2005-06-24_REVISION - M2000016 (13)

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Form No. OFFICE OF THE STATE ENGINEER Gws-z5- COLORADO DIVISION OF WATER RESOURCES 818 Centennial altlg., 7313 Sherman St, Denver, Cdorado 80203 3 ( 03)856.3587 APPLICANT 1279 WELL PERMIT NUMBER 250145 _ DIV.1 WD2 DES. BASIN MD LAFARGE WEST INC %T AXLEY (a~WATER & WASTE ENG 621 17TH ST STE 1020 DENVER, CO 80293- (303)292-3503 APPROVED WELL LOCATION WELD COUNTY NE 1/4 NE 1/4 Section 13 Township 1 N Range 67 W Sixfh P.M DISTANCES FROM SECTION LINES 975 Ft. from Norfh Section Line 70 Ft. from East Section Line UTM COORDINATES rvvrcnmg: ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT CONDRIONS OF APPROVAL 1) This well shall be used in such a way as to cause no material injury to ezisting water dghtr. The issuance of Ibis permit does not assure the applicant that no injury will occur to another vested water right or preclude another owner of a vested water right from seeking relief in a civil wurt action. 2) The censWetion of this well shall be in compliance with the Water Well Construction Rules 2 CCR 402-2, unless approval of a vadance has been granted by the State Board of Examiners of Water Well ConsWction and Pump Installation Contractors in accordance with Rule 18. 3) Approved pursuant to CRS 37-92-602(3)(b)(I) for uses as descdbed in CRS 37-92-602(1 )(f). Use of this well is limited to monitoring water levels andlor water quality sampling. 4) Approved for the use of an existing well acknowledged for consWCtion under monitoring hole notice MH-01768, and known as CH03 MW02. 5) This well must be equipped with a locking cap or seal to prevent well contamination or possible hazards as an open well. The well must be kept capped and locked at all times except dudng sampling or measuring. 6) Records of water level measurements and water quality analyses shall be maintained by the well owner and submitted to the Division of Water Resources upon request. 7) Upon conclusion of the monitoring program the well owner shall plug this well in accordance with Rule 16 of the Water Well ConsWUion Rutes. A Well Abandonment Report must be completed and submitted to the Division of Water Resources within 60 days of plugging. 8) The owner shall mark the well in a conspicuous place with well permit number(s) and name of aquifer as appropdate, and shall take necessary means and preraugons to preserve these markings. 9) This well must have been wnsWCted by or under the supervision of a licensed well driller or other authorized individual according to the Water WeII Construction Rules. 10) This well must be located not more than 200 feet from the location specfied on this permit. ~i/DS APPROVED _~j. /1 T r iJ~_ _„~ ~ ,~~ ~~ RAB ]~rA~ .LJ iV~7'~„ State Engineer