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Well AbandonmentHARNETT COUNTY DEPARMENT OF PUBLIC HEALTH Well Abandonment Permit Permit Number: 26416Application Number: 11-5-26019 Applicant Name: Michael & Celia Jones Address: 1607 Cone Ave Apex N.C. 27502 Type of Well: BoredTotal Dept: 3 5Diameter: 24" Grouted: yes Static Water Level: 17 Directions to Site: SR 1403 Kipling RD Agent of the State Date: 2-24-11 Abandonment Procedure: Abandonment Procedure: 1. Remove all plumbing or piping into the well, along with any obstructions inside the well; 2.Remove as much of the well the casing a possible, but no les than to a depth of three feet below land surface; 3. remove all soil or other subsurface material present down to the top of the remaining well casing, and extending to a width of at least 12 inches outside of the well casing on all sides; 4. Using 5 oz. of hypochlorite solution (such as HTH), disinfect the well in accordance with 15A NCAC 2C .0111 of this Subchapter. Do not use a common commercial household liquid bleach, as this is too weak a solution to ensure proper disinfection; 5. Fill the well up to the top of the remaining casing with cement grout, concrete grout, bentonite grout, dry clay, or material excavated during drilling of the well and then compacted in place; 6. Pour a one foot thick concrete grout or cement grout plug that fills the entire excavated area about the top of the casing, including the area extending on all sided of the casing out to a width of at least 12 inches on all sides; 7. Complete the abandonment process by filling the remainder of the well above the concrete or cement plug with additional concrete grout, cement grout, or soil. Note: Contact Harnett County Environmental Health for appointment prior to beginning of well abandonment procedure. Well must be abandoned by a Certified North Carolina well driller/contractor. -4- WE. 1. NO N.C. GRID MONUMENT FOUND WITHIN 2000'. REFERENCES: I- AN 0853--10-8149.000 Z D.B. 2159 PG.892 N/F RYALS CATIAS SR. D.B. 908 PG. 830 COMPUTED POINT ZY FROM BENT EIP t 200.09• 01 N a N 2 N/F SUSAN VUNCANNON O.Q 2244 PG. 331 S 76'57 22 f 125.3„ Sy ~ 1x L 20.,3' N l¢.¢. a sy DECK I spoRy 25,103 SQ. FT. 0.576 ACRES 342 KIPLING ROAD +t n nr ~~•Sy,4o+ PICKET FENCE (Ov"ERSMIP UNKNOWN) 0{ i1 w z Z3 17 0 g •F,.,~ SOD r;'Ibil ' N/F JERRY VUNCANNON ° 'Z PIN 0853-10--7167 • Y i -se 1.7R GRAVEL. DRIVE Tlrr CONTROL CORNER (.Lijtil 1 601 P(j ~S}• 2403, rps ss~p• 1 ` NAIL 0 C.L. INTERSECTION BOUNDARY SURVEY FOR KIPUNG RD. do HWY. 401 CELIA. P. JONES',,: I I HARNETT COUNTY, NORTH CAROLINA o'' 40•