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Home My WebLink Aboutwell info WELL LOCATION MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WELL NO. County,-me .. ._ WELL AND BORING RECORD � ::; Minnesota Statutes Chapter 1031 58G488 Township Name Township No. Range No. Section No. Fraction WELL DEPTH(completed) Date Work Completed C�z'ono 11 1 2,CiG- n 10-8--96 House Number,Street Name,City,and Zip Code of Well Location or Fire Number DRILLING METHOD 3G1Itirnhain Roan Orono, 114. 55359 ❑ Cable Tool ❑ Driven ❑ Dug ❑ Auger Rotary ❑ Jetted Show exact location of well in section grid with"X". ap of well location. E1 Sho property lines, "oajcl buildings. DRILLING FLUID Bentonite N I I I 1 USE ❑ Monitoring ❑ Heating/Cooling IVDomestic ❑ Communi PWS El Irrigation �' ❑ Industry/Commercial I I I r ❑ Noncommunity PWS ❑ Remedial w, E �£L ❑ Test Well El Dewatering ❑ — - _r 112M, /z Mae t x CASING Drive Shoe? ❑ Yes No HOLE DIAM. V. ❑ Steel ❑ Threaded ❑ Welded [41astic ❑ s ` CASING DIAMETER WEIGHT _ / PROPERTY OWNER'S NAME t 1' in.to 191 ft. 1.9 lbs./ft. 7/� 3 ttC1l lel zst ky in.to ft. lbs./ft. — toy 1h Property owner's mailing address if different than well location address indicated above. in.to ft. lbs./ft. _in.to_ft. SCREENOPEN HOLE Make t from ft.to ft. Type s .c in 5v Steel Diam. Ll 1 t? Length SISlot/Gauze Set between j1 ft.and i {, ft. FITTINGS: "." '1S �Z_t t W STATIC WATER LEVEL WELL OWNER'S NAME I<i' ft. C"below ❑ above land surface Date measured 10-8-96 -8` 96 PUMPING I.En(below land surface) Well owner's mailing address if different than property owner's address indicated above. ft. after hrs.pumping �'} air 9 p m ELL HEAD COMPLETION Pitless adapter manufacturer M1.tewater Model ❑ Casing Protection [$;12 in.above grade ❑ At-grade(Environmental Wells and Borings ONLY) GROUTING INFORMATION Well grouted? 7P Yes ❑ No GEOLOGICAL MATERIALS COLOR HARDNESS OF FROM TO Grout Material EI Neat cement ❑;Bentonite ❑ Concrete ❑ High Solids Bentonite MATERIAL from (l t to 11'1 ft. ��, ❑ yds. C� bags KtY r y i t from t7 to �� ft. .❑ bags 1 1( czi7 t .+-tqidie, from to ft. ❑ yds. ❑ bags &-Anel/Clay Grey/Hr S 1 10 1 1 fy t NEARS F gSpIN SOURCE OF COt�AMII�T�_ �— feet 2 fj,/$ � direction C type Well disinfected upon completion? EXYes ❑ No Water : rxi Grey r 185' 1C PUMP ❑ Not installed Date installed 1(.3—1"� 9 �3 Manufacturer's name �tda Model number 1 US 1 E�i 4'1LT, HP 11^- Volts t_;•f: Length of drop pipe1 t ft. Capacity I g.p.m. Pressure Tank Capacity �2 U X—TMI Type: ❑:Submersible ❑ L.S.Turbine ❑ Reciprocating ❑Jet ❑ ABANDONED WELLS Does property have any not in use and not sealed well(s)? ❑ Yes EN. VARIANCE Was a variance granted from the MDH for this well? ❑ Yes Oj No WELL CONTRACTOR CERTIFICATION Use a second sheet,it 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. LX'fi 9,""OLS. WETS., MILLING (Xi., 1W-% 27174: ,,,L.:,ce,na Business Name ; ,.-�. _- Lic.or Reg.No. Authorized Representative Signature Date Muck Mc.:0re 1 C-8-96 Date Name of Driller HE-01205-05(Rev.1/95) L(-,AL COPY 1586498 J.i. City .ter clink, Jnc- 61713thAveSo • Hopkins, Minnesota 55343 • (612) 935 - 3556 10/15/1996 Stodola Well Drilling 15306 Hwy 7 Minnetonka MN 55345 93&2111 REPORT OF WATER ANALYSIS Lab*: 31146 Our Laboratory reports these analytical results, determined on a sample taken by CLIENT on 10/08/1996 from the following location: Butch Zelinsky 320 Turnham Rd Orono,Mn Unique Wall 0586498 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 goes not include analysis of Lead and other contaminants. (Unless as specified by client). T 'rr� y,, at r Clinic, Inc. Bill V A-bical W--tmy Wow Analysis Rmgem Boils water Cbengmh Lab Certification 0 029.033-119 WELL OR BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH Minnesota Well and Boring WELL AND BORING SEALING RECORD Sealing H 112974 County Name Minnesota Unique No. I3emepin Minnesota Statutes,Chapter 1031 or W-series No. (Leave blank if not known) Township NameTownship No. Range No. Section No. Fraction(sm.