HomeMy WebLinkAbout20010253.tiff REPORT DATE OLORADO WELL APPLICATIf ; AND PERMITS
Tue Oct 31 09:27:37 MST 2000 COLORADO DIVISION OF WA1 _ _ RESOURCES
I ,
Receipt 9065195
Permit 69614/
Div 1 Wd 2
Basin Md
Engineer User
'Full Name ' Uses
ZESCHIN GERALD L
DOMESTIC
Address
RT 2 BOX 135 A
City State Zip
FT LUPTON CO 80621 Pump Rate Ann Amt Depth
Telephone Proposed 0 0 0
( ) Actual 10.00 0 420
Case Irrigated Area 1.00 acres
Permit XRef 0 Elevation 0
Well Name Perf Casing Top 0
County WELD Perf Casing Bottom 0
Q10 Water Level 90
Q40 NW Aquiferl ALL UNNAMED AQUIFERS
160 NE Aquifer2
Sec 31 Driller
Ts 3 North Pump Installer
Rng 66 West
Statute Meter Log Qual AbReq
Pm Sixth
No No No No
250 feet from North Section line
Comment
1325 feet from East Section line
Subdivision Filing Block Lot
Parcel Size PIN
0
Main Activity
Interim Status
Last Action
Permit Issued
Permit Expires
Expire Notice Sent
Well Const Report
Well Const Complete
Well Report(Non-trib)
Pump Install Report
Pump Install Complete 2001-0253
'It Beneficial Use 11-13-1973 I
atement Benef. Use
Benef Use (Non-trib) I EXHIBIT
Abandonment Report I
Well Plugged $ /
1
Wa1ze-72 <. _ r ccn
COLORADO DIVISION OF WATER RESOURCES
,�`LF�`rh
THIS FORT*MUST Be SUBMhTTEDez
300 Columbine Bldg., 1845 Sherman St. Cu
WITHIN 8'1,. DAYS OF COMPLETION Denver, Colorado 80203 J�
ON.OF rTYPHE EOR PRK INT IN BLACK SCRIBED RE WELL COMPLETION AND PUMP INSTALLATION REPORT » O� r1Q
INK. PERMIT NUMBER C-•r)r:11} - etc!
•
WELL OWNER GN:RAT,?)Y. 7,,:SC?TN %of the Tr,. of b' Sec. '31
ADDRESS RT. 2 DOT 135-s n i,").Tf*T T. 3 ttN , R. Al I.' , C - P.M
DATE COMPLETED`- idrn( 13 , 19.n HOLE DIAMETER
WELL:LOG 778 in.from 0 to 60 - ft.
Water �3 60
From To Type and!'Colcr of Material Lot --,--m.from to 42c% ft.
n 6 cg,nd
,5 clay shale
in. from to ft.
55 `7 rock DRILLING METHOD ROTARY ,flit).
5? 79 she 3e - CASING RECORD: Plain Casing
79 9` san(l :•,hale 5
lit,, cool Size r,& kind steel from I/0 to 7 ft.
103 177 shale Size +� k'' & kind Steel from 40 to 320 ft.
177 1`0 coal
130 210 shale
210 225 saml Size & kind from to ft.
225 279 shale streakes sand .
279 280 rock , Perforated Casing, ,
280 305 shale Size_IL& kind steel from 320 to 420 ft.
305 330 sand. x
330 337 shale Size & kind from to ft
337 385 sand' x
385 391+ shale Size & kind from to ft.
394 42n shale
14,20 . .
GROUTING RECORD
Material cement
Intervals constvrt
Placement Method °unwed,
GRAVEL PACK: Size
Interval
TEST DATA
Date Tested T CV 13 , 19 ._:3.
Static Water Level Prior to Test 90' ft.
Type of Test Pump ''i.1ed
Length of Test iihr.c•
' Sustained Yield (Metered)- 12
TOTAL DEPTH il20' .
Use additional pages necessary to complete log. Final Puniphnq Wafer Level . 300'
__
- JS.2- p7/Z t
7, r Z-t-4: V
StaIRJi12 COLORADO DIVISION OF WATER RESOURCENECEIVED # V
101 Columbine Bldg.,1845 Sherman St.,Denver,Colorado 80203
PERMIT APPLICATION FORM MAY 2 9 73
Application must »121
be complete where (_ )A PERMIT TO USE GROUND WATER "sale eat. n.0 al
applicable. Type or (X)A PERMIT TO CONSTRUCT A WELL coto. ^� 10.
print in BLACK FOR: (X) A PERMIT TO INSTALL A PUMP r° fLJ ?t,
i
INK.No overstrikes ivRF - 97 N
or erasures unless ( 1 REPLACEMENT FOR NO, — NwJai�„(kji_ a ,0
initialed. et O4 Q ,uo
( )OTHER COQ Gyre et* s �1,
-t
(1) APPLICANT- mailing address FOR OFFICE USE ONLY: DO NOT WRITE I MN
NAME tTelaid ,... /se7t,1-_in Receipt No. •Se, RAC- /
STREET it # 2 Box 135-A Basin , . Dist.
CITY ft. Lupton, Colo. 80621 ^ONDITIONSOFAPPROVA4
(State) (Zip) Y
TELEPHONE NO. - - 785-2398 ._ -- _. - _ .This .well--shall-be-used--in such a way as to cause
no material injury to existing water rights. The
(2) LOCATION OF PROPOSED'WELL 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
County Weld right from seeking relief in a civil court action.
+b
G L
NV] r
1'! '/. of the NENE ,Section 31
Twp. 3 Tnr till,Rng.CIL 'ri 6th_ P.M.
