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Form No. OFFICE OF THE STATE ENGINEER <br />GWS-25 COLORADO DIVISION OF WATER RESOURCES <br />Bib Centennial Bldg., 1313 Sherman SL, Denver, Colorado 60203 <br />(303)8663581 <br />WELL PERMIT NUMBER 250148 - _ <br />APPLICANT DIV. 1 WD 2 DES. BASIN MD <br />APPROVED WELL LOCATION <br />WELD COUNTY <br />SE 1/4 NE 1/4 Section 13 <br />LAFARGE WEST INC Township 1 N Range 67 W Sixth P.M. <br />%T AXLEY @WATER & WASTE ENG DISTANCES FROM SECTION LINES <br />621 17TH ST STE 1020 1400 Ft. from Nortfi Section Line <br />DENVER, CO 80293- 1565 Ft. from East Section Line <br />(303)292-3503 <br />UTM COORDINATES <br />..,.,.,...y. ~.... ..a. <br />ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT <br />CONDRIONS OF APPROVAL <br />1) This well shall be used in such a way as to cause no matedal injury to existing water dghts. The issuance of this permit <br />does not assure the applicant that no injury will occur to another vested water right or preclude another owner of a vested <br />water right from seeking relief in a civil court action. <br />2) The constmction of this well shall be in compliance with the Water Well Construction Rules 2 CCR 402-2, unless approval <br />of a vadance has been granted by the State Board of Examiners of Water Well Construction and Pump Installation <br />ConVactors 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)(1). Use of this well is limited to <br />monitoring water levels andlor water quality sampling. <br />4) Approved for Me use of an existing well acknowledged for construction under monitoring hole notice MH-01772, and <br />known as CH03 MW01. <br />5) This well must be equipped with a locking cap or seal to prevent well confaminagon or possible hazards as an open well. <br />The well must be kept capped and locked at all times except dudng sampling or measuring. <br />6) Records of water level measurements and water quality analyses shall be maintained 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 ConsWcOon Rules. A Well Abandonment Report must be completed and submitted to the Division of Water <br />Resources within 60 days of plugging. <br />8) The owner shall mark the well in a conspicuous place with well permit number(s) and 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 Me supervision of a licensed well driller or other authorized individual <br />according to the Water Well Construction Rules. ~('~~ <br />10) This well must be locatetl not more Man 200 feet from the IocaOOn specified on this permit. S~ 2/G3 ~1~5 <br />APPROVED ~~ A //~ ~~ C~ 1 ,~ \ <br />RAB s~ is3"'~^"P" ~ _ V~ <br />State Engineer <br />