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vtlast ST.aTE OF COLORADO <br />"' OFFICE OF THE STATE ENGINEER <br />~~\ ti'0 318 Centennial Blde .1313 Sherman St.. Denier. Colorado 80:OJ <br />I ~'9= 1303)366-3581 <br />Jr <br />.WELL ABANDONMENT REPORT <br />(To Report Plueging and Sealing Wells) <br />PERMIT NUMBER OF PLUGGED WELL Hole No. HG-2 <br />NAME: Monteomerv Watson Minin¢ Group <br />Mailing Address: P O Bas 774018 <br />Clq•. St.. Zip: Steamboat Sprin¢s CO 80477 <br />Phone. 970/879-6260 <br />Approval No G1VS9-96-08 <br />ACTUAL WELL LOCATION: COUNTY: Routt <br />PROPERTY ADDRESS: Hayden Gulch 64ine. Routt County Road 53 <br />SE I/J SE 1;1. Sec. 30 Twp. 5 ®N. ~ S., Range 88 ~ E. ® W. P.M. <br />Ft. from ~ N. or ~ S. Line, Ft. from ~ E. or ~ W. Line. <br />We report that an esisting well was <br />reason (s): <br />~ The well was plugged and sealed as required under the condi[ions of approval of Well Permit No. <br />The well was not in use and was plugged and sealed. <br />~® Other (pleaseesplain) ~o.l,w,,.,e.*^•+,4,~-+~, wGn~l.~, p~~~r~Ya.Y a~.1~/oee ~r.~a o~ 4~e..~ <br />]Slur Sie,~ Mrnv. r w.. w•oJL•y <br />Thz well was plugged and sealed according to the Water Well Construction and Pump Installation Rules on October 6. 1998. <br />~~'ell was pluggetl wlfn the IOllpwing ma[enals placetl at <br />AMOUNT AND TYPE OF MATERIAL METHOD OF PLACEMENT <br />IT bees ~ cemenUbentonite grout [remie from 0 feet t0 234 feel. <br /> from feet to feel. <br /> from feel 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 U feet to 15 feet <br />Pulled -4' cop piece. 0' - l9. <br />I have read the statements made herein and know the contents thereof, and that they are true to my knowledge. (Pursuan[ to Section <br />?-1--1-104 (13)(a) C.R.S.. [he making of false statements herein constitutes perjury in the second degree and is punishable as a class I <br />m Isdemeanor. ) <br />TIM HIMES,GeneralManager /^ ~ ., Dale: 10/13/98 <br />Himes Drilling Company. Inc. <br />2390 Hu~~ b & 50. Grand Jct CO 81505 < <' ~-t--~ .[~ <br />97U242-8893 <br />.INFORMATION - It is [he responsibility of [he well owner to have the well properly plugged and sealed. The well construction <br />contrac[or 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 />