Robeson_Well Abandonment_20240325

i 1
WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS 1
•
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: 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: 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 0 Dry Clay
❑Industrial/Commercial 0 Residential Water Supply(shared) ❑ Concrete Grout 0 Drill Cuttings,
❑Irrigation 0 Specialty Grout ❑ Gravel
Non-Water Supply Well: ❑Bentonite Slurry 0 Other(explain under 7g)
IMonitoring ❑Recovery .
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑GroundwaterRemediation 1.5 lbs of Bentonite
i
❑Aquifer Storage and Recovery 0 Salinity Barrier- 1
❑Aquifer Test ❑StormwaterDrainage Concrete
•❑Experimental Technology ❑Subsidence Control
7g.Provide a brief description of the'abandonment procedure:
OGeothermal(Closed Loop) OTracer Well was filled with bentbnite chips to within 1 foot
❑Geothermal(Heating/Cooling Retum) ❑Other(explain under 7g)
of the surface, then well was capped with concrete
4.Datewell(s)abandoned: 09/06/2023 and leveled flush with the.•ground. •
5a.Well location: •
Duke Energy Progress NA
Facility/Owner Name Facility ID#(if applicable) 8.Certification: 1. �1, i `.
MAR 2 ; .,6
491 Power Plant Rd. Lumberton, NC 28358 �j .. 3/19/2024
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Robeson Unknown Irrfie...pa.,isn F3r .1,.:,,,,
By signing this form, I hereby ce,tl ;thya t ipellTs}�ti' s (were) abandoned in
County Parcel Identification No.(PIN) accordance with 1 SA NCAC 02C.010i1 eq 2 '. 200 Well Construction Standards
and that a copy of this record has beenprovided 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:
34.587247 N -78.972473 • 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'abandonnrent,you can submit one form.
10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: MW-2 abandonment to the following:
i
•
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 12.4 (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 (in.)•
above, also submit one copy of this form within 30 days of completion of well
abandonment to the following: h '
6d.Water level below ground surface: 2.52 (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): 3.6-13.6 (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 I
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-3 0 is 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 I '
7c.Type of disinfectant used:
2.Well Construction Permit#: i
List all applicable well construction permits(i.e.UKC,County,State,Variance,etc.)if known j
• 7d.Amount of disinfectant used:
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials.used(check all that apply):
ID Agricultural 0 Municipal/Public ❑Neat Cement Grout ) e Bentonite Chips or Pellets • t
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑ Sand Cement Grout ❑ Dry Clay
❑Industrial/Commercial ❑Residential Water Supply(shared) ❑ Concrete Grout 0 Drill Cuttings
❑Irrigation ❑ Specialty Grout I 0 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 1.5 lbs of Bentohite i
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑StormwaterDrainage Concrete ,'
•
❑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 filled with bentonite chips to within 1 foot
of the surface, then well;was capped with concrete
4.Datewell(s)abandoned: 09/06/2023 and leveled flush with the ground.
5a.Well location: r,, I
Duke EnergyProgress NA , ,
Facility/Owner Name Facility IDI#(if applicable) 8.Certification: f`" 4 !w
i
491 Power Plant Rd. Lumberton, NC 28358 MAR,'2 2ou 3/19/2024
Physical Address,City,and Zip Signature of Certified Well tfSH3y�,tpragyC ll;9�yyne� Date
Robeson Unknown • G a,;� 9,,�,, y,fir, •
By signing this form, I hereby certrt/yrt7fu't-�t) ells) teas (were) abandoned in
County Parcel Identification No.(PIN) accordance with 1 SA 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 degree's: i. ,
(if well field,one lat/long is sufficient)
9.Site diagram or additional well details:
34.587247 N -78.972473 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 1.
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#: P-04 abandonment to the following:
Division of Water Resources,Information Processing Unit,
1617 Mail Service Center,Raleigh,NC 27699-1617
6b.Total well depth: 4.4 (ft.)
10b.For Injection Wells: In addition to sending the form to the address in l0a
6c.Borehole diameter: 2 (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 4.13 (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
i
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): 1•9-4.4 (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:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
•
William J. Miller I
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 l in well(s): (gal.)
•
CATLIN Engineers and Scientists FOR WATER SUPPLY WELLS ONLY:
P y
Corn an Name 7c.Type of disinfectant used:
2.Well Construction Permit#:
List all applicable well construction permits(i.e.UIC,County,State, Variance,etc.)(fknown
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 e Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑ Sand Cement Grout El 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)
IMonitoring ❑Recovery
Injection Well: . 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation 10 lbs of Bentonite Pellets
❑Aquifer Storage and Recovery ❑Salinity Barrier •
. ❑Aquifer Test• - ❑Stormwater Drainage
❑Experimental Technology ❑Subsidence Control
7g.Provide a brief description of the abandonment procedure:
❑Geothetma](Closed Loop) ❑Tracer All well material removed, hole backfilled to 1.5 ft '
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g)
. BLS then filled to land surface with concrete
4.Date well(s)abandoned: 09/06/2023
5a.Well location:
Duke Energy Progress NA • � .
