2011-05-19_HYDROLOGY - M1980047

• Permit No: M1980047
• IBM Index Class Name: HYDROLOGY
• Doc Date: 5/19/2011
• Doc Name: Form GWS-46
• From: Exxon Mobil
• To: DRMS
• Email Name: THM
• Media Type: D
• Archive: No

`COLORADO DIVISION OF WATER RESOURCES
NATURAL RESOURCES
GWS-46 MONINST (07/2009)
DEPARTMENT OF
MONITORING/OBSERVATION WELL PERMIT APPLICATION INSTRUCTIONS
Applications must be typewritten or printed in BLACK or BLUE INK. ALL ITEMS in the application must be completed.
Incomplete applications may be returned for more information. Applications are evaluated in chronological order.
Please allow approximately six weeks for processing. This form may be reproduced by photocopying or computer
generation. Reproductions must retain margins and print quality of the original form.
FEES: This application must be submitted with a $100 filing fee. (The fee for an application to replace or deepen an
existing permitted monitoring/observation well is $100 for locations outside Designated Ground Water Basins, and $60 inside
Designated Ground Water Basins.) Acceptable forms of payment are check or money order, payable to the "Colorado Division
of Water Resources", and Visa, MasterCard or Discover (card number and expiration date must be provided on a separate
attachment). Fees are nonrefundable.
USES: This form (GWS-46) is to be used when applying for a permit where the only uses are monitoring of water levels
and/or water quality sampling. For well construction criteria refer to the Colorado Water Well Construction Rules, 2CCR 402-
2. A copy of the Rules may be obtained from any Division of Water Resources Office for a fee of $5, or you may access
them online from the State Board of Examiners' (BOE) website at http://www.
ITEM INSTRUCTIONS: (numbers correspond with those on the front of this forml
1. Provide the name of the well owner and the mailing address where all correspondence will be sent.
2. Check and complete all boxes that apply.
3. Provide the MH number assigned by the Division of Water Resources in response to the notice of intent to construct a
monitoring/observation well. Complete the well name if the structure has a name or identifying number.
4. If applying for a permit to construct a new well, you must provide the county, section #, township, range and principal meridian. You
do not need to provide the '/4 of the '/4 section designation, distances from section lines or an optional GPS location (UTM
coordinates). If a permit is issued and a well constructed, the authorized individual will be required to provide an accurate GPS
location (UTM coordinates) of the "as-built" well location. If applying for a permit to use an existing well you must provide the well
location information stated above, as well as either a GPS location (UTM coordinates) of the existing well site, or distances from
section lines (including the'/4 of the'/4 section designation) as follows: In a typical case, a township is comprised of 36 sections,
with each section ideally one mile square, or 5,280 feet on each side. Sections are further divided into quarter sections. Each '/4
Section is 2,640 feet by 2,640 feet and comprises 160 acres. Each 1/4 section can be further divided into additional quarters. Each 1/4
of the 1/ Section is 1,320 feet by 1,320 feet and comprises 40 acres. The distances are measured from the section lines. In the
following example, the well is located 2,500 feet from the South Section line and 1,400 feet from the East Section line:
5280 ft
1
2540 ft
13210 ft
Z
Well Location Example:
NW1/4 of the SE1/4 of
Section 3, being 2500 feet
from the South Section Line
and 1400 feet from the East
Section Line.
If providing a GPS location (UTM coordinates), the required GPS unit settings must be as indicated on this form. Colorado contains
two UTM zones (12 & 13). Zone 13 covers most of Colorado. The boundaryf between Zone 12 and Zone 13 is the 108th Meridian
(longitude). West of the 108th Meridian is UTM Zone 12 and east of the 108 Meridian is UTM Zone 13. The 108th Meridian is
approximately 57 miles east of the Colorado-Utah state line. On most GPS units, the UTM zone is given as part of the Easting
measurement, e.g. 1270123456. Check the appropriate box for the zone. Provide the property address of the well location if one
exists. If it is the same as the mailing address, check the box next to the well location address.
5.
6.
7.
8.
9.
10.
Provide property owner information.
Use of this well is limited to monitoring water levels and/or water quality sampling only.
The actual or anticipated total depth must be provided. Provide the name of the aquifer in which the well will be completed.
Provide consultant information (if applicable).
Monitoring/observation wells must be constructed by a Colorado licensed well construction contractor or authorized individual, as defined
in the Well Construction Rules, 2CCR 402-2. Only a licensed contractor may construct any monitoring/observation well that penetrates a
confining layer, or, is to be converted into a future production well. The well must be constructed in compliance with the Well Construction
Rules, unless a variance has been approved allowing an alternative construction design.
An ORIGINAL signature of the well owner, or their authorized agent must be on the application.
IF YOU HAVE ANY QUESTIONS regarding any item on the application form, please call the Division of Water Resources Ground Water
Information Desk (303-866-3587), or the nearest Division of Water Resources Field Office located in Greeley (970-352-8712), Pueblo
(719-542-3368), Alamosa (719-589-6683), Montrose (970-249-6622), Glenwood Springs (970-945-5665), Steamboat Springs (970-879-
0272), or Durango (970-247-1845), or refer to CDW R web site at http://www.water.state.co.us for general information.
NW1/4 NE1/4
------------------ ------------------
NW114 NE1/4
SE1/4 SE1/4
SW114 L--------- r --------
SW1l4 SE1/4
SE1/4 SE1/4