PERMFILE49145

• Permit No: M2005080
• IBM Index Class Name: Permit File
• Doc Date: 6/13/2006
• Doc Name: Applicants comments
• From: EAI
• To: SEO
• Media Type: D
• Archive: No

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' "~;"' ^i WELL GONSTRI, i ION AND TE5T REPORT ~
t~'~+_L STATE OF COLORADO, OFFICE OP 7H8 CTATE ENGINEER !
-___~
i WELL PERMIT ~+illMBER MH-46102 I
2. OWNER NAME(S) Alfen Drilling, Inc. ~ y`__~
I

blailirg .adcress Post Office Box 398 I
1
I CiTy, St. Zip Fairplay, Colorzdo 8C 440

Phone (7t9) 836.2672
f
1
_
3 SE U4
WELL LOCATION AS DRILLED: -
SbV tl4, sec. tt twp. tC Sou_h- ,range 77_ West
-
DISTANCES FROM 5E0. LINES: -A
ft from :oath Sec. line, and
100 225G ft. `rom 'u`1es: uec. line, OR
_
r (north or southl (east or vast)
i ~ SUBDIVISION: N!A _ ,__- Lot -_ BI Fiong(unR) --
~TREET ADDRESS AT WELL LOCATION'
4. ~ GROUNC SLiRFACE ELEVATION ~ft. DRILL.!NG METHOD Air Rotary
DATE COWIPLETED . Total Deotn 20 ft. Depth Completed 20 ft. I
_ __
EOLOGIC
74 G ~ AM. (in.i F-om (tt)
- HCLg ~ 1
TO t 2
'
e ~ pJen ot!watenai (Type, Size, Cdr~r ^:a cer Lccauun T 0
8
0
0.20 Sand ,3 Gravel Alluvial -_-__
~- _-_~
-
~
~ - ?. PLAIN CASfNG
_
r- ~ Vlondonn Hole #3 -
G-----;_-_.1____. __
- ~ OD (i-i) K nd VVrll Size From(ft) To(rt)
Static Le:e! - 13'11" ) t86 +1 16
7 Stee_
_

~ PcRF. CASING: Screen Slot Size: .032
J
i _
~ 7 Steel __ 188 16 20
__ _
r - ----
-
~ -- -~ --
--
---- ~ `
---- -- ~1 8. FILTER PACK: 9. PACKER PLACEMENT:
t_ _._.--- ----- --
(_--__._v__ ---- -
----- ,
~
Pvfzt°'i21 _-- N/A _- TYPe .~ WA
I
_ Size __
~-_--
- -
~ tC. GROUTIr!G RECORD:
--- , ivtaterizl Amour*. Gensiy H :e:vai Plat:ement
REM,4RKS: ~ Cement 9cf -- 0-16_ Poured!
y
- --------
-- _
I - -
Vibrated

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-
~
tt.
j 12. - A-~'_ U_sea: __ __ _
DISiNFEC_TiOtJ: Tree "--------~--
_
1M1'EU_ T_ST DALA: ~ Check boz if Test Data is subn:itte..d or: F: rm Nc GYd 5 39 Supp'emeetai WeII Test.
TE~TlN, METt-;O~ NtA

Static L_vcl 1 "~'" ft. Dater-Time neasured -~
R. Date~rfirne rt~e2=ured ~
Pt:>;roing t_eve! Nis I
-_--- Prodt:ction Rete _ N_iA_ gpm i
,Test Leny:h (hrs.} ^~Ja
--

t _
-
Remar><s ------ --- - I
-- ----i
13. ; F. are read the ;r~snertts mace ne:e~r'• and zncw the :Drat LS thereo', art: ha±theY are ~.r.,a ro n'.y krewiedge. INUrsua~t'c se4.~~, .3-- w+ tr.~,
tar
C.R.S., t"a making ci fake ~,~te;neres heroin ccnstitutas pe~lurr in 7e sea~ad tl:aaree ar.c is Guvshaole as 3 da951 miSdE:near.Cr.j
GOtvTRACTOR Aiha ~ Criili„ rg ~ Excavarn. Ccmo3nv laq_ _._ F'!~c.^.e 719 836.2072 Lir.. Nc. 76 .__
hAa~;lino Address Post q~fi;rte E'~ox: X98. ~airol~ Coin. _AO?40
tdame.'1'It:~ (Please type or print) Signatu:s i uate
I ,• ~~i/ i
.tack A!e.~ /President { i , i 5!':L6