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2007-2072
Form No. OFFICE OF THE STATE ENGINEER
GWS-25 COLORADO DIVISION OF WATER RESOURCES
�-. 818 Centennial Bldg., 1313 Sherman St.,Denver,Colorado 80203
(303)866-3581
LIC
WELL PERMIT NUMBER 65759 -F
APPLICANT DIV. 1 WD2 DES. BASIN MD
APPROVED WELL LOCATION
WELD COUNTY
SE 1/4 SE 1/4 Section 24
SEMCRUDE LP Township 3 N Range 65 W Sixth P.M.
C/O GLENN COLLUM DISTANCES FROM SECTION LINES
11501 SOUTH 1-44 SERVICE RD 610 Ft. from South Section Line
OKLAHOMA CITY, OK 73173-8315 610 Ft. from East Section Line
(405) 692-5120 UTM COORDINATES (Meters,Zone:13,NAD83)
PERMIT TO CONSTRUCT A WELL Easting: Northing:
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 ensure 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 37-90-137(4)and the findings of the State Engineer dated May 21,2007.
4) The use of ground water from this well is limited to industrial,irrigation and commercial.
5) The pumping rate of this well shall not exceed 500 GPM.
6) The average annual amount of ground water to be appropriated shall not exceed 19.8 acre-feet.
7) Production is limited to the Laramie-Fox Hills aquifer which is located 190 feet below land surface and extends to a depth of 505 feet. Plain
casing must be installed and grouted to prevent the withdrawal of ground water from other aquifers and the movement of ground water
between aquifers.
8) The depth to the top of the Laramie-Fox Hills aquifer Is approximate. To ensure the exclusion of poor quality water from zones immediately
above the aquifer,plain casing and grout shall extend through the lowermost coal and/or carbonaceous shale that overlies the Laramie sand
portion of the aquifer.
9) The entire length of the hole shall be geophysically logged as required by Rule 9 of the Statewide Nontributary Ground Water Rules prior to
installing casing.
10) The owner shall mark the well in a conspicuous place with well 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.
11) 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.
12) This well shall be constructed at least 600 feet from any existing well,completed in the same aquifer,that is not owned by the applicant.
13) This well shall be constructed not more than 200 feet from the location specified on this permit.
14) Pursuant to CRS 37-90-137(9)(b)and the Denver Basin Rules,no more than 98%of the nontributary 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.
15) This well is subject to administration by the Division Engineer in accordance with applicable decrees,statutes,rules,and regulations.
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.
1ML 5/407
APPROVED
JMW
Receipt No. 3615073 ste er DATE ISSU 05-21-2007 EXP ATION DATE 05-21-2008
COLORADO DIVISION OF WA" RESOURCES Office Use Only Form GWS-45(06/2006)
DEPARTMENT OF NATURA- .ESOURCES
1313 SHERMAN ST,RM 818,DENVER,CO 80203
phone—info:(303)866-3587 main:(303)866-3581 fax:(303)866-3589
http://www.water.state.co.us
--GENERAL PURPOSE
4Vater Well Permit Application
Review instructions on reverse side prior to completing form.
The form must be completed in black or blue ink or typed.
1.Applicant Information 6. Use Of Well (check applicable boxes)-_
--____
Name e of applicant --------- ._...........
SemCrude L.P. Attach a detailed description of uses applied for.
c/o Glenn Collum 0 Industrial O Other(describe):
Mailing address 0 Municipal
11501 South I-44 Service Road 0 Irrigation
City State I Zip code ®Commercial
Oklahoma City OK 1. 73173-8315 7.Well Data (proposed)
Telephone 0 E-mail(Optional)
(405)692-5120 -Maximum pumping rate I Annual amount to be withdrawn
2.Type Of Application (check applicable boxes) 500 gpm 21.7 acre-feet
Total depth I Aquifer
0 Construct new well O Use existing well
❑ Replace existing well536 feet I LarauL a-Fox Hills
O Change or increase use _—_-
❑Change source(aquifer) O Reapplication(expired permit) 8. Land On Which Ground Water Will Be Used
El Other: Legal Description(may be provided as an attachment): 80 Acres consisting of
3. Refer To (if applicable) the South 1/2 of the Southeast 1/4 of Section 24,Township 3
Well permit u Water Court case C — North,Range 65 West of the 6th P.M.,County of Weld,State of
I Colorado
Designated Basin Determination 1t Well name or#
4. Location Of Proposed Well
County I — (If used fort rop irrigation,attach a scaled map that shows Irrigated area.)
