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Home My WebLink About991746.tiff Form No. OFFICE OF THE STATE ENGINEER GWS-25 COLORADO 'IIVIc'ON OF WATER RESOURCE -1 ; :.f at 818 Centennial Bldg., 131.. Sherman St., Denver, Colorado 80203 ' - . (303) 866-3581 857 EXHIBIT WELL PERMIT NUMBER 214858 - - APPLICANT 1 q • DIV. 1 CNTY. 62 WD 2 DES. BASIN MD Lot: Block: Filing: Subdiv: APPROVED WELL LOCATION WELD COUNTY GLEN H WOMACK NW 1/4 NW 1/4 Section 20 13550 GRANBY ST Twp 2 N RANGE 66 W 6th P.M. BRIGHTON CO 80601- DISTANCES FROM SECTION LINES (303)659-4640 750 Ft. from North Section Line 225 Ft. from 'Nest Section Line PERMIT TO CONSTRUCT A WELL ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT CONDm0NS 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 Well Construction Pules 2 CCR 402-2, unless approval of a variance has been granted by the State Board cf Examiners of Water Well Construction and Pump Installation Contractors in accordance with Rule 18. 3) Approved pursuant to CRS 37-92-602(3)(b)(I) and the policy of the State Engineer dated 4/9/85 for appropriation of ground water tributary to the South Platte River system. 4) Approved as the only well on a site of 13.37 acres described as cart of the NW1/4, NW1/4 Section 20, Township 2 North, Range 66 West, Sixth Principal Meridian, also know as lot 2 of recorded exemption 1309-20-2-RE-1039, Weld County. 5) The use of ground water from this well is limited to drinking and sanitary facilities as described in CRS 37-92-60_(1)(c), for a commercial business. Water from this well shall not be used for lawn or landscape irrigation or for any other purpose outside the business building structure. 61 The total depth of this well shall not exceed 60 feet. or the first confining clay/shale series enccunterd, whichever comes first and which corresponds to the base of the alluvial aquifer. • 7) The maximum pumping rate shall not exceed 15 GPM. 8) The maximum annual amount of ground water to be withdrawn shall not exceed 1/3 acre-foot (108,600 gallons). : 9) 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. The maximum consumptive use of ground water shall not exceed 10 percent. 10) A totalizing flow meter must be installed on this well and maintained in good working order. Permanent records of all diversions must be maintained by the well owner (recorded at least annually) and submitted to the Division Engineer upon request. 11) This well shall be constructed net more than 200 feet from the location specified on this permit., < 991746 APPROVED / n RAN 4 d I d2 /1 1�2 L 1v State Engineer Sv Receipt No. 0438690 DATE ISSUED DEC 1 7 �9� EXPIRATION DATE DEC 1 7 JO • .,IM Pa.!. Vrr1L.L 'Jr Inc JIAIt tNGiNEER • GWS-25 COLORADn DIVISION OF WATER RESOURCE" 818 Centennial _...g., 1 Sherman St., Denver, Colorado 80203 (303) 866-3581 857 • WELL PERMIT NUMBER 214858 - _ APPLICANT DIV. 1 CNTY. 62 WD 2 DES. BASIN MD Lot: Block: Filing: Subdiv: APPROVED WELL LOCATION WELD COUNTY GLEN H WOMACK NW 1/4 NW 1/4 Section 20 13550 GRANBY ST Twp 2 N RANGE 66 W 6th P.M. BRIGHTON CO 80601- DISTANCES FROM SECTION LINES (303)659-4640 750 Ft. from North Section Line PERMIT TO CONSTRUCT A WELL 225 Ft. from West Section Line ISSUANCE CF THIS PERMIT DOES NOT CONFER A WATER Pia-7 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 apprcant 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 Well 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)(I) and the policy of the State Engineer dated 4/9/85 for appropriation of ground water tributary to the South Platte River system. 4) Approved as the only well on a site of 13.37 acres described as part of the NW1/4, NW-I/4 Section 20, Township 2 North. Range 66 West, Sixth Princpal Meridian, also know as lot 2 of recorded exemption 1309-20-2-RE-1039, Weld County. 5) The use of ground water from this well is limited to drinking and sanitary facilities as described in CRS 37-92-602(1)(c), for a commercial business. Water from this well shall nct be used for lawn or landscape irrigation or for any other purpose outside the business building structure. 5) The total depth of this well shall not exceed 60 feet, or the first confining clay/shale series enceunterd. whichever comes first and which corresponds to the base cf the alluvial aquifer. 7) The maximum pumping rate shall not exceed 15 3PM. 8) The maximum annual amount of ground water to be withdrawn shall not exceed 1 3 acre-foot (108,600 gallons). 9) 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. The maximum consumptive use of ground water shall not exceed 10 percent. 10) A totalizing flow meter must be installed on this well and maintained in good 'working order. Permanent records of all diversions must be maintained by the well owner (recorded at least annually) and submitted to the Division Engineer upon request. 