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1200 Bracketts Point Road - PID: 11-117-23-32-0021
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Well Sealing Record
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Last modified
8/22/2023 3:30:02 PM
Creation date
1/25/2017 11:12:18 AM
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x Address Old
House Number
1200
Street Name
Bracketts Point
Street Type
Road
Address
1200 Bracketts Point Road
Document Type
Correspondence
PIN
1111723320021
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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: 16-14049 Twin City Water Clinic Inc. <br /> Sample Collection Date: 10/10/�5 617 13th Avenue South <br /> Address: 3841 North Main Street Sample Collection Time: 11:30 Hopkins, MN 55343 <br /> st.sonifacius,MN 55375 Sample Receipt Date: 10/11/16 Phone: (952)935-3556 <br /> Report Issue Date: lo/12j16 Fax: (952)935-5077 <br /> Laborator Analyte Client ID Parameter Sample Prep Sample Analysis Test <br /> Sample ID Date Time Date Time Results Units <br /> 16-14049 Coliform Drinking Water 10/11/16 1323 Absent <br /> 16-14049 Nitrete/N Drinking Water 10/11/16 12:43 <1.0 mg/L <br /> 16-14049 Arsenic Drinking Water 10/11/16 8:30 10/12/16 11:27 Q.0 µg/L <br /> Lead Drinking Water µg/L <br /> Nicrite/N Drinking Water mg/L <br /> D�inking Water <br /> Drinking Water <br /> Well No.: 823433 <br /> X No samples were subcontracted;or the above test result(s) <br /> with'**'designation were produced by a subcontracted Sample pt: Well <br /> laboratory. [Laboratory name;address;MDH Lab IDfi!]. The Well Adr: 1220 8racketes Point Road;Orono,MN <br /> subcontracted laboratory maintains MDH Certification for the Owner: Welch Forsman <br /> field�s)of testing performed. <br /> Owner Adr: <br /> Sample Conditions: Sample Temp: 15 °C <br /> Discussion: <br /> Notes: <br /> Approved methods used in analyzing the samples listed Maximum contaminant levels: <br /> above have the following reporting levels: Coliform-<1 cfu/100 ml <br /> SM92228-Coliform,1 cfu/100 ml Nitrate Nitrogen 10.0 mg/IL <br /> SM4500F or EPA 353.2-Nitrate Nitrogen,1.0 mg/L Arsenic,10.0 µg/L <br /> SM31136-Arsenic,2.0µg/I,Lead,2.0 µg/L Lead,15.0µg/L <br /> EPA 353.2-Nitrite Nitrogen, 1.0 mg/L Nitrite,1 mg/L <br /> ''V r,�,;?��'/� L�,.l-��_�.l.c,.3G��-f <br /> Sample Collected by: X Client _TCWC Approved By: 1; ��; - <br /> Bill Van Arsdale Alan Senechal <br /> Laboratory Manager SeniorAnalyst <br /> The results listed in this report apply only to the above listed samples.All routine quality assurance 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 2.0 Page 1 of 1 <br />
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