Loading...
HomeMy WebLinkAbout10.04 Well Permit 67588-FFORM NO. GWS.11 07/93 Best Copy Av t da::›ae STATE OF COLORAD, OFFICE OF THE STA1 _NG!NEER 816 Centennial Bldg., 1313 Sherman St, Denver, Colorado 80203 (303) 866.3531 PRIOR TO COMPLETING FORM, SEE INSTRUCTIONS ON REVERSE SIDE CHANGE IN OWNERSHIP/ADDRESS / LOCATION WEU. PERMIT, LIVESTOCK TANIC OR EROSION CONTROL AAM 1. NEW OWNER 11 NAME(S) �li...1 s:��l...0 5 L I_ L Mailing Address...... z? w�.:, z� t i t: u , I U C.j.0 City, St. Zip .krrl i 1 a.:i U.t?ri%...7.7.0..a`t.._._.._.................................__......, Phone ( ) 2. THIS CHANGE IS FOR ONE OF THE FOLLOWING: E WELL PERMIT NUMBER .....(.L?..7_5_ C, .,j - LIVESTOCK WATER TANK NUMBER„. ..... ..................... EROSION.CONTROL DAM NUMBER._.._...._ For Office Use ony RECElVEP FEB 0 3 2016 WATER RESOURCE STATE ENGINEER COLO• WELL LOCATION: COUNTY 12:11,(„1„:C.( -"I r (i OWNER'S WELL DESIGNATION (Addre ) (City) (State) MI4 f = 1/4 or the ii' i/4, Sec,....(.f ........ Twpw�� ❑ N, or ©S. Range. 9 Distances from Section Lines t;)-1 <I C.' Ft. from ❑ N. or ❑ S. Line, .L.) C Ft. from Eli!. or ❑ W. Line. Subdivision... Lot Block .. Filing (Unit), 4. LIVESTOCK TANK OR EROSION CONTROL DAM LOCATION: COUNTY 1/4, Sec, ._. .�..., Twp........ ❑ N..or 0 S., RangR......_.... ❑ E. or 0 W. P.M. 5. The above listed owner(s) say(s) that he (they) own the structure described herein. The existing record is being amended for the following reason(s): EChange in name of owner. • ❑ Change in mailing address. ElCorrection of location, 6. I (we) have read the statements made herein, know the contents thereof, and state that they are true 10 my (our) 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 misdemeano.] Name/ rtle (New Owner) Please type or print Brett T. Agee , President Bayou Well Services, LLC State Engineer Court Case No. Div. FOR OFFICE USE ONLY Co. Date Z6jtn 70 )4 ACCEPTED -AS A CHANGE OF OWNERSHIP ND/OR MAILING ADDRESS Z-3-/� Dais MD Use RF1 FR! r; FORM NO. GWS -31 04/2005 WELL CONSTRUCTION AND TEST REPORT STATE OF COLORADO, OFFICE OF THE STATE ENGINEER 1313 Sherman St., Room 818, Denver, CO 80203 Phone — Info (303) 866-3587 Main (303) 866-3581 Fax (303) 866-3589 http://www.water.state.co.us For Office Use Only DEC 2 4 200$ WATER RESOURCES STATEOOLO EENGINEER 1. WELL PERMIT NUMBER: 67588-F 2. WELL OWNER INFORMATION NAME OF WELL OWNER: Rocky Mountain Hotshot & Transportation MAILING ADDRESS: P 0 Drawer 790 CITY: Glenwood Springs STATE: CO ZIP CODE: 81602 TELEPHONE NUMBER: (970) 945-6456 3. WELL LOCATION AS DRILLED: SE1/4, NE1/4, Sec. 11, Twp. 6 IN N or /1 S, Range 93 • E or W DISTANCES FROM SEC. LINES: ft. from IN N or ■ S section line and ft. from • E or ■ W section line. SUBDIVISION: , LOT , BLOCK , FILING (UNIT) Owner's Well Designation: following Format be UTM, Optional GPS Location: GPS Unit must use the settings: must Units must NAD83, Unit be to true N, ■ Zone 12 1 Zone 13 Easting. be meters, Datum must be must set or STREET ADDRESS AT WELL LOCATION: 28730 Hwy 6 & 24, Rifle CO Northing: 4. GROUND SURFACE ELEVATION 5413 feet DRILLING METHOD mud rotary DATE COMPLETED 11/13/2008 TOTAL DEPTH 78 feet DEPTH COMPLETED 60 feet 5. GEOLOGIC LOG: 6. HOLE DIAM (in.) From (ft) To (ft) Depth Type Grain Size Color Water Loc. 10" 0' 27.5' 6 1/2" 27.5' 78' 0-2 clay fine brown 2 - 22 sand med tan/brn 22 - 62 rvr gravel cobbles assorted 30 - 62 7. PLAIN CASING: OD (in) Kind Wall Size (in) From (ft) To (ft) 7" steel .188 + 1' 27.5' 62 - 78 ss shale med yellow/tan 4 1/2" pvc sch 40 0' 20' PERFORATED CASING: Screen Slot Size (in): .020 4 1/2" pvc sch 40 20' 60' 8. FILTER PACK: Material wash rock 9. PACKER PLACEMENT: Type 7" cern bsk Size 3/8" Interval 18 - 60 10. GROUTING RECORD Material Amount Density cement 19 bqs 7 Depth 27' Interval Placement ql/bq 7-27.5 tremie Remarks: 60' - 78' drill cuttings, sand, native fill, 2 yds wash rock 11. DISINFECTION: