HomeMy WebLinkAboutWell ReportWELL CONSTRUCTION AND YIELD ESTIMATE REPORT
STATE OF COLORADO, OFFICE OF THE STATE ENGINEER
1313 Sherman St., Room 821, Denver, CO 80203 303.866.3581
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FOR OFFICE USE ONLY
1. WELL PERMIT NUMBER 80525-F Receipt #:: 9504187
2. Owner's Well Designation:
3. Well Owner Name: Alpen Badgett
4. Well Location Street Address: 0956 County Road 106 Carbondale, Co
5. GPS Well Location: Zone 12 X Zone 13 Fasting: 3 08 037 Northing: 43 65 293 County: Garfield
6. Legal Well Location: NE 1/4 SW 1/4 Sec: 28 Twp: 7 S Range: 88 W 6th P.M.
Distances from Section Lines ft. from Sec. line and ft. from Sec. line
Subdivision: Lot: Block: Filing (Unit):
7. Ground Surface Elevation: 6179 ft. Date Completed: 1/31/2017 Drilling Method Air Rotary
8. Completed Aquifer Name Alluvium Total Depth 70 feet Depth Completed: 70 feet
9. Notification: Was Notification Requird Prior to Construction? Yes X No Date Notification Given :
10. Aquifer Type: Type I (One Confining Layer) Type I (Multiple Confining Layers) Laramie-Fox Hills
P.M. Type II (Not overlain by Type III) Type II (Overlain by Type III) X Type III (alluvial/colluvial)
Geologic Log
12. Hole Diameter (in) From (ft) To (ft)
Depth Type Grain Size Color
9.0
0
50
6.5
50
70
000-050
Cobbles, Boulders
050-070
Cobbles, Sand, Gravel
13. Plain Casing
OD (in) Kind Wall Size From (ft) To (ft)
7.0 Steel 0.240 -1 50
5.5 Steel 0.188 40 50
Perforated Casing
5.5 Steel 0.188 50 70
Water Located: 50±
Remarks :
14. Filter Pack
Material :
Size :
Interval :
15. Packer Placement
Type :
Depth :
16. Grouting Record
Material Amount Density interval Placerneni
Cement 7 sks 6 gal/sk 10-30 poured
17. DISINFECTION : Type : HTH Amt. Used : 1.5 oz.
18. Well Yield Estimate Data: () Check box if Test Data is submitted on Form Number GWS-39, Yield Test Report
Well Yield Estimate Method : Air Compressor
Static Level : 46 ft.
Date/Time Measured 1/31/2017
Estimated Production Rate 15 gpm
Estimated Length (hrs) 2 Hours
Remarks:
9.1 have read the statements made Ii rain and know the contents tloereof. and Slum they are tete to my knowledge. This document is signed (or name entered if Ening online) and certified in accgidanee
ith 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 7 91 108(1)(e),C.R.S., and is punishable by fines
p to $1000 and/or rcvoetion 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.
:ompany Name : Shelton. Drilling Corp. Email: wsdi[ctxofnet Phone : (970) 927-4182 License Number 1095
,flailing Address : P.O. Box 1059 Basalt, Co. 81621
iign (or enter name if filing online)
Print Nme and Title
Wayne Shelton / President
Date
2/1/2017