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Home My WebLink Aboutwell info � r - , � MINNESOTA UNIQUE WELL WELUBORING LOCATION MINNESOTA DEPARTMENT OF HEALTH AND BORING NO. : co��tY Name WELL AND BORING RECORD 7 3 917 4 � �n Minnesota Statutes,Chapter 103I Township Name Township No. Range No. Section No. Fraction WELUBORING DEPTH(completed) DATE WORK COMPLETED � Orono 127 23 10 ��a ��a ��a 295 n 9-6-46 GPS DRILLING METHOD LOCATION: Latitude degrees minutes seconds ._ i Cable Tool Driven I7 Dug Longitude degrees minutes__ seconds _�Auger �otary ❑Jetted House Number,Street Name,City,and Zip Code of Well Location or Fire Number �� C AV� Or�no 55323 DRILLING FLUID � WELL HYDROFRACTURED? f.!Yes -. .o Show exact location of well/boring in section gr' with"X." Sketch map of well location. �t�t� � Showing properry lines, From tt.To ft. � USE . omestic ❑Monitoring �f'Heating/Cooling N roads,buildings, - �� and direction. i '�Noncommunity PWS !l�Environ.Bore Hole i I Industry/Commercial ��:� --'--- --'-----`-- ' ' WS I � f --- -- � � .Communiry P 17 rriga ion � �.Remedial � I I Elevator _!Dewatering _I --'--- --'-----�--- ---'-- CASING M�A/T�ERIAL Drive Shoe? es I �No HOLE DIAM. W E T �� ip�teel �KThreaded ._�Welded I '�7 Plastic : , ; ' '/z Mile � ". , ; j ; j � � CASING �� --�--- --'-----�— --•_ s Diameter Weight Specifications S qt Q �1 Mile� '�y�J,� � ,`� � in,to_Z�_. ry. li _ Ibs./ft. �� `�' in.to_ �ft. � �j __in.to____._ft. _._. Ibs./ft. �__in.to_�!�ft. 4:� PROPERTY OWNER'S NAME/COMPANY NAME )p ry�C in.to ft. Ibs./ft. __, _�7L47in.to�ft. ` �(.`[�pC1 11{3(1[1,LE SCREEN OPEN HO+L}E ? Property owner's mailing address if different than well location address indicated above. Make From `� ft.To —I I ft. Type Diam. SlotlGauze Length Set between ft.and - fl. FITTINGS STAT}I,C�WATER LEVEL �+ __ft.�Below I 1 Above land surface Date measured � " "" PUMPING LEVEL(below land surface) WELUBORING OWNER'S NAME/COMPANY NAME [ _. ��! ft.after_� hrs.pumping_� g.p.m. �L HEAD COMPLETION � -- Well/boring owner's mailing address if different than property owner's address indicated above. itless Adapier Manufacturer ��del �. i Casing Protection . �12 in.above grade �_At-grade(Environmental Well and Boring ONLY) GROUTING INFORMATION�,( . Well grouted? �l'Yes -No Grout materials I I Neat cement�entonit�f,,;Concrete ��.--�..O�r �� From To `�j ft. '. �Ytd's. I I Bags From�To�ft. �� I��cfF� ��. �Bags GEOLOGICAL MATERIALS COLOR HARDNESS OF FROM TO From To ft. I �.Yds. '�. '�Bags MATERIAL NEAREST KNOWN SOURCE OF CONTAMINATION tO �s� Ll�y �t� Q L •J feet � direction`�-"y"'� ��'�``"'�"r't4'�72' , 1 Ul Il 1 � Well disinfected upon completion? I�Yes l_l No _1_�,,,�� a t e� PUMP "�'� v�� `�� G�''.Not installed Date installed " +� G� C�$ � r� �ct �� n Manufacturer's name a G �� Model Number HP /�� Volts �1 �Qft 2,7V 27 Length of drop pipe /O� ft. Capacity_ _ g.p.m. Type:� ubmersible i,LS.Turbine �"-!Reciprocating !_'��Jet ❑ - fi $ll��e b� .�tt 276 � ABANDONED WELLS Does property have any not in use and not sealed well(s)7 , �es ,�lo � � L�{� ZgU 'l(�S VARIANCE Was a variance granted from the MDH for this well? _!Yes '�Mf(Vo 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. i Use a second sheet,if needed. 7�� c T - REMARKS,ELEVATION,SOURCE OF DATA,etc. 1�i711 �7co�oia �ei� �c�.�i� co�� 1�. 169! � ---- — --— ' � �Sj nn �f�L_AAL Licensee Business N me �Lic.or Reg.No. � � i..a !. {T60V : _.�-�""'^e � t ' f �y /(�-V�L.� .'-. iori ed epresentative Sig re Date �il{ll:lt t'�� LOCAL COPY 7 3 917 4 Name of Driller r HE-01205-09(Rev.9/05) IC 140-0020 , � � r .> .