Laserfiche WebLink
FORM No. WELL CONSTRUCTION AND TEST REPORT For Office Use only <br />cus-31 STATE OF COLORADO, OFFICE OF THE STATE ENGINEER <br />11/90 <br />t. WELL PERMIT NUMBER 163756 M.W.-2 <br />OWNER NAME(S) Cotter Corporation <br />Mailing Address 1 596 West ayau venue, #350 <br />City, St. Zip Lakewood, Colorado 80228 <br />Phone (303 ) 980-1292 <br />3. WELL LOCATION AS DRILLED: NW 1/4 SE 1/4, Sec. 25 Twp. 2 S , Range 71 W <br />DISTANCES FROM SEC. LINES: <br />1982 ft. from South Sec. line. and 1531 ft. from East Sec. line. OR <br />(north or south) (east or west) <br />SUBDIVISION: LOT BLOCK FILING(UNIT) <br />STREET ADDRESS AT WELL LOCATION: <br />4. GROUND SURFACE ELEVATION 6581.3 n, DRILLING METHOD Auger <br />DATE COMF LETED 11/12/81 TOTAL DEPTH 22.5 ft. DEPTH COMPLETED 22.5 ft. <br />S. GEOLOGIC LOG: <br /> <br />Depth Description of Material (type, Size, Color, water Location) <br />0' - 3.5' Fill - Cs.Cobbles, some cs. 6. HOLE DIAM. (in.) From O m (ft) To <br />(ft)5 <br />22 <br />gravels <br /> <br />5' - 12.0' Boulders, cs. Gravel with cobbles 7. PLAIN CASING <br />and cs. to med. sand OD (in) Kind Wall Size From(ft) To(ft) <br /> 2-1/2' PVC Sch 40 +3.0 8.4 <br />• - ante as above with increased 2-1/2" PVC Sch 40 13.4 15.4 <br />gravel an sand <br /> <br />21 - 22.5' Bedrock, sound competent PERF. CASING: Screen Slot Size: " <br />amghibolite 2-1/2" PVC Sch 40 8.4 13:4 <br /> <br />22.5' T.D. <br /> <br /> <br />*Hit water (a 7 n' - <br /> 8. FILTER PACK- 9. PACKER PLACEMENT: <br /> Material Si 1 i ca Sand Type <br /> Size - es <br />_ Interval 5' - 20' Depth <br /> <br /> <br /> 10. GROUTING RECORD: <br /> Material . Amount Density Interval Placement <br />REMARKS: Neat Cement 0' - 1.0. Manually <br /> <br /> <br />11 DISINFECTION: Type. Amt. Used <br />1 WELL TEST DATA: ? Check box if Test Data is submitted on Supplemental Form. <br />TESTING METHOD <br />Static Level ft. Date/Time measured , Production Rate gpm. <br />Pumping level ft. Date/Tme measured , Test length (hrs.) <br />Remarks <br />13. 1 have read the statements made herein and know the contents thereof, and that they are true to my knowledge. [Pursuant to Section 24-4-104 (13).(a) CAS., the makinc <br />of false statements herein constitutes perjury in the second degree and is punishable as a class 1 misdemeanor.) <br />CONTRACTOR Cotter Corporation Phone C 303) 980-1292 Lic. No. N/A <br />-Mailing Address West Bayau. Avenue, #350 - Lakewood CO 80228 <br />[.I RiegisleC PlPLepr?pe or print) <br />Mine Geologist Signature - - Date <br />