Onslow_Well Abandonment_20240205

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WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
William J. Miller 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 I GW-30 is needed. Indicate TOTAL NUMBER of
2927A wells abandoned: I
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gal.)
CATLIN Engineers and Scientists FOR WATER SUPPLY WELLS ONLY:
Company Name
7c.Type of disinfectant used: 1'
2.Well Construction Permit#: I'
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)ifknown
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 a Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑ Sand Cement Grout 0 Dry Clay
❑Industrial/Commercial ❑Residential Water Supply(shared) ❑ Concrete Grout 0 Drill Cuttings
❑Irrigation ❑ Specialty Grout 0 Gravel
Non-Water Supply Well: _ ❑ Bentonite Slurry 0 Other(explain under 7g)
•Monitoring ❑Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
DAquifer Recharge ❑Groundwater Remediation Bentonite .2 cubic feet
❑Aquifer Storage and Recovery ❑Salinity.Barrier
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology ❑Subsidence Control
7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer I
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g) Well was pulled and filled'with bentonite up to 1 foot
and hydrated. •
4.Date well(s)abandoned: 09/18/2023 _
5a.Well location: 44.0r s..•-t l itt,,.,
•
Camp Lejeune NA F tti 5 2024
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
Site FC-39, Camp Lejeune, Jacksonville, NC �'Wit• , a f% ri�9�ZOG 1 /9/2023
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
NA Unknown i •
By signing this form, 1 hereby certify that the well(s) was (were) abandoned in
County Parcel Identification No.(PIN) accordance with 15A NCAC 02C.01,00,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:
34.658114° N -77.315421° 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(s)rjavailable. For multiple injection or non-water supply wells
ONLY with the.same consttuctionabandonment,you can submit one form.
10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: UST-FC39-MWO3 abandonment to the following: '
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 11.56 (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617
10b.For Injection 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
6c.Borehole diameter: 2.25 (in)
abandonment to the following: •
6d.Water level below ground surface: NA (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
NA 10c.For Water Supply&Injection Wells: In addition to sending the form to the
6e.Outer casing length(if known): (ft.)
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): NA (ft.) abandoned.
6g.Screen length(if known): UNKNOWN (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

li
i
WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAIIIS
William J. Miller
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
2927A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gal.)
I '
CATLI N Engineers and Scientists FOR WATER SUPPLY WELLS ONLY:
Company Name
7c.Type of disinfectant used:
2.Well Construction Permit#: is
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 0 Neat Cement Grout a Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) 0 Residential Water Supply(single) 0 Sand Cement Grout ❑ Dry Clay
❑Industrial/Commercial ❑Residential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings
0 Irrigation 0 Specialty Grout ❑ Gravel
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 ❑Groundwater Remediation Bentonite 0.2 cubic feet
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage
r '
['Experimental Technology ['Subsidence Control ' I
7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer I '
❑Geothermal(Heating/Cooling Return) ['Other(explain under 7g) Well was pulled and filled with bentonite up to 1 foot
and hydrated. I.
4.Date well(s)abandoned: 09/18/2023 .—.,TM.
f
5a.Well location: ,,,,� e(l .i! V .,....1.,,-
Camp Lejeune NA 5 2024
Facility/Owner Name Facility ID#(if applicable) 8.Certification: FEB D !�
nli
Site FC-39, Camp Jacksonville, NC --` .• � •
'
_ Lejeune, Mtn 3-7C .'6% t SC ..
� �,r � 11/9/2023
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
NA Unknown
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.0100i or 2C.0200 Well Construction Standards
and that a copy of this record has been I provided to the well owner.
fib.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:
34.658114° N -77.315421° 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 we//construction record(s)ifavailable. For multiple injection or nor-water supply wells
ONLY with the same constructiovabandonment,you can submit one form.
10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: UST-FC39-MWO4 abandonment to the following: ; ,
i
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 11.40 (ft) 1617 Mail Service Center,Raleigh,NC 27699-1617
1,
lOb.For Iniection Wells: In addition to sending the form to the address in 10a
6c.Borehole diameter: 8.25 (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: NA (ft.)
