Iredell_Well Abandonment_20240401

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WELL ABANDONMENT RECORD For Internal Use ONLY:
,
1.Well Contractor Information: WELL ABANDONMENT DETAILS
Marc Howie I
7n.For Geoprabe/DPT or Closed-Loop Geothermal Wells having the same
Well Contractor Name(or well owner personally abandoning well on hisiher property) well construction/depth,only I(3W-30 is needed.Indicate TOTAL NUMBER of
3554-A wells abandoned:
NC Well Contractor Certification Number 7b,Approximate volume of water remaining In well(s):•427 (gal)
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY: '
Company Name
7c.Type of disinfectant oiled:N/A
2.Well Construction Permit N:N/A
List all applicable well c utraction permits(i.e.UIG County,State,Variance,eta)ifkn can
7d.Amount of disinfectant used:N/A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(cheek all that apply):
°Agricultural OMimicipal/Public RI Neat Cement Grout ❑Bentonite Chips or Pellets
°Geothermal(Heating/Cooling Supply) °Residential Water Supply(single) 0 Sand Cement Grout Cl Dry Clay
Olndusttial/Commemial °Residential Water Supply(shared) 0 Concrete Grout ElDrill Cuttings
°Irrigation Cl Specialty Grout 0 Gravel
Non-Water Supply Well: Cl Bentonite Slurry 0 Other(explain under 7g)
IRMonitoring °Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
OAquiferRecharge 0GroundwaterRemediation .4532 cu ft
°Aquifer Storage and Recovery °Salinity Barrier
°Aquifer Test ❑Stmmwater Drainage
°Experimental Technology °Subsidence Control
°Geothermal(Closed Loop) OTmea 7g.Provide a brief description of the abandonment procedure:•
OGeothermal(Heating/Cooling Return) °Other(explain under 7g) Trimmie grout with neat cement
IJ ;� � , r+�Z ' C. �4.Datewell(s)abandoned:3/20/2024 - r
Ss.Wenlocation: I I f'N it I •7(i24
Williams Pipeline Transco Station 150 1 LVL`t
Facility/Owner Name Facility IDS/(if applicable) 8.certification: tnk:r r.''e i1 i?..,t_,r^,,�y +,ng Uma
236 Transco Rd., Mooresville, NC, 28117 ,c3J,
0' 3/20/2024
Physical Address.City,and Zip Signature of Certified Well Con'ictaror Well Owner Date
Iredell 465619445
County Parcel Identification No.(PIN) By signing this form,I hereby,certify that the well(s)war(were)abandoned in
accordance with I5A NCACO2C.0100 or 2C.0200 Well Construction Standards
Sb.Latitude and longitude In d and that a copy of this recor1 has been provided to the well owner.
g degrees/minutes/seconds or decimal degrees: ''
(if well field,one LNong is mColon!) 9.Site diagram or additional well details:
35° 31'31.50" N 80° 51'32.60" W You may use the back of this page to provide additional well site details or well
abandonment details.You Tay also attach additional pages if necessary.
CONSTRUCTION DETAILS OF WELLS)BEING ABANDONED SUBMITTAL INSTRUCTIONS
Attach nr/teouinmtlanreeord(,)(favatlable.For multiple injection orrmn•wa:ersupptywelts
ONLYnith tlterame eet -1 otuntrualon/abandonmenr,you can submit one form. I
M VY 10a.For All Wells: Submit this form within 30 days of completion of well
6n.Well IN: abandonment to the following:
I
Division of Water Resources,Information Procesting Unit,
6b.Total well depth:20.6 (ft,) 1617 Mail Service Center,Raleigh,NC 27699-1617
10b.For Inleetlon Wells: In addition to sending the form to the address in IOa
6c.Borehole diameter:2 (IO,) above,also submit one copy of this form within 30 days of completion of Well
• abandonment to the following:
6d.Water level below ground17.98
surface: ((t,) Dlvlalan of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699.1636
6e.Outer casing length(if known):N/A (ft.) 10e.For Water Supply&Injection Welk:In addition to sending the form to the
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
6L Inner casing/tubing length(If known):22.8 (ft.) abandoned. I.
6g,Screen length(If known): 14 (ft.)
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FormGW-30 Noel,Carolina Depanmcnt of Envfrnnn,estal Quality-Diviaioa of Water geLsnea Revised2-22-2016
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WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
Marc Howie 7a.For GeoprobefDPT 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
3554-A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining In well(s):2.0538 (go.)
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Company Name
7c.Type of disinfectant used: N/A
2.Well Construction Permit#:N/A
List all applicable well construction permits(i.e.UIC,County State,Variance,etc.)(/known
7d.Amount of disinfectant used: N/A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public M Neat Cement Grout I ❑Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑Sand Cement Grout I 0 Dry Clay
❑Industrial/Commercial ❑Residential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings
❑irrigation 0 Specialty Grout I 0 Gravel
Non-Water Supply Well: 0 Bentonite Slurry ❑Other(explain under 7g)
lilMonitoring ❑Recovery
I
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑GroundwaterRemediation .649 cu ft
❑Aquifer Storage and Recovery ❑Salinity Barrier I
❑Aquifer Test OStormwater Drainage
❑Experimental Technology ❑Subsidence Control 7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer Trimmie grout with 'neat cement
OGeothetmal(Heating/Cooling Return) ❑Other(explain under 7g)
3/20/2024 ' t ::r,.p '-.IrA
4.Date well(s)abandoned. I,1 ¢"
Sa.Well location: ' �,r�l t/ j 4 I4
Williams Pipeline Transco Station 150 lilk„/r
Facility/Owner Name Facility!DO(if applicable) 8.Certifcation: 'o..%u�t 4�' ts�JR.46
236 Transco Rd., Mooresville, NC, 28117 3/20/2024
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Iredell 465619445
By signing this form,I hereby certify that the well(s)was(were)abandoned in
County Parcel Identification No.(PIN) accordance with ISA NCAC 02C.0100 or 2C.0200 Well Construction Standards
and that a copy of this record has beef,provided to the well owner.
Sb.Latitude and longitude In degrees/minutes/seconds or decimal degrees:
(if well field,one let/long is sufficient)
9.Site diagram or additional well details:
35° 31' 31.50" N 80° 51' 32.60" 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 SUBnrrAL INSTRUCTIONS
Attach well constructionrecord(r)ifavailable.Formuhlple infection ornon-water supply welle
ONLY with the same construaton/abandanment,you can submit one_form,
MW-2 10a.For Ail Wells: Submit this form within 30 days of completion of well
6a.Well ID#: abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth:29.5 (fL) 1617 Mall Service Center,Raleigh,NC 27699-1617
10b.For Infection Welly: 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:
6d.Water level below ground surface: 16.917.98 (ft) Division of Water Resources,Uridergroand Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(If known):N/A (ft) IOc.)Far Water Suosiv&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
3045 of well abandonment to the county health department of the county where
6f.Inner casing/tubing length(if known): (ft) abandoned.
i
6g.Screen length(If known): 10 (ft.)
Form OW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

WELL ABANDONMENT RECORD For lnteroa I
lUte ONLY: I
i
1.Well Contractor Information: WELL ABANDONMENT DETAILS
Marc Howie i I
7a.For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same
Well Contractor Norm(or well owner personally abandoning well on his/her property) well construction/depth,only 1 OW-30 is needed. Indicate TOTAL NUMBER of
3554-A wells abandoned I
• NC Well Contractor Certification Number lb.Approximate volume of water remaining in well(s):2.593 (gal,)
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Company Name
lc.Type of disinfectant used:N/A
2.Well Constroctlon Permit#:N/A
List all applicable well coartruetion permits(le.WC,County,State,Variance,eta)ijbrosr,
7d.Amount of disinfectant used:N/A
. 3.Well use(check well use): '
Water Supply Well: 7e.Sealing materials used(cheek all that apply):
°Agricultural OMtmicipal/Public II Neat Cement Grout ❑Bentonite Chips or Pellets
°Geothertal(Heating/Cooling Supply) °Residential Water Supply(single) Cl Sand Cement Grout 0 Dry Clay
D)ndustristCommercial °Residential Water Supply(shared) Cl Concrete Grout Cl Drill Cuttings
O)nigation 0 Specialty Grout Cl Gravel
Non-Water Supply Well: Cl Bentonite Slurry 0 Other(explain under 7g)
MMonitoring °Recovery '
Injection Well: 7f.For each material selected above,provide amount of materials used:
°Aquifer Recharge °GroundwaterRemediation .737 cu ft 1
°Aquifer Storage and Recovery °Salinity Barrier
°Aquifer Test OStormwater Drainage '
°Experimental Technology °Subsidence Control
°Geothermal(Closed Loop) OTmeer 7g.Provide a brief description'of the abandonment procedure:
UGeothermal(Hating/CoolingRetum) °Other(explain under 7g) Trimmie grout with neat cement
a.Date well(a)abandoned:3/20/2024 fi b
5a.Well location:
Williams Pipeline Transco Station 150 4 PR Z0«
Facility/Owner Name Facility 1Dfi(if applicable) 8.Certineation:
236 Transco Rd., Mooresville, NC, 28117 "'" v.",t'f''
Physical Address,City,and Zip r 20-7,2024
�� (-
,
Signature o Ted ell Contractor or Well Owner Date
Iredell 465619445 ! :
By signing this farm,I hereby cernfy that the well(s)was(were)abandoned In
County Parcel Identification No.(PIN) accordance with ISA NCACO2C.0100 or 2C.0200 Well Construction Standards
and that a copy of Mir record has been provided to the well owner,
5b.Latitude rind longitude in degreetdrninotes/seconda or decimal degrees:
(if well field,omelet/long is eutlteient) 9.Site diagram or additional well details:
35° 31'31.50" N 80° 51'32.60" K, You may use the back of this page to provide additional well site details or well
abandonment details.You lay also attach additional pages if necessary.
CONSTRUCTION DETAILS OF WELLS)BEiNG ABANDONED SUBMITTAL narRUC TIONS
Amid wellconsnuction records)tfavallable.For multiple infectionornan-watersupply wells
ONLY wieh the same con,wctlas/abaadaament,you can submit one form 10a.For All Wells: Submit this form within 30 days of completion of well
6a.Well IN:MW-3 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth:33.5 (ft.) 1617 Mail Set Center,Raleigh,NC 27699-1617
I
• 10b.For inlectlon Weil`: 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.
6d.Water level below ground surface:17.59 (it.) Division of WaterResoulrces,Underground Injection Control Program,
1636 Mall Service Center,Raleigh,NC 27699-1636
II
IOe For Water Sooaly&inlatlom Wells:in addition to seeding the form to the
6e.Outer casing length(If known):N/A (R.)
address(es)above,also submit one copy alibis form within 30 days of completion
34.85 of well abandonment to the county health department of the county where
6f.Inner casing/tubing length(if known): (ft.) abandoned.
6g.Screen length(If known): 10 (ft.)
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Form OW-30 North Carolina Departmeetof Environmental Quality-Division of Water Resources Revised2-22-2016
1l

WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
Marc HowieI
7a.For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same
Well Contractor Name(or well owner personally abandoning well on hislber property) well construction/depth,only 1 GW-30 is needed.indicate TOTAL NUMBER of
3554-A wells abandoned:
NC Well ContractorCedifialion Number 7b.Approximate volume of water remaining In we'l(a):•998 (gat)
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Company Name 7c.Type of disinfectant used:N/A
2.Well Construction Permit#:N/A
List all applicable well construction permits(Le.WC County.State,Variance,era)iflarosa
7d.Amount of disinfectant used: N/A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
['Agricultural OMunicipaVPublic ill Neat Cement Gout ❑Bentonite Chips orPellets
°Geothermal(Heating/Cooling Supply) ['Residential Water Supply(single) ❑Sand Cement Grout ❑Dry Clay
°Indtatrial/Commercial °Residential Water Supply(shared) °Concrete Grout ❑Drill Cuttings
°Irrigation ❑Specialty Grout O Gravel
Non-Water Supply Well: ❑Bentonite Shinty O Other(explain under 7g)
•Monitoring ['Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
['Aquifer Recharge °Groundwater Rentediation .55 Cu ft •
['Aquifer Storage and Recovery °Salinity Barrier
°Aquifer Test OStounwater Drainage
['Experimental Technology OSubsidentx Control 7g.Provide a brief description of the abandonment procedure:
OGeD Geothermal(Closed Loop) °Tmeer Trimmiegrout with neat cement
OGothemsl(Heating/Cooling Return) ['Other(explain under 7g) __
l: 1,;` F , ii,t P!
4.Date welts abandoned:3/20/2024 -"'�D t tt t.
5,.Well location: I APR u 1 2024
•
Williams Pipeline Transco Station 150
Facility/Owner Name Facility IDa(If applicable) 8.Certification: I Intl:7;T Cif tDrr., as
236 Transco Rd., Mooresville, NC, 28117 v`'''g/20/2024
Physical Address,City,and Zip Signature of Cerra eel Well Contractor or Well Owner Date
Iredell 465619445 By signing this form,I hereby certify that the well(s)was(were)abandoned in
County Parcel Identification No.(PIN) accordance with I SA NCAC 02C.0100 or 2C.0200 Well Construellan 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:
Orwell field,one InUlong is sufficient)
9.Site diagram or additional I well details:
35 31'31.50" N 80o 51'
32.60" You may use the back of this page to provide additional well site details or well
W abandonment details.You may also attach additional pages if necessary.
CONSTRUCTION DETAILS OF WELL(S1 BEING ABANDONED sIIgAL INSTRUCTIONS
Attach well construction record(a)ifavellebfe.For mukluk infection ornon-waterrupply swims
ONLY with the same contraction/abandonment,you can submit one form. 10a.For All Wells: Submit,this form within 30 F days of completion of well
6s.Well ID#:M W-4 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth:25 (ft) 1617 Mall Service Center,Raleigh,NC 27699.1617
1
106.For Injection 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:
6d.Water level below ground surface:18.88 (fL) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
•
6e.Outer casing length(if known):N/A (ft) lOe.For Water Suaoly&Injection Wells:In addition to sending the form to the
address(es)above,also submit ane copy of this form within 30 days of completion
27.80 of well abandonment to the(county health department of the county where
Of.Inner easing/tubing length(if known): (ft.) abandoned.
6g.Screen length(If known): 10 (ft.)
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Form GW-30 North Carolina Department of Environmental Quality-Division of Water Raourcee Revised 2-22.2016

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WELL ABANDONMENT RECORD For Internal Use ONLY: { '
1
1.Well Contractor Information: WELL ABANDONMENT DETAILS
Marc Howie . 7a,For GeoprobeJDPT or Closed-Loop Geothermal Wells having the same
Well Contractor Name(or well owner petsomlly abandoning well on hiraier property) Well construction/depth,only l GW-30 is needed.Indicate TOTAL NUMBER of
3554-A wells abandoned: II.
• A
' NC Well Contractor Certification Number 7b.Approximate volume of water remaining la well(s):4.34 (gal.)
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Company Nome '
t�' 7c.Type ofdisinfechndused:N/A
2.Well Construction Permit N:N/A
List all applicable well conrauctlan penults(En• UIC Cmmry,Store,Variance,etc)1If sawn
7d.Amount of disinfectant used:NIA
3.Well use(check well use):
•
Water Supply Well: 7e.Seaing materials used(check all that apply):
°Agricultural OMunicipallPublie PI Neat Cement Grout ❑Bentonite Chips or Pellets
°Geothermal(Heating/Cooling Supply) °Residential Water Supply(single) 0 Sand Cement Groat 0 Dry Clay
°Industris&Commercial °Residential Water Supply(shared) C Concrete Grout 0 Drill Cuttings
❑irrigation 0 SpecialtyGrout 0 Gravel
Non-Water Supply Well: ❑Bentonite Slurry 0 Other(explain under 7g)
eMonitoring . °Recovery
Injection Well: 7E For each material selected above,provide amount of materials used:
• DAquifer Recharge OGmundwatcr Remediation .97 Cu ff
°Aquifer Storage and Recovery °Salinity Bonier :
°Aquifer Test ❑Stomrwater Drainage
°Experimental Technology °Subsidence Control
°Geothermal(Closed Loop) °Tracer 7g.Provide a brief description of the abandonment procedure:
OGeothermal(Heating/CoalingReturn) OOther(explain under 7g) Trimmie grout with.rJe #cement
3/20/2024 v L a.. �' '.0' e
4.Date well(s)abandoned: ()(�
Sa.Well location:
�'r i! i 2024
Williams Pipeline Transco Station 150 ' a�__rrt .^
Facility/Owner Name :Inv.,rrr re„(e• eDr::.
rt' Facility lDN(ifappliable) 8.Certification: G � +dZ> "
236 Transco Rd., Mooresville, NC, 28117 G ''�� J
3/20/2024
Physical Address.City,and Zip Signature otCa' ad Well Contractor or Well Owner Date
Iredell • I
465619445 By signing this form.I hereby Berth that the well(a)was(were)abandoned in
County Parcel Identification No.(PIN) accordance with 1SA NCAC 02C.0100 or 2C.0200 Well Consirucilon Standards
Sb.Latitude and longitude In degrees/minutes/seconds or decimal degrees: and that a copy of Mir record has been provided to the well owner.
(if wen field,one lot/long is sufficient)
9.Site diagram or additional wen details:
35° 31'31.50" N 80 51' 32.60" µ, 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 xel1construction record(r)Ijavailable.Far multiple Infection ornan•watersupplywells
ONLY with the same construction/abandonment,you can submit onefarm. I
MW 4D 10a.For AN Wells: Submit this form within 30 days of completion of well
6a.Well DM: abandonment to the following:I
Division of Water Resources,Information Processing Unit,
6b.Total well depth:44.2 (ft.) 1617 Mall Service Center,Raleigh,NC 27699-1617
I
• • 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:17.55 (ft.) Division of Water Resources;Underground Injection Control Program,
1636 Mall Service Center,Raleigh,NC 27699-1636
i
be,Outer casing length(If known):N/A (ft) 10c.Per Water S"otsly&Ioleetloa Wells:In addition to sending the form to the
address(es)above,also submit one copy of this farm within 30 days of completion
•
43.55 of well abandonment to meicounty health department of the county where
6f.Inner casing/tubing length(if known): (ft.) abandoned.
1
6g.Screen length(if known):4 (it)
Form GW-30 - North Carolina Deponnent of Environmental Quality-Division of Water Resoiaeea Revised 2-22.2016

WELL ABANDONMENT RECORD For Internal Use ONLY: • •
1
1.Well Contractor Information: WELL ABANDONMENT DETAILS
Marc Howie , •
7a.For GeoproheMPT or Closed-Loop Geothermal Wells having the same
Well Contractor Name(or well owner personally abandoning well on hisrherproperty) well construction/depth,only l GW-30 is needed.Indicate TOTAL NUMBER of
3554—A wells abandoned: I :
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in wen(s);1.11 (gaL)
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Company Name 7e.Type of disinfectant used:NIA
2.Well Construction Permit tic N/A
list all applicable well ronetructlan permits(i.e.U/C.Covnor,Stare,Variance,era)Thrown
7d.Amount of disinfectant used:N/A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
cAgdcultuml OMunicipal/Public IN Neat Cement Grout ❑Bentonite Chips or Pellets
DGeotheemal(Heating/Cooling Supply) °Residential Water Supply(single) ❑Sand Cement Grout • 0 Day Clay
°Industrial/Commercial °Residential Water Supply(shared) D Concrete Grout °Drill Cuttings
Obligation 0 Specialty Grout U Gravel
Non-Water Supply Well: ❑Bentonite Slurry 0 Other(explain under 7g)
!Monitoring ORecovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
DAquifer Recharge ❑GrnundwaterRemediation .55 cu ft ,
DAquifer Storage and Recovery °Salinity Bather
['Aquifer Test DStotmwater Drainage '
['Experimental Technology ['Subsidence Control 7g.Provide a brief description of the abandonment procedure:
DGeothetnsal(Closed Loop) °imcec Trimmie grout with neat cement
°Geothermal(Heating/Cooling Return) °Other(explain under 7g)
��.•'' .,fir
4.Date well(s) , ,,
abandoned:3/20/2024 I ', :,-., —.i r ' D
Sa.Well location: i ^
Williams Pipeline Transco Station 150 AIR ,� if
Facility/Owner Name Facility ION(if applicable) S.Certineation: Ori _r•
236 Transco Rd., Mooresville, NC, 28117 Aiet./j0172djLb24
Physical Address,City,and Zip Signature of Ceni Well Contractor or Well Owner Date
Iredell 465619445 signing this onts,I herebycent that the well(s)was By 8 •8 f cent), (were)abandoned in
County Parcel Identification Na(PIN) accordance with ISA NCAC 02C.0100 or 2C.0200 Well Construction Standards
and that a copy of this record had been provided la the well owner.
Sb.Latitude and longitude in degrees/minutes/seconds or decimal degrees: I
Orwell field,eon fat/long is aut6cient) 9.Site diagram or additional well details:
35° 31'31.50" N 80° 51'32.60" 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 WELLS)BEING ABANDONED Sf BMITAL INSTRUCTIONS
Attach well construction record(s)ljavallable.Far multiple Infection ar non-lover sapplywelr
ONLY with the same cmurnerNan/abandonmrnt you can sabmuoneform. 10a.For All Wells: Submit this form within 30 days of completion of well
6n.Well 1130:M W-5 abandonment to the following:
Division of Water Resources,Information Processing Unit,
lib,Total well depth:25 (ft) 1617 Mali Service Center,Raleigh,NC 27699-1617
IOb.For Infection Welk: In addition to sending the form to the address in 10a
6c.Borehole diameter:2 ((o,) 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:18.21 (n,) Division of Water Resources,Underground Injection Control Program,
• . 1636 Man Service Center,Raleigh,NC 27699-1636
I
IOa For Water Supply e Iniectioq WeftIn addition to sending the form to the
6e.Outer easing length(If known):N/A (R.)
address(es)above,also submit one copy of this form within 30 days of completion
27.75 of well abandonment to the'county health department of the county where
6f.Inner casing/tubing length(if known): (ft.) abandoned
6g.Screen length(if known): 10 (ft.)
Fenn OW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016
' I
i r

