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Fd H•N0. ` WELL CONSTRUCTION AND TEST REPORT For office use only <br /> cus-31 STATE OF COLORADO, OFFICE OF THE STATE ENGINEER RECLI��' i <br /> 11/90 <br /> t. WELL PERMIT NUMBER 163755 M.W.-1 NOV20'92 <br /> 2- OWNER NAME(S) --- Cotter Corporation q RURM <br /> Mailing Address 12596 West Ba and Avenue #350 W % <br /> City, St. zipLakewood, Colorado 8022 <br /> Phone ( 303 ) 980-1292 <br /> 3. WELL LOCATION AS DRILLED: NW 1/4 SE 1/4,Sec. 25 Twp, 1 S , Range 71 W . <br /> DISTANCES FROM SEC. LINES: <br /> 2165 ft. from South Sec. line, and 1773 ft. from East Sec. line. OR <br /> (north or south) (oast or west) <br /> SUBDIVISION: LOT BLOCK FILING(UNIT) <br /> STREET ADDRESS AT WELL LOCATION: <br /> 4. GROUND SURFACE ELEVATION 6590.4 ft. DRILLING METHOD Auger <br /> DATE COMPLETED 11-12-81 TOTAL DEPTH 25.5 ft. DEPTH COMPLETED 25.5 ft. <br /> 5. GEOLOGIC LOG: B. 4H�OLE DIAM. (in.) From (ft) T25(ft) <br /> peRth Descriptlon of Malarial(type, Size,Color,Water ) 5 <br /> 0 - 3' Fill - cs. angular co�bles with <br /> sine cs, grave_.s <br /> Brown cs. gravel with co BE Tes 7. PLAIN CASING <br /> and cs. to med. sand OD V Kind Wall Size From(ft) To�ft) <br /> 2-1 " PVC Sch 4U +2.5 1 .0 <br /> 13' - 17' Fine to cs. sand gravelly and 2-1 2" Sch 40 7270— 24.0 <br /> silty <br /> 17' - 23' Fine to cs. silty sand with PERF. CASING: Screen Slot Size: 1/8" <br /> some gravel 2-1/2" PVC Sch 40 <br /> 17.0 77- <br /> 23' - 25.5 Bedrock, competent amphibolite <br /> 25.5 T.D. <br /> 8. FILTER PACK: 9. PACKER PLACEMENT: <br /> *Hit water @ 7.0' Material Silica Sand Type <br /> Size 8-12 Mesh <br /> Interval 1 _ 24, Depth <br /> 1M GROUTING RECORD; <br /> Material Amount Density Interval Placement <br /> REMARKS: Neat Cement 0' - 1.5' Manually <br /> 1 DISINFECTION: Type Amt. Used <br /> 12 WELL TEST DATA: ❑Check box 9 Test Data is submitted on Supplemental Form. <br /> TESTING METHOD <br /> Static Level ft. Date/Time measured , Production Rate gpm. <br /> Pumping level fL Date/Time measured , Test length (hrs.) <br /> Remarks <br /> 3. t have read the statements made herein and know the contents thereof,and that they are true to my knowledge.(Pursuant to Section 24.4-104(13)(a)C.R. ,the rnakin <br /> of false statements herein constitutes perjury In the second degree and Is punishable as a loss 1 ndsderriewor.] <br /> CONTRACTOR Cotter Corporation Phone ( 303) 980-1292 Lic. No. N/A <br /> Mailing Address 12596 West Ba and Avenue #350 - Lakewood CO 80228 <br /> NameMile (Please type or print) sign. u Date <br /> Thomas C. Lepry <br /> Mine Geologist <br />