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Home My WebLink About2002 - well and boring WELL LOCATION MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WELL NO. County Name WELL AND BORING RECORD 6 7 7 8 6 8 Hennepin Minnesota Statutes Chapter 103/ Township Name Township No. Range No. Section No. Fraction WELL DEPTH(completed) Date Work Completed fr. Orono 118 23 33 % 228 7-8-02 House Number,Street Name,City,and Zip Code of Well Location or Fire Number DRILLING METHOD G 0 Cable Tool 0 Driven 0 Dug 170 Wear Lane N, Orono 56356 0 Auger Rotary ❑ Jetted Show exact location of well in section grid with"X". Sketch map of well loca on.\I 0 Showing property li esy' roads and buildi psi DRILLING FLUID WELL HYDROFRACTURED? ❑YES ( QO N I , water FROM ft.to__ ft. — USE 0 Monitoring 0 Heating/Cooling IDomestic ❑ CommunityPWS ,y i 1 0 Industry/Commercial a Li ❑ Irrigation El Noncommunity PWS 0 Remedial �'� 0 Environ.Bore Hole CI Dewatering 0 w i E Tu _ r r L -__ S, � VZM�Ie ` CASING Drive Shoe? 0 Yes yr No HOLE DIAM. ---- ❑ Steel ❑ Threaded 0 Welded Ir ❑ S - 1 Mile-- i : ,j, , __ i:, ,: N CASING DIAMETER WEIGHT PROPERTY OWNER'StNAME 4 in.to 215 ft. 2.01 lbs./ft. $_in.to_30 Scott Berkey in.to ft. lbs./ft. 61 in.to 'l�fL8 Property owners mailing address if different than well location address indicated above. in.to ft. lbs./ft. . in.to�' ft. same as above SCREEN OPEN HOLE Make Johnson from ft.to ft. Type stainless steael_Dian. 2 Slot/Gauze .010 Length R it ♦ 4 E + t 1 Set between 21` ft.and 228 ft. FITTINGS: a't' �9 6 U : P STATIC WATER LEVEL WELL OWNER'S NAME 120 ft. C below 0 above land surface Date measured p2 PUMPING LEVEL(below land surface) Well owner's mailing address if different than property owner's address indicated above. 210 ft. after 1 hrs.pumping 30 g.p.m. WELL HEAD COMPLETION ,Pitless adapter manufacturer wh i t eva t e yodel ❑ Casing Protection 1:3,�I2 in.above grade ❑ At-grade(Environmental Wells and Borings ONLY) /` GROUTING INFORMATION Well grouted? tEYes 0 No HARDNESS OF n Grout Material res cement ❑ Bentonite 0 Concrete ,o.a,/High Solids Bentonite GEOLOGICAL MATERIALS COLOR MATERIAL FROM TO from 0 to_ Q ft. 3 0 yds. f(bags from 30 to ft. nal❑f i:.l bags topsoil slack soft 0 1 from to ft. 0 yds. ❑ bags NEAREST KNOWN SOURCE OF CONTAMINATION clay gray soft 5 80 --?1'-'1(-) feet �JL-�1 direction .�) t ..L type Well disinfected upon completion? 9 /es 0 No sand brown soft 80 120 PUMP r� 0 Not installed Date installed 7'-9-02 clay/sand gray soft 120 215 Manufacturers name Aermotor C .�+�� Model number HP 1.5 Volts 230 sand gray soft 215 _y� Length of drop pipe 147 ft. Capacity g.p.m. Type:Jy��/�ubmersible 0 L.S.Turbine 0 Reciprocating 0 Jet 0 ABANDONED WELLS Does property have any not in use and not sealed well(s)? 