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
491 Power Plant Rd. Lumberton, NC 28358 3/19/2024
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
r
Robeson Unknown
By signing this form, !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 been1provided 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:
34.587247 N -78.972473 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 I .
Attach we!!construction record(s)ifavailable.For multiple injection or non-water supply wells !"
ONLY with the same construction abandonment,you can sr utit gtte�form.
y E, A^y w- ,. _ 10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID# P-26 �t"_ _y i 'a 9:L{ )abandonment to the following:
MAR2024 a� Division of Water Resources,Information Processing Unit,
6b.Total well depth: 6.1 (ft) e 1617 Mail Service Center;Raleigh,NC 27699-1617
r-.--„ ..
mt •
t'`r' ""`'i1 tLl ,..,.:,^:4y,;• ^Ui z 10b.For Inflection Wells: In addition to sending the form to the address in 10a
125 Dili r/.^�i`Jt3 above, also submit one copy of this form within 30 days of completion of well
.
6c.Borehole diameter: (in.) I
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&Inflection (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): 3.6-6.1 (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-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: • I i
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.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 ❑Neat Cement Grout a Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑Sand Cement Grout ;• ❑ Dry Clay
❑Industrial/Commercial ❑Residential Water Supply(shared) 0 Concrete Grout ' 0 Drill Cuttings _
❑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 10 lbs of Bentonite Pellets .
❑Aquifer Storage and Recovery OSalinity Barrier 1 '
❑Aquifer Test ❑Stormwater Drainage •
CI Experimental Technology ❑Subsidence Control •
7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer •
All well material removed,'hole backfilled to 1.5 ft
0 Geothermal(Heating/Cooling Return) ❑Other(explain under 7g)
BLS then filled to land surface with concrete
4.Date well(s)abandoned: 09/12/2023
•
5a.Well location:
Duke Energy Progress NA
Facility/Owner Name Facility ID#(if applicable) S.Certification:
•
491 Power Plant Rd. Lumberton, NC 28358 �'
3/19/2024
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Robeson ' Unknown
By signing this form, I hereby.certify'that the well(s) was(were) abandoned in
County Parcel Identification No.(PIN) accordance with I5A NCAC 02C.01,00 or 2C.0200 Well Construction Standards
and that a copy of this record has been provided to the well oivner.
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:
34.587247 N -78.972473 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 constntction record(s)if available.For multiple injection croon-water supply i,'ells I
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#: P-40 kJ:—
7 c. I;\I m[ abandonment to the following:
�.e:—le..I i. In
Division of Water Resources,Information Processing Unit, '
6b.Total well depth 12.9 (ft.) MAR 2 5 2024 1617 Mail Service Center,Raleigh,NC 27699-1617
iNir:r'!cn?r-.r5:,rst,;4_,3 Uni:JOb.For Injection Wells: In addition to sending the form to the address in 10a
6c.Borehole diameter: 2.0 (in.) CMQIISOG 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
NA 1Oc.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.
1
6g.Screen length(if known): 2.9-12.9 (ft.) 11+
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources I 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-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 re I aining in well(s): (gal.)
CATLIN Engineers and Scientists FOR WATER SUPPLY WELLS ONLY:
Company Name
7c.Type of disinfectant used: ' i •
2.Well Construction Permit#:
List all applicable well construction permits('i c:U/C,County,State,Variance,etc.J 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 ! 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 ❑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 ❑Groundwater Remediation 10 lbs of Bentonite Pellets
❑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 All well'material removed, hole backfilled to 1.5 ft
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g)
BLS then filled to land surface with concrete
4.Date well(s)abandoned: 09/06/2023 !',
5a.Well location: '
Duke Energy Progress NA
Facility/Owner Name Facility ID#(if applicable) 8.Certification: xf..------,
491 Power Plant Rd. Lumberton, NC 28358 ' 3/19/2024
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Robeson Unknown
By signing this form, 1 hereby certify;that the well(s) was (were) abandoned in
County Parcel Identification No.(PIN) accordance with I5A NCAC 02C.0100 or 2C.0200 Well Construction Standards
•
and that a copy of this record has been provided to the well owner.
Sb.Latitude and longitude in degrees/minutes/seconds or decimal degrees:. l•
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.587247 N -78.972473 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.
