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PERMFILE138116
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Entry Properties
Last modified
8/24/2016 10:38:43 PM
Creation date
11/26/2007 7:02:18 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M2001012
IBM Index Class Name
Permit File
Doc Date
3/23/1992
Doc Name
STATEMENT OF BENEFICIAL USE
Media Type
D
Archive
No
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T <br />WELL Loam <br />From To Type & Color of Material Water <br />Loc. <br />0 2 Top - <br />2 6 Loala <br />b 54 Gravel (coarse) - - <br />54 102 Shale bloaaom & thin rocks <br />102:1 <br />1O3~ 103 <br />109 ; Sock <br />shale <br />l0y 10i - Sd~Et~ Pock <br />109 135 Shale <br />1;5 135 Hock <br />~ 135 11.6 shale <br />~ ? 46 Roek <br />11,6~r 160 shale - <br />1b0 la3 Shale G Pcadtill sand <br />;133 ld3 Hock <br />123 135 shale <br />',1a5 1a5 Hock <br />IlaSi: zoz Shale <br />202 20~'' Hock <br />1202 224 Shale <br />2213 22a ?ock <br />' ?~:S?: 251 :.hale ~ a little faxhill sand <br />'''bl~ 261 Hock <br />j^^<61~ ZEZ Shale & Yo~ill sand <br />' ?a2 319 :hale 'r ioad^311 sand <br />1319 319 hock <br />319 <br />i <br />I <br />I <br />I <br />i 31,2 Shale _ - <br />I <br />Use additional paper if necessary to complete 109. <br />State of Colorado, Coun[y of <br />Subscribed and sworn to before me [hi <br />My Commission expi <br />ss <br />• WELL DATA <br />Type Drilling Standard Rotary <br />HOLE DIAMETER: <br />_~in. from 0 ft. to 342 <br />in. from ft. to <br />in. from ft. to <br />CASING RECORD <br />Plain Casing <br />Sized kind M x from 0 ft. to~- <br />Size, kind from ft. to <br />Size, kind trom ft. to <br />Perforated Casi <br />Size.{ kind W W from~~ft. to3>l9 <br />Size-, kind from ft. to <br />Size, kind from ft. to <br />GROUTING RECORD <br />Material ce^eat <br />Intervals 0-lOr <br />Placement Method sP~ tube <br />GRAVEL PACK RECORD <br />Size Interval 10r to bottoII <br />TEST DATA <br />Date Tested ~'~T ?O, 1571 <br />Type of Pump 6831'ed <br />Leng[h of Test ~9' i, <br />Sustained Yield (Nerered 1 2 <br />n......a......, 261 r <br />WELL DRILLERS STATEMENT <br />The undersigned, being duly sworn, deposes and <br />says: he is the driller of the well hereon <br />described; he has read the statement made hereo <br />knows [he con[ent thergof,;aed th~rs~e ~ tr-ue <br />of his own knowledge. 1 ld <br />,/ . <br />x ~% /~`ix, c:::s_~~.frL~2i r~ T/~ Tom:; <br />License No. 7''u <br />day of 19 <br />z <br />Notary Public _.,t <br />
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