| Engineer | Form: (02)
2286695
01/19/2012 | 1)24 HOUR NOTICE TO MOVE ON LOCATION REQUIRED. E-MAIL: Shaun.Kellerby@state.co.us
2)APPROVAL OF THIS FORM DOES NOT AUTHORIZE INJECTION. AUTHORIZATION TO INJECT REQUIRES APPROVAL OF FORM 31 AND FORM 33.
3)BEFORE STIMULATING THE WELL, CAPTURE A WATER SAMPLE FROM BOTH THE CORCORAN AND COZZETTE FORMATIONS AND ANALYZE FOR TOTAL DISSOLVED SOLIDS. SUBMIT LAB ANALYSIS TO DENISE ONYSKIW AT DENISE.ONYSKIW@STATE.CO.US
4)THE PROPOSED SURFACE CASING IS MORE THAN 50' BELOW THE DEPTH OF THE DEEPEST WATER WELL WITHIN 1MILE OF THE SURFACE LOCATION WHEN CORRECTED FOR ELEVATION DIFFERENCES. THE DEEPEST WATER WELL WITHIN 1 MILE IS 260 FEET DEEP.
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