2023-04-19_PERMIT FILE - C1981010 ‎(114)‎

• Permit No: C1981010
• IBM Index Class Name: Permit File
• Doc Date: 4/19/2023
• Doc Name: GX-1 Well Construction Log
• Section_Exhibit Name: Appendix V
• Media Type: D
• Archive: No

Form No.
GWS-31
/201
7.Ground Surface Elevation: feet
9.Advance Notification: Was Notification Required Prior to Construction? Yes No, Date Notification Given: ______________
10. Aquifer Type: Type I (One Confining Layer) Type I (Multiple Confining Layers) Laramie-Fox Hills
(Check one) Type II (Not overlain by Type III) Type II (Overlain by Type III)Type III (alluvial/colluvial)
Depth Grain Size Water Loc.
13. Plain Casing
OD (in)Kind From (ft)To (ft)
Perforated Casing
OD (in)Kind From (ft)To (ft)
14. Filter Pack:15.Packer Placement:
Material Type
Size
Interval __________ Depth _________
16. Grouting Record
Material Amount Density Interval
Remarks:
18. Well Yield Estimate Data:
Well Yield Estimate Method: _______________________________________________
Estimated gpm
Estimate Length (hrs) ___________
Remarks:
Static Level: ________________________________
______________________________________________________
_____________________________________________________
Type Color
6. Legal Well Location: 1/4, 1/4, Sec., Twp. , N or S , Range , E or W , P.M.
:
Subdivision: , Lot , Block , Filing (Unit) _______
11. Geologic Log: 12. Hole Diameter (in.)From (ft) To (ft)
WELL CONSTRUCTION AND YIELD ESTIMATE REPORT
State of Colorado, Office of the State Engineer
1313 Sherman St., Room 821, Denver, CO 80203 303.866.3581
and [e-mail]
1. Well Permit Number: Receipt Number:
2. Owner's Well Designation:
4. Well Location Street Address:
5.As Built GPS Well Location (required): Zone 12 Zone 13 Easting: Northing:
Drilling Method: __________________________Date Completed: _____________
19.I have read the statements made herein and know the contents thereof, and they are true to my knowledge. This document is signed (or name entered if
filing online) and certified in accordance with Rule 17.4 of the Water Well Construction Rules, 2 CCR 402 2. The filing of a document that contains false
statements is a violation of section 37 91 108(1)(e), C.R.S., and is punishable by fines up to $1,000 and/or revocation of the contracting license. If filing online
Date/Time measured: ________________________
Sign (or enter name if filing online) Print Name and Title Date:
3. Well Owner Name:
For Office Use Only
8. Completed Aquifer Name : Total Depth: feet Depth Completed: feet
Wall Size (in)
Wall Size (in)
Mailing Address:
Phone w/area code: License Number:
17. Disinfection: Type Amt. Used
Company Name: Email:
Check box if Test Data is submitted on Form Number GWS-39, Well Yield Test Report
Screen Slot Size (in): _______
63571-MH
GX-1
Trapper Mining Inc.
6.5 Miles SW of Craig CO
NE NW
276722.2 4479913.3
Moffat
32 6 91 6
6351.657 07/16/2022 Air Rotary
318.5 318.5
07/12/2022
0-25 clay fine brown
25-37 sand & gravel coarse brown
37-95 ss/ms med brn to grey 75
95-105 ss med tan
105-110 coal coarse blk
110-120 ss med grey
120-132 ms fine drk grey
132-169 ss/ms fine drk grey
169-179 coal coarse blk 0.030
179-185 ms fine drk grey
185-187 coal coarse blk
187-209 ms med drk grey
209-226 ss med grey
226-228 coal coarse blk
228-256 ms/ss fine drk grey
256-261 coal coarse blk
261-270 ms fine drk grey
270-273 coal coarse blk
273-302 ms fine drk grey
302-308 coal coarse blk
9 7/8"0 39
5 5/8"39 80
5"80 318.5
6 5/8"Steel 0.188 +4
39
4"PVC SCH40 +2
298.5
4"PVC SCH40 298.5
318.5
Silica Sand
6/9
290 to 318.5
Bentonite Pellets 10 bkts 3/8"290 to 203 Pour
Bentonite Hole Plug 9 sks 3/8"203 to surface Pour
Portland 10 sks 6 gal/sak 0-39 Trimmie
NA
Trapper Mining [e-mail] [phone]
PO Box 187, Craig CO, 81626
Graham Roberts Graham Roberts, Environmental Supervisor 10/05/2022