HomeMy WebLinkAbout20040033.tiff cnsua / }, PUMP INSTALLATIv AND TEST REPORTor Office u.e only
rigs STATE OF COLORADO, OFFICE OF THE STATE ENGINEER RECEIVED
1. WELL PERMIT NUMBER 210958 SEP 11.1998
OWNER NAME(S) Lance F. Messinger
WATER RESOURCES
Mailing Address 895 N. 5th. Ave. STATE ENGINEER
City, SL Zip Brighton, Co. 80601 C°`°
Phone (303 ) 659-6699
3. WELL LOCATION AS DRILLED: NW 1/4 NW 1/4,Sec. 3 1 Twp. 3 N , Range 66 W
DISTANCES FROM SEC. LINES:
1 200 ft.from North Sec. line. and 2500 ft. from East Sec. line.
(ROM or SCUM) OM or wecq
SUBDIVISION: LOT BLOCK FILING(UNrf)
STREET ADDRESS AT WELL LOCATION:
4. PUMP DATA:Type Submersible Installation Completed 8-1 7-98
Pump Manufacturer Sta-Rite Pump Model No. LLUF4Uttu3
•
Design GPM 15 at RPM 3600 , HP 3/4 ,Volts 230 , Full Load Amps 6 . 9
Pump Intake Depth 40 Feet, Drop/Column Pipe Size 1 1/4 Inches, Kind PVC Sch 80
•
ADDITIONAL INFORMATION FOR PUMPS GREATER THAT 50 GPM:
TURBINE.DRIVER TYPE: ❑Electric ❑Engine ❑Other
Design Head feet, Number of Stages , Shaft size Inches.
S. OTHER EQUIPMENT:
Airline Installed❑Yes No, Orifice Depth ft. . Monitor Tube Installed ❑YesEkNo, Depth ft.
Flow Meter Mfg. Meter Serial No.
Meter Readout El Gallons,El Thousand Gallons,El Acre feet,❑Beginning Reading .
6. TEST DATA: ❑Check box if Test data is submitted on Supplemental Form.
Date 8-17-98 '
Total Well Depth 60 'Time 2. 00 PM
Static Level 16 Rate (GPM) 1 5
Date Measured 8-17-9 8 Pumping Lvi. 18
7. DISINFECTION: Type HTH Amt. Used 3/4#
8. Water Quality analysis available. ❑Yes4laNO
9. Remarks
•
10. I have read the statements made herein and know the contents thereof, and that they are true to my knowledge.
[Pursuant to Section 244-104 (13)(a) C.R.S., the making of false statements herein constitutes perjury in the second
degree and is punishable as a class 1 misdemeanor.]
CONTRACTOR R & R Well & Pump Inc. Phone (970) 353-3118. Lic. No. 857
Mailing Address P.O. box 577 Greeley, Co. 80632
—'me/rrrtle (Please type or print) Signature Date
•
vWNER Glenn A. Clement —9-2-98
•
• - 2004-0033 _
+M°' '' T1 WELL CONSTRUCV'"N AND TEST REPORT Asr Office Use only
asa 1.
1O i SPATE OF COLORADO, OFFIL_ OF THE STATE ENGINEER
1. WELL PERMIT NUMBER 210958 RECEIVED
QWNER NAME(S) Lance F. Messinger AUG 10 1998
Jailing Address 8 95 N. 5th. Ave.
City, St. Zip Brighton, Co. 80601 WATER RE5°Uja
STATE ENGINEERM
Phone (1 303) 659-6699
O.
a WELL LOCATION AS DRILLED: NW 1/4 NW 1/4, Sec. 31 Twp. 3 N , Range 66 W
DISTANCES FROM SEC. LINES:
1200 ft. from North Sec. line. and 2500 ft. from East Sec. line. OR
(noun or sown) (easr or wary -
SUBDIVISION: LOT_BLOCK FILING(UNIT) .