I
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 conslruction'abandonntenl,you can submit one form. 10a. For All Wells: Submit this form within 30 days of completion of well
P-41 ir--' '"' gndonment to the following:
6a.Well ID#: rk. ; i;11 ';a,
ry
Division of Water Resources,Information Processing Unit,
6b.Total well depth 12.6 (ft.) MAR 2 e.` 2024 • 1617 Mail Service Center,Raleigh,NC 27699-1617
• _, �p . For Injection Wells: In additidri to sending the form to the address in 10a
2.0 {Ttivf+ jP'1 ' "_"'7"' move, also submit one copy of this form within 30 days of completion of well
6c.Borehole diameter: (in.) 'Yt^ "
[�:'6UuJ�7 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&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.
•
2.6-12.6 `
6g.Screen length(if known): (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:
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 1 GW-30 is needed. Indicate TOTAL NUMBER of
2927A wells abandoned: i '
NC Well Contractor Certification Number 7b.Approximate volume of water regaining 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):
DAgricultural ❑Municipal/Public ❑Neat Cement Grout I Bentonite Chips or Pellets
•
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑ Sand Cement Grout 0 Dry Clay
❑Industrial/Commercial ❑Residential Water Supply(shared) 0 Concrete Grout ❑ 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 10 lbs of Bentonite Pellets
❑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 All well material removed, hole backfilled to 1.5 ft
❑Geothermal(Heating/Cooling Retum) ❑Other(explain under 7g)
BLS then filled to land surface with concrete
4.Date well(s)abandoned: 09/06/2023 ,
5a.Well location:
Duke Energy Progress NA
Facility/Owner Name Facility ID#(if applicable) 8.Certification: f%
491 Power Plant Rd. Lumberton, NC 28358 �Z' , 3/19/2024
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Robeson 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: '
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.587247 N -78.972473 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 constructian'abandontnent,you can submit one form.
10a. For All Wells: Submit this form within 30 days of completion of well
P-50 z't. ?T . _;.I 'p 'T' abandonment to the following:
6a.Well ID#: �'A.- L.-i k' 4.�
12.5 MAR 2 2024 Division of Water Resources,Information Processing Unit,
1617 Mail Service Center Raleigh,NC 27699-1617
6b.Total well depth: (ft.) . ,
UrrVrmiY.d:1L in Fir:-1 1�ri': I,i t;�'Ob.For Iniection Wells: In addition to sending the form to the address in 10a
6c.Borehole diameter: 2.0 (in.) G1�vs~.f:3' above, also submit one copy of this form within 30 days of completion of well
abandonment to the following: i'
8.1 8 Division of Water Resources,Underground Injection Control Program,
6d.Water level below ground surface: (ft.)
1636 Mail Service Center;Raleigh,NC 27699-1636
NA 1Oc.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): 2.5-12'5 (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources p Revised 2-22-2016

,
WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS '
I
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#s needed. Indicate TOTAL NUMBER of
2927A wells abandoned: I
NC Well Contractor Certification Number 7b.Approximate volume of water remaining aining 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,Slate,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 • Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
0 Industrial/Commercial ,❑Residential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings
❑Irrigation 0 Specialty i Grout 0 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:
DAquifer Recharge ❑GroundwaterRemediation 10 lbs of Bentonite Pellets
DAquifer Storage and Recovery ❑Salinity Barrier
DAquifer Test ❑Stormwater Drainage 1
❑Experimental Technology ❑Subsidence Control j
7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g) All well material removed, hole backfilled to 1.5 ft
BLS then filled to land surface with concrete
4.Date well(s)abandoned: 09/06/2023
5a.Well location:
Duke Energy Progress NA
Facility/Owner Name Facility ID#(if applicable) 8.Certification: ,
491 Power Plant Rd. Lumberton, NC 28358 ' j. 3/19/2024
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Robeson Unknown l' '
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 oi•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:
34.587247 N -78.972473 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 tnult,ple injection or non-waler supply smells
ONLY with the same construction,abandonntent,you can submit one form. I
10a. For All Wells: Submit this form within 30 days of completion of well
P-56 ,It, .� abandonment to the following:
6a.Well[D#: iLy•
,-�,r- 4 s
Division of Water Resources,Information Processing Unit,
6b.Total well depth 12.8 (ft.) MAR 2 �. 2024 1617 Mail Service Center,Raleigh,NC 27699-1617
,• ya.•., lOb.For Infection Wells: In addition to sending the form to the address in 10a
2.0 ITIiG�r"�'l`•'I U} bove, also submit one copy of this form within 30 days of completion of well
6c.Borehole diameter: (in.) DtP,SQ/ c abandonment to the following:
7.38 Division of Water Resources,Underground Injection Control Program,
6d.Water level below ground surface: (ft.) d
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.
