2009-10-16_PERMIT FILE - M2009082 ‎(9)‎

• Permit No: M2009082
• IBM Index Class Name: PERMIT FILE
• Doc Date: 10/16/2009
• Doc Name: New 112c Appl.
• From: Lafarge West, Inc.
• To: DRMS
• Media Type: D
• Archive: No

Form No.
GW S-25
OFFICE OF THE STATE ENGINEER
COLORADO DIVISION OF WATER RESOURCES
818 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203
[phone]
APPLICANT
MW-04
EXST
WELL PERMIT NUMBER 280585`
DIV. 1 WD3 DES. BASIN MD
LAFARGE NORTH AMERICA
C/O ENVIROGROUP LIMITED
3561 STAGECOACH ROAD #205
LONGMONT, CO 80504-
[phone]
APPROVED WELL LOCATION
WELD COUNTY
SE 1/4 SE 1/4 Section; 25
Township 6 N Range 67'W Sixth P.M.
DISTANCES FROM SECTION LINES
562 Ft. from South Section Line
450 `l=t. from East Section Line
UTM' COORDINATES (Meters Zone:13;NAD83}
c.,s,.,,,. Atnrihinn#
PERMIT TO USE AN EXISTING WELL `a?Lmv'
ISSUANCE OF THIS 'PERMIT 'DOES NOT'CONFER A WATER RIGHT
CONDITIONS OF APPROVAL
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
does not ensure that no injury will occur to another vested water right or preclude another owner of a vested water right from
seeking relief in a civil court action.
2) The construction of this well shall be in compliance with the Water Well Construction Rules 2 CCR 402-2, unless approval
of a variance' has been granted by the State Board of Examiners of Water Well Construction and Pump Installation
Contractors in accordance with Rule 18.
3) Approved pursuant to CRS 37-92-602(3)(b)(1) for uses as described in CRS 37-92-602(1)ft Use of this well is limited to
monitoring water levels and/or water quality sampling.
4) Approved for the use of an existing well acknowledged for construction under, monitoring hole notice MH-46994,'and
known as MW-04.
5) This well must be equipped with a locking cap or seal to prevent well contamination or possible hazards as an open well.
The well must be kept capped and locked at all times except during sampling or measuring.
6) Records of water level measurements and water quality analyses shall be maintained by the well owner and submitted to
the Division of Water Resources upon request.
7) Upon' conclusion of the monitoring program the well owner shall plug this well in accordance with Rule 16 of the Water`
Well Construction Rules. A Well Abandonment Report must be completed and submitted to the Division of Water
Resources' within 60 days of plugging:
8) The owner shall mark the well in aconspicuous place with the well permit number and name of aquifer as appropriate,
and shall take necessary means and precautions to preserve these markings.
9) This well must have been constructed by or under the supervision of a licensed well driller or other authorized' individual
according to the Water Well Construction Rules.
10) This well must be located not more than 200 feet from the location specified on this permit.
11) Issuance of this permit does not guarantee that this well can be converted to aproduction well under a future permit. The
ability of this well to be converted to a production well is limited by all governing statutes, rules, regulations, orders, `and/or`
decrees. S.1i N. '0,r/071o9
.APPROVED
BDH -
State Engin [
'Receipt No. 3639673D DATE-ISSUED 05-07-2009: EXPIRATION DA E