Type 65% HTH tablets Amt. Used 6 oz 12. WELL TEST DATA: • Check box if Test Data is submitted on Form Number GWS 39 Supplemental Well Test. TESTING METHOD airlift & pump Static Level 30 ft. Date/Time measured: 11-13-08; 12:OOpm , Production Rate 13+ gpm. Pumping Level ft. Date/Time measured 11-13-08; 11:OOam , Test Length (hrs) 3 hrs . Remarks: 13. I have read the statements made herein and know the contents thereof, and they are true to my knowledge. This document is signed 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 $5000 and/or revocation of the contracting license.] Company Name: Himes Drilling Company, Inc Phone: (970)242-8893 License Number: 531 Mailing Address. 90 High a & 50, Grand Junction CO 81505 Signature: J Print Name and Title Tim Himes, General Manager Date 12/19/2008 a FORM No. GWS -32 02/2005 PUMP INSTALLATION AND TEST REPORT STATE OF COLORADO, OFFICE OF THE STATE ENGINEER 1313 Sherman St., Room 818, Denver, CO 80203 Info (303) 866-3587 Main (303)866-3581 Fax (303) 866-3589 http://www.water.state.co.us For Office use Only RECEIvEr DEC 2 4 2008 WATER RESOURCES STATE ENCg:NEER COL " 1. WELL PERMIT NUMBER: 67588-F 2. WELL OWNER INFORMATION NAME OF OWNER Rocky Mountain Hotshot & Transportation MAILING ADDRESS P 0 Drawer 790 CITY Glenwood Springs STATE CO ZIP CODE 81602 TELEPHONE # (970) 945-6546 3. WELL LOCATION AS DRILLED: SE1/4, NE1/4 Sec. 11, Twp. 6 section • N or line and 600 S, Range 93 IN E or 0 W DISTANCES SUBDIVISION: Optional GPS must be meters, STREET ADDRESS FROM SEC. LINES: 2140 ft. from I N or ■ S ft. from E or (UNIT) • W section line. LOT , BLOCK , FILING Location: GPS Unit must use the following settings: Datum must be NAD83, Unit must be set to true AT WELL LOCATION: 28730 Hwy 6 & 24, Rifle CO Format must Zone 12 be UTM, Units Easting: N, ■ or ■ Zone 13 Northing: 4. PUMP DATA: Type: variable submersible Date Installed: 11/13/2008 Pump Manufacturer: Design GPM: Pump Intake ADDITIONAL Goulds Pump Model No. 10GS 15 at RPM 3450 HP GREATER 1 Volts 230 Full Load Amps 4.2 Depth: 45 Feet, Drop/Column INFORMATION FOR PUMPS Pipe Size 1" Inches, THAN 50 GPM: Kind of Drop Pipe Turbine Driver Type: sch 80 pvc t&c • Electric ■ Engine ■ Other Shaft size Design Head feet Number of Stages inches 5. OTHER EQUIPMENT: Depth ft. Monitor Tube Installed Serial Airline Installed Flow Meter Mfg. Meter Readout: • Yes ►� No, Orifice Master 1" • No. Yes 0 No, Depth ft. Meter Gallons, Reading • Gallons, ■ Thousand • Acre feet Beginning 6. TEST DATA: is submitted (gpm): on Supplemental Form. 11/13/08 • check box if Test Data Date: 60 ft. Time: Total Well Depth: Static Level: 30.4 12:00 ft. Rate 15 Date Measured: 11/13/08 Pumping Level (ft): 40' 7. DISINFECTION: Type 65% HTH tablets Amt. Used 6 oz 8. Water Quality yes, please submit with this report. analysis available: 0 Yes • No If 9. Remarks: 10. I have read the statements made herein and know the contents thereof, and they are true to my knowledge. This document is signed 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 $5000 and/or revocation of the contracting license.] Company Name: Himes Drilling Company, Inc Phone: 970)242-8893 License Number: 531 Mailing Address: 2390 Highway 6 0, Grand action CO 81505 Signature: v d-- Print Name and Title Tim Himes, General Manager Date 12/19/2008 Form No. GWS -25 APPLICANT OFFICE OF THE STATE ENGINEER COLORADO DIVISION OF WATER RESOURCES 818 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203 (303) 866-3581 LIC WELL PERMIT NUMBER 67588 - F DIV. 5 WD 45 DES. BASIN MD ROCK MOUNTAIN HOTSHOT & TRANSPORTATION C/O BALCOMB & GREEN PC PO DRAWER 790 GLENWOOR SPRINGS, CO 81602- (970) 945-6546 PERMIT TO CONSTRUCT A WELL APPROVED WELL LOCATION GARFIELD COUNTY SE 1/4 NE 1/4 Section 11 Township 6 S Range 93 W Sixth P.M. DISTANCES FROM SECTION LINES 2140 Ft. from North 600 Ft. from East Section Line Section Line UTM COORDINATES (Meters,Zone:13,NAD83) 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) The denial, no. AD. -13248 , is reversed, and the permit is approved pursunat to CRS 37-90-137(2) on the condition that the well be operated in accordance with the Rifle Ski Corporation Augmentation Plan approved by the Division 5 Water Court in Case no 94CW03. If the well is not operated in accordance with the terms of the said decree, it will be subject to administration including orders to cease diverting water. The well is known as Regulski Well No. 1. 