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Form No. OFFICE OF THE STATE ENGINEER <br /> GWS-26 COLORADO DIVISION OF WATER RESOURCES <br /> 818 Centennial Bldg.,1313 Shannon SL,Denver,Colorado 80203 <br /> (303)N8-3581 1466 <br /> WELL PERMIT NUMBER 290040 <br /> APPLICANT DIV. 1 WD7 DES. BASIN MD <br /> APPROVED WELL LOCATION <br /> JEFFERSON COUNTY <br /> NW 114 SE 1/4 Section 25 <br /> COTTER CORPORATION NSL Township 2 S Range 71 W Sixth P.M. <br /> C/O WHETSTONE ASSOCIATES INC DISTANCES FROM SECTION LINES <br /> 104 W RUBY AVENUE 1730 Ft.from South Section Line <br /> GUNNISON,CO 81230- 1820 Ft.from East Section Line <br /> (970)641-7471 UTM COORDINATES(Metem,Zone:13,NAD83) <br /> PERMIT TO CONSTRUCT A WELL Easting: Northing: <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 tights. 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 <br /> from 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 <br /> approval of a variance has been granted by the State Board of Examiners of Water Well Construction and Pump <br /> Installation Contractors in accordance with Rule 18. <br /> 3) Approved pursuant to CRS.37-92-602(3)(b)(D for uses as described In CRS 37-92-602(1)(1). Use of this well Is limited <br /> to monitoring water levels and/or water quality sampling. This well is known as MW18. <br /> 4) This well must be equipped with a locking cap or seal to prevent well contamination or possible hazards as an open <br /> wall. The well must be kept capped and locked at all times except during sampling or measuring. <br /> 5) Records of water level measurements and water quality analyses shall be maintained by the well owner and submitted <br /> to the Division of Water Resources upon request. <br /> 6) 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 /> 7) 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 /> 8) This well must be constructed by or under the supervision of a licensed well driller or other authorized individual <br /> according to the Water Well Construction Rules. If non-standard construction is anticipated,a variance request must be <br /> submitted In accordance with Rule 18 and approved prior to well construction. <br /> 9) A Well Construction and Test Report(Form GWS-31),including lithologic log must be submitted by the individual <br /> authorized to construct the well. For non-standard construction,the report must Include an as-built drawing showing <br /> details such as depth,casing,perforated zones,and a description of the grouting type and interval. <br /> 10) This well shall be constructed 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 <br /> from the State Engineer,a motoring hole may be converted to a monitoring well,recovery well for remedistion of the <br /> aquifer,or a dewatedrig system for dewatering the aquifer.) <br /> SVJAPP ROVED <br /> Revel t No.3658027F State�91 DATE ISSUED 12-19-2012 BY EXPIRATION DATE 12-19-2014 <br />