Onslow_Well Abandonment_20240827

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. WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
David Wilcox 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
3223—A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gaL)
Cascade Drilling FOR WATER SUPPLY WELLS ONLY:
Company Name
7c.Type of disinfectant used:
2.Well Construction Permit#:
N/A CERCLA site _
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)if known
7d.Amount of disinfectant used:_
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public ❑Neat Cement Grout ❑ 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: ❑Bentonite Slurry 0 Other(explain under 7g)
❑Monitoring ❑Recovery
Injection Well: If.For each material selected above.,provide amount of materials used:
❑Aquifer Recharge INGroundwaterRemediation Portland Cement C * 5 54-//o 7s-
❑Aquifer Storage and Recovery ❑Salinity Barrier —
❑Aquifer Test ❑Stormwater Drainage _
❑Experimental Technology ❑Subsidence Control 7g.Provide a brief description of the abandonment procedure: _
OGeothermal(Closed Loop) OTracer Tremie grout
❑Geothermal(Heating/Cooling Return) &Other(explain under 7g)
4.Date well(s)abandoned: C U
•
5a.Well location:
ABC One Hour Cleaner,Superfund Site NC D024644494 � �`�
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
2127 Lejeune Blvd, Jacksonville NC, 28546
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Onslow 439613047818 By signing this form, I hereby certify that the well(s) was(were)abandoned in
County Parcel Identification No.(PIN) accordance with 15A NCAC 02C.0100 or 2C.0200 Well Construction Standards
and that a copy of this record has been provided to the well owner.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.741400 N 77.366600 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.
T 10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: / 5 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth:C.,1 t 5 (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617
10b.For Iniection Wells: In addition to sending the form to the address in 10a
6c.Borehole diameter: (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: (ft) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): (ft.) 10c.For Water SunDly&Iniection Wells: In addition to sending the form to the
address(es)above,also submit one copy of this form within 30 days of completion
of well abandonment to the county health department of the county where
6f.Inner casing/tubing length(if known): (ft.) abandoned.
6g.Screen length(if known): (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

Temperature and Revision#:_0
g; TERRATHERM Release date:_5/12/23_
Pressure Monitoring Point
Construction Detail Approved by:_SL_��''')
Well ID T-5 Date (1 1 L- '3
Oversight AADS Job#R23-104
Driller t /' Pr
S !li� 7 Design Constructed Notes
(fill out if
different)
Pipe Diameter TMP: 1.5" -------Stick Up(TMP) 30" ~
PMP: 1" --Stick Up(PMP) 24"
Borehole Diameter: 6" /
Ground Surface 0.0'
HT Grout / Angle from Horizontal 90°
Casing Material •/�
Carbon Steel
Other: (......„)
Top of#00 Sand 1'
TMP Pipe Lengt69 Top of PMP Screen 3'
PMP Riser Leng5 .PMP Screen Leng2 Bags of#00 Sand 2.5
Bottom of PMP Screen 5'
Screen Material
Stainless Steel Bottom of#00 Sand 7'
Other:
Bags of Cement 18
Slot Size 10 Bags of Silica 5.75
Installation Method Borehole Diameter 6"
Dir__ Push
oni Bottom of TMP Well 67'
Hollow Stem Auger
Mud Rotary
Other:
i
Bottom of Borehole 67' /
Post-Installation QC(to be performed 24hrs after installation) PID Log:Make/M�odel: '
1)Confirm well is free of grout Design Constructed Time: v"Tt ; i.c Reading: i .. 0 PPM
Depth to bottom of TMP(ft bTOC]: 69 5' Time: j C b c" Reading: , PPM
Depth to bottom of PMP[ft bTOC]: 7' Time: Reading: PPM
if greater than or equal to lit less than designed alert the office Time: Reading: PPM
2)Confirm grout plug reaches ground surface Time: Reading: PPM
repeat daily until depth to grout is Oft bgs Notes:
Depth to Grout, Depth to Grout,
Date TMP[ft bgs) PMP[ft bgs)

WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
David Wilcox 7a.For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same
Well Contractor Name(or well owner personally abandoning well on his/her property) well construction/depth,only 1 GW-30 is needed. Indicate TOTAL NUMBER of
wells abandoned:
3223-A
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gal.)
Cascade Drilling FOR WATER SUPPLY WELLS ONLY:
Company Name p�+ 7c.Type of disinfectant used:_
2.Well Construction Permit#: N/A CERCLA site
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)if known
7d.Amount of disinfectant used:_
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Mimicipal/Public 0 Neat Cement Grout 0 Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑ Sand Cement Grout 0 Dry Clay
0 Industrial/Commercial ❑Residential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings
❑Irrigation 0 Specialty Grout 0 Gravel
Non-Water Supply Well: ❑ Bentonite Slurry ❑ Other(explain under 7g)
❑Monitoring ❑Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge SGroundwaterRemediation Portland Cement q
:Aquifer Storage and Recovery 0 Salinity Barrier J ,/ ^5
❑Aquifer Test ❑Stormwater Drainage _
GI Experimental Technology 0 Subsidence Control
7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) OTracer
❑Geothermal(Heating/Cooling Return) Slather(explain under 7g) Tremie grout
4.Date well(s)abandoned: C-d J-
5a.Well location:
ABC One Hour Cleaner,Superfund Site NC D024644494 5 e � R ", ""
_
Facility/Owner NameFacility ID#(if applicable) 8.Certification:
2127 Lejeune Blvd, Jacksonville NC, 28546"-- Z �'
Physical Address,City,and Zip �� a
ys' i Signature of Certified Well Contractor or Well Owner Date
Onslow 439613047818 By signing this form, I hereby certify that the well(s) was(were)abandoned in
County Parcel Identification No.(PIN) accordance with I5A NCAC 02C.0100 or 2C.0200 Well Construction Standards
and that a copy of this record has been provided to the well owner.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.741400 N 77.366600 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. 10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: I 3 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: + 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: (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: (ft,) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): (ft,) 10c.For Water Suooly&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): (ft.) abandoned.
6g.Screen length(if known): (f-)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

TERRATHERM Temperature and Revision ti: 0
Pressure Monitoring Point Release date:_5/12/23_
Approved by:_SL_
Construction Detail
Well ID T-3 Date ' I / • D2
Oversight i 14 ' Job#R23-104
Driller 7.trd/!l 11 /J'l4lrly
Design Constructed Notes
(fill out if
different)
Pipe Diameter TMP: 1.5" Stick Up(IMP) 30"
PMP: 1" Stick Up(PMP) 24" 2/#44.4
Borehole Diameter: 6"
Ground Surface 0.0' /7
HT Grout J Angle from Horizontal 90'
Casing Material
Carbon Steel
Other. Top of#00 Sand 1'
TMP Pipe Length 23.5' Top of PMP Screen 3'
PMP Riser Length 5'
PMP Screen Length 2' Bags of#00 Sand 2.5
Bottom of PMP Screen 5'
Screen Material
Stainless Steel Bottom of#00 Sand 7'
Other:
Bags of Cement 4.75
Slot Size 10 Bags of Silica 1.5
Installation Method Borehole Diameter 6"
Direct Push
CSoniC Bottom of IMP Well 21'
Hollow Stem Auger
Mud Rotary
Other:
Bottom of Borehole 21' L
Post-Installation QC(to be performed 24hrs after installation) PID Log:Make/Model:
1)Confirm well is free of grout Design Constructed Time: Reading: PPM
Depth to bottom of TMP[ft bTOC]: 23.5' Time:
Reading: PPM
Depth to bottom of PMP[ft bTOC]: 7' Time: Reading: PPM
if greater than or equal to 1ft less than designed alert the office Time: Reading: PPM
2)Confirm grout plug reaches ground surface Time: Reading: PPM
repeat daily until depth to grout is Oft bgs Notes:
Depth to Grout, Depth to Grout,
Date TMP[ft bgs] PMP[ft bgs]

• WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
David Wilcox 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
3223—A wells abandoned:
NC Well Contactor Certification Number 7b.Approximate volume of water remaining in well(s): _(gal.)
Cascade Drilling FOR WATER SUPPLY WELLS ONLY:
Company Name
2.Well Construction Permit#:
N/A CERCLA site 7c.Type of disinfectant used:
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)if known
7d.Amount of disinfectant used:_
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public 0 Neat Cement Grout 0 Bentonite Chips or Pellets
0 Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
0 Industrial/Commercial OResidential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings
0 Irrigation 0 Specialty Grout 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:
❑Aquifer Recharge •GroundwaterRemediation Portland Cement Sti//on S
0 Aquifer Storage and Recovery 0 Salinity Barrier
0 Aquifer Test ❑Stormwater Drainage _
❑Experimental Technology 0 Subsidence Control 7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer
Geothermal(Heating/Cooling Return) bother(explain under 7g) Trem i e grout
4.Date well(s)abandoned: C )0 3 1
51.Well location: u
ABC One Hour Cleaner,Superfund Site NC D024644494 'Ca e
Facility/Owner Name Facility ID#(if applicable) 8.Certification: �,: •_
2127 Lejeune Blvd, Jacksonville NC, 2854b �Z
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Onslow 439613047818 By signing this form, I hereby certify that the well(s) was(were)abandoned in
County Parcel Identification No.(PIN) accordance with 15A NCAC 02C.0100 or 2C.0200 Well Construction Standards
and that a copy of this record has been provided to the well owner.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.741400 N 77.366600 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)if available.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#• / - abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 6 I + 1 (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617
10b.For Iniection Wells: In addition to sending the form to the address in 10a
6c.Borehole diameter: (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: (ft,) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): (ft) 10c.For Water Supply&Iniection Wells: In addition to sending the form to the
address(es)above,also submit one copy of this form within 30 days of completion
of well abandonment to the county health department of the county where
6f.Inner casing/tubing length(if known): (ft) abandoned.
6g.Screen length(if known): (ft)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

t 1410
1ERRASHERM Temperature and Revision#: o
e Cocks r+a+cr*i Release date_5/12/23
Pressure Monitoring Point
k Approved by: St
Construction Detail
0
;1 __ 5
r5igl_ ,. , / lob#1 R23-104
'' Diller _4 _ k l:,"7A1•17 .I e�
dnli Do sign Consirutted Notes
(fill out if
different)
C
F4oe Diameter TMP. 1.5" r. -------Stick UP(Tl4MP) ._C r' Si
'Imo: 1" —Stick Up(PMP) •, 1
t oie..h'ir
6"
..7_
a
Ground Surface 00 i..1:-4 ,:" ,s
6.`
fiT Grout-- r i Angk from M#on1 I 38'
ng°A4at at
Carbon Stec
Other: r = Top of B00 Sand 3'
P Pipe Length SA CT OMTop of PMP Screen `5'
fP Riser Length 7,5,
PMP Screen Length 3 Bags of BOO Sand ?.75 3
.. Bottom of PMP Screen '� 4
•
--)Bottom of BOO Sand 10
1
3
Bags of Cement :1.5
.t Size ;. Bags of Silica 635
a "
Installation Method Borehole Diameter 6"
t- --.'ush
Soni :•ttom of TMP Well .'-o low Stem Auger Cril
..
Mud Rota
Other:
:, , R (
Bottom of Borehole 81.1
Post-Installation QC(to be performed 24hrs after installation) P#O tog:Make/Model: _
1)Confirm well is free of grout Design Constructed Time: ' J Reading: Q ., PPM
Depth to bottom of TMP[ft bTOC]: 84 5' Time: • Reading: 0 r PPM
Depth to bottom of PMP[ft bTOC]: 10.5' Time: _ Reading: Q'� PPM
if greater than or equal tolftless than designed alert the offer~ m Time: _ Reading: PPM
2)Confirm grout plug reaches ground surface acne Reading: PPM
• repeat daily until depth to grout is Oft bgs 'Notes:
Depth to Grout, Depth to Grout, 1
'' Dam TMP[ft bgs]` PMP[ft bgs] 1
S
0 '''' . -' 111111111111111111 --
-'..]
; 2

WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
David Wilcox 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
3223—A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gaL)
Cascade Drilling FOR WATER SUPPLY WELLS ONLY:
Company Name
7c.Type of disinfectant used:
2.Well Construction Permit#.
N/A CERCLA site
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)if brown
7d.Amount of disinfectant used:_
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public 0 Neat Cement Grout 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 0 Specialty Grout ❑ Gravel
Non-Water Supply Well: 0 Bentonite Slurry 0 Other(explain under 7g)
❑Monitoring ORecovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge SGroundwaterRemediation Portland Cement G //a4 5
❑Aquifer Storage and Recovery ❑Salinity Barrier J
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology 0 Subsidence Control
7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer
❑Geothermal(Heating/Cooling Return) Other(explain under 7g) Tremie grout
4.Date well(s)abandoned: _ .)0 " ti
Sa.Well location: 5e4.
ABC One Hour Cleaner,Superfund Site NC D024644494 =
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
2127 Lejeune Blvd, Jacksonville NC, 2854b - - Z L
Physical Address,City,and Zip
� e
Signature of Certified Well Contractor or Well Owner Date
Onslow 439613047818 By signing this form, I hereby certify that the well(s) was(were)abandoned in
County Parcel Identification No.(PIN) accordance with 1 SA NCAC 02C.0100 or 2C.0200 Well Construction Standards
and that a copy of this record has been provided to the well owner.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.741400 N 77.366600 You may use the back of this page to provide additional well site details or well
abandonment details. You may also attach additional pages if necessary.
CONSTRUCTION DETAILS OF WELL(S)BEING ABANDONED SUBMITTAL INSTRUCTIONS
Attach well construction record(s)if available. For multiple injection or non-water supply wells
ONLY with the same construction/abandonment,you can submit one form.
10a. For All Wells: Submit this form within 30 days of completion of well
-
6a.Well ID#: abandonment to the following:
avo Division of Water Resources,Information Processing Unit,
6b.Total well depth: U I 'F (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617
10b.For Injection Wells: In addition to sending the form to the address in l0a
6c.Borehole diameter: (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: (ft) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): (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): (ft,) abandoned.
6g.Screen length(if known): (ft)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

1 V
TERRATHERM1%0*
Temperature and Revision a:_0
Pressure Monitoring Point Release date_5/12/23_
Construction��t' Deta/il Approved by._SL_
well ID T-1 blo id (/' - i`I /( Q - D 3
L�'' f, Date � 'j /
Oversight '� ( � u fi IT free 1/e/I%r�/l,"� lob a R23-104
Driller �3T� k 110,_), ,�'7be-l
/ liX < Design Constructed Notes
(fill out if
_ different)
Pipe Diameter TMP 1.5" Stick Up(TMP) �7 t:1/
PMP: 1" Stick Up(PMP) 30"
Borehole Diameter: 6"
Ground Surface 0.0'
HT Grout----- ,angle from Horrtont 38
L 'I
Carbon S •
i.
•r: Top of#00 Sand 3'
TMP Pipe Length 84.5' _ Top of PMP Screen 5'
PMP Riser Length 7.5'
PMPScreen Length ' �+ _.+ Bogs of#00 Sand r175- 5
Bottom of PMP Screen \ 1
Screen Material
0 :,, Stainless Steel Bottom of#00 Sand 10'
—
Other:
_ • ` Bags of Cement ' , (a.
Slot Size 10 . ~ Bogs of Silica -kr15' 1 3
Installation Method Borehole Diameter 6'
a' -ct Push
Son'• Bottom of TMP Well 81'
-allow Stem Auger
Mud Rotary
Other:
Bottom of Borehole 81' i
Post-Installation QC(to be performed 24hrs after installation) PID Log:Make/Model:
1)Confirm well is free of grout Design Constructed Time '] ;3 O Reading 0, 0 PPM
Depth to bottom of TMP(ft bTOC): 84 5' Time:
Depth to bottom of PMP(ft bTOC]: 10.5' Time: q, © �� Reading (1,U PPM
q;�� �,.y� Reading Q,(� PPM
i• if greater than or equal to lit less than designed alert the office Time: Reading PPM
2)Confirm grout plug reaches ground surface Time: Reading. PPM
repeat doily until depth to grout is Oft bgs Notes:
Depth to Grout, Depth to Grout,
Date TMP[ft bgs) PMP[ft bgs]

WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
David Wilcox 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
3223—A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gaL)
Cascade Drilling FOR WATER SUPPLY WELLS ONLY:
Company Name 7c.Type of disinfectant used:
2.Well Construction Permit#: N/A CERCLA site
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)if known
7d.Amount of disinfectant used:_
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
0 Agricultural ❑Municipal/Public 0 Neat Cement Grout 0 Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) 0 Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
❑Industrial/Commercial ❑Residential Water Supply(shared) ❑Concrete Grout ❑ Drill Cuttings
0 Irrigation 0 Specialty Grout 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:
❑Aquifer Recharge INGroundwaterRemediation Portland Cement
❑Aquifer Storage and Recovery ❑Salinity Barrier — 5�` I O/1 S
0 Aquifer Test ❑Stormwater 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) Tremie grout
4.Date well(s)abandoned: 6- 1 0 -) / a U V L / L U C 4
5a.Well location:
ABC One Hour Cleaner,Superfund Site NC D024644494 4( 5 ce.. C.�`.,.y ._
Facility/Owner Name Facility ID#(if applicable) 8.Certification: �
2127 Lejeune Blvd, Jacksonville NC, 28546 �� -07 I
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Onslow 439613047818 By signing this form,I hereby certify that the well(s) was(were)abandoned in
County Parcel Identification No.(PIN) accordance with 15A NCAC 02C.0100 or 2C.0200 Well Construction Standards
and that a copy of this record has been provided to the well owner.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.741400 N 77.366600 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)((available. For multiple injection or non-water supply wells
ONLY with the same construction/abandonment,you can submit one form. 10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#• H - l L/ abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 5-7 + S) (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617
10b.For Injection Wells: In addition to sending the form to the address in IOa
6c.Borehole diameter: (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: (ft,) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): (ft,) 10c.For Water Suooly&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): (ft,) abandoned.
6g.Screen length(if known): (ft-)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

TERRATHERM SIW Boring Construction Detail
Revision tt: p
Release date:_5/12/23_
Approved by: SL_
Well ID H-44
Date d 9// — .
Oversight /*ID
Job# R23-104
Driller • e•-yd• ...Pt,'c t Design Constructed Notes
(fill out if
different)
p-
1/2n Thermocouple pipe?
Thermocouple Length
---Heater Stick Up Height 30"
MI 111—
--SIW Stick Up Heigh 18„ ,____.---'"'
Ground Surface 0.0'
Conductive HT Grout —
Heater Can Angle from Horizontal gp^
Schedule 80
Heater Can Length A
Heater Can Diameter WVBorehole Diameter _
SIW 5 Gal Buckets of Graphite 2.25
Riser Length 51S
Screen Length Bags of Silica 3
Screen Material 2 ft
Stainless Steel Bags of Cement 10
Fiberglass
Other: Top of#00 Sond 30'
SlwSlorSize
10
Screen Diameter ® Bags of Sand 7.5
,:ption MethodfirPr Gallons of Limestone 7.5
Direct Push — Top of Screen 50'
Hollow Stem Auger
Mud Rotary
Other:
Bottom of Screen 52'
Conductive High Temp Grout---- Bottom of#00 Sand 54'
Bottom of Borehole 57'
Post-Installation QC(to be performed 24hrs after installation)
1)Confirm well Is free of grout P/D Lo•:Make/Model:
Design Constructed
Depth to bottom of well[ft bloc]: Sa 5 Reading: all ilifilnigra
if greater than or equal to 1ft less than designed alert the office L11Reading: - a PPM 2)Confirm grout plug reaches ground surface Reading:
repeat daily until depth to grout is Oft Time: PPM
Reading: PPM
Date Depth to Grout[ft bgs] Time: Reading:
Notes: pp PPM
U/llG

WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
David Wilcox 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
3223—A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gal.)
Cascade Drilling FOR WATER SUPPLY WELLS ONLY:
Company Name 7c.Type of disinfectant used:
2.Well Construction Permit#: N/A CERCLA site —
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)if brown
7d.Amount of disinfectant used:_
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public ❑Neat Cement Grout 0 Bentonite Chips or Pellets
0 Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
0 Industrial/Commercial ❑Residential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings
❑Irrigation 0 Specialty Grout 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:
❑Aquifer Recharge lOGroundwaterRemediation Portland Cement 3 lion 5
:Aquifer Storage and Recovery 0 Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage _
❑Experimental Technology ❑Subsidence Control
7g.Provide a brief description of the abandonment procedure: -
❑Geothermal(Closed Loop) OTracer •
❑Geothermal(Heating/Cooling Return) MOther(explain under 7g) Tremie grout
%
4.Date well(s)abandoned: 6 -d v— (
1 1s.
Sa Well location: ' S C e 4 f f t c�t e d
ABC One Hour Cleaner,Superfund Site NC D024644494
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
2127 Lejeune Blvd, Jacksonville NC, 28546�����
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Onslow 439613047818
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:
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.741400 N 77.366600 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)((available. For multiple injection or non-water supply wells
ONLY with the sa'me/canstruction/abandonment,you can submit one form. 10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#• N. C` 0d E abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth:)(t• S f 36, 5 (It.) 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: (in,) above,also submit one copy of this firm within 30 days of completion of well
abandonment to the following:
6d.Water level below ground surface: (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): (ft-) 10c.For Water Sunnlv&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): (ft-) abandoned.
6g.Screen length(if known): (ft-)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

Revision : 1
A*fi TERRATHERM ISTD Heater Boring Construction Detail Release #te:_6/14/23_
o �,r. Approved by:
HC-02E Date 6 b - t 5
^, Well ID �`
Oversight "jr: {,rise 5 "i Job It R23-104
Driller Cr, ��3`b\ *- t
Constructed
(fill out if
Design different) Notes
—Length of Can Stick-Up(ft)/
Height of Can Stick-up Above
1/2"Thermocouple pipe? Ground(in) 5'/30"
Thermocouple Length 77.29' -Length of VEW Stick-Up(ft)/
Height of Riser Stick-Up Above
Ground(in) 1.5'/6" a. to
Ground Surface 0.0' _ _ ___ r_ -----
Heater Can A___ Conductive HT Grout— IIF
• gle from Horizontal 22'
Schedule 80
Borehole Diameter 7"
Top of#00 Sand 21.5'
Top of Screen 24: - Q L t£—
Heater Can Length 81.5 ft Gal Buckets of Graphite 2.75
M. Heater Can Diameter 3 in Bags of Silica 3.75
Screen Length .1fi) ft Bags of Cement 12
Riser Length 29 ft
Screen Diameter 1 in Bottom of Screen 349' 36.S
Installation Method
Direct Push Bags of#00 Sand 14
Ho ow Stem Auger Gallons of Crushed
Mud Rotary
Limestone 14
Other:
Bottom of#00 Sand 61.5'
'Bottom of Heater Can 76 5'
-c k'- ,_ V- ': Bottom of Borehole 7 . ')
Post-Installation QC(to be performed 24hrs after installation) PIO Log:Make/Model:
1)Confirm well is free of grout Design Constructed Time: Q ,0cO Reading: 19 v 0 PPM Ic " `,
Depth to bottom of well[ft bTOC Ri s' Time: *'Z '.,] Reading: (0 , 0 PPM
if greater than or equal to ift less than designed alert the office Time: 4 fJ L) Reading: 0, ,0 PPM
2)Confirm grout plug reaches ground surface Time: ' 'i.Q — w Reading: 0 , "'"
repeat daily until depth to grout is Oft. lime: t D l5 _ Reading: ti jU PPM , --7`;
Date Depth to Grout[ft bgs] Notes: ) ` . c,5 0 , 0

WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
David Wilcox 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
3223-A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gaL)
Cascade Drilling FOR WATER SUPPLY WELLS ONLY:
Company Name
2.Well Construction Permit#:
N/A CERCLA site 7c.Type of disinfectant used:
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)if known
7d.Amount of disinfectant used:_
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public 0 Neat Cement Grout 0 Bentonite Chips or Pellets
0 Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
❑Industrial/Commercial 0 Residential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings
❑Irrigation 0 Specialty Grout 0 Gravel
Non-Water Supply Well: ❑ Bentonite Slurry 0 Other(explain under 7g)
0 Monitoring ❑Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge eGroundwaterRemediation Portland Cement - 5 i/c-vt
❑Aquifer Storage and Recovery 0 Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage
DExperimental Technology 0 Subsidence Control 7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer
❑Geothermal(Heating/Cooling Return) ,Other(explain under 7g) Tremie grout
4.Date well(s)abandoned: G- 'J._ d 1 •
5a.Well location: ' - a c h e d
ABC One Hour Cleaner,Superfund Site NC D024644494
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
2127 Lejeune Blvd, Jacksonville NC, 28546
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Onslow 439613047818 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 1C.0200 Well Construction Standards
and that a copy of this record has been provided to the well owner.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.741400 N 77.366600 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 SUBMITTAL INSTRUCTIONS
Attach well construction record(s)((available.For multiple injection or non-water supply wells
ONLY with the same construction/abandonment,you can submit one form. 10s. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: f-1 C— C Or 0 abandonment to the following:
/ Division of Water Resources,Information Processing Unit,
6b.Total well depth:(L t I ( (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: (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: (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): (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): (ft.) abandoned.
6g.Screen length(if known): (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

