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Home My WebLink About20131805.tiffMA wo. SIYSYL lolf't / PUMP INSTALLATION AND STATE OF COLORADO, OFFICE OF TEST REPORT THE STATE ENGINEER For Office Use only `I' F_ I `' JUN 1 5 1999 , „ „ en rt E NG,w4 r C040 1. WELL PERMIT NUMBER 414 ek JP 2. OWNER Mailing City, Phone NAME(S) A y n +, .r- ja t?,. .e t36,( ..„, .5 Address SG 9d t.iC a 1 6 St Zip 1','' Lvy+tii s cl d kg) en 6, &) (.303) OSA -9]f's (o 3. WELL LOCATION AS DRILLED: iv, 1/4 /V4 1/4, Sec. / G Twp. 1 N , Range b2e0 4. ,cM.. DISTANCES .35o SUBDIVISION: STREET FROM SEC. UNES: ft from tu+ w Sec. Ilne. and /at So ft from Sec. line. FIUNG(UNIT) LOT BLOCK ADDRESS AT WELL LOCATION: craft Loa R10 o J7` vT.,/Jt a n de ,r b 4. PUMP DATA: Type s ub i,,, a ,. s J 6 /,-4 Installation Completed S -v -97 , Pump Design Pump ADDITIONAL Manufacturer G o vl,AS Pump Model No. jr, C Sao If/ d. . GPM / o at RPM , HP .3 , Volts a3u Full Load Amps Intake Depth .5 7 a Feet, Drop/Column Pipe Size / " Inches, Kind y.n /E u INFORMATION FOR PUMPS GREATER THAT 50 GPM: TURBINE Design DRIVER TYPE: illi Electric ❑ Engine ❑ Other Head feet Number of Stages , Shaft size inches. 5. OTHER EQUIPMENT: . Monitor Tube Installed Depth it. Airline Flow Meter Installed ❑Yes F2 No, Orifice Depth ft. ❑ Yes © No, Meter Mfg. Meter Serial No. . Readout ❑ Gallons, ❑ Thousand Gallons, ❑ Acre feet, ❑ Beginning Reading 6. TEE DATA: Ill Check box if Test data is submitted on Supplemental Form. 5-/v• -r7 Total Static Date Date Well Depth jeb'b Time tPief Level 7 g o Rate (GPM) ./., Measured 3Jan- 1047 Pumping Lvi. y y7 7. DISINFECTION: Type //74 Amt. Used .31 6-5 8. Water No Quality analysis available ❑Yes i. 9. Remarks C0.1 CONTRACTOR Mailing I have [Pursuant degree read the statements made herein and to Section 24-4-104 (13)(a) C.R.S., and is punishable as a class 1 misdemeanor.) GAopee5 PC/),1;4y know the contents thereof, and that they are true to my knowledge, the making of false statements herein constitutes perjury in the second Phone (363)837'aoy/ Lic.NO. /g!/ . Address 7a G/ 140/P 31 Ali., t.ph r, CAA A E'D k a r Name/Title (Please type or print) cle note,, M G/ove,, )3240C e,, Signature d fa,io% ,r, ),i-Zalv-el Date o' P-/ 19 1°""r "° or tn• � WELL CONSTRUCTION AND TEST REPORT STATE OF COLORADO, OFFICE OF THE STATE ENGINEER For Office {i%FlVt� May ""'c" .r4TEthn'NEEn. Use ony I k 199,. f w 1. • WELL PERMrf NUMBER o� / y sloS 2 OWNER Mailing City, Phone i{ // NAME(S) y, arm 11 -,(1n A e -r1 e CL o�1'T 5 Address if/ crn w C lti / D StZip ft L✓p%'uYa Co ro/OaA/ (303) ,Q 5e7 - 9' 934, a WELL LOCATION AS DRILLED: Ns 1/4 NE 1/4, Sec. /!o Twp. / it, Mange 424./ d 7934._ DISTANCES FROM SEC. UNES: JSo ft from "sb Sec. line. and /.150 ft. from Jail' Sec. line. OR RUNG(UNIT) SUBDMSION: STREET Site, orh um) -Z LOT BLOCK ADDRESS AT WELL LOCATION: 5,49D L-CiP/o /Ct Leapyo+•t Co BoGR l 4. GROUND DATE SURFACE ELEVATION ft. DRILLING . TOTAL DEPTH METHOD IF o fa . y , COMPLETED AQot.w-c4 Jo /997 Ler0 ft. DEPTH COMPLETED G8t ft. 5. GEOLOGIC LOG: desk Description of Materiel (Type, She, Color, Water Location) d top sa/'k 6. HOLE DIAM. (in.) From (ft) i 6{2 U To (ft) tab s - Va y4h ni 51,/9 y p- /en sh4.G-e 7. PLAIN CASING OD (in) Kind Wall 9?4. Spae4 ,al Size From(ft) To(ft) o Vito /to -in /Eed.k /fit --ado AseA-e 3�0-1Q ac awa -moo .5%CA.Q <.