•
WELL ABANDONMENT RECORD
For internal Use ONLY:
'
I.Well Contractor Information: WELL ABANDONMENT DETAILS
Marc Howie I`
7n.For GeoprobelDPT or Closed-Loop Geothermal Wells having the same
Well ContractorName(or well owner personally abandoning well on his/her property) well construction/depth,onlyIGW-30isneeded_Indicate TOTAL NUMBER of
3554-A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s):1.13 (gal)
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Compeey Name I
7c.Type of disinfectant use:N/A
2.Well Construction Permitii:N/A
list all applicable well ronrvuclton perm!,:(i.e.UIC County,State,Variance,etc.)Ortolan •
7d.Amount of disinfectant used: N/A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
OAgricultural [Municipal/Public II Neat Cement Grout ❑Bentonite Chips or Pellets
OGeothermal(Heating/Cooling Supply) OResidential Water Supply(single) ❑Sand Cement Grout ❑Dry Clay
❑Industrial/Commercial OResidential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings
•
Olrrigation ❑Specialty Grout ❑Gravel
Non-Water Supply Well:
!Monitoring ORecovery O Bentonite Slurry ❑Other(explain under 7g)
Injection Well: 7E For each material selected above,provide amount of materials used:
°Aquifer Recharge OGroundwaterRcmediation .55 Cu ft i
DAquifer Storage and Recovery OSalinity Barrier
DAquifer Test OStormwaler Drainage
DExperimental Technology ❑Subsidence Control
DGeothtuhnel(Closed Loop) OTraeer 7g.Provide a brief description of the abandonment procedure:
OGeothermal(Heating/CoolingReturn) OOther(explain under 7g) Trimmie grout with neat cement
4.Date well(s)abandoned:
3/20/2024 '"' =1
So.Well location:
Williams Pipeline Transco Station 150 Af)P 2624
Facility/Owner Name Facility ID,/(if applicable). 8.Certil on:
236 Transco Rd., Mooresville, NC, 28117 !n` ��r i�r
Physical Address,City.and Zip Signature of Cenifi Well Contractor or Well Owner )Iaie"-'
Iredell 465619445 '
By signing this form,I hereby cerrfy that the well(s)was(were)abandoned in
County Parcel Identification No.(PIN) accordance with 15A NCAC 01C.0100 or 2C.0100 Well Construction Standards
5b.Latitude and ion Rude In de and that a copy of this record hhar been provided to the well owner.
g grees/minutes/seconds or decimal degrees:
(if well field.one lat/long is sufficient)
9.Site diagram or additional well details:
35°31'31.50" N 80°51'32.60" M, 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
Attach troll construction record(s)Ifarailable.Far multiple infection ornon-water:upply welt SUBMITTAL INSTRUCTIQNS
ONLY with the same cw'struction/abandomnent,yea can submit onefarm.
MVV-6 10a.For All Wells: Submit this form within 30 days of completion of well
6a.Well DV: abandonment to the following:t.
Division of Water Resources,Information Processing Unit,
6b.Total well depth:25 (ft,) 1617 Mall 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 (la,) 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:18.04 (ft) Division of Water Resources,Underground Injection Control Program,
1636 Mall Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known):N/A (ft,) 10e.For Water Supply&Infection Wells:In addition to sending the form to the
address(es)above,also submit one copy of this fort within 30 days of completion,
27.75 of well abandonment to the�coimty health department of the county where
6L Inner casing/tubing length(If known): (ft,) abandoned. t
•
6g.Screen length(If known): 10 (ft.)
!
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised242-2016
I
II

•
WELL ABANDONMENT RECORD For letemal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT.DETAILS
Marc Howie la.For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same
Well Contractor Name(or well owner personally abandoning well on hislber property) well construction/depth,only 1 OW-30 is needed.Indicate TOTAL NUMBER of
3554-A wells abandoned:
NC Well Contactor Certification Number 7b.Approximate volume of water remaining in well(s):1.72 (gal.)
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Company Name 7c.Type of disinfectant used:N/A
2.Well Construction Permit a:N/A
List all a lieable well conrttucllon PP permits(i.e.VIC.Covnly,Same,Variance,clef if known 7d.Amount of disinfectant used:N/A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
°Agricultural [Municipal/Public PI Neat Cement Grout ❑Bentonite Chips or Pellets
°Geothermal(Heating/Cooling Supply) DResidcntial Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
°lndustrial/Commercial °Residential Water Supply(shared) Cl Concrete Grout 0 Drill Cuttings
°Irrigation 0 Specialty Grout 0 Gravel
Non-Water Supply Well: ❑Bentonite Slurry 0 Other(explain under 7g)
!Monitoring °Recovery
Injection Well: 71,For each material selected above
,provide amount of materials used:
DAquiferRecharge 0GroundwaterRemediation .66 cu ft
°Aquifer Storage end Recovery °Salinity Barrier
°Aquifer Test DStormwater Drainage
!Experimental Technology °Subsidence Control 7g.Provide a brief description of the abandonment procedure:
DGeothermal(Closed Lao DOt0Tr ear Trimmie grout with neat cement
°Geothermal(Heating/Cooling Return) °Other(explain under 7g)
v177-
�7..
3/20/2024 -
4.Date well(s)abandoned:
5a.Well location: �)R 0 1 nn11�
Williams Pipeline Transco Station 150 [ 4 •
Facility/Owner Name Facility IDI/(if applicable) 8.Certitiwti n: (fliv';T' (^.;l ce,,.!•^
sips U
236 Transco Rd., Mooresville, NC, 28117 /at,Q(33/,20%2024
Physical Address,City,and Zip Signalure of Certified Well Contractor or Well Owner Date
Iredell 465619445 By signing this form,I hereby certify that the well(s)war(were)abandoned in
County Parcel Identification No.(PIN) accordance with 15A NCAC 01C.0100 or 2C.0200 Well Construction Standards
and that a copy of this record has been provided to the well saner.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees: i
(if well field,one IahRong is sufficient) 9.Site diagram or additional well details:
35° 31'31.50" N 80° 51'32.60" 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 WELLS)BEING ABANDONED
Attach net!conronction record(s)((fawellable.Formaltlpie infection ornon-wvteraupply wells
SUBM1 AI.INSfRUCTIONS
ONLY with the same conunrerloa/abandonment,you can submit one jarm. 10a.For All Wells: Submit this form within 30 days of completion of well
6a.Well LW:MW-7 abandonment to the following: •
i
Division of Water Resource;Information Processing Unit,
6b.Total well depth:30 (ft) 1617 Mail Service Center,Raleigh,NC 27699-1617
lob.For Inlectlon Weller In addition to seeding 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:
6d.Water level below ground surface: 19.44 (D) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known):N/A (fL) 10e.For Water Supply&Initeeilon Welt:In addition to sending the fonts to the
addresses)above,also submit one copy of this form within 30 days of completion
33.65 of well abandonment to the county health department of the county where
6f.Inner casing/tubing length(if known): (ft.) abandoned.
6g.Screen length(If known): 10 (D.)
Fenn OW-30 North Carolina Department oflnvuonmenal Quality-Division of Water Resources Revised 2-22-2016

