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ENO', STATE OF COLORADO I Fa. gels Ua oNy <br />°~° OFFiCE OF THE STATE ENGINEER 1 <br />~~ <br />I ate c«rr~w ewe., ta+s stvrm~n se, oan+., cda.do eoxw - <br />PeW ~~ <br />~E OR PRwT w Bt.ACIC dVK <br />WELL ABANDONMENT REPORT <br />ABANDONED WElL NUMBER ~ REGISTERED N. u I ~ ~ Q .. C , , <br />t. wDMDU ANY RESPO <br />NAME(Sy , i,J e s +- 6 1 iC l~'1 ~ ru. <br />Mal>•stg Address , P o i ~r s q I <br />Phone ago GAG- a.~~42t-- <br />Z ACTUAL WELL LOCATION• COUNTY <br />PROPERTY ADDRESS ~ I"14 H ~.J Y ~ 13 ~~ _ 5°- <br />ta» <br />t/a 1la, sea Twp. ^ N. ^ S.. Range ^ E ^ w, _ <br />Distances from section Ltrtes393895. I Ft from ®N. ^ s. Llrtel~d 3~ U~3._~t. trom ®E a ~ W. Lute. <br />1 furs), report tfta4 an etustirtg wed was plugged and abandoned for the faeowing reason(s): <br />The wed was plugged and abandoned as required under the cortddiorrs of <br />approral of Wae Perm[ No. <br />The wet was not h use and was abandoned. <br />Other (please et~tain) . <br />s. The wed was p4gged and according td the water Wet Constructlon <br />and Pump 4tstaratlan Bute. on "aa~o I <br />~. The wet was pwrgt,Ted wdh fire materials placed at the trtdk~ted irtterval~ <br />AMOUNT AND ME OF MATERIAL METHOD OF PLACEMENT eJTERVAt <br /> from feet to teat <br />~ c. G-~ ~ L I r m i irart~feet ~ ,Meet <br />Q ' ~ <br /> from feet to feet <br /> from feet to feet <br />iNTERi/ALS OF CASING REMOVED/RtPPED W FEET from few to feet <br /> from feet to . -feet <br />1 (we) trove read the sgterrterus made herein and lotow the ooruaes thereof, and that they are true to my (our) <br />lutowledge. [Ptastrartt to Secticr- 244-104 (1~(a) C.RS., the making at take Natetstertts ttereirt cot>saddes perjury <br />in the second degree and is punishable as a class t rt-isderneartor.] <br />Narna/TWe (Please type or prim) - Signaare pate <br />tiny p. IdsateC owner ~~~G, J7.~. ~ ~ ~ ~ l ~ 31 I ~ ~ <br />TION- h ~ the respor~day of the wee owner to have the wed properly pkrgged arw abandoned. <br />wee consvuction carmacoor b fas<torn~le for rtotdyirtg the wee owner of the pYrggirtg and abartdaanem re <br />Th's farm may he reproduced M ptwtocopy a wad processing means <br />