The URL can be used to link to this page

Home My WebLink About09-16-19 Well & Boring Construction Record MINNESOTA UNIQUE WELL WELL OR BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH AND BORING NO. County Name WELL AND BORING CONSTRUCTION RECORD Minnesota Statutes,chapter 1031 8 4 4 7 8 0 ' ' <: Hennepin Township Name Township No. Range No. Section No. Fraction(sm.—.Ig.), WELL/BORING DEPTH(completed) DATE WORK COMPLETED Orono 117 23 23 '/NE NW SW 108 ft. 9-16-19 GPS LOCATION—decimal degrees(to four decimal places). DRILLING METHOD : Latitude Longitude ❑Cable ,1 '-, Driven ❑Dual Rotary ❑Auiotary f❑Rotasonic House Number,Street Name,City,and ZIP Code of*ell Location ❑Other T 360 Big Island, Orono 55J 71 DRILLING FLUIDLUIWELI,.HYDROFRACTURED? ❑Yes o Show exact location of well/boring in section grid with"X" Sketch ma. • well/boring location. bentonite From ft.To ft. Sh. ' g property lines, N roads,buildin. and direction. USE Domestic ❑Monitoring ❑Heating/Cooling ;_____i__,__ I ]Noncommunity PWS ❑Irrigation ❑Industry/Commercial ❑Community PWS ❑Dewatering ❑Remedial a-___ __-;___ ❑Elevator w E <>;1' CASING MATERIAL Drive Shoe? ❑Yes ❑o HOLE DIAM. -_;_". t `------" T `� ' . ;.❑Steel ❑Threaded El We d h mile P lastic ❑ - - F.--- - 1-- / ...9-"' CASING ' T s )':1- 1 Diameter Weight Specifications I- 1 Mile y // 4 in.To 98 ft. lbs./ft. in.To �ft. 61/2 117ffl PROPERTY OWNER'S NAME/COMPANY NAME in.To ft. lbs./ft. in.Toft. Harwood Gr in.To ft. lbs./ft. in.To ft. Property owner's mailing address if different than well location address indicated above. SCREENJ OPEN HOLE ohnson Make From ft. To ft. 6255 Bury Dr Type stainless steel Diam. 2" Eden Prairie, MN 55346 Slot/Gauze .010 Length 4' + 4' Set between 98 ft.and 108 ft. FITTINGS 2"x3' leader STATIC WATER LEVEL 26 ft, elow ❑Above land surface Date measured 9-16-19 Dry hole ❑Yes o WELL OWNER'S NAME/COMPANY NAME PUMPING LEVEL(below land surface) 2 50 95 ft,after hrs.pumpingq.p-m. Well/boring owner's mailing address if different than property owner's address indicated above. leLeLHEAD COMPLETION ite�7i stet 2Pitless/adapter manufacturer wilModel ❑Casing protection - X12 in.above grade ❑At-grade ❑Well House ❑Hand Pump GROUT INFORMATION(specify bentonite,cement-sand,neat-cement,concrete,cuttings,or other), Materialbent�lte From 0 To 50 ft. 3 ❑Yds. drags Materia t ingg From Tog ft. ❑Yds. Bags HARDNESS OF final From To ft. ❑Yds. ❑Bags GEOLOGICAL MATERIALS COLOR FROM TO MATERIAL Driven casing seal From To Bags = One bag94 lbs.cement or 50 lbs.bentonite 0 NEAREST KNOWN SOURCE OF CONTAMINATION fine sand/clay brown soft 15 Well is fi feet -1--' direction from type brown.! Well disinfected upon completion? Xes ❑No swamp clay gray soft 15 44 PUMP ❑Not installed Date installed 9-30-19 Clay/sand brown medium 44 58 Manufacturer's name Schaefer medium O Model Number L^ HP 3/4 Volts 230 sandy clay gray tmeditum 58, 77 Length of drop pipe 60 ft. Capacity g.p.m. sand/claygraysoft 77 92 Type: ubmersible ❑L.S.Turbine ❑Reciprocating ❑Jet ❑ ABANDONED WELLS O Does property have any not in use and not sealed well(s)? El Yes 1114 No sand mix soft 92, 108 VARIANCE ��//// Was a variance granted from the MDH for this well? ❑Yes [�.t�lo TN# WELL CONTRACTOR CERTIFICATION /T 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. REMARKS,ELEVATION,SOURCE OF DATA,etc. Dorb Stodola Well Drilling Co,. Inc. 1691 Licensee Business Name Lic.or Reg.No. 9-17-19 C ifi R res ntative l lure Certified pep.No. Date Rob Stodola LOCAL COPY 8 4 4 7 8 0 Name of Driller ID#52603 HE-01205-18(Rev.3/19) • • t R Minnesota State Laboratory ID#027-053-119 Twin City Water Clinic Laboratory Test Report Wisconsin State Laboratory ID#105-10117 Wisconsin DNR Lab ID#399073400 Client: Don Stodola Well Drilling Report Number: 19-10057 Twin City Water Clinic Inc. Sample Collection Date: 09/16/19 617 13th Avenue South Address: 3841 North Main Street Sample Collection Time: 16:00 Hopkins, MN 55343 St.Bonifacius,MN 55375 Sample Receipt Date: 09/17/19 Phone: (952)935-3556 Report Issue Date: 09/18/19 Fax: (952)935-5077 Laboratory Analyte Client ID Parameter , Sample Prep Sample Analysis Test Sample ID Date Time .Date Time Results Units 19-10057 Coliform Drinking Water 09/17/19 12:16 Absent 19-10057 Nitrate/N Drinking Water 09/17/19 14:01 <1.0 mg/L 19-10057 Arsenic Drinking Water 09/17/19 8:50 09/18/19 10:13 2.42 µg/L Lead Drinking Water µg/L Well No.: 844780 X No samples were subcontracted;or the above test result(s) with'**'designation were produced by a subcontracted Sample pt: well laboratory. [Laboratory name;address;MDH Lab 104]. The Well Adr: 360 Big Island;Orono,MN subcontracted laboratory maintains MDH Certification for the Owner: field(s)of testing performed. Owner Adr: Sample Conditions: Samples received on ice. Sample Temp: 6°C Discussion: Notes: Approved methods used in analyzing the samples listed above have the MCL is defined as the Maximum Contaminant Level allowed by the following reporting levels: Safe Drinking Water Act. The analyzed parameters have following SM9222B-Coliform,1 cfu/100 ml MCL: EPA 353.2 Nitrate Nitrogen expressed as NO3+NO2,1.0 mg/L Coliform,<1 cfu/100 ml Nitrate Nitrogen, 10.0 mg/L SM3113B Arsenic,2.0 pg/L,Lead,2.0 pg/L Arsenic,10.0 pg/L Lead,15.0 pg/L EPA 353.2 Nitrite Nitrogen,1.0 mg/L Nitrite,1 mg/! For further information call your state health department or call the EPA Safe Drinking Water Hotline 1-800-426-4791. Sample Collected by: X Client _TCWC Approved By: ' Bill Van Arsdale Laboratory Manager The results listed in this report apply only to the above listed samples.All routine quality assurance procedures were followed,unless otherwise noted.This analytical report must be reported in its entirety.All methods are certified by the Minnesota Department of Health,unless otherwise noted: TCWC Rev 7.0 19/19) Page 1 of 1