Weld SE 1/4 of the SE 1/4 A. •Acres B. Owner
80 SemCrude L.P.
r--.-lion I Township N or S Range Eo r W Principal Mendian
I
3 0 O l 65 0 O 6th C. List any other wells or water rights used on this land:
Distance of well from section lines(section lines are typically not property Ines)
610 Ft.from❑N O S 610 Ft.from 0 E❑W 9. Proposed Well Driller License#(optional):
For replacement wells only—distance and direction from old well to new well 10. Signature Of Applicant(s)Or Authorized Agent
feet direction The making of false statements herein constitutes perjury in the second
Well location address(Include City.State.Zip) O Check if well address is same as in l eem 1. degree,which is punishable as a Bass 1 misdemeanor pursuant to C.R.S.
Weld County road 49,Hudson,Colorado SEE. '+1f-1 tvrtk 24-4-104(13)(a). I have read the statements herein,know the contents
►+•'=1O cr st- Rowll,- — elol -i-i vO sr cOR11E R —thereof and state that the a true to my knowledge.
Sign h (Must be originalsignalu ) e l Date
Optional: GPS well location information in UTM format You must check GPS unit for — \�\
required settings as follows: I 1�
Format must be UTM ! Print name&title 3p 3 1-1
❑Zone 12 or O Zone 13 Fasting 1_f ►t�'2c a) I-,(H T - t o� �r
Units must be Meters I ��'
Datum must be NADB3 Northing Office Use Only
Unit must be set to true north USGS map name OWR map no. Surface e�ev.
Was GPS unit checked for above? O YES Remember to set Datum to NAD83
5. Parcel On Which Well Will Be Located ____Receipt:area only
(PLEASE ATTACH A CURRENT DEED FOR THE SUBJECT PARCEL)
A. Legal Description(may be provided as an attachment):
The South 1/2 of the Southeast 1/4 of Section 24,Township 3
North,Range 65 West of the 6th P.M.,County of Weld, State of
Colorado
_
B. X of acres in parch I C. Owner -_—.-_-- WE .___-_. -.-.- --._.._-.-____.__._.__._
jila SemCrude L.P. WR
.... Will this be the only well on this parcel?DYES ONO(it no—list other wells) CWCB
1I155-F
TOPO
E. Stale Parcel IDC(optional): - — -- - ---- MYLAR
SB5 DIV WD BA MD
GWS-38(Rev.Sept.1996)
STATE OF COLORADO
OFFICE OF THE STATE ENGINEER
DIVISION OF WATER RESOURCES
NONTRIBUTARY GROUND WATER CONSENT LANDOWNERSHIP STATEMENT
I (We) Dorthy K. Gurtler
(Name)
whose mailing address is 7538 Weld County Road 49
Street
Hudson CO 80649
(City) (State) (Zip)
claim and say that I (we) am (are) the owner(s) of the following described property consisting
of 80 acres in the County of Weld , State of
Colorado: (Insert Property Legal Description)
The South 1/2 of the Southeast 1/4 of Section 24, Township 3 Worth
Range 65 West of the 6th P.M. , County of Weld, State of Colorado
encompassing approximately BO acres.
and that I (we) have granted written consent to others to withdraw ground water from the
Laramie-Fox Hills aquifer as evidenced by the attached copy of a deed or
other document in the County or Counties in which the land is located, and that said ground
water has not been conveyed or reserved to another, nor has consent been given for
withdrawal by another except as indicated in the attached deed or other recorded document.
Further, I (we) claim and say that I (we) have read the statements made herein; know the
contents hereof;and that the same are true to my(our)own knowledge.
A/-f 4 `7 . a-/e2 � c /c
(Signature) (Date)
(Signature) (Date)
INSTRUCTIONS:
Please type or print neatly in black ink. This form may be reproduced by photocopy or word
processing means. See additional instructions on back.
1313 SHERMAN ST RM 818 DENVER CO 80203 (303)866-3581
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