11160 T ISTD Heater Boring Construction Detail Revision#:_0
TERRATHERM
Release date:_5/12/23_
Approved by: SL
.,,,., Well ID HC-02D Date -' / 0
Oversight , Bat Vc\ Job# R23-104
Driller �, 0 �- ` / b Miz.er/
Constructed
(fill out if
Design different) Notes
-Length of Can Stick-Up(ft)/
Height of Can Stick-up Above
1/2"Thermocouple pipe? Ground(in) 2.5'/30"
Thermocouple Length 61.75'
-Length of VEW Stick-Up(ft)/
Height of Riser Stick-Up Above
Ground(in) 0.5'/6"
Ground Surface 0.0'
- Heateram- Conductive HT Grout— pi
,, ,,
.-- _ r Angle from Horizontal 66'
/ Schedule 80 I
i
-, Borehole Diameter 7"
1
Top of#00 Sand 2'
r Li r
Top of Screen q'
Heater Can Length al ft 5 Gal Buckets of Graphite 0.75
Heater Can Diameter 3 in Bags of Silica 1 1
Screen Length 10 ft Bags of Cement 3
3
Riser Length c1 ft ;
Screen Diameter 1 in Bottom of Screen 14' Li
Installation Method f
Dire t.Push ; Bags of#00 Sand 26.5 1 I
onic
Hollow Stem Auger Gallons of Crushed
Mud Rotary Limestone 26.5 1 n (ACE AS
Other: IVVV! Fi
Bottom of#00 Sand 54.5'
j
Bottom of Heater Can 62'
Bottom of Borehol 62' (61 Q
Post-Installation QC(to be performed 24hrs after installation) P1D Log:Make/Model: r
.i
1)Confirm well is free of grout Design Constructed Time: L 3,e c'9 Reading: ,p PPM
Depth to bottom of well[ft bTOC 64 S' Time:
it-3 C7 Reading: ,., c, PPM
if greater than or equal to lft less than designed alert the office Time: i N; pity Reading: 0, t7 ppM
2)Confirm grout plug reaches ground surface Time: Reading: PPM
repeat daily until depth to grout is Oft. Time: Reading: PPM
Date Depth to Grout[ft bgs) Notes:

WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
David Wilcox 7a.For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same
Well Contractor Name(or well owner personally abandoning well on his/her property) well construction/depth,only 1 GW-30 is needed. Indicate TOTAL NUMBER of
wells abandoned:
3223-A
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gal.)
Cascade Drilling FOR WATER SUPPLY WELLS ONLY:
Company Name 7c.Type of disinfectant used:
2.Well Construction Permit#: N/A CERCLA site
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)ijbtown
7d.Amount of disinfectant used:_
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public 0 Neat Cement Grout 0 Bentonite Chips or Pellets
OGeothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
0 Industrial/Commercial ❑Residential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings
0 Irrigation 0 Specialty Grout 0 Gravel
Non-Water Supply Well: 0 Bentonite Slurry 0 Other(explain under 7g)
❑Monitoring ❑Recovery
Injection Well: If.For each material selected above,provide amount of materials used:
❑Aquifer Recharge INGroundwaterRemediation Portland Cement
0 Aquifer Storage and Recovery 0 Salinity Barrier — ( 5 /�a
❑Aquifer Test ❑Stormwater Drainage _
0 Experimental Technology 0 Subsidence Control 7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) OTracer
❑Geotherral(Heating/Cooling Return) Other(explain under 7g) Tremie grout
4.Date well(s)abandoned: 6 J\; 3 7 / 7 01
s
5a.Well location:
ABC One Hour Cleaner,Superfund Site NC D024644494 5 ` 4R`�'e +i
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
2127 Lejeune Blvd, Jacksonville NC, 28546 — Z (�
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Onslow 439613047818 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 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:
34.741400 N 77.366600 W You may use the back of this page to provide additional well site details or well
abandonment details. You may also attach additional pages if necessary.
CONSTRUCTION DETAILS OF WELL(S)BEING ABANDONED SUBMITTAL INSTRUCTIONS
Attach well construction record(s)if available. For multiple injection or non-water supply wells
ONLY with the sameconstructian/abandonment you can submit one form. 10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well lI)#: H(-- 0? L- abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth:( -t LI (ft) 1617 Mail Service Center,Raleigh,NC 27699-1617
10b.For Injection Wells: In addition to sending the form to the address in l0a
6c.Borehole diameter: Om) abandonment
also submit one copy of this form within 30 days of completion of well
abandonment to the following:
6d.Water level below ground surface: (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): (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): (ft.) abandoned.
6g.Screen length(if known): (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

TERRATHERM ISTD Heater Boring Construction Detail
Revision#: 0
�c,vIc�:"�R,„
_-'- o 1i Release date:_5/12/23_
Approved by: SL
l ( I �
,,� Well ID HC-02C ed
('/( 1/CG r Date - 1$ I
Cj
Oversight +L'L tO'''') lob# R23-104
Driller Lei -L 11.li/&1!/t✓'-id'ip er-ly
Constructed
(fill out if
Design different) Notes
--Length of Can Stick-Up(ft)/
Height of Can Stick-up Above
1/2"Thermocouple pipe? —.e•— Ground(in) 3'/30"
Thermocouple Length 75.92' Length of VEW Stick-Up(ft)/
Height of Riser Stick-Up Above
Ground(in) 0.5'/6"
Ground Surface 0.0'
Heater Can Conductive HT Grout 111,
Angle from Horizontal 48"
Schedule 80
i — t.
i Borehole Diameter 7"
` „, Top of#00 Sand 2' 2-
--I _ Top of Screen 4' 4
Heater Can Length 79 ft 5 Gal Buckets of Graphite 0.7S
,-
�� Heater Can Diameter 3 in Bogs of Silica 1
Screen Length 1d-S� ft Bags of Cement 3.5
Riser Length �ft ,..:, .; • i.
Screen Diameter 1 in Bottom of Screen 17.E'
Installation Method -
Direct Push Bags of#00 Sand 33 vj
on
ZHollow Stem Auger Gallons of Crushed
Mud Rotary Limestone 33
Other:
Bottom of#00 Sand 67.5'
Bottom of Heater Can 76'
Bottom of Borehole 76' k d t,v'
Post-installation QC(to be performed 24hrs after installation) PID Low:Make/Model:
1)Confirm well is free of grout Design Constructed Time: tl(yr`_ Reading: i� s v PPM
Depth to bottom of well[ft bTOC 79' Time: k-1 r(; Reading: 0. 0 PPM
if greater than or equal to Ift less than designed alert the office Time: \T•, Z. Reading: d , 0PPM
2)Confirm grout plug reaches ground surface Time: i ' Z,c)- / 01 Li) Reading: eti . 0 PPM
repeat daily until depth to grout is Oft. . Time: "O$O5 Reading: ,D PPM
Date Depth to Grout[ft bgs] Notes:
Z ak 4 t- - \c\ — it,a 0 t PST-A- 11.E .& Ct<-

WELL ABANDONMENT RECORD For Internal Use ONLY:
I.Well Contractor Information: WELL ABANDONMENT DETAILS
David Wilcox 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
3223-A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gal-)
Cascade Drilling FOR WATER SUPPLY WELLS ONLY:
Company Name
7c.Type of disinfectant used:
2.Well Construction Permit#:
N/A CERCLA site
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)if known
7d.Amount of disinfectant used:_
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public 0 Neat Cement Grout 0 Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
0 Industrial/Commercial ❑Residential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings
0 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 PI Groundwater Remediation Portland Cement 3 t
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage
0 Experimental Technology 0 Subsidence Control 7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer
❑Geothermal(Heating/Cooling Return) hlOther(explain under 7g) Tremie grout ,
4.Date well(s)abandoned: V— a Y
Sa Well location: 5 , �-H,r c h.e U -
ABC One Hour Cleaner,Superfund Site NC D024644494
Facility/Owner Name Facility iD#(if applicable) 8.Certification:
2127 Lejeune Blvd, Jacksonville NC, 28541f
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Onslow 439613047818 By signing this form,I hereby certify that the well(s) was(were)abandoned in
County Parcel Identification No.(PIN) accordance with 1 SA NCAC 02C.0100 or 1C.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►at/long is sufficient) 9.Site diagram or additional well details:
34.741400 N 77.366600 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)iifavailable.For multiple injection or non-water supply wells
ONLY with the same construction/aba/�ndonment you can submit one form. 10a. For All Wells: Submit this form within 30 days of completion of well
/
6a.Well ID#• I 1\i 0 d 1� abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: El-5 r ZZ 5 (g,) 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: (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: (ft) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): (ft) 1Oc.For Water SUDDIV&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): (f-) abandoned.
6g.Screen length(if known): _(ft)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

TERRATHERM ISTD Heater Boring Construction Detail Revision#: 0
c.,.,,wc Release date:_5/12/23_
Approved by:_SL_
Well ID HC-02B Date 1'7 - 19 tea, 3
Oversight _JOY .S-41 Job# R23-104
Driller of). r/r..✓4.+ Al,a),,,,,, e,r/tii Constructed
(fill out if
Design different) Notes
--Length of Can Stick-Up(ft)/
Height of Can Stick-up Above
1/2"Thermocouple pipe? L `1, Ground(in) 3.5'/30" Z•436.
Thermocouple Length 87.67' -Length of VEW Stick-Up(ft)/
Height of Rher Stick-Up Above
Ground(In) 1'/6" Z
Ground Surface 0.0'
Heater Can Conductive HT Grout—
Angle from Horizontal 35"
Schedule 80
- Borehole Diameter 7"
TT 1
- Top of#00 Sand 3'
_ !Top of Screen 5'
Heater Can Length 91 ft 5 Go!Buckets of Grophlte 1
- I
Heater Can Diameter 3 in - Bogs of Silka 1.5
Screen Length 17.5 ft Bags of Cement 4.5
Riser Length 7 ft —
Screen Diameter 1 in Bottom of Screen 22.5'
Installation Method
Dir-- Push Bags of#00 Sand 28 V
Sonic
• ow Stem Auger Gallons of Crushed
Mud Rotary mestone 28 20
Other:
Bottom of#00 Sand 76.5'
Bottom of Heater Can 87.5'
Bottom of Borehole 87.5'
Post-Installation QC(to be performed 24hrs after installation) PID Log:Make/Model:
1)Confirm well is free of grout Design Constructed Time: f2 lr+ Reading: 0,0 PPM
Depth to bottom of well[ft bTOC 91' Time: I tro Reading: qp PPM
if greater than or equal to 1ft less than designed alert the office Time: Z 1.) Reading: Q„p PPM
2)Confirm grout plug reaches ground surface Time: -a oft, Reading: Odo PPM
repeat daily until depth to grout is Oft. Time: Rl:el" Reading: 8•0 PPM
Date Depth to Grout[ft bgs] Notes:

WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
David Wilcox 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
3223—A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gaL)
Cascade Drilling FOR WATER SUPPLY WELLS ONLY:
Company Name
2.Well Construction Permit#:
N/A CE RC LA site 7a Type of disinfectant used:
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)if known
7d.Amount of disinfectant used:
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public 0 Neat Cement Grout 0 Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Thy Clay
0 Industrial/Commercial 0 Residential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings
0 Irrigation 0 Specialty Grout 0 Gravel
Non-Water Supply Well: 0 Bentonite Slurry 0 Other(explain under 7g)
Cl Monitoring ❑Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge eGroundwaterRemediation Portland Cement a c"f 5 a/47./1 S
❑Aquifer Storage and Recovery 0 Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage
0 Experimental Technology 0 Subsidence Control 7g.Provide a brief description of the abandonment procedure:
0 Geothermal(Closed Loop) ❑Tracer Tremie grout
El Geothermal(Heating/Cooling Return)) iOtheher(explain under 7g)
4.Date well(s)abandoned: 6 -1 I - (J�
Ss Well location: 4( 5 C 4 f ft c Q d
ABC One Hour Cleaner,Superfund Site NC D024644494
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
2127 Lejeune Blvd, Jacksonville NC, 28546 ��� -�-a-� Y
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Onslow 439613047818 By signing this form,I hereby certify that the well(s) was(were)abandoned in
County Parcel Identification No.(PiN) accordance with 15A NCAC 02C.0100 or 2C.0200 Well Construction Standards
and that a copy of this record has been provided to the well owner.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.741400 N 77.366600 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)!I-available.For multiple injection or non-water supply wells
ONLY with the same construction/abandonment,you can submit one form. 10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#• Hc - 0,94 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 5 (ft 7.-5 t 13 1617 Mail Service Center,Raleigh,NC 27699-1617
)
10b.For Injection Wells: In addition to sending the form to the address in l0a
6c.Borehole diameter: (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: (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): (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): (ft,) abandoned.
6g.Screen length(if known): (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

it _
A. TERRATHERM ISTD Heater Boring Construction Detail Revision#: 1
c,, -. Release date_6/14/23_
Approved by:
Well ID HC-02A Date b - ) S -c) 3
Oversight s.��,n... / Job# R23-104
Driller C404/ liv, t 1 ��y
/ Constructed
(fill out If
Design different) Notes
-Length of Can Stick-Up(ft)/
Height of Can Stick-up Above
1/2"Thermocouple pipe? Ground(in) 2.5'/30" 2,c1
Thermocouple Length 57.17'
-Length of VEW Stick-Up(ft)/
Height of Riser Stick-Up Above 1
Ground(in) 0.5'/ii" v
Ground Surface 0.0'
Heater Can Conductive HT Grout—
gle from Horizontal 78"
Schedule 80
ehole Diameter 7"
Top of#00 Sand 1'
Top of Screen 3'
Heater Can Length 60 ft Gal Buckets of Graphite 0.5
Heater Can Diameter 3 in -
Bags of Silica 0.75
Screen Length 10 ft Bags of Cement 2.75
Riser Length 4.5 ft __
Screen Diameter 1 in Bottom of Screen 13'
installation Method
Direct Push
Bags of#00 Sand 19
Sonic
Hollow Stem Auger ;Gallons of Crushed
Mud Rotary i Limestone 19
Other:
Bottom of#00 Sand 50.5'
i
Bottom of Heater Can 57.5'
Bottom of Borehole 57.5'
Post-Installation QC(to be performed 24hrs after installation) PiD Log:Make/Model:
1)Confirm well Is free of grout Design Constructed Time: 1 1 ;bb
Reading: e)z6 PPM
Depth to bottom of well[ft bTOC 6n' Time: L ;30 Reading: n,6 PPM
if greater than or equal to ift less than designed alert the office Time: AA Reading: ea! PPM
2)Confirm grout plug reaches ground surface Time: '06 Reading: 40 PPM
repeat daily until depth to grout is Oft. Time: Reading: PPM
Date Depth to Grout[ft bgs) Notes:

WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
David Wilcox 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
3223-A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gal.)
Cascade Drilling FOR WATER SUPPLY WELLS ONLY:
Company Name /� 7c.Type of disinfectant used:
2.Well Construction Permit#: N/A CERCLA site
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)if known
7d.Amount of disinfectant used:_
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public 0 Neat Cement Grout 0 Bentonite Chips or Pellets
0 Geothermal(Heating/Cooling Supply) 0 Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
❑Industtial/Commercial ❑Residential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings
0 Irrigation 0 Specialty Grout 0 Gravel
Non-Water Supply Well: 0 Bentonite Slurry 0 Other(explain under 7g)
0 Monitoring ❑Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge SGroundwater Remediation Portland Cement 3 a R 4,//,A S
0 Aquifer Storage and Recovery 0 Salinity Barrier — J
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology ❑Subsidence Control 7g.Provide a brief description of the abandonment procedure: •
❑Geothermal(Closed Loop) ❑Tracer
0 Geothermal(Heating/Cooling Return) il6Other(explain under 7g) Tremie grout
* rr y ... •
G ', I '?,
4.Date well(s)abandoned: 6~/ I-d Ii
Sa Well location: 4' 5 cc. c,-Ha c A R t+
ABC One Hour Cleaner,Superfund Site NC D024644494
Facility/Owner Name Facility ID#(if applicable) 8.Certification: /
2127 Lejeune Blvd, Jacksonville NC, 2854 �Z��
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Onslow 439613047818 By signing this form, I hereby certify that the well(s) was(were)abandoned in
County Parcel Identification No.(PIN) accordance with 15A NCAC 02C.0100 or 2C.0200 Well Construction Standards
and that a copy of this record has been provided to the well owner.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.741400 N 77.366600 W You may use the back of this page to provide additional well site details or well
abandonment details. You may also attach additional pages if necessary.
CONSTRUCTION DETAILS OF WELL(S)BEING ABANDONED SUBMITTAL INSTRUCTIONS
Attach well construction record(s)if available.For multiple injection or non-water supply wells
ONLY with the same construction/abandonment,you can submit one form. 10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: f f — ) ) abandonment to the following:
Division of Water Resources.,Information Processing Unit,
6b.Total well depth:7 L S t 3 C S'(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: (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: (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): (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): (ft.) abandoned.
6g.Screen length(if known): (ft-)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

iSTD Heater Boring Construction Detail Revision#: 1
:.r<)TERRATHERM Release date:_6/14/23_
gym. Approved by:
"— Well ID HC-01E Date iJ -V * 3
Oversight 6,.),t,.3 L Job# R23-104
Driller L, I�:'-J�)� 1. �fr/‘/RIPr/j
Constructed
(fill out if
Design different) Notes
—Length of Can Stick-Up(ft)/
Height of Can Stick-up Above
1/2"Thermocouple pipe? Ground(in) 5'/3C_
Thermocouple Length 77.29' .Length of VEW Stick-Up(ft)/
Height of Riser Stick-Up Above ,
Ground(in) 1.5'/6.' Q.J
Ground Surface 0.0'
Ti
a II
Heater Can Conductive HT Grout-
1 vi •ngle from Horizontal 650
Schedule 80 '
Borehole Diameter 7"
Top of#00 Sand 21.5' rr��
Top of Screen ?4:4' or la, r S
Heater Can Length 81.5 ft Gal Buckets of Graphite 2.75
— Heater Can Diameter 3 in Bogs of Silica 3.75
Screen Length to 8 ft f Bags of Cement 12
Riser Length 29 ft
Screen Diameter 1 in Bottom of Screen 60.4 'lye [s
Installation Method
Dire t Push -`:: :1 Bags of#00 Sand 14
Ho ow Stem Auger i Gallons of Crushed
Mud Rotary Limestone 14
Other:
Bottom of#00 Sand 61.5'
Bottom of Heater Can 76.5'
Bottom of Borehole 76.5'
Post-Installation QC(to be performed 24hrs after installation) PID Log:Make/Model:
1)Confirm well Is free of grout Design Constructed Time: Reading: PPM
Depth to bottom of well(ft bTOC R1 5' Time: Reading: PPM
if greater than or equal to 1ft less than designed alert the office Time: Reading: PPM
2)Confirm grout plug reaches ground surface Time: Reading: PPM
repeat daily until depth to grout is Oft. lime: Reading: PPM
Date Depth to Grout[ft bgs] Notes:

•WILL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
David Wilcox 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
3223-A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gal.)
Cascade Drilling FOR WATER SUPPLY WELLS ONLY:
Company Name
7c.Type of disinfectant used:
2.Well Construction Permit#:
N/A CERCLA site
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)if known
7d.Amount of disinfectant used:_
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
0 Agricultural ❑Municipal/Public 0 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 ❑ Gravel
Non-Water Supply Well: ❑ Bentonite Slurry 0 Other(explain under 7g)
El Monitoring ❑Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge SGroundwaterRemediation Portland Cement 5 5" I Jon5
❑Aquifer Storage and Recovery ❑Salinity Brinier
❑Aquifer Test ❑Stormwater Drainage _
❑Experimental Technology ❑Subsidence Control
7g.Provide a brief description of the abandonment procedure:
OGeothermal(Closed Loop) OTracer Tremie grout
El Geothermal(Heating/Cooling Return) iOtther(explain under 7g)
L -
4.Date well(s)abandoned: -( - �I
5a.Well location:
ABC One Hour Cleaner,Superfund Site N C D024644494
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
2127 Lejeune Blvd, Jacksonville NC, 28546
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Onslow 439613047818 By signing this form, I hereby certify that the well(s) was(were)abandoned in
County Parcel Identification No.(PIN) accordance with 1 SA NCAC 02C.0100 or 2C.0200 Well Construction Standards
and that a copy of this record has been provided to the well owner.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.741400 N 77.366600 You may use the back of this page to provide additional well site details or well
abandonment details. You may also attach additional pages if necessary.
CONSTRUCTION DETAILS OF WELL(S)BEING ABANDONED SUBMITTAL INSTRUCTIONS
Attach well construction record(s)if available.For multiple injection or non-water supply wells
ONLY with the same construction/abandonment,you can submit one form. 10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well BM: 14(-— 010 abandonment to the following:
`/ Division of Water Resources,Information Processing Unit,
6b.Total well depth: 6 d -I- 1 I (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: (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: (ft,) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): (ft.) 10c.For Water Suooly&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): (ft,) abandoned
6g.Screen length(if known): (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

100 TERRATHERM ISTD Heater Boring Construction Detail Revision a:_0
' Release date:_5/12/23_
Approved by: SL
Well ID HC-01D Date `) ' a`3-- d:� 1 /#:
C. -)s`l
Oversight N( `)
Job q R23-104
Driller ; \--R_ J-?\LLt N)/�A9/141er// 3 ,c,T
1 ',L-14; ST A- -
/ Constructed
AO
(fill out if
Design different) Notes
—Length of Can Stick-Up(ft)/
Height of Can Stick-up Above
1/2"Thermocouple pipe? Ground(in) 2.5'/30"
Thermocouple Length 61.75'
�/� _ -Length of VEW Stick-Up(ft)/
1` `dQvr� t-i�7nN kit C- 3_D Height of Riser Sttk-Up Above
Ground(in) 0.5','6"
Ground Surface 0.0'
Heater Can Conductive HT Grout— '
Angle from Horizontal 66'
Schedule 80
Borehole Diameter 7"
- Top of//OC Sand 2'
Top of Screen 4'
Heater Can Length 64.5 ft '5 Gal Buckets of Graphite 0.7E i
Heater Can Diameter / 3 in Bogs of Silica 1 _ I
Screen length 10 ft Bags of Cement 3
3
- Riser Length ft
Screen Diameter 1 in Bottom of Screen 14' t
Installation Method j
'
Direct P f
-h- -��� l Bags of#00 Sand 26.5
onic
allow Stem Auger Gallons of Crushed
Mud Rotary ,, Limestone 26.5 L 13 1(Ct')
Other:
Bottom of#00 Sand 54.5'
Bottom of Heater Can 62'
Bottom of Borehole 62' 12 2.—
Post-Installation QC(to be performed 24hrs after installation) PIO Cog:Make/Model:
1)Confirm well is free of grout Design Constructed Time: , O S-a- Reading: l ,"V 0 PPM
Depth to bottom of well[ft bTOC 64 S' Time: 0.0 Reading: 1k2',pZ PPM
if greater than or equal to Ift less than designed alert the office Time: 0 C'.0 s3 C,-�-).ok Reading: )r') PPM
2)Confirm grout plug reaches ground surface Time: Reading: PPM
repeat daily until depth to grout is Oft. Time: Reading: PPM
Date Depth to Grout[ft bgs) Notes: 1,A.�'iL1C...x,— O r-+ ' Lc .0-kV') CA go
—

WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
David Wilcox 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
3223-A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gal.)
Cascade Drilling FOR WATER SUPPLY WELLS ONLY:
Company Name
2.Well Construction Permit#:
N/A CERCLA site 7c.Type of disinfectant used:
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)if known
7d.Amount of disinfectant used:_
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
0 Agricultural ❑Municipal/Public 0 Neat Cement Grout 0 Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑ Sand Cement Grout 0 Dry Clay
0 Industrial/Commercial ❑Residential Water Supply(shared) ❑ Concrete Grout ❑ Drill Cuttings
0 Irrigation ❑ Specialty Grout 0 Gravel
Non-Water Supply Well: ❑ Bentonite Slurry 0 Other(explain under 7g)
❑Monitoring :Recovery
Injection Well: If.For each material selected above,provide amount of materials used:
:Aquifer Recharge •GroundwaterRemediation Portland Cement 3 f q//ori S
:Aquifer Storage and Recovery 0 Salinity Barrier
0 Aquifer Test ❑Stornwater Drainage
❑Experimental Technology 0 Subsidence Control
7g.Provide a brief description of the abandonment procedure:
❑Geothernal(Closed Loop) ❑Tracer Tremie grout
❑Geothermal(Heating/Cooling Return) Bother(explain under 7g) •
— '1 4.Date well(s)abandoned: 1 L,
5a.Well location: `<
ABC One Hour Cleaner,Superfund Site NC D024644494 S � �c Q
Facility/Owner Name Facility ID#(if applicable) 8.Certification: ,�
2127 Lejeune Blvd, Jacksonville NC, 2854b� . `��j
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Onslow 439613047818By g ffywell(s) (were)signing this form, I herebycerti that the was abandoned in
County Parcel Identification No.(PIN) accordance with 15A NCAC 02C.0100 or 2C.0200 Well Construction Standards
and that a copy of this record has been provided to the well owner.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.741400 N 77.366600 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)tjavailable.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+Y: H C— ( ( (_ abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 1". ' ( (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617
lob.For Injection Wells: In addition to sending the form to the address in l0a
6c.Borehole diameter: (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: (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): (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): (ft,) abandoned.
6g.Screen length(if known): (ft-)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

