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rwo.NO.f STATE OF COLORADO ~ ~ rbr onk. u.. ony <br />°~'~ 1 OFFlCE OF THE STATE ENGINEER <br />~~ <br />ate carrurd ewe., tats Stwern se. oa~.r, Cabrado ao2at <br />Aml oeaasat <br />OR PRd~rT W HL11,C.tC INIC <br />WELL ABANDONMENT REPORT <br />ABANDONED WE11 NUMBER ~ FIEGISfEF~ Nolte T D '~ L" <br />Ma~rtg Address . ~ u >3 ~ 5 a 1 <br />Ca1r. St Zp 50 Yh.er ~ ~ C x ~ `~ ~` ~ `_ <br />Plane 970 _ gc1Q - a 3D ~ ' <br />2 A_ CTUAL WELL LOCATION: COUNTY <br />PROPERTY ADDRESS 5l7 ~ H ~l Y ~ 1?, ~1 gnrv.p r5 Q~-- C.C, <br />u~«a t~ t:~ <br />1/4 t/4, Sec. Twp. ^ N. ^ S., Range ^ E ^ W. <br />Distartcvs from Section Ones 3 0~. Ft. from ^ N. ^ s. L'vtel'j37 bt4~ Ft from ~ E ar ^ W. Line. <br />3 1 (vre), report that an a»assting war was phrgged and abandoned for ilia forowing reason(s): <br />^ The war ores p4rgged and abandoned as required under the cortd'rtionss of <br />approval of War PertNt No. <br />The war was not it use and was a6andorwd. <br />Outer (please e~lain) . <br />The war was p4rgged and abandoned acoordfrg to the water War Constnrcuon <br />and Pump 4rstarariort Rules on~(~ 1 • ~~~ <br />Ttte war was pbecied wltt the toaoVr:tg - placed at the wed Qttervals: <br />AMOUNT AND TYPE OF MATERUIL METHOD OF PLACEMENT INTEFIVAL <br />~n.c ~ -~ 5 6, R TrP.m ~~ <br />INTERVALS OF CASING REMOVED/RIPPID W FEET <br />Trom feet to feet <br />rrom~teet to ` feel <br />from feet to feet <br />from feel to teat <br />from feet to feet <br />from feet to . -feet <br />I (we) have read the staternerris made fterein and lotow the ovrruuertts thereof, and that they are true to my (Dori <br />bwiwled9e_ [Pursuerrt to section 2a-4-toa (13)(a) c.R.s., the malting of raise smtemarm l-arain corwtrhnes perjwy <br />in the second degree and Ls ptatishable as a class 1 ntisdemeanor.] <br />Name/rafe (Please type or ptirt~ +e .. ~ Date <br />BItY Q Owner %~~ ~ ~~ ' I3/ /o~ <br />ATtoN- r is the raspons~y of the war owner ro have the war propery p4tgged and abandoned. <br />fie war corsuttcticn oarraaor m respatsbte for rtat~7yirtg the war owner of the pkrggirtg and abandorvnent re <br />This form may be repodaed by ptatocopy a word processing rtreans. <br />