Division of Water Resources,UI derground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
NA 10c.For Water Supply&Iniectio I•Wells: In addition to sending the form to the
6e.Outer casing length(if known): (ft.)
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): NA (ft.) abandoned.
6g.Screen length(if known): UNKNOWN (ft.)
1
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

•
r �
WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAIL'S
William J. Miller 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 I GW-30 is needed. Indicate TOTAL NUMBER of
2927A wells abandoned: I
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gal.)
CATLIN Engineers and Scientists 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
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 0 Neat Cement Grout II Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout ❑ Dry Clay
❑Industrial/Commercial ❑Residential Water Supply(shared) 0 Concrete Grout ❑Drill Cuttings
❑Irrigation 0 Specialty Grout ❑ Gravel
Non-Water Supply Well: ❑ Bentonite Slurry ❑ Other(explain under 7g)
GMonitoring ❑Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation Bentonite 0.2 cubic feet
•
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology ❑Subsidence Control •
7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g) Well was pulled and filled with Bentonite up to 1 foot
and hydrated
4.Date well(s)abandoned: 09/18/2023 I - ---
5a.Well location:
Camp Lejeune NA ht_d_-O 5 2024
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
Site FC-39, Camp Lejeune, Jacksonville, NC f/ • •' W:1
.,�fft,:.rsr ems:� f..�w- i �1/9/2023
DWOi:1 Ora
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
NA Unknown
By signing this form, I hereby certify that the well(s) was (were) abandoned in
County Parcel Identification No.(PIN) accordance with/5A 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:
34.658114° N -77.315421° 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
Auac/z,,'ell cons/rod ion record(s)ifavailable.For multiple injection ornon-watersupply 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#: UST-FC39-MW08 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 11.51 (ft) 1617 Mail Service Center,Raleigh,NC 27699-1617
IOb.For Inflection Wells: In addition to sending the form to the address in 10a
above, also submit one copy of this;•fdrm within 30 days of completion of well
6c.Borehole diameter: 2.25 (in.) abandonment to the following:
6d.Water level below ground surface: NA (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
NA 10c.For Water Supply&Iniection'Wells: In addition to sending the form to the
6e.Outer casing length(if known): (ft.)
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): NA (ft.) abandoned.
6g.Screen length(if known): UNKNOWN (ft.)
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: I
is
1.Well Contractor Information: WELL ABANDONMENT DETAILS I
William J. Miller 7a.For Geoprobe/DPT or Closed-LI op Geothermal Wells having the same
Well Contractor Name(or well owner personally abandoning well on his/her property) well construction/depth,only 1 GW-3b i3 needed. Indicate TOTAL NUMBER of
2927A wells abandoned: 1
i.
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gal.)
I.
CATLIN Engineers and Scientists '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
7d.Amount of disinfectant used: !
3.Well use(check well use):
is
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Pub lic ❑Neat Cement Grout C Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑Sand Cement Grout ❑Dry Clay
❑Industrial/Commercial :Residential Water Supply(shared) ❑ Concrete Grout ❑Drill Cuttings
❑Irrigation ❑ Specialty Grout ❑ Gravel
Non-Water Supply Well: ❑ Bentonite Slurry ❑Other(explain under 7g)
UMonitoring ❑Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
:Aquifer Recharge ❑Groundwater Remediation Bentonite 0.2 cubic feet
DAquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology ❑Subsidence Control
7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer I .
❑Geothermal(Heating/Cooling Return) ❑Other(explain under7g) Well was pulled and filled with bentonite up to 1 foot
it ,
and hydrated 1
4.Date well(s)abandoned: 09/18/2023 I.
