HomeMy WebLinkAbout2005 well and boring record WELL LOCATION MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WELL NO.
County Name WELL AND BORING RECORD 71. 14 9 3
Hennepin Minnesota Statutes,Chapter 1031
Township Name Township No. Range No. Section No. Fraction WELL DEPTH(completed) Date Work Completed
Orono '1�7 23 6 '/, ,, ,, 155 n. 2-24-05
GPSDRILLING METHOD
LOCATION: Latitude degrees minutes seconds
❑C2ble Tool ❑Driven ❑Dug
Longitude degrees minutes seconds ;l
❑Auger Rotary ❑Jetted
House Number,Street Name,City,and Zip Code of Well Location or Fire Number -�
356 Lake St W, Orono 55356 DRILLING'FLUID WELL HYDROFRACTURED? ❑Yes$o
Show exact location of well in section grid with 'X". Sketch map of well location. bentonite FROM ft.TO ft.
Showing property lines
N N% roads and buildings USE
❑Monitoring ❑Heating/Cooling
_i___ Domestic ❑Environ.Bore Hole ❑Industry/Commercial
C Noncommunity PWS ❑Irrigation ElRemedial
❑Community PWS ❑Dewatering ❑
I I / CASINGk/ HOLE DIAM.
w E Drive Shoe? ElYes J2 No
I ❑Steel ❑Threaded ❑Welded
lh Mile Plastic 111--------r--- ---- 1
CASING DIAMETER WEIGHT
S ,
4 __ 2 lbs./ft. 8 in.to Oft.
I -1 Mile in.to1_4R ft.
in.to ft. lbs./ft. 63 in.to5ft
_1S 7
PROPERTYOWNER'SNAME/COMPANY NAME in.to ft. lbs./ft. in.to ft.
Stonewood Design Build SCREEN Johnson
. OPEN HOLE
Property owner's mailing addressFROM if different than well location address indicated above. Make FJiRi
442- Shoreline Dr Type stainless stlDiam.2 r. ft. TO ft.
Seting Park, MN 55384 Slot/Gauze .010 Length 4' + 4
Set between _ft.and 155 ft. FITTINGS Z X36) wilp
STATIC WATER LEVEL s�
52
?below ❑above land surface Date measured`-24-05
PUMPING LEVEL(be owland surface)
WELL OWNER'S NAME/COMPANY NAME 145
1 J ft.after hrs.pumping S0 g.p.m.
W LL HEAD COMPLETION a
Well owner's mailing address if different than property owners address indicated above. 1� -itless adapter manufacturer whituter Model
❑Casing Protection In.above grade
_❑At-grade(Environmental Wells and Boring ONLY)
GROUTING INFORMATION
Well grouted D9 Yes ❑No
• Grout material ❑Neat cement ❑Bentonite ❑Concrete„High Solids Bentonite
from_to3_ft. _3___ ❑yds. bags
from40_to448_ftm flids.fbags
GEOLOGICAL MATERIALS COLOR HARDNESS MATERIA OF FROM TO from to ft. ❑yds. ❑bags
NEAREST KNOWN SOURCE OF CONTAMINATION
(� feet i �
direction ''t �� .”lr Jrr type
clay yellow medium 0 30
Well disinfected upon completion Yes ❑No
PUMP
clay p
gray medium ❑Not installed Date installed -2 V-05
clay/sand/gravel gray soft 92 146 Manufacturer's name Amraotor
L Model number HP 1 Volts 230
watersand , gray medium 146 155 Length of drop pipe 84 ft. Capacity g.p.m.
Type:r Submersible ❑L.S.Turbine ❑Reciprocating ❑Jet ❑
ABANDONED WELLS
Does property have any not in use and not sealed well(s) ❑Yes �'FJo
VARIANCE !
Was a variance granted from the MDH for this well? ❑YesNo 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 t{1�,,,,.� c t�,� Inc. t1
REMARKS,ELEVATION,SOURCE OF DATA,etc. Kon Stodola Well Drilling Co., Inc 27172
172
Licensee Business Name Lic.or Reg.No.
4 /
/i/4 2-24-05
,/ ,n ed'epresentative Sigyr- Date
Jim Kohis
LOCAL COPY 71 14 9 3 Name of Driller
HE-01205-08(Rev.5/02)
IC 140-0020
rw C( y W cter C , I vtc'.
617 13th Ave So Hopkins, Minnesota 55343 • (612) 935 - 3556
02/28/2005
Stodola Well Drilling
3841 North Main
St. Bonifacius MN 55375
938-2111
REPORT OF WATER ANALYSIS
Lab #: 104BN
Our Laboratory reports these analytical results, determined on a sample taken
by CLIENT on 02/24/2005 from the following location:
356 Lake St. W
Orono,Mn
Well #711493
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).
Twin City Water Clinic, Inc.
Bill V, n-4rsdale
Lab Certification#027-053-119