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Home My WebLink Aboutwell info 11 AWE!_;LCZCATION MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WELL NO. County Name WELL AND BORING RECORD 591096 H e n n e o i n Minnesota Statutes Chapter 103/ Township Name Township No. tange Na Section No. Fraction WELL DEPTH(completed) Date Work Completed Orono 117 23 08 153 • n 9-30-98 House Number,Street Name,City,and Zip,it e of Well Location .olF.iraN ber ( DRILLING METHOD 1090 Tonkawa Road 'Or MN. 45539 i El Cable Tool El Driven ❑ Dug ❑ Auger R1 Rotary [I Jetted Show exact location of well in section grid wilh"Xw•w*�.� .� °'Sl�etch map of will locaticIn N ❑ Showing pro erty lin ...-�- roads ad s DRILLING FLUID N Natural USE ❑ Monitoring ❑ Heating/Cooling } X Domestic [I Irrigation ❑ Community PWS ❑ Industry/Commercial ❑ Noncommunity PWS ❑ Remedial WE T f 7 Test Well F] Dewatering El-, r Uz Mne CASING Drive Shoe? ❑ Yes X No HOLE DIAM. ❑ Steel r] Threaded - ❑ Welded V Plastic Cl S 1 M,le CASING DIAMETER WEIGHT PROPERTY OWNER'S NAME 4 in.to—15 ft. —i.9 lbs./ft. ; in.to3_0_ft. Lauer Homes _.— in.to ft. lbs./ft —�f`4rl�ft. Property owner's mailing address if different than well location address indicated above. -_.-_ in.to ft. __. lbs./ft. in.to ft. 509 N. Ferndale Road SCREEN_ OPEN HOLE Wayzata, MN. 55391 Make_. johnson___ from ft.to fL Typ Diarn 2 0 _ Slot/Gauze f 1707 _Length L 8• Set betweeny1 V-- ft.and ft. FITTING STATIC WATER LEVEL WELL OWNER'S NAME fK❑ below ❑ above land surface Date measure—�B PUMPING LEVEL(below land surface) Well owner's mailing address if different than property owner's address indicated above. ft. after hrs.pumping Q na�.a_aa_A rr _gp.m. WELL HEAD COMPLETION Pitless adapter manufacturer ►_►L t e.__s e r Model Cl Casing Protection X❑ 12 in.above grade F7 At-grade(Environmental Wells and Borings ONLY) GROUTING INFORMATION (tell grouted? XJ Ves EIN'Ve `..«._. GEOLOGICAL MATERIALS COLOR FROM TO Orbu(Material ❑ Neat ��iiiohite ❑ Concrete gh HARDNESS OF hH Solids Bentonite MATERIAL from o to ft. ❑ ❑ bas 3-0- 2•�- Y� 9 from_ to ft. ❑ yds. ❑ bags from _ to ft. ❑ yds. ❑ bags NEAREST KNOWN SOURCE OF CONTAMINATION feet direction __type Well disinfected upon completion? i Yes ❑ No ay Sand Gray 60 1 30 PUMP ElNot installed D I installed 10-27-98 ,.later Manufacturers nanIT O4tEt�WNER' - Predator ST r Modelnumber ST20-20 HP2 VoltQ1j0 Length of drop pipe 8 4 ft. Capacity 2 0 —9 p.m. Pressure Tank Capacity a2 S 0 Type[] Submersible ❑ L.S.Turbine ❑ Reciprocating ❑ Jet ❑ _ ABANDONED WELLS Does property have any not in use and not sealed well(s)? ❑ Yes X No VARIANCE Was a variance granted from the MDH for this well? ❑ Yes No 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 STODOL.A WELL DRILLING CO. INC. Licensee Business Name Lic.or Reg.No. / ' t 27172 filAuthorized Reb'eser'tahv nature Date Chuck Moore 9-30-98 1 Date Name of Driller HE-01205-05(Rev.1195) LOCAL COPY 591096 ' J.i. City .ter ��irtic, J.. 617 13th Ave So . Hopkins, Minnesota 55343 • (612) 935 - 3556 10/06/1998 Stodola Well Drilling 15306 Hwy 7 Minnetonka MN 55345 938-2111 REPORT OF WATER ANALYSIS Lab#: 35866 