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RESOURCES 3p3 966 3589 P.7~~=__ <br />c.`ss~ NOTICE OF INTENT TO CONSTRUCT MONITORING.I-EOLE(S}-~i 33fCf1VFC <br />03rd, - Pieria type or prin[Ir_giniy .n b1aBA_InA",l - - ^_ .:,i <br />'; : is '~..._ - ~ - i `s ~iAR 2 3 2004 <br />- ~ ... <br />' 1~ ~~ ~ WgTER RESOURL•ay <br />m 'I `. _ STgTE ENGIryEER <br />'tee- //11 //~1 1/ 11 ~A~ n ... s^,'~' ....'; ~'-i CoLO <br />`h'@II Ow'necs Name nW f Y ~l~DGt Y~~r'u11~1~ 1 /Q11~ l~a~~~~~~~ - ~ ~~~'l•JC2L'Cn ~~-~f`~~+ %a, N~ % . Szction ~9 <br />Lar,Cbw ter"s Name w: ~ Volts I~u~'u nh L,nNe(~!~I TCwnS`Ip ~ N.~`~r23nG= ~ ~/ (g~" =M <br />Mailing ,address: (Authdr;zed Individual/cr ^riller) <br />Conrad ~+rcM.. laatt er ~t'lt tcf' £nutre.rw ><le, ~~:.vJS,/ <br />Company e~! \( Cznld -ltunrwc rn .w+r <br />ACd: ess ~ I3aX ~ 9 ~ _ <br />Gcy, State. Zip U14i9~'~~ ~~g~~ <br />Phdrte 7(9~pf $9 -y053~ lax No. 719/(.rF74- 3?~ <br />Onuer Lit. Na. (ir applicable) /~~C Nfrljit+~ +~#r~` ~I Y~i T~ <br />5.~c- YV1e..~wtr~ {-{ole Z)0 : I~{ IJ -~.$ <br />..ounty (L'...~~ <br />~cacivision ly~~-t <br />Lct ~ ~ .Six fJ >4 .Fig AJl'la <br />Hole(s) Co 3e Cpnstn:ced: Number 1 <br />Est.mac2COep[n~1`l9F[. Aquifer <br />P rpase or Moni[Crinq Hole(s) <br />L7fouric! 1~]o.ScY Ir+a n~{o~~r`G <br />V <br />Appr~zimace Gate or Consvuction o>< 2y/o~ <br />L / ' <br />~~ <br />aCKNOVVLEDGEIViENT FROlvt STA ~ E ENGINEER'S OFrICE <br />FCR <JFFIC'e l)Se ONLY <br />,wH- 4325 ~ROCSS~ 3V ~, <br />oi~. ? wo ~ Z B.zS _ N10 _ DATE AG;<uCwLECGEO 3 -a 3 - o y <br />Gacc~O _~ ev <br />uses NIAp ,: <br />CONCITIONS OF MONITORING HOLE AG4NOIr'~'LEDGEMENT <br />A COPY OF THE WRtTTEN NOTICE OR ACKNOWLEDGEMENT SHALL BE AVAILABLE AT THE DRIWNG SITE. <br />,vocice was provided :o ;: a Scace Engineer ac teas; 3 days ,tor co cpnswcvon of moniccnng 3 Observaoon nNe(s; <br />Constnrctien cF ctie hoe(s) mus be cpmpleced wiciin 30 Cays of Ne care notice was given :o me ovate "engineer. <br />Tasnng anC/ns ,pumping snau ,'ipi excmtl a total of 200 pours unless pnor•wnaen approval is obtained tram me State Eng>.~eer. <br />Water diverted Cuing testing snyll not be used for Denef;cial purposes. Tne owner of ;ne ~.aie(s) .s resportslble Itx coraining pertrrc;s; <br />and complying wit:, au (Vies and regulations pertein;ng ;p :ne dis.:narge of rtuids prpduced donna ;esvng. <br />All wpf% must comply anRt .•ne `Hater Well Cpnstnxf'pn RVIeS. 2 CCR x02.2. Arlinimum cpnsttLCUOn iiapdartl5 must be met cr <br />a variance obtained. <br />Wan Cdn5GnlCtiOn and Test Reports (GWS-]~) This: ce submittzd ro mis dice by the IicanseC cOntraCpr or euNCnz¢d ineividuel <br />wiL^..n o0 Cays pf [ne cpmpievon of tre wont. <br />Unless a well permit ~s obcained.:ne hole(s) must be pwgged and sealed wicn,n cne (~) year aver cpnsiiuCtion. An Aoandonment <br />Report (form GWS-91 must be wom;aed '.`am;n 60 oays of plugging & seating. <br />The pwne! of the no/e(57 srtotdd msiatain redares of wa[Er quality [esting and vomit :tus .rata to Ufe Stare Enrneer upon request. <br />The monitoring hole numoer, owner's svucture name. and iMle :Jwner'S .name and aCG253 must tie prw;ded on all well permit <br />appli[a[idn(S), well COtgtTICJOn and dnandpnmBrtt reports. <br />A mon;[onng nae cyrmoc be cprwer;ed co a prdeuction water well. excapi Far purmses cf remediacort ;redpveryl a as a permanent <br />dewateting system, if CpnSttLC;ad in aGLOttlancE vim me `Hater Wen CorcauC'on Rules one pplip;e5 of the State Engrr,eer. <br />THIS ACKNOWLEDGEMEYT OF NOTTOE GOES NOT INDICATE THAT `HELL PfSiMff(S) CAN gE 4PPROVE71. <br />AdCitipnal Cundiudns <br />TOTP~ ~.'~2 <br />