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rorirNO.~ STATE OF COLORADO ~ Fa omo. u.. ody <br />°~° OFFICE OF THE STATE ENGtVEER <br />BAs <br />eta c.nrNrr eep., tma sn.m.~ st. n.m.r, col«.ae soap <br />PoW ess,~.,et <br />OR PROFIT Qd BLACK Q~OC <br />WELL ABANDONMENT REPORT <br />ABANDONED WEIl NUMBER ~ REGIST13~7D >_I ale 2.O ~'- - <br />INDMDUAL/ MPANY R PO B 'FOR <br />~~ ~101~-n. Q l n a o m Q o..n ~ l-, L. ~- <br />YJ - 5T /r ~ = E <br />Madvlg Address . ~O ~5 a~ Jl l <br />Phone 970 Q ate- 02 2~ 3 <br />2 ACTUAL WELL LOCATION: COUNTY <br />PROPERTY ADDRESSrj l~i ~-~ 1-1 \,J Y ~ 7i' ~ 56Yri¢~5-~ ~ ~.~ <br />tAdd~~ lcM t~I <br />t/4 1/4, Sea Twp. ^ N. ^ S•. Range ^ E ^ W. . <br />Des from Section 0 3 Ft hen ~ N. ^ 3. Unel'~ 3"1_~t from ~ E or ~ W. Line. <br />3 1 fwe), report rhea an existing wet was plugged and abandoned for the fo0owh'ip reason(s): <br />The wet was p4rgged and abarxlated 85 ragtdred under the corxDtbr>s of <br />approval of Wet Parma No. <br />The wet wasrrtot M tree and was abandoned <br />The wet was plugged arW abandoned awading m The Water Wet Construction <br />and Ptmrp 4~albticn Rrstes on~ l,1,Y11 ~Q .~~j,Q 1 __ <br />The wet was pN~gged wah iTw roYdMwng matalals placed at the Ina~ated tntenra~ <br />AMOUNT AND TYPE OF MATERIAL METHOD OF PLACEMENT INtEfi1/AL <br />~_ ~ GIRL Ire:,-,'~ e <br />~~ ~ l~n, a7 50' <br />INTERVALS OF CASING AEMOVED/RIPPED W FEET <br />from teat to feet <br />trorrn~_feet to ~,~teet <br />iron teat to feet <br />tram feet w rest <br />iron feM to teat <br />tram feet to , _ _ -tees <br />I (we) have read the statertnerps made herein and lonow the coraeras thereof, and that they are true to my loco] <br />Ianowledge, fPusuant to Section 2A-4-104 (13)(a) C.RS., the making of false statat-atrts herein peryury <br />in the second degree and is ptatLginable as a class 1 rNsdemearar.] <br /> <br />uTtoaa- n .s the respona'btay or the wet owner to have the well properly Pa+98~ and abandoned <br />~1,e well cor>strucoon oorttr-actor is resparrs~te far rrotaytrg the wet owner a the ptuggirg and abandorvner-t re <br />rn6 tam may be rapoduced by vty a word processing means. <br />