2008-03-13_PERMIT FILE - C1992081 ‎(9)‎

• Permit No: C1992081
• IBM Index Class Name: Permit File
• Doc Date: 3/13/2008
• Doc Name: Well HGDAL4 Well Information
• Section_Exhibit Name: Tab 07 Attachment 7-4
• Media Type: D
• Archive: No

FORM NO.
GWS31
04/2005 WELL CONSTRUCTION AND TEST REPORT
STATE OF COLORADO, OFFICE OF THE STATE ENGINEER
1313 Sherman St., Room 818, Denver, CO 80203
Phone -Info [phone] Main [phone]
Fax [phone] htt :/M~ww.water.state.co.us For Office Use Oniy

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1. WELL PERMIT NUMBER: MW-45768 - -
. WELL OWNER INFORMATION
NAME OF WELL OWNER: Hayden Gulch Terminal, Inc. ~ -'

MAILING ADDRESS: 701 Market Street, Suite 700 _
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CITY: SL Louis STATE: MO ZIP CODE: 63101
TELEPHONE NUMBER: 314 342-3400
3. WELL LOCATION AS DRILLED: NEt/4, NW1/4, Sec. 23, Twp. 6 ~] N or ^ S, Range 88 ^ E or ® W
DISTANCES FROM SEC. LINES:- 3 _S_ ft. from ®N or ^ S section line and l° tS ft. from ®E or ^ W section line.
SUBDIVISION: ° ~r°~4`'`J ,LOT-, °BL CK,kd FILING {UNIT)-
Optional GPS Location: GPS Unit must use the following settings: Format must be UTM, Units Owner's Well Designation: HG°D r1 a
must be meters, Datum must be NAD83, Unit must be set to true N, ^ Zone 12 or ^ Zone 13 Easting: ~ ~ I
STREET ADDRESS AT WELL LOCATION: Northin
4, GROUND SURFACE ELEVATION 6384.7 feet DRILLING METHOD Hollow Siem Au er
DATE COMPLETED 11!28105 TOTAL DEPTH 14.5 feet DEPTH COMPLETED 12.4 feet
5. GEOLOGIC LOG: 6. HOLE DIAM in. From ft To R
De th T e Grain Size Color Water Loc, 4 0 14.5
2 to soil sand cla drak brown
w/ ravels
5 alluvium sit da It. brown/ 7. PLAIN CASING:
w/ ravels ra OD (in) Kind Wall Size (in) From (ft) To (ft) ,
7 alluvium sil clay It. brown/ oist ~_ Sch 40 0 6
ra
8 alluvium sand w/ It. brown
ravels
10 alluvium sil c!a It. ra PERFORATED CASING: Screen Slat Size (in): O.OiO
14.5 shale dark ra 2 Sch 40 6 12.4

8. FILTER PACK: 9. PACKER PLACEMENT:
Material silica son Type
Size 8/12
Interval 4 -12.5 De th
0. GROUTING RECORD
Material Amount Density Interval Placement
Remarks: hole backfilled w/ bentonite pellets from entoni 1 boa 0.5 j4 poured
14.5 to 12 5' 4" OD steel monument w! 2.5 ft
stick-u ;concrete ad from 0.5 to 0; lock ca
1 1. DISINFECTION: T e not used Amt. Used
1 2. WELL TEST DATA: Check box if Test Data is submitted on Fonn Number GWS 39 Supplemental Well Tesi.
TESTING METHOD
Static Level 6.73 ft. Datefime measured: 12/2/05:1315 Production Rate gpm.
Pumping Level ft. Date/Time measured Test Length (hrs)
Remarks:
1
a
s 3. I have read the statements matle herein and know the contents thereof, and they are true to my knowledge. This document is signed and cerf~ed in
ccordancs with Rule 17.4 of the Water We)I Construction Rules, 2 CCR 402-2. [fhe filing of a documen! that contains false statements is a violation of
ection 37.91-108 1 e , C.R.S., and is unishable b fines u to 55000 and/or revocaticn of the contredin license.
Company Name: Phone: License Number:
H dro-Environmental Solutions, Inc. 970 871-8125
Mailin Addr ss: P.O. Box 772996 Steamboat S rin s, CO 80477
Signature: ~ ~ Print Name and Title
Jahn Weinman, President Date
1/23/2006
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