Our Laboratory reports these analytical results, determined on a sample taken by CLIENT on 10/01/1998 from the following location: 1040 Tonkawa Rd. Orono,Mn Unique Well#591096 Coliform Bacteria <1/100 ml Nitrates Nitrogen <1.0 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). Water Clinic, Inc. Bill V e Analyiwl laboratory Consulting Etgioeer Water Analysis Reagents Boiler Water Chemical Lab Certification N 027-053-119 MINNESOTA DEPARTMENT OF HEALTH Minnesota Well and Boring w O2^ WELL OR BORING LOCATION Sealing No. H 1 County Name WELL AND BORING SEALING RECORD Minnesota Unique No. — -- Hennepin Minnesota Statutes,Chapter 1031 or W-series No. (Leave blank,f not known) Township Name Township No. Range No. Section No. Fraction(sm.i Ig.) Date Sealed Date Well or Boring Constructed Orono 117 23 08 13-GO1 ,�� Numerical Street Address or Fire Number and City of Well or Boring Location �t�( //^. l 1040 Tonkava Rd, Orono Depth Before Sealing /��/ ft. Original Depth "' _fl Show exact location of well or boring Sketch map of well or boring $?UIFER(S) STATIC WATER LEVEL in section grid with"X". location, showing property F��R"Single Aquifer ❑ Mulbaquifer lines,roads,and buildings. N � '� WELUBORING Measured ❑ Estimated Water Supply Well ❑Monit.Well R ❑ Env.Bore Hole ❑Other t./ ft. ❑below ❑ above land surface W --------------�-- --i-- E -+' CASING TYPE(S) z - -- - -- -i-- -- Steel ❑ Plastic ❑Tile ❑ Other u mile f! -- - -- -- -- --'-- CASING Diameter Depth / J Set in oversize hole? Annualar space initially grouted? LS 111 /[) in.from� to� ft. E] Yes XNo El Yes ❑ No � Unknown PROPERTY OWNER'S NAME in.from to ft. ❑ Yes ❑No ❑ Yes ❑No ❑ Unknown T-aper Romps 473 0314 Property owner's mailing address if different than well location address indicated above. in.from to ft. ❑ Yes ❑No ❑ Yes ❑No ❑ Unknown SCREEWOPEN HOLE Screen from / to ft. Open Hole from to ft. OBSTRUCTIONS WELL OWNER'S NAME Rods/Drop Pipe ❑ Check Valve(s) ❑ Debris ❑ Fill E] No Obstruction y7 Well owner's mailing address if different than property owner's address indicated above. Type of Obstructions(Describe),JitI/1 Obstructions removed? Yes ❑ No Describe PUMP Type ,.��..;r� ��m A GEOLOGICAL MATERIAL 7COLOR HARDNESS OF FROM TO X Removed ❑ Not Present ❑ Other FORMATION If 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: ' .� t No Annular Space Exits } ❑ Annular space grouted with tremie pipe r , ❑ Casing Perforation/Removal in.from to ft. ❑ Perforated ❑ Removed in.from to ft. ❑ Perforated ❑ Removed Type of perforator ❑ Other GROUTING MATERIAL(S) Grouting Material lr7t C j� '� from �+ to ft. yards _ bags from to ft. yards bags from to ft. yards bags from to_ ft. yards bags REMARKS,SOURCE OF DATA,DIFFICULTIES IN SEALING OTHER WELLS AND BORINGS Other unsealed and unused well or boring on property? ❑Yes ) No How many? LICENSED OR REGISTERED CONTRACTOR CERTIFICATION 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. Don Stodika Well DRillino Co. , Inc. 21772 Contractor Business Name License or Registration No. rt 'Authorized'Representative Signature Date All LOCAL COPY H 134902 Name of Person Sealing Well or Boring HE-01434-03 2/97 R