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Home My WebLink Aboutwell info .� :i. .� .,:('� ' ' y'.. . '� . � ..j�� ' ..� , i.. • .. .. . . . �8...'.; :^ .. - . . ....+��F'+'T:.'�M . . . . ��. . . e. i✓.. WELL LOCATION MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WELL NO. . . CountyName aenne ia WELL AND BORING RECORD 6 3 914 7 p Minnesota Statutes Chapter f03! Township Name Township No. Range No. Section No. Fractio� WELL DEPTH(completed) Date Work Completed n. 117 23 04 �,, ,. �,. 109' 3-3-00 House Number,Street Name,City,and Zip Code of Well Location or Fire Number DRILLING METHOD 2685 Raine �Dad �r�QO� �• 5392 � CableTool Driven ❑ Dug Y ❑ Auger �Rotary ❑ Jetted Show exact location of well in section grid wit�)".. Sketch map of well location. ❑ ___ � � �� Showing property lines, roads and buildings. DRILLING FLUID WELL HYDROFRACTURED? ❑YES ❑NO N , , , , �ater FROM n.,o h. -,- -,- -,-- -,- USE ❑ Moni[oring ❑ Heating/Cooling i i i i C7�omestic ❑ Community PWS ❑ Industry/Commercial _i_ _�_ _a_ -i- ❑ Irrigation � i i � ❑ Noncommunity PWS ❑ Remedial ,N E T ❑ Environ.Bore Hole ❑ Dewatering ❑ i i i i -r -�- -r- -r I � i i i '/zM e CASING Drive Shoe? ❑ Yes �No HOLE DIAM. i _ �_ _� _ _�_ � ❑ Steel ❑ Threaded ❑ Welded ' ' ' ' �Plastic ❑ s - �-1Mile-� CASING DIAMETER WEiGHT PROPERTYOWNER'SNAME 4 in.to 1� ft. ��$'�' Ibs./ft. 7�� 3�. TON BREN HOPiBS in.to ft. Ibs./ft. in.to�y�rt. Property owner's mailing address if diflerent than well bcation address indicated above. —__ in.ro ft. Ibs./tt. in.to ft. 7526 Turner ��ad SCREEN OPEN HOLE �nas�enae�►ce, t�N. 55328 Make �Q i 8 a from ,,.,o h. Type st��fllls� st�81 Diam. � A SIoUGauze Qj!3—A 1 R Length 4• f 4� Set between ��(�ft.and_�..QQ_ft. FITTWGS: 3� STATIC WATER LEVEL WELL OWNER'S NAME 5� R. �below ❑ above land surtace Date measured 3�3�0� PUMPINAG LEVEL(below land surtace) 7 Well owner's mailing address if different than propeRy owner's address indicated above. 7S ft. after a hrs.pumping 30�' g.p.m. WELL HEAD COMPLETION t�f� L ��itless adapter manufacturer Aaa��.e�a 4�r Model ❑ Casing Protection �12 in.above grade • ❑ At-grade(Environmental Wells and Borings ONLY) • GROUTING INFORMATvION Well grouted? LlAres ❑ No HARDNESS OF Grout Material ❑ Neat cement ❑ Bentonite ❑ Concrete C�iigh Solids Bentonite GEOLOGICAL MATERIALS COLOR MATERIAL FROM TO /� from__y�to_3Q_ft. __�'� ❑ yds.$ bags Clap—GraY@1 Y611 S �• 20 from __to n. ❑ vds. ❑ bags from to ft. ❑ yds. ❑ bags NEARE � WJJ SOURCE OF CONTAMINATION Ciay C7reY � Z� �7 feet ��/L�� direction��rype Well disinfected upon completion? �Yes ❑ No y Sandp clay Hro 3 85 95 PUMP * G ❑ Not installed Date installed ��1�s00 Sand •AQ S �`� +O� Manufacturer'sname �e��s Model number HP�_�_�_.__ Volts�_ Length of drop pipe OR ft. Capacity g.p.m. Type: ubmersible ❑ L.S.Turbine ❑ Reciprocating ❑ Jel ❑ ABANDONED WELLS Does property have any not in use and not sealed well(s)? ❑ Yes �No VARIANCE Was a variance granted from the MDH for this well? ❑ Yes �No TN# WELL CONTRACTOR CERTIFICATION Use a second sheet,i1 needed This well was drilled under my supervision and in accordance with Minnesota Rules,Chapter 4725. _ REMARKS,ELEVATION,SOURCE OF DATA,etc. The intormation contained in this report is true to the best of my knowledge. DON STODO�,,,�, T�tBLL DRILLING C0. • INC. Licensee B siness Name ,�Lic. r Reg.No. ��i�� +...�-�--". .- - .- 6-23-00 A orized epreseq,{c�f� Signature Date �aes� Leiby 3�3-00 LOCALCOPY 6 3 914 7 Nameo�Driller Date HE-01205-07(Rev.2/99) d , ' T"w�w Ci,�y 1�tla�� C ' ' , I��,c�. 