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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 623570 A Hennepin Minnesota Statutes Chapter 103/ Township Namel Township No. Range No. Section No. Fraction WELL DEPTH(completed) Date Work Completed ft. /. /. 'L1281 House Number,Street Name,City,and Zip Code of Well Location or Fire Number DRILLING METHOD ❑ Cable Tool ❑ Driven ❑ Dug y C Auger EX Rotary ❑ Jetted Show exact location of well in section grid with"X'. Sketch map of well location. ❑ _ __ __ _ h, Showing property lines, Vt roads and buildings. DRILLING FLUID WELL HYDROFRACTURED? ❑YES J NO FROM ft.to ft. - 1 USE Domestic ❑ Monitoring ❑ Heating/Cooling El Community PWS ❑ Industry/Commercial ❑ Irrigation El PWS 1-1Remedial w E ❑ Environ.Bore Hole 1 O 11 Dewatering ❑ CASING Drive Shoe? ❑ Yes IXNo HOLE DAM. _i _ [I Steel El Threaded El Welded {{ti X Plastic ❑ —1 md, CASING DIAMETER WEIGHT PROPERTY OWNER'S NAME __g_ in.to170 ft. 1 _Q lbs./ft. in.to_3Qft. Greq Dahl Construction -- _ _—in.to ft. lbs./ftin.to 121 Property owner's mailing address if different than well location address indicated above. in.to ft. lbs./ft. in.to ft. 300 gest Point Roar] SCREEN OPEN HOLE Tonka Bay, Kn. 5555331 Make Johnson from ft.to ft. Type—Stainless—_.C'.LZ:c�Diam. 2 M Slot/Gauze Length $• Set between �_2.� .and_i_�_p ft. FITTINGS:2 44 X 3 0 a STATIC WATER LEVEL A 7 V WELL OWNER'S NAME 401 ft. [below ❑ above land surface Date measured 1 2_2 Q_ 9 PUMPING LEVEL(below land surface) Well owner's mailing address if different than property owner's address indicated above. 11 15 i __ 1 1 5 1 ft. after hrs.pumping 3) WELL HEAD COMPLETION Pitless adapter manufacturer Model Casing Protection X 12 in.above grade ❑ At-grade(Environmental Wells and Borings ONLY) GROUTING INFORMATION Well grouted? X Yes ❑ No GEOLOGICAL MATERIALS COLOR HARDNESS OF FROM TO Grout Material ❑ Neat cement ❑ Bentonite ❑ Concrete X High Solids Bentonite MATERIAL from$ to_ 30 ft. _3_ ❑ yds. EX bags Clay Sand Brown S 01 is from to ft. ❑ yds. ❑ bags from to ft. ❑ yds. ❑ bags o NEAREST WOWN SOURCE OF CONTAMINATION r (� Clay Grey S i 8 110 feet .-- J 1-'E j ti,.�G"?[J direction type Well disinfected upon completion? [ji Yes ❑ No Water Sand Grey S 110 126PUMP ❑ Not installed Date installed 1_13_99- Manufacturer's name Red J ac tc e t Model number 0127907 HP 3/4 Volts 2 3 0 Length of drop pipe 63 ft. Capacity 12 g,p.m. Type: ['Submersible ❑ L.S.Turbine ❑ Reciprocating ❑ Jet ❑ ABANDONED WELLS Does property have any not in use and not sealed welts)? ❑ Yes XNo VARIANCE Was a variance granted from the MDH for this well? ❑ Yes -k❑ No TN# 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. ON STODOLA WELL DRILLING CO. , INC. Licensee Business Name Lic.or Reg.No. 1-26-99 27172 Authorized Represcrntative Signature Date Chuck Moore 12-29-98 Name of Driller Date LOCAL COPY � 623570 HE-01205-06(Rev.7/96) rw%vv C Xy W ac t� CU4/� I vti� 617 13th Ave So Hopkins, Minnesota 55343 (612) 935 - 3556 07/17/1999 Stodola Well Drilling 3841 North Main St. Bonifacius MN 55375 938-2111 REPORT OF WATER ANALYSIS Lab#: 37392 Our Laboratory reports these analytical results, determined on a sample taken by CLIENT on 07/13/1999 from the following location: Greg Dahl Const. 