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<br />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 />EXST <br />WELL PERMIT NUMBER 279721 - <br />DIV. 1 WD6 DES. BASIN MD <br /> APPROVED WELL LOCATION <br /> WELD COUNTY <br /> NE 1/4 NE 1/4 Section 34 <br />LAFARGE NORTH AMERICA Township 6 N Range 66 W Sixth P.M. <br />C/O TETRA TECH INC DISTANCES FROM SECTION LINES <br />1900 SOUTH SUNSET STREET 658 Ft. from North Section Line <br />LONGMONT, CO 80501- 416 Ft. from East Section Line <br />(303) 772-5282 UTM COORDINATES (Meters,Zone:13,NAD83) <br />PERMIT TO USE AN EXISTING WELL CGJUIIV._ Jr-VI VJ I`IVI u II, IV. <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 />4) Approved for the use of an existing well acknowledged for construction under monitoring hole notice MH-48265, and <br />known as TT-MW-08. <br />5) This well must be equipped with a locking cap or seal to prevent well contamination or possible hazards as an 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, regulations, orders, and/or <br />decrees. <br />NOTICE: This permit has been approved subject to the following changes: The distances from section lines were <br />calculated from UTM coordinate values provided with the permit application. You are hereby notified that you have the right <br />to appeal the issuance of this permit, by filing a written request with this office within sixty (60) days of the date of issuance, <br />pursuant to the State Administrative Procedures Act. (See Section 24-4-104 through 106, C.R.S.) Z•D-44 . 01 17,5'/104 <br />APPROVED <br />BDH (,,Cf 0-'-t-41 -44 <br />+ <br />State Engineer <br />'Receipt No. 3636578H DATE ISSUED 01-28-2009 EXPIRATION DATE