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Form No, OFFICE OF THE STATE ENGINEER <br />GWS -25 COLORADO DIVISION OF WATER RESOURCES <br />818 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203 <br />(303) 866 -3581 <br />WELL PERMIT NUMBER 2 268 <br />APPLICANT DIV. 1 WD5 DES. BASIN MD <br />APPROVED WELL LOCATION <br />WELD COUNTY <br />NW 1/4 NE 114 Section 1 <br />BESTWAY CONCRETE & AGGREGATE Township 2 N Range 58 W Sixth P.M. <br />301 CENTENNIAL DRIVE DISTANCES FROM SECTION LINES <br />MILLIKEN, CO 8D543- 200 Ft. from North Section Line <br />2672 Ft. from West Section Line <br />(970) 587 -7277 UTM COORDINATES Meters ione:l NAD83 <br />PERMIT TO USE AN EXISTING WELL Easting: Northing: <br />ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT <br />CONDITIONS QF APPROVAL <br />1) This well shall be used in such a way as to cause no material injury to existing water rights. The Issuance of this permit <br />does not ensure that no injury will occur to another vested water right or preclude another owner of a vested water right from <br />seeking relief in a civil court action. <br />2) The construction of this well shall be in compliance with the Water Well Construction Rules 2 CCR 402 -2, unless approval <br />of a variance has been granted by the State Board of Examiners of Water Well Construction and Pump Installation <br />Contractors in accordance with Rule 18. <br />3) Approved pursuant to CRS 37- 92 -602(3)(b)(i) for uses as described in CRS 37- 92- 602(1)(0. Use of this well is limited to <br />monitoring water levels and/or water quality sampling. <br />4) Approved for the use of an existing wall acknowledged for construction under monitoring hole notice MH- 52403, and <br />known as MW 4. <br />5) This well must be equipped with a locking cap or seal to prevent well contamination or possible hazards as an open well. <br />The well must be kept capped and locked at all times except during sampling or measuring. <br />6) Records of water level measurements and water quality analyses shall be maintained by the well owner and submitted to <br />the Division of Water Resources upon request. <br />7) Upon conclusion of the monitoring program the well owner shalt plug this well in accordance with Rule 16 of the Water <br />Well Construction Rules. A Well Abandonment Report must be completed and submitted to the Division of Water <br />Resources within 60 days of plugging. <br />8) The owner shall mark the well in a conspicuous place with the well permit number and name of aquifer as appropriate, <br />and shall take necessary means and precautions to preserve these markings. <br />9) This well must have been constructed by or under the supervision of a licensed well driller or other authorized individual <br />according to the Water Well Construction Rules. <br />10) This well must be located not more than 200 feet from the location specified on this permit. <br />NOTE: issuance of this permit does not guarantee that this well can be converted to a production well under a future <br />permit. Additionally, pursuant to Rule 14.2 of the Water Well Construction Rules (2 CCR 402 -2), monitoring holes <br />constructed pursuant to a monitoring hole notice shall not be converted to a production well. (Upon obtaining a permit from <br />the State Engineer, a monitoring hole may be Converted to a monitoring well, recovery well for remediation of the aquifer, or <br />a dewatering system for dewatering the aquifer.) <br />APPROVED <br />SVJ <br />State Engineer <br />DATE ISSUED 05 -09 -2014 BEXPIRATION DATE <br />