`5a.Well location: 'e '�s,.,CvIL' :.%?` dal k...-Li
Camp Lejeune NA l.Fto 0 5 2024
Facility/Owner Name Facility ID#(if applicable) S.Certification:
Site FC-39, Camp Lejeune, Jacksonville, NC '�` /�:
In:Wrsr�:
�<,c,, P.r-,,.,<.a, i'/9/2023
D' 3rz3OG
Physical Address,City,and Zip Signature of Certified Well Contractor or W ARell Owner Date
NA Unknown I,
By signing this form, I hereby certif}l 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:
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.658114° N 77.315421° 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(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# UST-FC39-MW10 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 11.20 (ft) 1617 Mail Service Center,Raleigh,NC 27699-1617
I'
10b.For Injection Wells: In addition to sending the form to the address in 10a
6c.Borehole diameter: 2.25 (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: NA (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
I. :
f
6e.Outer casing length(if known): NA (ft.) 10c.For Water Supply&Infection 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): NA (ft.) abandoned.
6g.Screen length(if known): UNKNOWN (ft.)
I
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources " ' Revised 2-22-2016
.

WELL ABANDONMENT RECORD For Internal Use ONLY: ,
I
1.Well Contractor Information: WELL ABANDONMENT DETAILS
VViIliam J. Miller 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 I GW-30 is needed. Indicate TOTAL NUMBER of
2927A wells abandoned: I
,
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gal.)
CATLIN Engineers and Scientists 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 ,
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 0 Neat Cement Grout a Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
❑Industrial/Commercial ❑Residential Water Supply(shared) 0 Concrete Grout ❑ Drill Cuttings
0 Irrigation 0 Specialty Grout 0 Gravel
Non-Water Supply Well: 0 Bentonite Slurry . 0 Other(explain under 7g)
lMonitoring ❑Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation Bentonite 0.2 cubic feet
❑Aquifer Storage and Recovery ❑Salinity Barrier
['Aquifer Test ❑Stormwater Drainage
❑Experimental Technology ['Subsidence Control
7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer
❑Geothermal(Heating/Cooling Return) ['Other(explain under 7g) Well was pulled and filled with bentonite up to 1 foot
and hydrated j
4.Date well(s)abandoned: 09/18/2023
5a.Well location:
Camp Lejeune NA ( i_u ; 5 2024
Facility/Owner Name Facility ID#(if applicable) S.Certification: �r�rc • , x
n;v;t;.:,R;n t �rn:..�l�ri:r
Site FC-39, Camp Lejeune, Jacksonville, NC i ; Gtsai lwt� 11/9/2023
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
NA Unknown 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
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: 1
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.658114° N -77.315421° 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(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#: UST-FC39-MW11 abandonment to the following:
Division of Water Resources,Information Processing Unit,
11.10 1617 Mail Service Center,Raleigh,NC 27699-1617
6b.Total well depth: (ft.)
10b. For Infection Wells: In addition Ito sending the form to the address in 10a
6c.Borehole diameter: 2.25 (in.) above, also submit one copy of this1,focm within 30 days of completion of well
abandonment to the following:
i
NA Division of Water Resources,Underground Injection Control Program,
6d.Water level below ground surface: (ft.)
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): NA (ft.) 10c.For Water Supply&Infection 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): NA (ft.) abandoned.
6g.Screen length(if known): UNKNOWN (ft.)
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: I
I
1.Well Contractor Information: WELL ABANDONMENT DETAIL'S
William J. Miller 7a.For Geoprobe/DPT or Closed-LI op Geothermal Wells having the same
Well Contractor Name(or well owner personally abandoning well on his/her property) well construction/depth,only I GW-30 i i needed. Indicate TOTAL NUMBER of
2927A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water re miaining in well(s): (gal.)
CATLIN Engineers and Scientists FOR WATER SUPPLY WELLS ONLY:
Company Name
7c.Type of disinfectant used: II
2.Well Construction Permit#:
List all applicable well construction pertness(i.e.UIC,County,State,Variance,etc.)if known
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 0 Neat Cement Grout IRR Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
❑Industrial/Commercial ❑Residential Water Supply(shared) 0 Concrete Grout ❑Drill Cuttings
❑Irrigation 0 Specialty Grout 0 Gravel
Non-Water Supply Well: 0 Bentonite Slurry ❑Other(explain under 7g)
(Monitoring ❑Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
DAquifer Recharge ❑GroundwaterRemediation Bentonite 0.2 cubic feet
❑Aquifer Storage and Recovery .❑Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage '
❑Experimental Technology ❑Subsidence Control
7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer I
❑Geothermal(Heating/Cooling Retum) ❑Other(explain under 7g) Well was pulled and filledwith bentonite up to 1 foot
and hydrated I.
