FORM 6.1
WATER USE DATA SUBMITTAL FORM (TOTALIZING FLOW METER)
To be Filed in Compliance with Rule 6 of the RULES GOVERNING THE MEASUREMENT OF GROUND WATER DIVERSIONS LOCATED
IN WATER DIVISION 3, THE RIO GRANDE BASIN.
To:
Division Engineer, Water Division No. 3
301 Murphy Drive
Alamosa, CO 81101
Telephone:
FAX:
(719) 589-6683
(719) 589-6685
CONTACT INFORMATION (*EMAIL IS REQUIRED FOR ON-LINE METER READING REPORTING):
USER (IF NOT SAME AS OWNER)
OWNER
Name:
Address:
City, State, Zip:
Phone:
*E-Mail:
TOTALIZING FLOW METER REPORTING INFORMATION:
(REQUIRED)
(REQUIRED)
Flow Meter
Serial Number
Date
Of Meter
Reading
(Sensor & Register If Applicable)
(mm/dd/yyyy)
(REQUIRED)
Actual Water Meter Reading
(Record ALL DIGITS)
*Additional Flow Meter Readings may be recorded on the back of this form. Examples of reporting are included on the
back of this form.
HAS THIS METER BEEN REMOVED OR REPLACED DURING THE PREVIOUS YEAR? IF SO, EXPLAIN THE CIRCUMSTANCE AND THE METER
READING BEFORE AND AFTER REMOVAL.
OWNER/USER CERTIFICATION AND CONSENT TO RELEASE POWER DATA:
The above information is true and correct to the best of my knowledge. For electrically powered wells/pumps, I agree to the release of information of
information pertaining to my use of electrical energy to pump ground water, including Current Transformer factor, Voltage/Potential transformer factor,
and electric meter readings to the Colorado Division of Water Resources by my electrical supplier (if applicable) for purposes of verifying water use from
the well.
SIGNATURE:
DATE: ________
CHECK ONE:
□ WELL OWNER □ WELL USER
Updated: 1/6/2017
FORM 6.1
WATER USE DATA SUBMITTAL FORM (TOTALIZING FLOW METER)
TOTALIZING FLOW METER REPORTING INFORMATION (CONTINUED):
(REQUIRED)
(REQUIRED)
Flow Meter
Serial Number
Date
Of Meter
Reading
(Sensor & Register If Applicable)
(mm/dd/yyyy)
(REQUIRED)
Actual Water Meter Reading
(Record ALL DIGITS)
Example Flow Meter Serial Numbers:
1) McCrometer (typical but not all inclusive): 06-12-5421 (year manufactured-size of flow meter-number)
2) SLV Hydromag: 01061411 / 01061434: the flow meter register (read-out) and sensor will have separate serial numbers. Record
both serial numbers, indicating if it is the Register or Sensor. Example: 01061411R / 01061434S (Register=R, Sensor=S).
Updated: 1/6/2017