New Hanover_Well Abandonment_20240119 (6)

WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAItIs
Frank Beecher 7a.For Geoprobe/DPT or Closed-Lloop 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:- I I
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): 77 (gal.)
AECOM Technical Services of North Carolina, Inc. FOR WATER SUPPLY WELLS ONLY:
Company Name 7c.Type of disinfectant used: Ny/A
2.Well Construction Permit#: N/A
List all applicable well constructionpermits(i.e.WC,County,State,Variance,etc.)if/mown
7d.Amount of disinfectant used:N/A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public ❑Neat Cement Grout i^i-`-: P-Bentgnite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑Sand Cement Grout" 17a��)CJ�y
❑lndustriaUCommercial ❑Residential Water Supply(shared) S Concrete Grout JA N 1, p 20X G ,I Cuttings
❑irci anon ❑Specialty Grout v7 Ub Gravel
Non-Water Supply Well: ❑ Rentonite Slurry1mzrn;csi^,7 i?:C.^ ;p, t6e�r:�(explain under 7g)
❑Monitoring RRecovery
injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑GroundwaterRemediation Portland-182.74 pounds Bentonite-7.61 pounds
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑StormwaterDrainage Water-13.65 gallons
❑Experimental Technology ❑Subsidence Control routed with a Portland Mix.
[:]Geothermal(Closed Loop) ❑Tracer 7g.provide a brief description of the abandonment procedure:
re
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g) Tremmie 9
The well was abandoned in accordance with 15A NCAC
4.Date well(s)abandoned: 10.17.2023 02C .0113.
5a.Well location:
River Road Terminall Kinder Morgan NONCD0001697
Facility/Owner Name Facility iD#(if applicable) 8.Certification,
3340 River Road, Wilmington, 28412 �1, 1- "1L4`j� 12.16.2023
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Dale
New Hanover R06400-001-003-000 By signing this form, 1 hereby certify,that the lvell(s) was(here) abandoned in
County Parcel identification No.(Pith accordance with 15A NCAC 02C.0700 or 2C.0200 Well Construction Standards
Sb.Latitude and longitude in degrees/minutes/seconds or decimal degrees: and that a copy of this record has been provided to the well owner.
�
(if well field,one latllong is sufficient) 9.Site diagram or additional well details:
34.1777581 N -77.9531750 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(S)BEING ABANDONED SUBMITTAL INSTRUCTIONS
Attach well construction record(v)ifavailable.Formu/liple injection ornon-Ivalersupplywells
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 TD#• RW-7 abandonment to the following: f
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 22.5 (ft) 1617 Mail Service Center,Raleigh,NC 27699-1617
lob.For iniection Wells: in addition;to sending the form to the address in 1Oa
6c.Borehole diameter:4.0 (in.) above, also submit one copy of this iform within 30 days of completion of well
abandonment to the following:
7.53 Division of Water Resources,Underground Injection Control Program,
6d.Water level below ground surface: (ft.) 1636 Mail Service Center,Raleigh,NC 27699-1636
6c.Outer casing length(if known): N/A (ft.) 10c.For Water Supply&Tniection Wells: in addition to sending the form to the
address(es)above,also submit one copyJof this form within 30 days of completion
of well abandonment to the county' health department of the county where
6L Inner casing/tubing length(if known): N/A (ft.) abandoned.
6g.Screen length(if known): N/A (ft.)
i
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016
I

t
WELL ABANDONMENT RECORD For Internal Use ONLY:
� 1
1.Well Contractor Information: WELL ABANDONMENT DETAILS
Frank Beecher 7a.For Geoprobe/DPT or Closed- op Geothermal Wells having the same
Well Contractor Name(or well owner personally abandoning well on his/her property) well construction/depth,only i r -30 is needed. indicate TOTAL NUMBER of
3225-A wells abandoned:wA
NC Well Contractor Certification Number 7b.Approximate volume of water rim i ining in well(s): 7.23 (gal.)
AECOM Technical Services of North Carolina, Inc. FOR WATER SUPPLY WELLS ONLY:
1. '
Company Name N/A
7c.Type of disinfectant used: I,
r
2.Well Construction Permit#:
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)iflmown
7d.Amount of disinfectant used: N/A
`'V/A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all;that apply):
❑Agricultural ❑Municipal/Public ❑Neat Cement Grout { S Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑ Sand Cement Grout
r
❑IndustriaUCommercial ❑Residential Water Supply(shared) ❑ Concrete Grout JA i`, I. ❑Drill Cuttings
❑irri ation ❑Specialty Grout aX.1el
Non-Water Supply Well: ❑ Bentonite Slurry I K .. i _�Othe,r F(explain under 7g)
evi is,r..t:l :-
❑Monitoring CRecovery ��b�w��?,�
injection Well: 7f.For each material selected aiRovc,pF56VI lc amount of materials used;
❑Aquifer Recharge ❑GroundwaterRemediation Bentonite Chips-92 Ibs
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test Water-1.0 gallons
❑Stormwater Drainage
i -
❑Experimental Technology ❑Subsidence Control 7g.provide a brief description of the abandonment procedure:
❑Geothemtal(Closed Loop) ❑Tracer i
❑Geothermal(Heating/Cooling Return) 00ther(explain under 7g) Slowly added bentonite chips and ensured there was no bridging
taking place. Then added water to hydrate bentonite chips.
4.Date well(s)abandoned: 10.1 8.2023 The well was abandoned in accordance with 15A NCAC
5a.Well location: 02C .0113.
River Road Terminal/Kinder Morgan NONCD0001697
Facility/Owner Name Facility iD#(if applicable) 8.Certification:
3340 River Road, Wilmington, 28412 � 12.16.2023
Physical Address,City,and Zip Signature orCertified Well Contractor or Well Owner Date
New Hanover R06400-001-003-000 By signing this form, I hereby certJ'that the well(s) was(were)abandoned In
County Parcel identification No.(P" 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: - ;.
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.1771484 N -77.9513988 `,1, 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(S)BEING ABANDONED SUBMITTAL INSTRUCTIONS
Attach well construction remrd(.v)ifavailahle.Formullipleinjectionornon-waiersupplywells
ONLY with the same constructionlabandonment,you can submit one form.
10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: RW-6 abandonment to the following: i
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 13.5 (N 1617 Mail Service Center,Raleigh,NC 27699-1617
10b.For iniection Wells: In addition to sending the form to the address in 10a
6c.Borehole diameter•4.0 (in.) above, also submit one copy of this form within 30 days of completion of well
abandonment to the following:
6d.Water level below ground surface• 2.43 (f£) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6c.Outer casing length(if known): N/A (ft.) IOc.For Water Sunnly&inicetion 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 countyt health department of the county where
6£Inner casing/tubing length(if known): N/A (ft.) abandoned.
6g.Screen length(if known): N/A
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