2.8-12.8
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 DETAILSI
William J. Miller
7a.For Geoprobe/DPT or Closed-Loge 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?s needed. Indicate TOTAL NUMBER of
2927A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining
aining 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 ❑Neat Cement Grout a 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 0 Other(explain under 7g)
U Monitoring ❑Recovery •
Injection Well: 7f.For each material'selected above,provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation 10 lbs of Bentonite Pellets
❑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) All well material removed, hole backfilled to 1.5 ft
BLS then filled to land surface with concrete
4.Date well(s)abandoned: 09/06/2023 '
- 5a.Well location:
Duke Energy Progress NA
Facility/Owner Name Facility ID#(if applicable) 8.Certification: ��
491 Power Plant Rd. Lumberton, NC 28358 3/19/2024
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Robeson Unknown By signing this form, 1 hereby certify that the well(s) was (were) abandoned in
County Parcel Identification No.(PIN) accordance with 1 SA 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:
34.587247 N -78.972473 . W You may use the back of this page toIprovide additional well site details or well
abandonment details. You may also attach additional page's 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#: P-61 '7' .`-i 1 .j'-04ndonment to the following:
C i ,,-,L.i q,
•
Division of Water Resources,Information Processing Unit,
6b.Total well depth 7•4 (ft.) • MAR 2 �� 2024 1617 Mail Service Center;Raleigh,NC 27699-1617
�- lOb.For Infection Wells: In addition to sending the form to the address in 10a
fi}iufr;kv:lc tt ?i• `^.tip n
6c.Borehole diameter: 2.0 (in.) CSii`VQi•�; a wa aye, also submit one copy of this form within 30 days of completion of well
abandonment to the following:
7.95 Division of Water Resources,Underground Injection Control Program,
6d.Water level below ground surface: (ft.)
1636 Mail Service Center;Raleigh,NC 27699-1636
NA 10c.For Water Supply&Infection Wells: In addition to sending the form to the
6e.Outer casing length(if known): (ft.)
addresses)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): 2.4-7.4 (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 ,
1.Well Contractor Information: WELL ABANDONMENT DETAILS
William J. Miller 7a.For Geoprobe/DPT or Closed-Lo Ip 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.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 ❑MunicipallPublic ❑Neat Cement Grout U 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
❑Irrigation ❑ Specialty Grout ❑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 ❑GroundwaterRemediation 10 lbs of Bentonite Pellets
ElAquifer 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 All well material removed, hole backfilled to 1.5 ft
['Geothermal(Heating/Cooling Return) ❑Other(explain under 7g)
BLS then filled to land surface with concrete
4.Date well(s)abandoned: 09/06/2023
5a.Well location: •
Duke Energy Progress NA '
`Facility/Owner Name Facility ID#(if applicable) 8.Certification:
,,,-/ i
491 Power Plant Rd. Lumberton, NC 28358 3/19/2024
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Robeson Unknown.
By signing this farm, 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:
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.587247 N -78.972473 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)javailable. For multiple injection or non-water supply wells
ONLY with the same construction abandonment,you can submit one form.
. -� 5 ;ram„,,;10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: P-62 E r®��,,i-uy}. '4t4 .,.,[bandonment to the following:
MAR 2 i 2024 Division of Water Resources,,Information Processing Unit,
6b.Total well depth 6.8 •
(ft.) 1617 Mail Service'Center,Raleigh,NC 27699-1617
Irf iNrie::'r.:C•••?i Pr ^: avgfW1 l ly!` 10b.For Infection Wells: In additionIto-sending the form to the address in 10a
2.0 G`vJti` tic: above, also submit one copy of this foim•within 30 days of completion of well
6c.Borehole diameter: (in.)
abandonment to the following:
6d.Water level below ground surface 8'81 (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
i ' •
NA 10c.For Water Supply&Infection Wells: In addition to sending the form to the
6e.Outer casing length(if known): (ft.)
address(es)above,also submit one copylofIthis 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.
•
88-6.
