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Home My WebLink Aboutwell info WELL LOCATION MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WELL NO. CountyName WELL AND BORING RECORD � 6 6 8 O 3 7 Hennepin Minnesota Statutes Chapter�031 Township Name Township No. Range No. Section No. Fraction WELL DEPTH(completed) Date Work Completed Orono 317 23 d4 ,, ,. ,. 115 tt 9-20-41'� House Number,Sireet Name,Ciry,and Zip Code of Well Location or Fire Number DRILLING METHOD Z 6�1 Rai nep Rd �r�Q� ❑ Cable Tool f] Driven CI Dug J ! ❑ Auger 6tl�otary �7 Jetted Show exact location of well in seclion pri wi ". Sketch map of well location. ❑ � � .. E Showing property lines, --------- --- �--- ----------_-- -------- S roads and buildings. DRILLING FLUID WELL HYDROFRACTURED? (.]YES O N � i i i �a t e r FROM ft.to_______ ft. -i- -i- -�- -� USE �] Monitoring ❑ Heating/Cooling � � i i �Domestic ❑ Communit PWS \ ❑ Irrigation Y ❑ Industry/Commercial -�- � -� i e ❑ NoncommunityPWS ❑ Remedial yy E ❑ Environ.Bore Hole i � � � ❑ Dewatering ❑ i i �r �r i � � CASING Drive Shoe? ❑ Yes .No HOLE DIAM. '2 e � _i � i _i_ I r;.�, � ❑ Steel ;7 Threaded ❑ Welded . i_ _ _ _i _ i � � J�rp�astic ❑ � S f �-1Mile� � f �� V CASING DIAMETER WEIGHT PROPERTY OWNER'S NAME �in.to I48 ft. �.�1. Ibs./ft. in.to 30 n. Patrick/I�irsten burton ��.+o h. IbsJft. in.��h. Property owner's mailing address if different than well location address indicated above. ___—__--in.to__._____ft. __.__ _Ibs./ft. _in.to ft. Ib417 L1�aer3ck Lsne SCREE _ OPENHOLE Aii�netonka, P4� 55345 Make �o�ga/�n f�om h.�o h. TyPe— —Q�St_--- ---Diam. - --- SIoUGauze �1 n Length $� _ Set between ___trtA ft.and ft. FITTINGS:_ i�T� 1Ty p-- STATIC W TE LEVEL Jl WELL OWNER'S NAME _—__��'______n.�elow ❑ above land surface Date measured ��Z�' 1 ; • PUMPING LEVEL(below land surface) +�/� : <; Well owner's mailing address if different than property owner's address indicated above. �O3 . ____h. after_____ 1�S__ hrs.pumping�71�+ _g.p.m. `� �L HEAD COMPLETION yhi t eva t�s �Pitless adapter manufacturer ______ Mod ._____________ .. ❑ Casing Protection__._._..____ _.,.___ _ ___ � 12 in.above grade :�� ❑ At-grade(Environmen[al Wells and Borings ONLY) GROUTING INFORMATION Well grouted? �Yes ❑ No HARDNESS OF Grout Material� ❑ Neat cement ❑ Bentonit ❑ Concrete High Solids Bentonite GEOLOGICAL MATERIALS COLOR MATERIAL FROM TO from___ � to �Q R � ❑ yds. ags from�Q_to_��ft. �$ f!'A 1 C€��ags Topsoil black sof t 0 3 from to n. o yds. ❑ bags j +� 8 NEARE ��y'yj N�SOURCE OF CONT MINAT�IQ�" — ,�---�.. ).1 C+B� g�$p $�� • J 7� V feet G �5 f direction� � �type Well disinfected upon completion? - ves ❑ No SSL�d CSEZ SOL t 30 1 i� PUMP � - ❑ Not installed Date installed _. �5["�16"V� Manufacturer's name Aer�o t o r Model number ____ _ HP ��j�lts `�� Length of drop pipe � ft. Capacity _ _ __ g.p.m. Type: f�Submersible ❑ L.S.Turbine ❑ Reciprocating C] Jet ❑ __ ABANDONED WELLS � ` Does property have any not in use and not sealed well(s)? ❑ Yes Lym�o r VARIANCE Was a variance granted from[he MDH for this well? i7 Yes No TN# WELL CONTRACTOR CERTIFICATION Use a second sheet.il needed This well was drilled under my supervision and in accordance with Minnesota Rules,Chapter 4725. � REMARKS,ELEVATION,SOURCE OF DATA,eta The information contained in this report is irue to the best of my knowledge. Dan Stod 1T2 Licensee Business Name �c.or Reg. o. _._..�w _ � ; �-'; I2-17-fl1 .� - Authorized Repres ` �ve Signature Date Chnck �Ioore 9-2€�-C}1 Name o/Driller Date LOCAL COPY 6 6 8 0 3 7 HE-01205-07(Rev.2/99) IC#140-0020 i� � rw � c�-y w�� c � � , r�,�. 617 13th Ave So � Hopkins, Minnesota 55343 � (612) 935 - 3556 09/24/2001 Siodola Well Drilling 3841 North Main St. 8oni facius MN 55375 938-21 1 1 REPORT OF WATER ANALYSIS �, Lab #: 1047 Our Laboratory reports these analytical results, determined on a sample caken by CLIENT on 09/20/2001 from the following locacion: Patrick Burton 2601 Rainey Rd Orono,Mn Unique Well #66803T Coliform Bacteria <1/100 ml Niirates Nirrogen <1.0 mg/1 The result-s of these tesrs indicate that ihis well is producing water that meers rhe srandards for F.H.A., V.A., or conven[ional loans. This report is an analysis for coliform and nitrate only and does not include analysis of Lead and other contaminants. (Unless as specified by client). ity Water Clinic, lnc. Bil �e � Lab Certification#027-053-119 f -� WELL LOCATION MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WELL NO. ,,�,��;�,e WELL AND BORING RECORD 6 6 H O 3 H �'riennepin `�innesota Statutes Chapter f031 Township Name Township No. Range No. Section No. Fraction WELL DEPTH(completed) Date Work Completed t?rono 117 �� Q� ,, �,, �,. 121 � 1�-20-01 House Number,Street Name,City,and Zip Code o(Well Location or Fire Number DRILLWG METHOD 2601 Raineq Rds Orono 55391 ❑ CableTool [_7 Driven ❑ Dug ❑ Auger �Rotary � ❑ Jetted Show exact location of well in section grid with"X". Sketch map of well loca5on. �1 __ _____________ — .____.- -- -- � Showing property lines, ' �� roads and buildings. DRILLING FLUID WELL HYDROFRACTURED? ❑YES ' O N ;::� t�,,_, (�:;, �uper gel-x _i i i �_ � FROM ft.to ft. i_ _i_ 'i_ 'i USE �/ ❑ MoNtoring ❑ Heating/Cooling i i i i �CDomestic ❑ Communit PWS _i_ _�_ _i_ _i_ �� E- Irrigation Y ❑ Industry/Commercial i i i i ❑ Noncommunity PWS ❑ Remedial w I I I i e T ./3< C Environ.Bore Hole ❑ Dewatering ❑ �Y '� i i i r +�ZIM1e Q CASING Drive Shoe7 ❑ Yes o HOLE DIAM. i � _i_ _i_ � ,,,❑��,,,,,,CCCSteel ❑ Threaded ❑ Welded ' ' � 1 t �lastic ❑ _ '� S �--1 Miie-� CASIN�DIAMETER 113 WEIGHT sdr �1 ! 7/4 � PROPERTY OWNER'S NAME in.to ft. Ibs./ft. '".�° � Patrick/Kirsten Bnrton ;�.to n. ,bs.,h. �;�.,o Property owner's mailing address if different than well location address indicated above. -___—_ in.to ft. Ibs./ft. in.to ft. 16�i17 L�erick Lane SCREEN* OPENHOLE Mictnetonk�, MN 55345 MakeytQ�'itilf0�_ __ from ft.