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HomeMy WebLinkAbout1999 Well & Boring Record WELL LOCATION MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WELL NO. County Name WELL AND BORING RECORD 6 2 4 9 6 7 Hennepin Minnesota Statutes Chapter 1031 Township Name Township No. Range No. Section No. Fraction WELL DEPTH(completed) Date Work Completed Orono 118 23 27 202 ' 8-19-99 House Number,Street Name,City,and Zip Code of Well Location or Fire Number DRILLING METHOD 850 Willow Drive North Orono,Mn. 0 CableueTool 0 Drivenotar0 Dug ❑ Auger �Rotary 0 Jetted Show exact location of well in section grid with'X". 55356 Sketch map of well location. ❑ Showing property lines, roads and buildings. DRILLING FLUID WELL HYDROFRACTURED? ❑YES 0 NO " Bentonite ____ j ___ FROM ft.to ft. USE 0 Monitoring ❑ Heating/Cooling Domestic -I 1 ''. _a ❑ Irrigation ❑ Community PWS 0 Industry/Commercial 0 Noncommunity PWS 0 Remedial IN I E ❑ Environ.Bore Hole ❑ Dewatering 0 -i r r /ZMu, CASING Drive Shoe? 0 Yes ❑ No HOLE DIAM. ____ ❑ Steel 0 Threaded 0 Welded N)), x WELL �Plastic 0 S 1 Mile CASING DIAMETER WEIGHT PROPERTY OWNER'S NAME 4 0.098'198' n. SDR21 lbs./n. 7 71 3(1, Erotas Building Corp. in.to ft. lbs./ft. V in.202_ft. Property owner's mailing address if different than well location address indicated above. in.to ft. lbs./ft. in.to ft. 3436 40th Street NE SCREEN OPEN HOLE Buffalo, Kn. 55313 Make Johnson from ft.to ft. Type Stainless Steel Diam._3R Slot/Gauze ir8 Length 4' Set between in ft.and 202 ft. FITTINGS: STATIC WATER LEVEL WELL OWNER'S NAME 1101 ft. L�+y below 0 above land surface Date measured 8-19- ri PUMPING LEVEL(below land surface) Well owner's mailing address if different than property owner's address indicated above. 1 94 ft. after 2 hrs.pumping 2 5 g.p.m. WELL HEAD COMPLETION ❑ Pitless adapter manufacturer Model ❑ Casing Protection 0 12 in.above grade ❑ At-grade(Environmental Wells and Borings ONLY) GROUTING INFORMATION Well grouted? J Yes ❑ No HARDNESS OF Grout Material 0 Neat cem t 0 Betgqite ❑ Concrete 11 High Solids Bentonite GEOLOGICAL MATERIALS COLOR MATERIAL FROM TO from to 4 v U ft. 0 yds.8 bags CLay Yel low S 0' 30 I from to ft. El yds. 0 bags from to ft. ❑ yds. 0 bags NEARFy�F T KNOWN SOURCE OF CONTAMINATION)l Clay, Gravel Grey S 30 ' 120' 4OO feet �./604-Ts^i direction ''S--- /421.67– type Well disinfected upon completion? XYes 0 No Sand, Gravel Tan S 12012021 PUMP CINot installed Date installed 11-3-99 Manufacturer's name Goulds Model number HP 1•5 Volts 230 Length of drop pipe 147 ft. Capacity g.p.m. Type:,'bmersible El L.S.Turbine 0 Reciprocating El Jet 0 ABANDONED WELLS Does property have any not in use and not sealed well(s)? El Yes No VARIANCE Was a variance granted from the MDH for this well? 0 Yes O 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 STODOLA WELL DRILLING CO. . INC. Licensee'usiness N. e ic.or Reg.No. 27172 Authorized Repregentlltide Signature Date fred Leiby 8-13-9 Name of Driller H E-01ate 205-06(Rev.7/98) LOCAL COPY 624967 .. Tw iIAA/ City Wafter C , I vtc'. 617 13th Ave So • Hopkins, Minnesota 55343 • (612) 935 - 3556 08/26/1999 Stodola Well Drilling 3841 North Main St. Bonifacius MN 55375 938-2111 REPORT OF WATER ANALYSIS Lab #: 37648 Our Laboratory reports these analytical results, determined on a sample taken by CLIENT on 08/23/1999 from the following location: 850 Willow Dr. Orono,Mn Unique Well #624967 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). i• ity W ter Clinic, Inc. Bill V• .` sda 0 Analyical laboratory Consulting Engineer Water Analysis Reagents Boiler Water Chemicals Lab Certification#027-053-119