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Home My WebLink Aboutwell info " '� Tw%vv C i,t� 1�t1��' C ' . " I��,c�. . . y . . . . . _ . . . . � 617 13th Ave So • Hopkins, Minnesota 55343 � (612) 935 - 3556 - 04/16/2001 Stodola Well Drilling 3841 North Main St. Bonifacius MN 55375 938-21 1 1 � REPORT OF WATER ANALYSIS Lab #: 304 Our Laboratory reports these analytical results, determined on a sample taken by CLIENT on 04/12/2001 from the following location: Sailors Worid 1955 Shoreline Dr. Orono,Mn \ Unique Weli#655096 Coliform Bacteria <1/100 ml Nitrates Nitrogen <1.0 mg/! The resul[s of ihese tescs indicate thar this well is producing water that meets the standards for F.H.A., V.A., or conveniional loans. This report is an analysis for coliform and nitrate only and does not inciude analysis of Lead and other conraminants. (Unless as speci�ed by client). ", T in City Water Clinic, Inc. .�.,. `.. e� �.. 8 �\� sdale � Lab Cerl�cation#027-053-I 19 ,<- _ ,�- ,��'�� MINNESOTA DEPARTMENT OF HFALTH Minnesota Well and Boring .t �b�� Y7�`lL OA B�RING LOCATION I WELL AND BORING SEALING RECORD sea�i�9 No. �H j p co�r,ry Name Minnesota Unique Well No. ----- ---- --� ��Qep�,(Z Minnesota Statu�es, Chapfer 1031 or W-series No. (Leeve tlarik tt iwt krawn) �.__'_.__._ __ � Township Name Township No Fange No. Section No. Frachorr.lsm.i Ig.) Date Sealed Date Well or Bonng Consiructetl orono �17 a3 Io . ,. Numerical Sireet Adtlress or Fire Number and Ciry ot Well or Bonng Location-� � �� 1955 Shotelint �C y flroflo Depih BeforP Sealing__ �„�� R Original Depth � h Show exact location of well or bormg Sketch map ot well o�bonng (10UIFER(S) STATIC WATER LEVEL in section grid with"X". locahon, sho�roperty P�Single Aywfer � Mulnaquder �`.� II�'s,roads, d b ildings. N ,_„��, ��..� WELUBORING Measured ❑ Estimated I , , � Water Supply Well ❑Monit.Well — - - - -- -i-- — -- � ❑ Em.Bore Hole ❑Other �' �__ft. `�below ❑ above land suAace /� � -�- -�-- -;— --;-- CASING TVPE�S) W E � � � � � �, -�- -�-- -i-- --�-- � Steel � Plas[ic �Tile �Other � � � � .. �i�e ��\ CASING(S) -'-- -i-- -�-- --�— l3� Diamete� �� Depth � Set In oversize hole? Annular space initially grouted7 S � /��'T �—i m�re—#�'r ��in from� to_��l_J n. ❑ Ves ❑No ❑ �es ❑No ❑ Unknown PROPERTY OWNER'S NAME in.from to ft. ❑ Yes ❑No ❑ �es ❑ No ❑ Unknown Pr � aiG s i tion address indlcated above. in.irom to ft. ❑ Yes ❑No ❑ �es ❑No ❑ Unknown SCREEWOPEN HOLE 530 Shorevf.e� Park �C� screen from ro ft Open Ho�e trom_t__/_L�o�� n. Shorevie�, Mht 551�b AtCn:�igflCB (`,tf !3 oesTaucnoNs WEIL OWNER'S NAME Rods/Dro Pi e p p ❑ Check Valve(s) ❑ Debris ❑ Fill ❑ No Obstruction Well owner's mailing adOress il tliflerent ihan properry owner's aAdress indicated above. Typ6 of Obstruc�ions(Describe) a��L'� /'".��f�� Obstructions removed? Yes ❑ No Describe PUMP Type �1 1��1rS ��'.l�p 6EOLOGICAL MATERIAL COLOR HARDNESS OF FROM TO �Removed ❑ Not Present ❑ Other FORMATION If not Wawn,indicate estimeted tormatbn log from nearby well or bonng. METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS,OR CASING AND BORE HOLE: ' � `� ,f o Annular Space bcists '�� ❑Annular space grouted with tremie pipe p� �y, � ❑CasingPerforation/Removal in.from to R. ❑ PeAorated ❑ fiemoved in.from �p tt. ❑ Perforated ❑ Removed Type of perforator ❑ otner GROUTING MATERIAI(S) (One bag of cement=94 Ibs.,one bag of bentonite=50 Ibs.) �/�/+' /� Q(� t Grouting Matenal��F��"'T�Sm _.3,rC— to�._/_Q tt. yards �� bags . from to R. yards bags from to ft. yards bags from to__ it. yards bags REMARKS,SOURCE OF DATA,DIFFlCULTIES IN SEALING OTHER WELLS AND BORINGS Other unsealed and unused well or boring on property? ❑Yes No How many? UCENSED OR REGISTEREO CONTRACTOR CERTIFICATION `{ tr�is well or bor�ng wa;szaled:�,ccordznos+virn,?,�innes�ta Rules,Chapte•4725. The informatio�contained in this report is � t�ae to the bost of my knowladge- Doa Stocla2a �1e11 Dri113ng Co., Iac.