Craven_Well Abandonment_20240403 (7)

WELL ABANDONMENT RECORD For Internal Use ONLY:
This form can be used for single or multiple wells
1.Well Contractor Information: WELL ABANDONMENT DETAILS
William J. Miller 7a.Number of wells being abandoned: N/A
Well Contractor Name(or well owner personally abandoning well on his/her property) Fornadtiple hyecrion or non-u,atersupply wells ONLYwtth ilia same
constntctioniabandonmmni,you can submit one form.
2927A
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): N/A (gal.)
CATLIN Engineers and Scientists FOR WATER SUPPLY WELLS ONLY:
Company Name 7c.Type of disinfectant used: N/A
2.Well Construction Permit#: N/A
List all applicable well permits(i.e.County,Srate,Variance,Injection,etc.)ifknou,tt 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 El Neat Cement Grout ®Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑Sand Cement Grout ❑Dry Clay
❑Industrial/Commercial ❑Residential Water Supply(shared) ❑Concrete Grout ❑Drill Cuttings
❑Irrigation ❑Specialty Grout ❑Gravel
Non-Water Supply Well: ❑Bentonite Slurry ❑Other(explain under 7g)
■Monitoring ❑Recovery
Injection Well: 7E For each material selected above,provide amount of materials used:
❑Aquifer Recharge ❑Groundwater Remediation Bentonite Pellets +/-5 Ibs.
❑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) All well materials removed from boring then backfilled
with bentonite pellets for+/-0.5 feet below land surface.
4.Date well(s)abandoned: 12/19/2023
5a.Well Location:
PIE-PS
Facility/Owner Name Facility ID#(if applicable) 8•Certification:
�y
PIT 4, Havelock, NC 28532 •--'=�'"`�"""-'' Janua 22.2024
Physical Address,City,and Zip Signature of Certified Well actor or Well Owner Date
CRAVEN By signing this form I hereby certify that the mvell(s)was(were)abandoned in
County Parcel Identification No.(PIN) accordance with 15A NCAC 02C.0100 or 2C Well Construction Standards and
that a copy of this record has,been provided to the well owner.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.9089797 N -76.89038192 �y 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 nurlliple h jection or non-water supply
well ONLYwith the saute construction abandonment,you can submit onefornt 10a.For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: P4-TW25 I'R - abandonment to the following:
�.�c... V r._ ...
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 14.15 (ft.) APR 0 v 2024 1617 Mail Service Center,Raleigh,NC 27699-1617
InA swi2� r^ cr��LFy> 10b.For Iniection Wells: In addition to sending the form to the address in
]Oa above,also submit one copy of this form within 30 days of completion
6c.Borehole diameter: 2 (In.) G`tir'tt`�'JC of well abandonment to the following:
6d.Water level below ground surface: 7.6 (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): N/A 10c.For Water Supply&Iniection Wells: In addition to sending the form
to the address(es)above,also submit one copy of this form Within 30 days of
completion of well abandonment to the county health department of the
6f.Inner casing/tubing length(if known): 4.15(ft.) county where abandoned.
6g.Screen length(if known): 10 (ft.)
\2023\223060-PIE-PS-CHERRY POINT-DELINEATION,WELL INSTALL ABANDONMENT AND INJECTION PROJECTS\PIT 4-PHASE II LNAPL DELINEATIOMFIELD ITEMS\223060_PIT4_CHERRYPOINT.GPJ
Adapted from NCDENR-DWR Form GW-30 North Carolina Department of Environment and Natural Resources-Division of Water Resources Revised August 2013

ENVIRONMENTAL,CIVIL 10-4
GEOTECHNICAL UATL•>f1�.y
WELL LOG Wilrririgton,Raleigh.Washington, j 11�
CharlestonEngineers and Scientists
223060 SHEET 1 OF 1
lMlniiglon,NC
PROJECT NO.: 223060 STATE: NC COUNTY: CRAVEN LOCATION: Havelock
PROJECT: PIT 4 - PIT 5 area aboard MCAS Cherry LOGGED BY: Ashley Jessen WELL ID:
Point DRILLER: William J. Miller P4-TW25
NORTHING: 428524 1 EASTING: 2632415 CREW: S; Chasteen
SYSTEM: NCSP NAD 83 USft DRILL MACHINE: Power Probe T.O.C.ELEV.: 22.60
VERT.DATUM: NAVD88 USft METHOD: DPT 0 HOUR DTW: 12.0 TOTAL DEPTH: 16.0
START DATE: 11/28/23 END DATE: 11/28/23 124 HOURbM 12.6 WELL DEPTH: 14.2
DEPTH BLOW COUNT OVA LAB. 0 o SOIL AND ROCK WELL
0.5ft 0.5ft 0.5ft 0.5ft (PPm) s c DEPTH DESCRIPTION ELEVATION DETAIL
0.9
0.0 Land Surface 21.8 0.0
0.0 (SM)-Tan to light brown,Silty,0.to f.SAND. No HCO -
Direct 3.5 M >
Push -
a
v
2.0
2.0 19.8 _
(SP)-Tan,0.to f.SAND w/minor orange staining. No
Direct HCO
Push 3.3 M
4.0 4.0------------------------�.8 4.2
(SP)-Tan,v.f.to f.SAND w/minor red staining. Slight
Direct HCO
Push 3.0 M -
6.0 6.0 15.8 _
SAA -
Direct M
Push 3.7
0 8.0 13.8
8. SAA
O U
Direct 183.4 M
Push
o
Ut
10.0 : 10.0 ---------------------- 11.8
(SP)-Tan to dark gray,0.to f.SAND.Minor red
Direct staining. Sheen and strong HCO
Push 152.3 W
12.0 ? ::4......................................................................9.8.
(SP)-Dark gray,0.to f.SAND.Strong HCO
Direct 126.4 W -
Push
14.0 1a.o 7.8 14.2
SAA -
Direct W _
Push 74.8
16.0 16.0 5.8 16.0
BORING TERMINATED AT ELEVATION 5.8 ft
LL
Stratigraphy color(LOG)represents inferred stratum
permeability as follows:
■ VERY LOW E,$ MEDIUM VERY HIGH
LOW 0 HIGH
Native Backfill