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HomeMy WebLinkAbout2002 well & boring record WELL LOCATION MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WELL NO. County Name WELL AND BORING RECORD 6 8 6 5 6 2 Hennepin Minnesota Statutes Chapter 1031 Township Name Township No. Range No. Section No. Fraction WELL DEPTH(completed) Date Work Completed Orono 117 23 07 148 n 10-11-02 House Number,Street Name,City,and Zip Code of Well Location or Fire Number DRILLING METHOD 1074 Wildhurst Trl, Orono 55364 0 Cable Tool 0 Driven El Dug ❑Auger 5erotary El Jetted Show exact location of well in section grid with"X". Sketch map of well lo .ion. 0 Showing prop-Ctiods.•.buildings. DRILLING FLUID WELL HYDROFRACTURED? (DYES N i --4/-7- water FROM ft.to ft. USE 0 Monitoring 0 CommunityPWS 0 Heating/Cooling 1 omeslic 0 Industry/Commercial u Yr V ❑ Irrigation !l ❑ Environ.Bore Hole ❑ Noncommunity PWS ❑ Remedial W e C 0 Dewatering 0 - i --� �y�, _ s.-e-.4 l t CASING Drive Shoe? 0 Yes j�}�'No HOLE DIAM. L ❑ Steel 0 Threaded0 0 Welded S I---1 Mn. CASING DIAMETER WEIGHT PROPERTY OWNER'S NAME 4 in.to-1-4A_ft. lbs./ft. 6 in.to_'0. in.to ft. - lbs./ft. in.tot. Jnhn Thomas CnatnisfF'+S4 Frames TOc. Property owner's mailing address if different than well location address indicated above. _ in.to ft. lbs./ft. in.to ft. 1161 Wayzata Blvd, 0218 SCREEN OPEN HOLE yU Make Johnson from ft.to ft. Wayzata, MN 55391 Type stainless stl Diam. �» Slot/Gauze •010 Length ,,, t 4, Set between 14Q ft.and ft. FITTINGS: 2 w x3o„ w/kp STATIC WATER LEVEL G WELL OWNER'S NAME 25 ft.j>k•llelow ❑ above land surface Date measured 10-11-02 PUMPING LEVEL(below land surface) Well owner's mailing address if different than property owner's address indicated above. 136 ft. after 1 hrs.pumping 60 g.p.m. WELL M Pitless adapterHEADCOmanufacturerPLETION vhf t eva t e r Model r jr'j c.: El Casing Protection t2 in.above grade $ .) 0 At-grade(Environmental Wells and Borings ONLY) /` GROUTING INFORMATION (:1f Y Luis iii., Well grouted? Yes 0 No HARDNEgg jy' ba Grout Material 0 Neat cement 0 Bentonite 0 Concrete igh Solids Bentonite GEOLOGICAL MATERIALS COLOR MATERIAL FROM TO from to_30_ft. ❑ yds. *bags from 30 to4_40_ft. natural Cfls11 bags fill black soft 0 10 from to ft. ❑ yds. 0 bags NEAREST KNOWN SOURCE OF CONTAMINATION peat black soft 10 20 feet 4-4J direction type_, Well disinfected upon completion? fYes 0 No _ + a sand gray soft 20 30 PUMP ❑ Not installed Date installed 1-7-03 clay gray soft 30 135 Manufacturer's name Aermotor graysoft 148 Model number HP 1•5 Volts 23$ - sand 135Length of drop pipe 63 ft. Capacity •7 g.p.m. Type: '6a/tubmersible 0 L.S.Turbine ❑ Reciprocating 0 Jet 0 ABANDONED WELLS Does property have any not in use and not sealed well(s)? 0 Yes XIClo VARIANCE Was a variance granted from the MDH for this well? 0 Yes >10No 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 So ul •o].ae W,�ll D llin Lsorce5,lb. Ina. 2717. 77"/9 �� �� 1-10-0 Authored Represent.,ve Signa ure Date Chuck Moore 10-11-02 6 8 6 5 6 2 Name of Driller Date LOCAL COPY HE-01205-07(Rev.2/99) i th - Tw( vv Cc y weer C LIvuc,, I v c 617 13th Ave So • Hopkins, Minnesota 55343 • (612) 935 - 3556 10/15/2002 Stodola Well Drilling 3841 North Main St. Bonifacius MN 55375 938-2111 REPORT OF WATER ANALYSIS Lab #: 1064 Our Laboratory reports these analytical results, determined on a sample taken by CLIENT on 10/14/2002 from the following location: 1074Wildhurst Trail Orono,Mn Unique Well #686562 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). Water Clinic, Inc. Bill \f1 •'le Lab Certification tt 027-053-119