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2020-06-25_REVISION - C1981035 (34)
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2020-06-25_REVISION - C1981035 (34)
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Entry Properties
Last modified
1/8/2025 2:27:49 AM
Creation date
6/24/2020 5:07:19 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981035
IBM Index Class Name
Revision
Doc Date
6/25/2020
Doc Name Note
King II App 4(5) DWR Data Sheets
Doc Name
Proposed Revision Materials
From
GCC Energy, LLC
To
DRMS
Type & Sequence
PR10
Email Name
JHB
THM
Media Type
D
Archive
No
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WELL CONSTRUCTION AND YIELD ESTIMATE REPORT For Office Use Only <br /> Z-1 <br /> Form No. State of Colorado, Office of the State Engineer 3 <br /> GWS-31 1313 Sherman St., Room 821, Denver, CO 80203 303.866.3581 l S a&�FjV ZD <br /> 02/2017 www.water.state,co.us and dwrpermitsonlineCstate.co.us : 9`ggG` <br /> 1. Well Permit Number: 303362 Receipt Number: 9703921 L /0, [06 Ia 6 s <br /> 2. Owner's Well Designation:MW-4-MI W?,TER R E 5�? <br /> 3. Well Owner Name:GCC Energy, LLC STkA7 E�S )URC S� <br /> 4. Well Location Street Address:620 Sand Ridge Ct. Hesperus, CO 81326 COL t,)WEER <br /> 5. As Built GPS Well Location (required): [EQ Zone 12 ❑Zone 13 Easting:752104.0 Northing:4125641 <br /> 6. Legal Well Location:X 1/4, SE 1/4, Sec., 34 Twp.35 EEJ N or Sf, Range 12 E or W M. NM P.M. <br /> County: La Plata <br /> Subdivision: Vista del Oro Lot NA Block NA Filing (Unit) NA <br /> 7. Ground Surface Elevation:7571.7 feet Date Completed: 03/10/2017 Drilling Method: Rotary Air Hammer <br /> 8. Completed Aquifer Name : Unspecified Total Depth: 421.35 feet Depth Completed: 389.35 feet <br /> 9. Advance Notification: Was Notification Required Prior to Construction? Yes QNo, Date Notification Given: <br /> 10. Aquifer Type: []Type I (One Confining Layer) []Type I (Multiple Confining Layers) ❑Laramie-Fox Hills <br /> (Check one) ❑Type II (Not overlain by Type III) ❑Type II (Overlain by Type III) []Type III (alluvial/colluvial) <br /> 11. Geologic Log: 12. Hole Diameter (in.) From (ft) To (ft) <br /> Depth Type Grain Size Color Water Loc. 12.0 0.00 40.50 <br /> 0.5 topsoil silt dk yet orang NA 7.0 40.50 421.35 <br /> 5.40 weath'd silts/ss silt/sand dk yet orang NA <br /> 40-330 siltstone/sandstn silt/sand med gray NA 13. Plain Casing <br /> 330-341 sandstone sand med gray NA OD (in) Kind Wall Size (in) From (ft) To (ft) <br /> 341-341.5 coal (A-seam) coal black NA 8.625 STEEL 0.188 -3.50 40.50 <br /> 341.5-345 carb shale clay black NA 2.375 PVC 0.218 -3.00 369.00 <br /> 345-355 siltstone silt med gray NA <br /> 355-355.5 carb shale clay black NA NA <br /> 355.5-357.5 coal (A-seam) coal black NA Perforated Casing Screen Slot Size (in): 0.020 <br /> 357.5-358 carb shale clay black NA OD (in) Kind Wall Size (in) From (ft) To (ft) <br /> 358-362 sandstone sand med gray NA 2.375 PVC 0.218 369.00 389.35 <br /> 362-362.5 coal (A-seam) coal black NA <br /> 362.5-375 siltstone silt med gray NA <br /> 375-421.35 sandstone sand light gray 375 <br /> 14. Filter Pack: 15. Packer Placement: <br /> Material Silica Sand Type NA <br /> Size 10-20 NA <br /> Interval 366,00.391.35 Depth <br /> 16. Grouting Record <br /> Material Amount Density Interval Method <br /> Remarks:Monitoring well.Dry drilling method.Drilling services by DAK Drilling.TX TX 0.5'cement t 14"nenrnnne pellet: (2)5-gat pails NA 360r00-366.00 tremie poured <br /> pad installed around locking wellhead.Annular seal is 14 gal potable water per 1 sack grout EnvrroPlug Grout 36 sacks 10.2 lb/gal {).00-360.i)0 tremie pumped <br /> for 30%bentonile solids. SS centralizers installed toplbottom of screen section and every <br /> 40'on casing. Guttings damp at 375'.Free water entered borehole overnight. <br /> 17. Disinfection: Type NA Amt. Used NA <br /> 18. Well Yield Estimate Data: Check box if Test Data is submitted on Form Number GWS-39, Well Yield Test Report <br /> Well Yield Estimate Method: bailer <br /> Static Level: 378.20 ftbgs Estimated Yield (gpm) 0.5 <br /> Date/Time measured: 3/30/17 08:16 Estimate Length (hrs) 1.0 <br /> Remarks:monitoring well development by bailer surging£t production <br /> 19. 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 <br /> 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 <br /> statements is a violation of section 37 91 108(1)(e),C.R.S.,and is punishable by fines up to$1,000 and/or revocation of the contracting license. If filing online <br /> the State Engineer considers the entry of the licensed contractor's name to be compliance with Rule 17.4. <br /> Company Name: Email: Phone w/area code: License Number: <br /> Resource Hydrogeologic Services, Inc. info@resourcehydrogeoLogic.com (970) 764-4920 NA <br /> Mailing Address:101 W 11th St#103 Durango, CO 81301 <br /> Sign (or enter name if filing online) Print Name and Title Date: <br /> Landon Beck Landon Beck - Principal Hydrogeologist 08/17/2017 <br />
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