STREET ADDRESS AT WELL LOCATION:
4. GROUND SURFACE ELEVATION ft. DRILLING METHOD Rotary
DATE COMPLETED 7-16-98 . TOTAL DEPTH 60 ft. DEPTH COMPLETED 60 ft.
5. GEOLOGIC LOG: 6. HOLE DIAM. (in.) From (ft) To (ft)
Depth Description of Material(Type,Size,Color,Water Location) 8 7/8 0 60
0-3 Top soil
3-14 Brn. Clay
14-40 Sand & gravel Fine to 1/16 X
40-55 " " 1 X 7. PLAIN CASING
55-56 Yellow clay OD (in) Kind Wall Size From(ft) . To(ft)
56-60 Shale 6 5/8 Steel . 250 +1 20
5 PVC . 277 20 40
•
PERF. CASING: Screen Slot Size: .035
— 5 PVC . 277 4U bU
8. FILTER PACK 9. PACKER PLACEMENT:
Material Gravel Type
Size 3/8 .
Interval 20-4U Depth
10. GROUTING RECORD:
Material Amount Density Interval Placement
REMARKS: Cement 3 SIC. 1 .86 0-20 Poured
rype l&2
11. DISINFECTION: Type HTH Amt. Used 3/4 It
12. WELL TEST DATA: ❑Check box if Test Data is submitted on Form No. GWS 39 Supplemental Well Test
TESTING METHOD Bailed •
Static Level 16 ft. Date/Time measured 7-16-98 , Production Rate 15 gpm.
Pumping level . 1 8 • ft. Date/lime measured 7-16-98 ,Test length (hrs.) 2
Remarks
13. I have read the statements made herein and know the contents thereof,and that they are true to my knowledge. [Pursuant to Section 24-4-104(13)(a)
C.R.S.,the making of false statements herein constitutes perjury in the second degree and is punishable es a class 1 misdemeanor.)
rcoNTRACTOR R & R Well & Pump Inc. Phone ( 970) 353-3118 ' Uc. No.857 ,
AailinoAddress P.O. box 577 Greeley, Co. 80632 ,
IName/Tale (Please type or print) Signature. • Date
OWNER Glenn A. Clement 7-31-98
,rm No. OFFICE OF THE STAr ENGINEER
awS:26 ' ' COLORADO DIVISION JF WATER RESOURCES
. • 818 Centennial Bldg.. 1313 Sherman St.,Denver,Colorado 80203 857
(303)866-3561
WELL PERMIT NUMBER 210958 - --
APPLICANT DIV. 1 CNTY. 62 WD 2 DES. BASIN MD
Lot: Block: Filing: Subdiv:
APPROVED WELL LOCATION
WELD COUNTY
NW 1/4 NW 1/4 Section 31
LANCE F MESSINGER Twp 3 N RANGE 66 W 6th P.M.
895 N 5TH AVE #8
BRIGHTON CO 80601- • DISTANCES FROM SECTION LINES
1200 Ft. from North Section Line
(303)659-6699 2500 Ft. from East Section Line
PERMIT TO CONSTRUCT A WELL
ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT
CONDmONS OF APPROVAL
1) not assure the applicant
This well shall be used in such a way as to cause no material injury to that no injury will existing rights. does
occur to another vested water right or preclude anotherr owner of a vested water
r right
from seeking relief In a civil court action.
er l Construction 2) variance has Ibeengrantedll shall be inby the Slate Boarrliance with d of Examinersf1Wa eerlWell Construction es 2 CCR and Pump02-2,InstallationsContracto 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) The use ofcommercialgbusiness. Water from th slwell shall not be used for lawn or landscape Is limited to drinkg and sanitary facilities irrigation or f described ior any other n CRS 37-92pose outside
the business building structure.
5) The total depth of this well shall not exceed 55 feet, or the first confining clay/shale series,whichever comes first,corresponding
to the base of the Alluvial aquifer.