11) This well shall be constructed not more than 200 feet from the location specified cn this permit. • / r/ APPROVED , 1 RAN a rr ✓ j� l Lt¢ 1 -eih, State Engineeray v Receipt No. 0438690 DATE ISSUED DEC 1 7 1998 EXPIRATION DATE DEC 1 7 2 006 WELL CONSTRUCTION CONSTRUCTION AND Pr"iP INSTALLATION BY THE WELL OWNF- You may construct the well anwor install the pump yourself if the well is for your own use, is on property you own, and is constructed or pumping equipment is installed with equipment owned and operated by you. It is yotr responsibility to complete and submit the Well Construction and Test Report, Foram Number GWS-31 and/or the Pump Installation.and Test Report, Form Number GWS-32. These forms are available from our offices. The well must be constructed and the pump installed in accordance with the well construction standards of the State Board of Examiners of Water Well Construction and Pump Installation Contractors. The Water Well Construction Rules are available from Division of Water Resources offices for a fee of$3.00. The Rules cover the minimum requirements for well construction, pump installation, disinfection, plugging and sealing and include contractor licensing regulations. If you are constructing your own well or installing pumping equipment, it is recommended that you obtain a copy of these Rules for reference. RULE 14 WELL TESTING 14.1 General - The provisions of this rule establish minimum standards for the testing of water wells. Every well constructed for the purpose of producing ground water shall be tested to determine: a. a yield test for the well; and b. the production rate of the equipment installed when the well is placed into service. 14.2 Well Yield Test - The yield of a well shall be determined as a stabilized production rate where the withdrawal rate and the drawdown do not chance by more than 10 % during the last hour of the test. The test shall demonstrate that either a. the well is capable of producing the permitted pumping rate for the well: or b. that the maximum yield of the well is less than the permitted production rate. 14.3 Responsibility for Well Yield Test - Well construction contractors are responsible for performing the well yield test and submitting the test data to the State Engineer. If the construction contractor also installs the production equipment, the well yield test may be combined with the production equipment test, provided that the test meets the requirements of Rule 14.2. The construction contractor may forgo the well yield test if he can show that a licensed pump installer will perform the well yield test with the permanent production equipment within 60 days of his drilling of the well. • 14.4 Production Equipment Test- The production equipment installed in wells shall be tested to make sure it is functioning as designed. The test shall demonstrate the production capacity of the equipment as actually installed in the well or that the production from the well complies with the conditions of the permit, whichever is less. 14.5 Responsibility for Production Equipment Test - Pump installation contractors are responsible for testing the production equipment installed in a well upon completion of their work. If the well construction contractor determined the well yield and submitted a report, the pump installer need not perform another well yield test. If the pump installer does nct perform a well yield test with the permanent production equipment, he shall perform a production equipment test and re ort the data results to the State En ineer. Wells to be plugged and sealed must be plugged in accordance with of the Water Well Construction Rules. A Well Abandonment Report, form number GWS-9 must be submitted to confirm plugging and sealing of the well. This form is available from our offices. The general Rule for plugging and sealing wells is printed below. The specific rules are found on the reverse side of the Well Abandonment Report form. RULE 15 STANDARDS FOR PLUGGING AND SEALING WELLS AND WELL EXCAVATIONS 15.1 General - The plugging and sealing of all wells, monitoring and observation wells, monitoring and observation holes, and test holes, which are no longer intended to be used, is necessary to prevent contamination of ground water and the migration of water through the unused borehole. It is the ultimate responsibility of the well owner to have a well property plugged and sealed. The well construction contractor or authorized individual is responsible for notifying the well owner of these plugging requirements. Persons authorized to install pumping equipment may plug and seal wells which do not require the removal of casing from more than one aquifer or the ripping