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Well and Boring Construction Record
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Last modified
8/22/2023 5:27:23 PM
Creation date
10/3/2018 10:41:45 AM
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x Address Old
House Number
650
Street Name
Pinehurst
Street Type
Court
Address
650 Pinehurst Ct
Document Type
Land Use
PIN
0611723340006
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Minnesota State Laboratory ID#027-053-119 <br /> Twin City Water Clinic Laboratory Test Report Wisconsin State Laboratory ID#105-10117 <br /> Wisconsin DNR Lab ID#399073400 <br /> Client: Don Stodola Well Drilling Report Number: 18-07574 Twin City Water Clinic Inc. <br /> Sample Collection Date: 06/17/18 617 13th Avenue South <br /> Address: 3841 North Main Street Sample Collection Time: 14:00 Hopkins, MN 55343 <br /> St.Bonifacius,MN 55375 Sample Receipt Date: 06/18/18 Phone:(952)935-3556 <br /> Report Issue Date: 06/19/18 Fax:(952)935-5077 <br /> Laboratory :Analyte Client ID Parameter Sample Prep Sample Analysis Test <br /> Sample ID Date Time Date Time Results Units <br /> 18-07574 Coliform Drinking Water 06/18/18 13:03 Absent <br /> 18-07574 Nitrate/N Drinking Water 06/18/18 12:46 <1.0 mg/L <br /> 18-07574 Arsenic Drinking Water 06/18/18 8:00 06/19/18 12:02 <2.0 µg/L <br /> Lead Drinking Water µg/L <br /> Well No.: 827810 <br /> X No samples were subcontracted;or the above test result(s) Sample pt: well <br /> with**'designation were produced by a subcontracted <br /> laboratory. [Laboratory name;address;MDH Lab IDM. The Well Adr: 650 Pinehurst Court;Orono,MN <br /> subcontracted laboratory maintains MDH Certification for the Owner: Norton Homes <br /> field(s)of testing performed. <br /> Owner Adr: <br /> Sample Conditions: Sample Temp: 14'C <br /> Discussion: <br /> Notes: <br /> Approvedmethods usedin analyzing the samples listed above have <br /> the following reporting levels: Maximum contaminant levels: <br /> SM9222B Coliform,1 cfu/100 ml Coliform-<1 cfu/100 ml Nitrate <br /> EPA 353.2-Nitrate Nitrogen expressed as No3+NO2,1.0 mg/L Nitrogen 10.0.mg/L Arsenic,10.0 <br /> SM3113B-Arsenic,2.0 pg/I,Lead,2.0 µg/L µg,/L Lead,15.0µg/L <br /> EPA 353.2-Nitrite Nitrogen,1.0 mg/L Nitrite,1 mg/L <br /> Sample Collected by: X Client _TCWC Approved By: <br /> Bill Van Arsdale <br /> Laboratory Manager <br /> The results listed in this report apply only to the above listed samples.All routine quality:asurance procedures were followed,unless otherwise <br /> noted.This analytical report must be reported in its entirety.All methods are certified by the Minnesota Department of Health,unless otherwise <br /> noted. <br /> TCWD Rev 4.0 Page 1 of 1 <br />
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