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Form No. OFFICE OF THE STATE ENGINEER <br />GWS -25 COLORADO DIVISION OF WATER RESOURCES <br />81 B Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203 <br />(303) 8813 -358f <br />APPLICANT <br />EXST <br />WELL PERMIT NUMBER 285821 <br />DIV. 4 WD60 DES. BASIN MD <br />APPROVED WELL LOCATION <br />MONTROSE COUNTY <br />NW 114 SW 114 Section 25 <br />WESTERN FUELS COLORADO Township 47 N Range 16 W New Mex P.M. <br />PO BOX 628 DISTANCES FROM SECTION LINES <br />NUCLA, CO 81424- 1978 Ft. from South Section Line <br />41 Ft. from West Section Line <br />(970) 864 -2165 UTM COORDINATES (Meters,Zone:13.NAD83) <br />PERMIT TU USE AN EAISTINU Wt4-L, " " "'y. <br />ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT <br />CONDITIONS OF 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)(1) 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 well known as GW -N54, <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 shall 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.)>z:::.Z.j !irlb � <br />APPROVED <br />JSG L)4041. Of <br />State Engineer By <br />Receipt No. 3649892H DATE ISSUED 05 -25 -2011 EXPIRATION DATE 1 r7 <br />