i
WELL ABANDONMENT RECORD For Internal Use ONLY: f
1.Well Contractor Information: WELL ABANDONMENT DETAILS
Frank Beecher 7a.For Geoprobe/DPT or Closed-L I op Geothermal Wells having the same
Well ContractorName(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 abandone(:W^ f
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): 8.78 (gal.)
AECOM Technical Services of North Carolina, Inc. FOR WATER SUPPLY WELLS ONLY:
Company Name
7c.Type of disinfectant used: N/A
2.Well Construction Permit#: N/A
List all applicable well construction permits(i.e.07C,County,State,Variance,etc)iflorown
7d.Amount of disinfectant used: N/A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all•that apply):
❑Agricultural ❑Municipal/Public ❑Neat Cement Grout N Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑Sand Cement out., r _ ^11-07-n Clay
❑Industrial/Commercial ❑Residential Water Supply(shared) ❑Concrete Grout '��' a' LIE11•Dcill Cuttings
Dim ation ❑Specialty Grout JAN 1 9 e024❑Gravel
Non-Water Supply Well: ❑ Rentonite Slurry El Other(explain under 7g)
❑Monitoring WRecovery n 11h:i
Injection Well: 7E For each material sclgtcd�abgve;�providc amount of materials used:
❑Aquifer Recharge ❑GroundwaterRemediation Bentonite Chips-112 Ibs
DAquifer Storage and Recovery ❑Salinity Barrier
❑AquiterTest ❑StormwaterDrainage Water-1.0 gallons
❑Experimental Technology ❑Subsidence Control I.
7g.Provide a brief description of the abandonment procedure:
DGeothemral(Closed Loop) ❑Tracer
❑Geothermal(Heating(Cooling Return) ❑Other(explain under 7g) Slowly added bentonite chips and ensured there was no bridging
taking place.Then added water to hydrate bentonite chips.
4.Date well(s)abandoned: 10.18.2023 The well was abandoned in accordance with 15A NCAC
5a.Well location: 02C .0113.
River Road TerminaV Kinder Morgan NONCD0001697
i
Facility/Owner Name Facility iD#(if applicable) S.Certification:
3340 River Road, Wilmington, 28412 �✓ n" 12.16.2023
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Dale
New Hanover R06400-001-003-000 By signing this form, I 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
Sb.Latitude and longitude indegrees/minutes/seconds or decimal degrees: and that a copy of this record has been provided to the well owner.
(if well field,one Iatllong is sufficient) 9.Site diagram or additional well details:
34.1774297 N -77.9513471 `,I, You may use the back of this page to provide additional well site details or well
abandonment details. You may also attach additional pages ifnecessary.
CONSTRUCTION DETAILS OF WELL(S)BEING ABANDONED SUBMITTAL INSTRUCTIONS
Attach well construction record(s)tfavailable.Pormultiple injection ornon-watersupply wells
ONLY with the same constnrctionlabandonment,you can submit one form.
10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#• RW-5 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 15.1 (fit) 1617 Mail Service Center;Raleigh,NC 27699-1617
10b.For iniection Wells: in addition to sending the form to the address in 10a
4.0 above, also submit one copy of this form within 30 days of completion of well
6c.Borehole diameter: (in.)
abandonment to the following: I '
6d.Water level below ground surface:
1.95 Division of Water Resources,Underground Injection Control Program,
(fit.)
1636 Mail Service Center;Raleigh,NC 276994636
I
6e.Outer casing length(if known): (fit.)N/A 10c.For Water Suomly&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): N/A (ft.) abandoned.
6g.Screen length(if known): N/A
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources ' Revised 2-22-2016