Craven_Well Abandonment_20240306

WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
Thomas J. Benthall, Jr. 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
4508-B wells abandoned:rrn
NC Well Contractor Certification Number
7b.Approximate volume of water remaining in well(s): 1.248 (gaL)
Labrador Environmental Consultants, P.C. FOR WATER SUPPLY WELLS ONLY:
Company Name NA _
W M 0701307 7c.Type of disinfectant used:
2.Well Construction Permit#: L i j
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc)(known NA
7d.Amount of disinfectant used:
MAN
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply): Intori a�ic
❑Agricultural ❑Municipalftblic ❑Neat Cement Grout a Bentonite Chips®Nh .a
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑ Sand Cement Grout ❑ Dry Clay
❑Industrial/Commercial ❑Residential Water Supply(shared) s Concrete Grout ❑Drill Cuttings
[]Irrigation ❑ Specialty Grout ❑Gravel
Non-Water Supply Well: ❑ Bentonite Slurry ❑Other(explain under 7g)
FlMonitoring ❑Recovery
Injection Well: 7E For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑GroundwaterRemediation approx. 9.3lbs (0.14 cu. ft.) Bentonite Chips
❑Aquifer Storage and Recovery ❑Salinity Barrier -"
❑Aquifer Test ❑StormwaterDrainage approx. 12.5 lbs. Concrete Grout
❑Experimental Technology ❑Subsidence Control
7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer
Removed casing and screen;checked for obstructions in borehole
❑Geothermal (Heating/Cooling Return ❑Other(explain under 7 )
(collapsed to approx.3.25 ft.BGS);placed bentonite in borehole at a
4.Date well(s)abandoned: 2/28/2024 rate of of about 2 Ibs/min from approx.3.25 to 0.75 ft.BGS;hydrated
5a.Well location: with potable water;completed with concrete grout to ground surface
lhaken Holdings Jet Incident MCAS Cherry Pt. N/A
Facility/Owner Name Facility ID#(if applicable) 8.Certificadon:
100 Roosevelt Boulevard, Havelock, NC 2/28/2024
Physical Address,City,and Zip SignattxKCe5rod4refl Contractor or Well Owner Date
Craven 6-060-065
By signing this form, I hereby certify that the wells) 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 in degrees/minutes/seconds or decimal degrees: and that a copy of this record has been provided to the well owner.
(ifwell field,one tat/long is sufficient) 9.Site diagram or additional well details:
34.882349 N -76.906472 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#: MW-1 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 13.00 (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: 3.25 (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: 5.20 TOC (ft) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): 3.00 (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
61 Inner casing/tubing length(if known): NA (ft.) abandoned.
6g.Screen length(if known): 10.00 00
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

Figure 3
Monitor Well Location
Draken Holdings Jet Incident
Marine Corp Air Station Cherry Point
Havelock, North Carolina
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Monitor Well Location
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