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>HN No. 1f(/[_LL (rUY~{:J I HULr I IUtV /~IriU 1 tb l H{::YUH 1 I <br />'s~'17~ STATE OF COLORADO, ICE OF THE STA- =t•'CI"'-^ <br />ivo :~ <br />T WELL PERMR NUMBER File No.` MH-1863• For oma ue~ Doty <br />OWNER NAME(S) Pete Rlein & Ric <br />Mailing Address P.O, Box 1 17 <br />City, St. Zlp Ouray, CO 1 27 <br />Phone (303 ) 325- 970 <br />WELL LOCATION AS DRILLED; NW 1/4 SW 1/4, Sec. 2 Twp. 44N , flange 8W <br />DISTANCES FROM SEC, LINES: <br />1547+ ft. from South Sec. line. and 690 R from West Sec. Ilne. OR <br />(oath a eaM) (~ a w~eeL <br />SUBDIVISION: LOT_ BLOCK FILING(UNIT) <br />STREET ADDRESS AT WELL LOCATION: <br />GROUND SURFACE ELEVATION 7184 ft. DRIWNG METHOD Baclchoe <br />DATE COMPLETED January 29, 1992. TOTAL DEPTH 16 ft. DEPTH COMPLETED 16 h. <br />GEOLOGIC LOG: Test Well # 3 <br />o.vm oe.ortpeo„ a ~u (ryv.. slzw caa. ww too.tlan) <br />0-16' Unconsolidated alluvium within d HOLE DIAM. (in.) From (ft) To (ft) <br />6" 0 16 <br />is oric c one o ncompa gre <br />aver. <br /> 7. PLAIN CASING <br /> OD (In) land WaII Site From(ft) To(ft) <br /> <br />emar es pi was ug wi h a backhoe <br />y e owner. 2 point of <br />a uminum casing, with 1 2' holes <br />e on cen ers, was paced PERF. CASING: Screen Slot Size: <br />n e o e, ou ers rom a ore 6" Al 1/4" 0 16 <br />were p ace aroun a casing o <br />s a i ize i an he remaining test <br />pi was ac i e e casing wi 1 <br />e visua y inspec a moot y to <br />assure a wa er a e is not 8 FILTER PACK: 9. PACKER PLACEMENT: <br />wi in o a proposed gravel Material N/A Type N A <br />excava ion. Size <br /> Interval Depth <br /> <br /> 10. GROUTING RECORD: <br /> Material Amount Density Interval Placement <br />IEMARKS: N/A <br /> <br /> <br />DISINFECTION: T e N/A Amt. Used N/A <br />WELL TEST DATA; ^ Check box if Test Data 4s submitted on Supplemental Forth. <br />TESTING METHOD Visual <br />Static Level > ft. Date>Tme measured 1 2 - 1:00 PM Production Rate~~gpm. <br />~ Pumping level ~~ R Date~me measured N A ,Test length (hrs.) N/A <br />Remarks <br />I new rud IM Y~artgnb meAe twain erd rata. tM con0etm C,rsd, ettd tltel Qry w trtM b my btoM,adp~. (PmnterLL to Seglon 21y701 (1 ~(a) C.RS., me melon <br />of Idae afeteinenb Mreln canlLeltee pet(tey In the eecaW CeQtM Yd b pioWhebb ee • Uer 1 mbderrruwr.l <br />ONTRACTOR Phone (r) Lic. No. <br />railing Address <br />rme/Title (Please type or print) <br />Pe,d ~. ~ A. /~,.sd.~- , C 0(r 46 B Z Sig re <br />~ ~~ • ~ ---_ Date <br />3~i1 ~9 L <br />