I
• ISTD Heater Boring Construction Detail Revision#:_0
l TERRATHERM n n Release date:_5/12/23_
)4-t /c!
0 j�f Approved by: SL_
Well ID HC-01C 4r 1 0 1-,1/ Date -\--k - -J 5-- l -,71-_.3
Oversight ,k\ C_C> v i ` t o 6 1 l i C°I Job# R23-104
Driller ` �- ! /G/ !� M�tzi �,/ 9�-^
1 / l Constructed
(fill out if
Design_ different) Notes
-Length of Can Stick-Up(ft)/
aL-. Height of Can Stick-up Above 4.
1/2"Thermocouple pipe? Ground(in) 3'/30'_
Thermocouple Length 75.92' IX -Length of VEW Stick-Up(ft)/
Height of Riser Stick-Up Above
Ground(in) 0.5'/6"
Ground Surface 0.0'
Heater Can Conductive HT Grout— P.
Angle from Horizontal 48°
Schedule 80 '771
.I
EI . Borehole Diameter 7"
ji Top of#00 Sand 2'
,,.1 I •Top of Screen 4'
11
Heater Can Length 79 ft , 4 S Gal Buckets of Graphite 0.75
Heater Can Diameter 3 in .] Bags of Silica 1
© i
Screen Length /�« Bags of Cement 3.5
Riser Length ft+G . %
Screen Diameter 1 in j I Bottom of Screen 17.5' F
tej
Installation Method
Direct Push - Bags of#00 Sand 33
,onic 1
Hollow Stem Auger Gallons of Crushed \ gVL,`�L+5
Mud Rotary , limestone
33 Fi
Other:
Bottom of#00 Sand 67.5'
Bottom of Heater Can 76'
Bottom of Borehole 76'
Post-Installation QC(to be performed 24hrs after Installation) PIO Log:Make/Model: _
1)Confirm well is free of grout Design Constructed Time: Reading: cr. C3 PPM
Depth to bottom of well[ft bTOC 79' Time: Reading: PPM
if greater than or equal to Ift less than designed alert the office Time: Reading: PPM
2)Confirm grout plug reaches ground surface lime: Reading: PPM
repeat daily until depth to grout is Oft. Time: Reading: PPM
Date Depth to Grout[ft bgs] Notes: t ,..) 1...)1."); (?El. A
17J`-i.rt.l. a'S- T

WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
David Wilcox 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
3223—A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gal.)
Cascade Drilling FOR WATER SUPPLY WELLS ONLY:
Company Name
7c.Type of disinfectant used:
2.Well Construction Permit ft: N/A CERCLA site
List all applicable well construction permits(i.e.U1C,County,State,Variance,etc.)ifbtovm
7d.Amount of disinfectant used:_
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑MunicipaVPublic ❑Neat Cement Grout 0 Bentonite Chips or Pellets
0 Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑ Sand Cement Grout 0 Dry Clay
❑Industrial/Commercial ❑Residential Water Supply(shared) ❑Concrete Grout ❑ Drill Cuttings
❑Irrigation ❑ Specialty Grout 0 Gravel
Non-Water Supply Well: ❑Bentonite Slurry 0 Other(explain under 7g)
❑Monitoring ❑Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge NGroundwaterRemediation Portland Cement 3 S
0 Aquifer Storage and Recovery CI Salinity Ranier — / f/v.1
❑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) Tremie grout
4.Date well(s)abandoned: C _ ( I" /
5a.Well location:
S e Ifs`ti Q j.
ABC One Hour Cleaner,Superfund Site NC D024644494
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
2127 Lejeune Blvd, Jacksonville NC, 28546 � ��7
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
-�
Onslow 439613047818 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 1C.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) 9.Site diagram or additional well details:
34.741400 N 77.366600 You may use the back of this page to provide additional well site details or well
abandonment details. You may also attach additional pages if necessary.
CONSTRUCTION DETAILS OF WELL(S)BEING ABANDONED SUBMITTAL INSTRUCTIONS
Attach well construction record(s)if available.For multiple injection or non-water supply wells
ONLY with the same(construction/aban/d�onment,you can submit one form. 10s. For All Wells: Submit this firm within 30 days of completion of well
6a.Well ID# fT• C - o 1 IJ abandonment to the following:
* Division of Water Resources,Information Processing Unit,
6b.Total well depth: 3 (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617
106.For Injection Wells: In addition to sending the form to the address in 10a
6c.Borehole diameter: (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: (ft) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): (ft) 10c.For Water Suooly&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): (ft,) abandoned.
6g.Screen length(if known): (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

TERRATHERMillii
ISTD Heater Boring Construction Detail
aRevision#: 0
Release date:_5/12/23
Approved by:_5L __
'...'`, ' Well ID HC-01B
Date :E -1 z
Oversight c.] Qee S'hr
Job# R23-104
Driller g (! ` /7 /-
&''r//L.
Constructed
(fill out if
Design different) Notes
—Length of Can Stick-Up(ft)/
1/2"Thermomu (e i e7 Height of Can Stick-up Above
P P P Ground(in) 3.5'/30"
Thermocouple Length 87.67'
-Length of VEW Stick-Up(ft)/
Height of Riser Stick-Up Above
Ground Surface 0.0'——T Ground(in) 1',l 6"
Heater Can Conductive HT Grout—
Schedule 80 _ Angie from Horizontal 3
— Borehole Diameter 7"
Top of#00 Sand
- Top of Screen 5 3 .
Heater Can Length 91 ft
5 Gal Buckets of Graphite 1 —
Heater Can Diameter 3 in
— Bags of Silica i..;
Screen Length a© }ieT" ft
Riser Length — Bags of Cement 4.5
7 ft
Screen Diameter
—1 in Bottom ofScreen —
Installation Method
D' -ct Push
Sonic Bags
of+10OSand 28 Man
o low Stem Auger
Mud Rotary Gallons of Crushed
Other: 'Limestone 28 . O
Bottom of#00 Sand 76.5'
Bottom of Heater Can 87.5'
Bottom of Borehole 87.5'
Post-Installation QC(to be performed 24hrs after Installation) PIO Log:Make/Meddh.
1)Confirm wen Is free of grout Design Constructed Time:
Depth to bottom of well[ft bTOC ____g_i Reading: • ppM
if greater than or equal to 1ft less than designed alert the officeTime: •
1
Time: x -- �' '
2)Confirm grout plug reaches ground surface Reading: D . ppM
Time:
repeat doily until depth to grout is Oftl3 Reading: PPM
Time:
DateCriffrilliallairin
Depth to Grout[ft bgsj
Notes:
1

WELL ABANDONMENT RECORD For Internal Use ONLY:
J
1.WSJ Contractor Information: WELL ABANDONMENT DETAILS
David Wilcox 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
3223-A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gal.)
Cascade Drilling FOR WATER SUPPLY WELLS ONLY:
Company Name
7c.Type of disinfectant used:
2.Well Construction Permit#:
N/A CERCLA site
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)if known
7d.Amount of disinfectant used:
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public 0 Neat Cement Grout 0 Bentonite Chips or Pellets
0 Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑ Sand Cement Grout 0 Dry Clay
0 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)
❑Monitoring ❑Recovery
Injection Well: 7E For each material selected above,provide amount of materials used:
[Aquifer Recharge SGroundwaterRemediation Portland Cement S 5.-.I/on 5
❑Aquifer Storage and Recovery ❑Salinity Ranier
l
❑Aquifer Test ❑Stormwater Drainage _
0 Experimental Technology 0 Subsidence Control
7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) OTracer Tremie grout
❑Geothermal(Heating/Cooling Return) &Other(explain under 7g)
4.Date well(s)abandoned: C - I c-'- /
I
5a.Well location:
ABC One Hour Cleaner,Superfund Site NC D024644494 S 4a c 2
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
2127 Lejeune Blvd, Jacksonville NC, 28546�� Z ��,
Physical Address,City,and Zip Well�� �
Signature of Certified Contractor or Well Owner Date
Onslow 439613047818 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:
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.741400 N 77.366600 N, You may use the back of this page to provide additional well site details or well
abandonment details. You may also attach additional pages if necessary.
CONSTRUCTION DETAILS OF WELL(S)BEING ABANDONED SUBMITTAL INSTRUCTIONS
Attach well construction record(s)if available. For multiple injection or non-water supply wells
ONLY with the sameconsnuctian/aba//ndonment,you can submit one form. 10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: n C— 0 1 A abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 5 -r 52.5 (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: ((n) 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: (ft) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): (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): (ft.) abandoned.
6g.Screen length(if known): (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

.111, TERRATHERM SIW Boring Construction Detail Revision#: 0
cz-,o'm,,4
Release date:_5/12/23_
Approved by:_SL
Well ID HC-01A Date (p//tat)
Oversight J(-rE i 3".11+4 Job# R23-104
Driller Coe-y r/�'-'kr i�-y, Al. if/J�Ae.-1/ Design Constructed Notes
l f (fill out if
different)
1/2"Thermocouple pipe? i
Thermocouple Length 59.17' ----Heater Stick Up Height 30" all
----SIW Stick Up Height 1
Ground Surface 0.0'
Conductive HT Grout ,Angle from Horizontal 78"
Heater Can
Schedule 80
Heater Can Length 60' Borehole Diameter 7"
Heater Can Diameter 3'
5 Gal Buckets of Graphite 2.25 _
SIW
Riser Length 51.5 ft Bags of Silica 3
I
Screen Length 2 ft
Screen Material Bags of Cement 10
Stainless Steel
Fiberglass '-' Top of J100 Sand 30'
Other:
SlW Slot Size 10 Bags of Sand 7.5
Screen Diameter 1"
Gallons of Limestone 7.5
installation Method
on Y. Top of Screen 50.5'
Direct Push ,,'
Hollow Stem Auger
Mud Rotary
Other: `. Bottom of Screen 52.5'
NI
Bottom of#00 Sand 54.5'
Conductive High Temp Grout---
Bottom of Borehole ( :::-AT �'
Post-installation QC(to be performed 24hrs after Installation) PID Log:Make/Model: J _
1)Confirm well is free of grout Design Constructed lime: 2./3 p Reading; PPM
Depth to bottom of well[ft bTOC]: 60' Time: S : V Reading_ . PPM
if greater than or equal to Ift less than designed alert the office Time: 4"C .♦ Reading C PPM
2)Confirm grout plug reaches ground surface Time: 6 . --.CtIr Reading Co PPM
repeat daily until depth to grout is Oft. Time: 0 0('' Reading d. PPM
Date Depth to Grout[ft bgs] Notes:

- WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
David Wilcox 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
3223-A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gaL)
Cascade Drilling FOR WATER SUPPLY WELLS ONLY:
Company Name 7c.Type of disinfectant used:
2.Well Construction Permit 4: N/A CERCLA site
List all applicable well construction permits(i.e.UIC,County,State, Variance,etc.)if!mown
7d.Amount of disinfectant used:_
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Mtmicipal/Public ❑Neat Cement Grout 0 Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) 0 Residential Water Supply(single) ❑ Sand Cement Grout 0 Dry Clay
❑Industrial/Commercial DResidential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings
❑Irrigation 0 Specialty Grout 0 Gravel
Non-Water Supply Well: ❑ Bentonite Slurry ❑ Other(explain under 7g)
El Monitoring :Recovery
Injection Well: 7E For each material selected above,provide amount of materials used:
❑Aquifer Recharge eGroundwaterRemediation Portland Cement ' 5 //Ql S
❑Aquifer Storage and Recovery ❑Salinity Barrier — J
❑Aquifer Test ❑Stormwater Drainage _
❑Experimental Technology ❑Subsidence Control
7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer
CI Geothermal(Heating/Cooling Return) &Other(explain under 7g) Tremie grout
4.Date well(s)abandoned: G 19 - d /
5a.Well location: 4' r� 4-11,t c 41 e
ABC One Hour Cleaner,Superfund Site NC D024644494
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
2127 Lejeune Blvd, Jacksonville NC, 28546-7---- � /�� 7_ _ A ,-f"
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Onslow 439613047818 By signing this form, I hereby certtfy that the well(s) was(were)abandoned in
County Parcel Identification No.(PIN) accordance with 15A NCAC 02C.0100 or 2C.0200 Well Construction Standards
and that a copy of this record has been provided to the well owner.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.741400 N 77.366600 You may use the back of this page to provide additional well site details or well
abandonment details. You may also attach additional pages if necessary.
CONSTRUCTION DETAILS OF WELL(S)BEING ABANDONED SUBMITTAL INSTRUCTIONS
Attach well construction record(s)if available. For multiple injection or non-water supply wells
ONLY with the same construction/abandonment,you can submit one form.
10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: H - el 7 abandonment to the following:
r Division of Water Resources,Information Processing Unit,
6b.Total well depth: a lO (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617
lOb.For Iniection Wells: In addition to sending the form to the address in 10a
6c.Borehole diameter: (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: (ft,) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): (fL) 10c.For Water Supply&Iniection Wells: 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
6f.Inner casing/tubing length(if known): (ft.) abandoned.
6g.Screen length(if known): (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

