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. ~ <br />.J <br />~~~~~yEO <br />WELL ABANDONMENT AFFIDAVIT'~~ ~E.~~k~1E5• <br />SCUD' <br />STATE OF COLORADO ) W~`c`? ,_hEER <br />) 55 . S~~ ~~ ~ <br />COUNTY OF ROUTT ) <br />I (we) George M. L. Robinson ,I~eing <br />first duly sworn upon oath, despose and say: <br />That an old well, located in the SW 1/4 of the SE 1/4, Section 27 , <br />Township 6 N Range 87 w 6 P.H., was replaced <br />for the following reason(s): <br />Yield not sufficient for mine shop needs <br />That the old well, which was replaced by a new well drilled under permit <br />:o- <br />number 22647-F <br />was plugged and abandoned according to the <br />• <br />from 9 feet to O.5 fce_ <br />rules and regulations of the State Board of Examiners of Water Well and Pump <br />Installation Contractors by <br />Coal C <br />(oerson <br />or company <br />on October 13, 19 77, <br />That the old well was plugged with,the following materials placed at the <br />indicated intervals: <br />Silty clays <br />Topsoil •. /~ <br />Signature of aff iant (s) , <br />Subscribed and sworn to before me 9~fiis <br />of December 1977 <br />My Commission expires: <br />~ feet to t) feet <br />12th <br />day <br />• <br />'•~lt is the o~mer's responsibility pursuant to tha r.undi[inns of approval l~~ sec <br />that the affidavit is returned. <br />cc: D. Sturges <br />F. Gilbert 7-g_22 <br />M. Sanders <br />