6g.Screen length(if known): 1. (ft.) I
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: h
•
1
1.Well Contractor Information: WELL ABANDONMENT DETAILS ' '
William J. Miller 7a.For Geoprobe/DPT or Closed-Lolp Geothermal Wells having the same
Well Contractor Name(or well owner personally abandoning well on his/her property) well construction/depth,only I GW-301is needed. Indicate TOTAL NUMBER of
2927A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining aining 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 i,
7d.Amount of disinfectant used:
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural I ❑Municipal/Public • ❑ Neat Cement Grout a Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑ Sand Cement Grout I ❑Dry Clay
❑Industrial/Commercial ❑Residential Water Supply(shared) ❑ Concrete Grout ❑ 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:
❑Aquifer Recharge ❑GroundwaterRemediation 10 lbs of Bentonite Pellet's
❑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 All well material removed, hole backfilled to 1.5 ft
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g)
BLS then filled to land surface with concrete
4.Date well(s)abandoned: 09/06/2023 '
5a.Well location: I
Duke Energy Progress NA
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
491 Power Plant Rd. Lumberton, NC 28358 -- 3/19/2024
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Robeson • Unknown .
By signing this form, 1 hereby certify.chat 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:
34.587247 N -78.972473 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 I
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
P-63 4. bandonment to the following:
6a.Well ID#: th i7-'r- it t`
h"`�'"e t: A( Division of Water Resources,Information Processing Unit,
6b.Total well depth: 6.9 (ft.) MAR 2 L024 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: 2'0 (in.)
ff►fA;v;r.kaC;I+3'7';75"N fig UKvbove, also submit one copy of this form within 30 days of completion of well
DWQMOG abandonment to the following: I
8.97 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.) IOc.For Water Supply&injection Wells: in addition to sending the form to the
address(es)above,also submit one copyiof 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. I
•
6g.Screen length(if known): 1'9-6'9 (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-Lo I p iGeothermal 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 heeded. 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 all 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 ❑ 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)
•Monitoring ❑Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation 10 lbs of Bentonite Pellets
❑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 Retum) ❑Other(explain under 7g) All well material removed, hole backfilled to 1.5 ft
BLS then filled to land surface with concrete
4.Date well(s)abandoned: 09/06/2023
5a.Well location:
Duke Energy Progress NA _
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
491 Power Plant Rd. Lumberton, NC 28358 ��%� r; 3/19/2024
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Robeson Unknown
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.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 welt field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.587247 N -78.972473 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 sell 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#: P-65 ,,, abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 6.9 (ft.) MAR 2 e 2024 1617 Mail Service Center,Raleigh,NC 27699-1617
10b. For Injection Wells: In addition 4o sending the form to the address in 10a
2.0 tf4'itirMs.: '2l r3i' C+ t�'':�, unx above, also submit one copy of this fo to within 30 days of completion of well
6c.Borehole diameter: (in.) �,
• CSvvQ1B'JCa 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.) lOc.For Water Supply&Injection Wells: In addition to sending the form to the
address(es)above,also submit one copyiof 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): 1.9-6.9 (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-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-30Iis needed. Indicate TOTAL NUMBER of
2927A wells abandoned: •
NC Well Contractor Certification Number 7b.Approximate volume of water remaining
aining 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 ❑Neat Cement Grout i U Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑Sand Cement Grout 0 Dry Clay
❑industrial/Commercial ❑Residential Water Supply(shared) U Concrete Grout ❑ 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 10 lbs of Bentonite Pellet's
❑Aquifer Storage and Recovery . ❑Salinity Barrier i
❑Aquifer Test ❑Stormwater Drainage '
❑Experimental Technology ❑Subsidence Control
7g.Provide a brief description of the abandonment procedure:
UGeothermal(Closed Loop) ❑Tracer • All well material removed,'hole backfilled to 1.5 ft
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g)
BLS then filled to land surface with concrete
4.Date well(s)abandoned: 09/06/2023 ,
5a.Well location:
•
Duke Energy Progress NA ,
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
491 Power Plant Rd. Lumberton, NC 28358 3/19/2024
Physical Address,City,and Zip , Signature of Certified Well Contractor or Well Owner Date
Robeson 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:
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.587247 N -78.972473 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 saute construction'abandonment,you can submit one form.
10a. For All Wells: Submit this form within 30 days of completion of well
P-66 T' a, abandonment to the following:
6a.Well ID#: abandonment d
L. o(n o
.,p,:) Division of Water Resources,Information Processing Unit,
6b.Total well depth: 7.1 (ft.) MAR 2 `i 2024 1617 Mail Service Center,Raleigh,NC 27699-1617
i ea,:i}. 10b. For Injection Wells: In addition'.to sending the form to the address in 10a
4uti::' i1 am!
2.0 (in.) ,,,,: -'n54 .0t16.gvYe, also submit one copy of this form within 30 days of completion of well
6c.Borehole diameter:
'C:10a °abandonment to the following:
8.43 Division of Water Resources,Underground Injection Control Program,
6d.Water level below ground surface: (ft.)
1636 Mail Service Cente},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 copylof,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): 2'1-7.1 (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:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
I
William J. Miller 7a.For Geoprobe/DPT or Closed-Lol p: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 aining in well(s): (gal.)
