Well & Boring - Laserfiche WebLink

Home Browse Search

• MINNESOTA UNIQUE WELL WELL C3R BOR11,0G LOCATION MINNESOTA DEPARTMENT OF HEALTH AND BORING NO. County7Va/be WELL AND BORING CONSTRUCTION RECORD 823469 Minnesota Statutes,Chapter 10.4I Townshiirl Township No. Range No. Section No. Fraction WELL/BORING DEPTH(completed) DATE WORK COMPLETED nano 117 23 10 NE Sg N4J'' 106 # 4-6-17 GPS LOCATION-decimal degrees(to four decimal places). DRILLING METHOD C � � Latitude Longitude ❑Cable Tool ❑Driven R❑Auger `'Rotary House Number,Street Name,City,and ZIP Code of Well Location f ❑Other / �� (� ) 1099 Willow Dc SA Or( f 55371 DRILLING FLUID WELL HYDROFRACTUREYek!X71 Nc�I 1 Show exact location o welVbonng in ction_gnTd_wi"th"X' Sketch map of well/boring location. bentonite From ft.To j� ft. Showing property lines, jr r-�� N n O roads,buil and di. tion. USE gsis Domestic ❑Monitoring ❑HOe r / obNrig ORONO `-. r ,....and . __;______:_____I __;__ 0 Noncommunity PWS ❑Environ.Bore Hole ❑Industry/Commercial �- ❑Community PWS ❑Irrigation ❑Remedial ❑Elevator 0 Dewatering w : ET. CASING MATERIAL Drive Shoe? ❑Yes }ry(No HOLE DIAM. --b F-- I ❑Steel ❑Threaded ❑Welded - ----_ 'k Mile f 6i[Plastic El1 CASING/- T s Diameter Weight Specifications — —1 Mile I 4 - in.To 9R ft. lbs./ft. ._in.To_50.ft. lla PROPERTY OWNER'S NAME/COMPANY NAME in.To ft. bs./ft. 1/4_in.Toft. Nate ung in.To ft. lbs./ft. in.To ft. OPEN HOLE Property owner's mailing address if different than well location address indicated above. SCREEN mameG, i }_)n--. - Make Johnson From ft. To ft. /� �._ . Type stainless steel Diam.2M 7L/ai jJ 71-= (�- `1, Slot/Gauze .010 Length 4t 4 t_! l/S l� Set between an ft.and 106 ft. FITTINGS L it} leader A..........-• 474}.......:-..1_4- fY1 N S-Y 6 STATIC WATER'LLEVEL Measured from L-`- 36 ft. Below ❑Above land surface Date measured 4-6-17 WELL OWNER'S NAME/COMPANY NAME PUMPING LEVEL(belwlland surface) 95 ft.after 2 hrs.pumping 50 q.p.m. Well/boring owner's mailing address if different than property owner's address indicated above. WELLHEAD COMPLETION XWhitewater �j yy Pitless/adapter manufacturer with ter Model ❑Casing protection 'i2 in.above grade ❑At-grade ❑Well House ❑Hand Pump GROUT INFORMATION(specify bentonite,cement-sand,neat-cement,concrete,cuttings,or other) Material bentonite From 0 To 50 ft. 3 ❑Yds. [Bags Material cut t Ings From_ 0 To 98 ft. ❑Yds. ❑Bags HARDNESS OF Material From To ft. ❑Yds. ❑Bags GEOLOGICAL MATERIALS COLOR FROM TO MATERIAL Driven casing seal From To Bags NEAREST KNOWN SOURCE OF CONTAMINATION topsoil black soft 0 a!_..► feet E... direction (-2.t5 4:�-......s--t)pe Well disinfected upon completion? 1'Yes ❑No sand/clay brown soft 2 15 PUMP ❑Not installed Date installed 9-8-17 clay gray medium 15 74 Manufacturer's name Schaefer sand/clay gray soft 74 92 Model Number HP 1 Volts 230 Length of drop pipe 63 ft. Capacity g.p.m. sand brown soft 92 110 Type:tgSubmersible ❑L.S.Turbine ❑Reciprocating ❑Jet ❑ ABANDONED WELLS Does property have any not in use and not sealed well(s)? ❑Yes lino VARIANCE Was a variance granted from the MDH for this well? ❑Yes I�'No TN# WELL CONTRACTOR CERTIFICATION J^ This well was drilled under my supervision and in accordance with Minnesota Rules,Chapter 4725. The information contained in this report is true to the best of my knowledge. Use a second sheet,it needed. REMARKS,ELEVATION,SOURCE OF DATA,etc. Don Stodola Well Drilling co,. Inc. 1691 Licensee Business Name Lic.or Reg.No. <7,- ter/ 11-17-17 ifie R se»YJSSign.u= - Certified Rep.No. Date LOCAL COPY 823469. Name of Driller Rob stodola ID#52603 HE-01205-15(Rev.8/13)