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w Rl~76~7] ' <br />~' J WATfiR RESOVRCES <br />' COLORADO DIVISION OF WATER RESOURCES s,'~ CE:~TE'1!~I~ L ELD <br />Trtl$ FOr~M h:;J$T 8E SUBMITTED 300 Columbine Bltlg., 1845 Sherman Sl. j 3 13 S ~ E ~ . f.: A: • =' <br />WITHIN fi0 DAV$ OF COMPLETION Denver, Colorado 80203 ~ xi <br />~EWORK DE$CR19ED HERE DEn~Ef,,L,U ~7JZOJ <br />PE Oq PRINT IN BLACK WELL COMPLETION ANO PUMP INSTALLATION REPORT <br />I K. <br />PERMIT NUMBER ~Gy7- n <br />WELL OWNER ~P rdV C°n :~~ ~n~ TJ'YTY ~W '/. of the J ~ %of Sea~~ <br />AOORESS / ~~ 7'S? E *~5~ ~rc~ 1P r yt /c~ R _ Vic. r 7.._(,~._ .~ . R. ~S .Z ~~ ~ P.M. <br />DATE COMPLETED S~P~ T 1 5 , 19 <br />WELL LOG <br /> <br />From <br />To <br />Type and Color of Material Water <br />Loc. <br />o ~l ~'/vy, ~`3RN, <br /> <br />/5 ~ ~ 53 ~7c2/ <br />/53 :?ofl% Sated 57on.~, /,~yT <br /> c Cdr. <br />•o~= ~~~ ~'oaL <br /> <br />are ~3Lt % C~ ~ .L <br />3~' 2 3~5 % G' r3 a y <br />sa"~ <br /> r <br />r <br />Ys1 3~f9 coax <br />Y9 ~ 1 sa~f~, ~R~y <br />~,.: ... <br /> <br />s~% 'y`/` .S`a-rtd S r. yf P, t,v/s7ir~ry5 <br /> <br /> o~ .4hale, 0yr{It <br />~ ji;,~y <br /> ~ 44n <br /> 1 n <br /> ~.. <br /> Li <br /> TOTAL DEPTHG ~o <br /> Use a dd~Iional pages necessary to complete loq. <br />HOLE DIAMETER .~ -' <br />3 in. from ~ to ~~ ft. ^^ <br />~j ~ 1 1 <br />CL <br />2 <br /> ~ <br />, <br />V <br />~ ~~[ <br />-'~r`--~ in. from ~-y_[[_ to ~" y ft. ~ a~ ACr3 <br /> w~ <br />~~ ~GtsE`~ <br />in. from to ft. l0. <br />DRILLING METHOD A I r~ ROT /f ~ti V <br />CASING RECORD: :r Ptain Casing <br />~/ ~ <br />Size ~ & kind ~ CT' • from ~ ~ <br />to ~_ f' <br />i/ ~ <br />Size ~-~ & kind l- s' 1- from ~,_ to 57a f <br />Size & kind from to f <br />W ¢ z~ Perforated Cajing <br />it S c f7 r r •Y <br />Size ~' & kind j2Lc~?LS from ~~ to C•e ~ f <br />Size & kind from to f <br />Size & kind from to f <br />GROUTING RECORD <br />Material ~12^rr.r a -x i ~ .~a-,w .~ `t'l ~'. <br />r <br />Intervals [~ - 3 ~~ <br />Placement Method ..$sd u e~e Z~ <br />i •, <br />GRAVEL PACK: Size ~4 <br />Interval ~ QO ~ -~ L GO r <br />TEST DATA <br />Date Tested ~ /~ 'Ylo? ~ 7 , jg _ <br />Static Water Level Prior to Test ~~ ~ <br />Type of Test Pump <br />length of Test <br />Sustained Yield INleteredl. <br />Final Pumping Water Level <br />r <br />L <br />7-8-23 <br />