2011-09-26_PERMIT FILE - C1981012A ‎(4)‎

• Permit No: C1981012A
• IBM Index Class Name: Permit File
• Doc Date: 9/26/2011
• Section_Exhibit Name: EXHIBIT 11 WATER WELL INFO PART 3
• Media Type: D
• Archive: Yes

COLORADO DIVISION OF WATER RESOURCES
~
THIS FORM MU57 BE SUBMITTED 101 Columbine Bldg., 1845 Sherman St. ~1
WITHIN (i0 DAYS OF COMPLETION /O Denvef, Colorado 80203
OF THE WORK DESCRIBED HERE- 1 ~ ~ J
ON. TYPE OR PRINT IN BLACK l/WELL COMPLETION AND PUMP INSTALLATION REPORT
I
PERMIT NUMBER ~7 ~~ 7
LOWNER ~1'e_IP Nt ~ ~ Cl ~D f-Lt
e2USP~~ke $t.BcXd/
ADDRESS S[~$~PTT~SX.GM~AS ~7A7'L-
TJil~ Y. of the
r , ~ .o~
RE qr,9, N
I'"~rF,~CF/~ 3 n°~
jj'17 RfS f0 N
o,. Co Q N E4ts '
T.~_-~-. R.~~1~,~ P.M
DATE COMPLETED _%D T2 i L ~ ~_ , 19 Z-3 HOLE DIAMETER
WELL LOG ~ in. from _~L_ to._a.ZQ ft.
From I To
and Color of Material. I Loc.
!S y8 /moo c,ks ~lird C~ RH-YeL.
FSft 5o S h ~ ~- e
_C
I TOTAL DEPTH vQ~},
Use additional pages necessary to complete log.
in. from to ft.
in. from to ft.
CASING RECORD: Plain Casing
ii
Size & kind from a to ~.5.= ft.
Size & kind from to ft.
Size & kind from to ft,
Perforated Casing
Size ~ & kind ~a. e~from ~ to ~~ ft.
Size & kind from to ft.
Size & kind from to ft.
GROUTING RECORD
Material ~ ~ /1~~,_[~ E ~~
Intervals ~- L
Placement Method ~,,/ ~/~Nn
GRAVEL PACK: Size /J~/4'T~C?~~ "~~-~
Interval
TEST DATA
Date Tested ~~?~/ ~ /~ , 19Z
Static Water Level Prior..toTest .-'1~,5 ft.
Type of Test Pump lf/GL L ~~ ~ E ~
Length of Test ~~ yd Gc R
Sustained.Yield (Metered) ~`S~yc~/4 L $
Final Pumping Water Level H {~ 7`
.. r ~c. .. .. _-..