617 13th Ave So � Hopkins, Minnesota 55343 � (612) 935 - 3556 03/09/2000 Stodola Well Drilling 3841 North Main St. Bonifacius MN 55375 938-21 1 1 j REPORT OF WATER ANALYSIS I Lab #: 38642 Our Laboratory reports rhese analytical results, derermined on a sample iaken by CLIENT on 03/06/2000 from the following locaiion: Tom Bren Homes 2685 Rainey Rd. Orono,Mn Unique Well #639147 Colifor� Bacteria <1/100 ml Nitra[e Nirrogen <1.0 mg/I The results of these iesrs indicare that rhis well is producing water that meets rhe standards for F.H.A., V.A.; or conventional 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 clienr). . \ . � T � � at r Clinic, Inc. �� . ', � � \\- BiN �A sc� e Malyiwl laboratory Consulting Engineer Water Malysis Reagents Boiler Water Chemicals Lab Certification#027-053-I 19 MINNESOTA DEPARTMENT OF HFALTH Minnesota Well and Boring ��(� WELL OR BORING LOCATION Se811f19 NO. i H— p Counry Name WELL AND BORING SEALING RECORD Mi��esota u�iq�e we��rvo. � -- Minnesota Statu�es.Chapter 103/ or W-series No. Henrie i n h.�.a.�x�k^�� — Township Name Township No. Range No Section No. Fracuon�sm.-s Ig.) Date Sealed Date Well or Boring Constructed Orono 1 l7 23 44 . ,. f"� �� Numerical Street Address o�Fire Number and Ciry ol Well or Bonng Locauon J 2685 ��i�� 0$� V=��a> ��5�� Qepth Before Seal�ng_�__ft Ongmal Depth l 11t� R Show exact locahon ol w�ell or boring Sketch map ol well or boring ApUIFER(S) STATIC WATER LEVEL in section gnd wrth"X". .,Joca�ion, showing property �ingle Aywfer � MulUaquiter .lines,roads,and bwldings. N � WELUBORING Measured ❑ Esumated � � � � ,r�-5�- �'Water Supply Well ❑Mornt.Well � _�__ � � � --r' --r- --�-- #f . --, F�� t�� ❑ Env Bore Hole ❑Other _ _ ft [�below ❑ above land surface . �+,�� W —i-- -i-- -i-- —;-- E CASING TVPE(S) . � � � � � � � � -�-- - -'- —' � [� --- �' �-' teel � Plastic �Tile � Other � }zmile I —�- -�-- -�— --�-- � CASING(S) � Diameter Depth Set in oversize hole9 Annular sp2ce initially grouted? L� S �J� ,7 "" �tr—�mae--a�e " �� m.from__.�_ to �1� tt. ❑ Yes ❑No ❑ Ves ❑No ❑ Unknown I I PFOPERTY OWNER'S NAME in.from to ft. ❑ Yes ❑ No ❑ �es ❑No ❑ Unknown T Bren Ho�e� Property owner's mailinq adtlress B ditterent ihan well location address indicated above. in.from to fl. ❑ Ves ❑ No ❑ Yes ❑No ❑ Unknown '�� T�r�� Q�� SCREEWOPENHOLE Indepe�dence, ��• Screen from � � to� fl Open Hole from to R. ��3�$ ossraucnoNs WELL OWNER'S NAME ❑ Rods/Drop Pipe ❑ Check Valve(s) ❑ Debris ❑ Fill ❑ No Obstruction Well owner's meiling aAOress if diHerent than property owner's atltlress mdicated above. Type ot Obsiructions(Describe) +,�,,,,� �>....? w�"i.s��F�"',�"� • Obstructions removed? ❑Yes ❑ No Describe PUMP Type „�y :l �� GEOLO(i1CAL MATERIAI COLOR HARDNESS OF FpOM TO emoved ❑ Not Present ❑ Other FORMATION If not known,indicate estimated formatbn log from nearby well or bonng METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS,OR CASING AND BORE HOLE: f�No Annular Space Exists � ❑Annular space grouted with tremie pipe ❑Casing Pertoratlon/Removal in.from to R. ❑ PeAorated ❑ Removed in.irom to ft. ❑ PeAorated ❑ Removed Type of peAorator ❑ othe� GROUTING MATERIAL(S) (One bag of cement=941bs.,one bag of bentonite=50 Ibs.) Grouting Matenal!��`��'`�� t �t��„r�+m to tt. yards � ba � from to 8. yards bags from to ft. yards bags hom to__ ft. yards bags REMARKS,SOURCE OF DATA,DIFFlCULTIES IN SEAIING OTHER WELLS AND BORINGS Other unsealed and unused well or boring on property? ❑Yes ❑No How many? LICENSEO OR HEGISTERED CONTRACTOR CERTIFICATION This well or boring was sealetl in accordance with Minnesola Rules,Chapter 4725. The information contained in this report is � true to ihe best of my knowledge. DON STODO�.A 'WSLL DIi�LLING C4., �xe. z��2 Confracfor Business Nam License a Regisfrefion Fo. i , ' /- /,._„t ;,,�j "� f � J on R senta rve Dete ' .._�•—•.--�,.-.... -�...,,..,,��...:?.r i�.� � ��J i - H 1�319 6 Name ol Person Sealing Well oi Bonng -