2008-09-29_REPORT - M2007044 ‎(2)‎

• Permit No: M2007044
• IBM Index Class Name: REPORT
• Doc Date: 9/29/2008
• Doc Name: Whirlwind mine sump
• From: Energy Fuels Resources Corporation
• To: DRMS
• Email Name: GRM
• Media Type: D
• Archive: No

FORM NO.
GWS-31
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] hftp:/twww.water.state.co.us For Office Use Only
1. WELL PERMIT NUMBER: 66419
2. WELL OWNER INFORMATION
NAME OF WELL OWNER: Energy Fuels Resources Corporation
MAILING ADDRESS: 44 Union Boulevard, Suite 600
CITY: Lakewood STATE: CO ZIP CODE: 80228
TELEPHONE NUMBER: 303 974-2140
3. WELL LOCATION AS DRILLED: SE1/4, SE1/4, Sec. 35, Twp. 51 ® N or ? S, Range 20 ? E or ® W
DISTANCES FROM SEC. LINES: 4322 ft. from ® N or ? S section line and 1292 ft. from ® E or ? W section line.
SUBDIVISION: NA , LOT NA, BLOCK NA, FILING (UNIT) NA
Optional GPS Location: GPS Unit must use the following settings: Format must be UTM, Units Owners Well Designation:
must be meters, Datum must be NAD83, Unit must be set to true N, ? Zone 12 or ? Zone 13 Easting:
STREET ADDRESS AT WELL LOCATION: 30100 5/10 Road, Gateway, CO 81522 Northin :
4. GROUND SURFACE ELEVATION 7080 feet DRILLING METHOD NA - Sum in Under round Mine
DATE COMPLETED NA TOTAL DEPTH 190 feet DEPTH COMPLETED 190 feet
5. GEOLOGIC LOG: 6. HOLE DIAM in. From ft To ft
Depth Type Grain Size Color Water Loc. NA
NA

7. PLAIN CASING:
OD (in) Kind Wall Size (in) From (ft) To (ft)
NA

PERFORATED CASING: Screen Slot Size (in):
NA

8. FILTER PACK: 9. PACKER PLACEMENT:
Material NA Type NA
Size
Interval Depth
10. GROUTING RECORD
Material Amount Density Interval Placement
Remarks: See Attached Supplemental Information NA

11. DISINFECTION: Type None Amt. Used NA
12. WELL TEST DATA: ? Check box if Test Data is submitted on Form Number GWS 39 Supplemental Well Test.
TESTING METHOD NA
Static Level NA ft. Date/Time measured: Production Rate gpm.
Pumping Level NA ft. Date/Time measured Test Length (hrs)
Remarks:
13. 1 have read the statements made herein and know the contents thereof, and they are true to my knowledge. This document is signed and certified in
accordance with Rule 17.4 of the Water Well Construction Rules, 2 CCR 402-2. [The filing of a document that contains false statements is a violation of
section 37-91-108 1 e , C.R.S., and is punishable b fines u to $5000 and/or revocation of the contracting license.
Company Name:
NA Phone:
- License Number:
Mailing Address:
Signature: Print Name and Title Date