1200 Tonkawa Rd. 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. 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). \BiIIV Wr Clinic, Inc. Analreal laboratory Consulting Engineer Water Analysis Reagents Boiler Water Chemicals Lab Certification#027-053-119 WELL OR BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH Minnesota Well and Boring rH 148443 —_ WELL AND BORING SEALING RECORD Sealin No County Name -- — Minnesota Unique No. Hennepin Minnesota Statutes,Chapter 1031 or W-series No. (Leave blank it not known) '1 Township Name Township No I Range No Section No. Fraction(sm.i Ig.) Date Sealed Date Well or Boring Constructed Orono f17 23 08 13-0005 7i -/q/j yS 1. Numerical Street Address or Fire Number and City of Well or Boring Location RDepth Before Sealing / ft Original Depth �t / h 1200 Tonkawad Or Show exact location of well or boring it Sketch map of well or boringAOl)IFER(S) STATIC WATER LEVEL in section gnd with"X' location, showing property Single Aquifer ❑ Multiaquifer lines,roads.and buildings. N WELUBORING Measured ❑ Estimated `• Water Supply Well ❑Monit Well i 1 E] Env.Bore Hole ❑Other '1710 tt. below ❑ above land surface W --�- -T- -i-----T E CASING TYPE(S) -r- ---' - -- --�-- - feel E] Plastic ❑Tile ❑Other CASING Diamet�� Depth Set in oversize hole? Annualar space initially grouted? S f mile infrom to /CIO 1. E] Yes [ Jo ❑ Ves ❑No E] Unknown 1 PROPERTY OWNER'S NAME infrom to It. ❑ Yes ❑No ❑ Yes ❑No ❑ Unknown r, O..-, Dahl Connt-runtinn Property owner's mailing address If different than well location address indicated abovein.from to tt. ❑ Yes ❑No ❑ Yes ❑No ❑ Unknown 100 W Point Rd SCREEN/OPEN ��HOLE ''�, r //�� Tonka Bay, 14N 55331 Screen from�to ft Open Hole from to ft. OBSTRUCTIONS WELL OWNER'S NAME Rods/Drop Pipe El Check Valve(s) ❑ Debris ❑ Fill ❑ No Obstruction WeII owner's mailing address if different than property owner's address indicated above. Type of Obstructions(Describe) Obstructions removed? [)f<es ❑ No Describe PUMP Type 5(;P: Feu m e GEOLOGICAL MATERIAL COLOR HARDNESS OF FROM TO Removed ❑ Not Present ❑ Other FORMATION If not known,inidicate estimated formation log from nearby well or boring. METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS,OR CASING AND BORE HOLE: WNo Annular Space Exits Q ❑ Annular space grouted with tremie pipe ❑ Casing Perforation/Removal in.from to ft. ❑ Perforated ❑ Removed in.from to ft. ❑ Perforated ❑ Removed Type of perforator ❑ Other GROUTING MATERIAL(S) 1 '471 A-1 GroutingMaterial from lin to ft. yards bags from to ft. yards bags from to ft. yards bags from to_ It. yards bags REMARKS,SOURCE OF DATA,DIFFICULTIES IN SEALING OTHER WELLS AND BORINGS Other unsealed and unused well or boring on property? ❑Yes XNo 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. Jon STodola ;?ell Drilling Co. Inc. 27172 Contractor Business Name License or Registration Pro. o RApresentative Signatures...• Date LOCAL COPY JH 14 8 4 4 3 Neme of Person Sealing Welf or Boring HE-01434-03 2197 R