Laserfiche WebLink
OWS1O <br />fQ1°` <br />WELL CONSTRUCTION AND TEST REPORT <br />STATE OF COLORADO, OFFICE OF THE STATE ENGINEER <br />1313 Sherman St., Rm 916, Denver, CO 130203 <br />For Dmas Use only <br />I�; %�: W3 <br />APR 6 2044 <br />wA=:, <br />ararcoLo. <br />1. <br />WELL PERMIT NUMBER MH -43399 <br />2. <br />OWNER NAME(S) Silver Peaks Metr000llten District No. i <br />Mailing Address 5450 South Q ebeo Street. Suite 110 <br />City. St. rip Greenwood Village, CO 80111 _ <br />Phone(303) 773.11005 <br />3. <br />WELL LOCATION AS DRILLED: NW 114_.n 1/4, Sec. 35 Twp, I S Range 67 W <br />DISTANCES FROM SEC. LINES: <br />from N Sec. line, and 1150 ft. from E Sec. line. OR <br />SUBDIVISION: LOT t R BLOOK FILING(UNIT) <br />STREET ADDRESS AT WELL LOCATION: NIA <br />4. <br />GROUND SURFACE ELEVATION 5030 M. DRILLING METHOD 4114" HSA <br />DATE COMPLETED 4115104 , _ TOTAL DEPTH 30.5 _ _ ft. DEPTH COMPLETED 29 <br />5. GEOLOGIC LOG. <br />Depth DowtipUon or Material (Type, Sire, Color, water Lo=Uon) <br />S. HOLE DIAM. (in.) From (ft) To (ft) <br />8 0 30.5 <br />— <br />0-2' Cle , very sandy, gravels present, moist. <br />7. PLAIN CASING <br />OD (in) Kind Wall Size From(ft) To(ft) <br />2 PVC SCH 40 TAGS 19' . <br />PERF. CASING: Screen Slot Size: 0.01" <br />—2'J VC SCH 40 _Jff 2W <br />2'— 27' Gravelly sand. well graded sand, dry to wet, <br />Gray -pink. <br />27'— 30.5' Cla tone, medlum plastic, moist, gray. <br />S. FILTER PACK: <br />Material Sand <br />size 10-20 <br />Interval 5'— ' <br />9. PACKER PLACEMENT: <br />Type <br />Depth <br />10. GROUTING RECORD: <br />Material Amount Density Interval Placement <br />, oncreet I ban <br />Bentonite 2 be <br />REMARKS: MW-30UT <br />Water Level = 13.5' <br />Natural Cave =13' — 30.5' <br />11. <br />DISINFECTION: Type Amt. Used <br />12 <br />WELL TEST DATA: n Check box if Test Data is submitted on Form No. GWS 39 Supplemental Well Test. <br />TESTING METHOD <br />Static Level ft. DateMme measured , Production Rate — spm. <br />Pumping level ft. Daterrime measured , Test length (hre.) <br />Remarks <br />13.1 have road the statements merle herein and know the contents thereof, and that they on: true to my knowledge. (Ptrrsuent to Section 24-4-104 (13) (a) <br />C.R.S., rha making al fabe statements herein constitutes pejury in the second dmme and is punishable me class 1 misdemeanor.) <br />CONTRACTOR Tetra Tech RMC Phone ( 303 } 772-52 Lie. No. <br />Mailing Address 1900 South Sunset Street, Suite 1-F, Longmont, Colorado 80501 <br />NameMIle (Please type or print) <br />Marshall Massaro, Scientist <br />Ignature <br />Date <br />1':41505 0021Wd1 Co"srrwhion Rcpuft%MW-30UT doe <br />