TERRATHERM ISTD Heater Boring Construction Detail Revision#: 0
C:^.aroC.vn..aq Release date: 5/12123
Approved by: SL
Well ID H-47 Date 7- g'a3
Oversight 1 Job# R23-104
Driller f it/,ALA.4 i17
Constructed
(fill out if
Design different) Notes
--Stick Up Height
1/2"Thermocouple pipe? _ 24" a/"
Thermocouple Length .67'
Ground Surface 0.0'
•
Heater Can Conductive HT Grout— Angle from Horizontal 90*
Schedule 40
Borehole Diameter 6"
Heater Can Length 28 ft I 5 Gal Buckets of Graphite 1.25
Bags of Silica _1.75
Heater Can Diameter 3 in
• Bags of Cement 6
i .
Installation Method
,D ect Push
Hollow Stem Auger
Mud Rotary
Other:
Bottom of Heater Can 26'
•
Bottom of Borehole 26' ab
Post-Installation QC(to be performed 24hrs after installation) PID Log:Make/Model:
1)Confirm well is free of grout Design Constructed Time: ;eV Reading: (f,e PPM
Depth to bottom of well[ft bTOC JR' Time: 8,"Sy Reading: a,0 PPM
if greater than or equal to ift less than designed alert the office Time: t; ;S7 Reading: ey, PPM
2)Confirm grout plug reaches ground surface Time: Reading: PPM
repeat daily until depth to grout is Oft. Time: Reading: PPM
Date Depth to Grout(ft bgs] Notes:

WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
David Wilcox 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
3223—A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gaL)
Cascade Drilling FOR WATER SUPPLY WELLS ONLY:
Company Name � /� 7c.Type of disinfectant used:
2.Well Construction Permit#: N/A CERCLA site
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)if known
7d.Amount of disinfectant used:_
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public 0 Neat Cement Grout 0 Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) 0 Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay
0 Industrial/Commercial ❑Residential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings
0 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 eGroundwaterRemediation Portland Cement qq J` 0.//��❑Aquifer Storage and Recovery 0 Salinity Barrier s
0 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) i0ther(explain under 7g) Tremie grout . .l
4.Date well(s)abandoned: V I
5a.Well location: 1
ABC One Hour Cleaner,Superfund Site NC D024644494 5�GA c/n e
Facility/Owner Name Facility ID#(if applicable) 8.Certification: ���
2127 Lejeune Blvd, Jacksonville NC, 28546 Y
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Onslow 439613047818
By signing this form, I hereby certify that the well(s) was(were)abandoned in
County Parcel Identification No.(PIN) accordance with 1 5A NCAC 02C.0100 or 2C.0200 Well Construction Standards
and that a copy of this record has been provided to the well owner.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.741400 N 77.366600 W You may use the back of this page to provide additional well site details or well
abandonment details. You may also attach additional pages if necessary.
CONSTRUCTION DETAILS OF WELL(S)BEING ABANDONED SUBMITTAL INSTRUCTIONS
Attach well construction record(s)if available.For multiple injection or non-water supply wells
ONLY with the same construction/abandonment,you can submit one form.
10a. For All Wells: Submit this form within 30 days of completion of well
H i S
6a.Well ID#: " abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 3 L t i 3 (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617
lOb.For Iniection Wells: In addition to sending the form to the address in 10a
6c.Borehole diameter: (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: (ft,) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): (ft) 10c.For Water Supply&Iniection Wells: In addition to sending the form to the
address(es)above,also submit one copy of this form within 30 days of completion
of well abandonment to the county health department of the county where
6f.Inner casing/tubing length(if known): (ft.) abandoned.
6g.Screen length(if known): (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

•
TERRAI f U ISTD Heater Boring Construction Detail Revision 11: 0
,Release date:_5/12/23_,
Approved by:
well in H-45 Date
Oversight Job# R23 104
Constructed
lflll out If
Design different) Note
[err
1 ?"Thermocouple pipe' -Heater Stick-Up Height 30" /
Thermocouple Length 37.67' 0;
VEW stick-tip Height 18" 1�
Ground Surface 0.0'
Heo'fer Con Condurt1ve HT Grout--
Angle from Horizontal 90"
Schedule 80
Borehole Diameter 7"
Top of#00 sand 1'
Top of Screen 3'
Neater Can Length 38.5 ft 5 Gal Buckets of Graphite 0.5
Heater Can Diameter 3 in
Bags of Silica 0.75
Screen length 10 It4110
Screen Diamter 3 in Bags of Cement 2.25
Bottom of Screen 13'
Installation Method
Direct Push Bags of#00 Sand 10.S
Sonic - ,��—
Hollow Stern Auger Gallons of Limestone 10.5
Mud Rotary
°titer:
Bottom of#00 Sand 30'
Bottom of Heater Can IC
Bottom of Borehole 36'
I t-wutaliatkrn Q_C(to be performed Mrs after Installation) MO Log:Make/Model:
I1 confirm well well is fron of rt I 1
grout —Design n Constructed Time , f 1 Reading: 1n7 r' PPM
iDepth to$.Doom of well lft blOC - 3I 5 Time (J('r Reading: f?. ` PPM
if greater Hum or equal to 1 fi less than designed alert the office Time: et) Reading: ("{)c PPM
2)Confirm grout plug reaches ground surface Time: I ,f,l f'r Reading: "r . PPM
repeat dolly until depth to grout is left. Time: 9,04,) Reading: : f PPM
Gate Depth to Grout lR Lips) Notes:

0
- WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
David Wilcox 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
3223-A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gal-)
Cascade Drilling FOR WATER SUPPLY WELLS ONLY:
Company Name 7c.Type of disinfectant used:
2.Well Construction Permit#: N/A CE RCLA site
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)if known
7d.Amount of disinfectant used:
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑MunicipaVPublic 0 Neat Cement Grout ❑ Bentonite Chips or Pellets
OGeothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout ❑ Dry Clay
❑lndustrial/Cornmercial :Residential Water Supply(shared) ❑Concrete Grout ❑ Drill Cuttings
❑Irrigation ❑ Specialty Grout ❑ Gravel
Non-Water Supply Well: ❑Bentonite Slurry 0 Other(explain under 7g)
❑Monitoring ❑Recovery
Injection Well: If.For each material selected above,provide amount of materials used:
:Aquifer Recharge fiGroundwaterRemediation Portland Cement 19 5 j/O/15
:Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage _
❑Experimental Technology ❑Subsidence Control 7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer , - - . . .
❑Geothermal(Heating/Cooling Return) &Other(explain under 7g) Tremie grout 1
4.Date well(s)abandoned: 1 `1- `� °tIG 2 7 207.1
�+"
Sa Well location: :� L,rx
ABC One Hour Cleaner,Superfund Site NC D024644494 5 � �`�'e
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
2127 Lejeune Blvd, Jacksonville NC, 2854
� � -
Physical Address,City,and Zip �I�-�
Signature of Certified Well Contractor or Well Owner Date
Onslow 439613047818 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/►ong is sufficient) 9.Site diagram or additional well details:
34.741400 N 77.366600 W You may use the back of this page to provide additional well site details or well
abandonment details. You may also attach additional pages if necessary.
CONSTRUCTION DETAILS OF WELL(S)BEING ABANDONED SUBMITTAL INSTRUCTIONS
Attach well construction record(s)if available. For multiple injection or non-water supply wells
ONLY with the same construction/abandonment,you can submit one form. 10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well LD#: N — d i abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 7 .(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: (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: (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): (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): (ft.) abandoned.
6g.Screen length(if known): _(ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

/TERRATHERM ISTD Heater Boring Construction Detail Revision 4: 0
`""'"'"`NN Release date: 5/12/23
Approved by: SL
Well ID H-42 Date 7- 8'- ]
Oversight // - n� Job q R23-104
Driller F 5 ! 2 L,(/s•/2)6er/y
Constructed
(fill out if
Design different) Notes
--Stick Up Height
1/2"Thermocouple pipe? 24" r2.2lJ
Thermocouple Length 48.67'
Ground Surface 0.0'
Heater Con Conductive HT Grout— Angle from Horizontal 90°
Schedule 40
Borehole Diameter 6"
•
Heater Can Length 49 ft 5 Gal Buckets of Graphite 2.5 t
Bags of Silica _.25
Heater Can Diameter 3 in
Bags of Cement 1).75
ti
(
Installation Method
Direct Push
Sonic
Hollow Stem Auger
Mud Rotary
Other:
Bottom of Heater Can 4[7'
Bottom of Borehole 47' I/7f
Post-Installation QC(to be performed 24hrs after installation) PID Log:Make/Model:
1)Confirm well is free of grout Design Constructed Time: I/.tb Reading: Q� PPM
Depth to bottom of well(ft bTOC A9' Time: I,'� Reading: 9r PPM
if greater than or equal to ift less than designed alert the office Time: . i13 Reading: JE.() PPM
2)Confirm grout plug reaches ground surface Time: Reading: PPM
repeat daily until depth to grout is Oft. Time: Reading: PPM
Date Depth to Grout[ft bgs] Notes: 6

WELL ABANDONMENT RECORD ForinternalUseONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
David Wilcox 7a.For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same
Wet 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
3223-A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gal.)
Cascade Drilling FOR WATER SUPPLY WELLS ONLY:
Company Name p 7c.Type of disinfectant used:
2.Well Construction Permit#: N/A CERCLA site
List all applicable well construction permits(i.e.UIC,County,State, Variance,etc.)if known
7d.Amount of disinfectant used:
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
:Agricultural ❑Municipal/Public ❑ Neat Cement Grout ❑ Bentonite Chips or Pellets
:Geothermal(Heating/Cooling Supply) :Residential Water Supply(single) ❑ Sand Cement Grout 0 Dry Clay
❑IndustriallCommercial ❑Residential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings
❑Irrigation 0 Specialty Grout 0 Gravel
Non-Water Supply Well: 0 Bentonite Slurry ❑ Other(explain under 7g)
❑Monitoring ❑Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge •Groundwater Remediation Portland Cement /
❑Aquifer Storage and Recovery ❑Salinity Barrier — r ,010,15
❑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) iliOther(explain under 7g) Tremie grout
7 20?.4
4.Date well(s)abandoned: (. - 1 I
5a.Well location: ji, ,: . ... tdP,,a/
ABC One Hour Cleaner,Superfund Site NC D024644494 S c e
Facility/Owner Name Facility IDd(if applicable) 8.Certification:
2127 Lejeune Blvd, Jacksonville NC, 28546
Physical Address,City.and Zip Signature of Certified Well Contractor or Well Owner Date
OnSIOW 439613047818 By signing this form, I hereby certify;hat the well(s) was (were) abandoned in
County Parcel Identification No.(PIN) accordance with 15A NCAC 02C.0100 or 2C.0200 Well Construction Standards
and that a copy of this record has been provided to the well owner.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.741400 N 77.366600 W You may use the back of this page to provide additional well site details or well
abandonment details. You may also attach additional pages if necessary.
CONSTRUCTION DETAILS OF WELL(S)BEING ABANDONED SUBMITTAL INSTRUCTIONS
Attach well construction record(s)if available. For multiple injection or non-water supply wells
ONLY with the same construction/abandonment.you can submit one form.
10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: H' - Y 3 abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: 3 C (ft.) 1617 Mail Service Centtr,Raleigh,NC 27699-1617
10b.For Injection Wells: hi addition to sending the form to the address in 10a
6c.Borehole diameter: (in.) above, also submit one copy of this fcrm within 30 days of completion of well
abandonment to the following:
6d.Water level below ground surface: (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): _(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): (ft-) abandoned.
6g.Screen length(if known): (ft-)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