• t
WELL ABANDONMENT RECORD For internal Use ONLY:
•
•
I.Well Contractor Information: WELL ABANDONMENT DETAILS
Marc Howie 7a.For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same
Well Contractor Phone(or well owner personally abandoning well on his/her property) well construction/depth,only I GW-30 is needed.Indicate TOTAL NUMBER of
3554-A wells abandoned: 1 '
i
NC Well Contractor Certification Number 7b.Approximate volume of water remaining In well(e):5.05 (gal.)
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Company Name
7c.Type of disinfectant used:N/A
2.Well Construction Permit 0: N/A
Litt all applicable well conrtntetion permits(i.e LUG County,State,Variance.eta)Ifknotm
7d.Amount of disinfectant used:N/A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
°Agricultural OMunicipal/Public PI Neat Cement Grout ❑Benton ite Chips or Pellets
DGeothermal(Heating/Cooling Supply) °Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
Olndtstrial/Cornmercial °Residential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings
Olnigation 0 Specialty Grout 0 Gravel
Non-Water Supply Well: 0 Bentonite Slurry 0 Other(explain under 7g)
'Monitoring °Recovery
Injection Well: 7f.For each material seiectedfubove,provide amount of materials used:
DAquiferRecharge OGroundwaterRemodiatian 1.056 cu ft
°Aquifer Storage and Recovery °Salinity Barrier
°Aquifer Test OStormwater Drainage
❑Experimental Technology ❑Subsidence Control
7g.Provide a btief description of the abandonment procedure:
OGeotheratal(ClosedHearin Loop) °Tracer Trimmie grout with neat cement
°Geothermal alcating/Cooling Return) °Other(explain under 7g)
4.Date wel(s)abandoned:3/20/2024 C-� .- y', f__-
Se.Well location:
Williams Pipeline Transco Station 150 1 APR 0 1 20«
Facility/Owner Name Facility ID//(if applicable) 8.Certifleatl n: tt-�
236 Transco Rd., Mooresville, NC, 28117 ��" ^�err.,....:
�� �v�Dltd : /2t�/24)V4X
Physical Address,City,and Zip Signature of Certified ell Contractor or Well Owner Dadl._
Iredell 465619445
By signing this form,I hereby cerhfy that the well(s)was(were)abandoned in
County Parcel Identification No,(PIN) . accordance with ISA NCAC 02C.0I00 or 2C.0200 Well Construction Standards
Rude In d and that a copy of this record has been provided to the well owner.
Sb.Latitude and long
itude degrees/minutes/seconds or decimal degrees:
(if well field,aria lat/long is sufficient) 9.Site diagram or additional well details:
35° 31' 31.50" N 80° 51'32.60" 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 WELLS)BEING ABANDONED SUBMITTAL INSTRUCTIONS
Attach well construction record(s)ffavullable.For multiple Injection or non-water supply wells
ONLY with the sonic eanatrvnlan/abandonmem,you can submit one farm. 10a.Yor All Wells: Submit this form within 30 days of completion of well
6a.Well ID#:M W-7 D abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth:48 ((L) 1617 Mall Service Center,Raleigh,NC 27699-1617
lob.For Infection Wells: In addition to sending the form to the address in 10a
6e.Borehole diameter:2 (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: 17.00 (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mall Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(H known):N/A ((L) 10c.For Water Snooty&Infection Wells:In addition to sending the form to the
address(es)above,also submit one copy of this form within 30 days of completion
50.20 of well abandonment to the county health department of the county where
6f.Inner casing/tubing length(if known): (D,) abandoned. i
I
6g.Screen length(if known): 10 (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
Marc Howie 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 is needed. Indicate TOTAL NUMBER of
3554-A wells abandoned: i•
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): 1•86 (gal.)
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Company Name
7c.Type of disinfectant used: N/A
2.Well Construction Permit#: N/A
List all applicable well construction permits(i.e.UIC,County,Stale,Variance,etc.)If known
7d.Amount of disinfectant used: N A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public IR Neat Cement Grout ❑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 0 Drill Cuttings
❑Irrigation 0 Specialty Grout 0 Gravel
Non-Water Supply Well: 0 Bentonite Slurry 0 Other(explain under 7g)
IRMonitoring ❑Recovery
Injection Well: .7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑GroundwaterRemediation .671 Cu ft '
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage '
❑Experimental Technology ❑Subsidence Control 7g.Provide a brief description of the abandonment procedure:
❑Geothermat(Closed Loop) ❑Traeer Trimmie grout with neat cement
❑Geothermal(Hcating/Cooling Return) ❑Other(explain under 7g)
4.Date well(s)abandoned: 3/20/2024 • , ' ‘4,-;,,,j: -V'
5a.Well location:
PR 0 1 2024
Williams Pipeline Transco Station 150 ,
Facility/Owner Name Facility ID#(if applicable) it Certi iea on: iRiii:-r'r2:04.tC n, r Wit: +'.4 asa U s
236 Transco Rd., Mooresville, NC, 28117 �22� �,,�y,Q;.3,
3��0/2024
Physical Address,City,and Zip • Signature of Certified Well Contractor or Well Owner Date
Iredell 465619445 Bysigning thisform, I herebycerti that the well(s)was(were)abandoned in
g g Iy
County Parcel Identification No.(PIN) accordance with ISA NCAC 02C.0100 or 2C.0200 Well Constntction 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:
35° 31' 31.50" N 80° 51' 32.60" ,,i, 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)ijavailable.FormultipleiiJectionornon-watersupp►ywells
ONLY with the same construction/abandonment,you can submit one form. 10a.For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: MW-8 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 30.5 (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617
lob.For Infection 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:
i •
6d.Water level below ground surface: 19.11 (ft) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
i
6e.Outer casing length(if known): N/A (ft.) 10c.For Water Supply&Infection Wells: in addition to sending the form to the
address(es)above,also submit one copy of this form within 30 days of completion
33.70 of well abandonment to the county' health department of the county where
6f.Inner casing/tubing length(if known): (ft) abandoned.
6g.Screen length(if known): 1 0 (ft)
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 i
Marc Howie 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
3554-A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): 1.74 (gal.)
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Company Name
7c.Type of disinfectant used: N/A
2.Well Construction Permit#: N/A
List all applicable well construction permits(i.e.UIC County,State,variance,etc.)((known t,�''
7d.Amount of disinfectant used: I tl/A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public I Neat Cement Grout 0 Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
❑lndustrial/Commercial ❑Residential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings
❑Irrigation 0 Specialty 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:
❑Aquifer Recharge ❑Groundwater Remediation .66 Cu ft
❑Aquifer Storage and Recovery ❑Salinity Bather
❑Aquifer Test ' ❑Stormwater Drainage
❑Experimental Technology ❑Subsidence Control 7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer Trimmie grout with neat cement
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g)
4.Date well(s) 3/20/2024 abandoned: �'' � �� ra 9 44j`"F
52.Well location: 1 APR n t 2O2I
Williams Pipeline Transco Station 150 "J'
Facility/OwnerName Facility lD#(if applicable) S.Certilication: htf 7 r.tics l Pr..._.c 44„9(J,�3t
236 Transco Rd., Mooresville, NC, 28117 DwQ OQ3/20/2024
Physical Address,City,and Zip Signature of Well Contractor or Well Owner Date
Iredell ' 465619445 i
By signing this form,1 hereby certl&that the well(s)was(were)abandoned in
County Parcel Identification No.(PIN) accordance with ISA 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 1at/longis sufficient) 9.Site diagram or additional well details:
350 31' 31.50" N 80` 51' 32.60" 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'WELLS)BEING ABANDONED SUBMITTAL INSTRUCTIONS
Attach well construction recard(s)lfavailable.For multiple injection ornon-watersupplywells
ONLY with the same construction/abandonment,you can submit one form.
MI n,-9 10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: V Y abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 30 (ft.) 1617 Mall Service Center,Raleigh,NC 27699-1617
i
lob.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:
6d.Water level below ground surface: 19.30 (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mall Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): N/A (ft.) 10c.For Water Supply&Injection Wells: In addition to sending the form to the
address(es)above,also submit one copyof this form within 30 days of completion
32.00 of well abandonment to the county health department of the county where
6f.Inner casing/tubing length(If known): . (ft,) abandoned. j
0
6g.Screen length(if known): 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! •
Marc Howie 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
3554-A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): 1'36 (gal.)
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Company Name
7c.Type of disinfectant used:
2.Well Construction Permit#: N/A
List all applicable well construction permits C.e.UIC,County,State,Variance,etc.)if;mown
7d.Amount of disinfectant used: N/A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public !Neat Cement Grout 0 Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
❑lndustriallCommercial ❑Residential Water Supply(shared) 0 Concrete Grout ❑Drill Cuttings
❑Irrigation 0 Specialty Grout 0 Gravel
Non-Water Supply-Well: 0 Bentonite Slurry ❑Other(explain under 7g)
!Monitoring ❑Recovery
Injection Well: 7E For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation .54 cu ft
❑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) OTracer
❑Geothermal(Hcating/CoolingReturn) ❑Other(explain under 7g) Trimmie grout with neat cement
4.Date well(s) 3/20/2024 abandoned: �,-
a
Sa.Well location:
Williams Pipeline Transco Station 150 4PR 1 2024
Facility/Owner Name Facility ID#(if applicable) 8.Certiftcation: ktiv- inLrii..:wo'1236 Transco Rd., Mooresville, NC, 28117 /4', 7 Dwc% , �.�O. r/ r �02 4
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Iredell 465619445
By signing this form,I hereby certf 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.
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:
35° 31' 31.50r" N 80° 51' 32.60" 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)ijavailable.For multiple infection ornon-water supply wells •
ONLY with the same construction/abandonment,you can submit one form.
MW-10 10a.For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 24.5 (it.) 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:
6d Water level below ground surface: 16.16 (ft) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
do.Outer casing length(if known): N/A (ft) 10c.For Water Supply&Infection Wells: In addition to sending the form to the
address(es)above,also submit one copy of this form within 30 days of completion
of well abandonment to the county!health department of the county where
6f.Inner casing/tubing length(if known): 33.70 (ft) abandoned.
6g.Screen length(if known): 9 (ft)
Form GW-30 North Carolina Department ofEnvironniental Quality-Division of Water Resources Revised 2-22-2016
•

WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS I
Marc Howie 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
3554-A wells abandoned: j
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): •87 (gal.)
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Company Name N/A
7c.Type of disinfectant used:
2.Well Construction Permit#: N/A
List all applicable well construction permits(i.e.UIC,County.State,Variance,etc.)ij own
7d.Amount of disinfectant used: N/A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public C 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 0 Drill Cuttings
Mitigation 0 Specialty Grout 0 Gravel
Non-Water Supply Well: 0 Bentonite Slurry ❑Other(explain under 7g)
INIMonitoting ❑Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation 54 cu ft
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑Stotmwater Drainage
❑Experimental Technology OSubsidence Control
7g.Provide a brief description of the abandonment procedure:
❑Geothennal(Closed Loop) ❑Tracer
❑Geothcrmal(Heating/CoolingReturn) ❑Other(explain under 7g) Trimmie groutwith;neat cement
:r•
r-
4.Date well(s)abandoned: 3/20/2024 i o, d ` v; 0
5a.Well location: APR e7 1 2024
Williams Pipeline Transco Station 150
Facility/Owner Name Facility ID#(if applicable) 8.Certification: info'�* 'Eil �f-+2.` •y uStt
236 Transco Rd., Mooresville, NC, 28117 "Q''"'
�� 3/20/2024
Physical Address,City,and Zip Signature of Well Contractor or Well Owner" Date
Iredell 465619445 By signing this form,I hereby certrfy 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 ben 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:
35° 31' 31.50" N 80° 51' 32.60" 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 nndt/ple injection or non-water supply wells
ONLY with the same construction/abandonment,you can submit one fonn.
MW-11 10a. For All Wells: Submit this:foim within 30 days of completion of well
6a.Well ID#: abandonment to the following: ;'
Division of Water Resources,Information Processing Unit,
6b.Total well depth:24-5 (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617
10b.For Infection Wells: In addition to sending the form to the address in 10a
6c.Borehole diameter:2 (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: 1 9.19 (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): N/A (ft.) 10c.For Water Supply&Iniectioh Wells: In addition to sending the form to the
address(es)above,also submit one copy of this form within 30 days of completion
2650 of well abandonment to the county health department of the county where
6f.Inner casing/tubing length(if;mown): (ft,) abandoned..
6g.Screen length(if known): 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!
Marc Howie 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
3554-A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s):4.02 (gal.)
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
CompanyName
7c.Type of disinfectant used: N/A
2.Well Construction Permit#: N/A
List all applicable well construction permits'Le.UIG Counry,State,Variance,etc)ifknown
7d.Amount of disinfectant used: N/A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public III Neat Cement Grout ❑Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
❑lndustriaVCommercial ❑Residential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings
❑Irrigation 0 Specialty Grout 0 Gravel
Non-Water Supply Well: 0 Bentonite Slurry Cl Other(explain under 7g)
IrlMonitoring ❑Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation .968 cu ft
❑Aquifer Storage and Recovery ❑Salinity Bather
❑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) Trimmie grout with neat cement
4.Date well(s)abandoned: 3/20/2024Q.
5a.Well location:
R 1 2024
Williams Pipeline Transco Station 150
Facility/Owner Name Facility ID#(if applicable) 8.Certification: inform 'e ;ar •St4 15('?,X
Qa
236 Transco Rd., Mooresville, NC, 28117 W. Lzc
3/20/2024
Physical Address,City,and Zip Signature o Certified Well Contractor or Well Owner Date
Iredell 465619445 Bysigning thisform,I herebycerti that the well(s)was(were)abandoned in
g g Jr
County Parcel Identification No.(PIN) accordance with ISA 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:
(ifwell field,one lat/long is sufficient) 9.Site diagram or additional well details:
35° 31' 31.50" N 80° 51' 32.60" `Ir You may use the back of this page;to provide additional well site details or well
abandonment details. You may also attach additional pages ifuecessaty.
CONSTRUCTION DETAILS OF WELL(S)BEING ABANDONED SUBMITTAL INSTRUCTIONS
Attach well construction record(s)ifavailable.For multiple Injection ornon-water supply walls
ONLY with the same construction/abandonment,you can submit one form.
MW-11 D 10a.For All Wells: Submit this.form within 30 days of completion of well
6a.Weil ID#: abandonment to the following:
I
Division of Water Resources,Information Processing Unit,
1617 Mail Service Center,Raleigh,NC 27699-1617
6b.Total well depth:44 (ft.)
10b.For Infection Wells: In addition to sending the form to the address in 10a
6c.Borehole diameter:2 On) abandonment
also submit one copy of this form within 30 days of completion of well
abandonment to the following: !
lid.Water level below ground surface: 19.35 ((t) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): N/A (ft.) 10c.For Water Sanely&Infection Wells: In addition to sending the form to the
address(es)above,also submit one copy of this form within 30 days of completion
49.95 of well abandonment to the county health department of the county where
6L
Inner casing/tubing length(if known): (ft.) abandoned.
6g.Screen length(if known):4 • (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

