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Home My WebLink AboutNew Hanover_Well Abandonment_20241115 ii WELL ABANDONMENT RECORD For Internal Use ONLY: 1 1.Well Contractor Information: WELL ABANDONMENT DETAILS Trevor Mizell• 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 130 is needed. Indicate TOTAL NUMBER of 4629-C wells abandoned: I I NC Well Contractor Certification Number 7b.Approximate volume of waterlremaining in well(s): 2.29 (gal.) CATLIN Engineers & Scientists FOR WATER SUPPLY WELLS ONLY: Company Name 7c.Type of disinfectant used: 2.Well Construction Permit#: List all applicable well construction permits(i.e.UK',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 ❑lndustriaUCommercial ❑Residential Water Supply(shared) 0 Concrete Grout ❑Drill Cuttings ❑Irrigation 0 Specialty Grout ❑Gravel Non-Water Supply Well: ❑Bentonite Slurry 1 ❑Other(explain under 7g) •Monitoring - ❑Recovery -- - - ---- i - ----- Injection Well: 7f.For each material selected above,provide amount of materials used: ❑Aquifer Recharge ❑GroundwaterRemediation Bentonite 50 lbs ❑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) ❑Other(explain under 7g) Well was buried in Sand. Uncovered top of well casing stickup. Cut off top of metal stickup casing and well, 4.Date well(s)abandoned: 10/28/2024 bringing them flush with new grade. Filled in well 5a.Well location: i bentonite and hydrate. Y �h-� ��- .. �:�'?e;�_ � Burgess Corp. Site NOV 1 Facility/Owner Name Facility ID#(if applicable) 8.Certification: < <O2"r' N Terminal Rd, Wilmington, NC 28401 �5 10/29/2024 Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner "''''- Date New Hanover By signing this form, I hereby certi&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: 34.25799358528886 N -77.95151117895365 W You may use the back of this page to provide additional well site details or well abandonment details. You may also attach additional pages if necessary. CONSTRUCTION DETAILS OF WELL(S)BEING ABANDONED SUBMITTAL INSTRUCTIONS Attach well constructionrecord(s)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#: MW-1 abandonment to the following: Division of Water Resources,Information Processing Unit, 6b.Total well depth: 18.35 (It) 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: 2 (in.) above, also submit one copy of this form within 30 days of completion of well abandonment to the following: 6d.Water level below ground surface: 4.31 (ft.) Division of Water Resources,Underground Injection Control Program, 1636 Mail Service Center,Raleigh,NC 27699-1636 6e.Outer casing length(if known): N/A (ft.) 10c.For Water Supply&Injection-Wells: In addition to sending the form to the address(es)above,also submit one copy of this form within 30 days of completion of well abandonment to the county health department of the county where 6f.Inner casing/tubing length(if known): Unknown (ft.) abandoned. I . 6g.Screen length(if known): Unknown (ft.) Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources 1 Revised 2-22-2016 WELL ABANDONMENT RECORD For Internal Use ONLY: r II 1.Well Contractor Information: WELL ABANDONMENT DETAILS Trevor Mizelle 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 GOO,is needed. Indicate TOTAL NUMBER of wells abandoned: 1 4629-C I NC Well Contractor Certification Number 7b.Approximate volume of water;remaining in well(s): 2.23 (gal.) CATLIN Engineers & Scientists FOR WATER SUPPLY WELLS,ONLY: Company Name 7c.Type of disinfectant used: 2.Well Construction Permit#: List all applicable well construction permits(i.e.UIC,County,State,Variance,etc)if known 7d.Amount of disinfectant used: 3.Well use(check well use): Water Supply Well: 7e.Sealing materials used(check all that apply): ❑Agricultural ❑Municipal/Public 0 Neat Cement Grout I Bentonite Chips or Pellets O Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout ❑Dry Clay ❑Industrial/Commercial ❑Residential Water Supply(shared) 0 Concrete Grout ❑ Drill Cuttings ❑Irrigation ❑ Specialty Grout 0 Gravel. Non-Water Supply Well: 0 Bentonite Slurry ❑Other(explain under 7g) SMonitoring - ❑Recovery - - - - i Injection Well: 7f.For each material selected above,provide amount of materials used: ❑Aquifer Recharge ❑Groundwater Remediation Bentonite 100 lbs • ❑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 Removed metal casing stickup, concrete pad, and ❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g) well from ground,, Filled in hole with bentonite and 4.Date well(s)abandoned: 10/28/2024 hydrate. ; �'''Y" ;' 5a.Well location: i ) Burgess Corp. Site NOV 1 , 2024 Facility/Owner Name Facility ID#(if applicable) 8.Certification: N Terminal Rd, Wilmington, NC 28401 �• z..-i:10/29/2024 Physical Address,City,and Zip Signature of Certified Well Contractor or Well Owner Date • New Hanover Bysigning thisform, I herebycerti 'that the wells was were abandoned in g g r () ( ) 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: 34.25799358528886 N -77.95151117895365 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 welt 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#: MVV 2 abandonment to the following: Division of Water Resources,Information Processing Unit, 6b.Total well depth: 19.2 (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: 2 (in) above, also submit one copy of this form within 30 days of completion of well abandonment to the following: 5.54 Division of Water Resources;Underground Injection Control Program, 6d.Water level below ground surface: (ft.) 1636 Mail Service Center,Raleigh,NC 27699-1636 F 1 6e.Outer casing length(if known): N/A (ft.) 10c.For Water Supply&Injection Wells: In addition to sending the form to the • address(es)above,also submit one copy of this form within 30 days of completion of well abandonment to the county health department of the county where 6f.Inner casing/tubing length(if known): Unknown (ft.) abandoned. 