The URL can be used to link to this page

Home My WebLink AboutWell and Boring Construction Record MINNESOTA UNIQUE WELL WELL'OR BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH AND BORING NO. County Name WELL AND BORING CONSTRUCTION RECORD Hennepin Minnesota Statutes,Chapter 1031 8 2 7 8 0 3 Township Name Township No, Range No. Section No. Fraction(sm.—.Ig.) WELUBORING DEPTH(completed) DATE WORK COMPLETED Orono 117 23 06 SW SEIM 140 ft. 5-3-13 _ GPS LOCATION—decimal degrees(to four decimal places). DRILLING METHOD Latitude Longitude ❑Cable Tool ❑Driven ❑Dual Rotary ❑Auger Rotary ❑Rotasonic House Number,Street Name,City,and ZIP Code of Well Location ��/ ❑Other 765 Lakeview Parkway, Orono 55364 DRILLING FLUID WELL HYDROFRACTURED? ❑Yes 'No Show exact location of well/boring in section grid with"X" Sketch map of well/boring location. water From ft.To ft. Showing property lines, N roads,buildings,and direction. USE ,Domestic ❑Monitoring ❑Heating/Cooling I f _E - Noncommunity N onc ommu PWS CommunityPWSIrrigation ❑ Environ. .Bore Hole ❑ Industry/Commercial dustry/C ommercial Irrigat on Remedial ::_y! ' ❑Elevator ❑Dewatering ❑ T 1"'�__ _^l-�j.L CASING MATERIAL Steel Drive Shoe? ❑Yes ONo Threaded ❑Welded HOLE DIAM.. • Smile I ' , lastI 0 -I -t- -:-- . 1 • I CASING I Diameter 130 Weight Specifications g I--1 Mile I - - _ . in.To ft. lbs./ft. 7` in.To 54. in.To ft. lbs./ft. 6 4 in.To 140ft. PROPERTY OWNER'S NAME/COMPANY NAME Con Homes in.To ft. lbs./ft. in.To ft. W[! SCREEN OPEN HOLE Property owner's mailing address if different than well location address indicated above. Make Johnson From ft. To ft. - Type stainless steel Diam?" f Slot/Gauze .010 Loi th+ 4' I J-7.) 1\J--I-p'--A..... • )-„•-r-a /-1 Set between 1 3() ft.and 140 ft. FITTINGS 2"x3' leader STATIC WATER LEVEL 50 ft.gBelow ❑Above land surface (IT--,-Q--1.--- - \'J .Q_`4, ./, Ai A) .: -_k/ 7 Willie J ' Measured from,t p Of measured 5-3-18 Dry hole 0 Yes [ No WELL OWNER'S NAME/COMPANY NAME PUMPING LEVEL(below land surface) 125 ft.after 2 hrs.pumping 40 o.p.m. Well/boring owner's mailing address if different than property owner's address indicated above. WELLHEAD COMPLETION XPitless/adapter manufacturer[r11r Model- ❑Casing protection yi 2 in.above grade ❑At-grade ❑Well House ❑Hand Pump GROUT INFORMATION(specify bentonite,cement-sand,neat-cement,concrete,cuttings,or other) Material bentoni`Flom 0 To 50 ft. 3 ❑Yds. 'Wags Material cUtting$rom 50 To 130 ft. ❑Yds. ❑Bags HARDNESS OF Material From To ft. ❑Yds. ❑Bags GEOLOGICAL MATERIALS COLOR MATERIAL FROM TO Driven casing seal From To Bags One bag=94 lbs.cement or 50 lbs.bentonite NEAREST KNOWN SOURCE OF CONTAMINATION i_ clay brown medium 0 18 Well is .i feet �1 direction from _1-'- type Well disinfected upon completion? Xes ❑No clay gray medium 18 32 PUMP ❑Not installed Date installed -44-16 sandy clay gray medium 32 83 Manufacturers name Schaefer 7r� ,7 Model Number HP 1.5 Volts 230 sand brown medium 83 140 Length of drop pipe 84 ft. Capacity _ _g.p.m. Type:,'Submersible ❑L.S.Turbine ❑Reciprocating ❑Jet ❑ ABANDONED WELLS Does property have any not in use and not sealed well(s)? ❑Yes 5;f to VARIANCE Was a variance granted from the MDH for this well? ❑Yes Xo 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. Use a second sheet,if needed. REMARKS,ELEVATION,SOURCE OF DATA,etc. Don StodolalWell Drilling Co,. Inc. 1691 Licensee Business Name Lic.or Reg.No. `-tee' �= 7-23-18 tifted'Ftepftative Signature '- Certified Rep.No. Date ROb Stodola LOCAL COPY 8 2 7 8 0 3 Name of Driller ID#52603 HE-01205-16(Rev.5/161 Minnesota State Laboratory ID#.027-053-119 Twin City Water Clinic Laboratory Test Report Wisconsin State Laboratory ID#105-10117 Wisconsin DNR Lab ID#399073400 Client: Don Stodola Well Drilling Report Number: 18-05675 Twin City Water Clinic Inc. Sample Collection Date: 05/03/18 617 13th Avenue South Address: 3841 North Main Street Sample Collection Time: 14:00 Hopkins, MN 55343 St.Bonifacius,MN 55375 Sample Receipt Date: 05/04/18 Phone:(952)935-3556 Report Issue Date: 05/07/18 Fax:(952)935-5077 Laboratory Analyte Client ID Parameter Sample Prep Sample Analysis Test Sample ID Date Time Date Time Results Units 18-05675 Coliform Drinking Water 05/04/18 13:16 Absent 18-05675 Nitrate/N Drinking Water 05/04/18 15:09 <1.0 mg/L 18-05675 Arsenic Drinking Water 05/04/18 8:30 05/07/18 11:17 5.91 µg/L Lead Drinking Water µg/L • mg/L Well No.: 827803 X No samples were subcontracted;or the above test result(s) Sample pt: well with'"'designation were produced by a subcontracted laboratory. (Laboratory name;address;MDH Lab ID#]. The Well Adr: 765 Lakeview Parkway;Orono,MN subcontracted laboratory maintains MDH Certification for the Owner Gonyea Homes field(s)of testing performed. Owner Adr: Sample Conditions: Sample Temp: 8 'C Discussion: Notes: Approved methods used in analyzing the samples listed above have. the following reporting"levels: " Maximim contaminant levels: SM9222B Coliform,1 cru/100 ml Coliform <1 cfu/100 ml Nitrate EPA 353.2 7 Nitrate Nitrogen expressed as No3+Noe,1.0 mg/L Nitrogen 10.0 mg/L Arsenic,.10.0 SM3113B Arsenic;'2.014'1 I,Lead,2.0 µg/L pg/L!' , Lead,15.0 pg/L EPA 353.2 Nitrite Nitrogen,1.0 mg/L • Nitrite 1 mg/L Sample Collected by: X Client _TCWC Approved By: ZI# ti€ Bill Van Arsdale Laboratory Manager The results listed in this reportapply only to the above listed samples.All routine quality assurance procedures were followed;unless otherwise noted.This analytical report must be reported in its entirety.All methods are certified by the Minnesota Department of Health,unless otherwise noted.,:., TCWD Rev 4.0 Page 1 of 1