! '
I I I
WELL ABANDONMENT RECORD For Internal Use ONLY: ,,
I
1.Well Contractor Information: WELL ABANDONMENT DETAILS,
Marc Howie 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
3554-A wells abandoned:
7b.Approximate volume of water lemainin in well(s):40.68 (gal.)
Well Contractor Certification Number PP , , g (g )
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Company Name
7c.Type of disinfectant used: N/A
2.Well Construction Permit#: N/A
List all applicable well construction permits(i.e.(NC,County.State,Variance,etc.)if blown A
7d.Amount of disinfectant used: N „
3.Well use(check well use): .
Water Supply Well: 7e.Sealing materials used(check all that apply):
OAgricultural OMunicipal/Public @ Neat Cement Grout 0 Bentonite Chips or Pellets
OGeothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout i 0 Dry Clay
Olndustrial/Commercial ❑Residential Water Supply(shared) O Concrete Grout 0 Drill Cuttings
Ol'rrigation 0 Specialty Grout 1 0 Gravel
Non-Water Supply Well: 0 Bentonite Slurry 0 Other(explain under 7g)
@Monitoring ❑Recovery
Injection Well: 7E For each material selected above,provide amount of materials used:
OAquifer Recharge OGroundwater Remediation 7.05 cu ft
OAquifer Storage and Recovery OSalinity Barrier
OAquifer Test OStormwater Drainage
❑Experimental Technology DSubsidence Control
7g.Provide a brief description of the abandonment procedure:
OGeothermal(Closed Loop) OTracer
OGeothermal(Heating/Cooling Return) ❑Other(explain under 7g)
Trimmie grout withJ�eat cement
3/20/2024 ri 1 E.'4.Date well(s)abandoned: APR a 1 2n24
5a.Well location:
Williams Pipeline In'a"' ' `�., '
Transco Station 150 �����t,..�
Facility/Owner Name Facility IDb(if applicable) 8.Certifies n:
236 Transco Rd., Mooresville, NC, 28117141' .(1; 3/20/2024
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Iredell 465619445
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 Iatfong is sufficient) 9.Site diagram or additional well details:
35° 31' 31.50" N 80° 51' 32.60" 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.
I
CONSTRUCTION DETAILS OF WELL(S)BEING ABANDONED SUBMITTAL INSTRUCTIONS
Attach well construction record(s)jfavailab!e.For multiple injection or non-water supplywells
ONLY with the same construction/abandonment,you can submit one form.
102. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID!!: MW-12 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 81 (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617
I
10b.For Infection Wells: In addition to sending the form to the address in 10a
6c.Borehole diameter:4 (m) 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: 18.71 (ft) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
1
N/A 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 co of this form within 30 Copy days of completion
8370 of well abandonment to the county;health department of the county where
6f. .
Inner casing/tubing length(if known): (ft.) abandoned.
6g.Screen length(if known):4•5 (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
Marc Howie 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
3554-A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s):(s): (gal.)
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Company Name 7c.Type of disinfectant used: N/A
2.Well Construction Permit#: N/A
List all applicable well construction pen nits f.e.UIC,County,State,Variance,etc.)if known
7d.Amount of disinfectant used: N/A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public a Neat Cement Grout 0 Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑Sand Cement Grout 0 Day Clay
❑Industrial/Commercial ❑Residential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings
['Irrigation 0 Specialty Grout 0 Gravel
Non-Water Supply Well: 0 Bentonite Slurry 0 Other(explain under 7g)
UMonitoring ❑Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation 2.13 cu ft
❑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 Trimmie grout with neat cement
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g)
4.Date well(s)abandoned: 3/20/2024
q
APP. 1 2G24
5a.Well location:
Transco Station 150
Williams Pipeline 5+,�.�:,�:-;, •�-,.� '(
nx
Facility/Owner Name Facility ID#(if applicable) 8.Certification: LPrr`(il l i
236 Transco Rd., Mooresville, NC, 28117 ,44 /101.0,{)
3/20/2024
Physical Address.City,and Zip Signature of Certified Well Contractor or Well Owner Date
Iredell 465619445
By signing this form,I hereby cert5 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 1at/long is sufficient) 9.Site diagram or additional well details:
35° 31' 31.50" N 80° 51' 32.60" 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 conseuctionrecord(s)ifavailable.For multiple injection or non-water supply wells
ONLY with the same construction/abandonment,you can submit one form.
MW-13 10a.For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: abandonment to the following: I
Division of Water Resources,Information Processing Unit,
1617 Mall Service Center,Raleigh,NC 27699-1617
6b.Total well depth: 96.5 (ft.)
10b.For Injection 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: I
Division of Water Resources,Underground Injection Control Program,
6d.Water level below ground surface: 18.11 (ft)
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): N/A (IL) 10c.For Water Sum*&Injection Wells: In addition to sending the form to the
address(es)above,also submit one copy of this fort within 30 days of completion
9875 of well abandonment to the county,health department of the county where
6f.Inner casing/tubing length(if known): (ft.) abandoned..
6g.Screen length(if known):4.5 (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources I Revised 2-22-2016
1

i
i
WELL ABANDONMENT RECORD For Internal Use ONLY: j ,
1.Well Contractor Information: WELL ABANDONMENT DETAII!S
Marc Howie 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
3554-A wells abandoned:
NC Well Contractor Certification Number • 7b.Approximate volume of water remaining in well(s):2.39 (gal.)
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Company Name
7c.Type of disinfectant used: N/A
2.Well Construction Permit#: N/A
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)if known
7d.Amount of disinfectant used: N/A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public U Neat Cement Grout ❑Bentonite Chips or Pellets
OGeothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
❑lndustrial/Commercial ❑Residential Water Supply(shared) ❑Concrete Grout ❑Drill Cuttings
❑Irrigation 0 Specialty Grout 0 Gravel
Non-Water Supply Well: 0 Bentonite Slurry ❑Other(explain under 7g)
UMonitoring ❑Recovery
Injection Well: 7L For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation .84 cu ft
❑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 Trimmie grout with heat cement
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g) j
L.:Cw+'11.,,',.i`'a iwee 1--)
3/21/2024 .-....v
4.Date well(s)abandoned: A ttR .7 1 202 R
5a.Well location:
Transco Station 150 In"`"'� `-
Williams Pipeline � • � •-�.."�;4;;�2 U��.
Facility/Owner Name FaclityION(if applicable) 8.Certification: I> rt^,,1
236 Transco Rd., Mooresville, NC, .28117 /0"1/1„. A'` y 3/21/2024
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Iredell 465619445
By signing this form,I 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:
(if well field,one 1at/long is sufficient) 9.Site diagram or additional well details:
35° 31' 31.50" N 80° 51' 32.60" 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 constructionrecord(s)((available.For multiple infection 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/l: M W-14 abandonment to the following: ,
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 38 (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617
106.For Infection Wells: In addition to sending the form to the address in 10a
6c.Borehole diameter:2 fin,) above,also submit one copy of this form within 30 days of completion of well
abandonment to the following
Division of Water Resources,Underground Injection Control Program,
6d.Water level below ground surface:23.36 (ft.)
1636 Mail Service Center,Raleigh,NC 27699-1636
•
6e.Outer casing length(if known): N/A (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
39.20 of well abandonment to the county' health department of the county where
6f.Inner casing/tubing length(if known): (ft.) abandoned.
6g.Screen length(if known): 5 (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016
I
i

WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT L1 DETAILS i
Marc Howie il
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
3554-A wells abandoned: 1
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): 83.56 (gal.)
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Company Name
lc.Type of disinfectant used: N/A
2.Well Construction Permit#: N/A i
List all applicable well construction permits(i.e.UItn County,State,Variance,etc.)if known
7d.Amount of disinfectant used: N/A
3.Well use(check well use):
I
Water Supply Well: • 7e.Sealing materials used(check all that apply): .
❑Agricultural ❑Municipal/Public 'Neat Cement Grout 0 Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
❑IndustriallCommercial ❑Residential Water Supply(shared) 0 Concrete Grout ❑Drill Cuttings
❑Irrigation 0 Specialty Grout 0 Gravel
Non-Water Supply Well: 0 Bentonite Slurry 0 Other(explain under 7g)
'Monitoring ❑Recovery
Injection Well: 7L For each material selected above,provide amount of materials used:
❑Aquifer Recharge , ❑Groundwater Remediation 14.7 Cu ft . 1
❑Aquifer Storage and Recovery ❑Salinity Barrier 1. ''
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology ❑Subsidence Control 7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer Trimmie grout with neat cement
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g)
t '
4.Date well 3/21/2024
s)abandoned: �t s tr~ 3,4
Sa.Well location: APR 0 1 zuz4
Williams Pipeline Transco Station 150 ;tnia;;rri z a,ter, � � .
^.
,
Facility/Owner Name Facility lD/l(if applicable) S.Certifica on: ` Di -
236 Transco Rd., Mooresville, NC, 28117 3/21/2024
Physical Address,City,and Zip Signature ofCertJ Well Contractor or Well Owner Date
Iredell 465619445 By signing this form,I hereby cert10.tliat the well(s)was(were)abandoned in
County Parcel Identification No.(PIN) accordance with ISA NCAC 02C.0100 or 2C.0200 Well Construction Standards
and that a copy of this record has been provided to the well owner.
511 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:
35° 31' 31.50" N 80° 51' 32.60" 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 WELLS)BEING ABANDONED 1
Attach well construction record(s)ijavailable.For multiple Injection ornon-watersuppty wells SUBMITTAL INSTRUCTIONS
ONLY with the same construction/abandonment,you can submit one form. i 10a.For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: PW-1 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 75 (ft) 1617 Mail Service Center,Raleigh,NC 27699-1617
10b.For Iniection Wells: In additio t to sending the form to the address in 10a
6c.Borehole diameter: 6 cm) above,also submit one copy of this form within 30 days of completion of well
abandonment to the following. I i
6d.Water level below ground surface: 18.12 (ft) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,1 Raleigh,NC 27699-1636
1, :I
6e.Outer casing length(if known): N/A (ft) 10c.For Water Snooty&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
77.25 of well abandonment to the county health department of the county where
6E Inner casing/tubing length(if known): (ft.) abandoned.
6g.Screen length(if known): 10 (ft)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

