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51 A I t UF I�1 NNESD TA I�RAIt Tl'!�N T OF HEAL�H <br /> ABANDOI�D MELL RECORD <br /> uTION Of wEll � M(I��Ei el�nt NiQnot knam)N0. ��� �� <br /> � <br /> nty Na�e Henne in � � <br /> msMp M�w� TownsAtp Nu�b�r Rangt Nu�Der S�ctlon No. Fraction �. YELL OEPTN (co�pl�t�d) Oat� st�l�d <br /> N E 4 ti of 4 /// <br /> rono 117 sr 23 Mr 2� SE SE NW 3 p�� ft. ���' � ��� <br /> rNt�l Strpt Addnss �nd C1ty af Y�11 Loutlo D1tt�nc� fro� Road 5. Il !N6 METH00 (1f kno►e) <br /> Intersectton 1�Cab1• tool �p�wrs� 7(�DNven 1��1� 5 �'�� <br /> 65 Carman Road Orono, Mn. � �D���«�� SCI�+r ep e�na ��p <br /> i� exact locatton oi r�ll <br /> aQ aoa�y 6Q�.cue eQ vowr �uy�� <br /> (tn s�ctlo� grtd rlth •X•) Sk�tch qp of w�ll laatlo� 6. OBSTRUCTIONS <br /> N iNll oestruet�Q�Y s No <br /> _ ► . : ._ _. Obstructio�i n�owd Y�s ❑No If obttructlons canrat b� <br /> . . • � • ��LI� ruoved. conUct NOM <br /> , , ' .I- - E d s�:..�,�9. <br /> - • - - • �,, <br /> : � : ; T C�rm � �� �. 5E <br /> 4 " �no..:etc Q noeturtny ep H.ac �oop <br /> ; y.i. 1 <br /> ..._ . ._:.. _.; . ..:._ I . <br /> 2Q IrN9attoa �Publit � [ndustry <br /> �'�„t�►I �T�st Wit 6p��c��.� iap co�..c�.i <br /> r 1 SL�—r 7(�Mr Co�dltioeing 11��,�.��_ <br /> 'ROVERTY OMNER'S NAIE Ma111nq Address if dtfferont thsn 8. SIN6(S) <br /> proptrty �ddnst indtuted �bov� �81�ck �Thrndtd 7[] <br /> irnet Realt �� <br /> _nda Ber an 1501 West 80th Street �O���• eO wia.a <br /> � Bloomi ton Mn. 55431 �►�+•t+� 6[1 sa��i.:: su.� <br /> MAliONESS OF �,�. �, 316 ,t. <br /> FORM11ifON LOG COION FON1NilON FBOM TO <br /> If not known. indlc�u Iar�tlon loq fro� nN�wll or n��rEy well. tn. to ft. <br /> 'ift 0 320' 9'�s�..�w r.ii r,�. 316rc. c, 320 rc. <br /> � (I f known) <br /> ❑OpM Nol� fro�_ft. to_ ft. <br /> 10. STATIC TER LEYE <br /> tt. btiw �Dow q <br /> lanA�a �D�c� N�uund 1 1 <br /> 11. NELLMEAD COIitETION <br /> 1�P1tl�ss Adapt�r �found luriW <br /> 2�]BasMent olfs�t 50 <br /> �Meil P1t <br /> REMARKS. ELEVATION, SOURCE OF DATA - USINGS RE1qYED. GSINCS PERFORATEC, ETC. <br /> 12. �TIN6 lNFONIMTIOIf <br /> IN�t C�nt 2�B�aLOMq � <br /> Jrout 4" Well Approx. 320' Deep 6rout �at��,�� r►n.k�ko� ft. cu. yda <br /> 28 Bags Cement <br /> 30 Lbs. Bentonite — — <br /> 2 Mer, Lab�r, Rig and Cement Graui. rump 1�. "ua�sfNou�ces o� ca►ru,e�n�e�,� crv. <br /> � wn ats��r.ee.a e.ror. :.,i��yt p r.s <br /> I�. VUIi Ra�orW �Not Pnunt <br /> Typ�:�Su0�n/pt� �]L.S. TurAin� �R�ciprocating <br /> 20,l�t �C�ntHfuq�l 6[] <br /> IS. EXISTING YELLS (Yl��s� sk�teA lx�ttorn af apandon�d and <br /> �ct1r� r�lt• in rwrks t 1on r on back.) <br /> OtA�r unused MI1(�) oe prop�rty7 �Y�f No <br /> AGndon�d: �i�rs�ntnt �Taporary � t �l�d <br /> 17. WTER WELL CONTRACTORS CERTIFIGTION <br /> TAts well ws sul�d und�r ry �urisdlctlon and tMs report <br /> is trw to tM O�tt of ry knorl�dy� anA D�Ittf. <br /> N STODOLA WEL.L DRILLING CO. , INC. <br /> L1c�nsee Buftinss Nue L1c�ns� No�71�2 <br /> Addnss 45 <br /> s�9�• ac. 9-21-90 <br /> Mark �trvjnl a o�u <br /> iFICiAI ABAlIpONEO WELL RECORD (!4y b� us�d for irop�rty Tr�nsh�) N� of ON lltr <br /> INPCYti'dU2's dl7d MZTH D�D <br />