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rnlt~t STATE OF COLORADO <br />~'" OFFICE OF THE STATE ENGINEER <br />U ti"a 318 Centtnnial BWg.. 131 J Sherman St.. Dem er. Colorado 30?03 <br />I ,'o~ (JIIJ1366-Jidl <br />.WELL ABANDONMENT REPORT <br />(To Report Plugging and Sealing Wells) <br />PERMIT NUMBER OF PLUGGED WELL Hole No. HG-1 <br />NAME: Monteomerv Watson Mining Grouo <br />Mailin, Address P O Box 774018 <br />City. St.. Zip: Steamboa[ Sorines CO 80477 <br />Phone. 970/879-6260 <br />ACTUAL WELL LOCATION: COUNTY: Routt <br />PROPERTY ADDRESS: Hayden Gulch Mine. Routt County Road 53 <br />S~~' I;4S\~' I/4, Sec. 30 Twp. 5 ®N. ~ S.. Range 88 ~ E. ® W. P.M. <br />Distances from Section Lines Ft. from ~ N. or ~ S. Line, Ft. from ~ E. or ~ W. Line. <br />14'e repor[ that an existing well was plugged and sealed for the following reason (s): <br />~ The will was plugged and sealed as required under the conditions of approval of Well Permit No. <br />~ The well was not m use and was plugged and sealed. <br />~® Other (please explain) 4al nn..a ~•,r+err~ ..a.ll, .6e+Y••eY , ~~r~4' ..M aa.~eY ft' Lrre.s.~r...a eG Cele..Ys Dr~,yr e~ I <br />.4,.ana s .. u e~ <br />The well ~+as plugged and sealed according to the Water Well Construction and Pump Installation Rules on October 6. 1998. <br />well was <br />A?IOGNT AND TYPE OF MATERIAL METHOD OF PLACEMENT <br />IT bags ~ cement/ben[onite grout tremie <br />INTERVALS OF CASING REMOVED/RIPPED IN FEET <br />Pull mp 3 fc uiC 4" PCC <br />from 0 feet to 280 feet. <br />from feet to feet. <br />from feet to feet. <br />from feet to feet. <br />from feet to feet. <br />from feet to feet. <br />from 0 feet to 3 feet. <br />I have read the statements made herein and know the contents thereof, and that they are true to my knowledge. (Pursuant to Section <br />_4--J-10-! (13)(a) C.R.S.. the making of false statements herein constitutes perjury in the second degree and is punishable as a class I <br />misdemeanor. ) <br />TIM HIMES. General Manager P Dale: 10/13/98 <br />Himes Drilling Company, Inc. r <br />?390 Huc 6 & 50. Grand Jci CO 81505 ~ 1~'r 1' `' <br />9i0,?42-8893 <br />INFORMATION - It is the responsibility of the well owner to have the well properly plugged and sealed. The well construction <br />contractor is responsible for notifying the well owner of the plugging and abandonment requirements. This form may be reproduced <br />by photocopy or word processing means. <br />Fnr t]lii.e f .e i Inl~ <br />