• ISTD Heater Boring Construction Detail Revision#: 0
IERRATHERM Release date: 5/12/23
Approved by: SL
WeII ID H-43 Date 7-7-0V
OVerSlght Job H R23-104
Driller Constructed
(fill out If
Design different) Notes
--Stick Up Height 1/2"Thermocouple pipe? _24" a5 V
Thermocouple Length 37.67'
Ground Surface 0.0'
Heater Con Conductive HT Grout— ngle from Horizontal 90'
Schedule 40
Borehole Diameter 6" ,
Heater Can Length 38 ft 5 Gal Buckets of Graphite 1.75
Bogs of Silica 2.5
Heater Can Diameter 3 In
Bags of Cement 8.25
I � .
•
Installation Method .
Direct Push •
Sonic
Hollow Stem Auger
Mud Rotary
Other:
{
Bottom of Heater Can 36' -
Bottom of Borehole 36'
Post4nstallation QC(to be performed 24hrs after installation) Pro Log:Make/Model:
1)Confirm well is free of grout Design Constructed Time: 7 Reading: ©.Q PPM
Depth to bottom of well(h bTOC tft' Time: Reading: (ly t7 PPM
if greater than or equal to ill less than designed alert the office Time: Reading: PPM
2)Confirm grout plug readies ground surface Time: Reading: PPM
repeat daily until depth to grout is Oft. Time: Reading: PPM
Date Depth to Grout(ft bgs) Notes:
yu/Al ybe/lair,

1 4
. WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
David Wilcox 7a.For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same
Well Contractor Name(or well owner personally abandoning well on his/her property) well construction/depth,only 1 GW-30 is needed. Indicate TOTAL NUMBER of
wells abandoned:
3223-A
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gal.)
Cascade Drilling FOR WATER SUPPLY WELLS ONLY:
Company Name 7c.Type of disinfectant used:
2.Well Construction Permit#: N/A CERCLA site
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)if known
7d.Amount of disinfectant used:_-
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
El Agricultural ❑Municipal/Public ❑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: 7f.For each material selected above,F rovide amount of materials used:
❑Aquifer Recharge SGroundwaterRemediation Portland Cement ' //0;15
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology ❑Subsidence Control 7g.Provide a brief description of the abandonment procedure:
UGeothermal(ClosedLoop) ❑Tracer Tremie grout
❑Geothermal(Heating/Cooling Retum) ✓fOther(explain under 7g) — ""
•
c — AUG 1 i Ito',4.Date well(s)abandoned: ( -
5a.Well location:
p N C D024644494 S e `` � '�ABC One Hour Cleaner,Superfund Site
Facility/Owner Name Facility ID#(if applicable) 8.Certification: /
2127 Lejeune Blvd, Jacksonville NC, 28546' ( /Z`�� 7-0/- y
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Onslow 439613047818 By signing this form, I hereby certify that the well(s) was (were) abandoned in
County Parcel Identification No.(PIN) accordance with 15A NCAC 02C.0100 or 2C.0200 Well Construction Standards
and that a copy of this record has been provided to the well owner.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.741400 N 77.366600 W You may use the back of this page to provide additional well site details or well
abandonment details. You may also attach additional pages if necessary.
CONSTRUCTION DETAILS OF WELL(S)BEING ABANDONED SUBMITTAL INSTRUCTIONS
Attach well construction record(s)if available. For multiple injection or non-water supply wells
ONLY with the same construction/abandonment,you can submit one form. 10a. For All Wells: Submit this fore within 30 days of completion of well
6a.Well ID#: 14 - -( // abandonment to the following:
/
2 ' Division of Water Resources,Information Processing Unit,
6b.Total well depth: to — 1 3 (ft.) 1617 Mail Service Centt r,Raleigh,NC 27699-1617
10b.For Injection Wells: In addition to sending the form to the address in 10a
6c.Borehole diameter: (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: (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): (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): (ft.) abandoned.
6g.Screen length(if known): (ft)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

` ISTD Heater Boring Construction Detail Revision II: 0
' TERRATHERM ��
Release date:_5/12/23_
Approved by: SL
Well ID H-41 Date
Oversight lob If R23 1.04
Driller f'tf) O l,/(ill- al;An f
.1' )r'e-1/
// Constructed
(fill out if
Design different) Notes
1/2"Thermocouple pipe? --Heater Stick-Up Height 30`"
Thermocouple Length 37.67'
--VEW Stick-Up Height LE"
Ground Surface 0.0'
Heater Can Conductive HT Grout-- 1 pr
Angle from Horizontal 90°
Schedule 80
Borehole Diameter CT�
= Top of#aa Sand 1'
� Top of Screen 3'
Heater Can Length 35.5) ft 5 Gni Buckets of Graphite 0:5 i
Heater Can Diameter 3 in
E Bags of Silica -d75 c,P
Screen Length 1(17 ft -.
Screen Diamter in F- Bags of Cement _..275 �'
Bottom of Screen .'13' 1
Installation Method
Direct Push Bags of#OD Sand 10.5
Sonic '
Hoilow Stem Auger Gallons of Limestone 10.5
Mud Rotary
Other:
Bottom of#09 Sand 30'
Bottom of Heater Can 36'
Bottom of Borehole (3_,e).
Post-Installation QC(to be performed 24hrs after installation) MD Log:Make/Model:
1)Confirm well is free of grout Design Constructed Time: '.' (, Reading: . , `\ PPM
Depth to bottom of well[ft bTOC 38.5' Time: r t Reading: PPM
if greater than or equal to ift less than designed alert the office Time: ; ti Reading: f PPM
2)Confirm grout plug reaches ground surface Time: Reading: PPM
repeat daily until depth to grout is Oft. Time: Reading: PPM
Date Depth to Grout[ft bgs) Notes:

WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
David Wilcox 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
3223—A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gaL)
Cascade Drilling FOR WATER SUPPLY WELLS ONLY:
Company Name
. N/A CERCLA site 7c.Type of disinfectant used:
2.Well Construction Permit#.
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.)if known
7d.Amount of disinfectant used:
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural OMunicipal/Public ❑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) ❑Concrete Grout 0 Drill Cuttings
❑Irrigation 0 Specialty Grout 0 Gravel
Non-Water Supply Well: 0 Bentonite Slurry 0 Other(explain under 7g)
El Monitoring ❑Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge lGroundwaterRemediation Portland Cement _ 15 5 4/1075
❑Aquifer Storage and Recovery ❑Salinity Barrier
0 Aquifer Test ❑Stormwater Drainage _
❑Experimental Technology ❑Subsidence Control
7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) OTracer Tremie grout
❑Geothermal(Heating/Cooling/Return)
e� iOther(explain under 7g)
4.Date well(s)abandoned: l.+ I
5a.Well location:
ABC One Hour Cleaner,Superfund Site NC D024644494 S ` � a`ti Q d
Facility/Owner Name Facility ID#(if applicable) 8.Certification: /
2127 Lejeune Blvd, Jacksonville NC, 28548 _.2 y
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Onslow 439613047818 By signing this form, 1 hereby certify that the well(s) was(were)abandoned in
County Parcel Identification No.(PIN) accordance with 15A NCAC 02C.0100 or 2C.0200 Well Construction Standards
and that a copy of this record has been provided to the well owner.
56.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:
34.741400 N 77.366600 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)iifavailable.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 fonn within 30 days of completion of well
6a.Well ID#: H ' V O abandonment to the following:
/ Division of Water Resources,Information Processing Unit,
l9 6b.Total well depth: 3 (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: Om) above, also submit one copy of this farm within 30 days of completion of well
abandonment to the following:
6d.Water level below ground surface: (ft,) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): (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
6L Inner casing/tubing length(if known): (ft,) abandoned.
6g.Screen length(if known): (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

ISTD Heater Boring Construction Detail Revision 4: 0 .._
TERRATHERM Release date: 5/12/23
Approved by: Sl
Well ID H-40 Date I I4 - X3
Oversight -S A?),fl,L t ,1 � ) / Job 4 R23-104
Driller Frei-) D�"1Q11r SVid-LIJ;M7jP.-//
Constructed
(fill out if
Design different) Notes
ii —Stick Up Height
1/2"Thermocouple pipe? 7_4"?
Thermocouple Length .67'
Ground Surface 0.0'
Heater. Conductive HT Grout— Angle from Horizontal 90°
'Schedule 40
Borehole Diameter • G"'
(—
Heater Can Length ft 5 Gal Buckets of Gmphite ^ 1..75 /
Bags of Silica 2.5 ,
Heater Can Diameter 3 in ,
Bags of Cement 8.25 It f
Installation Method
Direct Push
Sonic,
Hollow Stem Auger
Mud Rotary
Other:
Bottom of Heater Can 3(:,'
Bottom of Borehole 36'
Post-Installation QC(to be performed 24hrs after installation) PID Log:Make/Model:
1)Confirm well is free of grout Design Constructed Time: t./;;2 0 Reading: 0,, t PPM
Depth to bottom of well[ft bTOC, _._38_ Time: I f s 3;1'0 Reading; �?,y'." PPM
if greater than or equal to 1ft less than designed alert the office Time: I an f a7r„ Reading: c .0 PPM
2)Confirm grout plug reaches ground surface Time: Reading: PPM
repeat daily until depth to grout is Oft. Time: Reading: PPM
Date Depth to Grout(ft bgs) Notes:

WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
David Wilcox 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
3223-A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gal.)
Cascade Drilling FOR WATER SUPPLY WELLS WYLY:
Company Name
2.Well Construction Permit#:
N/A CERCLA site 7c.Type of disinfectant used:
List all applicable well construction permits(i.e.U/C,County,State, Variance,etc.)if known
7d.Amount of disinfectant used: _
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Municipal/Public ❑Neat Cement Grout ❑ 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: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge •GroundwaterRemediation Portland Cement I ✓�] Atio,15 C
[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 Tremie grout
❑Geothermal(Heating/Cooling Return) &Other(explain under 7g)
Al)ii LUL.
4.Date well(s)abandoned: 6 I I .) r
5a.Well location:
ABC One Hour Cleaner,Superfund Site NC D024644494 5
Facility/Owner Name Facility IDO(if applicable) 8.Certification:
2127 Lejeune Blvd, Jacksonville NC, 28546 � A2.7 -2_a- a`?
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Onslow 439613047818
By signing this form, I hereby certify that the well(s) was (were) abandoned in
County Parcel Identification No.(PiN) accordance with 15A NCAC 02C.0100 or 2C.0200 Well Construction Standards
and that a copy of this record has been provided to the well owner.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.741400 N 77.366600 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)BELNG ABANDONED SUBMITTAL INSTRUCTIONS
Attach well construction record(s)((available. For multiple injection or non-water supply wells
ONLY with the same construction/abandonment,you can submit one form.
10a. For All Wells: Submit this form within 30 days of completion of well
6a. t-f `1 Well ID#: - abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth: ` (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: (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: (ft,) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): (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): (ft-) abandoned.
6g.Screen length(if known): (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

TERRATHERM ISTD Heater Boring Construction Detail Revision#: 0
lotRelease date: 5/12/23
Approved by: SL
Well ID H-39 Date _ I
Oversight Job It R23-104
Driller A� ' C. l,.t/ er- `1
Constructed
(fill out if
Design different) Notes
--Stick Up Height
1/2"Thermocouple pipe? 24" Z-l
Thermocouple Length 37.67'
Ground Surface 0.0'
Heater Can Conductive HT Grout— •ngle from Horizontal 90"
r. Schedule 40
Borehole Diameter 6"
Heater Can Length 38 ft g ( Gal Buckets of Graphite 1.75
Bogs of Silica 2.5
Heater Can Diameter 3 in
Bags of Cement 8.25
Installation Method
Direct Push
Hollow Stem Auger II!
Mud Rotary
Other:
Bottom of Heater Can 36'
Bottom of Borehole 36'
Post-Installation QC(to be performed 24hrs after installation) PID Log:Make/Model:
1)Confirm well is free of grout Design Constructed Time: Reading: PPM
i)npth to bottom of well[ft bTOC 4R' Time: _Reading: PPM
if greater than or equal to lit less than designed alert the office Time: Reading: PPM
2)Confirm grout plug reaches ground surface Time: Reading: PPM
repeal daily until depth to grout is Oft. Time: Reading: PPM
Date Depth to Grout[ft bgsj Notes:

