2012-09-06_REVISION - M2008070 ‎(22)‎

• Permit No: M2008070
• IBM Index Class Name: REVISION
• Doc Date: 9/6/2012
• Doc Name: AM-01 APPENDIX C: HYDROGEOLOGY & HYDROLOGIC INNFORMATION
• From: WESTERN GRAVEL
• To: DRMS
• Type & Sequence: AM1
• Email Name: THM
• Media Type: D
• Archive: No

1
WELL CONSTRUCTION AND TEST REPORT
STATE OF COLORADO, OFFICE OF THE STATE ENGINEER
1.
2.
3.
4.
5.
WELL PERMIT NUMBER 67535 -F
Owner Name(s): Halliburton Energy Services Inc.
Mailing Address: 3199 D Road
City, State, Zip : Grand Junction, Co 81504
Phone # .
WELL LOCATION AS DRILLED
DISTANCES FROM SEC. LINES
163 ft. from South Sec. line and
SUBDIVISION:
STREET ADDRESS AT LOCATION
SE 1/4 SE 1/4 Sec: 35 Twp: 2 N 1 Range: 97 W
233 ft. from East Sec. line OR Easting: Northing:
LOT: BLOCK: FILING (UNIT):
GROUND SURFACE ELEVATION ft. DRILLING METHOD Air Rotary
DATE COMPLETED: 10/1/2008 TOTAL DEPTH: 60 DEPTH COMPLETION: 40
GEOLOGIC LOG
Depth
000 -007
007 -020
020 -060
Type of Material (Size, Color, and Type)
Dirt, Cobbles
Cobbles, Gravels
Wasatch Formation
Water Located: 10- 20
Remarks : Revariance 2008 -117A. Backfilled hole with native
materials 40 - 60 feet
Name / Title (Please Type or Print)
Wayne Shelton / President
6. HOLE DIAMETER (in)
9.0
7. PLAIN CASING
OD (in)
7.0
7.0
PERF. CASING : Screen Slot Size
7.0
8. Filter Pack
Material :
Size .
Interval :
10. GROUTING RECORD
Material
Cement
Kind
Steel
Steel
Amount
15 sks
11. DISINFECTION : Type : HTH
Amt. Used : 2 oz.
12. WELL TEST DATA : () Check Box If Test Data Is Submitted On Supplemental
TESTING METHOD : Air Compressor
Static Level : 7 ft.
Pumping Level : Total ft. Date /Time Measured 10/1/2008
Test Remarks :
Date/Time Measured 10/1/2008 Production Rate 25+ gpm
Test Length : 2 hours
13. I have read the status made herein and know the contents thereof, and that they are true to my knowledge. (Pursuant to Section 24 -4-14 (13Xa) CRS, the making of false statements
constitutes perfiny m the second degree and is punishable as a class 1 misdemeanor.)
CONTRAC fOR : Shelton Drilling Corp. Phone : [phone]
Mailing Address : P.O. Box 1059 Basalt, Co. 81621 Lic. No. 1095
FOR OFFICE USE ONLY
APPROVAL # GWS31 -91-03
RECEIVEC,
JAN 2 2 2009
WATER RE ,.. , , • _. .. •
STATE ETi VEER
COLO
FROM (ft)
0
Wall Size
0.240
Steel
0.240
0.240
Density
6 gal/sk
Date
From (ft)
-1
20
10
10/10/2008
TO (ft)
40
Interval
0 - 10
To (ft)
10
40
20
9. Packer Placement
Type :
Depth :
Placement
poured