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COLORADO
Division of Water Resources
Department of Natural Resources
WELL PERMIT NUMBER 322682 -
RECEIPT NUMBER 10012254
ORIGINAL PERMIT APPLICANT(S)
KERRY MADOLE
PERMIT TO CONSTRUCT A NEW WELL
APPROVED WELL LOCATION
Water Division: 1 Water District: 1
Designated Basin: LOST CREEK
Management District: LOST CREEK
County: WELD
Parcel Name: N/A
Physical Address: N/A
NW 1/4 SW 1/4 Section 24 Township 1.0 N Range 63.0 W Sixth P.M.
UTM COORDINATES (Meters, Zone:13, NAD83)
Easting: 551922.2 Northing: 4431741.1
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 37-90-105 for a well on a tract of land of 160 acres described as the SW1/4 of Section 24, Township 1
North, Section 63 West of the Sixth P.M., Weld County.
4) Water from this well may be used for domestic purposes inside 2 single family dwellings, and the watering of 4 of the owner's
own large non-commercial domestic animals (per single family dwelling).
5) The irrigated area shall not exceed 2,000 square feet of lawn and garden (1,000 square feet per single family dwelling).
6) Water from this well may be used for the watering of livestock on range and pasture.
7) The pumping rate of this well shall not exceed 15 GPM.
8) The annual withdrawal of groundwater from this well shall not exceed 1.80 acre-feet (0.4 acre-feet per single family dwelling).
9) Production from this well is limited to the Arapahoe aquifer. The total depth of the well shall not exceed 205 feet, which
corresponds to the base of the Arapahoe aquifer. At a minimum, plain casing shall be installed and grouted through all
unconsolidated materials and shall extend a minimum of ten feet into the bedrock formation to prevent production from other
zones.
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 Lost Creek Ground Water Management
District and the Division of Water Resources upon request.
11) This well shall be constructed within 200 feet of the location specified on this permit.
NOTE: At the proposed well location, the Arapahoe aquifer is located at or near the ground surface and extends to a depth of
approximately 205 feet. Wells completed in the Arapahoe aquifer must be constructed in accordance with Well Construction
Rule 10.4.6 (2 CCR 402-2) for a Type II aquifer.
NOTE: This well is withdrawing water from a non-renewable aquifer. While the withdrawals from this aquifer are administered
based on a 100 year aquifer life, water level declines may prevent this well from diverting the permitted amounts for that 100
years.
NOTE: This well is located within the Lost Creek Ground Water Management District where local District Rules apply which may
further limit the withdrawal and use of designated ground water as authorized under this permit.
Printed 07-07-2021
For questions about this permit call 303.866.3581 or go to www.water.state.co.us Page 1 of 2
WELL PERMIT NUMBER 322682 -
RECEIPT NUMBER 10012254
NOTE: This permit has been approved with a change to the permit application as submitted by the applicant. The irrigated
acres and annual appropriation have been reduced to comply with the Lost Creek Ground Water Management District rules. You
are hereby notified that you have the right to appeal the issuance of this permit, by filing a written request with this office
within sixty (60) days of the date of issuance, pursuant to the State Administrative Procedures Act. (See Section 24-4-104
through 106, C.R.S.)
NOTE: This permit will expire on the expiration date unless the well is constructed by that date. A Well Construction and Yield
Estimate Report (GWS-31) must be submitted to the Division of Water Resources to verify the well has been constructed. An
extension of the expiration date may be available. Contact the DWR for additional information or refer to the extension request
form (GWS-64) available at: dwr.colorado.gov
Issued By SHANNON PORTER
Date Issued: 7/7/2021
Expiration Date: 7/7/2023
Printed 07-07-2021
For questions about this permit call 303.866.3581 or go to www.water.state.co.us Page 2 of 2
WELL CONSTRUCTION AND YIELD ESTIMATE REPORT
State of Colorado, Office of the State Engineer
1313 Sherman St., Room 821, Denver, CO 80203 303.866.3581
dwr.colorado.gov and dwrpermitsonline@state.co.us
1. Well Permit Number: 322682 Receipt Number: 10012254
2. Owner's Well Designation:
Form No.
GWS-31
02/2017
3. Well Owner Name: Kerry Madole
4. Well Location Street Address:
5. As Built GPS Well Location (required): El Zone 12 0 Zone 13 Easting: 557925.0 Northing: 4431735
6. Legal Well Location: NW 1/4, SW 1/4, Sec., 24 Twp. 1 0 N or Sri, Range 63
County: Weld
Subdivision:
, Lot , Block
7. Ground Surface Elevation: feet Date Completed: 3 -17 -ova Drilling Method: Rotary Mud
Total Depth: 110 feet Depth Completed: 110
9. Advance Notification: Was Notification Required Prior to Construction? O Yes QNo, Date Notification Given:
10. Aquifer Type:
(Check one)
8. Completed Aquifer Name : Arapahoe
11. Geologic Log:
Ej Type I (One Confining Layer)
Type II (Not overlain by Type III)
Depth Type
0-15 Sand
15-35 Gravel
35-40 Clay
40-90 Sand
90-110 Shale
OType I (Multiple Confining Layers)
[Type II (Overlain by Type III)
Grain Size Color Water Loc.
12. Hole Diameter (in.)
7.5625
For Office Use Only
n E or W t: • 1, 6 P.M.
