2013-08-13_HYDROLOGY - M1977348 (2)

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FORM NO GWS-31 412012 WELL CONSTRUCTION AND TEST REPORT STATE OF COLORADO, OFFICE OF THE STATE ENGINEER 1313 Sherman SL, Ste 821, Denver, CO 80203 Main 303 866 -3581 Fax 303 8663589 water state For Office Use Only `� F1Y ` 1. L DOWN 2. WELL R INFORMATION NAME OF WELL OWNER: Holcim (US ), Inc. MAILING ADDRESS: 3500 Highvvay Highway 120 CITY Florence STATE: Colorado ZIP CODE: 61226 TELEPHONE NUMBER wlares gods: 719 - 784 -1402 . WELL LOCATION AS DRILLED: SWA 114, NW 114, Sec., B Twp 8 x N or S, I Range d E] E or W � o� DISTANCES FROM SEC. LINES- 142 ft from X N or S section line and P5 ft from L] E or W W section line SUBDIVISION: . LOT BLOCK. FILING (UNIT) Optional GPS Location: GPS Unit must use the fallowing settings: Format must be UTM, Units Owners Well Designation: MW-5 must be meters, Datum must be NADB3, Unit must be set to true N. I Zone 12 or I • I Zone 13 Eastmg: 487365 STREET ADDRESS AT W ELL LOCATION: 4629 North Overland Trail, Laporte, CO 80535 Northiing 4502982 _ GROUND SURFACE ELEVATION 5273.86 feet DRILLING METHOD Hallow Stem Auger DATE COMPLETED 12/05/2012 TOTAL DEPTH 60 feet DEPTH COMPLETED 57.4 feet . GEOLOGIC LOG: 8. HOLE DIAM in. From ft To R Depth ing Grain Size Color Water Loc_ 725 0 60 0-10 silt sift pale brown 10-14 shale sift dark gray 14-20.4 lie n hale silt dark grav 7. PLAIN CASING. OD (in) Kind Wall Size (in) From (ft) To (ft) 2.375 SCH 40 n-154 0.0 37.3 2.375 CAL_ 0.154 57.05 57.4 PERFORATED CASING: Screen Slot Size (in)- 0.02 2.375 SCH 40 0.154 37.3 57.05 204-26.8 silt silt aray-ora 26.8-31 fenestone-shale sift light Gray 31-39 silt sift gray 39-40 limestone -shale silt dark grav 39.4 40-41 silt sift brown 41-42 limestone-shale silt dark gray 42-54.5 silt w/limestaone silt brown-Qrav 54.5-55.8 siftV clay sift/clay brown -wa 55.o-6o limestone -shale silt dark pray 8. FILTER PACK. Mail sand Size 10120 Interval 35.2-57.4 9. PACKER PLACEMENT. Type Depth 0. GROUTING RECORD Material Amount Density Interval Placement Bentonite 50 Ibs 32.7-35.2 gravity Bent Gro 4 bapS 30% solk 3.0 - 32.7 tremig Concrete 8 baps 0.0-3.0 Remarks: Bentonde smut nixed bao of Cetco Pureaold grout for 14 gallons of water to each 50 lb. 30% solids � 11. DISINFECTION: T none I Amt Used none 12. WELL TEST DATA: 0 Check box if Test Data is submitted on Form Number GWS 39 Supplemental Well Test TESTING MEAD Static Level 40.01 ft. DatefTime measured: 01/23/2013 Production Rate gpm. Pumping Level ft- Date/Time measured Test Length (hrs) Remarks: Depth to water measured below land surface. 1& t have read the stets made hersin and know the contents thereof, and they are Inn to my knowkmdge. This docranent Is signed (or name entered If filling online) and cerdNW in accordance wNh Rule 17.4 of the Walsr Well Construction Rules, 2 CCR 402-L The flNng of a docurnard that contains fake statements is a violation of section 37 -01406(1Ke), C.R.S., and Is pranishable by fines up to $5000 andlor revocation of the contracting Ncense. if Mng online the Stale Engineer considers entering of licensed contractor name to be com Vance with Rule 17.4 Company Name Golder Associates, Inc. Phone w /area code: 303- 980-0540 License Number. Maing Address: 44 Union Blvd, Suite 300, Lakewood CO 80228 S1gr} ( n the if fits on ) ? r Pnnt Name and Titlo Christopher Krambis Senior Staff Hydrogeolopist Date 02/2512013