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Home My WebLink AboutBrunswick_Well Abandonment_20240311 WELL AI5AN DUN 1VJLN 1 KLLUKU For Internal Use ONLY: 1.Well Contractor Information: WELL ABANDONMENT DETAILS Scott M. Werley 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 3344-A wells abandoned:One i NC Well Contractor Certification Number 7b.Approximate volume of wateir remaining in well(s): 1.32 (gal.) ECS Southeast, LLC FOR WATER SUPPLY WELLS ONLY: Company Name 7c.Type of disinfectant used: 2.Well Construction Permit#: WM0801216 List all applicable well construction permits(i.e.WC.County,State, Variance,etc.)if known 7d.Amount of disinfectant used: I 1 3.Well use(check well use): Water Supply Well: 7e.Sealing materials used(checli all that apply): 0 Agricultural ❑Municipal/Public I Neat Cement Grout a Bentonite Chips or Pellets OGeothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay ❑Industrial/Commercial ❑Residential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings Oh-ligation 0 Specialty Grout I 0 Gravel Non-Water Supply Well: 0 Bentonite Slurry 0 Other(explain under 7g) ` IMonitoring . ❑Recovery . Injection Well: 7f.For each material selected above,provide amount of materials used: ❑Aquifer Recharge ❑Groundwater Remediation Bentonite 20 lbs. ❑Aquifer Storage and Recovery ❑Salinity Barrier ❑Aquifer Test ❑StormwaterDrainage Neat Cement -30 ibSr ❑Experimental Technology ❑Subsidence Control . � 7g.Provide a brief description of the abandonment procedure: ❑Geothermal(Closed Loop) OTracer I '. ❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g) Gravity feed bentonitei chips from 15' to 5' bgs Pour neat cement from!5' bgs to ground surface 02/20/2024 I' _ d 4.Date well(s)abandoned: I c pa.4 r �-- -�,�r i Ez o I.,) 5a.Well location: MMI( 1 i 2074 Lanvale Developers LLC NA Facility/Owner Name Facility ID#(if applicable) 8.Certification: : tntc.,;;ra;;r n ?t^.^ ..r;; I•��.i Lanvale Road and Highway 17 Leland, NC r 1, _/y/zeoy Physical Address,City,and Zip Signal re of Certified a out ctor on Well Owner Date Brunswick 0470001205 By signing this form, I hereby certiji that the well(s) was (were) abandoned in County Parcel Identification No.(PIN) accordance with 15A NCAC 02C i 0100 or 2C.0200 Well Construction Standards and that a copy of this record has beers provided to the well owner. 5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees: I i (if well field,one lat/long is sufficient) 9.Site diagram or additional well'details: 34.20175749 N -78.05321138 W You may use the back of this pagelto 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)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 MWO 1 6a.Well ID#: abandonment to the following: Division of Water Resources,Information Processing Unit, 6b.Total well depth: 15 (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: 6 (in.) above, also submit one copy of this form within 30 days of completion of well abandonment to the following: 6.94 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&Iniectlon 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): 5 (ft.) abandoned. 6g.Screen length(if known): 10 (ft.) Eomt GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016 WELL LL AlSA1V 1)U1N 1V1L+1V 1 MAMMY V 1tI) For Internal Use ONLY: 1 1.Well Contractor Information: WELL ABANDONMENT DETAILS Scott M. We rl ey 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 0 is needed. Indicate TOTAL NUMBER of 3344-A wells abandoned:one I .I NC Well Contractor Certification Number 76.Approximate volume of wat Ir'remaining in well(s): 1.25 (gal.) It ECS Southeast, LLC FOR WATER SUPPLY WELLS ONLY: Company Name 7c.Type of disinfectant used: 2.Well Construction Permit#: WM0801216 List all applicable well construction permits(i.e.U!G 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): 0 Agricultural ❑Municipal/Public • Neat Cement Grout 1 , • Bentonite Chips or Pellets OGeothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout ❑ Dry Clay ❑Industrial/Commercial ❑Residential Water Supply(shared) ❑ Concrete Grout 0 Drill Cuttings ❑Irrigation 0 Specialty Grout 0 Gravel Non-Water Supply Well: ❑ Bentonite Slurry 0 Othei•(explain under 7g) - •Monitoring ❑Recovery Injection Well: 7f.For each material selected above,provide amount of materials used: ❑Aquifer Recharge ❑Groundwater Remediation Bentonite — 20 lbs. ❑Aquifer Storage and Recovery ❑Salinity Barrier ❑Aquifer Test ❑Stormwater Drainage Neat Cement —30 lbs. ❑Experimental Technology ❑Subsidence Control 7g.Provide a brief description of the abandonment procedure: OGeothermal(Closed Loop) ❑Tracer I I: OGeothermal(Heating/Cooling Return) ❑Other(explain under 7g) Gravity feed bentonite chips from 15' to 5' bgs Pour neat cement from 5' bgs to ground surface 4.Date well(s)abandoned: 02/20/2024 i> F^ 5a.Well location: a e r,—C L.—t \� / Lanvale Developers LLC NA ' ' MAK 1 1 2024 Facility/Owner Name Facility ID#(if applicable) 8.Certification: 1 lft��i fY'I.x': ii ?;"'r /e:,�mY:y liR�: Lanvale Road and Highway 17 Leland, NC �� ; el DVQ; , �y�zozv Physical Address,City,and Zip Signature of Certified II C tractor;or Well Owner D t'e Brunswick 0470001205 By signing this form, I hereby cin-eij,that the well(s) was (were) abandoned in County Parcel Identification No.(PIN) accordance with 15A NCAC 02C10.100 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 :I (if well field,one lat/long is sufficient) 9.Site diagram or additional well details: 34.2014541 N -78.05296027 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.Formultiple 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 MWO2 6a.Well ID#: abandonment to the following: Division of Water Resources,Information Processing Unit, 6b.Total well depth: 15 (ft) 1617 Mail Service Center,Raleigh,NC 27699-1617 10b.For Infection Wells: In addition to sending the form to the address in l0a 6c.Borehole diameter: 6 (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: 7.34 (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.) 1Oc.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): 5 (ft.) abandoned. . 6g.Screen length(if known): 10 (ft.) Ear GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016 WILL AI5AINI)UINIVIEIN'l' KI±CUKI For Internal Use ONLY: 1.Well Contractor Information: WELL ABANDONMENT DETAILS Scott M. Werley 7a.For Geoprobe/DPT or Close_d[ oop Geothermal Wells having the same Well Contractor Name(or well owner personally abandoning well on his/her property) well construction/depth,only 1 G W`L-310 is needed. Indicate TOTAL NUMBER of 3344-A wells abandoned:one NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): 1'98 (gal.) ECS Southeast, LLC FOR WATER SUPPLY WELLS ONLY: Company Name 2.Well Construction Permit#: WM0801216 7c.Type of disinfectant used: 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 • Neat Cement Grout I IN Bentonite Chips or Pellets 1 OGeothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) El Sand Cement Grout El Dry Clay ❑IndustriallCommercial ❑Residential Water Supply(shared) ❑ Concrete Grout ❑ Drill Cuttings ❑Irrigation 0 Specialty Grout ❑ 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: ❑Aquifer Recharge ❑Groundwater Remediation Bentonite - 25 lbs. • DAquifer Storage and Recovery ❑Salinity Barrier ❑Aquifer Test ❑StormwaterDrainage Neat Cement -30 lbs: ❑Experimental Technology ❑Subsidence Control I 7g.Provide a brief description of the abandonment procedure: OGeothermal(Closed Loop) ❑Tracer OGeothermal(Heating/Cooling Return) ❑Other(explain under 7g) Gravity feed bentoniter,chips from 20' to 5' bgs • Pour neat cement from'5' bgs to ground surface 02/20/2024 4.Date well(s)abandoned: ; I 5a.Well location: 'R.L.,Lrd...i T �L Lanvale Developers LLC NA MAK 1 1 ZOZ4 Facility/Owner Name Facility ID#(if applicable) 8.Certification: ' Lanvale Road and Highway 17 Leland, NCinc.:�rr24i ti Pr : 1 j , Dtf9C.t BOG 3 202 4/Physical Address,City,and Zip SignT-4,1444 f Certified Well Contractor or Well Owner Date Brunswick 0470001205 By signing this form, I hereby certlly 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 Irdn provided to the well owner. 5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees: (if well field,one latllong is sufficient) 9.Site diagram or additional well details: ' 34.20124924 N -78.05317393 �r 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.WellID#: MWO3 abandonment to the following: ' I Division'of Water Resources,Information Processing Unit, 6b.Total well depth: 20 (ft.) 1617 Mail Service enter,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 tli is:form within 30 days of completion of well abandonment to the following: 6d.Water level below ground surface: 7.89 (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&IniectiLnl 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): 5 (ft.) abandoned. 6g.Screen length(if known): 15 (ft.) ' Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resourcels . Revised 2-22-2016