F ,
WELL ABANDONMENT RECORD For Internal UscONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
Marc Howie 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
3554-A wells abandoned: I '
•
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s):2-34 (gal.)
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Company Name 7c.Type of disinfectant used: N/A
2.Well Construction Permit#: N/A
Llrt all applicable well construction permits(i.e.UIC,County,State,Variance.etc.)if known
7d.Amount of disinfectant used: N/A
3.Well use(check well use):
•
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public II Neat Cement Grout 0 Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
❑lndustrial/Commercial ❑Residential Water Supply(shared) ❑Concrete Grout ❑Drill Cuttings
❑Irrigation 0 Specialty Grout 0 Gravel
Non-Water Supply Well: 0 Bentonite Slurry ' 0 Other(explain under 7g)
UMonitoring ❑Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation ,375 cu ft
❑Aquifer Storage and Recovery OSalinity Bather
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology ❑Subsidence Control
7g.Provide a brief description of the abandonment procedure:
OGeothermal(Closed Loop) ❑Tracer Trimmie grout with neat cement
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g)
3/21/2024 ! • b
4.Date well(s)abandoned: ! '�" ''"'���i.�.d "^b
Sa.Well location: I H F'ti' jJ 1 2G24
Williams Pipeline Transco Station 150 ink; .r,�`n "^
Facility/Owner Name ' Facility ID#(if applicable) 8.Certifica n: 1vjb
,ti.�..5�z�f*,u;;aca U •
236 Transco Rd., Mooresville, NC, 28117 4] 3/21/2024
Physical Address,City,and Zip Si lure of Certified Well Contractor or Well Owner Date
Iredell 465619445
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:
35° 31' 31.50" N 80° 51' 32.6011 Nr 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 ornon-watersupply wells
ONLY with the same construction/abandonment,you can submit one form.
10a.For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: PZ-1 abandonment to the following:
•
Division of Water Resources,Information Processing Unit,
6b.Total well depth:75 (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617
1
10b.For Iniection Wells: In addition to sending the form to the address in 10a
6c.Borehole diameter: 1 (in.) above,also submit one copy of this form within 30 days of completion of well
abandonment to the following. I
Division of Water Resources,Underground Injection Control Program,
6d.Water level below ground surface: 17.90 (�)
1636 Mail Service Cent r,Raleigh,NC 27699-1636
6e.Outer casing length(if known): N/A ( ) 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 11141th department of the county where
6f.Inner casing/tubing length(if known): (ft.) abandoned.
•
6g.Screen length(if known): 77.25 (ft)
Form GW-30 ' North Carolina Department of Environmental Quality-Division of Water Resources I Revised 2-22-2016

r
WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS j
Marc Howie 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
3554-A . wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s):2•53 (gal.) •
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
1•
Company Name N/A
lc.Type of disinfectant used:
2.Well Construction Permit#: N/A 1 ,'
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)if known
7d.Amount of disinfectant used: N/A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(cheek all that apply):
❑Agricultural ❑Municipal/Public a Neat Cement Grout 0 Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
❑lndustrial/Commercial ❑Residential Water Supply(shared) 0 Concrete Grout j • 0 Drill Cuttings
❑Irrigation 0 Specialty Grout ) • 0 Gravel
Non-Water Supply Well: 0 Bentonite Slurry I ❑Other(explain under 7g)
IMMonitoring ❑Recovery
Injection Well: 7£For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation .66 cu ft I. '
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology ❑Subsidence Control 7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer I'
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g) Trimmie grout with neat cement
�:.
4.Date well(s)abandoned: ,.
3/21/2024 i"+
5a.Well location: APR
Williams Pipeline Transco Station 150 I: ' t'� i 2024
1.
Facility/Owner Name Facility ID#(if applicable) 8.Certi cation: it,."• . 7 ,•...
236 Transco Rd., Mooresville, NC, 28117 1 la"" 3 ..�
���1/2024
Physical Address,City,and Zip Signature of Certified Well C n for or Well Owner Date
fredell 465619445 signing thisform,I herebycerti I that the well(s)was(were)abandoned in
By g g Iy�
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 let/long is sufficient) 9.Site diagram or additional well details:
35° 31' 31.50" N 80° 51' 32.60° 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 I'
Attach well construction record(s)illimitable.For multiple injection or non-water supply wells I, ,
ONLY With the same construction/abandonment you can submit one form. I
10a.For All Wells: Submit this form within 30 days of completion of well
6a.Well lD#: M W-13-1 abandonment to the following:
i'
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 30 (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617
10b.For Infection Wells: In additi I to sending the form to the address in 10a
6c.Borehole diameter:2 (m.) 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: 14.50 (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
iI
6e.Outer casing length(if known): N/A (ft.) 10c.For Water Supply&Infection Wells: In addition to sending the form to the
address(es)above,also submit one copy of this form within 30 days of completion
2975 of well abandonment to the county` health department of the county where
6f.Inner casing/tubing length(if known): (ft,) abandoned..
6g.Screen length(if known): 15 (it.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources I Revised 2.22.2016

WELL ABANDONMENT RECORD For lntcmal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
Marc Howie 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
3554-A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s):2.53 (gal)
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Company Name 7c.Type of disinfectant used: N/A
2.Well Construction Permit#: N/A
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)ifknoum
7d.Amount of disinfectant used: N/A
3.Well use(check well use):
•
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public s Neat Cement Grout 0 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 0 Drill Cuttings
❑Irrigation ❑Specialty Grout ❑Gravel
Non-Water Supply Well: ❑Bentonite Slurry ❑Other(explain under 7g)
('Monitoring ❑Recovery
Injection Well: 7E For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation .66 cu ft
❑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 Trimmie grout with neat cement
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g)
3/21/2024 `4R�
4.Date well(s)abandoned: --k;4...i.a' 1, ,, `�' ,-
5a.Well location: Alf W
Williams Pipeline Transco Station 150 t i0Zg
8.Certification: ; `"'�?r
Facility/Owner Name Facility ID#(if applicable) E��,��� fir' N4;,
236 Transco Rd., Mooresville, NC, 28117 r% ` °3/21/ 024
Physical Address,City,and Zip Signature of citified Well Contractor or Well Owner Date
Iredell 465619445 1
By signing this form,1 hereby certijy''that the well(s)was(were)abandoned in
County Parcel Identification No.(PIN) accordance with ISA 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:
35° 31' 31.50" N 80° 51' 32.60" 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.Far mulhple 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#: M Y YlA�-13-2 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth:30 (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617
10b.For Infection Wells: In addition to sending the form to the address in 10a
6c.Borehole diameter:2 (in.) . above,also submit one copy of this fours within 30 days of completion of well
abandonment to the following: i
14.50 Division of Water Resources,Underground Injection Control Program,
6d.Water level below ground surface: (ft.)
1636 Mail Service Center,Raleigh,NC 27699-1636
1
6e.Outer casing length(if known): N/A (ft.) 10c.For Water Simply&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
2975 of well abandonment to the county health department of the county where
.
6f.Inner casing/tubing length(if known): (ft.) . abandoned.
6g.Screen length(if known): 15 (ft)
I
• 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
Marc Howie 7a.For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same
Well Contractor Name(or well owner personally abandoning well on his/berproperty) well construction/depth,only 1 GW-30 is needed. Indicate TOTAL NUMBER of
3554-A wells abandoned: i
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s):2.53 (gal.)
McCaII Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Company Name
7c.Type of disinfectant used: N/A
2.Well Construction Permit#: N/A
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)ifdnown
7d.Amount of disinfectant used: N/A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public s Neat Cement Grout ❑Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
❑lndustrial/Commercial ❑Residential Water Supply(shared) ❑Concrete Grout ❑Drill Cuttings
❑Irrigation 0 Specialty Grout 0 Gravel
Non-Water Supply Well: 0 Bentonite Slurry 0 Other(explain under 7g)
eMonitoring ❑Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑GroundwaterRemediation .66 cu ft
❑Aquifer Storage and Recovery ❑Salinity Bather
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology ❑Subsidence Control
7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer Trimmie grout with neat cement
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g)
4.Date well(s) 3/21/2024
abandoned: �1,�;� ��.�;'• ,��—.;
58.Well location: •t
Williams Pipeline Transco Station 150 APR ®a i Z024
Facility/Owner Name FactilityID#(if applicable) 8.Certification: 1R��;;:�;,�• _�
236 Transco Rd., Mooresville, NC, 28117 "3f2�1/2024
Physical Address,City,and Zip Si/ 'fli
of Certified Well Contractor or Well Owner Date
Iredell 465619445 Bysigning thisform, I certi that the well(s)was(were)abandoned in
g s hereby Iy�
County Parcel Identification No.(PIN) accordance with IBA 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:
(if well field,one lat/long is sufficient) �f 9.Site diagram or additional well details:
35° 31' 31.50" N 80° 51' 32.60" 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 i
ONLY with the same construction/abandonment,you can submit oneform.
10a.For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: M W-13-3 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 30 (ft) 1617 Mail Service Center,Raleigh,NC 27699-1617
10b.For Infection Wells: In addition to sending the form to the address in 10a
6c.Borehole diameter:2 (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: 14.50 (ft) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
N/A10c.For Water Sunaly&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
29.75 of well abandonment to the county health department of the county where
6f.Inner casing/tubing length(if known): • (ft.) abandoned
6g.Screen length(if known): 15 (ft)
ii
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:
1
1.Well Contractor Information: WELL ABANDONMENT DETAIL'S ,
Marc Howie 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
3554-A wells abandoned: i i
7b.Approximate volume of water remaining in well(s): 57.70 al NC Well Contractor Certification Number PP t g (g )
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Company Name lc.Type of disinfectant used: NIA
2.Well Construction Permit II: N/A
•
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)ifknown
7d.Amount of disinfectant used: N/A
3.Well use(check well use):
I
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public NI Neat Cement Grout 0 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 0 Drill Cuttings
❑Irrigation ❑Specialty Grout 0 Gravel
Non-Water Supply Well: ❑Bentonite Slurry 0 Other(explain under 7g)
eMordtoring ❑Recovery
Injection Well: 7f.For each material selected above,'provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation 1.1 Cu ft
❑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) OTracer Trimmie grout with neat cement
OGeothermal(Heating/Cooling Return) ❑Other(explain under 7g)
3/21/2024 -` ~�
4.Date well(s)abandoned: >- t.i, *_�T
5a.Well location: A PR
aWilliams Pipeline Transco Station 150 - LC24
Facility/Owner Name Facility ID#(if applicable) 8.Certification: 1N.; 1.-..,•i:-1 .'Dr
236 Transco Rd., Mooresville, NC, 28117
`'t'' -'(33�2t1:%2024
Physical Address,City,and Zip Signature of edified Well Contractor or Well Owner Date
Iredell 465619445
By signing this form,I hereby certify that the well(s)was(were)abandoned in
County Parcel Identification No.(PIN) accordance with ISA 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: ;
(ifwell field,one lat/long is sufficient) 9.Site diagram or additional well details:
35° 31' 31.50" N 80° 51' 32.60" 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-watersupplywells
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#: M Y V�A/-13-3D abandonment to the following:
1
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 50 (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617
lob.For Infection 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: 1
I
6d.Water level below ground surface: 14.60 (ft) Division of Water Resources,Underground Injection Control Program,
1636 Mall Service Center,Raleigh,NC 27699-1636
10c.For Water Supply&Infection Wells: In addition to sending the form to the
6e.Outer casing length(if known): N/A (ft.)
address(es)above,also submit one copyof this form within 30 days of completion
of well abandonment to the county health department of the county where
6f.Inner casing/tubing length(ifc 'mown): 50 (ft.) abandoned.
6g.Screen length(if known): 5 (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 DETAIL'S I
Marc Howie 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
3554-A wells abandoned: 1
•
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s):2.53 (gal.)
I '
McCall Brothers inc FOR WATER SUPPLY WELLS ONLY:
Company Name 7c.Type of disinfectant used: N/A
Z.Well Construction Permit#: N/A
List all applicable well construction permits(Lc.UIC,County,State,Variance,etc.)rf/mown
7d.Amount of disinfectant used: N/A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public a Neat Cement Grout 0 Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
❑lndustrial/Commercial ❑Residential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings
❑Irrigation 0 Specialty Grout I 0 Gravel
Non-Water Supply Well: 0 Bentonite Slurry 0 Other(explain under 7g)
IMMonitoring ❑Recovery
Injection Well: 7f.For each material selected above;provide amount of materials used:
❑Aquifer Recharge ❑GroundwaterRemediation ,67 Cu ft I
❑Aquifer Storage and Recovery ❑Salinity Bather
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology ❑Subsidence Control
7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer Trimmie grout with neat cement
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g) 1
It'�K .,�. , . ;?..
3/21/2024 y{' illa�ti
4.Date well(s)abandoned: r
5a.Well location: Q r P 1 tUj4
Williams Pipeline Transco Station 150 '"f., ..
.•",,.:tt Jr.+
Facility/Owner Name FacilityIDka applicable) 8.Certificatio : C,W ,,,.,, ,"'g Ur,.
(ifPP ) ot/`u
236 Transco Rd., Mooresville, NC, 28117 3/21/2024
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Iredell 465619445 Bysigning this orm,I hereby cent that the well(s)was(were)abandoned in
� g f � ly'
County Parcel Identification No.(PIN) accordance with ISA 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 lot/long is sufficient) 9.Site diagram or additional well details:
35° 31' 31.50" N 80° 51' 32.60" W You may use the back of this page to provide additional well site details or well ,
abandonment details. You may also attach additional pages if necessary.
CONSTRUCTION DETAILS OF WELL(S)BEING ABANDONED SUBMITTAL INSTRUCTIONS
Attach well construction record(s)ifavailable.For multiple injection or non-water supply wells ,
ONLY with the same construction/abandonment,you can submit one form.
MW-13-4 10a.For All Wells: Submit this form within 30 days of completion of well
6a.Well IN: abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 30 (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617
10b.For Injection Wells: In additionItoisending the form to the address in 10a •
6c.Borehole diameter: 2 (in.) above,also submit one copy of this foimj within 30 days of completion of well
abandonment to the following. I
6d.Water level below 14.50 ( ) Division of Water Resources,Underground Injection Control Program,
ground surface: ft.
1636 Mail Service Center,Raleigh,NC 27699-1636
I
6e.Outer casing length(if known): N/A (ft.) 10c.For Water Supply&Injection Wells: In addition to sending the form to the
address(es)above,also submit one copyjof this form within 30 days of completion
29.65 of well abandonment to the county health department of the county where
6f..Inner casing/tubing length(if known): (ft.) abandoned
6g.Screen length(if known): 15 (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
Marc Howie 7a.For Geoprobe/DPT or Closed-LI op Geothermal Wells having the same
Well Contractor Name(or well owner personally abandoning well on his/her property) well construction/depth,only I GW-30 is needed. Indicate TOTAL NUMBER of
3554-A wells abandoned: I 1
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): 1'81 (gal.)
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Company Name
7c.Type of disinfectant used: N/A
2.Well Construction Permit it: N/A
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)if known
7d.Amount of disinfectant used: N/A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public IN Neat Cement Grout 0 Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑Sand Cement Grout ❑Dry Clay
❑lndustrial/Commercial ❑Residential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings
Obligation 0 Specialty Grout 0 Gravel
Non-Water Supply Well: 0 Bentonite Sluny 0 Other(explain under 7g)
Monitoring ❑Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation ,67 cu ft
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology OSubsidence Control 7g.Provide a brief description of the1abandonment procedure:
❑Geothermal(Closed Loop) OTracer
❑Gcothennal(Hcating/CoolingReturn) ❑Other(explain under 7g) Trimmie grout with neat cement
3/21/2024 r .�
4.Date well(s)abandoned: ' /� �, ; t '� ' ",1 /
5a.Well location:
Williams Pipeline Transco Station 150 laPR, CQ?A
Facility/Owner Name Facility ID#(if applicable) 8.CertificaHo fl v; • •;
236 Transco Rd., Mooresville, NC, 28117 1 G cl'` G /21/2024
Physical Address,City,and Zip Signature of Certi led Well Contractor or Well Owner Date
lredell 465619445
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/loog is sufficient) 9.Site diagram or additional well details:
35° 31' 31.50" N 80° 51' 32.60" 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 WELLS)BEING ABANDONED SUBMITTAL INSTRUCTIONS
Attach well constrod ion record(s)(favailable.For multiple injection or non-water supply wells
ONLY with the same construction/abandonment,you can submit one form.
IOa.For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: MW-13-5 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 30 (ft) 1617 Mail Service Center,Raleigh,NC 27699-1617
10b.For Infection Wells: In additionjto sending the form to the address in 10a
6c.Borehole diameter:2 (In-) above,also submit one copy of this foim within 30 days of completion of well
abandonment to the following:
6d.Water level below ground surface: 18.92 (ft.) Division of Water Resources,Und Irground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): N/A (1t 10c.For Water Supply&Injection Wills: 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): 33-50 (ft.) abandoned.
6g.Screen length(if known): 15 (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2 22-2016