0 Yes ?No VARIANCE Was a variance granted from the MDH for this well? 0 Yes ,'No 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. Don Stddola Well Drillin&o 1 g.4 Inc. 2717 Licen --Business Name --- Ate/- - ��hiSnze•Represent: 'Signature ate Chuck Moore 7-8-02 Name of Driller Date LOCAL COPY 6 7 7 8 6 8 HE-01205-07(Rev.2199) Ir`..1 An nn')n t M Tw('v C(ty W atrv' C , I vtcc 617 13th Ave So Hopkins, Minnesota 55343 • (612) 935 - 3556 07/12/2002 Stodola Well Drilling 3841 North Main St. Bonifacius MN 55375 938-2111 REPORT OF WATER ANALYSIS Lab #: 690 Our Laboratory reports these analytical results, determined on a sample taken by CLIENT on 07/10/2002 from the following location: Scott Berkey 170 Wear Lane N Orono,Mn Unique Well#677868 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 does not include analysis of Lead and other contaminants. (Unless as specified by client). \Twi Water Clinic, Inc. Bill 11\A le Lab Certification#027-053-119 • MINNESOTA DEPARTMENT OF HEALTH Minnesota Well and Boring �+ A 0 WELL OR BORING LOCATION Sealing No. H b County Name WELL AND BORING SEALING RECORD Minnesota Unique Well No. r Hennepin Minnesota Statutes,Chapter 1031 t .5 nir as known) NoIl Township Name Township No. Range No. Section No.•Fraction(sm.-s Ig.I Date Sealed Date Well or Boring Constructed Orono 118N 23W 33 ti N . 20 St P OZ Numerical Street Address or Fire Number and City of Well or Boring Location `/ / / 170 Wear Ln N Long Lake, Mn. Depth Before Sealing f / ft Original Depth /GeV h Show exact location of well or boring 5356 Sketch map of well or boring AOUIFER(S) STATIC WATER LEVEL in section grid with"X". location, showing property XSingle Aquifer ❑ Multiaquifer lines,roads,and buildings. N s''�i WELUBORING [Measured CI Estimated ,1. I , WWater Supply Well ❑Monit.Well f �~ ❑ Env.Bore Hole ❑Other /7U tt. [below CI above land surface W'--c--- --'-� E i CASING TYPE(S) II---i----r--- --- T ,„,1 i Steel ❑ Plastic ❑Tile ❑ Other I I I I kmue ':,,,.:1 -t---+---i 1 CASING(S) ll N l _ Diameter } Depth f Set in oversize hole? Annular space initially grouted? t mire .� t/in.from `� to /7 ft. ❑ YesNo ❑ Yes ❑No ❑ Unknown PROPERTY OWNER'S NAME 4 in.from to ft. ❑ Yes ❑No ❑ Yes ❑ No ❑ Unknown Scott Berkey Property owner's mailing address if different than well location address indicated above. in.from to ft. ❑ Yes ❑ No ❑ Yes ❑ No 0 Unknown SCREEN/OPEN HOLE i Screen from /C 7 to / t/ ft. Open Hole from to ft. OBSTRUCTIONS WELL OWNER'S NAME ❑ Rods/Drop Pipe 0 Check Valve(s) 0 Debris 0 Fill Eo Obstruction Well owners mailing address if different than property owner's address indicated above. Type of Obstructions(Describe) Obstructions removed? 0 Yes ❑No Describe PUMP Type GEOLOGICAL MATERIAL COLOR HARDNESS OF FROM TO CIRemoved XNot 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: _f >fiNo Annular Space Exists J . ) k ) /` ,t ❑Annular space grouted with tremie pipe y. ❑Casing Perforation/Removal in.from _ to ft. 0 Perforated 0 Removed in.from to ft. ❑ Perforated 0 Removed Type of perforator ❑ Other GROUTING MATERIAL(S) (One bag of cement=94 lbs.,one bag of bentonite=50 lbs.) / Grouting Material A.//r?/ <-</j Nfrom/ /l _/''�,,:_LII to! ' ft. yards > bags from to//// ��' ft. yards bags from to . ft. yards begs from to_ ft. yards bags REMARKS,SOURCE OF DATA,DIFFICULTIES IN SEALING OTHER WELLS AND BORINGS Other unsealed and unused well or boring on property? ❑Yes ty No How many? 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 WELL DRILLING CO. , INC. 27172 Contractor Business Name License or Registration No. �. - / = {.te i `- o zed e`presentative Signature . �-- Oafs I ! ✓ O Name of Person Sealing Wall or Boring LOCAL COPY H