WELL ABANDONMENT RECORD For Intel Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
David Wilcox 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
3223—A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gal.)
Cascade Drilling FOR WATER SUPPLY WELLS ONLY:
Company Name
7c.Type of disinfectant used:
2.Well Construction Permit#:
N/A CERCLA site
List all applicable well construction permits(i.e.UIC,County,State, Variance,etc.)if known
7d.Amount of disinfectant used:
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ❑Mimicipal/Public ❑Neat Cement Grout ❑ Bentonite Chips or Pellets
El 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: 7f.For each material selected above,provide amount of materials used:
Aquifer Recharge UGroundwaterRemediation Portland Cement _ ( 5 5rz.f/c.,.-1 5
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage _
❑Experimental Technology OSubsidence Control
7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer
❑Geothermal(Heating/Cooling Return) &Other(explain under 7g) T re m i e g ro u t
C C,�
4.Date well(s)abandoned: 6 ( . 1 I 2
5a.Well location:
ABC One Hour Cleaner,Superfund Site NC D024644494
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
2127 Lejeune Blvd, Jacksonville NC, _dY
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Onslow 439613047818 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 1C.0200 Well Construction Standards
and that a copy of this record has been provided to the well owner.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.741400 N 77.366600 ,,`, You may use the back of this page to provide additional well site details or well
abandonment details. You may also attach additional pages if necessary.
CONSTRUCTION DETAILS OF WELL(S)BEING ABANDONED SUBMITTAL INSTRUCTIONS
Attach well construction record(s)if available. For multiple injection or non-water supply wells
ONLY with the same construction/abandonment,you can submit one form.
10a. For All Wells: Submit this fonn within 30 days of completion of well
6a.Well ID#: f 3' 8 abandonment to the following:
77 Division of Water Resources,Information Processing Unit,
6b.Total well depth: 7 t 1 3 (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: (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: (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): (ft.) 1Oc.For Water Supply&Injection Wells: In addition to sending the form to the
address(es)above,also submit one copy of this form within 30 days of completion
of well abandonment to the county health department of the county where
6f.Inner casing/tubing length(if known): (ft.) abandoned.
6g.Screen length(if known): (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

v
• TERRATHERM ISTD Heater BoringBoringConstruction Detail Revision#: 0
Release date:- 5/12/23_
Approved by: S1
h
Well ID H-38 Date /-' / —Q3
Oversight r ' o'- 5111
1 d Job t! R23-104
Drieler T r c.J 1:)1....".c t/*./-41, erl
Constructed
!'fill out if
Design different) Motes
112"Thermocouple pipe? Yes Heater Stick-Up Height 30" j(j)
\a7 Thermocouple Length l.1-'
--VEW Stick-Up Height (a", f ,'
Ground Surface 0.0'
Heater Can Conductive HT Grout-- --
� _Angle from Horizontal 90"
schedu►e BO
Borehole Diameter 7"
- Top of#OD Sand 1'
Top of Screen 3'
Heater Can Length 38 5 Gal Buckets of Graphite 0t.) - i
Heater Can Diameter 3 in �
.. - 1f -- BOOS of Silica 4.75 a
Screen Length / 10 ! ft '
Soren Diamter �3/ in _ Bags of Cement �£25 /
Bottom of Screen 13'.
Installation Method
Jj ect Push Bags of M00 Sand 10.5
,,,,-".:Sonic.‘-)
.,_e 1=
Hollow Stem Auger Gallons of Limestone 10.5
Mud Rotary
Other:
Bottom of BOO Sand 30'
Bottom of Heater Can 36'
Bottom of Borehole r 36'1 j 7
Post-Installation QC(to be performed 24hrs after installation) PIO Log:Make/Model;
1)Confirm well is free of grout Design Constructed Time: rf',` j(1 Reading: CY'l' I PPM
Depth to bottom of well[ft bTOC: 3P S__. _____. Time: C":"LIE Reading: 69. 2 PPM
if areater than or equal to 1ft less than designed alert the office Time:/l1 `�� Reading: Ay / PPM
2)Confirm grout plug reaches ground surface Time: Reading: PPM
repent daily until depth to qrnut is Oft. Time: Reading: PPM
Date Depth to Grout[ft bgs] Notes:

' WELL ABANDONMENT RECORD For Internal Use ONLY:
1.Well Contractor Information: WELL ABANDONMENT DETAILS
David Wilcox 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
3223—A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gal.)
Cascade Drilling FOR WATER SUPPLY WELLS ONLY:
Company Name
2.Well Construction Permit#:
N/A CERCLA site 7c.Type of disinfectant used: _
List all applicable well construction permits(i.e.UIC,County,State, Variance,etc.)if known
7d.Amount of disinfectant used:
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
❑Agricultural ElMunicipal/Public ❑Neat Cement Grout ❑ Bentonite Chips or Pellets
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑ Sand Cement Grout ❑ Dry Clay
❑lndustriaUCommercial ❑Residential Water Supply(shared) ❑Concrete Grout ❑ Drill Cuttings
❑Irrigation ❑ Specialty Grout 0 Gravel
Non-Water Supply Well: ❑ Bentonite Slurry ❑ Other(explain under 7g)
❑Monitoring ❑Recovery
Injection Well: 7f.For each material selected above,provide amount of materials used:
❑Aquifer Recharge •Groundwater Remediation Portland Cement _ 3 15 a J/U,i S
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage _
❑Experimental Technology ❑Subsidence Control 7g.Provide a brief description of the abandonment procedure:
OGeothermal(Closed Loop) ❑Tracer
❑Geothermal(Heating/Cooling Return) &Other(explain under 7g) Tremie grout
4.Date well(s)abandoned: C. I �� " 1 • Z, 7 12.1
5a.Well location:
ABC One Hour Cleaner,Superfund Site NC DO24644494
Facility/Owner Name Facility ID#(if applicable) 8.Certification:
2127 Lejeune Blvd, Jacksonville NC, 28546' �Z`� __�_�y
Physical Address,City,and Zip Signature of Certified Well Contractor or Wet Owner Date
Onslow 439613047818
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 lablong is sufficient) 9.Site diagram or additional well details:
34.741400 N 77.366600 W You may use the back of this page to Frovide 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.
�c C r 10a. For All Wells: Submit this form within 30 days of completion of well
(1-6a.Well ID#: I4' ' V (� abandonment to the following:
Division of Water Resources,Information Processing Unit,
6b.Total well depth:7 (•5+3-e L(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: (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: (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): (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): (ft-) abandoned.
6g.Screen length(if known): (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

TERRATHERM ISTD Heater Boring Construction Detail Revision#: 1
Release date:_6/14/23_
Approved by:
Well ID HC-06E Date e
Oversight 0 •",(S°f k y/A Job# R23-104
Driller q Fa n, L
„/`l`� +,rc,l�
jConstructed
(fill out if
Design different) Notes
--Length of Can Stick-Up(ft)/
Height of Can Stick-up Above
1/2"Thermocouple pipe? No Ground(in) 5'/30"
Thermocouple Length 77.29'
-Length of VEw Stick-Up(ft)/
Height of Riser Stick-Up Above
Ground(Inl 1.5'/6"
Ground Surface 0.0' '
Heater Can Conductive HT Grout—
Angle from Horizontal 22'
Schedule B0
Borehole Diameter 7"
Top of#00 Sand 21.5'
Top of Screen 26.5'
Heater Can Length 81.5 ft 5 Gal Buckets of Graphite 2.5
Heater Can Diameter 3 in Bags of Silica 3.5
Screen Length /Q -� ft Bags of Cement 11
Riser Length 29 ft
Screen Diameter 1 in Bottom of Screen -14T'i 6`l
Installation Method
Direct Push Bags of WOO Sand 15
Sonic
Hollow Stem Auger Gallons of Crushed
Mud Rotary Limestone 15
Other:
Bottom of k00 Sand 61.5'
Bottom of Heater Can 76.5'
Bottom of Borehole 76.5'
Post-Installation QC(to be performed 24hrs after Installation) PlO Log:Make/Model:
1)Confirm well is free of grout Design Constructed Time:1r11;j ry` Reading: 0.1 PPM
Depth to bottom of well[ft bTOC R1 5' Time: `37 toNf Reading: 1, PPM
if greater than or equal to lit less than designed alert the office Time: R eadin:: - PPM
2)Confirm grout plug reaches ground surface Time:3Lzay
,_1,� Reading: PPM
repeat daily until depth to grout is Oft. Time: Reading: PPM
Date Depth to Grout[ft bgsl Notes:

WELL ABANDONMENT RECORD For Internal Use ONLY:
•
1.Well Contractor Information: WELL ABANDONMENT DETAILS
David Wilcox 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
3223-A wells abandoned:
NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): (gal.)
Cascade Drilling FOR WATER SUPPLY WELLS ONLY:
Company Name 7c.Type of disinfectant used:
2.Well Construction Permit#: N/A CERCLA site
List all applicable well construction permits(i.e. U/C County,State, Variance,etc.)if known
7d.Amount of disinfectant used:
3.Well use(check well use):
Water Supply Well: 7e.Sealing materials used(check all that apply):
EAgricultural ❑Mtmicipal/Public ❑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: If.For each material selected above,provide amount of materials used:
EAquifer Recharge •Groundwater Remediation Portland Cement L 4��� S
❑Aquifer Storage and Recovery ❑Salinity Barrier —'
❑Aquifer Test ❑Stormwater Drainage _
❑Experimental Technology ❑Subsidence Control 7g.Provide a brief description of the abandonment procedure:
❑Geothermal(Closed Loop) ❑Tracer
❑Geothermal(Heating/Cooling Return) &Other(explain under 7g) Tremie grout
4.Date well(s)abandoned: (...2 � 1-tt �� 02 4
5a.Well location: �y
ABC One Hour Cleaner,Superfund Site NC D024644494 e
Facility/Owner Name Facility 1DS(if applicable) 8.Certification:
2127 Lejeune Blvd, Jacksonville NC, 28540-- �Z�� -) _a_)y
Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date
Onslow 439613047818
By signing this form, 1 hereby certify chat the well(s) was (were) abandoned in
County Parcel Identification No.(PIN) accordance with 15A NCAC 02C.0100 or 2C.0200 Well Construction Standards
and that a copy of this record has been provided to the well owner.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one lat/long is sufficient) 9.Site diagram or additional well details:
34.741400 N 77.366600 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 well construction record(s)if available. For multiple injection or non-water supply wells
ONLY with the same construction/abandonment,you can submit one form.
10a. For All Wells: Submit this form within 30 days of completion of well
6a.Well ID#: &I C. ( I) abandonment to the following:
u Division of Water Resources.Information Processing Unit,
6b.Total well depth: (,) fi / I (ft.) 1617 Mail Service Center,Raleigh,NC 27699-1617
10b. For Injection Wells: In addition':o sending the form to the address in 10a
6c.Borehole diameter: (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: (ft.) Division of Water Resources,Underground Injection Control Program,
1636 Mail Service Center,Raleigh,NC 27699-1636
6e.Outer casing length(if known): (ft,) 10c.For Water Supply&Iniection Wells: In addition to sending the form to the
address(es)above,also submit one copy of this form within 30 days of completion
of well abandonment to the county health department of the county where
6f.Inner casing/tubing length(if known): (ft.) abandoned.
6g.Screen length(if known): (ft.)
Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

- 1010TERRATHERM ISTD Heater Boring Construction Detail Revision#: 0
ace c Release date:_5/12/23_
Approved by:_SL_
Well ID HC-06D Date Lam' `'L '
— --?
Oversight - 1)tJ Ck / ' Job# R23-104
Driller --- \ ' . ri 4L.1 /,/lAAter/�
!!!///��� Constructed
(fill out if
A Design different) Notes
-Length of Can Stick-Up(ft)/
Height of Can Stick-up Above
1/2"Thermocouple pipe? Ground(in) 2.5'/:30"
Thermocouple Length 5' -Length of VEW Stick-Up(ft)/
Height of Riser Stick-Up Above
Ground(in) 0.5'/6"
Ground Surface 0.0'
Heater Can Conductive HT Grout—
gle from Horizontal 66"
Schedule 80
Borehole Diameter
_ Top of#00 Sand 2'
— Top of Screen
Heater Can Length ft _ Gal Buckets of Graphite 0.75
71
Heater Can Diameter 3 in - Bogs of Silica 1
Screen Length 10 ft _ Bags of Cement 3
Riser Length 5.5 ft
Screen Diameter 1 in Bottom of Screen 14'7,-,-)
Installation Method
Dir fi Bogs of#00 Sand 20 k
r Sonic
Hollow Stem Auger Gallons of Crushed
Mud Rotary Limestone 20 S
Other:
Bottom of#00 Sand 54.5'
Bottom of Heater Can 62'
Bottom of Borehole 62' ( �_7---
Post-Installation QC(to be performed 24hrs after installation) MD Log:Make/Model:
1)Confirm well is free of grout Design Constructed Time: Reading: - J PPM
Depth to bottom of well[ft bTOC 64 S' Time: Reading: PPM
if greater than or equal to ift less than designed alert the office Time: Reading: PPM
2)Confirm grout plug reaches ground surface Time: Reading: PPM
repeat daily until depth to grout is Oft. Time: Reading: PPM
Date Depth to Grout[ft bgsj Notes: