Wake_Well Abandonment_20240318 (2)

WELL ABANDONMENT RECORD For lnlerratlVwONLY
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L Well('ontraemr Information: WELL ABANDONMENT DF.TAIIS
Scott Hunt, Jr 7a.Number of w r1h being;abandoned: 1
WWI C't7rtracta+f nanrC trot r,W an,fut'A . . efls O,VLF' +.dill lkc'
snap.,n,y, .,, .. .. ., .,.. ,�� vk•,i,rtw
4561-A
NC!1'c11 Cnmttct,tt CcnifiCatinn NPlrhci 7b._-1 ppr o%i mete i olu tur of"Ater remaining in weB1s►:
SABDACCO FOR\A-\TER SUPPLY W NHS ONI.Y:
Caatpatn Naimc ?.. 1}Inc of d►.in(rctant used:
L W'dl Cnmtntctiun Pcrnlit N:.
hs,ail :is fkr,.ttl.n.e.{'enroll.SM*.r ar)OWe brrrabam eh,r it AeoVH
7d• \rnount jot di.infcclant used:
3.'Alit avr(Chcdk tell use):
V1'atrr Gry►ph \\el I: 7e.Sealing materials used(ctreck:ill that al►ph):
DAgtrultuntl DMus crpal Ubir: M NIC31 Ceatcrrt Grout f I Rcnlonirc Chip,,or Pellets
OCinxhermal(Flaiting,Coolnl Sl p %) ❑Rcci3rfrli:rl\A'atet Supph eu.nVic) ❑ Sand C'ernem Gout ❑ Dr%Clay
❑ltdnslnal.,Conin=W DR,-.Wet nal W-.ucr tiupph isharod) ❑Concrete Grout CI Drill Cultings
Dim ativll ❑ Speaalh Groot ❑ Chisel
NOD-\A Ater Sultilh Well: tj Ekracmnc Slurn I-!(Viet(ej pholl ulxk-I 7p
�t.Toiaurtin:: DRc'cuicr
lnjectina WdI' 7f.For each marrriA Wlcctrd ahftl.e. of mairriak went:
DAiµufcrRcdufrge ❑Cinxindlu.szReradiatxm Neat Cem.:94lbslb ,Wtr:5, al. Sand Cem.:lb ,Wtr:gal.
❑ nutter*44raee and kccen en ❑Salnut-, Hamer --
eentonite-:5%lb ,Wtr:gal. type 2 portland Amount:2.5 ga
❑A yuilcr lest DSlormwatcrDrurmee
DExpenntrtftalleclrtwlogy DSubstckuceC'orrnri
7y Prm lilt:at brief tkxriptinn of the abandonment prveedtare:
iiCecodiernial iClosed ixiop) 1_1Tracer
Tremie grout well from bottoa to tops no 1re11 tag with into
rlGtcttWmw1(1-l"mnq-Coolin Rehrrn) !ldtilcrlcx hvill klackir?g I
on well was found
4.Dattnr111:'e ah;u►doncd: 2-28-29
Sm Well tuiatiterr.
r 1._
North White Street Landfill
r•,u tlih(l,. . Ir,,:,,t� x�, , 1).CertifiraNt►a:
unlit
1226 N. White St, Wake Forest, NC 27587 r *'` i' 3/3/2024
Ph.sisal .Jc r--. r',».artd Zip n_}..r•trc a!'A runkm WWI Capri m•titr t.t W0101%Rr Uafc
Wake Jiv vgnow thii/iwm, 1 herehi,reMA-)hw dw wellf-et wax oaerei uhamkitied ur
laaan t'-acd1,1-ar,fkaaallo 1131N1 ter(-f,.,tr>.x<•Of Ilk 1isI W.-I('Q:v- w(N).,.r2r- tl,W ifa11(w.slrucholo Cfratt MyA
and drat o ail nI ibis rrrfw•cllras been prrn,tlefl la Me m-rll ottrri•r.
V►.lartirade and loaptwde in dctrve%.minlrtee•.cemnds or deeimal funs:
d lsd;frkl .^ix ter l:ri•t.•nt'r.k,x: 9•Site Matrain or Additional vt0l details:
You smo tome dic bwk of this page tcl prcx idr addilivird Bell site&nmis or we'll
S K' abaraiunutern dewi6. You niai also auavii additional pclgrs tf tt< essan
('(INSTRUCTION DETAILS OF WE11-Id5)BEING ABANDONED S17BMITTA1.iNSTRUCTIONS
lftacif AeA,urs.,lrw.tt-,r,r.,,v:(.:tt n. A&Nk ,-.w-*Ili(!*nt,t:L•.,,.a W.fr-M'Utl7 aj�}•ft
,lx-eh OALV-emit rlar e~w -vvgrrucgrec car,,v&k-mrrni.t w cart.t•As1M,vrt••a err Ina. For All Welb: Submit this form wtlhin.10 days of compklwn of well
63.Well IDO-NW-3B :rhartdenntent In the falimrinc
Di,Won of Water Rem mm-m.information Precrs+unr I.nit,
1617 Mali Semite('eater.Raleigh.R('2709-1617
(tip. fatal well depth, 19 IfLI
111h. For Iniedion Willa: In addition to setdntg the funu to Itic address in Ma
choir. at-A) oltc� of tins funu%whin Ott days of completion of sell
i.c.Thetrl►l)le diautctcr:2 in.) .ibaafonnrrru to IN Iolluumg
Dl%W4 n of AA'ater Re..wercn,CndetRnmad Injectiun Control Program.
f.d.\\aR r tri'cl he{na �ruund atrial e: 3 (h•) 1636 Alai Senice Cetmcr,Raleigh,N(•I7699-1636
unknown Igoe, For)�tr Sal}ph & ialeetlon R'ells: To addition to statdfng IN-form to
hr.Outer ca.in li m�ah!iC Imuu n r: oft-) Ifte addressiti) aboi e. also submit Mu Cop/ of this femi a ithin i11 cklys of
:ornpiction of well abandoninew to the:otum• hcahh depanmcia 4 Ilic toum
i,t. Inner iasini,,;tubint icnLKh(if hnnicn'i unknown where ahandnncd: Ih.)
Stmenten-.:fli ,I'knutln);unknown
Fona GW-+tr Nonh('arohrn L)eMiwlcrx of Ems trontimia aril Natufat Remmmes Uts own of WM.-r Rcsoarsys Re%med\tryust Hot i