->Ig.) Date Sealed Date Well or Boring Constructed Clrcr►c� 1 t t 23 31 0 <=(� Numerical Street Address or Fire Number and City of Well or Boring Location i 320 Ttri1l=i R(}�d (,r(')ll Mi. Depth Before Sealing —ft. Original Depth 14oz– ft. Show exact location of well or boring Sketch map of well or boring AQUIFER(S) STATIC WATER LEVEL in section grid with"X". location, shpwing propertyingle Aquifer E] Multiaquifer linac rnarlc Andbu�dings. N WELL/BORING )<vAeasured ❑ Estimated : E Water Supply Well E]Monit.Well ` ❑ Env.Bore Hole ❑Other ft. below ❑ above land surface --r- -�-- --�-- --�-- W E ,-e J CASING TYPE(S) r � � �lle I Steel E] Plastic E]Tile E] Other -�-- - - -i-- - it CASING j d f Diameter Depth Set in oversize hole? Annualar space initially grouted? pIts I 1 milef.We , in.from U to ❑ Yes No ❑ Yes ❑No ❑ Unknown PROPERTY OWNER'S NAMEButch Ze3..11lik in.from to ft. ElYes ❑�No E] Yes E] No E] Unknown Property owner's mailing address if different than well location address indicated above. in.from to ft. ❑ Yes ❑No ❑ Yes ❑ No ❑ Unknown SCREEN/OPEN HOLE Screen from to ft. Open Hole from to ft. OBSTRUCTION/DEBRIS/FILL WELL OWNER'S NAME Obstruction ❑ Debris ❑ Fill ❑ No Obrstructiofn/.�9 Well owner's mailing address if different than property owner's address indicated above. Type of Obstruction/Debris/Fill Obstruction/Debris/Fill removed? XYes ❑ No PUMP Type :5 GEOLOGICAL MATERIAL COLOR HARDNESS OF FROM TO }ia 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: )<No Annular Space Exits r_.. ❑ Annular space grouted with tremie pipe l.j ❑ Casing Perforation/Removal in.from to ft. ❑ Perforated ❑ Removed in.from to ft. ❑ Perforated ❑ Removed Type of perforator ❑ Other GROUTING MATERIAL(S) Grouting Material -f om 4— to ft. yards ,5p bags from to ft. yards bags from to ft. yards bags from to ft. yards bags REMARKS,SOURCE OF DATA,DIFFICULTIES IN SEALING UNSEALED WELLS AND BORINGS Other unsealed well or boring on property? ❑ Yes No _ 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. rjN ODU a WELL iRT2aNG W. 11C. t Contractor Business Name License or Registration No. rr „AfithoR presentaGv�" rgnature Date LOCAL COPY H 2974 Name of Person Sealing Well or Boring HE-01434-02 10/95R WELL OR BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH Minnesota Well and Boring WELL AND BORING SEALING RECORD Sealing No. H 112979 County Name LiF,� E,��Il Minnesota Unique No. Minnesota Statutes,Chapter 1031 or W-series No. (Leave blank if not known) Township Name Township No. Range No. Section No. Fraction(srr,.->Ig.) Date Sealed Date Well or Boring Constructed Oro w 118 G3 s % % �o a!T c�L Numerical Street Address or Fire Number and City Of Well or Boring Location t , 32320 'lUrnhan Rc-,ad Orono,` , No. Depth Before Sealing ft. Original Depth ' ft. Show exact location of well or boring Sketch map of well or boring AQUIFER(S) STATIC WATER LEVEL in section grid with"X". p,{ location, showing property Ingle Aquifer ❑ Multiaquifer N l lines,roadg _u4 buildings. WELUIBORING E] Measured ❑ Estimated [y(Water Supply Well ElMor it.Well , '� -- ❑ Env.Bore Hole ❑Other �Q ft. [>61ow ❑ above land surface W -- ------ --�-- E ,�} CASING TYPE(S) - -------- --�-- --�-- y E]Steel �lastic E]Tile E] Other 0 w mile t _ CASING Diameter Depth i^ r Set in oversize hole? Annualar space initially grouted? S ""��"" Iw t mile~ 15' x, in.from to ft. ❑Yes JgNo ❑ Yes ❑No ❑ Unknown PROPERTY OWNER'S NAME in.from to ft. