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Form No. OFFICE OF THE STATE ENGINEER <br />GWS25 COLORADO DIVISION OF WATER RESOURCES <br />818 Centennial Bldg.. 1313 Sherman Sl., Denver, Colorado 80203 <br />(303)8663581 <br />WELL PERMR NUMBER 250749 - <br />APPLICANT DIV. 1 WD 2 DES. BASIN MD <br />APPROVED WELL LOCATION <br />WELD COUNTY <br />NW 1/4 SE 1/4 Section 1 <br />LAFARGE WEST INC Township 1 N Range 67 W Sixth P.M. <br />%T AXLEY QWATER & WASTE ENG DISTANCES FROM SECTION LINES <br />621 17TH ST STE 1020 1125 Ft. Trom South Section Line <br />DENVER, CO 80293- 2575 Ft. from East Section Line <br />(303)292-3503 <br />IfTM COORDINATES <br />¢nsung. <br />ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT <br />CONDITIONS OF APPROVAL <br />1) This well shall be used in such a way as to cause no material injury to exisOng water rights. The issuance of this permit <br />does not assure the applicant that no Injury will occur to another vested water dght or preclude another owner of a vested <br />water right from seeking relief in a civil court action. <br />2) The construction of this well shall be in compliance with the Water Well Construction Rules 2 CCR 402-2, unless approval <br />of a variance has been grenled by the State Board of Examiners of Water Well Construction and Pump Installation <br />Contrectors in accordance with Rule 18. <br />3) Approved pursuant to CRS 37-92-602(3)(b)(I) for uses as described in CRS 37.92-602(1)(f). Use of this well is limited to <br />monitoring water levels andlor water quality sampling. <br />4) Approved for the use of an exisfing well acknowledged for r4nsWC8on under monitoring hole no0ce MHd1759, and <br />known as DS03 MW01. <br />5) This well must be equipped with a locking rap or seal to prevent well contamination or possible hazards as an open well. <br />The well must be kept capped and locked at ali times except during sampling or measuring. <br />6) Records of water level measurements and water quality analyses shall be maintainetl by the well owner and submitted to <br />the Division of Water Resources upon request. <br />7) Upon conclusion of the monitoring program the well owner shall plug this well In accordance with Rule 16 of the Water <br />Well Construction Rules. A Well Abandonment Report must be completed and submitted to the Division of Water <br />Resouros within 60 days of plugging. <br />8) The owner shall mark the well in a censpicuous place with well permit number(s) antl name of aquifer as appropriate, <br />and shall take necessary means and precautions to preserve these markings. <br />9) This well must have been constructed by or under the supervision of a licensed well driller or other auNOrizeO individual <br />according to the Water Well Construction Rules. ~ / <br />1D) This well must be located not more than 200 feet from the location specifietl on this permit. ~~S/721D3 <br />APPROVED ~~ ,~ ~ p~ ~ ` ``~ ~\~~ ~~ <br />RAB _J~~ S <br />State Engineer <br />