[o _ft. TYPe �t��g� 5��# Diam. -- — � SIoUGauze t A Length -�$ --�-�--- --- Set between ft.and ft. FITTINGS STATIC W/A�TER LEVEL � .��q/� WELL OWNER'S NAME �7,1___._. tt. �below ❑ above land surface Date measured�{-y_L(�' 1 PUMPING LEVEL(below land surface) r Weil owner's mailing address if different than property owner's address indicated above. ___.1�.____ft, after _ 1.5 hrs.pumping 7� g.p.m. �L HEAD COMPLETION Pitless adapter manufacturer_.�j��'P T Model __ ❑ Casing Protection__ �"12 in.above grade ❑ At-grade(Environmental Wells and Borings ONLY) GROUTING INFORMATION Well grouted? �Yes ❑ No GEOLOGICAL MATERIALS COLOR HARDNESS OF FROM TO Grout nnateria� ❑ Neat cement ❑ Bentonite ❑ Concrete �liigh Solids Bentonite MATERIAL from�to_3Q ft. _�_,_.__. ❑ yds.�bags clay yellow soft 0 3.3 from__'�_�o_�_'�tt p$x_�;a_� C�7�Is�� bags from to ft. ❑ yds. ❑ bags CIS OI8p SOf C '�3 g3 NEAREST KNOWN SOURCE OF CONTAMINATION Y O J feet direction type Well disinfected upon completion? Yes ❑ No c2sy/grsvel gr�y soft 93 102 -�--------- PUMP 58�� a�8� �Ot� �Qe� �Z� [7 Notinstalled Dateinstalled �� __ � 1 L Manufacturer's name Aa r�a�A/� Model number_ _.__. HP � Volts__�_ ,_._ . Length of drop pipe 04 ft. Capacity ___ g.p.m. Type: �ubmersible ❑ l.S.Turbine ❑ Reciprocating ❑ Jet ❑ ______ ABANDONED WELLS Does property have any not in use and not sealed well(s)? C! Yes f�No VARIANCE Was a variance granted from the MDH for this well? ❑ Yes Qf�No TN# ! WELL CONTRACTOR CERTIFICATION Use a second sheet,if needed This well was drilled under my supervision and in accordance with Minnesota Rules,Chapter 4725. REMARKS,ELEVATION,SOURCE OF DATA,etc. The information contained in this report is true to the best of my knowledge. Don Stodola WeII Drilling Co., Inc. 2 172 ; � L� see Bus' ss Name � Lic.or Reg.No. __. : �...�.��—. . . -.. � ___ _ - - =-- 8-2'�-02 Authorized Re� entative Signature Date Duane Mathe�s 12-20-UI � --_-. _ — -- Name oI Driller Date �-.�� L�CAL CQPY 6 6 8 0 3 8 HE-01205-07(Rev.2199) IC#140-0020 . - rw� c�- w�� c � � , r�;�. � y 617 13th Ave So • Hopkins, Minnesota 55343 • (612) 935 - 3556 l2/27/2001 Siodola Well Drilling 3841 North A�lain Si. Bonifacius MN 55375 938-21 1 1 REPORT OF WATER ANALYSIS Lab #: 1394 Our Laboratory reports ihese analyiical results, determined on a sample iaken by CLIENT on 12/26/2001 from the following locaiion: Pat Burton 2601 Rainey Rd. Orono,Mn Unique Well#668038 Coliform Bacieria <1/100 ml Niirates Nitrogen <1.0 mg/1 The resulrs of these tesrs indicate ihar rhis well is producing waier rhat meets rhe standards for F.H.A., V.A., or conventional loans. This report is an analysis for coliform and n'rrare only and does not include analysis of Lead and orher conraminanrs.�(Unless as speci�ed by client). ,, Twf ..Cit rer Clinic, Inc. ,``� Bill Va�ri dal Lab Certification tl 027-053-119