2010-08-20_PERMIT FILE - C2009087 (4)

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FORM NO, GWS -31 0412005 WELL CONSTRUCTION AND TEST REPORT STATE OF COLORADO, OFFICE OF THE STATE ENGINEER 1313 Sherman St., Room 618, Denver, CO 80203 Phone — Info (303) BN -3587 Main (303) 866 -3581 Fax 303 866 -3589 http:1Mww.water.state.co.us For Office Use Only 1. WELL PERMIT NUMBER: 277246 2. WELL OWNER INFORMATION NAME OF WELL OWNER: Colorado Coal Resources, LLC MAILING ADDRESS: 701 Market Street STE 700 CITY: St. Louis STATE: MO ZIP CODE: 63101 TELEPHONE NUMBER: 314 342 -3400 3. WELL LOCATION AS DRILLED: NW1 /4, SW1/4, Sec. 14, Twp. 05 19 N or [] S, Range 87 E or ® W DISTANCES FROM SEC_ LINES: 1501 ft. from ❑ N ar ® S section line and 1311 ft. from ❑ E or 0 W section line. SUBDIVISION: , LOT , BLOCK , FILING (UNIT) Optional GPS Location: GPS Unit must use the following settings: Format must be UTM, Units Owner's Well Designation: CWU13 must be meters, Datum must be NAD83, Unit must be set to true N. © Zone 12 or 0 Zone 13 Easting: 320051 STREET ADDRESS AT WELL LOCATION: Northing: 4472962 4. GROUND SURFACE ELEVATION 7282 feet DRILLING METHOD MUD DATE COMPLETED 7124/2008 TOTAL DEPTH 925 feet DEPTH COMPLETED 925 feet 5. GEOLOGIC LOG: 6. HOLE DIAM (in.) From ft To ft Depth Type Grain Size Color Water Loc. 8.75 0 40 5.625 40 925 0 SANDSTONE VF SAND GRAY 56 COAL BLACK 58 SHALE CLAY D GRAY 7. PLAIN CASING: OD (in) Kind Wall Size (in) From (ft) To (ft) 6.25 STEEL .188 0 40 2.375 T5 EEL .190 0 862 PERFORATED CASING: Screen Slot Size (in): .025 4,5 S. Steel Muni -Pak 862 922 93 ISANDSTONE F SAND GRAY 254 SHALE CLAY D GRAY 772 SANDSTONE F SAND D GRAY 778 COAL BLACK 783 SANDSTONE VF SAND GRAY $13 SHALE CLAY D GRAY 818 SANDSTONE VF SAND GRAY 830 SHALE CLAY D GRAY 832 COAL BLACK 841 SHALE CLAY D BROWN 843 SANDSTONE VF SAND GRAY 8. FILTER PACK: Material Silica Snd Size 10120 Interval 852 -925 9. PACKER PLACEMENT: Type Bentoniite Pellets 3/8 in. __Depth 847 -852 851 SHALE CLAY D GRAY 853 COAL BLACK 854 SANDSTONE VF SAND GRAY 863 SHALE CLAY D GRAY 10. GROUTING RECORD Material Amount Density Interval Placement CEMENT 236 GAL 11.0 LB 223 FT TREMIE CEMENT 232 GAL 10.8 LB 219 FT TREMIE CEMENT 439 GAL 9.9 LB 403 FT TREMIE 878 SANDSTONE VF SAND GRAY Remarks: 11. DISINFECTION: Type Amt. Used 12. WELL TEST DATA: ❑ Check box if Test Data is submitted on Form Number GWS 39 Supplemental Well Test. TESTING METHOD Static Level ft. Date/rime measured: Production Rate gpm. Pumping Level ft. Date[Time measured Test Length (hrs) Remarks: 13. 1 have read the statements made herein and know the contents thereof, and they are true to my knowledge_ This document is signed and certified in accordance with Rule 17.4 of the Water Well Constfuction Rules, 2 CCR 402 -2. rrhe filing of a document that contains false statements is a violation of section 37-91-108(1 Le)_, C.R.S., and is punishable by fines up to $5000 and /or revocation of the contracting license. Company Name: Western American Drilling, Inc. Phone: (970)824-9579 License Number: NO Mailing Address j P.Q, Box 750 Craig, Colorado 81626 Signature: ( i - "." E Print Name and Title Mark S_ Whitney, P-G. Consulting Geologist Date 9/20/2008 M