�%c/f' bAvts.,f Also • 35o S/i 4 .a- e wise - yN0 6/,.,L e . R e .- C4 a h �y2a.a PERF. CASING: Screen Slot yit ate ,/c'P' Sae: Ail teA co( t yYo — yktb ,? a-,• d r a-44/. R /..J y4'.s mix_ 1060 yarn - milo send X (,ao - ft fro sA4.L 4. 8. FILTER PACK Material 9. PACKER Type Depth PLACEMENT: Size Interval 10. GROUTING RECORD: Xriel Amount Density yy i 2 .i/.9ae �''°r' Interval Placement , ' A - lea tAs%.< Pap REMARKS: 11. DISINFECTION: Type H f ti Ant. Used S "{.bS 12. WELL TEST DATA: k Check box if Test Data is submitted on Form No. GWS 39 Supplemental Well Test. /S gpm. TESTING Static Pumping Remarks METHOD Mt kill Q 4 Level 5 y 6 ft. Date/Time measured ,j4 -).oh 330 /9t P tAM, Production Rate level gab ft. Date/ lime measured 3 3o - /ft? /o AM, Test length (hrs.) 2 13. I have CAS., CONTRACTOR Mailing read the statements made herein and know the comers thereof. and that they are true to my knowledge. [Pursuant the making of false statements herein constitutes perjury in the second degree and is punishable as a cues )A1€$ try 4 Ah%u y Phone (3°3 ) SSP - to Section 24-4-104 (13)(a) t misdemeanor.] c d y/ Lie. No.4/C . Address 7dr<r WC. 3 / Ft Jv t hi h Co h a 3 oft 3 I Name/TMe (Please type or print) Sim OA AT Al C/O' ee Reci-) •t, c t. Signature 4, >, >-i -47 ay -el Date y-31 -99 Form No. GWS-25. APPLICANT OFFICE OF THE STATE ENGINEER . COLORADO DIVISION OF WATER RESOURCES 818 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203 (303) 866-3581 LYNN & JOLENE JOHNS 8690 WCR 10 FORT LUPTON CO 80621- (303)252-9856 PERMIT TO CONSTRUCT A WELL LIC WELL PERMIT NUMBER 214568 DIV. 1 CNN. 62 WD 2 DES. BASIN MD Lot: Block: Filing: Subdiv: APPROVED WELL LOCATION WELD COUNTY NE 1/4 NE 114 Section 16 Twp 1 N RANGE 57 W 6th P.M. DISTANCES FROM SECTION LINES 350 Ft. from North Section Line 1250 Ft. from East Section Line ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT CONDMONS OF APPROVAL 1) This well shall be used In such a way as to cause no material injury to existing water rights. The issuance of the permit does not assure the applicant that no Injury will occur to another vested water right or preclude another owner of a vested water right from seeking relief in a civil court action. 2) The construction of this well shall be in compliance with the Water Weil Construction Rules 2 CCR 402-2, unless approval of a variance has been granted by the State Board of Examiners of Water Well Construction and Pump Installation Contractors in accordance with Rule 18. 3) Approved pursuant to CRS 37.92-602(3)(b)(II)(A) as the only well on a tract of land of 46 acres described as that portion of the NE1/4 more particularly described on attached Exhibit A. 4) The use of ground water from this well is limited to ordinary household purposes inside not more than three single family dwellings, fire protection, the watering of poultry, domestic animals, and livestock on farms and ranches, and the irrigation of not over one acre of home gardens and lawns. 