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F. ~asl ,ti .a I ~ o. co~o,,.aDo <br />`~~ OFFICE OF THE STATE ENGINEER <br />\\ ~-4 $ I S Cenitnmal Pld_e . 131 i Sherman 9 . Dtmer. Colorado SO?03 <br />I] °` 13U?1 yh5-331 <br />• WELL ABANDONMENT REPORT <br />[To Report Pluegin¢ and Staling Wells) <br />PERMIT NUMBER OE PLUGGED WELL Hole No. UC- <br />NAME. Monteomerv Watson MinineGrouo <br />Marlin, Address. P O Bo.x 774018 <br />Cin'. St., Zip: Steamboat Sorines CO 80477 <br />Phone. 970/379-6260 <br />COUNTY: <br />PROPERTY ADDRESS Hayden Gulch b4ine. Routt County Road 53 <br />N4t~ Ii1SE I/4, Sec. 30 Twp. 5 ®N. [] S., Range 88 ^ E. ® W <br />Ft. from ^ N. or ^ S. Line, <br />P.M. <br />Ft. from ~ E. or ~ W. Line. <br />We report that an ezisung well was <br />reason (s): <br />^ The well «as plugged and sealed as required under [he conditions of approval of Well Pertni[ No. <br />^ The well was not in use and was plugged and sealed. <br />Other (please explain) ~wre ,.~..,1..;„a ..[ill , .(i,.14+~ <br />IcY Otr tY,ra clsws .f ~a., YO l~r~rYU 1 <br />The well was plugged and staled according to the Water Well Construction and Pump Installation Rules on October 6. 1998. <br />oeu was olue_ea w <br />A~IUCN C AND T\'PE OF MATERIAL METHOD OF PLACEMENT <br />~bn,e ~,emen[/benronite grout tremie from p feet to 242 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 />INTERVALS OF CASING REMOVED/RIPPED IN FEET from 0 feet to 2 feet. <br />Cut off'?" P1'C and 8" protec[tve casing <br />I leave read the statemen[s made herein and know the contents thereof, and [hat they are true to my knowledge. (Pursuant to Section <br />' i-4-104 (13)(a) C.R.S., the making of false sta[ements herein constitutes perjury in the second degree and is punishable as a class I <br />Inlsdemeanor.) <br />TIM H1MES,GtneralManagtr / Dale: 10/13/98 <br />Himes Drilling Company, Inc. ~_ ' <br />?390 Hsvv 6 & 50. Grand Jct CO 81505 h~ ~~ ~/ <br />970r?4?-8893 <br />.INFORMATION - It is the responsibility of the well owner to have the well properly plugged and sealed. The welt/ construction <br />contractor is responsible for notifying the well owner of the plugging and abandotunent requirements. This form may be reproduced <br />by photocopy or word processing means. <br />