HomeMy WebLinkAboutwell info WELL LOCATION MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WELL NO.
County Name WELL AND BORING RECORD rte,
Minnesota Statutes,Chapter 1031 7 19 0 'st wk`"
Township Name rTownshipNo. Range No. Section No. Fraction WELL DEPTH(completed) Date Work Completed
Oman27 23 48 y, ,/, % 161 ft. 12-6-04
GPS DRILLING METHOD
LOCATION: Latitude degrees minutes seconds
Longitude degrees minutes seconds ❑Cable Tool ❑Driven ❑Dug
❑Auger otary ❑Jetted
House Number,yS,,tr�ee�t Name,City,and Zip
�,Code of.Well Locatgioent jor Fire Number ❑
1335 onkm AdOb 553% DRILLING FLUID WELL HYDROFRACTURED? ❑Yes No
Show exact location of_well in section grid with"X. Sketc AuZ of well location. FROM ft.TO ft.
o g property lines,
Nro ds and buildings USE
❑Monitoring ❑Heating/Cooling
/Domestic LlEnviron.Bore Hole L]Industry/Commercial
-1--
` ❑Noncommunity PWS ❑Irrigation ❑Remedial
�+ ❑Community PWS ❑Dewatering ❑
--'-----'----- -----F-- •
CASING HOLE DIAM.
w � � e
'' Drive Shoe? ❑Yes y��LrcJ No
;___-- ---__ El Steel ❑Threaded ❑ elded
1T Mile lastic ❑
1 CASING DIAMETER WEIGHT
y in.to 153 ft. 2.(Albs./ft. n.to rift.
1 Mile
in.to ft. lbs./ft. in.tori ft.
PROPERTY OWNER'S NAME/COMPANY NAME - in.to ft. lbs./ft. in.to ft.
Steiner & KWpelm l SCREEN OPEN HOLE
Property owner's mailing address
if different than well location address indicated above. Make johmm FROM ft. TO ft.
18340 Minnetonka Blvd Type stain—lin Dia
Wayzata SIN 55391 Slot/Gauze 0010 Length 4 + 41
Set between ft.and__I_J_I_ft. FITTINGS„ W/
STATIC WATER LEVEL �f
% ft. . below [_]above land surface Date measured 12-6-04
WELL OWNER'S NAME/COMPANY NAME PUMPING LEVEL(below land surface)
150 ft.after 2 hrs.pumping 60—_ -9-p.m.
WELL HEAD COMPLETION
Well owner's mailing address if different than property owners address indicated above. Pitless adapter manufacturerls ;�12
F1Casing Protection in.above grade
❑At-grade(Environmental Wells and Boring ONLY)
GROUTING INFORMATION
Well grouted Yes ❑No
Grout material ❑Neat cement ❑Bentonite ❑Concre High Solids Bentonite
from to 0 ft. _- 3 ❑yds.?<bags
from to_ 53 ft. fj2� [_1bags
GEOLOGICAL MATERIALS COLOR HARDNESS OF MATERIAL FROM TO from to ft. E]yds. L]bags
NEAREST KNjjOWWNL`SOURCE OF CONTAMINATION
!V feet ++ direction
topsoil black acrft 0 $
Well disinfected upon completion Yes ❑No .;-A"
PUMP
'
cla brown soft
4 12 ❑Not installed Date installed ea/ v
f
clay soft 12 1" Manufacturer's name a"
1 1 1!r 4'Q Model number HP Volts
r$VeI broitm soft 148 162 1 Length of drop pipe y ft. Capacity g.p.m.
Type: ubmersible ❑L.S.Turbine ❑Reciprocating ❑Jet ❑
ABANOONED WELLS
Does property have any not in use and not sealed well(s) ❑Yes XNo
VARIANCE
Was a variance granted from the MDH for this well? ❑Yes XNo TN#
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.knowledge. �ry
Use a second sheet,it needed DM Sti la IM �-lim W.>*u. 2l 172
REMARKS,ELEVATION,SOURCE OF DATA,etc. WLi .k
Licensee Business Name Lic.or Reg.No.
G5,
ore =presentative S(gPaKur= Date
Chuck 1—bore
LOCAL COPY 719809
Name of Driller'
HE-01205-08(Rev.5/02)
IC 140-0020
,+ l
f �
rw cry w abeor c , I ncl.
617 13th Ave So Hopkins, Minnesota 55343 (612) 935 - 3556
12/08/2004
Stodola Well Drilling
3841 North Main
St. Bonifacius MN 55375
938-2111
REPORT OF WATER ANALYSIS
Lab #: 933
Our Laboratory reports these analytical results, determined on a sample taken
by CLIENT on 12/06/2004 from the following location:
1335 Tonkawa Rd
Orono,Mn
Unique Well#719809
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);,.
T City Water Clinic, Inc.
Bill sdale
Lab Certification#027-053-119