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STATE OF MINNESOTA DEPARTMENT OF HEAL.TH <br /> , r;—., � ABANDONED NE11 RECORD <br /> i. �oc�tto� oF �e�� MINNESOTA UNIQUE WELL N0. <br /> (itav� Dlank 1f not known) <br /> co��cr h,�. Hennepin <br /> TownshiD N+n� Township Nunber Itange Nu�Ger Stctton No. Fractton �. 11ELL DEPTH (capl�t�d) O�tt s��l�d <br /> N E ti 4 ot y <br /> Or'oTlo 1 17 5� 23 M� 17 5�,� � N� � � tt. � � G+ °�� <br /> Numertcal Street Addnss and City of Y�11 Locatton or Dist�nc� trow Ro�d 5. I LIN6 METH00 (1f knawn) <br /> Intersection Cabl• tool 1�R�v�rs� 7�]Dr1v�n la]Dug <br /> 3525 Lyric Avenue Wayzata, Mn. 55391 zp ii,,, aoa 5[]A1r ep a��.a i�p <br /> 30 Rotary 60 J�tt�d �]Power Auytr <br /> Show exact location o1 wll <br /> (in section grtd rlth 'X') Sk�tch eap of wil lot�tlon 6. OBSTRUCTIONS <br /> N t wl l obstroct•a p��tw <br /> _ � . _ �_ _` l���� ' G ���+ Obstructlonf n�ov�d res �ho It oDstructloes cannot b� <br /> , • � , rnwwd, conUtt MOH <br /> ' �, <br /> � ' ' �— t-�„ �JeII �.s.,�,�9. <br /> ' -I- - E <br /> ' y _ . . <br /> , , , T �. S <br /> - . .- - y.:. ,�„�1e�I �oo..sc�� �MonitoNny e❑�..c �oop <br /> _ <br /> � , . , � 2[]Irrlg�tion 50 Pub)ic 9Q Industry <br /> ..�_ . ._�.. _.�-. _.. <br /> 3[]T�st Wil fi�Munlclpal 1CQ Coe�ercl�1 <br /> �_1 SL__� 7[]Air Gondlttonfny 13(] <br /> 2. PROVERTY OWNER'S NAME Matling Address 1f dliferent Yhaa S. CASIiiGiS) <br /> property addnss indicated abov� 1(]Bl�ck �Threaded JC1 <br /> `I'1IT1 �2ci1S S� �Wlv. 501N1d�d <br /> • ap vi.sc�o �sat�i�:: sce.� <br /> HARONESS OF � 1n, to 8� ft. <br /> 3. FONMIITION LOG COLOR FORMIITION fROM TO <br /> If not known. lndicate fonutlon log frow n�w wll or ntarhy wll. tn, to ft. <br /> Drift p 84� 9. SCREEN <br /> �Scr�enW w�ll f►o��ft. to��ft. <br /> (If known) <br /> �Open Iblt frwi_ft. to__ ft. <br /> 10. STATI YAiER LEYE� <br /> �_ft. Wlor �abo�� � <br /> land su ac� Datt 14�sured� <br /> 11. YEILHEAO CONVLET20N <br /> 1�P1tl�es Ad�pter �iaund Bur1�d <br /> 2(]B�s�nrnt ofls�t '�] <br /> �wit vtc <br /> 16. REMARKS, ELEYATTON. SOURCE Of DATA - LASIN6S RElqVEU. CASIM6S PERFORATED, ETC. <br /> 12. G�TING INFOIUNTION <br /> Grout 2" Well 84' Deep ""` `"'"` ��`"`°""' '� <br /> 2 �dgS CF1TlEnt 6rout iwt�Hal frw 1to U ft. cu. yds <br /> 4 Lbs. Bentonite — — <br /> 2 Men, L,abor, Rig and Celrtient Grout Puntp 13. NEAREST SOURCES Of COKTAMINATION <br /> _ teet dinctlon ___+, type <br /> IM11 disinf�ct�d b�fon su11�q7 �Yes <br /> 14. PUMP �RNovW �Noc Pns�nt <br /> Typ�: lQ Sub�nibt• �L.S. Turbin� �R�clproc+tiny <br /> 2[]d�t �Cantrlfugal E� <br /> r — <br /> 15. EXISTING MElLS (Vl�as� sk�tch toutlons of �bandonW �nd <br /> acttv� �wils in n�arkt i�c o o� on back.) <br /> � Otn�r unus 11(s) an prop�rtyt �Y�s No <br /> AWndon�d:�P�ryn�nt �T�porary �No��l�d <br /> 17. MATER 11ELL CONTRACTOIIS CERTIFICATION <br /> Thts rKil w�s seal�d und�r sy �urisdlction and thls nport <br /> is tru� to CM best of my tnowl�dge and belSef. <br /> ;;U'�; 1 r ' � DON STODOLA WELL DRILLING CO. , INC. <br /> Licen:�e Busin�ss Naw Licenst No.2']�72 <br /> �aa�.:(: �'• m?nne o a, . 345 <br /> S1yn�d` _i-'.�_�_ �' �Oat� — — <br /> Mark�G�Stodola au 6-4-92 <br /> FFICIAL ABANOONEO 1IELL RECORO (!4y b� u��0 for irop�rty Transt�r) N�� oi Dr111�r <br /> 71�GRTa/ir lIIB �IITH DEED <br />