Free Microsoft Word - 07Exempt info.DOC - Colorado

Form No. GWS-7 6/2009

EXEMPT PERMIT INFORMATION SHEET STATE OF COLORADO OFFICE OF THE STATE ENGINEER 821 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203 (303) 866-3581 Fax (303) 866-3589 INFORMATION FOR WELL PERMITS APPROVED PURSUANT TO CRS 37-92-602 (HOUSEHOLD, DOMESTIC, LIVESTOCK AND EXEMPT COMMERCIAL USES)

Carefully read the conditions of approval on your well permit. The conditions and the information on this information sheet must be complied with in order for the permit to remain valid. THE PERMIT EXPIRATION DATE IS TWO YEARS FROM THE DATE ISSUED. The well must be constructed and evidence of it's construction must be received by this office in the form of a Well Construction and Test report from the well construction contractor confirming that the well was constructed prior to expiration of the well permit. The well permit number is located in the upper right hand corner of the permit, and the expiration date is located in the lower right hand corner. The expiration date of the permit may be extended one year at a time at the discretion of the State Engineer for good cause shown. If an extension of time is necessary to construct the well, a written request for the extension of time must be received by this office prior to the expiration date of the well permit. In the request, you must provide the well permit number, your name and mailing address and the reasons why the well has not been constructed and approximately when it will be constructed. Water well construction and pump installation contractors are specifically licensed in Colorado to perform these specialized tasks. It is illegal for contractors who do not hold these licenses to construct wells and/or install pumping equipment in or on wells. The well must be constructed and the pump installed by contractors with current license(s) issued by the State of Colorado unless exempted as described on the reverse side. Please ask to see their license(s). Backhoe Operators and Licensed Plumbers may or may not hold the respective Well Construction and/or Pump Installation licenses. Please be aware of this when you contract to construct the well and install pumping equipment. The well construction report including a test of the well yield must be submitted to the office of the State Engineer within sixty (60) days of completion of the work or within seven days after expiration of the permit, whichever is earlier. The pump installation report including a pumping system test must be submitted within sixty (60) days of completion of the work. The contractor(s) must provide you with a copy of the work report(s) filed with the State Engineer. The Well Construction and Test Report, Form Number GWS-31 and the Pump Installation and Test Report, Form Number GWS-32 are available from the Division of Water Resources offices. Additional information regarding well construction, pump installation, required testing and well plugging and sealing regulations are found on the reverse side of this sheet. You have been provided with at least two copies of the well permit. Keep a copy for your records. There is also a copy for the pump installation contractor. Copies have been sent to the driller if you indicated a driller license number on the application, or two additional copies have been enclosed. You may make additional copies for the well construction contractor if you select one different from the one indicated in your application. The original permit is on file in the Denver office Records Section. Copies may be obtained for a fee of 50 cents per page. Statutes require that any change of mailing address or ownership be reported to the State Engineer. Form number GWS-11 is used both by new owners to report ownership changes and current owners to report address changes. If you have questions, contact the Denver Office, or the Division Office in the area where your well is located.
Division 1 th nd 810 9 St. 2 Floor Greeley, CO 80631 (970) 352-8712 Fax (970) 392-1816 Division 5 Direct mail to Box 396 Glenwood Spgs CO 81602 50633 U.S. Hwy 6 & 24 Glenwood Spgs., CO 81601 (970) 945-5665 Fax (970) 945-8741 Call first Division 2 310 E. Abriendo Ave Ste B Pueblo, CO 81004 (719) 542-3368 Fax (719) 544-0800 Division 6 Direct mail to Box 773450 505 Anglers Dr. Suite 101 Steamboat Spgs, CO 80477 (970) 879-0272 Fax (970) 879-1070 Division 3 301 Murphy Drive Alamosa, CO 81101 (719) 589-6683 Fax (719) 589-6685 Division 7 160 Rock Point Dr., Ste. E Durango, CO 81301 (970) 247-1845 Fax (970) 259-0944 Division 4 1871 East Main St. Montrose, CO 81401 (970) 249-6622 Fax (970) 249-8728 Denver Office 1313 Sherman St. Rm. 818 Denver, CO 80203 (303) 866-3581 Fax (303) 866-3589

