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°q-1 STATE OF COLORADO <br />~~ OFFICE OF THE STATE ENGWEEFi <br />81e Cadwaid 61da..1313 Shaman St, Darvar. Colorado t102W <br />Q03) 1t6635a1 <br />OR PFtl17T tN BUIt'.IC aaC <br />WELL ABANDONMENT REPORT r„ <br />ABANDONED WELL NUMBER fF REGISTERED Noleln_ ~~ ~~ <br />DU COMPANY RESPO FOR <br />~E(~. Wes~t0.inK p~a~o•r,-I ~Iti ~~ l_C.. <br />MaTutg address . p b~~ 5 q I J-- <br />Ciy, St ~p 5 o m:2r ~5trt ~ ~ ' `b` 143{ <br />Pltorte quo g a s- x 3 0 3 <br />2 ACTUAL WELL LOCATION: COUNTY <br />PROPERTY ADDRESS 5 11'--I <br />Far p9ea u« arty <br />t~~ IQM lam) <br />t,4 „4. ~ TWp. o N. o s.. Range ^ E ^ W _ <br />I>iwarrees from sexton Lures 3 q 31 ~ ~ •~, liam ®N. ^ s. Llnel a 3~~e~1. aFt Gom ~ E. or ~ w. Lane. <br />t (we), report that an eousting weft was plugged and aharxlaned for the t8 reason(s): <br />The weo was p4rgged and abardorted as regtr4ed under the oor><Nions d <br />approval d WeA PecmQ No. <br />The wei was rat in use and was abardaNd. <br />Outer (P~ase ~) . <br />S. The weft was pWgged and abandorwd according td the Water WaC Cortstructfort <br />and Pump 4>sLaYaftort Rules on t9~~; <br />~. The wed was pMgc,Tad weft ttw materials placed at the Ind~ated intervals: <br />AMOUNT AND TYPE OF MATI]iWL METHOD OF PLACEMEhTi' INfERYAL <br />tl 0 0..i, l'.imer~ ~t~C-~flL lram~t~ <br />-~ ~~~a ~ 50 ~ . <br />INTERI/AL.S OF CASING REMOVED/RIPPED IN FEET <br />from feet to feet <br />from O real to ~ reel <br />from feet to teat <br />rrom rase m feet <br />from feet to feet <br />from feet to .... feet <br />I (we) Have read the staterrlerVS made herein and latow the ooruertts thereof. and that they are true to my (our) <br />Imowledge. Pursuant to section 2a-a-toa (1~(a) c.R.s., n,e malctng a false s~tatameras t-ereirt perilay <br />in the secord degree and is ptatishable as a Class 1 rrdsdemeartor.] <br />N~enY a laar,ec o e- ~ ~ ~ !/ ~~-~-~ ~`--e~ I ~ 131 I Da.. <br />TION- R is the responab~Ay of the well owner to have ttte wetl propery pkrgged and abandoned. <br />wep cortsouctiort oaltractar to rasponsbla for rtofifying the we! owner of the pYggirtg and abartdoNtterti re <br />This tam may be reproduced by pttobocApy or ward processig means. <br />