}
i
I �
WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
Marc Howie 7a.For Geoprobe/DPT or Closed-Loop op Geothermal Wells having the same
Well Contractor Name(or well owner personally abandoning well on higher property) well construction/depth,only I GW-30 is needed. Indicate TOTAL NUMBER of
3554-A wells abandoned: 1
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): 2.45 (gal.)
1
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Company Name
7c.Type of disinfectant used: NIA
2.Well Construction Permit#: N/A
List all applicable well construction permits(.e.UIC,County,State,Variance,etc.)ifknown
7d.Amount of disinfectant used: N/A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public s Neat Cement Grout ❑Bentonite Chips or Pellets
❑Geothemtal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑Sand Cement Grout ; 0 Dry Clay
❑Industrial/Commercial OResidential Water Supply(shared) 0 Concrete Grout i 0 Drill Cuttings
❑Irrigation 0 Specialty Grout 0 Gravel
Non-Water Supply Well: 0 Bentonite Slurry 1 0 Other(explain under 7g)
191Monitoring ❑Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation .67 cu ft
❑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 Trimmie grout with neat cement
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g)
4.Date well(s)abandoned: 3/21/2024 /"
5a.Well location: r 4., _.,,,t if S a
Williams Pipeline Transco Station 150 'Q Eta ' d
Facility/Owner Name Facility ID#(if applicable) 8.Certification: lt,;o
236 Transco Rd., Mooresville, NC, 28117
Physical Address,City,and Zip Signature of Certified Weil0-014-4z,QPIQ;11.--.0„,-----a'no/21/2024
tor or Well Owner Date
Iredell 465619445 By signing this form,I hereby certifr that the well(s)was(woe)abandoned in
County Parcel Identification No.(PIN) accordance with ISA 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:
35° 31' 31.50" N 80° 51' 32.6011 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 canstrucion/abandonment,you can submit one Jane.
10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well m#: MW-13-6 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth:30 (ft-) 1617 Mail Service Center,Raleigh,NC 27699-1617
10b.For Infection Wells: In addition to sending the form to the address in 10a
6c.Borehole diameter:2 (in.) above,also submit one copy of this form within 30 days of completion of well
abandonment to the following: 1
Division of Water Resources,Undel ground Injection Control Program,
6d.Water level below ground surface: 15 (ft)
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): N/A (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): 29.60 (ft) abandoned. I
6g.Screen length(if known): 15 (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
!! I
Marc Howie 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
3554-A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water l remaining in well(s):2 58 (gal.)
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Company Name
7c.Type of disinfectant used: N/A
2.Well Construction Permit#: N/A
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)if known N
7d.Amount of disinfectant used: V/A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public !Neat Cement Grout 0 Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
❑lndustriallCommercial ❑Residential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings
❑Irrigation 0 Specialty Grout 0 Gravel
Non-Water Supply Well: 0 Bentonite Slurry,
Cl Other(explain under 7g)
!Monitoring ❑Recovery
Injection Well: 7f.For each material selected above,'provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation .67 cu ft
❑Aquifer Storage and Recovery OSalinity Bather
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology ❑Subsidence Control 7g.Provide a brief description of the abandonment procedure:
❑Geothemral(Closed Loop) ❑Tracer Trimmie grout with neat cement
0 Geothermal(Heating/Cooling Return) 0 Other(explain under 7g)
4.Date mils)abandoned:3/21/2024 r _ .&
5a,Well location: 1
N PH
1 1 21'?
Williams Pipeline Transco Station 150. in; -1
Facility/Owner Name Facility 1D (if applicable) 8.Certifrcation:
Iv.+Oi?t f ,.,*:: Lint236 Transco Rd., Mooresville, NC, 28117 ��/ 't �¢� 0(' 3/21/2024
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Iredell 465619445 By signing this form,1 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.
Sb.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one lat/ong is sufficient) 9.Site diagram or additional well details:
35° 31' 31.50" N 80° 51' 32.60" 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 WELLS)BEING ABANDONED SUBMITTAL INSTRUCTIONS
Attach well construction record(s)ifavailable.For multiple infection 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 Mil: M W-13-7 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 30 (ft) 1617 Mail Service Center,Raleigh,NC 27699-1617
•
10b.For Infection Wells: In addition'to sending the form to the address in 10a
6c.Borehole diameter:2 (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: 14.17 (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mall Service Centc i,Raleigh,NC 27699-1636
6e.Outer casing length(it known): N/A (ft.) 10e.For Water Supply&Infection Wells: In addition to sending the form to the
address(es)above,also submit one copy of this form within 30 days of completion
of well abandonment to the county health department of the county where
• 6f.Inner casing/tubing length(if known):3(10 (ft) abandoned• it
6g.Screen length(if known): 15 (ft.) •
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
t •
Marc Howie 7a.For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same
Wcl1 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
3554-A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): •40 (gal)
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Company Name 7c.Type of disinfectant used: N/A
2.Well Construction Permit#: N/A
List all applicable well conrtntctlon permits(i.e.UIC,County,State,Variance,etc)if known
7d.Amount of disinfectant used: N/A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public @ Neat Cement Grout I 0 Bentonite Chips or Pellets
❑Geothermal(Heating/Coaling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
❑Industrial/Commercial ❑Residential Water Supply(shared) 0 Concrete Grout ❑Drill Cuttings
❑Irrigation 0 Specialty Grout 0 Gravel
Non-Water Supply Well: 0 Bentonite Slurry 0 Other(explain under 7g)
@Monitoring ❑Recovery ,
Injection Well: 7f.For each material selected above;provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation .15 cu ft
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology ❑Subsidence Control
7g.Provide a brief description of the;abandonment procedure:
DGeothermal(Closed Loop) ❑Tracer Trimmie grout with heat cement
-❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g)
4.Date well 3/21/2024 abandoned: '1." " I1 �' JJJJ
Ss.Well location: f'h' I i V
Williams Pipeline Transco Station 150 1 AN,ni•
Facility/Owner Name Facility ID#(if applicable) 8.Certification: f i�•.i ,a';
236 Transco Rd., Mooresville, NC, 28117 f C%fr t y 312 cs
1 024
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Iredell 465619445
By signing this form,I hereby certO,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 lat/long is sufficient) 9.Site diagram or additional well details:
35° 31' 31.50" N 80° 51' 32.60" 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)iiavailable.For multiple injection or non-water supply wells
ONLY with the same construction/abandonment,you can submit one form.
p 10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: r-1 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 30 (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: 1 (in,) above,also submit one copy of this fort within 30 days of completion of well
abandonment to the following:
I '
6d.Water level below ground surface:20.20 (ft) Division of Water Resources,Underground Injection Control Program,
1636 Mall Service Center,Raleigh,NC 27699-1636
fi
6e.Outer casing length(if known): N/A (ft,) 1Oc.For Water Supply&Infection Wells: In addition to sending the form to the
address(es)above,also submit one copy of this form within 30 days of completion
2950 of well abandonment to the county health department of the county where
.
6f.Inner casing/tubing length(if known): (ft) abandoned.
6g.Screen length(if known): 5 (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016
i

