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

TEST?REPORT
WELL CONSTRUCTION A For Office use Only
FORM NO. _ .
OFFICE OF THE SLATE ENGINEER
E OF COLORADO
T
GWS-31
04!2005 ,
AT
S
1313 Sherman St, Room 818, Denver, CO 80203
Phone - Info [phone] Main [phone]
Fax [phone] littP./Aww.water.state.oo.us

1. WELL PERMIT NUMBER: 49458-MH
2. WELL OWNER INFORMATION
NAME OF WELL OWNER: Exxon Mobil Corporation
MAILING ADDRESS: GSC-GP2-224 P. 0. Box 2567
CITY: Houston STATE: TEXAS ZIP CODE: 77252

TELEPHONE NUMBER: 281 6546246
3. WELL LOCATION AS DRILLED: SS_W114, SW114, Sec. Z. Twp. -4 ? N or ® S, Range 95 ? E or ® W
DISTANCES FROM SEC. LINES: 869 ft. from ? N or ® S section line and 1166 ft. from ? E or ® W section line.
SUBDIVISION: LOT , BLOCK , FILING (UNIT)
Owners Well Designation: EF AW1
Owner's
Optional GPS Location: GPS Unit must use the following settings: Format must be UTM, Units
g:
must be meters, Datum must be NAD83, Unit must be set to true N, ? Zone 12 or ? Zone 13
STREET ADDRESS AT WELL LOCATION:. Northin :
GROUND SURFACE ELEVATION 6690 feet DRILLING METHOD Air Rotary - Casing Advancement
.
DATE COMPLETED 11/15/2010 TOTAL DEPTH 150 feet DEPTH COMPLETED 150 feet
5. GEOLOGIC LOG: 6. HOLE DIAM in. From ft To ft
Depth Type I Grain Size Color Water Loc. 7.125 0 144
0-66 OilShale Fill as td bm/bl 5.875 144 150
68-142 Alluvium asstd b
1142-J50 it Shale I n bm/blk 7. PLAIN CASING:
f OD (in) Kind Wall Size (in) From (ft) To (ft)
j 4.5 SCHQFJ .250 +1 93
4.5 SCH40FJ .250 143 150

j PERFORATED CASING: Screen Slot Size (in): 020
j 4:5 SCH40FJ .250 93 143

8. FILTER PACK: 9. PACKER PLACEMENT:
Material Silica Type
Size 10-20
Interval 81-145 Depth
0. GROUTING RECORD
Material Amount Density Interval Placement
Remarks: 65/8 Casino Advanced through fill and 3/8chip 1 bid 145 150
alluvium and pulled upon completion 38chip 1 bkt 76 81
Lost returns at 56 318chi 26 sks 2 76
11. DISINFECTION: TYP2 Amt Used
if Test Data is submitted on Form Number GWS 39 Supplemental Well Test.
k b
Ch
ox
ec
12. WELL TEST DATA:
TESTING METHOD Airlift
Static Level none ft. Daterrime measured: 11-15-2010 Production Rate < 1 gpm•
Pumping Level ft. Dateffime measured Test Length (hrs)
Remarks: No measurable water durin airlift
13. 1 have read the statements made herein and know the contents thereof, and they are true to my knowledge. This document is signed and certified in
(The filing of a document that contains false statements is a violation of
2
CCR 402
.
-
accordance with Rule 17.4 of the Water Well Construction Rules, 2
section 37-91-108 f e C.R.S. and is punishable fines u to $5000 and/or revocation of the contracts license. License Number
Phone:
Company Name:
531
[phone]
Himes Drilling Company
Mallin Addres • U. S. B and 50 Grand Junction Colorado 81505
Date
Date
Signature ?. Print Name and Title
010
Tim Himes Owner
b