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<br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />Pmts OMYIng <br />.Form STATE OF COLORADO ~ For Office Use Oely , <br />No. OFFICE OF THE STATE ENGINEER ' <br />~~ 821 Centennial Bidg., 1313 Shemfat St, Deriver, CO t102IXi <br />86/00 (303) 688-3581 Fax (303) 888-3589 <br />WElL ABANDONMENT REPORT <br />~ <br />Type a prhtt In Wade Ink <br />~ ' <br />IVED <br /> RECE <br />~~ / /~ <br />WBII Peimk Number of the well being phlggecl [ ~o~~y . <br /> ~ . <br />DEC ~ 4 <br /> <br />IrdhAduaVComosm reaoottMblefor ohtrtnim anti seadna 6te wed• „s~e,,,.~e <br /> w~ <br />WtME(S)~ut 4~ L~a1at,.L~~ITfre ~l SSX7 ~eF/~-/1 ~A <br /> . <br />MaIdn9lWdross tOAOH 93 lJ~t A <br />clty,stav .601 e.- <br />~f2S~fo'~-~ <br />, <br />Phare c X3...1 - b o ot~a a F y~ ~ . <br />Acluuwr3ttocnnoN: ~ <br />Proparonema~ /08"08' NG/~: F3 Ge/o(e.~ Co. t~3 <br />lsmte) (av> <br />1~~) fir 1 r' <br />I ` <br />S?i/ ifd of fies'* 1f4, Sec ~, Twp. Z <br />U <br />N, or®3., Fiaange ~O E aA1J W., V <br />P.M, <br />1I <br />1f <br />7 <br />ra <br />Disfartce Ban seetbn ones °7s FL Flom C~.1 N. a~8., i973 Ft F <br />n <br />®E or,CJ W <br />L <br />Jna. <br />. <br />~ <br />~~ <br />~ <br />~ <br />j <br />~~ <br />SubdNfsion Noma ~~ ~ t.ot,~,-,Block'%^ -FflinglUnft--~- . <br />1(we) report da! an exbVttg wed was plugged erd5eekd for lha ldbwlrlg reason(s): ~ . <br />o The wall was phrgged mM seated ea regrdiad adet Web remdr Nwnbar <br />Tire wad was trot M aao end waa ptogged and eected. <br />.. ~ . <br />/ / <br />ahar (pfaase elgrlefn) a//• r, L/e~/ QOetb/O/~Ci~?.C. i' /tUL 1a5, <br />-7 <br />sfe esere _ <br />G,/e// GI.t? c. rye .H1.ta>~ ~ . <br />~¢ - ~etzrLss~F.i2•-,~ <br />~'~ <br />' <br />, <br />, <br />9 <br />L <br />~ <br />Tire date dre wet! wee plugged eccordhtg f0 6M w1Ear WOB Cormtrnd[on Rutea was / ~J ~ O ~ <br />The wdl was plugged wim Bre k~IlovAng maladala plated ffi the located Intervals: ' - . <br />f~Iatertal M§thad Placement Interval <br />Amount a d Typeo <br />~ <br />~yr~ <br />n~ <br />/Z 9~6 /l/4o Sr <br />lcv s4 <br />~ ew'e. dam.~Lraerm~fee< . <br />// <br />/ <br />1 <br />I~4~I/atS br'}'q'hkfRr ~PIUd'it~T~° ~~t/' 1rom ~~ feet to ~~ feet . <br />~t Q V9V w CPn?Pi+~_,_,_ I~_ trtm ~! ~ rear ro ? • ° teat <br />y U~ S~Gr _ ~ from 2 <br />0 <br />lest to ~.O . tpel <br />~/ <br />,, <br />IMervala of easing remowadfdppad M feet ~ ~ Iran 7, ~ teat to O. ~ feet <br />1 (we) trove read the stalemenb made herein, lae7w tlta wrdetds tl1ere06 and Chet they afa tole ib my (out) Mtowladge• . <br />Please print the Signers Name E TN1e Signaltae(s) ~. De1e <br />Steven R. Schiesavohl s~-- <br />Realty Officer ' // 3 <br /> <br />It Is the respotgd~idly of the wed owner to have the wed properly plugged and sealed. The Wed Construdion ContatEcr la <br />res Pole for n the owner of this requirement <br />