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Form No. OFFICE OF THE STATE ENGINEER <br />GWS-25 COLORADO DIVISION OF WATER RESOURCES <br />818 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203 <br />• (303) 8663581 <br />I WELL PERMIT NUMBER 250152 <br />APPLICANT Il DIV.1 WD2 DES. BASIN MD <br />APPROVED WELL LOCATION <br />WELD COUNTY <br />NE 1/4 NW 1/4 Section 12 <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 1300 Ft. from North Section Line <br />DENVER, CO 60293- 2350 Ft. from West Section Line <br />(303)292-3503 <br />UTM COORDINATES <br />,.,,.... „y. ~..., ,.y. <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 existing water dghts. The issuance of this permit <br />does not assure the applicant that no injury will occur to another vested water dght or preGude another owner of a vested <br />water right tram seeking relief in a civil court action. <br />2) The construction of this well shall be in compliance with the Water Well ConsWclion Rules 2 CCR 402-2, unless approval <br />of a variance has been granted by the Sta[e Ooard of Examiners of Water Well Construc0on and Pump Installation <br />Contractors in accordance with Rule 18. <br />3) Approved pursuant to CRS 37-92-602(3)(b)(0 for uses as described in CRS 37-92-602(1)(fJ. Use of this well is limited to <br />monitoring water levels anNor water qualiy sampling. <br />4) Approved for the use of an existing well acknowledged for censWCtion under monitodng hole no0ce MH-01761, and <br />known as DS03 MW04. <br />5) This well must be equipped with a locking cap or seal to prevent well wntamination or possible hazards as an open well. <br />The well must be kept capped and locked al all times except during sampling or measudng. <br />6) Records of water level measurements and water quagty 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 monitorng 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 />Resources within 60 tlays 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 io preserve these markings. <br />9) This well must have been constructed by or under the supervision of a licensed well ddller or other authorized individual <br />according to the Water Well Construction Rules. ~ / ~^ <br />10) This well must be located not more than 200 feet from the IocaOOn specked on this permit ! z o'3 \`v~s~S <br />A~PBROVED ~^~ ~ r /J,w,re,pti ~~~ <br />State Engineer <br />