4) The use of ground water from this well is limited to commercial vehicle washing and the irrigation of not more than 1/2 acre of landscape in accordance with Case no. 94CW03, 5) The pumping rate of this well shall not exceed 20 GPM. 6) The average annual amount of ground water to be appropriated shall not exceed 11.05 acre-feet. 7) 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. 8) 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. 9) 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. 10) This well shall be constructed not more than 200 feet from the location specified on this permit. NOTE: Expired permit no. 46040-F was previously issued for this well. NOTE: Unless a completed Well Completion Report (GWS -31) and Pump Installation and Test Report (GWS -32) is received by the Division of Water Resources before the expiration date shown below, this permit will expire on the expiration date. An extension of the expiration date may be available. Contact DWR for additional information or refer to the extension request form (GWS -64) available at: http://www.water.state.co.us/pubs/forms/gws-64.pdf.-'t/ APPROVED MJV Receipt No. 3632094 State Eng.j DATE ISSUED ' 10-08-2008 By TE 10-08-2009 COLORADO DIVISION OF WATER RESOURCES DEPARTMENT OF NATURAL RESOURCES 13,3 SHERMAN ST, RM 818, DENVER, CO 80203 phdne - info: (303) 866-3587 main: (303) 866-3581 fax: (303) 866-3589 http://www.water.state.co.us Office'Use Only Form GWS -45 (06/2006) RECEIVED IECEIVED AUG 0 6 2008 T 0 2 2008 WATER RESOURCES �iATE88ESnI,BCEG STATE E C�bNEER . STATE ENGINEER COW criko GENERAL PURPOSE Water 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 of applicant ROCKY MOUNTAIN HOTSHOT & TRANSPORTATION, ,INC. Attach a detailed description of uses applied for. ■Industrial 0 Other (describe): Vehicle washing, per • Municipal Decree in Case No. 94CW3 Irrigation ►Zi Commercial Mailing address c/o Balcomb & Green, P.C., P.O. Drawer 790 City Glenwood Springs State I Zip code CO I 81602 7. Well Data (proposed) Telephone # (970) 945-6546 E-mail (Optional) _ withdrawn ------- Maximum pumping rate I Annual amount to be 20, conditional gpm 11.05 acre-feet 2. Type Of Application (check applicable boxes) Total depth ' Aquifer 200 feet 1 Colorado River 0 Construct new well • Use existing well ■ Replace existing well 0 Change or increase use ■ Change source (aquifer) @ Reapplication (expired permit) • Other: 8. Land On Which Ground Water Will Be Used Legal Description (may be provided as an attachment): See attached Deed for descriptions of parcel. (If used for crop irrigation, attach a scaled map that shows irrigated area.) 3. Refer To (if applicable) Well permit # 046040-F (Expired) Water Court case # 94CW3 Designated Basin Determination # N/A Well name or # Regulski Well No. 1 4. Location Of Proposed Well County Garfield SE 1/4 of the NE 1/4 A. #Acres 13.69 B. Owner Applicant Section .11 Township N or S 6 ■ o Range E or W 93 ■ -' Principal Meridian 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 lines) 2140 Ft. from ►i N ■ $ 6600 _,'' Ft. from 0 E • W 9. Proposed Well Driller License #(optional): Fel-replacement wells only — distance and direction from old well to new well feet direction 10. Signature OfApplicant(s) Or Authorized Agent — - --------- — ------- The making of false statements herein constitutes perjury in the second degree, which is punishable as a class 1 misdemeanor pursuant to C.R.S. 24-4-104(4 )(a).,., have read the statements herein, know the contents + and state at the are true to my knowledge. gry ere(Mustbeor mal sig rature) i Date n Well location address (Include City, State, Zip) ■ Check if well address is same as in Item 1. 