5) Production from this well is restricted to the Laramie -Fox Hills aquifer which corresponds to the interval between 440 feet and 720 feet below ground surface. Plain casing shall be installed and grouted to prevent production from other zones. 6) The maximum pumping rate shall not exceed 15 GPM. 7) The return flow from the use of the well must be through an individual waste water disposal system of the non -evaporative type where the water is returned to the same stream system in which the well is located. 8) This well shall be constructed not more than 200 feet from the location specified on this permit. Note: To insure a maximum productive life of this well, perforated casing should be set through the entire producing interval of the approved zone or aquifer indicated above. Note: This permit has been approved with the following change(s): Based on legal description the distance from the West Section Line has been changed to the East Section Line. You are hereby notified that you have the right to appeal the issuance of this permit, by filing a written request with this office within sixty (60) days of the date of issuance, pursuant to the State Administrative Procedures Act. (See Section 24-4.104 through 106, C.R.S.). APPROVED LMB 6Pa Ikydi.•.n) We Engines' Receipt No. 0437387 DATE ISSUED DEC 0 8 1998 EXPIRATION DATE DEC 0 8 2000 COLOILADO DIVISION OF WATER RESOURCES DEPARTMENT OF NATURAL RESOURCES 1313 SHERMAN ST., RM. 818,DFEIVER CO 802013 phone - info: (303) 866-3587 main: (303) 866-3581 NEW 35+ ACRE RESIDENTIAL Review Instructions prior m conwletnto form 1. APPLICANT RIFORMATION Din of npaet YNN f rT <En/dr 6.oH/V Mao Addiew gin? G✓G 'ea/ /O City /7 ! uprose Telephone Netter meter rya code) ue.i) .252 98SG o r ,252 775'9 2. TYPE OF APPLICATION ti: �'ElVE� 001 2 3 1998 wA IEM NEBCNA(CEa Water Well PermatlfaiTircation Must be completed hi black ink or 6. USE OF WELL (check em*nrlgle entry cc entries) p. Ortimry household purposes In up m 3 single -tenth dwellings, the waosrktg of domestic animas, and the Irrigation of not more �y that one (1) ace of home gardens and lawns * B. Livestock watering ton $r hwtatN.noelpaedM typed Ca. code b'O(11 / 7. WELL DATA CONSTRUCT A NEW WELL ON A TRACT OF LAND OF 35 ACRES OR MORE MAXIMUM PRODUCTION RATE OF THE WELL SHALL NOT EXCEED 15 GPM 8. TYPE OF RESIDENTIAL SEWAGE SYSTEM %Septic tank / absorption leach field ❑ Central system oiwea cony: ❑ Vault Localise, swage to be SIAS t.: ❑ Other (meat Mg m rentndg ! do) 3. REFER TO Of apple ble): Monitoring hole acknowledgment r MH- 4. LOCATION OF WELL /6 Distance of war horn section Ones Tower$ N w $ /At -dal 0 ours.Arro wu.. frOr//MO Range E or W 67a>;a. Gun, N/rii eae)t114 Principal Meridian S/x/A r 3 5C IL trom$N ❑ : /r2 .5-O n. horn ❑ EIS* Wer baton address. rf different hem emir oddness IS amicable) /3/4 5. TRACT ON WHICH WELL WILL BE LOCATED A. ATTACH LEGAL DESCRIPTION FOR 3S+ ACRE TRACT ❑ Development Name Lot no. Unit S .other -7 ec 7t %q c NOM e/`Fntix"..4-4, 9. PROPOSED WELL DRILLER (optional) Name License number 10. SIGNATURE of applicants) or authorized agent The making of take statement herein constitutes perjury in the second degree. which is punishable as a Bass 1 mis- demeanor pU3Wnt to C.R.S. 244-104(13)(a). I have read the statements herein, know the contents thereof and state that fly we true to my knowledge. T Ow e Dace B. STATE PARCEL ID# (opsarll: C. aetre. in meet D. THIS WILL BE THE ONLY WELL ON THIS TRACT Office Use Only LAN CWCB WRL✓LOT.,eo MAP f' MYLAR/ SBS ✓ At< 2E W 14l:r Pier redI/ DWR MapNo. D4 rr . h DIV DECKS TRp437387102398 ��__�v1� DIY (F IASER RESUCES co C�A'- USE WD BA MD Form GWS-50 (12/95) COLORADO DIVISION OF WAT6t RESOURCES _DART Off F.