CATLIN Engineers and Scientists FOR WATER SUPPLY WELLS ONLY:
Company Name
• 7c.Type of disinfectant used: _ I
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 ❑Neat Cement Grout II 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 El Specialty Grout 1 ❑Gravel
Non-Water Supply Well: ❑ Bentonite Slurry 1 0 Other(explain under 7g)
IAIMonitoring ❑Recovery 1
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑GroundwaterRemediation 10 lbs of Bentonite Pellet's
❑Aquifer Storage and Recovery ❑Salinity Barrier 1
❑Aquifer Test ❑Stormwater Drainage 1
❑Experimental Technology ❑Subsidence Control 1
7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer All well material removed, hole backfilled to 1.5 ft
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g)
BLS then filled to land surface with concrete
4.Date well(s)abandoned: 09/06/2023
5a.Well location: I'
Duke Energy Progress • NA
• Facility/Owner Name Facility ID#(if applicable) _8.Certification:' 1
491 Power Plant Rd. Lumberton, NC 28358 3/19/2024
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Robeson 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:
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
• 34.587247. N -78.972473 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 abOndonment,you can submit one form.
10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: P-76 d�= >";7, ., r,riandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth l V 15.2 (ft.) MAR 2 �f;Z4 1617 Mail Service Center,Raleigh,NC 27699-1617
__ lOb.For Injection Wells: In addition lto sending the form to the address in l0a
2.0 IThD,.4-1.4�c'r�'7'5'r::o U?bove, also submit one copy of this form within 30 days of completion of well
6c.Borehole diameter: (in.) D`:'v�o'3J{a •
abandonment to the following: 1
•
6d.Water level below ground surface: 7.85 (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
i
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 copylof 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.
1.2-15.2
6g.Screen length(if known): (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Watcr Resources Revised 2-22-2016

i •
•
WELL ABANDONMENT RECORD For Internal Use ONLY: I •
j ,
1.Well Contractor Information: WELL ABANDONMENT DETAILS
William J. Miller 7a.For Geoprobe/DPT or Closed-Lol p'Geothermal Wells having the same
Well Contractor Name(or well owner personally abandoning well on his/her property) well construction/depth,only 1 GW-30I is needed. Indicate TOTAL NUMBER of
2927A wells abandoned: 1
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
7c.Type of disinfectant used: 1
•
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 Grotit a 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)
IMonitoring ['Recovery !. '
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation 10 lbs of Bentonite Pellets
❑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) All well material removed, hole backfilled to 1.5 ft
BLS then filled to land surface with concrete
4.Date well(s)abandoned: 09/06/2023
5a.Well location: ,
Duke Energy Progress NA
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
491 Power Plant Rd. Lumberton, NC 28358 3/19/2024 '
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Robeson Unknown
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.0100,or 2C.0200 Well Construction Standards
and that a copy of this record has been 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:
34.587247 N -78.972473 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 sane construction abandonment,you can submit ne f .
10a, For All Wells: Submit this form within 30 days of completion of well
P-81 t.T6' '' r._.�a.t -.r, bandonment to the following:
6a.Well ID#: C,,,,.�£.,,,t, 'r Q ;, �
MAR •
"° Division of Water Resources,Information Processing Unit,
15.37 2 �° 1617 Mail Service Center,Raleigh,NC 27699-1617
6b.Total well depth: (ft.) �G24
in...2 i.-A :'F
r:lD. ?r-,�� 10b. For Injection Wells: In addition•to sending the form to the address in 10a
2.0v '�,^i" ''u j) bove, also submit one copy of this foim within 30 days of completion of well
6c.Borehole diameter: (in.) .i
abandonment to the following:
6d.Water level below ground surface: 9.37 (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)i NA (ft) abandoned. • I
6g.Screen length(if known): 1'4-15'4 (ft.) •
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

(
WELL ABANDONMENT RECORD For lntemal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
William J. Miller 7a.For Geoprobe/DPT or Closed-L lop 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 isineeded. Indicate TOTAL NUMBER of
2927A wells abandoned: 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 I.
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
0 Industrial/Commercial 0 Residential Water Supply(shared) ❑ Concrete Grout ❑Drill Cuttings
❑Irrigation ❑ Specialty Grout ❑Gravel •
Non-Water Supply Well: ❑ Bentonite Slurry e Other(explain under 7g)
❑Monitoring PIRecovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
:Aquifer Recharge ❑GroundwaterRemediation Concrete Slurry 1,
❑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) Abandoned using a concrete slurry to approximately
1.5' BLS. The remaining'1.5'was then filled with
4.Date well(s)abandoned: 09/11/2023
clean soil.