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown Butch Zelinsky Property owner's mailing address if different than well location address indicated above, in.from to ft. ❑ Yes ❑ No ❑ Yes ❑No ❑ Unknown SCREEN/OPEN HO��LE Screen from !lei!!// ` to ft. Open Hole from to ft. OBSTRUCTION/DEBRIS/FILL WELL OWNER'S NAME ❑ Obstruction ❑ Debris ❑ Fill >(No Obstruction Well owner's mailing address if different than property owner's address indicated above. Type of Obstruction/Debris/Fill Obstruction/Debris/Fill removed? ❑ Yes ❑ No PUMP Type GEOLOGICAL MATERIAL COLOR HARDNESS OF FROM TO El Removed XNot Present El 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: -.f 5ir No Annular Space Exits ❑ 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) Grouting Material ' «�� fr6m to2C 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 UNSEALED WELLS AND BORINGS Other unsealed well or boring on property? ❑ Yes No 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. IxN S`X00U, WELL LFZIj�jW, a). INC. 2`/11 Contractor Business Name License or Registration No. 7 A _o4uthoked IWStgnaturel Date H ry Name of Person Sealing)Yell or Boring LOCALCOPY f HE-01434-02 10/95R Minnesota Well and Boring WELL OR BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH Sealing No. H 51 ,957 County Name WELL AND BORING SEALING RECORD Minnesota Unique No. Minnesota Statutes,Chapter 103/ or W-series No. (Leave blank it not known) Township Name Township No. Range No. Section No. Fraction ism. �Ig.) Date Sealed "� Approximate Date Well J — '=;� {� _ 11 or Boring Constructed 73 31 Drem in I 18 4 �} Numerical Street Address or Fire Number and City of Welt or Boring Location 7 i Depth Before Sealing `� ft. Original Depth320 Mirnham Rd Orom 55159 Show exact location of well or boring Sketch map of well I r boring Static Water Level Accurate In section grid with"X. local torr.-e Pen ng prope y lines. N roads,and b ildings. Approximate p i Yf� Single Aquifer ❑Multiaquifer �v ft -- below above land surface _l_ _�_ _�_ _i_ CASING TYPE W E } -r -�- -r- -r feel ❑Plastic ❑Tile ❑Other s mile S Screen from to 1 ft. Open Hole from to ft. ,., r'"11e 1 OBSTRUCTION/DEBRIS/FILL Obstruction ❑Debris ❑Fill PROPERTY OWNER'S NAME John/Sherry Menge 475-2319 .-�-- Type ofdebris/obstruction Mailing Address if different than property address indicated above. Obstruction/Debris/Fill removed? El Yes ❑No PUMP ❑Removed )�-t Present ❑ Other CASING GEOLOGICAL MATERIAL COLOR HARDNESS OF FROM TO FORMATION Diameter Depth Set in oversize hole? Annular space initially grouted? If not known,indicate estimated formation log from nearby well or boring. rr drift 17 r� in.from O to ft ❑Yes ❑Yes ❑No ❑Unknown in.from to ft. ❑Yes El No ❑Yes ❑No ❑Unknown in.from to ft. ❑Yes ❑No ❑Yes ❑No ❑Unknown 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 ft. ❑Perforated ❑Removed infrom to ft. ❑Perforated ❑Removed Type of perforator ❑Other GROUTING MATERIAL `y Grouting material 1 V�G..t%\.� C Vror' io to t 1 ft. yards bags from to h. yards bags REMARKS,SOURCE OF DATA,DIFFICULTIES IN SEALING from to fi yards bags RECEMED from to ft yards bags MAY8 1 UNSEALED WELLS AND BORINGS � e Other unsealed well or boring on property? El Yes �Xo C,1 /Or 1 ORONO 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 Stodola Jell Drilling Cn.- T 27172 Contractor Business Name _ License or Registration No. 4-11-94 �ilrlih6fz'ej Representative Signature— Date LOCAL COPY H 51557 tim e Name of Person Sealing Well or Boring HE-01434-01