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FORM NO. WELL CONSTRUCTION AND TEST REPORT For Office use only
<br /> 11/90 STATE OF COLORADO, OFFICE OF THE STATE ENGINEER
<br /> i. WELL PERMIT NUMBER 163760 M.W.-6
<br /> NNER NAM_(S) Cotter Corporation `
<br /> Mailing Address es ayau venue,
<br /> City, St. zip Lakewood, Colorado 80228
<br /> Phone ( 303 ) 980-1292
<br /> 3. WELL LOCATION AS DRILLED: NE 1/4 SE 1/4, Sec. 25 Twp. 2 S , Range 71 W
<br /> DISTANCES FROM SEC. LINES:
<br /> 1400 ft. from South Sec, line. and 822 ft. from East Sec. line. OR
<br /> (north or south) (east or west)
<br /> SUBDIVISION: LOT BLOCK FILING(UNIT)
<br /> STREET ADDRESS AT WELL LOCATION:
<br /> 4.rDATE
<br /> ND SURFACE ELEVATION 6551.1 ft. DRILLING METHOD Hammer/Ai r
<br /> COMPLETED 06/20/89 TOTAL DEPTH 15.0 ft. DEPTH COMPLETED 15.0
<br /> 5. GEOLOGIC LOG: 6. HOLE DIAM. Cin.) From (ft) To ft)
<br /> Depth Description of Material (Type,Size, Color,water Location) 6" 0
<br /> 0' - 12' Unconso1 idated Road Fi 11 (BRN)
<br /> 12' - 13" Alluvial Grav is _
<br /> 7. PLAIN CASING
<br /> 13' - 15' Competent Bedrock Hornhlende OD (in) tend Wall Size From(ft) To(ft)
<br /> Gneiss) " • 2" PVC : Sch40 +1.8 -.5.0 ,
<br /> 15.0' T.D. _._:..
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<br /> p y:
<br /> 'RECORD
<br /> REMARKS:
<br /> REMARKS: Material •`,:'` �Amount j Density- Interval.'Placement _
<br /> -' >f>
<br /> '�enton 0,Q 5' Manually:
<br /> 1 DISINFECTION: T pe - Amt. Used-
<br /> WELL= 0 kTA: .0 Check fjo .;... �r•'�x;�`; :;•> :;: = !
<br /> x=if Teri Data`:issdbinitted on"SupplementaE Foy
<br /> 'TE8TlNG 4 , . >,., Y ,o- ,;n: .4..,,.
<br /> _Static Level
<br /> ft. , ;:• � ; _ :��-�,a;.✓v:::aS:3r�.,rux- .:�.�-::-�: =.��-� •,x;��:;_.:a'`. -• ,
<br /> Date�me measured Production Rate
<br /> Pumping lave! �ft. Date�me measured • xt
<br /> Test length (hrs.)
<br /> Remarks ...-. -
<br /> 3. !have read the statements made herein and know the contents iherect,and that they are true to my'IvsowlecJgeY(Pursuant to Section 24 4 104(1a)(a)CAS.,the m.''f false statements herein constitutes perjury in the second degree and Is punishable as a class ! misdemeanor,] =4
<br /> ` . TRACTOR Cotter Corporation '
<br /> M ailing Address 12596 West Ba and Avenue #350 - LakewoodnCO�22880-1292 Lic, No. N .
<br /> Name/Title (Please type or print) Sure Date
<br /> Thomas C. Lepry ignat
<br /> Mine Geologist ' - -
<br />
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