6g.Screen length(if known): Unknown (ft.) j •Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources ' Revised 2-22-2016 WELL ABANDONMENT RECORD For Internal Use ONLY: • 1.Well Contractor Information: WELL ABANDONMENT DETAILS Trevor Mizelle • 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 4629-C wells abandoned: II NC Well Contractor Certification Number 7b.Approximate volume of water{remaining in well(s): 8.47 (gal.) CATLIN Engineers & Scientists FOR WATER SUPPLY WELLS,ONLY: Company Name 7c.Type of disinfectant used: 2.Well Construction Permit#: List all applicable well construction permits(i.e.UIC,County,State,Variance,etc)if known • 7d.Amount of disinfectant used: 3.Well use(check well use): Water Supply Well: 7e.Sealing materials used(check all that apply): ❑Agricultural ❑Municipal/Public ❑Neat Cement Grout 'Bentonite Chips or Pellets ❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ❑ Sand Cement Grout ❑Dry Clay ❑Industrial/Commercial ❑Residential Water Supply(shared) ❑ Concrete Grout 0 Drill Cuttings ❑Irrigation 0 Specialty Grout ❑Gravel Non-Water Supply Well: ❑ Bentonite Slurry ❑Other(explain under 7g) 'Monitoring ❑Recovery t__ Injection Well: 7f.For each material selected above,provide amount of materials used: ❑Aquifer Recharge ❑Groundwater Remediation Bentonite 100 lbs ❑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 Well was buried in sand. Uncovered top of well casing ❑Geothermal(Heating/Cooling Return)* ❑Other(explain under 7g) stickup. Cut off top of metal stickup casing and well, 4.Date well(s)abandoned: 10/28/2024 bringing them flush with new grade. Filled in well 5a.Well location: bentonite and hydrate. Burgess Corp. Site x Facility/Owner Name Facility ID#(if applicable) 8:Certification: G E' < N Terminal Rd, Wilmington; NC 28401 1V1 2024 10/29/2024 Physical Address,City,and Zip Signature of Certified Well Contractor or Well New Hanover 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: 34.25799358528886 N---77.95151117895365 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#: REC-1 abandonment to the following: Division of Water Resources,Information Processing Unit, 6b.Total well depth: 17.55 (ft) 1617 Mail Service Center,Raleigh,NC 27699-1617 lOb.For Injection Wells: In addition to sending the form to the address in 10a 6c.Borehole diameter: 4 (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: 4.57 (ft) Division of Water Resources;Underground Injection Control Program, 1636 Mail Service Center,Raleigh,NC 27699-1636 6e.Outer casing length(if known): N/A (ft.) 10c.For Water Supply&Injection Wells: In addition to sending the form to the address(es)above,also submit one copy of this form within 30 days of completion of well abandonment to the county health department of the county where 6f.Inner casing/tubing length(if known): Unknown (ft.) abandoned. 6g.Screen length(if known): Unknown (ft.) Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016 i • WELL ABANDONMENT RECORD For Internal Use ONLY: i I I.Well Contractor Information: WELL ABANDONMENT DETAILS; Jeff Stewart 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 2540 wells abandoned:I NC Well Contractor Certification Number 7b.Approximate volume of water remaining in well(s): 0 (gal.) Mid Atlantic Drilling FOR WATER SUPPLY WELLS ONLY: - Company Name 7c.Type of disinfectant used: - 2.Well Construction Permitil: WM0801260 List all applicable well construction permits(i.e.(JIC,County.State,Variance,etc.)ifknown 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 R Bentonite Chips or Pellets ❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) 0 Sand Cement Grout 0 Dry Clay ❑Industrial/Commercial ❑Residential Water Supply(shared) 0 Concrete Grout 0 Drill Cuttings ❑Irrigation 0 Specialty Grout 0 Gravel Non-Water Supply Well: 0 Bentonite Slurry 0 Other(explain under 7g) !Monitoring ❑Recovery Injection Well: 7f.For each material selected above,provide amount of materials used: ❑Aquifer Recharge ❑Groundwater Remediation 2-3 lbs ❑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) ❑rraeer Direct push boring advanced to 12', groundwater sample ❑Geothermal(Heating/Cooling Return) ❑Other(explain under 7g) collected through tooling, tooling removed and bore 4.Date well(s)abandoned: 10/31/2024 hole abandoned with bentonite and water emplaced/ Sn.Well location: poured from the surface.,. -; Fred Nasseri , r Facility/Owner Name Facility IDii(if applicable) 8.Certification: 5743 Oleander Dr. Wilmington 28403 + 1 �_—�� NOV L02413 t Physical Address,City,and Zipi � ) " - F y S'q'�� tf!.` art led Well Contractor or' a 19si`ner ate. New Hanover R06207-003-010-001 By signing this form, I hereby cert fy 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 Tat/long is sufficient) 9.Site diagram or additional well details: 34.20968717848115 N -77.84788216575865 , 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 recanl(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 Il?N: DPT-01 abandonment to the following: Division of Water Resources,Information Processing Unit, 6b.Total well depth: 12 (ft.) 1617 Mall Service Center,Raleigh,NC 27699-1617 10b.For Iniection Wells: In addition to sending the form to the address in I0a 6c.Borehole diameter: 2.25 (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: 10 (ft.) Division of Water Resources,Underground Injection Control Program, 1636 Mail Service Center,Raleigh,NC 27699-1636 6e.Outer casing length(if known): (ft.) 10e.For Water Snooty&Infection Wells: In addition to sending the form to the address(es)above,also submit one copy of this form within 30 days of completion of well abandonment to the county health department of the county where 6f.Inner casing/tubing length(if known): (ft.) abandoned. 6g.Screen length(if known): 4 (ft.) Form GW-30 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016