� � . .. ' C i�' 1NG�PJv' C � � � ��• rw� y 617 13th Ave So Hopkins, Minnesota 55343 - (612) 935 - 3556 09/08/2006 Stodola Well Drilfing 3841 Novth Main St. Boni fucius MN 55375 938-21 1 1 R PORT OF WATER ANALYSIS Lab #: 592BN Our Laboratary reports these analytical resalts, derermined on a sample taken by CLlFNT on 09/06/2006 from the fbllowing locarion: Michael Maddie 2170 Prospect Ave. Orono,Mn Weil #739174 Coliform Bacieria � <1/)00 ml Nitrates Nitrogen ' <1.0 mg/! The results of these tests inditate rhat rhis we!!is producing water that meets rhe standards for F.H.A., V.A., or conventi�»al loans. This repori is an analysis for coliform an� nitrare only and does not irtc!ude analysis of Lead and othsr conraminants. (Unless as spe ified by client). �T►�in City Water Clinic, Inc. �,\�� ,,1,\\\� 8iN � , �� dale � Lnb Ccrtification i!027-053-119 �. , . ' WELL OR BORING LOCATON MINNESOTA DEPARTMENT OF HEALTH Minnesota Well and Boring '„I '''}�'►'� � County Name WELL AND BORING SEALING RECORD MinnlesoNa Unique Well No. - " ` " ' Minnesota Statutes,Chapter 1031 or W-series No. (Lenva dank�I nd kriwn) Township Na e Township No. Range No. Section No. Fradion(sm�Ig) Date Sealed Date Well or Boring Constructed ; Oroncs 117 23 10 3�-0018''' c . GPS Lati��de degrees minutes seconds LOCATION: Depth Before Sealing ��,,,�� R. Original Depth ft. Longitude degrees minutes seconds ppUIFER(S) STATiC WATER LEVEL Numerical Street Address or Fire Number and Ciry of Well or Boring Location ingle Aquifer ❑Muldaqu'rfer 21/0 �.��.'t A�i VLV�ev SG3�3 ELUBORING �vleasured ❑Estimated ' Water Supply Well ❑Monit.Well � Show exact location of well or boring Sketch map of well or boring � in section grid with"X" location,showing property ❑Env.Bore Hole ❑Other .�_ft. �below ❑above land surface N lines,roads,and buildings. CASiNG TYPE(S) - - - - - -- -i-- •--------'"""� Steel ❑Plastic ❑Tile ❑Other W --�- -'r- -i-- --i-- E WELLHEADCOMPLE710N , � \� T ti 11 1 � cY� Outside: ❑Well House Inside: �iasement Offset -Y- -- - -;-- -i-- �� 1�� ❑Pitless Adapter/Unit ❑Well Pit --�- -�-- -�-- --i-- I 1 ❑Well Pft ❑Buried S ��"^�"-� _ ❑Buried � PROPERTY OWNER'S NAME/COMPANY NAME CASING(S) Diameter � Depth � Set in oversize hole? Annular space initially grouted? Property owner's mailing address it different than weil location address indicated above '�jE � �/ �� in.from �' to L1L_ft. ❑Yes �No ❑Yes ❑No ❑Unknown in.f�om t0 ft. ❑Yes ❑No ❑Yes ❑No ❑Unknown in.from t0 ft. ❑Yes ❑No ❑Yes ❑No ❑Unknawn � WELLOWNER'S NAME/COMPANY NAME SCREEWOPEN HOLE � � Well owner's mailing address it ditterent than properry owners address indicated above Screen from�.�.�_t0��ft. Open Hole from t0 ft. OBSTRUCTIONS ❑ Rods/Drop Pipe ❑Check Valve(s) ❑ Debris ❑ Fill �(1�10 Obstruction Type of Obstructions(Describe) GEOLOGICAL MATERIAL COLOR HARDNESS OR FROM TO Obstructions removed? ❑Yes ❑ No Describe FORMATION If not known,indicate estimated formation log from nearby well or boring PUMP Type '-' '1 � �— ❑ Removed Not Present ❑Other ; METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS,OR CASING AND BORE HOLE: No Annular Space Exists ❑ Annular space grouted with tremie pipe ❑ Casing Perforation/Removal in.from to ft. ❑ Perforated ❑ Removed in.from to ft. ❑ Perforated ❑ Removed Type of perforator ❑ Other GROUTING MATERIAL(S) (One bag of cement=94 Iqs.,one bag of bentonite=SO lbs.) Grouting Material�f � `f��from��to�.�Jft. yards � bags from to ft. yards bags from to ft. yards bags OTHER WELLS AND BORINGS REMARKS,SOURCE OF DATA,DIFFICULTIES IN SEAUNG Other unsealed and unused well or boring on property? ❑ Yes No How many? i LICENSED OR REGISTERED CONTRACTOR CERTIFICATION This well or boring was sealed in accordance with Minnesota Rules,Chapter 4725.The intormation contained in this report is true to the best of my knowledge. Ik� Sto�vla Well Dcillir� Co,. Inc. I692 Contrac[or Business Name i License or Registration No. ..:,�� CJ f� i entatrv Sign re Date LOCALCOPY H 17�? � _� -� Name ol Person Sealing Well or Boring