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Home My WebLink Aboutwell info * , WELL LOCATION MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WELL NO. CountyName t;�nr��.-,,i� WELL AND BORING RECORD � 9�� -� � , Minnesota Statutes Chapter 703! Township Nar.�� Township No. Range No. Section No. Fraction WELL DyEPTH(completed) Date Work Completed ��.7 C�.(..1 Z � I� 4� �.,!�2 1 ��.r t fl. � � ' � c_' . . /. Ya V� House Number,Street Name,City,and Zip Code of Well Location or Fire Number DRILLING METHOD 4�! %`,� SO:'i�I'�,�'� Lar��* Q�C?IlCJ� MIl. . � � `�f' ❑ CableTool ❑ Driven ❑ Dug ' ,;;�_ ❑ Auger �'Rotary ❑ Jetted Show exact location ot well in section grid with"X". Sketch map of well location. ❑ ��`AS�,t,. / �` Showing property lines, /��G�� G.. roads and buildings. DRILLING FLUID WELL HYDROFRACTURED? ❑YES NO N �+<ter. , , , , FROM n.to n. -,- -;- -,-- -,- USE ❑ Monitoring ❑ Heating/Cooling i i � i C3�Domestic _i_ _�_ _�_ _i_ �� ❑ Community PWS ❑ Industry/Commercial i � i i X ❑ Irrigation ❑ Noncommunit PWS w E T ❑ Test Well Y ❑ Remedial i i i i ❑ Dewatering ❑ i i i r +ZIM_ie CASING Drive Shoe? ❑ Yes o HOLE DIAM. _i i � i_ I ❑ Steel ❑ Threaded ❑ Welded ; -;- -, - -, 1 C�P�asci� ❑ s �-1 Mlle-� CASING DIAMETER WEIGHT PROPERTY OWNER'S NAME � 1�3 ��.�� 1 r;Ey _3 t� in.to ft. _ Ibs./ft. in.to ft. ��i E`t�i(:.�.�Fsi;� �'��;i'rc3iiSf �t. in.to ft. Ibs./fl. �_��__�_�_ i 1 . Property owner's mailing address if different than well location address indicated above. in.to ft. Ibs./ft. in.to ft. ��Z �I�t� 7�tI� St-��G�L� W��'�- SCREEN •r..t,,,,...,_.,._ OPENHOLE Ed�Tl Pr�irie, A'IIII. �a�1�� Make � from n.to n. Type_ � "i' `�� iam. SIoUGauze �3 Length Set between 1�� ft.and�j[. FITTINGS: 3 � STATIC IAMfiER LEVEL j �r'+,� � � � � / WELL OWNER'S NAME ft. ❑�elow ❑ above land surface Date measured PUMPIN�LEV�L(below land surface) i�. ;��, � Well owner's mailing address if different than property owner's address indicated above. ft. after 2 hrs.pumping J g.p.m. ,WELLHEADCOMPLETION ��,��$,�� '�J Pitless adapter manufacturer odel ❑ Casing Protection C�12 in.above grade ❑ At-grade(Environmental Wells and Borings ONLY) GROUTING INFORMA[TION Well grouted? ❑�Yes ❑ No }� }� HARDNESS OF Grout Material ❑ Neat cement `0 Bentonite ❑ Concrete L7'Hi h Solids Bentonite GEOLOGICAL MATERIALS COLOR MATERIAL FROM TO �r' 9 from L- to�ft. _ 1',�� ❑ yds. �a bags Clay B12iC7�C :': t' ,, from to ft. ❑ yds ❑ bags from to ft. ❑ yds. ❑ bags ��v ��t�� ; �� $JEA (NOWN SOURCE OF C MINAT�/} r "i 1 feet �U41 J ("� ! direction��rype Well disinfected upon completion? ❑ Yes ❑ No Cldy Grey ' 1t ` £i_ ` PUMP *a�� +�� (� i j � t❑ Notinstalled Dateinstalled 1l�6�� Manufacturer'sname �2C� JFEC�L�t c.I<�y—Gr�3v�1 Brc�s�n S 1 � � 1� �lodelnumber 150CNS2--CNS�A��,� 1.5 �o��s 230 Length of drop pipe 1`�� ft. Capacity Z� g.p.m. �...'�'Cs1C.Y �I�c3.f�2 .. ��! � �rJ �Type: Submersible ❑ LS.Turbine Cl Reciprocating ❑ Jet ❑ ABANDONED WELLS ��y C.C�i3�.�"1� r'il k.E.'.C� :] 1 fy:' p ��l boes property have any not in use and not sealed well(s)? ❑ Yes CTIVo VARIANCE Was a variance granted from the MDH tor this well? ❑ Yes ❑�lo 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. I�t:�I� f�'1'GI7(�.i.�1 WELI, DRILLING CC. , 1ItiC. Licensee Business Name .Lic.or Reg.No. L� J�. �--_.... /' ' l �' �,..� �'..+�"- _�. � �r �� Authorized Representative Signature Date �`r�.c+ Leiby 11-12-9'� Name of Driller HE 01205-06(Rev.9/96) L��L ��Y � � E7� � � C � � �w�� c�t� �a�� c��, ��. 617 13th Ave So • Hopkins, Minnesota 55343 • (612) 935 - 3556 11/17/1997 Stodola Well Drilling 15306 Hwy 7 Minnetonka MN 55345 938-2111 REFOR'P OF WATER ALYSIS Lab#: 34007 Our Laboratory reports these analytical results, determined on a sample taken by CLIENT on 11/12/1997 from the following location: Peter Mdrea 2975 Somer�et Lane Orono,IlVln Unique 1MM�11�596679 Coliform Bacteria <1/100 ml Nitrates Nitrogen <1.0 mg/I The results of these tests indicate that this w�ell is producing water that meets the 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 contam�nants. (Unless as specified by client). T � 't Water Clinic, Inc. �� Bill a ale an.tyioa lsboramry ��g� Water Aoalyais Reagen4 Boilm Wster Chemiale I.ab CeK�ication!!027-033-119