09/18/2023
4.Date well(s)abandoned: ,_t ^, -a-
• ,.,,mot:a,_is e5 -,a..'5„i,
5a.Well location:
Camp Lejeune NA [ed 0 5 2024
Facility/Owner Name Facility ID#(if applicable) 8.Certification: ._
74'ng(jet
Site FC-39, Camp Lejeune, Jacksonville, NC pgh �� 11/9/2023
Physical Address,City,and Zip Signature of Certified Well Contractor or Wellr Owner Date
NA Unknown
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
and that a copy of this record has been provided to the well owner.
56.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one Iat/long is sufficient) 9.Site diagram or additional well details:
34.658114° N -77.315421° 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(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# UST-FC39-MW12 abandonment to the following:
Division of Water Resources,Information Processing Unit,
11.23 1617 Mail Service Center,Raleigh,NC 27699-1617
6b.Total well depth: (ft.)
10b.For Injection Wells: In addition to sending the form to the address in l0a
above, also submit one copy of this form within 30 days of completion of well
6c.Borehole diameter: 2.25 (in)
abandonment to the following: r '
6d.Water level below ground surface NA (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): NA (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): NA (ft.) abandoned.
6g.Screen length(if known): UNKNOWN (ft) .
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources 1 Revised 2-22-2016
I I

WELL ABANDONMENT RECORD For Internal Use ONLY: •
;
1.Well Contractor Information: WELL ABANDONMENT DETAIIJS
William J. Miller 7a.For Geoprobe/DPT or Closed-LI op 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
2927A wells abandoned:
I I
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gal.)
I
CATLIN Engineers and Scientists 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/Pub lic ❑Neat Cement Grout IN Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑Sand Cement Grout ❑ Dry Clay
❑Industrial/Commercial ❑Residential Water Supply(shared) ❑Concrete Grout 0 Drill Cuttings
0 Irrigation ❑ Specialty Grout ❑Gravel
Non-Water Supply Well: ❑ Bentonite Slurry ❑Other(explain under 7g)
IMonitoring ❑Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑GroundwaterRemediation Bentonite 0.2 cubic feet
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology ❑Subsidence Control
7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer
0 Geothermal(Heating/Cooling Return) ❑Other(explain under 7g) Well was pulled and filled'with bentonite up to 1 foot
and hydrated
4.Date well(s)abandoned: 09/18/2023
5a.Well location: (qa L$ a>f Rfi
Camp Lejeune NA
Facility/Owner Name Facility 1Db(if applicable) 8.Certification: FtD 5 2024
Site FC-39, Camp Lejeune, Jacksonville, NC i'
inforxO n 'I'1`/9/2023
Physical Address,City,and Zip Signature of Certified Well Contractor or Well OPner Date
NA Unknown By signing this form, I hereby cent,that the well(s) was (were) abandoned in
County Parcel Identification No.(PIN) accordance with/5A 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:
34.658114° N -77.315421° 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 records)if available. For multiple injection or non-water supply wells
ONLY with the same cons trnction,abandontnenb you can submit one form. 10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: UST-FC39-MW13 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 11.41 (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617
10b.For Injection Wells: In addition to sending the form to the address in l0a
above, also submit one copy of this form within 30 days of completion of well
6c.Borehole diameter: 2.25 (in)
abandonment to the following:
NA Division of Water Resources,Underground Injection Control Program,
6d.Water level below ground surface: (ft.)
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): NA (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): NA (ft.) abandoned.
6g.Screen length(if known): UNKNOWN (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources i Revised 2-22-2016

1
WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
William J. Miller 7a.For Geoprobe/DPT or Closed-LI op Geothermal Wells having the same
Well Contractor Name(or well owner personally abandoning well on his/her property) well construction/depth,only 1 GW-3 0 is needed. Indicate TOTAL NUMBER of
2927A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gal.)
