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DI4.TJSIOII c,R xnxEa x>~ol>tlc~s ~ RECEIVED <br />pEr-s:a+5` y373 ae~alas i 13M. 83r9 <br />C0~0 X03 Nav a e lseo <br />++EU aeaacoNrlENr AFF1uAV1T~ ~ ~ <br />STATE OF GOLORA00. ) 1 ~~' <br />COUNTY OF mutt )} sf. } <br />' ~ 1 (~~ C. C. Legal, H^G Coal Co. ~ ~ .bean <br />9 <br />first duly sworn upon oath, desposa and say: <br /> <br /> <br />Thai an old wall. located in tiN ~+ 1/4 of the ~ 1/4, Saetlon 30 <br />Township 5 x _ Nangn 88 w 6th P.M., was replaced ' <br />for'tM fol taring reason (sj : 1 <br />' ~ Nell collapsed at the 210' level and~went~dry ~ CZiy )1 - F, <br />That. the old well, which was replaced 4y.a'nsw we11 drilled under permit <br />nunber 2a57g - F .was plugged and abandonee#.aeeordtng Co the <br />rules and regulations of the. SE+ts Boa'rd of Exaainers of wasar Mell end Pump <br />Instilbatfon Contractors by ~C. C. Lega1,.H-G~ Coal Co. ~ ~ ~ ~ .~ <br />rson s or;.campeny <br />On ~ October ~ 15, ~ ~.' .1980 ~ . ~ .. ., , , <br />That the old well wa plugged with the foilowtng metartals placed at the <br />Indiutsd intervals: <br />. ~.~ ~ thin~eonerete from 210 feet to surface ~~ <br />fr~oJm ~ feet to feat <br />Signature of affient(s} ~~ C <br />Subscribed and sworn to before ma thi; day <br />of 19~. <br />„Mp Codrelssion e~irsa: <br />.. ' !~% <br />., <br />' c , <br />_ .rte _ _ <br />= ~: -- _ <br />i-. ._ <br />~,=,.,'... ~'it jf _thj~ownerrs. rosponsibtlity pursuant to the conditions of appibvel to sae <br />'; _,that`th~l affidavit is returned. <br />. (3ae ravierse side for AbinSogmeaL Hsgu3Atioaa) <br />