The URL can be used to link to this page

Home My WebLink Aboutwell info .. Minnesota Well and Boring 33414 WELL OR BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH Sealing No. H County Name WELL AND BORING SEALING RECORD Minnesota unique No. — Hennepi n Minnesota Statutes,Chapter 103/ or W-series No. (Leave blank.1 not-own) Township Name Township No. Range No. Section No. Fraction Ism. �Ig.) Date Sealed Approximate Date Well Orono 118N 23M 31 1 SE,4 SEtAV. 11/10/93 or Boring Constructed Numerical Street Address or Fire Number and City of Well or Boring Location p 425 Turnham Road Depth Before Sealing 198 ft Original Depth it Show exact location of well or boring Sketch map of well or boring Static Water Level El Accurate in section grid with'X location.showing property lines. N roads,and buildings. r.]Approximate Single Aquifer ❑Multiaquifer 1777 ft, below above land surface _ CASING TYPE W E T KI Steel El Plastic El Tile El Other i,mile S Screen from to fl. Open Hole from to ft. OBSTRUCTION/DEBRIS/FILL ❑Obstruction ❑Debris ❑Fill PROPERTY OWNER'S NAME William Stempel Type of debris/obstruction 'e Mailing Address ifdifferent than property address indicated above. Obstruction/Debris/Fill removed? ❑Yes 11 No 425 Turnham Road PUMP Maple Plain, MN 55359 Removed ❑Not Present ❑ Other 41 HARDNESS OF CASING GEOLOGICAL MATERIAL COLOR FORMATION FROM TO - Diameter Depth Set in oversize hole? Annular space initially grouted? If not known,indicate estimated formation log from nearby well or boring. 4 in from to — ft ❑Yes ❑No ❑Yes ❑No ®Unknown " in.from to — ft. ❑Yes ❑No ❑Yes ❑No ❑Unknown in.from to — ft. ❑Yes ❑No ❑Yes ❑No ❑Unknown METHOD USED TO SEAL ANNULAR SPACI=BETWEEN 2 CASINGS,OR CASING AND BORE HOLE: No Annular Space Exists ❑Annular space grouted with tremie pipe ❑Casing Perforation/Removal infrom to fl. ❑Perforated ❑Removed in.from to ft. ❑Perforated ❑Removed Type of perforator ❑Other GROUTING MATERIAL Grouting material neat cement — from 0 to 198 ft. yards 17 bags from to ft. yards bags }.; REMARKS,SOURCE OF DATA,DIFFICULTIES IN SEALING from to ft, yards bags from to ft. yards bags UNSEALED WELLS AND BORINGS Other unsealed well or boring on property? 1iYes ❑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. �Q- W -11 Contractor usiness Name ktf--1--1--f--F--' --- - License o e istration No. 11/15/93 Authorized Representative Signature Date LOCAL COPY Dan Maas H 33414Name o/Person Sealing Well or Boring HE-01434-01 WELL LOCATION MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WELL NO. County Name WELL- RECORD 530230 Hennepin Minnesota Statutes Chapter 1031 Township Name Township No. Ran a No. Secti No. Fr do WELL DEPTH(completed) Date Work C I Orono 118N h 0 Sf k NW 196 Y�3y s/93 Numerical Street Address and City of Well Location or Fire Number DRILLING METHOD 425 Turnham Road ❑ Cable Tool ❑ Driven ❑ Dug ❑ Auger Rotary ❑ Jetted Show exact location of well in section grid with"X". Sketch map of well location. ❑ Showing property lines, N roads and buildings. DRILLING FLUID water t i I USE Domestic ❑ Monitoring El Heating/Cooling ❑ Industry/Commercial W i :X 1 E ❑ Irrigation ❑ Public El Test Well ❑ Dewatering El Remedial I � ' CASING Drive Shoe? ❑ Yes xl No HOLE DIAM. --�- - —r- I ❑ Steel ❑ Threaded ❑ Welded i � 1 Ix Plastic ❑ CASING DIAMETER WEIGHT PROPERTY OWNER'S NAME 4 in.to 191 ft. lbs./ft. �in.to 196 ft. William Stempel in.to ft. lbs./ft. in.to ft. Mailing address if different than property address indicated above. in.to ft. lbs./ft. in.to ft. SCREEN�� co OPEN HOLE 425 Turnham Road Make may""' � from ft.to ft. Maple Plain, iA 55359 Type �8 s Slot/Gauzelot LLength Set between --------BI-ft.and 196 ft. FITTINGS: HARDNESS OF STATIC WATER LEVEL GEOLOGICAL MATERIALS COLOR MATERIAL FROM TO 127 ft.,X below Elabove land surface Date measured rt p PUMPING LEVEL(below land surface) 0 Clay brown 3$ ft. after hrs.pumping 75+ g.p.m. WELL HEAD COMPLETION u Clay gray 38 101 X Pitlessadaptermanufacturer Mass Model 4J1 ❑ Casing Protection ❑ 12 in.above grade Clay & gravel gray 101 129 GROUTING INFORMATION Well grouted? X Yes ❑ No Sand brown 129 152 Grout Material EX Neat cement ❑ Bentonite from to 30 ft. ❑ yds. ❑ bags from to ft. ❑ yds. ❑ bags Gravel mixed 152 196 from to ft. ❑ yds. ❑ bags NEAREST KNOWN SOURCE OF CONTAMINATION feet direction type Well disinfected upon completion? IT,Yes ❑ No PUMP ❑ Not installed Date installed Manufacturer's name Goulds Model number HP 3/4 Volts 230 Length of drop pipe 140 ft. Capacity 10 — 9-p.m-Pressure Tank Capacity_ 33 gal- Type: X Submersible ❑ L.S.Turbine ❑ Reciprocating ❑ Jet ❑ ABANDONED WELLS Does property have any not in use and not sealed well(s)? a Yes ❑ No 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. Use a second sheet,if needed Stevens Well Drilling Co. Inc. 86654 REMARKS,ELEVATION,SOURCE OF DATA,etc. Licensee Business Name Lic.or Reg.No. 10/28/93 Authorized Representative Signature Date Paul Swearingen 10/28/93 Name of Driller Date LOCAL COPY 15302301 HE-01205-04(Rev.5/92)