PERMFILE114585

• Permit No: M2005080
• IBM Index Class Name: Permit File
• Doc Date: 5/4/2006
• Doc Name: Response to April 25 2006 Adequacy Review
• From: EAI
• To: DMG
• Media Type: D
• Archive: No

"'-" "'' WELL CONSTRUCTION ANd TEST REPORT ~
~'~~~~ Sl'AfE OF COLORADO, OFFICE OF THE STATE EN^viNEEP. I =orOt7!ce Use Onty i
1 ~ WELL PERMlT NUMBER MH•4~6101
-]
2. ~i I;~NNER NAMES; AHEn Drilling, Inc - _
~-1
Giai!ing Address Past Office Box 398 {
Cit}'. St. Zip Fairpiay, Colorado 80440 1 ~
1 Pone 719 838-2G72
_(_~-..- I

~
3. ' 1NELL LOCATION AS DRILt.EG; NE 1i4 Nb":
i!4, sPc, 1a bn•p. 1G South
,range 77 VUast
t i DIS7ANC_S PROM SEC. L:!'.ES' _
-
~Z5 ft. from Nort`~ Sec, (inE, and 1500 n from West Sec. fine. OR
(nortt or south; (aasi or west)
i S;UBDIviSIUN: PJrA LOt Bi Fiting(uni;)
STREET ADDRESS AT WELL LO+,ATIUN: ~-
_
A.
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GROUND SURFA'•:E ELE`iATION _-- __
_ `i. DRILLING METHOD Air FtOtary
' OATS COMPLETED .Total Depth 20 ft Depth Completed 2~ ft.
_
5. GEOLC•G1C LOG; ~
.~ _
r 6. HOLE OIAM. (ir.) From (ft) TO (f?) -
Depth ^ascdc?Ion of Materiat!T/pe, Size. Colpr, W'eter Locatlcn) I g 7/g _ 0 _ 20
0 - 20 Sand ~ Gravel Altuvail
-
~` t ___ _
--i-_
-
~- yV~ 7. PLAIN CASING
-
i Monitoring Hole #? _
StadcLevsl--1T6" __
~~-~ 00 (Ir,) Kind Wa0 SIZE From(ft} To(ft} ~
7 Stee_ 138
_ f1 16
__
- ,
_
~
i
~ ~ PERF
CASING; Screen Siot Siz
.032
1 -
e
7 SteEl 188 f 6 20
^ ^_
-
-- `~__
~
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r
__ 1 8. FILTER PACK: $. PACKER PLACEMENT:
^_ ~__
~ `
1 U2tericl
N,'A Type NiA
__ _
~.__-_ _
~~_._.' __
~.
JIZE
-__~~
I _ ~
Interval '~ Depth

~~ _-- -~ i tG. GR~Ci)T!NG rZE.^,ORO:
Material Ar:ount Cansi[y Irbsrvai Pla:.emant
REMARKS: ____ ! ..^.mert 9 c` 15 0 - i6 _ Pouredr

__ _ __
._.«- yi Eariv ?~~ - 1
- -- --, _. _______-------
i• -fT;'SINFE'"InR .f ;,,E. _ - -- 1
~~„r%- ----_._.--.._-._____`.~
_ _ _.., _., , .. -yt.__~~ _ _ , .~~~~. _ _ __ J
~' Z VYcL=PEST C'AT.A: L Cr I ,he;k br~x if TeSf Dail 'S 3ubmi!iea On Form F!a.:il~~ 5 ?9 Sliool~man:al °aVe`I TESt. i
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_S''7Nt, tsE' _ _ __ __ _ __
< ~zic L~;~ j --17 tiII~ R Dale?ir-5 rmeas;:reo - _-`--- _ ~__Y Proc~r:.yi Rates } -J_
I F,•n~li Le•.P N',A ft. Cate?,rrE •nea_~r+.d Test Ler ~tt (hr... Il-4
Rea~r,~kn I
F-_li.~_,_._. ~.--.._._-..__-------------------~.-..--..-
t ? ?. ~ trd~. ~ read the stztame.^'~ made herei ; arttl k.~cw ;he xnte~ts !;•,er~oF, and ma! in:=r vra troa to my knnMOdga. ,PU~sea~t Cc Seue or. 24<-1G> (?3)
C. r`i.F ire m,,',r,y of hlse sia:ements hace~n cons±itui~s perjury is [ha sewed dac~?e and is GJrvshauie ~s a aa„ ? m!s~erneanUr:
`:;GN"'RAC'fGP. Allen Drillirg & c:rcavatinc Ccmoanv. !n.c. _~_. Phnn= ~9Z8°:5i2672 Lic. No 763
h:laai~AddreS•; POSt Cffic> Boz 39Ej,Fa;rplay, COIO. 8G44p
~ i`;atre%T ". o (F!ease type Or print) Signature ---~--~~~,~" -~-~ -yam Date -~
Jack Fv;es ! t=•raside:n: i /7 / ~i/s"` ~ 511!Q I