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Form No. OFFICE OF THE STATE ENGINEER <br />GWS-25 COLORADO DIVISION OF WATER RESOURCES. <br />818 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203 <br />(303) 866-3581 <br />APPLICANT <br />MW-02 <br />EXST. . <br />WELL PERMIT NUMBER:. 280583; <br />DIV. 1 ` W03 DES..BAS1N MD <br />APPROVED WELL LOCATION <br />WELD COUNTY <br />NE 1/4 SW 114 Section 30 <br />LAFARGE NORTH AMERICA Township 6 N; Range 66 W Sixth P.K <br />C/O ENVIROGROUP LIMITED DISTANCES FROM SECTION LINES` <br />3561 STAGECOACH ROAD #205 1977 Ft, from South Section Line <br />LONGMONT, CO 80504 1753 Ft from West Section Line <br />2600 UTM COORDINATES Meters Zone:13 NAD83 <br />(720) 494- <br />PERMIT TO USE AN EXISTING WELL Fasting: Northing: <br />ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT <br />CONDITIONS OF APPROVAL <br />1) This well shall be used in such a way as to cause no material injury to existing water rights- The issuance of this permit <br />does not ensure that no injury will occur to another vested water right or preclude another owner of a vested water right from <br />seeking relief in a civil court action <br />2) The construction of this well shall be in compliance' with the Water Well Construction, Rules 2 CCR 402-2, unless approval <br />of a variance has been granted by the State Board of Examiners of Water Well Construction and Pump Installation <br />Contractors in accordance with Rule 18. <br />3) Approved pursuant to CRS 37-92-602(3)(b)(1) for uses as described in CRS 37-92-602(1)(f). Use of this well is limited to <br />monitoring water levels and/or water quality sampling, <br />4j Approved for the use of an existing well acknowledged for construction under monitoring hole notice MH-46991, and <br />known as MW-02. <br />5) This well must be equipped with a locking cap or seal to prevent well contamination or possible hazards `asan open well. <br />The well must be kept capped and locked at all times except during sampling or measuring. <br />6) Records of water level measurements and water quality analyses shall be maintained' by the well owner and submitted to <br />the Division of Water Resources upon request. <br />7) Upon conclusion of the monitoring program the well owner shall plug this well in accordance with Rule 16 of the Water <br />Well Construction Rules. A Well Abandonment Report must be completed and submitted to the Division of Water <br />Resources within' 60 days of plugging. <br />8) The owner shall mark the well in a conspicuous place with the well permit number and name of aquifer as appropriate, <br />and shall take necessary means and precautions to preserve these markings. <br />9) This well must have been constructed; by or under the, supervision of a licensed well driller or other authorized individual <br />according to the Water Well Construction Rules. <br />10} This well must be located not more than 200 feet from the location' specified on this permit: <br />11? Issuance of this permit does not guarantee that this well can be converted to a production well under a future permit., The <br />ability of this well to be converted to a`production well is limited by all governing statutes, rules, regulaftons, orders, and/or <br />decrees. D.H. as-/o?Jag <br />APPROVED <br />BDH <br />By <br />DATE ISSUED 0547-2009 . EXPIRATION