, Filing (Unit)
feet
Laramie -Fox Hills
OType III (alluvial/colluvial)
From (ft) To (ft)
0 110
13. Plain Casing
OD (in) Kind Wall Size (in)
5 9/16 Steel .188
Remarks:
17. Disinfection: Type Chlorine Amt. Used 2 gallons
From (ft) To (ft)
+1 20
5 9/16 PVC SCH 40 20 40
Perforated Casing
OD (in) Kind
5 9/16 PVC
Wall Size (in) From (ft)
SCH 40 40
To (ft)
110
14. Filter Pack:
Material Silica Sand
Size 10-12
Interval 40-110
15. Packer Placement:
Type
Depth
16. Grouting Record
Material Amount
Cement /5sacks
Density
78 gallons
Interval Method
5-40 t -pipe
18. Well Yield Estimate Data: OCheck box if Test Data is submitted on Form Number GWS-39, Well Yield Test Report
Well Yield Estimate Method: IaAlec
Static Level: 15
Date/Time measured: 3 —) ' — Q2.
Remarks:
Estimated Yield (gpm) . L O
Estimate Length (hrs) 2
19. I have read the statements made herein and know the contents thereof, and they are true to my knowledge. This document is signed (or name entered if
filing online) and certified in accordance with Rule 17.4 of the Water Well Construction Rules, 2 CCR 402 2. The filing of a document that contains false
statements is a violation of section 37 91 108(1)(e), C.R.S., and is punishable by fines up to $1,000 and/or revocation of the contracting license. If filing online
the State Engineer considers the entry of the licensed contractor's name to be compliance with Rule 17.4.
Company Name:
Crandall Drilling & Pump Service
Mailing Address: PO BOX Strasburg, CO 80136
Sign (or enter name if filing online)
LWou►-o .a( Cretv4eit
Email:
crandalldrilling@gmail.com
Phone w/area code:
(303) 622-4820
License Number:
1229
Print Name and Title
Howard Crandall - Owner
Date:
3 -08- a'a
15. Remarks:
Form No.
GWS-32
10/2016
PUMP INSTALLATION AND PRODUCTION EQUIPMENT TEST REPORT
State of Colorado, Office of the State Engineer
1313 Sherman St., Room 821, Denver, CO 80203 303.866.3581
dwr.colorado.gov and dwrpermitsonline®state.co.us
1. Well Permit Number: 322682 Receipt Number: 10012254
2. Owner's Well Designation:
3. Well Owner Name:Kerry Madole
4. Well Location Street Address:
5. GPS Well Location: OZone 12 (OZone 13
6. Legal Well Location: NW 1/4, SW 1/4,
Distances from Section Lines: ft.
Subdivision:
For Office Use Only
Easting: 551925 Northing: 4431735 County: Weld
Sec. 24 Twp. 1 I -I N or S 11, Range 63 jl E or W O
from O N or S fl sec. line, and ft. from O E or W O. sec. line
, Lot , Block , Filing (Unit)
7. Check Installation Type: []Initial Pump Installation []Replacement Pump ]Change in Depth Only []Repair
8. Pump Data: Type: Submersible
Pump Manufacturer: FPS
Design GPM: 10 at RPM 3450 HP1 Volts230 Full Load Amps13
Pump Intake Depth: 85 Feet, Drop/Column Pipe Size Inches, 1 Kind of Drop Pipe PVC
Additional Information for Pumps Greater Than 50 GPM: Turbine Driver Type: Electric O Engine ❑ Other
Design Head: feet Number of Stages: Shaft size: inches
9. Other Equipment:
Airline Installed:OYes itNo,
Flow Meter Mfg.
Meter Readout: OGallons, OThousand Gallons, MAcre feet
Date Installed(mm/dd/yyyy): 3- ( q L Z2
Pump Model No. 10FA1 S4
Orifice Depth ft.
Monitor Tube Installed:OYes [No, Depth ft.
Meter Serial No.
Beginning Reading:
10. Cistern Information: Material: Capacity: gallons Date Installed:
11. Production Equipment Test Data: n check box if data is submitted on Form Number GWS-39 Well Yield Test Report.
Date:
Total Well Depth: 110 ft. Time:
Static Level: 15 ft. Rate (gpm):
Date Measured: 3-17-za Pumping Level (ft):
12. Disinfection: Type: Chlorine
13. Notification: Was Advanced Notification Required Prior to Installation? F
14. Water Quality analysis available: OYes 0 No If yes, please submit with this report.
Yes
Amt. Used: 2 gallons
II
o, Date Notification Given:
16. I have read the statements made herein and know the contents thereof, and they are true to my knowledge. This
document is signed (or name entered if filing online) and certified in accordance with Rule 17.4 of the Water Well Construction
Rules, 2 CCR 402-2. The filing of a document that contains false statements is a violation of section 37-91-108(1)(e), C.R.S.,
and is punishable by fines up to $1,000 and/or revocation of the contracting license. If filing online, the State Engineer
considers the entry of the licensed contractor's name to be compliance with Rule 17.4.
Company Name:
Crandall Drilling Et Pump Service
Mailing Address:
Email:
crandalldrilling@gmail.com
Phone w/area code:
(303) 622-4820
License Number:
1229
Sign (or enter name if filing online)
.S 1 C'
PO BOX 357 Strasburg, CO 80136
Print Name and Title
Howard Crandall - Owner
Date:
Hello