WELL CONSTRUCTION AND PUMP INSTALLATION BY THE WELL OWNER You may construct the well and/or install the pump yourself if the well is for your own use, is on property you own, and is constructed or pumping equipment is installed with equipment owned and operated by you. It is your responsibility to complete and submit the Well Construction and Test Report, Form Number GWS-31 and/or the Pump Installation and Test Report, Form Number GWS-32. These forms are available from our offices. The well must be constructed and the pump installed in accordance with the well construction standards of the State Board of Examiners of Water Well Construction and Pump Installation Contractors. The Water Well Construction Rules are available from Division of Water Resources offices for a fee of $5.00. The Rules cover the minimum requirements for well construction, pump installation, disinfection, plugging and sealing and include contractor licensing regulations. If you are constructing your own well or installing pumping equipment, it is recommended that you obtain a copy of these Rules for reference. RULE 12 WELL TESTING

12.1 General - The provisions of this rule establish minimum standards for the testing of water wells. Every well constructed for the purpose of producing ground water shall be tested to determine: a. a stabilized yield for the well; and b. the production rate of the equipment installed when the well is placed into service. 12.2 Well Yield Test - The yield of a well shall be determined as a stabilized production rate where the withdrawal rate and the drawdown do not change by more than 10 % during the last hour of the test. The test shall demonstrate that either: a. the well is capable of producing the permitted pumping rate for the well; or b. that the maximum yield of the well is less than the permitted production rate. 12.3 Responsibility for Well Yield Test - Well construction contractors are responsible for performing the well yield test and submitting the test data to the State Engineer. If the construction contractor also installs the production equipment, the well yield test may be combined with the production equipment test, provided that the test meets the requirements of Rule 12.2. The construction contractor may forgo the well yield test if he can show that a licensed pump installer will perform the well yield test with the permanent production equipment within thirty (30) days of completion of construction of the well. If the pump installation contractor performs the well yield test, he/she shall submit the test information on the Pump Installation and Test Report. 12.4 Production Equipment Test - The production equipment installed in wells shall be tested to ensure it is functioning as designed. The test shall demonstrate the production capacity of the equipment as actually installed in the well. It is the responsibility of the person installing the pumping system to ensure that the production from the well complies with the conditions of the permit. 12.5 Responsibility for Production Equipment Test - Pump installation contractors are responsible for testing the production equipment installed in a well upon completion of their work. If the well construction contractor determined the well yield and submitted a report, the pump installer need not perform another well yield test. If the pump installer does not perform a well yield test with the permanent production equipment, he shall perform a production equipment test and report the data (results) to the State Engineer on the Pump Installation and Test Report. Wells to be plugged and sealed must be plugged in accordance with of the Water Well Construction Rules. A Well Abandonment Report, form number GWS-9 must be submitted to confirm plugging and sealing of the well. This form is available from our offices. The general Rule for plugging and sealing wells is printed below. The specific rules are found on the reverse side of the Well Abandonment Report form. RULE 16 STANDARDS FOR PLUGGING AND SEALING WELLS AND WELL EXCAVATIONS 16.1 General - The plugging, sealing and abandonment of all wells, monitoring and observation wells, monitoring and observation holes and test holes that are no longer intended for use, and the plugging, sealing, and abandonment of dry holes, collapsed or unusable boreholes, and other incomplete wells or excavations is necessary to prevent contamination of ground water and the migration of water through the borehole. It is the ultimate responsibility of the well owner to have an existing well properly plugged, sealed and abandoned. The well construction contractor or authorized individual is responsible for notifying the well owner in writing of these plugging requirements.