810 County Road 223 a/k/a 28730 Hwy. 6 & 24 Rifle, CO 81650 Rifle, CO 81650...a Optional: GPS well location information in UTM format You must check GPS unit for required settings as follows: i/ 8 - te na.y.`tie TIFFANY, D. WOOD, PRESIDENT Format must be UTM,Pn ❑ Zone 12 or ❑ Zone 13 iEasting Units must be Meters Datum must be NAD83 Northing Office Use Only USGS map name jI DWR map no. Surface elev. Unit must be set to true north Was GPS unit checked for above? III YES Remember to set Datum to NAD83 5. Parcel On Which Well Will Be Located (PLEASE ATTACH A CURRENT DEED FOR THE SUBJECT PARCEL) i.]i0 S" t.J D J1/46-- 1/45See ,(}c. _ UK Gp, — No { , `A,.- • K WE CWCB TOPO MYLAR SB5 Receipt area only f ittt l' tit.ii IN I.3U3LUy'I t1/u(LUU0 LAX) t' 'M roiaIda ,loiirlsan(14) .I Clint i an Atm *')Uu.Uu l.r1L..l.r. t.,11OCK IYUITIUFeI; 4,4L4 _....(,;fieCis.t tlluut1(1C1 UL U .._..._.._ ............._................................... ,.... L� �,vI7,�'O4? /j �l 1� " )rU/} DIV WD BA MD A. Legal Description (may be provided as an attachment): Seeattached Deed for description of parcel. B. # of acres in parcel @13.69 C. Owner ApplicantWR D. Will this be the only well on this parcel? r YES ■ NO (if no — list other wells) E. State Parcel ID# (optional): 217711100359 Building Company, Inc. October 1, 2008 Mr. Mark J. Vanarelli, PhD, PE, PG, BCEE Water Resources Engineer Division of. Water. Resources 1313 Sherman Street Suite 818 Denver, CO 80203 RE: Replacement Well Regulski Well No. 1 Application Receipt No. 3632094 Dear Mr. Vanarelli: CRECENZD OCT 0 2 2008 WATER RESOURCES C7 ATE ENGINEER COO Attacld with this letter is the returned Water Well Application referenced above, along with the600 Foot Well Spacing Statement. Also enclosed is a copy of the Surveyors drawing outlining the actual distance between Regulski Well No. 1 and Regulski Well No. 2 located on the adjacent property. The Statement is signed by the owner of the property, Richard Casey. As the General Contractor for Rocky Mountain Hotshot & Transportation, on behalf of the Owner, Tiffany Wood, I am resubmitting the application for final review and issuance of a Water Well Permit If there is any thing we have not provided to your satisfaction, please let me know so we can respond. Sincerely, ..r {, I Wni A. Oswald, Project Manager Alco Building Company, Inc. Cell Phone: 970-260-4116 E -Mail , ' oswald(a,alcobuildingcompanycom cc: Tiffany D Wood... 2526 Patterson Road Suite 101 1 Grand Junction, .CO 81505 TEL 970.242.1423 / FAX 970.242.6918 GWS -38 600 FOOT WELL SPACING STATEMENT I (we) Glir � �5� state as follows: 1. I (we) own real property described as .2c-5-75-- f-�'�. ,� �y in the 54c. 1/4 of the /1/Z 1/4, Section // , Township , Range 4 3 , P.M., Gai- 42`7&/I County, Colorado. We own the right and easement to the following well: Actual Actual Distance from Distance from Permit # 1/4 1/4 Sec. Twp. Rng. N/S Sec. Line E/W Sec. Line .5"/ V4 / Si &ZS 15 a 4o ft. / /$ ft. 2. I (we) have been apprised that , the present owners of a parcel of land in the '/. of the 1/4, Section Township , Range P.M., desire to drill a new well or extend the use of an existing well. I (we) also understand that the purpose of such well is set forth in the well permit application, and that I (we) have reviewed the application that was submitted to the State Engineer and receipted by him under receipt no. 3. The proposed location for the subject well will be 600 feet or less from my (our) well. 4. By this statement I (we) am (are) specifically waiving any objection to the issuance of a well permit