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m <br />STAIE OF MINNESO"M OEPARiMENT OF1IEALIH <br />�TT�iSi'RF <br />-------- MINNESHE'LL SO <br />.wnty Sam WATER 07A VNIQUE WELL RECORD y.. H'af.r .Sa.r/fe �T' �• 8iJ <br />s flow- fr Sftmft I36A of DIN <br />'conshlp Namr _-�--- Townahlp N.mbrr k.nar tiumben Srrt+orl No f"r.cl+un a WELL (N:ITH tcumplrtrd, - --J <br />Oa!r d Cm+ etr:n <br />OVMD 11Tlt� 23W 2 sw M. 165 5-9-Q9 <br />Ihaa.reand ihrro,on trim Reud Intrrwplo-e, Gfi r`r'! A-ddrr. n f Uryd R'ell laaatn - - S URII.LINti METNOU 11Q1 WM Fam dale �t � 10 C.bk tool 13 Rnerae 70 mfn in too Oua <br />! kcat+un d w,dk II I_11M "n Skclrh may .,41 Ionat.,_. 20 Ildlow red 50 Air Im Florid I10 . <br />I ' ' Addnlrrl Name 0 Rotary b0jrlud 90 Puwrr aug" <br />•-r' r -+ -L- --- <br />n DRILLING FLUID bentoaft <br />Block Numimpr <br />I • � I <br />W I E <br />a <br />I .0 Y <br />2 PROPERTY OWNER'S NAME `h'' <br />Address 13101 wort r <br />Mymta, Mgt 55391 <br />3 FIWAATION Lot; COWR <br />cuy bra= <br />S=d i drawl Imam <br />C3r� <br />Clfy i aaad <br />Clay i gsawl <br />Sod <br />r a In or/ ears �r wrrJnl <br />OAT A. n, <br />LOCAL COPY <br />10[lume+w tl]MunuunrlR Bp Most Pump <br />20Irnpllun 50Publ: 901fdumn <br />\ U <br />301'est Well 60 Munafpol I00Ca rnri—I <br />70 Air C.M,tlonlflR l 1p ___ _ _- <br />0 CASING <br />HEIGHT: Aboe. Belo. <br />HOLE OIAM <br />--i- <br />10 Hbck 413 Thrradrd <br />Surface — IL <br />.'0 1,.1, 50 Welded i <br />Ikfve Sher' Yea— No— <br />rl,Yy, ep <br />a p <br />h Weyht 1. �7 Ib., 11 <br />__ ___ fn. to __ t _ Ibr <br />IW e'dft 11 <br />m. 1. _, It Werht Ib►./it <br />_8 in. la''````Ylall <br />ten. l.t _.J <br />tento it. <br />A) NE&SO <br />FORMATION <br />FROST <br />TO <br />3 <br />•+ �(REEN Oropen hak <br />alcbmm IMIn It. to ---It <br />Makr ,t M 4. <br />I,w _.20 m U's-- <br />S4e (autr 1e11ttA_V--------- <br />a-- —— r1TTINts <br />3 <br />32 <br />- <br />32 <br />42 <br />M tx-twerp -_._ _ ft and _. 0 X y <br />iA <br />42 <br />135 <br />10 STATIL�ATER 1. <br />(I NU. ❑.h,, Itate Mrasurrd _. <br />land wrlur <br />135 <br />337 <br />I I Pt'MPNG Df1'E1. ibrkn land wins r, 2M <br />II alley __ __.__.. hre yumpna _____i_Y—Y - `pm <br />137 <br />165 <br />II stiff hn pumpry __-_.____S o m <br />I HEAD WELL COMPLETION <br />P111e>t adapter manufacturer._ . - nitdN --- __-- <br />:T) H.r I dlret 30 At kaat IY" above pound <br />J011a0u -.1114 p"AmIuw!_._ <br />L+ V4'ELI. i,ROUTED) <br />�YYPr. O No <br />IO,r,l lrmcnl YD Nrnionar :o -_--_.- -.-- <br />- - <br />�wya�y <br />Irnnil mat rr NJ __ from frump 0 10 .- It nr yde --- _ <br />11 NEAREST SOURCES OF POSSIBLE CONTAMINATION <br />-.-_ Irrt —_— dlfr.t+nn --type <br />Well dlunlreted upon compkl ton' *yea 0 No <br />I's P17AP <br />Dw -1,1 d 0 Not InfAsIW <br />Mmuf.O.— name •�� <br />M,drl num4r _-- ____________HP � Ydta9L__ <br />capnq 20 &VIM <br />Malrnal d dn•V 1nlr _ �- <br />tylr ISSulr,rr.�bk .10LS Turbine 50Reclpromtwd <br />T]Jn dCl lminfupl tip _ - <br />16 EXISTING WELLS <br />1 nosed well on popery' O Yes G <br />Abandnrd 0 P-nanenl 0 I r p,r 0 Not rakd <br />In WATER WELL CONTRACTOR.SCEFIMICATION <br />I hie well waa drilled unda m))umdwl.m and Ihie rcpal e. !rue 1u the br i ,d my <br />krowledp and brlrl <br />27 <br />Lreww /4araral .Wl.e Ixnor A, <br />-AulhunMd Repre"isime <br />Name d Dnlb <br />4487 ? 7174 <br />> e>.,Ilr <br />HE 011160't IRrv. 104M 7en"M <br />:rRe wi <br />