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STATE OF OOLORADO Far arse. u,. ody <br />OFFICE OF THE STATE ENGINEER <br />91e C«rw9tl Bwp.. 719 Stwwn sr.. Dw.w, Colorado smDa <br />Ptnl tlsssset <br />OR PRQdT W BLACdC 6~It <br />WELL ABANDONMENT REPORT <br />ABANDONED WE1L NUMBER ~ REGISTERED ~°~~ ~ D 5 a-- <br />1. LNDMDUAUCOMPANY ESPON51fi FO P GI <br />pw,nf Oo,,! ~mfJ l,l_C_ <br />Mang Addles . p ~ •tij ~ ~ 5 ~1 1 <br />car. SL Zrp S e,~r S 0.-1- , C:~~ ' ~ ~ `~ ~~ <br />Pftorre 9~0 `~ d q- a 3 0 3 - <br />At7TVAL WELL LOCATION: COUNTY <br />PROPERTY ADDRESS 5 I-1 ~4 N u/ "Y ' 1 `~i ~n a ~~' C.O <br />Ndm..4 (C44 l~l - <br />1!4 1/4, Sec. Twp. ^ N. ^ S„ Flange ^ E ^ W_ _ <br />lMtances fran Section L4~ss~ 31 ~" 3• D F~t from ~ N. ^ s. Line,11I3]~~eFt hom ~I E or ~ W. L1ne. <br />3 1 (we), report Utat an eodsting wee ryas plugged and abandoned for the foaowirtg reason(s): <br />Tl,e wa0 was pugged and abandoned a: regrdrad raider the condalorta or <br />approval of Well Perm't Na <br />The rret ryas not to use and was abandoned <br />01her (> ~) . <br />4. Tire we0 was pugged and abarWared aCDORlalg l0 the Water WeC Castructiar <br />and Pump IristeYatiort Rries an ~ 1 , .n , ~ 3 -_- _ , 99-~D I <br />i The rrea was pkgtled wah the r9 m placed at the i'rdicated intervals: <br />AMOUNT AND TYPE OF MATERIAL METHOD OF PLACEMENT INTERVAL <br />I <br />INTERVALS OF CASING FIEMOVED/RIPPED fN FEET <br />trorn teat to teat <br />from~Teet to d Teel <br />front feet iD Teat <br />from feet to feet <br />from feet to feet <br />tirorrr feet to ... !teat <br />i. 1 (we) have read the stazertrerrs made hereto and Imow the eaxergs ttrereof, and mat they are nitre to my (otrrl <br />Iatolrriedge. [Pursuant to Section 2a-4-104 (15)(a) C.RS., the maidrtg of false stateme%s herein perptry <br />in the second degree and !s punishable as a Cfass 1 rtdsdemearwc] <br />~o~ T~ ~~~~ I -I31~~. ~ <br />~_ n >s the respona'W1ty or the wee owner m have the wee properly plugged and abandoned <br />well car>struction ooraraaor b respamble Tor rtotdying the we! owner at the pkggirrg artd abarrdora+rern re <br />Th's tam may be reproduced by photocopy a tract processirg means. <br />