__27172 --------_ --- Contracror Business%Yam� -�... License or Registre0on I�o. �� J- � �/ . . A nz presen afive igna-s� �Date . . ` �+r.l�� `✓"'^'~�� LOCAL COPY u 1 �� Name of Pe eling Well or Bonng ri j t� �_.\ \ WELL LOC ITA ON MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WELL NO. �o��Y Name WELL AND BORING RECORD 6 5 5 0 9 6 y Minnesota Statutes Chapter 103/ t T�sCh�Na e� Township No. Range No. Section No. Fraction WELL DEPTH(completed) Date Work Completed � tt. �, � House Number,Street Name, ity and Zip Code of We I ocation or Fire Number DRILLING METHOD $S�.lOt3 �r14L'�t� MariSd ❑ CableTool ❑ Driven ❑ 0�9 � � ❑ Auger �C7.Rotary i.7 Jetted - - Show exact location of wel�in section grid with aX". ,� Sketch map of well location. ❑ �� Showing property lines, ��- �� - roads and buildings. DRILLING FLUID WELL HYDROFRACTURED? ❑YES �JIO N 'a i � � � � � .__..- Faonn _ _n.�o n. __ ___ ___ __ R �"�` � USE ❑ Monitoring ❑ Heating/Cooling i � i i ❑ Domestic -�- -�- -i- -�- ❑ Irrigation � Community PWS �7 Industry/Commercial i i i i � �Noncommunity PWS ❑ Remedial w I i e �� . ❑ Environ.Bore Hole ❑ Dewatering ❑ i , i r ,�'M � �` CASING Drive Shoe? es ❑ No HOLE DIAM. � _i_ _ i_ _L_ _i_ Z ��,�. � �Steel �Threaded ❑ Welded � � � � 1� ❑ Plastic ❑ S �-1Mrle� _ CASING DIAMETER WEIGHT PROPERTY OWNER'S NAME 4 in.to 259 n. I 1 Ibs./ft. 7 �if t6� tt. 0 Griggs Contractin �� o--___h __.___ �bs.�n. 3__T�� 5 Property owner's mailing address if diBerent than well location address indicated above. in,to ft. __Ibs./ft. in.to ft. -_-. a��n:Chancey Griggs SCREEN OPEN HOLE 530 Shoreview Park Rd Make from K.�o K. ' Shorevie�r, MN 5512b Type Diam. SbUGauze __ Length___. Set between ft.and ft. FITTINGS: STATIC WATER LEVEL WELL OWNER'S NAME yv ft.�'below ❑ above land surtace Date measured� PUdAP�LEVEL(below land surface) t c Well owner's mailing address if different than property owner's address indicated above. 1 _____ft. after_ v hrs.pumping 3 J g.p.m. WELL HEAD COMPLETION t �Pitless adapter manufacturer W�1�e��t @� Model _____________ ❑ Casing Protection ,y�12 in.above grade ❑ At-grade(Environmental Wells and Borings ONLY) �i GROUTING INFORMATION Well grouted? f�Yes G No � HARDNESS OF Grq�t M eri f l Neat r^—,� ❑ gento{'it�y � Concr te ❑ High Solids Ben[onite GEOLOGICALMATERIALS COLOR MATERIAL FROM TO VOLC�S� from_�� to 17�ft. ��______ ❑ yds.�bags cement from 19Q to��ft ZQ___ ❑ yds.�bags ° •- f i 1�, �p $fl f from___ ______to. ft. ❑ yds. ❑ bags ; NEAREST KNOWN SOURCE OF CONTAMINATION �.'�8 /fine sand t$ $Q f �.o--�Qet __direction inside type Well disinfected upon completion? �Ves � No �Iumbing (,`I8 ra r.��f PUMP �- ❑ Not installed Date installed _...4�+_�.�,..�� i$ Jfine sand r$ � Manufacturer'sname _��']�.Ot.Dl^_..... ..._ ._.__ Model number __ . .. .. . _. _ _. HP ��n f __�__ ,_._ Volts ' ravel/cobbles brow� Lengthofdroppipe _V`�___________ h Capacity _ g.p.m. Type: �Submersible r7 LS.Turbine ❑ Reciprocating ❑ Jet ❑ la L OWC� S ABANDONED WELLS Does property have any not in use and not sealed well(s)? ❑ Yes �No ra0e2�C1$ r VARIANCE � 7 r�Wn/ Was a variance granted from the MDN for this well? �Yes �J No TNri : .:i� �� 2a fine sa WELL CONTRACTOR CERTIFICATION lt �reen a e ond s et� needed 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. 'F REMARKS,ELEVATION,SOURCE OF DATA,etc. ' andstone brown hard 259 275 Dan_Stodola Well_ Drilling G�. . ��t�__ 172 ` ;,, �� Lic nse usiness Na -� f Li �Reg. o. � .'-' i �: „�r.��- 5'`7.'"�1 , � , uNio1'iz Represen ive ignature —^'' Date Duane Aiathews 4-6—pI _ ____ _ --_. - ___--- . 6 5 5 0 9 6 Name olOriller Date LOCAL COPY HE-01205-07(Rev.2/99)