6) The maximum pumping rate shall not exceed 15 GPM.
7) The maximum annual amount of ground water to be withdrawn shall not exceed 1/3 acre-foot (108,600 gallons).
8) Approved as the only well on a site of 12.3 acres described as a portion of the W yr, E h of Sec. 31,Twp. 3 N., Rng. 66 W,6th
P.M.,Weld County. Reference attached exhibit A.through an 9) where the water is returned to the same stream system individual
The return flow from the use of the well must sys em In which the wells 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 on this permit.
12) This permit has been approved with corrected distances from section lines, and a completed Location of Well per the map
request the apfice i. You are hereby notified he date of ssuance rlght to pur pursuant tothe the
Stat issuance
Admini trativis e�Procedures Act.written
(See
request with this office within sixty (60)day
Section 24-4-104 through 106, C.R.S.).
Note: To Insure aoMaximumons or productive
u ti ei life ndio fft this
above.perforated44440
casing should be set through the entire producing interval
of the app
r
APPROVED / T ('J n :n��°_^
BIS 1 WM - .0 ' 51998 ay J JUN 25 2040
Engineer •JUN Z EXPIRATION DATE
Receipt No. 0429887 DATE ISSUED
- a
WELD COUNTY HEALTH DEPARTMENT
1517 16TH AVENUE COURT, GREELEY, CO 80631
ICJ✓ I (970) 353-0635 EXT 2225 FAX (970) 356-4966 rn
•
Permit # : SP-9800292 sea/Twn/Rng: 3/ 3 Status: ISSUED
Permit Type : CNEW c=commercial, R=residential . NEW, REPair, VauLT
Applied: 06/24/1998
Parcel No : 1211 31pdgt4 ✓ Issued: 08/27/1998
Location: 111 Finaled:
'0' WCR 25 1/2 rAtIG 31
Legal Desc :
APPLICANT BOOS DON Phone : (303 ) 678-7983
19113 WCR 25, PLATTEVILLE CO 80651
OWNER MESSINGER LANCE Phone : (303) 678-7983
343 BELVIEW CT, LONGMONT CO 80501
Description: AG BUILDING
Commercial (Y/N) : Y Residential (Y/N) : N Acres : 12 . 00
Number of Persons : 8 Basement Plumbing (Y/N) : N
Number of Bedrooms : Bathrooms-> Full : 2 3/4 : 1/2 :
Water Public (Y/N) : • Utility Name :
Water Private (Y/N) : Y Cistern (Y/N) : Well (Y/N) : Y
-"Water Permit No:
Percolation Rate : 11 . 5 Limiting Zone : 00 ft 06 in Desc : SAND GRAVEL
% Ground Slope : Dir: Soil Suitable (Y/N) : N
Engineer Design Req' d (Y/N) : Y In 100 Yr Flood Plain (Y/N) : N
Minimum Installation
Septic Tank: 1000 gal Absorption Trench: sq. ft .
Absorption Bed: 488 sq. ft .
Actual Installation
Septic Tank: VW gal Absorption Trench: sq. ft .
�', __` n n "� Absorption Bed: 112 sq. ft .
Design Type : C� a 1
NOTICE
The issuance of this permit does not imply compliance with other state, county or local regulatory or building requirements, nor
shall it act to certify that the subject system will operate in compliance with applicable state, county and local regulations
adopted persuant to Article 10, Title 25, CRS as amended, except for'the purpose of establishing final approval of installed
system for issuance of a local occupancy permit persuant to CRS 1973 25-10-111 (2) .
This permit is not transferable. The Weld County Health Department reserves the right to impose additional terms and conditions
required to meet our regulations on a continuing basis. Final permit approval was contingent upon the final inspection of the
completed system by the Weld County Health De a t
\)\,,\00si\.\ ,,-(crx
610.0064
Environmental Specialist ate
SIS SEP 0 3 1998
Hello