HomeMy WebLinkAboutwell info WELL LOCATION MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WELL NO.
County Name WELL AND BORING RECORD 668027
Hennepin Minnesota Statutes Chapter 1031
Township Name Township No. I Range No. Section No. Fraction WELL DEPTH(completed) Date Work Completed
Orono 117 23 4 196 tt 8-24-41
House Number,Street Name,City,and Zip Code of Well Location or Fire Number DRILLING METHOD
❑ Cable Tool ❑priven 4 ❑ Dug
2995 Wktertowa Rd Orono 5 356 ❑Auger Rotary LI Jetted
Show exact location of well in section grid with"X". Sketch map of well local n. ❑
y �SJ�yygqwi property Iiis, --- ---- _--
N i`�� + (iFos and buildi s. DRILLING FLUID WELL HYDROFRACTURED? ❑YES O
! ti` Tv J.+�t r�11 prat er
FROM ft.to ft.
tt
USEomesticO Monitoring ❑ Heating/Cooling
❑ Community PWS
❑ Irrigation ty ❑ Industry/Commercial
i i , i .• ❑ Noncommunity PWS ❑ Remedial
w i E T ❑ Environ.Bore Hole ❑ Dewatering ❑
CASING Drive Shoe? ❑ Yes o HOLE DIAM.
❑ Steel ❑ Threaded ❑ Welded
F116c-
lastic ❑
s
f- i Mile-�
CASING DIAMETER WEIGHT
PROPERTY OWNER'S NAME _ 4 in.to 11 all ft. 201-5 lbs./ft. in.to—30.
Tony Eiden Company in.to ft. lbs./ft. l Lin.togt.
Property owner's mailing address if different than well location address indicated above, in.to ft. lbs./ft. �i in.to_ft.
4140 Berkshire Lane M SCREEN* 1. OPEN HOLE
Plyeau t h� 1'!11 55446 Make Johnson from ft.to ft.
1 TypeAtAk I st�.i Dam.
Slot/Gauze .01 o Length _ 4* + 4"
Set between ft.and rqir�ft. FITTINGS
STATIC WATER LEVEL J
WELL OWNER'S NAME 100 ft. elow ❑ above land surface Date measured A-26— 1
PUMPING LEVEL(( 2
below land surface) q-
Well owner's mailing address it different than property owner's address indicated above. 18S ft. after hrs.pumping 30 g.p.m.
ARL HEAD COMPLETION whi t ewa t e r
/JP�{Pitless adapter manufacturer Mo el
❑ Casing Protection 12 in.above grade
❑ At-grade(Environmental Wells and Borings ONLY)
GROUTING INFORMATION
Well grouted? Yes [_J No
GEOLOGICAL MATERIALS COLOR HARDNESS OF FROM TO Grout Material ❑ Neat cement El Bentonite ❑ Concrete igh Solids Bentonite
MATERIAL from 0 to_34ft. 1' 9-!=] yds.Xags
from 30 to j a ft. nail Cf IVIL I bags
clay yellow soft 0 20 from ft. ❑ yds. ❑ bags
NEAR WN SOURCE OF CON MINATION � t1_
clay brown soft 20 84 feet FSS/ direction type
Well disinfected upon completion? Yes ❑ No
sand/gravel brown soft 80 140 PUMP
��
!
11 Not installed Date installed 1.004 0411001Clay 8"y soft 100 1 54 Manufacturer's name Aenwter
Model number HP 1_ 5 Volts 230
sand tall soft 1 50 19� Length of drop pipe 147 ft. Capacity g.p.m.
Type: I'Yubmersible ❑ L.S.Turbine ❑ Reciprocating ❑ Jet ❑
ABANDONED WELLS
Does property have any not in use and not sealed well(s)? ❑ Yes o
VARIANCE
Was a variance granted from the MDH for this well? ❑ Yes o 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.
DonStodola Well Drilling Co., Inc. 27172
ce Fee Business Name �ic.or Reg.No.
12s14-01
Authorized Represen&7ve Signature Date
Chuck Moore 8-24-01
Name of Driller Date
LOCAL COPY � 668027 HE-01205-07(Rev.2/99)
IC#140-0020
rivi- v C c t" Wat-ef- C I no i.
y
617 13th Ave So Hopkins, Minnesota 55343 (612) 935 - 3556
08/29/2001
Stodola Well Drilling
3841 North Main
St. Boni facius MN 55375
938-2111
REPORT OF WATER ANALYSIS
Lab #: 927
Our Laboratory reports these analytical results, determined on a sample taken
by CLIENT on 08/27/2001 from the following location:
Tony Eiden
2995 Watertown Rd.
Orono,Mn
Unique Well #668027
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).
Cit Water Clinic, Inc.
Bil ale
Lab Cenification#027-053-119