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2006-09-13_REVISION - M1983102
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2006-09-13_REVISION - M1983102
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Entry Properties
Last modified
6/15/2021 5:35:57 PM
Creation date
11/21/2007 6:09:43 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1983102
IBM Index Class Name
Revision
Doc Date
9/13/2006
Doc Name
112c Amendment 02 Application
From
Thompson Properties
To
DRMS
Type & Sequence
AM2
Media Type
D
Archive
No
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/ VVE1L ACTION AND TEST REPOF(f I Fer oea. u.. eny <br />tae+ STATE OF COLORADO, OFFICE OF THE STATE ENGINEER <br />! ~ RECEIVEC <br />M~ ) ~,~1~!!,%~ o~^ ~ ~ ~';•~~ i[, lflcs'15.rG ~C B ~ 1999 <br />Cdy St IJp Gru.w b. Pw Ao~/rl <br />~. MM1ER NE$pyq~g <br />~~ ~G7O) ~R7-• /(9/iL) 87A~,,E„~WEER <br />WELL LOCATION AS DRIUFD: ~t/a,~~t/4, Sea~_ Twp.~_ ,./ . Rarlge„~_ <br />DISTANCES FROM SEC. LINES: <br />GOO tt. from or Sec. lure. erxi ?IO 1L from ,Sec. lase. OR <br />FIUNG(UNfn <br />4. GROUND SURFACE ELEVATION ."~ R DRIWNt3 METHOD A ~ r t~e ~-a r V <br />DATE COMPLETED O - 2 ! - 4 .TOTAL DEPTH .1_0. DEPTH COMPLETED /rro R <br />0. GEOLOGIC LOG: rx HOLE DIAM. (m) From (It) To (tt) <br />~ Dtawip~0on d Matar(al (Type, Size. Color, Water t.«atonJ $~4F! ~ ~~ <br />Iw G1 /.TO <br />D-/.~.- s.. dQ.iq-f-ava~e/ <br /> 7. PWN CABLING <br /> OD pn) IGnd Wap Sae Frtxn(ft) To(tt) <br /> Ovate,,.. .f, ' /Z o O rt ~ s fe a f . IS fr <br />tL <br />.23= <br /> /20 ~.~ _ <br />_ <br />uye PuC ,xoe /o ,~ <br /> <br /> <br /> PERF. CASING: Screen Slot Sae: Caj pv.:!leL3~i <br /> Sr`44! ,IBg ~ <br /> _ <br />.rrz P u ~ • :L o o ~S~ G~ <br /> <br /> <br /> <br /> 8. FILTER PACK: 9. PACKER PLACEMENT: <br /> Materlai Type N/ <br /> ~ <br />Size ~~~ <br /> Interval Depth <br /> ' <br /> t0. t3ROUTING <br />RECORD: <br /> Material Amoum Density Interval Placement <br />~l REMARKS: • s~S feyq(t~ /o~So, A.w~oo~ <br />1 DISINFECTK)N: Type Antt. Used a 2. <br />WELL TEST DATA: ^ Check box if Test Data ~ submitted on Form No. GW$ 39 Supplemental WeU Test. <br />IESTWG METHOD <br />Statle level ~~ R Date/ifine measured /o. r - q - :00 Production Ra3e_ <br />Pump(rg level j Y4 ft. DateRme measuredro~.t - 4 N /0;00 A M ,Test tertgth (hrs.)- .t~-- <br />3 I Mva read lM atatamanb nude herein and knaN the eodenb thsrod, and that they ere tote b my knovAadgs. lPuwsM to Ssetlon 24.4106 tl31N <br />C.0.S.,1M making d tale stetemetde herein coneOhMS perjury N Hu sacontl dsprsa and b puniahebN ea ^ oleos 1 miseamanorJ <br />CONTRACTOR t'l2c~~,-/1sa.-. fl~r l~ruo Phone (4~ 1 ,PP7-.T993 Uc. No./Olo~ . <br />o -• v w <br />Name/Title (Please type or print) SignC~aJtu~(rJe A Date <br />1<__- ,,,.,. NL, ~.O~.--- 1/.~.~.... /V•9/•l~'1~~K-- 12-4-94 <br />
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