HomeMy WebLinkAboutwell info WELL LOCATION MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WELL NO.
County Name F:E.�TLa->F,r._Fi.n WELL RECORD 532581
Minnesota Statutes Chapter 1031
Township Name Township No. - Range No. Section No. Fraction WELL DEPTH(completed) Date Work Completed
Numerical Street Address and City of Well Location or Fire Number DRILLING METHOD
4615 7orixaviev. lzjw. Clrorio, Mr.. ❑ Cable Tool ❑ Driven ❑ Dug
❑ Auger EJ Rotary ❑ Jetted
Show exact location of well in section grid with W. Sketch map of well location. ❑
Showing property lines,
N roads and buildings. DRILLING FLUID
I i
t tUSE E?�Domestic ❑ Monitoring ❑ Heating/Cooling
:.,r E,, 1i,: r ElIndustry/Commercial
E ❑ Irrigation ❑ Public
—�— T El Test Well ❑ Dewatering O Remedial
CASING Drive Shoe? 9 Yes ❑ No HOLE DIAM.
--t— — —; —r- I ❑ Steel ❑ Threaded ❑ Welded
' 1 li!�Plastic ❑
CASING DIAMETER WEIGHT J
PROPERTY OWNER'S NAME / /�/�/,
in.to ft. Ibs.ttt. O /in.to •` ft.
Ge(,Me Suntawsju �T�. 7/P
in.to ft. Ibs./ft. _m.to Mfr .
Mailing address if different than property address indicated above. in.to ft. lbs./ft. _in.to ft.
QbttJt i Aw!• th SCREEN���R OPEN HOLE
? 7
Maple ove, 14n. 55,311 t Make from�ft.to ft.
Type Diam.
SIoUGauze i Length
Set between 1 ft.and fy, ft. FITTINGS:
STATIC WATER LEVEL
GEOLOGICAL MATERIALS COLOR HARDNESS OF FROM TO 1 G�
MATERIAL ft. rti below 11 above land surface Date measured
PUMPING LEVEL(below land surface)
i f
Clayt7 at ft, after hrs.pumping 9.p-m.
WELL HEAD COMPLETION WhitE''wn:— r
,1(:+ 6;),t LK Pitless adapter manufacturer Model
❑ Casing Protection X7 12 in.above grade
GROUTING INFORMATION
Well grouted? %/E7 Yes ❑ No
Grout Material ❑ Neat cement R Bentonite
from /` to C t ft. 5 IN yds. ❑ bags
from to ft. ❑ yds. ❑ bags
from to ft. ❑ yds. ❑ bags
NEAREST KNOWN SOURCE OF CONTAMINATION
feet direction type
Well disinfected upon completion? 1't� Yes ❑ No
PUMP 6-26-93
❑ Not installed Date installed
Manufacturer's name Myers
Model number HP Volts
Length of drop pipe 146ft, pacijf_1 g.p.m.
Pressure Tank Capacity ball
I! %J0 1
Type: 49 Submersible ❑ L.S.Turbine ❑ Reciprocating ❑ Jet ❑
ABANDONED WELLS
Does property have any not in use and not sealed well(s)? ❑ Yes X No
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,it needed IXA S'XD-)1,A "K.1 MULLING CO., INC. 271-12
REMARKS,ELEVATION,SOURCE OF DATA,etc. Licensee Business Name Lic.or Reg.No.
Authorized Representative Signature Date
F.P. A'lct k' i ton
Name of Driller Date
LOCAL COPY ---T532581 HE-01205-04(Rev.5/92)
TWIN CITY WATER CLINIC, INC.
617 13th Ave. So.
Hopkins, Minnesota 55343
(612) 935-3556
f
08/06/93
Stodola Well Drilling
15306 Hwy 7
Minnetonka, MN 55345
938-2111
Lab #: 20585
REPORT OF WATER ANALYSIS
Our laboratory reports these analytical results, determined on a
sample taken by YOU on 08/04/93 from the following location:
George Sontowski
Unique # 532581
4629 Tonkaview Lane
Orono, Mn
Coliform Bacteria <1/100 ml
Nitrates Nitrogen <1.0 mg/1
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.
City Water Clinic, Inc.
Bill ale
Brian lair