HomeMy WebLinkAboutWell and Boring Record MAR-22-2611 11 : 12 AM LEUTHHER WELL IHC 952 447 2592 P. 61
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MINNES0 NIa E WELL
. AND •
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MINNESOTA DEPAYt'TM N7 OF HEALTH
WELL AND B INC3 RECORD 031 1
7 5 8`2
WELL OR BORING LOCATION Chapter C
Minnesota Stalun+r p !•;
,I.i; DATE WOFfN..MPL6TED .. ,
tNELl790nIN• OCf•TH loo ) i"
action No, 4Q � y
• Rance o. 6 r f /Jr" r
J DRILL c f'
V0 �_ I I�Driven h,Dug
seconds Jeuod
OPS df101aa min�iao Cablo Toot
Latitude C clary Z
LOCATION: degrees � minulas �-- seconds _. �ALUM '� _
IAnguuda C. -
DRILLING FLUID WELL.HVDROFRACTURED7 J Yea '
Houma umber.Sir 'd NEM,City,end Zip Code mf Wwll Location
No
/f From K.To.._-- '
A Al
;mien g d h°X1'
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Sketch map of buildiwellfongs,
ooRtloone, Ij Monitoring [I Hemin®ICooling
r not location o plJ' ' ;, Showing property Ir r oomr■dc
5r roads,building),anddirection. E nd�str IOommeMlel'
E]Nonaommunhy OWf3 D.environ.Oar.Holo �� y
���� r El community PWS
C Irrigatienviroan Li Ramedlal i;,
U Elsvntor 1 Detealenna
HOLE DIAM.
w��� CABI. MATERIAL Drive Shoe? j Ya. C�No "�i 'I
� ', U pteel U Thradeo ���)Welded
IIII T b tale L�- /
ENE= I." CrSINt3 - r.—
Wolght Specifications D amat:r / to 1' t.
SI
In,to ) r3 It. _�—.—Jbedlt .
I �� , In.IO_,/
��-1 Mud �����' �' ��In.to _It. Ibe,Al.
lbs". In.to . Il.
PROPERTY OWNCP's NAMO1COnnW+NV NAME: _In.to It. - .. '.I• i I
' 1 OPEN HOLE i:••!;,., is
40 A SCREEN I••'../1::.....•HI;I'I.': I
rt _ n; ' .._
Pf•• War's • n9 eddnes 1 d rant than viol location QOdfaea Indicated abo•a Moko � '•'
Qlam.
TyPa Length l,.s
Siol/0 wan
Eat between IL and R. FITTINOB._� ' ••
'Measur+oi trom__. I ."Ilaplai
VATIC WATER L .'L II,;'h'I!I;"Ilii)
It.n Bolan ❑Abcwe land surface Date mefleUrdl_.—
„-'�i�lilii;
PUMPING LEVCL(below land surfed)) 1 i,
v:pLL O NER'8 NAMGIGOMPANY NAME has d�^tbjn9°'___ —g-p.m.
It.alter
.� WELL�EADCOM-LETI•N .� Moder /r'. .!
orin0 OWnaf'i mailing adOrBaa II dltlerenl than property a^'nor's address Indicated above, Itlossradapt■r reanuhlcturer it�,.p �'.
rVS 1Lf� 'I ,'I'I.
____,... --:-.• [,J 12In.eoovl ,' y`I II'
casing Protection • I'I„', IIS
❑At sand)(Environmental Wall and BOrin ONLY)
.. Q-r TIN.INFORMATION �II ;.! I II 1d1LII
Well grouted jt'laa 0 No .,:!�I i.iil
afoul materiels J Neal cement entonlle E concrete L�Odler ,
From Tb II. ❑Yds. ace
From To It, - ❑Yds. . Sags
— W MAT E IA OF FROM 70 To It, f Yoe, r]'Sega
GEOLOGICAL MATERIALS COLOR MAS BRIAL From , .
I Pr NEAREST KNOWN SOURCE OR CONTAMINATION p
i • i N / J / fat ,`'1_ direction y `elfsp C•-- type
enell OIaIn1BMd upon ccme I]plellon9 L Wo
PUMP 'I:
NIMMF211/11Va 12111111111 Nol stalled time In' lad —L�- i
MenuheeuroPe namedrir f1111W11171111 •�• Model Numbor /� HP�r' —yplte_� Length of drop pipe rte"—._ +L Capocilw_.-- o.D.lh.
Type;g Submersible ❑L.S,Turbine ❑Reoiprocaonq ❑Jet '❑ ,i
ABANDONED WCLLB —
„I •
Dobe property have any not In ue.and not naiad w■Ilia)7 t 11 Yes ' o i
VARIANCE I''
was a ens.)grontod from the MOH Lor this Wwii9 I,I vee �•No TNd� '
') WELL CONTRACTOR CERTIFICATION S 'll
This well well drilled under my aupervlalon and In a000rdenao with Mlnnasola Rules.,fJhi'�'a
aprer d
The Information contained In Ws report is true to the beet of my knowledge.
U99 a second sheaf,11 needed.
REMAPKs.ELeVATION,80UROE OI DATA,aro. �� � � ` �
Ian a DuBlnon Na .�Llo.or Rag,No.
..1T' 0.4.
III e• -e• =sen a vi Signature -d Rap.No. Date
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LOCAL COPY 1 7 5 8 2 2 2 i�.ergeeti-!� �_ ;i
• Name or Driller l.
pC.alme•1'
I IC T+-0020
• 51\A cl
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0 a20 512_74f,
LJ—) . 61— 4C)
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O rakic Oil (4
20 L<J, "'"ZA 'TA T3 V A
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