- aLI AL RESOURCES__-___.. GWS-SO FMINSI S.121951. 35 + ACRE RESIDENTIAL • GEIf3E„_�LINSTRUCTIONS y,0ili 3U qq \ ti:)•n" ;n$'i It "7 to Ita >iJrl yd:u'kse '`iuryiotir 'virate in:Goto fado. This form (G1Fft-�j'is` familiar �be �uaed-only when applying for Use inaip.to duee.single ■amity reslderices, watering of up to onrer acre •E'Mi�iiQpoai l and ba•nt'ah `fl idatni�ow . one of, , ibard'• 'eitdta;'and i%'ia1`erin{('of-the owner's domestic animals (sometimes referred to as DOMESTIC"i�l�,'91iiill for'die'"Jra e}b oT'tiv`estock ona fwm..ranchaarige,_or pasture. This form is to be used onlyl('iRbl84i 3v illti the tinlywe6iiifyothrroact•of land of 35 acres or more. ✓r44-3fmq,ans)•,,. r.• .-.,n, • dK, • •.:u This form.aho(dd.kQtbe used•in the,followingCases; Best Copy Availablel HOOSEHOED USE ONLY ;We fdfri1 1N5=49: HEt Lit A.E VT -of a residential, ogfell - Use form GW5444 FFFC This dppik rtion must be sub►niteed with tfi Checks. should be payable to the GOL,ORAD ,.pavisioN OF WA T . Pie ...•'7 F AppGptipimire evaluated in chrondogicid order. Please allow approximately six weeks for processing. APPLICATIONS must be completed dearly, i.. ITEMS in die application must be completed. Incomplete applications may tamed to the applicant for more information. Do not change or alter the application in any way. THE LOCATION of the well in item 4 must be correctly and accurately described. The county, quarterlquarter, section, township, grange, principal meridian, and distance from section lines must be provided. NOTE Distances are not necessarily the same distances as the distances from (your) 'property Ones. For additional assistance in describing the location of your well, review the publication entitled 'How to Determine Well Locations' which was provided with your packet, or can be requested from any Colorado Division of Water Resource office. A LEGAL DESCRIPTION or survey plat of your lot or parcel of land is required in item 5. An ORIGINAL signature must be on each application. The applicant's authorized agent may sign the application, if a letter sinned by the applicant is submitted with the application authorizing them to act as agent for the purpose of obtaining a well permit. IF YOU HAVE ANY QUESTIONS regarding any item on the application form, please call the Division of Water Resources Ground Water Information Desk (303-866-35871, or the nearest Division of Water Resources Field Office located in Greeley (970-352-87121, Pueblo (719-542-33681, Alarnosa (719-589-66831, Montrose (970-249-6622), Glenwood Springs 1970-945-56651, Steamboat Springs 1970-879-02721, or Durango (970.247-1845). DETAILED INSTRUCTIONS ARE AVAILABLE UPON REQUEST COLORADO DIVISION OF WATER RESOURCES, 1313 SHERMAN STREET. ROOM 821, DENVER, CO 80203 PHONE 303-866-3587 (Information), 303-866-3561 (Mani, 303-966-3447 (Wei & Water Rights Records', 303-966-3589 (Fax; x//s/r4 4 /s 7 OCT 231998 WA rElisemacts EEMd� R •,Ix n LAND SURVEY PLAT OF THE NORTH 1/2 OF THE NORTHEAST 1/4 OF SECTION 16, TOWNSHIP 1 NORTH, 7 WEST OF THE SIXTH PRINCIPAL MERIDIAN, COUNTY OF WELD, STATE OF COLORADt PROPERTY DESCRIPTION: ("PARCEL WESTERLY OF THE RELOCATED BULL CANALS") THAT PART OF THE NORTH 112 OF THE NORTHEAST 1/4 OF SECTION 16, TOWNSHIP 1 NORTH. RANGE 67 WEST OF THE 6TH P.M., COUNTY OF WELD. STATE OF COLORADO. BEING' MORE PARTICULARLY DESCRIBED AS: BEGINNING AT THE NORTHEAST CORNER OF SAID SECTION 18; THENCE NORTH 90 DEGREES 00'00" WEST ON AN ASSUMED BEARING ALONG THE NORTH LINE OF THE NORTHEAST 1/4 OF SAID SECTION 16 A DISTANCE OF 848.18 FEET TO THE TRUE POINT OF BEGINNING; THENCE SOUTH 33 DEGREES 35'00" EAST A DISTANCE OF 6.08 FEET; THENCE SOUTH 06 DEGREES 01'55" WEST A DISTANCE OF 68.47 FEET; THENCE SOUTH 29 DEGREES 00'Ob" WEST A DISTANCE OF 909.01 FEET: THENCE SOUTH 29 DEGREES 32'25" EAST A DISTANCE OF 260.05 FEET; THENCE SOUTH 43 DEGREES 48'10" EAST A DISTANCE OF 162.11 FEET; THENCE SOUTH 31 DEGREES 25'30" EAST A DISTANCE OF 53.94 FEET; THENCE SOUTH 18 DEGREES 55'30" EAST A DISTANCE OF 53.28 FEET; THENCE SOUTH 51 DEGREES 10'00" WEST A DISTANCE OF 18.86 FEET TO THE SOUTH LINE OF SAID NORTH 112 OF THE NORTHEAST 1/4 OF SECTION 16; THENCE SOUTH 89 DEGREES 59'19" WEST ALONG SAID SOUTH LINE OF THE NORTH 112 OF THE NORTHEAST 1/4 OF SECTION 16 A DISTANCE OF 1806.82 FEET TO THE CENTER -NORTH 1/16 CORNER OF SECTION 16; THENCE NORTH 00 DEGREES 04'17" WEST ALONG THE WEST LINE OF SAID NORTH 1/2 OF THE NORTHEAST 1/4 OF SECTION 16 A DISTANCE OF 1319.99 FEET TO THE NORTH 114 CORNER OF SAID SECTION 16; THENCE SOUTH 90 DEGREES 00'OC" EAST ALONG SAID NORTH LINE OF THE NORTH 1/2 OF THE NORTHEAST 1/4 OF SECTION 16 A DISTANCE OF 1781.88 FEET TO THE TO THE POINT OF BEGINNING. CONTAINS: 46.757 ACRES MORE OR LESS. EXEMPT WELL DATA SHEET - DENVER BASIN, COLORAD APPLICANT: JOHNS RECEIPT NO. 437387 LOCATION: NW1/4 OF NW1/4 OF SEC. 16, T.1N., R.67W. (350 NSL, 1250 WSL) PROPOSED AQUIFER: SURFACE ELEVATION: 5015 NUMBER OF ACRES IN TRACT: 46.75 IS PROPERTY WITHIN SERVICE BOUNDARIES OF MUNICIPALITY S.B.5 CONSENT MAPS? N IF SUBDIVISION IS UNDER AUGMENTATION PLAN, CASE NO. IS IF SUBDIVISION WAS RECOMMENDED FOR APPROVAL BY THE WATER MANAGEMENT BRANCH, INFORMATION ON SUBDIVISION OR TRACT OF LAND/SPECIAL RESTRICTIONS: eva AQUIFER ELEVATION NET BOT. TOP SAND DEPTH TO ANNUAL APPROP STAT BOT. TOP A -F UPPER DAWSON LOWER DAWSON DENVER UPPER ARAPAHOE LOWER ARAPAHOE LARAMIE-FOX HILLS I / note: E indicates * indicates 4976 5020 4296 4577 18 233 39 -5 1.431 E NNT 719 438 16.269 NT location is at aquifer boundary and values may be m the proposed aquifer. All values are interpolated from the S.B.5 data base assembled in Nove Permit Application Chanze Form To be used when issuing well permits based upon information other than as received Please file with final Permit Receipt No. 04(511/4581 Name of Applicant / iVe tit/ E Jc//NS Summary of change(s): l _o,P‘rc7'3gse,' O ✓ /6 6A( t/7THc c/6 . yE 5Ct�/g /-/e) Date /;2/ 'y8 / r Signet ,c.�zr Print Name 4 di, A Al LJ2Yo/ 10 Hello