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Home My WebLink Aboutwell info WELL LOCATION MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WELL NO. County Name WELL AND BORING RECORD 660554 Hennepin Minnesota Statutes Chapter 1031 Township Name Township No. Range No. Section No. Fraction WELL DEPTH(completed) Date Work Completed Orono 117 23 051. 212 n 5-30-02 House Number,Street Name,City,and Zip Code of Well Location or Fire Number DRILLING METHOD 684 Tonkava Rd. ❑ Auger Orono 553 ❑ Cable Tool [:1Rotary ❑ Dug ❑ Jetted Show exact location of well in section grid with"X". _ Sketch map of well location. ❑ 94owigp.)roperty lines, roads a d buildings. DRILLING FLU WELL HYDROFRACTURED? ❑YES O N bentonite i FROM ft.to ft. USE ❑ Monitoring ❑ Heating/Cooling Domestic El Irrigation El Community PWS ❑ Industry/Commercial E t El Environ.Bore Hole ❑ Noncommunity PWS El Remedial w E -a s ry El Dewatering ❑ CASING Drive Shoe? ❑ Yes No HOLE DIAM. Steel ❑ Threaded ❑ Welded Plastic ❑ CASING DIAMETER WEIGHT PROOPPROPERTYOWNERS NAME iI 4 in.to 204 ft. 1,99 lbs./ft. 8 in.to 0 Denali du s t on HoInc.Inc• in.to ft. lbs./ft. in.to 2 Property owner's mailing address if different than well location address indicated above. in.to ft. lbs./ft. _in.to ft. 2600 Christian Crt SCREEAIv n OPEN HOLE 6haska s NN 55318 Make' from ft.to ft. Type stainlssfs steel Diam. _ R SIottGauze 01 n Length r 4 Set between I � ft.and�ft. FITTING 2* • STATIC�JER LEVEL WELL / 6 WELL OWNER'S NAME VV ft.11 below ❑ above land surface Date measured 5-30-01 PU��}pI(�G�LEVEL(below land surface) Well owner's mailing address if different than property owner's address indicated above. 100 ft. after 3 hrs.pumping 15 g.p.m. QV/ELL HEAD COMPLETION whf tura ter ,A Pitless adapter manufacturer Model ❑ Casing Protection 12 in.above grade ❑ At-grade(Environmental Wells and Barings ONLY) GROUTING INFORMATION Well grouted? 1J Yes ❑ No HARDNESS OF Grout Material ❑ Neat ce�g nt ❑ Benton t ❑ Concrete �Hi h Solids Bentonite I GEOLOGICAL MATERIALS COLOR MATERIAL FROM TO from q/V to � ft. 2.1 ❑ yds.V bags /� p from '10 204 ft. natural ft&V bags cls !Drown and 0 1$ from to ft. ❑ yds. ❑ bags NEA�T_KNQWN SOURCE OF CON2p11 I 101, cls rown oft is 38 ' feet Y N� _ � r direction� ` e t type Well disinfected upon completion? Yes ❑ No clsy _�ray 50ft 38 120 PUMP /� ❑ Not installed Date installed 7•-501 sand (fine) Lown Oft 120 195 Manufacturer'snameaermotor Model number 02657 HP A Volts sand/ vel kray soft 195 212 Length of drop pipe 147 ft. Capacity g.p, . Type/Submersible ❑ L.S.Turbine ❑ Reciprocating ❑Jet ❑ ABANDONED WELLS �/ Does property have any not in use and not sealed well(s)? ❑ Yes 27 No VARIANCE Was a variance granted from the MDH for this well? ❑ Yes )(No TN# WELL CONTRACTOR CERTIFICATION Use a second sheet,i/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. Don Stodola Well Drilling co., Inc. 2� 72 L" nsee B ess fjfa Lic.or Reg.No. 7-13-01 Authorized-Representative Signature Date Chuck Moore 5-30-01 Name of Driller Date LOCALCOPY1660554 � _ HE-01 205-07(Rev.Mill) IC#140-0020 riv" CXy wCUfiic/ Ytc/. 