional pages if necessary. CONSTRUCTION DETAILS OF WELL(S)BEING ABANDONED SUBMITTAL INSTRUCTIONS Attach well construction record(s)Ifavailable.For multiple injection or non-watersupplywe!ls ONLY with the same construction/abandonment,you can submit one form. 10a. For All Wells: Submit this form within 30 days of completion of well 6a.Well ro#: M W-14 abandonment to the following: Division of Water Resources,Information Processing Unit, 170 1617 Mail Service Center,Raleigh,NC 27699-1617 . 6b.Total well depth: (ft.) lob.For Inflection Wells: In addition to sending the form to the address in 10a 6c.Borehole diameter: 2.0 (in.) above, also submit one copy of ails!form within 30 days of completion of well abandonment to the following: i 6d.Water level below ground surface: 6.52 (ft.) Division of Water Resources,,Underground Injection Control Program, 1636 Mail Service Center,Raleigh,NC 27699-1636 6e.Outer casing length(if known): N/A (ft,) l Oc.For Water Supply&Inflection Wells: In addition to sending the form to the address(es)above,also submit one,copy of this form within 30 days of completion of well abandonment to the county health department of the county where 6f.Inner casing/tubing length(if known): 7.0 (ft.) abandoned. 6g.Screen length(if known): 10.0 (ft.) i, ' Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016