for the subject well, as set forth in the referenced application, and would request that permit issuance not be postponed or denied because of any concerns by the Division or others that the proposed well will materially affect my (our) well or water right. I (we) am (are) also specifically waiving my (our) right I (we) may have to participate in a hearing before the State Engineer pursuant to Section 37-90-137(2), C.R.S. Dated this /7 day of , e2da 400 EIV 2 2008 WATER RESOURCES STATE. ENGINEER NO2°24'45"E N89°39'46"E OCT 0 2 2008 WATER RESOURCES STATE ENGINEER caw BUILDING 591.41' PROPOSED WELL EXISTING WELL ¶«8S, 96°00S Al „8S, 96°00N DEPARTMENT OF NATURAL RESOURCES 0 2 2008 IVIIiER RESOURCES STATE ENGINEER COLO DIVISION OF WATER RESOURCES August 20, 2008 Rocky Mountain Hotshot & Transportation Attn: Tiffany D. Wood, President 810 County Road 223 Rifle, Colorado 81650 Re: Replacement Well Regulski Well No. 1 Dear Ms. Wood: Bill Ritter, Jr. Governor Harris D. Sherman Executive Director Dick Wolfe, P.E. Director A preliminary review of application receipt no. 3632094 indicates that the following issue exists with your well application. It appears that your proposed well may be within 600 feet of one or more existing wells. The provisions of Colorado Revised Statute 37-90- 137(2) prohibit the issuance of a permit for a well to be located within 600 feet of any existing well, unless the State Engineer finds that circumstances so warrant after a hearing held in accordance with the procedural rules in 2CCR 402-5. This hearing may be waived if you are able to obtain statements from owners of all wells within 600 feet, verifying that they have no objection to your well being located within 600 feet of their wells. A sample waiver form is enclosed for your reference. If there are no existing wells within 600 feet of your proposed well, you may submit an affidavit verifying this information, after having conducted a field inspection of the area. A field inspection is required because it is possible that there are wells in existence that are not of record with the state, and these wells are included under the provisions of Colorado Revised Statute 37-90-137(2). A sample affidavit form is enclosed to complete if your field inspection verifies that there are no other wells, not owned by you, within 600 feet of your proposed well. If there are wells within 600 feet, and you are unable to obtain a waiver from the owners, you may request a hearing. A sample waiver is enclosed for your use, if necessary. You must identify the well(s) (permit number (if applicable), current owner's name and address) and confirm the approximate distance between the well(s) and the proposed well. Once this information is submitted, the required notice and hearing process will be initiated. The original permit application form should not be resubmitted until the notice and hearing process has been completed. PIs. return the enclosed document with any necessary corrections and/or additional information. The approval of your well permit application will be pursuant to your compliance with the above requirements. Thank you for your cooperation. Please be advised that the criteria mentioned in this letter must be addressed and received by this office within sixty (60) days of Office of the State Engineer 1313 Sherman Street, Suite 818 • Denver, CO 80203 • Phone: 303-866-3581 • Fax: 303-866-3589 www.water.state.co.us August 20, 2008 2 the date indicated above, to retain active status of the ground water well permit application. Information submitted after that date will require a new ground water well permit application and will be assessed the appropriate fee. If you have any questions, feel free to contact me at this office at (303) 866-3587 and reference the receipt number. Sincerely, Mark J. Vanar-�'i, PhD, PE, PG, BCEE Water Resources Engineer Enclosure(s) cc: file MV/mv