•
5a.Well location:
Duke Energy Progress NA
Facility/Owner Name Facility 1D#(if applicable) 8.Certification: �'l,.
491 Power Plant Rd. Lumberton, NC 28358 3/19/2024
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Robeson 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:
(if well field,one ladlong is sufficient) 9.Site diagram or additional well details:
34.587247 . N -78.972473 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(wadable.For multiple injection or non-water supply wells
ONLY with the same construction'abandonment,you can sub romlfi rth:. ??. d' 7:- i i
L . a aa. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#:
RW-00 °a"" "' 0.'- abandonment to the following:
MAR 2 e 2024 Division of Water Resources,Information Processing Unit,
6b.• Total well depth:23.9 (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617
li::1,.;;.-`ih'rt Pr-::^.:;-';2 F;y LW,:
DVJGl3''OG 10b.For Injection 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: 7.72 (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.) I Oc.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): 3-4-23.4 (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016
'

WELL ABANDONMENT RECORD For Intemal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS ;
i
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: 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#: 1
List all applicable well construction pennies(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 ❑Neat Cement Grout" a 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 e Other(explain under 7g)
❑Monitoring (Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation Concrete Slurry , .
❑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) Abandoned using a concrete slurry to approximately
1.5' BLS. The remaining•.1.5' was then filled with
4.Date well(s)abandoned: 09/11/2023
clean soil.
5a.Well location:
Duke Energy Progress NA
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
491 Power Plant Rd. Lumberton, NC 28358 Z 3/19/2024
Physical Address,City,and Zip .Signature of Certified Well Contractor or Well Owner Date
Robeson 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:
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.587247 N -78.972473 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 const•uction'abandonment,you can submit one form.
10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: RW-02 T-- ., r 7..., 'gbandonment to the following:
6�y i 1df s"�'s j
; �` A Division of Water Resources,.Information Processing Unit,
6b.Total well depth: 23.5 (ft.) MAR 2 t 2024 1617 Mail Service Center,Raleigh,NC 27699-1617
Q. .,1For Injection Wells: In addition to sending the form to the address in l0a
4.0 s rirn r °7-'4"r Jab'ove, also submit one copy of this form within 30 days of completion of well
6c.Borehole diameter: (in.) K;;i;;;';=:P .,.,..
�a;it44 .. , abandonment to the following:
•
6d.Water level below ground surface: 7.8 (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): 3'0-23'0 (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

i 9
WELL ABANDONMENT RECORD Forintcmal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
William J. Miller 7a.For Geoprobe/DPT or Closed-L lop 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: 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.UIC,County,State,Variance,etc.)if known
7d.Amount of disinfectant used: '
3.Well use(check well use): I -
Water Supply Well: 7e.Sealing materials used(check all that apply): '
❑Agricultural ❑Municipal/Public 0 Neat Cement Grout 1 e 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
0 Irrigation ❑ Specialty Grout ❑ Gravel
Non-Water Supply Well: • ❑ Bentonite Slurry U Other(explain under 7g)
❑Monitoring lRecovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation Concrete Slurry
❑Aquifer Storage and Recovery ❑Salinity Barrier
i
❑Aquifer Test ❑Stormwater Drainage I
El Experimental Technology OSubsidence Control
7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g) Abandoned using a concrete slurry to approximately
1.5' BLS. The remaining1,5'was then filled with
4.Date well(s)abandoned: 09/11/2023
clean soil.
5a.Well location: '
Duke Energy Progress NA
Facility/Owner Name Facility ID#(if applicable) 8.Certification: O,
491 Power Plant Rd. Lumberton, NC 28358 3/19/2024
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Robeson Unknown II •
By signing this forms, 1 hereby cert(,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:
34.587247 N -78.972473 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 construciioWabandonment,you can submit one form.
10a. For All Wells: Submit this form within 30 days of completion of well
RW-04 ) �'i v bandonment to the following:
6a.Well ID#: f
t
''k jL r. a Division of Water Resources,Information Processing Unit,
6b.Total well depth: 23.7 (ft.) MAR 2 'i° 2UZ`t 1617 Mail Service Center,Raleigh,NC 27699-1617
,:.ra 1'h11b.For injection Wells: In addition Ito sending the form to the address in 10a
6c.Borehole diameter: 4.0 (in.) ITtii;f-f,t i. te r_1 - ,� r 4° above, also submit one copy of this foim within 30 days of completion of well
Erna. :,...).(z, abandonment to the following:
6d.Water level below ground surface: 7.6 (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
. R
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): 3'2-23'2 (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

1
. WELL ABANDONMENT RECORD For internal Use ONLY:
i
1.Well Contractor Information: - WELL ABANDONMENT DETAIL1S 1 ,
William J. Miller 7a.For Geoprobe/DPT or Closed-LoopI Geothermal Wells having the same
Well Contmctor 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.)