(3)WATER USE AND WELL DATA
Proposed maximum pumping rate(gpm) 15 gal Per 1.1 -
Average annual amount of ground water
to be appropriated (acre-feet): 1 acre rt.
Number of acres to be irrigated: 1 acre
Proposed total depth (feet): 300 ft.
Aquifer ground water is to be obtained from:
Snnd
Owner's well designation
GROUND WATER TO BE USED FOR:
( I HOUSEHOLD USE ONLY-no irrigation(0)
(X 1 DOMESTIC (1) ( 1 INDUSTRIAL (5)
( ) LIVESTOCK (2) ( 1 IRRIGATION (61
( I COMMERCIAL (4) ( ) MUNICIPAL (8)
I ) OTHER (9) APPLICATION APPROVED
PERMIT NUMBER 69614
DILL(4) DATE ISSUED JUN t27 �Qj'�
r9r3
Name Licensed Driller EXPIRATION DATE .IUN 2 71975
e
Street
e
City (S AT IN
(state) (Le)
BY
Telephone No. Lic.No.
I.D. r)
-- COUNTY 6)._
PUMP INSTALLATION REPORT
P Make A"f' t" A�LO }3s.ec \`
Type Sup,. k,�r.,.•. • •r..
Powered by iSkt. HP 1i A .1.4. s
Pump Serial No. 4. '5
3'4 'WATER
Motor Serial No. > at; TABLE
Date Installed LOys 13 '� 1-
cc 0
Pump Intake Depth — - 257` _ - - - - - - -- � - - - -
a
Remarks _ •
z
. . .rr •• z , no-- -07-�• f / ,
r.,
x
t K ' T: !
WELL TEST DATA WITH PERMANENT PUMP a F , ! �'� ._
Date Tested ,•;nv 13 ..I z s' GONE OF
t- a • ;.'P . - • .DEPRESSION
Static Water Level Prior to Test 90' it W ¢•;
,
1 :h of Test Imre.: Hours • .S' T
Sustained yield (Metered) 10 GPM • = i •
Pumping Water Level 300' •
Remarks :
J 1 no
r
CONTRACTORS STATEMENT
The undersigned, being duly sworn upon oath,deposes and says that he is the contractor of the well or
pump installation described hereon; that he has read the statement made hereon; knows the content
• thereof,and that the same is.true of his own knowledge. •
Signature - - : -,..-r_20,
4 � License No. �t.�
State of Colorado;County of t�/�Y 4 SS
Subscribed and`sworn to before me this2day of A—e-c�• , 197
sy Commission expires May 21, 1975
My Commission e>fpire 0_A
Notary Public UU g^
FORM TO BE MADE OUT IN QUADRUPLICATE: WHITE FORM must be an original copy on both sides and signed.
WHITE AND GREEN copies must be filed with the Stine Engineer.PINK COPY is for the Owner and YELLOW COPY is for the Driller.
1
(5) THE LOCATION OF THE PROPOSED WELL and the area on (6) THE WELL MUST BE LOCATED BELOW
which the water will be used must be indicated on the diagram below. by distances from section lines.
Use the CENTER SECTION (1 section, 640 acres)for the well location.
+ — —l- — + — + — --F — ± — 4.. 25() ft.from r,n r•t� sec. line
-+- — -� (north or south)
i .E---1 MILE,6280 FEET---$J I 1325 ft.from e o t sec. line
(east or west)
I
+ + + + t + I LOT BLOCK FILING «
I SUBDIVISION
+ —
-)- —
NORTH SECTION LINE — + —
f (7) TRACT ON WHICH WELL WILL BE.
I I
I I I LOCATED
NORTH I
t-,
- +. z" — + — — — + — _y ,
± ± No.of acres 4 1 2B : ere:; . Will this be
-i
o I m I
the only well on this tract? Yes
F-1+ ±
y I -a- - + (8) PROPOSED CASING PROGRAM
I I- I I r 1 Plain Casing
-b- ;I-. _ T _ — ___, .+ - 3, + 4- 6 5/8r" in.from 0 ft.to 265 it.
I I I
from ft.to ft.
.I- — -4., _ I I _ .+ 4_ Perforated casing _
SOUTH SECTION LINE
I I I i 5 5/8 in. from 265 ft.to 300 ft.
4- + + 4- -1- 4 -I- -I- in.from ft.to ft.
I I I I I (8) FOR REPLACEMENT WELLS givedistance
t' — -- — +- — + — + —• -I- — -)- — - — -4- and direction from old well and plans for plugging
The scale of the diagram is 2 inches- 1 mile
Each small square represents 40 acres.
WATER EQUIVALENTS TABLE (Rounded Figures)
An acre-foot coven 1 acre of lend 1 foot deep
1 cubic foot per second(cfs) ...449 gallons per minute(gpm)
A family of 5 will require approximately 1 acre-foot of water per year.
1 acre-foot...43,560 cubic feet...325,900 gallons.
t000 gpm pumped continuously for one day produces 4.42 acre-feet.
(10) LAND, N WHICH GROUNDWATER WILT, BE USED'
Owner(s): L �p �%e t. . ' 'e_i�fi.4, No.of acres:_ y . 1 ;1:i acres
Legal description:2N NE Section 3 North, Range 66 West, 6TH P.M.
(11) DETAILED DESCRIPTION. of the use of ground water:
')nne stir 11RP .._ .
(12) OTHER WATER RIGHTS used on this land, including wells.
Type or right Used for(purpose) Description of land on which used
inn p
(13) THE APPLICANT(S) STATE(S) THAT THE INFORMATION SET FORTH HEREON IS
T2R.9E TO THE BEST OF H KNOWLEDGE.
SIGN TURF OF APPLICANTS)
Use additional sheets of paper if more space is required.
Hello