HomeMy WebLinkAbout20022163.tiff MAY-31-02 04 :35 PM STONEBACK LANDSCAPE j'�J�' 30/3/6�5�482111,' /J P. 01
Form No. OFFICE OF THE STATE ENGINEER
GWs-25" COLORADO DIVISION OF WATER RESOURCES
818 Centennial Bldg..1313 Sherman St.,Denver,Colorado 80203
(303)868.3581
EXST
WELL PERMIT NUMBER 057406 - F •
APPLICANT DIV. 1 WD 2 DES. BASIN MD
APPROVED WELL LOCATION
WELD COUNTY
NW 1/4 NW 1/4 Section 33
JENNIFER BARGEN Township 1 N Range 67 W Sixth P.M.
848 WCR 17 DISTANCES FROM SECTION LINE$
BRIGHTON, CO 80603- 600 Ft.from North Section Line
450 Ft. from West Section Line
4303)654-8210 JJTM COORDINATES
CHANGE/EXPANSION OF USE OF AN EXISTING WELL Northing: Easting:
ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT
CONDITIONS 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 this 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 rellef in a civil court action.
g) The construction of this welt 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.
r"'9) Approved pursuant to CRS 37-90-137(4)and the findings of the State Engineer dated 7 ..7.,00.0—for the
expansion of use of an existing well constructed under permit no.218478.
4) The use of ground water from this well is limited to commercial and residential purposes.
5) The maximum pumping rate of this well shall not exceed 15 GPM.
8) The average annual amount of ground water to be appropriated by this well in combination with well permit
no. 0579 4-F shall not exceed 24.7 acre-feet.
7) Production Is limited to the Laramie-Fox Hills aquifer which Is located 540 feet below land surface and extends to a depth
of 845 feet.
4) The owner shall mark the well In a conspicuous place with wall permit number(s),name of the aquifer,and court case
number(s)as appropriate. The owner shall take necessary means and precautions to preserve these markings.
8) A totalizing flow meter must be installed on this well and maintained In good working order. Permanent records of ell
diversions must be maintained by the well owner(recorded at least annually)and submitted to the Division Engineer upon
request.
10) This well shall be located at least 800 feet from any existing well, completed in the same aquifer,that is not owned by the
applicant.
11) This well shall be located not more than 200 feet from the location specified on this permit.
12) Pursuant to CRS 37-90-137(9)(b)and the Denver Basin Rules,no more than 98%of the nontrlbutary ground water
withdrawn annually shall be consumed and the well owner shall demonstrate to the reasonable satisfaction of the State
Engineer that no more than 98%of the water withdrawn will be consumed.
13) This well is subject to administration by the Division Engineer in accordance with applicable decrees, statutes, rules, and
regulations.
14) The issuance of this permit cancels permit no.218478.
NOTE:The ability of this well to withdraw Its authorized amount of water from this non-renewable aquifer may be less than
the 100 years upon which the amount of water In the aquifer Is allocated,due to anticipated water level declines.
Ort:.�' s-r—oz
APP ice . . // h ! ,p
State Engineer MAY 0 yip By
;,Recaiot No.0489441 DATE ISSUED MAY 7 L`i�iTIL EXPIRATION DATE MAY 0 7
2002-2163
FORM NO. PUMP INSTALLATION AND TEST REPORT - For Office Use only
GWS32
10184 STATE OF COLORADO, OFFICE OF THE STATE ENGINEER
WELL PERMIT NUMBER 218478
2 OWNER NAME(S) Geist Pivonka Inv
Mailing Address 745 N. Lincoln Ave .
City, St. Zlp Loveland, CO 80537
Phone ( 970) 667-3333
3. WELL LOCATION AS DRILLED: NW 1/4 NW 1/4, Sec. 33 Twp. 1 N , Range 67 W
DISTANCES FROM SEC. LINES:
600 ft. from North tSec. line. and 450 ft. from Wax Sec. line.
t norm o m sou o Wesq
SUBDIVISION: Tract of land LOT BLOCK FILING(UNIT)
STREET ADDRESS AT WELL LOCATION: Unknown
4. PUMP DATA: Typo Submersible Installation Completed 10/5/99
Pump Manufacturer Goulds Pump Model No. 5GS 15412
Design GPM 5 at RPM 3500 , HP 115 , Volts 230 , Full Load Amps 11 . 6 •
Pump Intake Depth 656 Feet, DropiColumn Pipe Size 1. Inches, Kind Galvanized •
ADDITIONAL INFORMATION FOR PUMPS GREATER THAT 50 GPM:
TURBINE DRIVER TYPE: ❑Electric ❑ Engine ❑Other
Design Head _ feet. Number of Stages . Shaft size inches.
5. OTHER EQUIPMENT:
Airline Installed❑Yes t3 No, Orifice Depth ft. . Monitor Tube Installed ❑Yes IX No, Depth ft.
