HomeMy WebLinkAbout2000 - well & boring record MINNESOTA DEPARTMENT OF HEALTH
CountyName MINNESOTA UNIQUE WELL NO.
WELLName LOCATION WELL AND BORING RECORD
6 4 9 2 3 5
tennepin Minnesota Statutes Chapter 1031
Township Name Township No. Range No. Section No. Fraction WELLDEPTH(completed) Date Work Completed
itOrono 117 23 07 , 51 ' 8-3-00
House Number,Street Name,City,and Zip Code of Well Location or Fire Number DRILLING METHOD
1000 Wildhurst Trail Orono, Nn. 55364 0 Cable Auger 0 IRotary 0 Jetted
Show exact location of well in section grid with°X".( A.. '`�4Ls1- Sketch map of well location. 0
1.4)14r 1 Showing property lines,
roads and buildings. DRILLING FLUID WELL HYDROFRACTURED? 0 YES f�MO
I
I
N !`
x t,/611.. Quick-gel
FROM_ ft.to ft.
USE 0 Monitoring 0 Heating/Cooling
1 i It Domestic
❑ Community PWS ❑ Indust /Commercial
❑ Irrigation
0 NoncommunityPWS Industry/Commercial
I 1 E ❑ Environ.Bore Hole ❑ Remedial
❑ Dewatering 0
I r CASING Drive Shoe? 0 Yes FNo HOLE DIAM.
1 1 1/I2Ma,
1 L 0 ID ❑ Steel ❑Threaded 0 Welded
S 1
1 Plastic 0 glued.
1 Mil,- I
CASING DIAMETER WEIGHT
PROPERTY OWNER'S NAME 4 in.to 2443 ft. SDR21 lbs./ft. 7 7/8 39
ROBERT WAADE & ASSOC• __ in.to ft. lbs./ft. 6 in.i ft.
Property owner's mailing address if different than well location address indicated above. in.to _ft. • lbs./ft.- in.to ft.
3286 Northshore Drive SCREEN OPEN HOLE
Orono, Mn. 55391 Make_Johnson_ from tt.to . ft.
Type Stainless Diam. 2-
Slot/Gauze 018 Length 8'
Set between x,43 ft.and _ft. FITTINGS:_21_3[. ■3A kpac ker
STATIC WATER LEVEL
WELL OWNER'S NAME 65' till below 0 above land surface Date measured 8-3-00
PUMPING LEVEL(below land surface) ,.
Well owner's mailing address if different than property owner's address indicated above. 240' ft. after 2 hrs.pumping 40 g.p.m.
WELL HEAD COMPLETION
❑7.Pitless adapter manufacturer wh i tF t e son r Model
Casing Protection 9/12 in.above grade
❑ At-grade(Environmental Wells and Borings ONLY) l
GROUTING INFORMATION
Well grouted?1❑ Yes 0 No
GEOLOGICAL MATERIALS COLOR HARDNESS OF FROM TO Grout Material 0 Neat cement 0 Bentonite 0 Concrete XHigh Solids Bentonite
MATERIAL
from-0 to 30 ft. 30_3_
0 yds.j bags
from__30_to 3 ft. p Atli rail, yds. 0 bags
Top Soil black a 0' 2' from to ft. 0 yds. 0 bags
�w
S NEA T KNOWN SOURCE OF CONTAMINATION
Clay yeleov S 2' 28' fO' feet ale' 7` direction 0 / type
Well disinfected upon completion? I Yes 0 No S' (A,, 6 rt-
Clay Gray $ 28' 104' PUMP
❑ Not installed Date installed 9-21-01
clay/gravel gray s 104' 120' Manufacturer's name Aermotor
Model number HP 1.5 Volts 230
play gray 8 120' 1804
Length of drop pipe 105 ft. Capacity g.p.m.
Type: I<Submersible 0 L.S.Turbine 0 Reciprocating 0 Jet 0
_clay/gravel gray a 180'236' ABANDONED WELLS
Does property have any not in use and not sealed well(s)? 0 Yes , No
eared tan a 236 '251 ' VARIANCE
Was a variance granted from the MDH for this well? 0 Yes ]QJ 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. a�
1 s , s els_7.:'ine4 ' r - c...'algNo. • 172
-t � � f' _ 9-26-01
Authorized Represen ative Signature Date
•
DuuRne Mathew 8-3-00
6 4 9 2 3 5 Name of Driller Date
LOCAL COPY HE-01205-07(Rev.2/99)
I i
Tw C£y warmer C , I vi,c'.
617 13th Ave So • Hopkins, Minnesota 55343 • (612) 935 - 3556
08/10/2000
Stodola Well Drilling
3841 North Main
St. Bonifacius MN 55375
938-2111
REPORT OF WATER ANALYSIS
Lab #: 39649
Our Laboratory reports these analytical results, determined on a sample taken
by CLIENT on 08/07/2000 from the following location:
Robert Waade
1000 Wildhurst Trail
Orono,Mn
Unique Well #649235
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 Van Arsdale
Analyical laboratory Consulting Engineer
Water Analysis Reagents Boiler Water Chemicals
Lab Certification#027-053-119