WELL ABANDONMENT RECORD For Internal Usc ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS'.
Marc Howie
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
3554-A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): •34 (gal.)
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Company Name N/A
7c.Type of disinfectant used:
2.Well Construction Permit#: N/A
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)if blown
7d.Amount of disinfectant used: N/A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public a Neat Cement Grout 0 Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
❑lndustrial/Commercial ❑Residential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings
❑Irrigation 0 Specialty Grout 0 Gravel
Non-Water Supply Well: 0 Bentonite Slurry 0 Other(explain under 7g)
eMonitoring ❑Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation .15 cu ft
❑Aquifer Storage and Recovery OSalinity Barrier
❑Aquifer Test ❑Stonnwater Drainage
❑Experimental Technology ❑subsidence Control 7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) OTracer
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g) Trimmie grout with neat cement
4.Date well(s)abandoned:3/21/2024
Yr
5a.Well location: AP l� '[UZ4
Williams Pipeline Transco Station 150 c
Facility/Owner Name Facility ID#(if applicable) 8.Certifies'on: Gip).-,` •
236 Transco Rd., Mooresville, NC, 28117 3/21/2024
Physical Address,City,and Zip Signature o rtified Well Contractor or Well Owner Date
Iredell 465619445 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:
35° 31' 31.50" N 80° 51' 32.60" 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 accessary.
CONSTRUCTION DETAILS OF WELLS)BEING ABANDONED SUBMITTAL INSTRUCTIONS
Attach well construction record(s)ifavailable.For multiple injection ornon-watersupply wells 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.Well1D#: P-2 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 30 (ft.) 1617 Mall Service Center,Raleigh,NC 27699-1617
10b.For Injection Wells: In addition to sending the form to the address in 10a
6c.Borehole diameter: 1 (in.) above,also submit one copy of this form within 30 days of completion of well
abandonment to the following: 1
i
6d.Water level below ground surface:21.65 (ft) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): N/A (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 Of known): 29.95 (ft,) abandoned.
•
6g.Screen length(if known): 5 (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 DETAILS
Marc Howie 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
3554-A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): •57 (gal.)
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Company Name 7c,Type of disinfectant used: N/A
2.Well Construction Permit#: N/A
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)if known
7d.Amount of disinfectant used: N/A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public a Neat Cement Grout 0 Bentonite Chips or Pellets
OGeothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
❑lndustrial/Commercial ❑Residential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings
❑Irrigation 0 Specialty 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:
❑Aquifer Recharge ❑Groundwater Remediation .15 cu ft
❑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) °TracerTrimmie grout with neat cement
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g)
4.Date well(s)abandoned: 3/21/2024 ; 'a "
5a.Well location: APR 0 1 2024
Williams Pipeline Transco Station 150 tn;v:,i, : 1�`'^
Facility/lhvnerName Facility ID#(if applicable) B.CertilieaN// .e,. ti U
236 Transco Rd., Mooresville, NC, 28117 Gtd ,
3/21/2024
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Iredell 465619445 Bysigning this form,I herebycerti that the well(s)was(were)abandoned in
g g f fy'
County Parcel Identification No.(PIN) accordance with ISA 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/ong is sufficient) 9.Site diagram or additional well details:
35° 31' 31.50" N 80° 51' 32.60" 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(r ifavailable.For multiple injection or non-water supplywells
ONLY with the same constniction/abandonment,you can submit one form.
10a.For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: P-3 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 30 (ft.) 1617 Mall Service Center,Raleigh,NC 27699-1617
106.For Infection Wells: In addition,to sending the form to the address in 10a
6c.Borehole diameter: 1 (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: 16.05 (ft) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): N/A (ft) 10e.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
2930 of well abandonment to the county health department of the county where
6f.Inner casing/tubing length(if known): (ft.) abandoned..
6g.Screen length(if known): 5 (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources j Revised 2-22-2016

WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
Marc Howie 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
3554-A wells abandoned: i
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): .36 (gal.)
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Company Name -
7c.Type of disinfectant used: N/A
2.Well Construction Permit#: N/A
List all applicable well construction permits(i.e.UIC,County,Stale,Variance,etc.)ifblown
7d.Amount of disinfectant used: N/A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public @ Neat Cement Grout 0 Bentonite Chips or Pellets
OGeothermal(Heating/Cooling Supply) DResidential Water Supply(single) 0 Sand Cement Grout i 0 Dry Clay
❑lndustrial/Commercial DResidential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings
Mitigation 0 Specialty Grout 0 Gravel
Non-Water Supply Well: 0 Bentonite Slurry ❑Other(explain under 7g)
@Monitoring DRecovery
Injection Well: 7f.For each material selected above;provide amount of materials used:
❑Aquifer Recharge ['Groundwater Remediation .15 cu ft
❑Aquifer Storage and Recovery OSalinity Barrier
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology ❑Subsidence Control 7g.Provide a brief description of the abandonment procedure:
OGeothermal(Closed Loop) DTracer
OGeothermal(Heating/Cooling Return) DOther(explain under 7g) Trimmie grout with neat cement
' r;�
4.Date well(s)abandoned: 3/21/2024
` J t ,+ ,
5n,Well location:
i 2u24
Williams Pipeline Transco Station 150 ,,,;:; „• :;
Ugt
Facility/Owner Name Facility ID#(if applicable) 8.Certification: IJµ`dJc
236 Transco Rd., Mooresville, NC, 28117
3/21/2024
Physical Address,City,and Zip Signa of Certified Well Contractor or Well Owner Date
Iredell 465619445 By signing this form,1 hereby cert fy'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 lat/long is sufficient) 9.Site diagram or additional well details:
35° 31' 31.50" N 80° 51' 32.60" �i, You may use the back of this page to provide additional well site details or well
abandonment details. You may also attach additional pages if necessary.
CONSTRUCTION DETAILS OF WELL(S)BEING ABANDONED SUBMITTAL INSTRUCTIONS
Attach well construction records)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-5 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 30.5 (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617
10b.For Injection Wells: In addition to sending the form to the address in 10a
6c.Borehole diameter: 1 (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: 21.83 (ft) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): N/A (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
30.15 of well abandonment to the county health department of the county where
6f.Inner casingltubing length(if known): (ft) abandoned.
6g.Screen length(if known): 5 (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:
Ii
I.Well Contractor Information: WELL ABANDONMENT DETAILS
Marc Howie
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
3554-A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): '57 (gal.)
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Company Name
7c.Type of disinfectant used: •
2.Well Construction Permit#: N/A
List all applicable well construction permits(i.e.UIC,County,Stare,Variance,etc)i(known
7d.Amount of disinfectant used: N/A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Pubiic !Neat Cement Grout 0 Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
❑Industrial/Commercial ❑Residential Water Supply(shared) ❑Concrete Grout 0 Drill Cuttings
❑Irrigation 0 Specialty Grout 0 Gravel
Non-Water Supply Well: ❑Bentonite Slurry• I El Other(explain under 7g)
!Monitoring ❑Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑GroundwaterRemediation .16 cu ft
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology ❑Subsidence Control
❑Geothermal(Closed Loop) ❑Tracer 7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g) Trimmie grout with neat cement
3/21/2024 � ���y •�-' "-
4.Date well(s)abandoned: °'"'' __.r. d f L.
5a.Well location: PR j)
Williams Pipeline Transco Station 150 Z024
p Facility/OwnerNaa Facility ID#(if applicable) 8.Certification: tn,L1+ }~Dye„ �'}.-'411g()MN
236 Transco Rd., Mooresville, NC, 28117 3/21/2024
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
lredell 465619445
By signing this form,1 hereby certlfr 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 let/long is sufficient) 9.Site diagram or additional well details:
35° 31' 31.50" N 80° 51' 32.60" `,i, You may use the back of this page to provide additional well site details or well
abandonment details. You may also attach additional pages if necessary.
CONSTRUCTION DETAILS OF WELL(S)BEING ABANDONED SUBMITTAL INSTRUCTIONS
Attach well construction record(s)ifavailable.For multiple injection or non-water supply wells
ONLY with the same construction/abandonment,you can submit one form. •
10a.For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: P-7 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.TotaI well depth:32 (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: 1 (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: 18 (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): N/A (ft.) 10c.For Water Sunni./&Infection Wells: In addition to sending the form to the
address(es)above,also submit one copy of this form within 30 days of completion
31.50 of well abandonment to the county health department of the county where
6f.Inner casing/tubing length(If known): (ft.) abandoned.
I
6g.Screen length(if known): 5 (ft.)
•
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources I . Revised 2-22-2016

WELL ABANDONMENT RECORD For Intcnio!Uac ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
Marc Howie 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 GW130 is needed. Indicate TOTAL NUMBER of
3554-A wells abandoned: I
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s):2.64 (gal.)
McCall Brothers Inc FOR WATER SUPPLY WELLS ONLY:
Company Name
7c.Type of disinfectant used:
2.Well Construction Permit#: N/A
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)(([known
7d.Amount of disinfectant used: N/A
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public IN Neat Cement Grout 0 Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
❑lndustriallCommercial ❑Residential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings
❑irrigation 0 Specialty 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:
❑Aquifer Recharge ❑Groundwater Remediation .77 cu ft
❑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 Trimmie grout with neat cement
❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g)
!
4.Date well(s)abandoned: 3/21 IZO24 e-' .-,4 c rde g,,,,,L,1
n^11117,
n 7 )
5a.Well location: H tn It tP 1 LG(,Q•
Williams Pipeline Transco Station 150 ,rc.f
Facility/Owner Name Facility ID#(if applicable) 8.Certification: j j';�'0,; 'a�S
236 Transco Rd., Mooresville, NC, 28117 `i/2 ,ICY 3/21/2024
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Iredell 465619445 Bysigning thisform,I hereby certi that the well(s)was were abandoned in
gg � t� (were)
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.
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:
35° 31' 31.50" N 80° 51' 32.6011
K, 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 WELLS)BEING ABANDONED SUBMITTAL INSTRUCTIONS i
Attach well construction record(s)(([available.For multiple injection ornon-watersupply wells
ONLY with the same construction/abandonment,you can submit one fonn.
10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: MWB-1 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 35 (ft) 1617 Mail Service Center,Raleigh,NC 27699-1617
10b.For Infection Wells: In addition to sending the form to the address in 10a
6c.Borehole diameter:2 (in) above,also submit one copy of this font within 30 days of completion of well
abandonment to the following: 1
Division of Water Resources,Underground Injection Control Program,
6d.Water level below ground surface: 18.81 (f4)
1636 Mail Service Center,Raleigh,NC 27699-1636
10c.For Water Supply&Injection Wells: In addition to sending the form to the
6e.Outer casing length(if known): N/A (ft.)
address(es)above,also submit one copy of this form within 30 days of completion
3480 of well abandonment to the county health department of the county where
6f.Inner casing/tubing length(if known): (ft.) abandoned..
6g.Screen length(if known): 10 (ft.)
i
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016