617 13th Ave So Hopkins, Minnesota 55343 (612) 935 - 3556 06/04/2001 Stodola Well Drilling 3841 North Main St. Bonifacius MN 55375 938-2111 REPORT OF WATER ANALYSIS Lab#: 516 Our Laboratory reports these analytical results, determined on a sample taken by CLIENT on 05/30/2001 from the following location: Denali Homes 685 Tonkawa Rd. Orono,Mn Unique Well #660554 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. 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). Cit Water Clinic, Inc. Billy% ale Lab Certification#027-053-119 MINNESOTA DEPARTMENT OF HEALTH Minnesota Well and Boring 172552 WELL NameOR BORING LOCATION _ WELL AND BORING SEALING RECORD Minna No. SIH_ Sealing County Name Minnesota Unique Well No. r HENNEPIN Minnesota Statutes, Chapter 1031 or W-series No. L� (Leave bank R nor krawn) Township Name Township No, Range No. Section No I Fraction Ismi lig Date Sealed Date Well or Boring Constructed ORONO 117 23 05 �'4 SW SW r. Monday,September 25,2000 Numerical Street Address or Fire Number and City of Well or Boring Location 100 684 TONKAWA ROAD Depth Before Sealing h Original Depth it Show exact location of well or boring Sketch map of well or boring AQUIFER(S) STATIC WATER LEVEL in section grid with"X'. location, showing property X Single Aquifer ❑ Mulhaquifer lines,roads,and buildings. N WELVBORING IK Measured ❑ Estimated ]Water Supply Well ❑Monit.Well 40 1�,yF�,, ❑ Env.Bore Hole L-1Other _ h. Cy below ❑ above land surface W '-�- - -- - -- --i-- E � CASING TYPE(S) I ------ Steel ❑ Plastic E]Tile ❑Other Black T&C }l mie d CASING(S) — 1 0 Diameter Depth Set in oversize hole? Annular space initially grouted? tttt S 4,f� lye—r mde---fie in.from 0 to 1 00 ft ❑ Yes X No ❑ Yes ❑ No ❑ Unknown PROPERTY OWNER'S NAME in.from to ft. ❑ Yes ❑No ❑ Yes ❑No ❑ unknown BEUTLER,ROBERT Property owner's mailing address if different than well location address indicated above. in.from to h. ❑ Yes ❑No ❑ Yes ❑ No ❑ Unknown 684 TONKAWA ROAD SCREEN/OPEN HOLE ORONO,MN 55356 Screen from 100 to h. Open Hole from to ft. OBSTRUCTIONS WELL OWNER'S NAME ] Rods/Drop Pipe ❑ Check Valve(s) ❑Debris ❑ Fill ❑ No Obstruction Well owner's mailing address if different than property owner's address indicated above. Type of Obstructions(Describe) Removed 63'Drop Pipe&Submersible Pump... Obstructions removed? g1 Yes ❑ No Describe PUMP Type 3 Wire Submersible Pump GEOLOGICAL MATERIAL COLOR HARDNESS OF FROM TO X Removed ❑ Not Present ❑ Other FORMATION It not known,indicate estimated formation log from nearby well or boring. METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS,OR CASING AND BORE HOLE: No Annular Space Exists ❑Annular space grouted with tremie pipe ❑Casing Perforation/Removal in.from to h. ❑ Perforated ❑ Removed in.from to h. ❑ Perforated ❑ Removed Type of perforator ❑ Other GROUTING MATERIAL(S) (One bag of cement=94 lbs.,one bag of bentonite=50 lbs.) Neat Cmt 0 .50 0.0016 Grouting