2023-05-08_HYDROLOGY - M2001046

• Permit No: M2001046
• IBM Index Class Name: Hydrology
• Doc Date: 5/8/2023
• Doc Name: Water Monitoring - Groundwater
• From: Brannan Sand and Gravel CO
• To: DRMS
• Email Name: ECS
• Email Name: MAC
• Media Type: D
• Archive: No

WELL CONSTRUCTION AND YIELD ESTIMATE REPORT For Office Use Only
Form No. State of Colorado, Office of the State Engineer
GWS-31 1313 Sherman St., Room 821, Denver, CO 80203 303.866.3581
02/2017 www.water.state.co.us and [e-mail]
1. Well Permit Number: MH-060094 Receipt Number:
2. Owner's Well Designation:RMCC-MW-9 (Piezo BH-5B)
3. Well Owner Name:Ready Mixed Concrete Company
4. Well Location Street Address:13505 County Road 19, Platteville, CO 80651
5. As Built GPS Well Location (required): []Zone 12 [D Zone 13 Easting: 509463.7 Northing: 4450358
6. Legal Well Location: NE 1/4, NE 1/4, Sec., 28 Twp.3 N or S 0, Range 67 E or W[Z], 6 P.M.
County: Weld
Subdivision: Lot , Block , Filing(Unit)
7. Ground Surface Elevation:4798 feet Date Completed: 10/16/2019 Drilling Method: Hollow Stem Auger
8. Completed Aquifer Name : Alluvial Total Depth: 31.5 feet Depth Completed: 31 feet
9. Advance Notification: Was Notification Required Prior to Construction? Yes []No, Date Notification Given: 10/02/2019
10. Aquifer Type: []Type I (One Confining Layer) ❑Type I (Multiple Confining Layers) []Laramie-Fox Hills
(Check one) ❑Type II (Not overlain by Type III) ❑Type II (Overlain by Type III) OType III (alluvial/colluvial)
11. Geologic Log: 12. Hole Diameter(in.) From (ft) To (ft)
Depth Type Grain Size Color Water Loc. 8 0 31
0-4 Overburden sand Brown
with clay
4-35.5 sand, some gravl tan 4' 113. Plain Casing
OD(in) Kind Wall Size(in) From (ft) To (ft)
31-31.5 sandstone grey 2 PVC Sch 40 11 3.0 ag
Perforated Casing Screen Slot Size (in): 0.010
OD (in) Kind Wall Size(in) From (ft) To (ft)
2 PVC Sch 40 31 11
14. Filter Pack: 15. Packer Placement:
Material Native Type NA
Size
Interval 31-5 Depth
16. Grouting Record
Material Amount Density Interval Method
Remarks: Bentonite 75 lbs 5-1 place ft hydrate
water measured below ground on 10-16-19 cement 1 sack 1-0 place a trowel
17. Disinfection: Type NA Amt. Used NA
18. Well Yield Estimate Data: FlCheck box if Test Data is submitted on Form Number GWS-39, Well Yield Test Report
Well Yield Estimate Method: NA
Static Level: 4 Estimated Yield (gpm) NA
Date/Time measured: time of drilling Estimate Length (hrs) NA
Remarks:
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
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$1,000 and/or revocation of the contracting license. If filing online
the State Engineer considers the entry of the licensed contractor's name to be compliance with Rule 17.4.
Company Name: Email: Phone w/area code: License Number:
Civil Resources, LLC [e-mail] [phone] NA
Mailing Address:P. 0. Box 680 Frederick, CO 80530
Sign (or enter name if filing online) Print Name and Title Date:
Gary Linden Gary Linden Sr Engineering Geologist 10/23/2019