CATLIN Engineers and Scientists 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
7d.Amount of disinfectant used:
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check al'that apply):
❑Agricultural ❑Municipal/Public 0 Neat Cement Grout "Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
❑Industrial/Commercial ❑Residential Water Supply(shared) El Concrete Grout ❑Drill Cuttings
0 Irrigation ❑Specialty Grout 0 Gravel
Non-Water Supply Well: ❑ 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 Bentonite 0.1 cubic feet
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage
DExperimental Technology ❑Subsidence Control
7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) OTracer Well was pulled and filled with bentonite up to 1 foot
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g)
and hydrated
09/18/2023
4.Date well(s)abandoned:
YW 5a.Well location:
Camp Lejeune NA f-tp d 5 2G24
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
yi
Site FC-39, Camp Lejeune, Jacksonville, NC '�`� s"" �:,.�- Mtn/
In+' � D C; 11/9/2023
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
NA Unknown
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 Consbuction 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 dl tails:
34.658114° N -77.315421° 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(s)ifavailable. For multiple injection or non-water supply wells
ONLY with the saute construction abandonment,you can submit one form.
10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: UST-FC39-MW14 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 6.40 (ft) 1617 Mail Service Center,Raleigh,NC 27699-1617
10b.For Infection Wells: In addition to sending the form to the address in 10a
6c.Borehole diameter 2.25 (in) above, also submit one copy of thisl'form within 30 days of completion of well
abandonment to the following:
6d.Water level below ground surface: NA (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): NA (ft.) 10c.For Water Supply&Iniection'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): NA (ft.) abandoned.
6g.Screen length(if known): UNKNOWN (ft.)
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
William J. Miller 7a.For Geoprobe/DPT or Closed-LI op 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 i5 needed. Indicate TOTAL NUMBER of
2927A wells abandoned: I 1
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gal.)
CATLIN Engineers and Scientists FOR WATER SUPPLY WELLS ONLY:
Company Name 1
7c.Type of disinfectant used:
2.Well Construction Permit#:
List all applicable well construction permits(i.e.UK',County,State,Variance,etc.)if known
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 a Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
❑Industrial/Commercial ❑Residential Water Supply(shared) 0 Concrete Grout I ' 0 Drill Cuttings
❑Irrigation 0 Specialty Grout 0 Gravel
Non-Water Supply Well: ❑ Bentonite Slurry 0 Other(explain under 7g)
UMonitoring ❑Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation Bentonite 0.2 cubic feet
❑Aquifer Storage and Recovery 0 Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology ❑Subsidence Control
7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) OTracer
❑Geothermal(Heating/Cooling Retum) ❑Other(explain under 7g) Well was pulled and filled with bentonite up to 1 foot
09/18/2023 and Hydrated F...L, w<, i,`v
4.Date well(s)abandoned:
5a.Well location: I-CD 0 J 2024
Camp Lejeune NA t „jiy� ,r; ��,�url?n
8.Certification: '7'1"' ..,•.-;xe.,
Facility/Owner Name Facility ID#(if applicable) �,�a ts�N 7i
Site FC-39, Camp Lejeune, Jacksonville, NC 11/9/2023
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
NA Unknown By signing this form, I hereby certify(hat 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:
(dwell field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.658114° N -77.315421° 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(s)ifavailable. For multiple injection or non-crater 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 liD#: UST-FC39-MW15 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 11.20 (ft) 1617 Mail Service Center,Raleigh,NC 27699-1617
r
10b.For Injection Wells: In additions to sending the form to the address in 10a
6c.Borehole diameter: 2.25 (in.) above, also submit one copy of this form within 30 days of completion of well
abandonment to the following:
I
6d.Water level below ground surface: NA (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Cel ter,Raleigh,NC 27699-1636
NA 10c.For Water Supply&Injection Wells: In addition to sending the form to the
6e.Outer casing length(if known): (ft.)
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): NA (ft.) abandoned.
UNKNOWN
6g.Screen length(if known): (ft.)