Flow Meter Mfg. N/A Meter Serial No. _._•
Meter Readout❑Gallons.❑Thousand Gallons,❑Acre feet. ❑ Beginning Reading
6. TEST DATA: ❑Check box if Test data is submitted on Supplemental Form.
Date 10/5/99
Total Well Depth 815 Time - 12 . 30pm
Static Level 510 Rate (GPM) 5
Date Measured 7/16/99 Pumping Lvl. Not avail ahl e
7. DISINFECTION: Type Clorox Amt. Used 2 gallons
8.I Water Quality analysis available. ❑Yes ® No
9. Remarks PUMP INTAKE DEPTH ON 9/14/99 WAS 580 FT .
PUMP INTAKE DEPTH ON 10/ 5/99 WAS 656 FT
•
10. 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 as a class 1 misdemeanor.]
CONTRACTORGround Water Systems , LLC Phone ( 30) 443-4395 Lic. No. 1706:
Mailing Address 4599 N . Broadway , Boulder , CO 80304
NameiTrtle (Please type or print) Signature a Date
Todd E . Hunter �C2 10/14/99
. ... _.. -:.....�...:w3..- .._w.�..,._ .....:u'.a.:..-......�..�_ .. ._..:1A
C 'T--2@-2701 N:;J 12!4i.4 P:'C EP:VIR0h HEhLTH SERVICE: 6703111 P. 0:
WELD COUNTY DEPARTMnT OF PUBLIC HEALTH AND MTVIROMMERT
1555 NORTH 17TH AVENUE, GREELEY, CO 80631
PHONE (970) 304-6415 FAX 19701304-6411
(9.)
" " r", ' r C:
Permit !f cp-99C0DS6 Sec/Twn/Rng; Status: t8ftn--
_erm-t Type: ENEW
.--. .. ^:ii1 n tea.9v:C_l: . �1�•P: >O]:J1 ....:?'
=41141 _ -=5? 33 ,_'cLied: 07/22/1999
Issued: 07/23/1999
5„_rald: 11,2/ 44v.1/2"
OCa:ien: 'FEND—aYS ?;L-^-R.'SG--i C-R-4-3; a'd..-17 33-1-67 r'+ ,
Leta_ Desc :
. Phone: ;SC3) 452-7174
TE,ORNION CO 902411
OWNER =yR'GE.N JENNIFER Phone: (103) 452-7174
1335`S BIRCH COURT, Tr'C.2?:TON CC S0241
SEF'.. -5$N:vc: FOUNDATION & SOILS _NOINEr^._NG
+� Phone: 303-702-06E1
515 MAIN S41, LCNGMONT COLORADO 8050
1
SEPT-I,N3Ti, SELF ' hone: (970) 999-4999
X, GREE_EY CO 8067.
Descr_ptlor: . HOUSE
Co."?:T.a_._jal (Y/0) : N R-^_3idential (Y/` ) : Y Aces • 80 . 00
_u.m.oe:c C Persons : 2 3aseinent F1vab_rq (Y/N) : Y
�'...._e of =edre'_c'c s 2
bat.hroccns-.> Fill. 2 3/4 : /c .
(Y/N) • N r-_ ; t __v Name:
°later P_ivdta (Y/N) : Y Cistern :Y/,:) . N Weil (Y/N)
Water :erm_t No : 218472
�. ) Percolation Rates 40.3 Limiting Zone: >08 ft 00 in ;s
-:roar: Slope . 2 Dir: W Soil SuitAbie (YIN) : lt
ngine=_:r Deal. Rec'_ ;�=/NI • N r
- _3. .D0 Yr Flood Plain ;YJN) : N
Mininun Instailaticn
S_ptic Tank : =•7C0 gal Absorption Trench: 853 sq. ft .
Absorption Bed: 1.117 sq. ft .
Actual Installation
Sept__ Tank: ga. Absorption Trench: sr. . ft .
Absorption E.ed; s: . ft .
Eesigr.
NOTICE
T::3 issoa:ez _i ca:_ ;c_^.[:_ ate,. s_ _ap_y m'epl:-.tce ._ch ethc: a:c:e cruel 0. 103.1 r_y:_a:crl or 41414141413 rg4 rant,. aer
.M S.11 :t icn :o .ar:a;' _ac :Le al•J]t:c syscen will ape:Late _^. rorplicrre with 9pp_iaa:_e rcase. ecnty en. 1_c.l: rc . atrare
ia:,[_e __a_!. ... :.rnicie 1.. -.1C:a u. _ i v cac,ced, a::cap: for ;ltc ir4iToae a_ cs:cb1.tn:::j Pi:s_ .4L-Low-2 ci cn:Callc:
C.•atem fa: _isual.Ca ar a _3.::i: coCup cy p€r•_t pnr:.arr. :o %S 1-.41 2i.ZC- !2.1. _
•
T:i?. ):]^ii_ _: Inn ctrai2ararl.. The 'n._- :runny eea',t: t2'artr?n'_ .as_r'£5 the ri-ht te S'?';D v'd.vionai :mren a__ con3:_as
._ :Set: ._r re?_ 3..__a_ _.. a _aCr:3'! ; 1•eo_L. .l:Al :G_: swra•e_ .41.3 q:.-DS':a 4r.: '_3.41.1 _LErsc::1^- c: 341
-ar•'^:ad s z:on -y t3.., Mote County health Tatar:nec:.
{
i
r^� k nvir::rme ta�7_:?:�aa.i.'_st Date
l V
Hello