Material from to h __ yards bags Enviroplug .5 100 0.3184 from to ft. yards bags 0 from to ft. yards bags from to_ ft. yards bags -LE REMARKS,SOURCE OF DATA,DIFFICULTIES IN SEALING OTHER WELLS AND BORINGS Pdless Adapter-House Demolished Other unsealed and unused well or boring on property? ❑Yes 17�1 No How many? LICENSED OR REGISTERED CONTRACTOR CERTIFICATION Measured From Grade Level... This well or boring was sealed in accordance with Minnesota Rules,Chapter 4725. The information contained in this report is true to the best of my knowledge. Malenke Water 763.493.3650 27600 Contractor Business Name License or Registration N. Myron Malenke September 25, 2000 5 117 23 33 0011 Authorized Representative Signature f Date LOCAL COPY —� j F 1 7 2 C C 2 Name of Person Sealing Well or Boring STATF'.OF MINNESOTA DUPARTMENTOI HEALTH KATION Of wF.LL MINNESOTA UNIQUE ampl WELL NO. 0 0 y Namr _ WATER WELL RECORD /n,ware.Sample fi. Minntrora St.—,/51A.III 08 ship Name Town,hlp Number Rang.Numher Sec Ron Nn. Frac oon 3. PROPERTY OWNER'S NAME ,,,and Direction from Road Intersections or Street Addres.and City of Well Lucaliun Address coact location of ywell in-.u.grid with"X." Sketch map of well location. 4. WELL DEPTH(completed) Dale of Completion ' N AJJiDon Name ✓,f'� 5 1❑Cahleln,it 4❑Re—w 70Drieen o❑Deg Block Number 20Hollnw rod 5❑AIr 808ored 110 - if Jc Rotary 6❑jetted 9❑Power Auger Lot Number 6. USE f❑Domeslic 4❑Puhlic Supply 70 Industry -•/ F--1 nll.tt'� 2❑Irriealion 5❑Municipal 8❑Cmmmercial >3s - FORM ATION LOG COLOR HARDNESS Of FROM TO FORMATION l❑Test Well 6❑Air Conditioning 9❑ 7.CASING HEIGHT:Above/Below HOLE DIAM i Ee I❑Black 40 Threaded 20Gaw. 51:1Welded Surface ft. 30 Plasfi�_. 6❑ Drive Shoe? Yes_ No_ m.to fl. Weight lbs./ft. in.to_ft. in.to ft. Weight lbs./fl. _in.loft. into fl. Weight lbs./ft. in.to_ft, 8.SCREEN , open ole Make from fl.to ft. f Type Dia. Slot/Gauze Length FITTINGS. Set between ft.and ft. ft.and A. 9.STATIC WATER LEVEL fl.❑below ❑above Date Measured "— "---- - land surface 10. PUMPING LEVEL(below land surface) fl.after h-pumping g.p.m. fl.after his.pumping g.p.m. 11.WELLHEAD COMPLETION 1n PW-s adapter,manufacturer - model 20 thi—ent ff., J❑Al least 12"above grade 12.WELL GROUTED? ❑Yes ❑No IQ Neat C'emcnl 20Benlonite J❑ Grout material Irom t. ft,Cu.Yds. 13.NEAREST SOURCES OF POSSIBLE CONTAMINATION feet direction type Well disinfected upon completion". YesE No❑ 14. PUMP .��. Dale installed ❑Not installed Manufacture!',Name Model Number HP Volts Length of drop pipe ft.capacity g.p.m. Material of drop pipe Type: 30 L.S.Turbine 5❑1feclprocaling 20jet 4❑C'ent,,f,"l 6❑ Use n second sheet.if needed 16.WATER WELL CONTRACTOR'S CERTIFICATION .REMARKS,ELEVATION,SOURCE OF DATA.etc. This well was drilled under my jurisdiction and this report is true to F the best of my knowledge and belief. A Licensee Business Name License No. Address Signed , Date Authorized Repr<eid.twe w Date Name of Driller LOCAL COPY 4 0 5 0 6 3 7/7630M 7/78 30M 7/78 30M ti E-01205-Ot 2/82 lOM