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 DETAII)S
William J. Miller 7a.For Geoprobe/DPT or Closed-LI op Geothermal Wells having the same
Well Contractor Name(or well owner personally abandoning well on his/her property) well construction/depth,only 1 GW-3 0 is needed. Indicate TOTAL NUMBER of
2927A wells abandoned: I I
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gal.)
CATLIN Engineers and Scientists FOR WATER SUPPLY WELLS ONLY:
Company Name
7c.Type of disinfectant used:
2.Well Construction Permit#:
List all applicable well construction permits(i.e.U/C,County,State, Variance,etc.)if known
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 0 Neat Cement Grout II Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
❑Industrial/Commercial ❑Residential Water Supply(shared) ❑Concrete Grout 0 Drill Cuttings
❑Irrigation ❑ Specialty Grout ❑Gravel
Non-Water Supply Well: ❑ Bentonite Slurry ❑Other(explain under 7g)
CMonitoring ❑Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
DAquifer Recharge ❑GroundwaterRemediation Bentonite 0.2 cubic feet
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology ❑Subsidence Control
7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g) Well was pulled and filled with bentonite up to 1 foot
and hydrated
4.Date well(s)abandoned:
09/18/2023
5a.Well location:
Camp Lejeune NA FE t) 014
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
Site FC-39, Camp Lejeune, Jacksonville, NC ""'j'�''G �` `1 1'/9/2023
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
NA Unknown By signing this form, I hereby certiy 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:
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.658114° N -77.315421° 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(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#: UST-FC39-MW16 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth 11.32 (ft) 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 2.25 (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 NA (ft,) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Ceintl r,Raleigh,NC 27699-1636
NA 10c.For Water Supply&Iniection Wells: In addition to sending the form to the
6e.Outer casing length(if known): (ft.)
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): NA (ft.) abandoned.
6g.Screen length(if known): UNKNOWN (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

, 2
WELL ABANDONMENT RECORD For Internal Use ONLY: '
1.Well Contractor Information: WELL ABANDONMENT DETAIIIS
William J. Miller 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
wells abandoned:
2927A
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gal.)
CATLIN Engineers and Scientists 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
7d.Amount of disinfectant used: I'
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public ❑Neat Cement Grout I Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout ❑Dry Clay
❑Industrial/Commercial ❑Residential Water Supply(shared) ❑ Concrete Grout El Drill Cuttings
❑Irrigation ❑Specialty Grout ❑ Gravel
Non-Water Supply Well: ❑ Bentonite Slurry ❑ Other(explain under 7g)
•Monitoring ❑Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation Bentonite 0.75 cubic feet
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology ❑Subsidence Control i
7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer '
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g) Well was pulled and filled with bentonite up to 1 foot
and hydrated
4.Date well(s)abandoned: 09/18/2023
5a.Well location: _ .�' ""$ )' �-- .y
Camp Lejeune NA I Co J 5 am
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
Camp Lejeune, Jacksonville, ]ni' ~Dud •,os 1`1/9/2023
Site FC-39, NC
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
NA Unknown By signing this form, I hereby certii that the well(s) was (were) abandoned in
County Parcel Identification No.(PIN) accordance with I SA NCAC 02C.0100 for 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: j
(if well field,one lat/long is sufficient) I
9.Site diagram or additional well details:
34.658114° N -77.315421° 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(s)ifavailable. 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# UST-FC39-MW17 abandonment to the following:
Division of Water Resources,Information Processing Unit,
1617 Mail Service Center,Raleigh,NC 27699-1617
6b.Total well depth: 34.20 (ft.)
1
10b.For Iniection Wells: In addition to sending the form to the address in 10a
6c.Borehole diameter: 8.25 (in) above, also submit one copy of thisifoi within 30 days of completion of well
abandonment to the following:
NA Division of Water Resources,Underground Injection Control Program,
6d.Water level below ground surface: (ft.)
1636 Mail Service Center,Raleigh,NC 27699-1636
I
6e.Outer casing length(if known): NA (ft.) 10c.For Water Supply&IniectioniIWells: 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): NA (ft.) abandoned.
6g.Screen length(if known): UNKNOWN (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources I Revised 2-22-2016