Well info - Laserfiche WebLink

Home Browse Search

MINNESOTA UNIQUE WELL WF�LL OR BORING LOCATION MINNESOTA D�PARTMENT OF HEALTH AND BORING NO. County Name � WELL AND BORING RECORD � 5 0�7 2 ��Pin Minnesota Statutes,Chapter 1031 Township Name Township No. Range No. Section No. Fraction WELUBORING DEPTH(completed) DATE WORK COMPLETED t)rono 117 23 08 ,, ,,, ,, 176 � 3-5-08 GPS DRILLING METHOD LOCATION: Latitude degrees _ minutes seconds Longitude degrees minutes seconds ❑Cable Tool ❑Driven ❑Dug -- ❑Auger ^�'Rotary ❑Jetted House Number,Street Name,City,and Zip Code of Well Location or Fire Number � / � I545 &yhns Point Rd, ��X1O 55391 DRILLING FLUID WELL HYDROFRACTURED? ❑Yes�No Show exact location of well/boring in section grid with"X" Sketch map of well/borin location. �ntQ�it� From ft.To ft. � Showing prop rry ines, : N roads,buildings,and di�\�\ ��n. USE �Domestic ❑Monitoring ❑Heating/Cooling ? j I I I I �^� , __,______,__. __�_.___,__ ( � ❑Noncommunity PWS ❑Environ.6ore Hole ❑IndustrylCommercial ` { + � _ [�Community PWS ❑Irrigation �Remedial �� ❑Elevator ❑Dewatering � ; w ; ' , `-- E T �� CASING MATERIAL Drive Shoe? ❑Yes ❑No HOLE DIAM. ' --�-----'--- ---�-- ---.-- ".r'� J � a I l �,� .) ❑Steel ❑Threaded ❑Welded � ; ; ; ; 'h Mile l�� PlastiC ❑ • X ', .� --�-----�--- '—�-- --•-- ..t �� i CASING � � S � � �'(� � Diameter Weight Specifications \ �1 Mile� � �m.to_�sn. _��_Ibs./ft. AetYn! ��n.to.��n. i � PROPERTY OWNER'S NAME/COMPANY NAME in.to ft. Ibs./fl. in.to ft. Ro'bert Craig No�es in.to ft. Ibs./flOPEN HOLE in.to ft. � Property owner's mailing address if different than well location address indicated above. SCREEN °FV� 2� St� Ste IOi Make J�j('�g��1 'From „ ff. To ft. � Type_�t��zni��n erl Diam. � ; Excelsior, NB�T 55331 SIoUGauze�nin _Length j Set between ft.and ft. FITTINGS ! STATIC WATER L te� Measured from 4J R.�Below I,]Above land surface Date measurec�+� � WELL OWNER'S NAME/COMPANY NAME PUMPING LEVEL(below land surface) � �.7� ft.after �S hrs.pumping �� g.p.m. Well/boring owner's mailing address if different than property owner's address indicated above. WELLHEAD COMPLETION -�.., �Pitless/adapter manufacturer �..? '�°'�-°��'�-�-�-+�.��'a-�-.�pAodel Casing Protection �12 in.above grade ❑At-grade(Environmental Well and Boring ONLY) GROUTING INFORMATION Well grouted ,�Yes ❑No Grout materials ❑Neat cement�Bentonite ❑Concrete ❑Other � From�To_�Q__ft. ?�_S ❑Yds. �]Bags HARDNESS OF From_�_To_I��j_fl.�.�,��(�s. ❑Bags GEOLOGICA�MATERIALS COLOR MATERIAL FROM TO - From 1 Sf To ds. Bags � NEAREST KNOWN SOURCE OF CONTAMINATION ��_�.., ��t�C� black �Qft � 16 < <"� feet '�-�� direction ..��.e .'J� -- — .�.�l��- tyPe Well disinfected upon completion? Yes ❑No �.�.,,. ��,..,��a.�- C�S CA .9OfC Z�j PUMP []Not installed Date installed +�-� � `J�-J sand fir� ra .91�f� � 1 $ Manufacturers name `'�-=-•�`�'" '�^� �" ) Model Number `�� HP �+: Volts <%"�� coarse sarxi r soft 1 8 j Length of drop pipe ``J � R. Capacity g.p.m. Type:?,�Submersible ❑LS.Turbine ❑Reciprocating ❑Jet ❑ � ABANDONED WELLS Does property have any not in use and not sealed well(s)? ❑Yes Q�No VARIANCE Was a variance granted from the MDH for this well? ❑Yes No TN# WELL CONTRACTOR CERTIFICATION 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,ifneeded. �,. �� ,�j'� �11 ]�iI1�L� ��• IT�• a division o REMARKS,ELEVATION,SOURCE OF DATA,etc. � ��Ola Weil Drilling Co,• 1�• I691 Licensee Business Name Lic.or Reg.No. ,- t.� c� �� , e rese ative Sig re Certified Rep.No. Date LOCALCOPY 7 5 0 6 7 2 Name of Driller � i�� IC 140-0020 HE-01205-10(Rev.6/O6) i