or perforating of casing opposite confining layers. All materials used for backfilling shall be clean and free from contaminants. The well casing may be cut off below land surface so that it will not interfere with the anticipated use of the land. If the casing is cut off below land surface, a watertight cover shall be permanently attached to the remaining casing and the excavation shall be filled with materials which are not more permeable than the surrounding soils. romi No. GWS-7 EXEMPT 4/97 STATE OF COLORADO OFFICE OF THE STATE ENGINEER 821 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203 (303) 866-3581 Fax(303) 866-3589 INFORMATION FOR WELL PERMITS APPROVED PURSUANT TO CRS 37-92-602 (HOUSEHOLD, DOMESTIC, LIVESTOCK AND EXEMPT COMMERCIAL USES) Carefully read the conditions of approval on your well permit. The conditions and the information on this information sheet must be complied with in order for the permit to remain valid. THE ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT. A STATEMENT OF BENEFICIAL USE FOR THIS TYPE OF WELL IS NOT REQUIRED. THE PERMIT EXPIRATION DATE IS TWO YEARS FROM THE DATE ISSUED. The well must be constructed and evidence of it's construction must be received by this office in the form of a Well Construction and Test report from the well construction contractor confirming that the well was constructed prior to expiration of the well permit. The well permit number is located in the upper right hand corner of the permit, and the expiration date is located in the lower right hand corner. The expiration date of the permit may be extended one year at a time at the discretion of the State Engineer for good cause shown. If an extension of time is necessary to construct the well, you must file a written request for the extension which must be received by this office prior to the expiration date. No fee is required for this type of permit extension. The request must state why the well has not been constructed, and include an estimate of when the well will be constructed. Water well construction and pump installation contractors are specifically licensed in Colorado to perform these specialized tasks. It is illegal for contractors who do not hold these licenses to construct wells and install pumping equipment in or on wells. The well must be constructed and the pump installed by contractors with current license(s) issued by the State of Colorado unless exempted as described on the reverse side. The well construction report including a test of the well yield must be submitted to the office of the State Engineer within sixty (60) days of completion of the work or within seven days after expiration of the permit, whichever is earlier. The pump installation report including a pumping system test must be submitted within sixty (60) days of completion of the work.Alie contractor(s) must provide you with a copy of the work report(s) filed with the State Engineer. The Well Construction arid Test Report. Form Number GWS-31 and the Pump Installation and Test Report, Form Number GWS-32 are available from the Division of.Water Resources offices. Additional information regarding well construction, pump installation, required testing and well plugging and sealing regulations are found on the reverse side of this sheet. You have been provided with copies of the well permit. The owner's copy is for your records. There is also a copy for the pump installation contractor. Copies have been sent to the driller if you indicated a driller license number on the application, or those two copies are also enclosed. You may make additional copies for the well construction contractor if you select a different well construction contractor. DO NOT GIVE YOUR"OWNER'S COPY" TO THE CONTRACTOR. The original permit is on file in the Denver office Records Section. Copies may be obtained for a fee of 50 cents per page. Statutes require that any change of mailing address or ownership be reported to the State Engineer. Form number GWS-11 is used both by new owners to report ownership changes and current owners to report address changes. If you have questions, contact the Denver Office, or the Division Office in the area where your well is located. DIVISION 1 DIVISION 2 Box 5728 DIVISION 3 Box 269 DIVISION 4 Box 456 800 8th Ave Rm 321 310 E Abriendo Suite B 422 4th St 1540 E Niagara Greeley CO 80631 Pueblo CO 81004 Alamosa CO 81101 Montrose CO 81402 (303) 352-8712 (719) 542-3368 (719) 589-6683 (970) 249-6622 DIVISION 5 Box 396 DIVISION 6 Box 773450 DIVISION 7 Box 1880 DENVER OFFICE 50633 US Hwy 6 & 24 625 So. Lincoln Ave. 1474 Main St Rm 821 Glnwd Spgs CO 81601 Stmbt Spgs CO 80477 Durango CO 81302 1313 Sherman St (970) 945-5665 (970) 879-0272 (970) 247-1845 Denver CO 80203 (303) 866-3581 Hello