HomeMy WebLinkAboutwell info WELL LOCATION MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WELL NO.
County Name WELL AND BORING RECORD 580409
Minnesota Statutes Chapter 103/
Township Name Township No. Range No. Section,No. Fraction WELL DEPTH(completed) rt Date Work Completed
Orono
F-96
House Number,Street Name,City,and Zip Code of Well Location or Fire Number DRILLING METHOD
7 ❑ Cable Tool El Driven El Dug
.,J�± 1C7x'ntK�i]7i {1. Win!? �.lCY1C3fl ❑ Auger ❑ Rotary ❑Jetted
Show exact location of well in section grid with X'. Skil map of well location. ❑
55356 3h ,,,i n,,,property lines,
s and buildings. DRILLING FLUID y�
N �lonl tf
--ry USE ❑ Monitoring ❑ Heating/Cooling
i [Y-Domestic
{ - El Community PWS ❑ Industry/Commercial
,. ❑ Irrigation ❑ Noncommunity i i i i X y PWS 1-1 Remedial
W E T ❑ Test Well ❑ Dewatering ❑
-� CASING Drive Shoe? ❑ Yes ❑ No HOLE DIAM.
'/z Mae ❑ Steel ❑ Threaded ❑ Welded
C�rPlastic ❑
s
Fi Mile
CASING DIAMETER WEI
PROPERTY OWNER'S NAME 268 . �� ��"
" in.to__ ft. lbs./ft. in.to ft.
'IA srry hicen Ccs anv
in.to ft. lbs./ft. "iq jj
Property owner's mailing address if different than well location address indicated above. in.to ft. lbs./ft. in.to ft.
s Berkshire SCREEN ==Fr4 ngr,A OPEN HOLE
��rt;4 $ex'►C.:,�]1.rE.' LF.ai2�
Plyt. - Make from ft.to ft.
I"x °uet..t'j Mn. �14��
Type St 1'a i�'��.. :7 Steel Diam. i
;
Slot/Gauze '"r _Length fi 411
Set between 269 ft.and 7 ft. FITTINGS:
STATIC WATER LEVEL
WELL OWNER'S NAME 12= ft. a below ❑ above land surface Date measured 5-1 15-96
PUMPING LEVEL(below land surface)
Well owner's mailing address if different than property owner's address indicated above. 1,6 ft. after hrs.pumping 3€. g.p.m.
WELL HEAD COMPLETION
El,fitless adapter manufacturer llt'Pilt'c E'L Model
❑ Casing Protection .L£] 12 in.above grade
❑ At-grade(Environmental Wells and Borings ONLY)
GROUTING INFORMATION
Well grouted? 3I Yes ❑ No
HARDNESS OF Grout Material El Neat cement ElBentoni ❑ Concrete ❑ High Solids Bentonite
GEOLOGICAL MATERIALS COLOR MATERIAL FROM TO
from L= to t' ft. L ❑ yds. [Xbags
from to ft. ❑ yds. ❑ bags
E 1
Clay Yellow 1. 4 ' from to ft. ❑ yds. ❑ bags
NEARES KNOWN SOURCE OF CONTAMINATION /
Clay C :i 4C 1 31,. .[ feet ��(,Ir f^ direction . %'� type
r+,.. Well disinfected upon completion? ❑les El No
Clay-Gravel Grey 5 138 3 7 V' PUMP t
El Not installed Date installed 6-1 t1-96
Manufacturer's name i' & W
S , Cldy, ('ra\el Brown �_ 17E' 2 _i n. , _ ,�
Model number C HP Volts
Length of drop pipe �t I ft. Capacity 19 g.p.m.
Clay 2151 GF! Pressure Tank Capacity (E-AIEHY'ler C-Al,;t
Type: [),,Submersible ❑ L.S.Turbine ❑ Reciprocating ❑ Jet ❑
Gravel
ABANDONED WELLS
Does property have any not in use and not sealed well(s)? ❑ Yes U.
VARIANCE
Was a variance granted from the MDH for this well? ❑ Yes IX No
WELL CONTRACTOR CERTIFICATION
Use a second sheet,it 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.
ITEM 631CCOLA WWUA, DRII.IJNG CCS., INC:. 27 1-i
'
/Licensee Business Name LIC.or Reg.No.
5—15-96
` Authorized Representative Signature Date
Fri Lerr_3y :')-15-96
1580409 �
Name o/Driller Date
LOCAL COPY HE-01205-05(Rev.1/95)
Jwin
Wa6r
City U tinic, inc.
617 13thAve So • Hopkins, Minnesota 55343 • (612) 935 - 3556
05/29/1996
Stodola Well Drilling
15306 Hwy 7
Minnetonka MN 55345
938-2111
REPORT OF WATER ANALYSIS
Lab N: 29749
Our Laboratory reports these analytical results, determined on a sample taken
by CLIENT on 05/15/1996 from the following location:
Tony Eiden
2485 Thoroughbred Lane
Long Lake,Mn
Unique Wall N680409
Coliform Bacteria <1/100 ml
Nitrates Nitrogen 2.51 mg/I
The results of these tests indicate that this well 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 contaminants. (Unless as specified by client).
ter linic, Inc.
Bill Va e
A-1yiod co—*irg Evgi—
wear Analysis Repgema Boiler Wear Cbsmioala
Lab Certd'ioation/027-033-119