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FCii/oe0~~ STATE DF COLORADO Far onko t1w odr <br />~° OFFlCE OF THE STATE ENGINEER <br />818 C~rdrmtd Bld4+ 7919 Sfwnun &.. DanrM. Colorado 807A9 <br />f~ eesasst <br />OR PRQdT W BL/-CtC WK <br />WELL ABANDONMENT REPORT <br />ABANDONm WEIl NUMBER ~ REGISTERED Flole ~ (,~ "Z" <br />INDMDUAUCOMPANY RESPONSIBLE FOR PUlGGINQ J L <br />mDu.rtQ.in Coal. ComDR~-K <br />NAME(S~ . ~J e {- 6 l k M~ n-R- J <br />MaiEng Address . ~~ ~7 ~(' S G 1 <br />cxy, s< ap 5 o rn er 5 e f- , t_r7 ' ~ l 4 3~ <br />Phone 970 9 a G- x 3 0 3 <br />2 ACTUAL WELL LOCATION- C <br />PROPERTY ADDRESS 51 <br />t~aa ta» ~, <br />t/4 t/4, Seo. Twp. ^ rL ^ S.. Range ^ E ^ W. _ <br />Oistalrrxa from Section Lirles~A3F 35.0 Ft from ®N. ^ S. Line) 3l l ()~. i)Ft from ~ E or ^ W. Line. <br />1 (vre), report tfrat an aldsting wen was phrgged and abandoned for the fo0orrring reason(s): <br />The well was plugged and abandoned as regrdred under the corrditiortS of <br />approval ~ Wei Penrrd No. <br />The wet w~ not In use and was abandoned <br />Ot11er ~) . <br />The was was p4lgged and abandoned awordirrg to the Water Wei CaraUtraorr <br />and Purnp 4rstaiadon Rules on ~.l.l, ~~ .~+s,~{j0 i <br />The wei was pkrgcfed with t1w foiowirlg rtrabar(als placed at the Indicated IrltervaL~ - <br />AMOUNT AND TYPE OF MATERIAL METHOD OF PLACEMENT INTERVAL <br />r~,l, ~ Tr¢m'+P. <br />~ / <br />INTERVALS OF CASING REMOVEDiRIPPED W FEET <br />Tram feet to feet <br />irom~_feet to ~ feet <br />from feet to feet <br />from feet to feet <br />from feet to feet <br />from feet to . .. _feM <br />I (we) have read the srdterrrerus made herein and Imow the corxents thereod. and that they are true to my (our) <br />lvtowledge (P1dSUant to Sectlotr 2a-4-t04 (73)(aQ C.RS., the making a false statemerns herein petjufy <br />to the second degree and is puntshabte as a lass 1 misdemeanor.] <br />~ <br />~ <br />~ <br />N Q l <br />assrlec o er <br />I ~~~~1 ~ ~ /vi I Il '~ ~ ~ ~ °~-_ J <br />TION- n is the respons~Tdy of tt-e wee owrrar to have the wen properly p4lgged and abandoned <br />we0 corlstructiort oorrractor as responsdlle for rroriryirrg the wee owner of the ptrggirrg and abarrdorvrrent re <br />This form may be reproduced by photocopy a word pro~ip mire <br />