CATLI N 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 ❑ 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 El Drill Cuttings
0 Irrigation 0 Specialty Grout ❑ Gravel
Non-Water Supply Well: ❑ Bentonite Slurry e Other(explain under 7g)
❑Monitoring PIRecovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
['Aquifer Recharge ['Groundwater Remediation Concrete Slurry .
DAquifer Storage and Recovery ❑Salinity Barrier ,
❑Aquifer Test ❑Stormwater Drainage ,
❑Experimental Technology ❑Subsidence Control
7g.Provide a brief description of the abandonment procedure: .
OGeothermal(Closed Loop) ❑Tracer
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g) Abandoned using a concrete slurry to approximately
_ 1.5' BLS. The remaining:1.5' was then filled with
4.Date well(s)abandoned: 09/1 1/2023
clean soil.
5a.Well location:
Duke Energy Progress NA _ •
Facility/Owner Name Facility ID#(if applicable) 8.Certification: / :
491 Power Plant Rd. Lumberton, NC 28358 3/19/2024
• Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Robeson Unknown •
By signing this form, I hereby certify that the well(s) was (were) abandoned in
County Parcel Identification No.(PIN) accordance with 1SA 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 Iat/long is sufficient) 9.Site diagram or additional well details: •
34.587247 N -78.972473 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# RW-05 _-. ;•.Rio t, abandonment to the following:
a 'L%� -'I r` r, Division of Water Resources,Information Processing Unit,
6b.Total well depth: 24'1 (ft.) MAR 2 t` L�2� 1617 Mail Service Center,Raleigh,NC 27699-1617
140b.For Iniection Wells: In addition to sending the form to the address in l0a
?S^':try' ''4 above, also submit one copyof this form within 30 days of completion of well
6c.Borehole diameter: 4.0 (in.) ��-y;,v5 +� y P
��t" DviicA u' abandonment to the following:
6d.Water level below ground surface: 8.58 (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. •
1
6g.Screen length(if known): 3.6-23.6 (ft.)
i
.,
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

1 •
WELL ABANDONMENT RECORD For Internal Use ONLY: I '
I ,
1.Well Contractor Information: WELL ABANDONMENT DETAIC.S 1
William J. Miller 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
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):
DAgricultural ❑Municipal/Public ❑Neat Cement Grout a Bentonite Chips or Pellets
OGeothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑ Sand Cement Grout ❑Dry Clay
❑Industrial/Commercial ❑Residential Water Supply(shared) ❑Concrete Grout 0 Drill Cuttings
❑Irrigation ❑Specialty Grout 0 Gravel
Non-Water Supply Well: 0 Bentonite Slurry I Other(explain under 7g)
❑Monitoring CRecovery ' -
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑GroundwaterRemediation Concrete Slurry
❑Aquifer Storage and Recovery ❑Salinity Barrier I
❑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) Abandoned using a concrete slurry to approximately
1.5' BLS. The remaining.1,5'was then filled with'
4.Date well(s)abandoned: 09/11/2023 clean soil.
5a.Well location:
Duke Energy Progress NA
Facility/Owner Name Facility ID#(if applicable) 8.Certification: /,--/' :
//
491 Power Plant Rd. Lumberton, NC 28358 3/19/2024
Physical Address,City,and Zip Signature.of Certified Well Contractor or Well Owner Date
Robeson Unknown
By signing this form, I hereby certify That the well(s) was (here) 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:
34.587247 N -78.972473 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 cons!ruclionrecord(s)ifavailable. For multiple injection or non-water supply wells
ONLY with the same constructiomabandonment,you can submit one form.
_ .10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: RW-06 .` E-�,f�`1 t-�' bandonment to the following:
FL •
M'` Division of Water Resources;Information Processing Unit,
6b.Total well depth: 23.8 (ft.) H 2.024 ??�� 1617 Mail Service Center,Raleigh,NC 27699-1617
r, Tr--.-.�.r7%..`:'UiOb.For Injection Wells: In addition to sendingthe form to the address in 10a
Zt ar
{f tizGiII1W ,..,
6c.Borehole diameter: 4.0 (in.) Ggj�(,ra'JL% above, also submit one copy of this form within 30 days of completion of well
abandonment to the following:
8.65 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 I In addition to sending the form to the
address(es)above,also submit one copy 4f 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): 3'3-23'3 (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources I Revised 2-22-2016