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HomeMy WebLinkAbout2006 - well and boring record MINNESOTA UNIQUE WELL WELL/BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH AND BORING NO. (Aunty Name WELL AND BORING RECORD 7 3 8 3 6 Hennepin Minnesota Statutes,Chapter 1031 Township Name Township No. Range No. Section No. Fraction WELUBORING DEPTH(completed) DATE WORK COMPLETED Orono 118 23 27 ,,, ,,, ,,, 182 ft. 512-06 GPS DRILLING METHOD LOCATION: Latitude degrees minutes seconds ❑Cable Tool Dag riven O Dug Longitude degrees minutes seconds ❑Auger :, otary ❑Jetted House Number,Street Name,City,and Zip lCode�of356 Well LocatiioonCor Fire Number ❑ 1849 West Rd, Orono 55DRILLING FLUID WELL HYDROFRACTURED? ❑Yes-80oShow exact location of well/boring in section g d with"X." Sketch map of well location. bentonite From ft.To ft. Showing property lines, USE -Kiomestic ❑Monitoring ❑Heating/Cooling N roads,buildings, 9 9 I and direction. ❑Noncommunity PWS ❑Environ.Bore Hole ❑Industry/Commercial i-----.j__ -- j --' . ❑Community PWS ❑Irrigation ❑Remedial I .. - 4 r, ❑Elevator ❑Dewatering ❑ \ ',A CASING MATERIAL Drive Shoe? ❑Yes Xfo HOLE DIAM. W t ; 1 ET ' CISteel ❑Threaded ❑Welded i i 'h Mile �i\ lastic ❑ ,04 CASING 1 • W Diameter Weight Specifications i i r— 4 174 L I--1 Mile---I !t 30 in.to ft. lbs./ft. 8 in to ff in.to ft. • lbs./ft. in.to_vise PROPETY OWNER'S NAME/COMPANY NAME in.to ft. lbs./ft. n,to ft. Anthony SCREEN -r OPEN HOLE Property owner's mailing address if diff‘rent than well location address indicated above. Make Jdmson From ft.To ft. 4100 Berkshire Lane Type Steal PRA Mitt Diam. 2" Plymouth, MN 55446 Slot/Gauze .Qi0 Length 411 + 4; Set between 174 ft.and 182 ft. FITTINGS 2b]G6�F kp �t w/ STA ATER LEVEL q #w}+ ft.Selow ❑Above land surface Date measured 5-2--06 PUlalfj,(pIG LEVEL(below land surface WELUBORING OWNER'S NAME/COMPANY NAME j ft.after hrs.pumping g.p.m. ELL HEAD COMPLETION . h wa e� Well/boring owner's mailing address if different than property owner's address indicated above. itless Adapter Manufacturer�/�/,} •1 �M del El-Casing Protection �.2 in ab"ove grade " ❑At-grade(Environmental Well and Boring ONLY) GROUTING INFORMATION Well grouted? 'Yes ❑No Grout materials ❑Neat cement Kentonite ❑Concrete ❑Other From_XL To ft. _ ❑Yds. ❑Bags From _To ft. natural_fin ❑Bags GEOLOGICAL MATERIALS COLOR HARDNESS OF FROM TO From To ft. ❑Yds. ❑Bags MATERIANEAREST KNOWN SOURCE OF CONTAMINATION topsoil black soft 0 90 feet direction^ . type Well disinfected upon completion?.f��/Yes ❑No C14.tii PUMP J ' 41, V F` clay/sand gray 170 C7 Not installed Date instilled watersand gray medium 170 182 Manufacturer's name sq" r O Q Model Number , HP�� —5 Volts C:7 ---3°C:7 ---3°Length of drop pipe /4:::: &/4:::: &/ ft. Capacity , g.p.m. Type:‘bmersible ❑L.S.Turbine ❑Reciprocating ❑Jet ❑ ABANDONED WELLS Does property have any not in use and not sealed well(s)? ❑Yes 'No VARIANCE ✓,,/ Was a variance granted from the MDH for this well? ❑Yes.Lat to TN# 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. R,._ 9 REMARKS,ELEVATION,SOURCE OF DATA,etc. Don Stodola Well Drilling Co,. Inc. 271 j2 I_'icensee Business Name _ _- . - Lic.ori Reg.No. G r Aut,P e.IP::.r enta ive Signature Date Jim_ ate'' LOCAL COPY 7 3 913 6 Name of Driller HE-01205-09(Rev.9/05) IC 140-0020 C Cty W ctter C , Inc/ 617 13th Ave So • Hopkins, Minnesota 55343 • (612) 935 - 3556 05/04/2006 Stodola Well Drilling 3841 North Main St. Bonifacius MN 55375 938-2111 REPORT OF WATER ANALYSIS Lab #: 246BN Our Laboratory reports these analytical results, determined on a sample taken by CLIENT on 05/02/2006 from the following location: 1849 West Farm Rd. Orono,Mn Well #739136 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). Twirl City Water Clinic, Inc. Bill Vc�i0` 1rs.�d le Lab Certification#027-053-119