Laserfiche WebLink
FORM NO. <br />GWS-a1 <br />? <br />ta94 <br />WELL CONSTRUCTION AND TEST REPORT <br /> <br />S?4TE OF COLORADO, OFFICE OF THE STATE ENGINEER <br />For Office Use only <br />1. WELL PERMIT NUMBER _ 2025111 RECEIVED <br />2 OWNER NAME(S) Paul R. w 1 ch <br />Mailing Address P.O. Box 217 <br />City, St. Zip -- Central CityCo. 80427 <br />Phone ( ) 659-0294 JUL 14 1997 <br /> <br /> <br />STATE ENGINEER <br />3. WELL LOCATION AS DRILLED: S .F 1/4 1 /4, Sec.. 2_ Twp._ 3s , Range ? aw 6 t hh pM <br />DISTANCES FROM SEC. LINES: <br />2000 tt. from NggtL Sec. line. and 0 3 n n ft. from 'Sec. line. OR <br />SUBDIVISION:. T rn j-_ t T.nAgn Surv y 5141 LOT BLOCK FILING(UNIT)- <br />STREET ADDRESS AT WELL LOCATION: <br />4. GROUND SURFACE ELEVATION q a g n ft. DRILLING METHOD i r-parcua s-i en <br />DATE COMPLETED AIIQ q7 TOTAL DEPTH <br /> <br />ft. DEPTH COMPLETED ft. <br />jaCL <br />5. GEOLOGIC LOG: <br />Depth Description of Material (Type, Size, Color, Water Location) <br />n _ 1 R Rrnwn c_rani f-.o dPr-nm=mart 6. HOLE DiAM, (in.) From (ft) To (ft) <br />8 ? ,E 0 _ 0 <br />64 20 30? <br />18 - ?7r,rag crhist <br /> <br />27 91 whi ie R_ijart 7. <br />IS _ 9n, rz r p pn gn p i, q 7. PLAIN CASING <br />50 - 167, r ra y s h i s t OD (in) Kind Wall Size From(ft) To(ft) <br />167 - 1951 Green aneai Gs. gray schi sh 6-Va" Steel .188 <br />120 <br />195 - 265.' Gray schist _;. <br />PVC 200 psi 15 240 <br />2.65 - 290' White quartz, green rrneiss . <br />290 - 300' Gray schist <br /> PERF. CASING: Screen Slot Size: 1/81, hole <br /> 41' PVC 200 psi 240 200 <br /> <br /> <br /> <br /> <br /> 8. FILTER PACK: 9. PACKER PLACEMENT: <br /> Material N/A Type <br />N/A <br /> Size _ <br /> Interval Depth <br /> <br /> 10. GROUTING RECORD: <br /> Material Amount Density interval Placement <br />REMARKS: Water located C 168' and 265' cement 188# 17# 0-20 pour+vibrat <br /> <br /> <br />11, DISINFECTION: Type Chlorine (dry)' Amt. Used 1-1/2 cups <br />12 WELL TEST DATA: ? Check box if Test Data is submitted on Form No. GWS 39 Supplemental Well Test. <br />TESTING METHOD _ A it <br />Static Level 7 0 tL Date/Time measured 6 / 3 0 / 9 7 , Production Rate a . gpm. <br />Pumping level 295 ft. Date/Time measured g &M__1 am , Test length (hrs.) 2 <br />Remarks <br />3. 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) <br />C.R.S., the making of false statements herein constitutes perjury in the second degree and is punishable as a class 1 misdemeanor.) <br />CONTRACTOR CR Smith Driilina Phone 30 642-3339 Uc. No. 328 <br />Mailing Address <br />Name/Title (Please type or print) <br />Calvin R. Smith Signature) <br />? ? Date <br />7/9/97