2018-12-26_HYDROLOGY - M1978039HR

• Permit No: M1978039HR
• IBM Index Class Name: HYDROLOGY
• Doc Date: 12/26/2018
• Doc Name Note: Groundwater Chemistry Data
• From: Western Water & Land, Inc.
• To: DRMS
• Email Name: LJW
• Media Type: D
• Archive: No

FORM NO. WELL CONSTRUCTION AND TEST REPORT For Office Use Only
GWS-31 STATE OF COLORADO, OFFICE OF THE STATE ENGINEER
4/2012 1313 Sherman St.,Ste 821, Denver,CO 80203
Main 303 866-3581 Fax [phone] www.water.state.co.us
1.WELL PERMIT NUMBER:
2.WELL OWNER INFORMATION
NAME OF WELL OWNER: Energy Fuels Resources (USA), Inc.
MAILING ADDRESS: Union Blvd., Suite 600
CITY: Lakewood STATE: CO ZIP CODE: 80228
TELEPHONE NUMBER w/area code: 303-389-4133
3. WELL LOCATION AS DRILLED: NE 1/4, SE 1/4, Sec., 10 Twp 44 Ix i N or S, I_I Range 18 © E or W ❑
DISTANCES FROM SEC. LINES: ft. from F_ N or F S section line and ft. from ❑ E or❑W section line.
SUBDIVISION: NA , LOT BLOCK FILING(UNIT)
Optional GPS Location: GPS Unit must use the following settings: Format must be UTM, Units Owner's Well Designation:Mw-TPz1
must be meters, Datum must be NAD83, Unit must be set to true N, ?_x I Zone 12 or I1"1 Zone 13 Easting: 689565
STREET ADDRESS AT WELL LOCATION: Topaz Mine area Northing:4217726
4. GROUND SURFACE ELEVATION 5607 feet DRILLING METHOD Auqer, hollow stem
DATE COMPLETED 05/07/2013 TOTAL DEPTH 29 feet DEPTH COMPLETED 20 feet
5. GEOLOGIC LOG: 16. HOLE DIAM(in.) From ft To ft
Dept Type Grain Size Color Water Loc. 8.25 inch 0 29
0-4 Sandy silt fin to v fin and lawn,It lawn Dry
4- 10 Silty sand,ss frag fin to v fin buff bwn Dry
10-14 Sand,silt,ss gvl fin to crs buff,It bwn Dry 7. PLAIN CASING:
14-16 Sand,silt,gvl Vfn to crs gv Lt pink,tan Slt moist OD(in) Kind Wall Size(in) From (ft) To(ft)
16-18 Shale,sm gvl ss V fin to crs gvl Lt pink,buff Slt moist 2 inch S40 PVC 0 10
18-20 Shale,midst V fin,fin Lt pink,buff Sit moist
20-22 Mdst V fin,fin Dk bwn,marron Slt moist
22-29 Midst,varigated V fin,fin Dk bwn,gm Sit moist
No grnd water PERFORATED CASING: Screen Slot Size(in):
backfilled to 20 ft 2 inch S40 PVC 0,010 10 20
with native cuttings
8. FILTER PACK: 9. PACKER PLACEMENT:
Material Sand Type
Size 10-20
Interval 7 to 20 ft Depth
0. GROUTING RECORD
Material Amount Density Interval Placement
Remarks: ben. chip 1 sack 4.3 to 7 ft poured
hole sloul 2.5 to 4.3 ft native slou(
Old cemE 0 to 2 ft poured
11. DISINFECTION: Type NA Amt. Used NA
12. WELL TEST DATA: ❑Check box if Test Data is submitted on Form Number GWS 39 Supplemental Well Test.
TESTING METHOD NA
Static Level Dry ft. Date/Time measured: NA Production Rate NA gpm.
Pumping Level NA ft. Date/Time measured NA Test Length(hrs) NA
Remarks: Dry hole and well at time of completion, to monitor potential qw in colluvium below dump
13. 1 have read the statements made herein and know the contents thereof,and they are true to my knowledge. This document is signed(or
name entered if filing online)and certified in accordance with Rule 17.4 of the Water Well Construction Rules,2 CCR 402-2. The filing of a
document that contains false statements is a violation of section 37-91-108(1)(e),C.R.S.,and is punishable by fines up to$5000 and/or revocation
of the contracting license. If filing online the State Engineer considers entering of licensed contractor name to be compliance with Rule 17.4
Company Name: Phone w/area code: License Number:
D.A. Smith Drillinq Company, Inc. 970-858-1950 1314
Mailing Address: P.O. Box 97 Loma, CO 81524
Sign (or enter name if filing online) Print Name and Title Date
Darry A Smith President 03/14/2014