The URL can be used to link to this page

Home My WebLink AboutWell and Boring Record rwo'�w CXy u1a � C v I yLc/ 617 13th Ave So • Hopkins, Minnesota 55343 (612) 935 - 3556 07/17/1999 Stodola Well Drilling 3841 North Main St. Bonifacius MN 55375 938-2111 REPORT OF WATER ANALYSIS Lab #: 37398 Our Laboratory reports these analytical results, determined on a sample taken by CLIENT on 07/13/1999 from the following location: Lake Associates 405 S.Willow Dr. Long Lake,Mn Unique Well#624937 Coliform Bacteria <1/100 ml Nitrates Nitrogen <1.0 mg/1 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). kleater Clinic, Inc. Bill Analyical laboratory Consulting Engineer Water Analysis Reagents Boiler Water Chemicals Lab Certification#027-053-119 MINNESOTA DEPARTMENT OF HEALTH Minnesota Well and Boring r WELL OR BORING LOCATIONSealing No. H 5 7 County Name _ WELL AND BORING SEALING RECORD Minnesota Unique No. Minnesota Statutes, Chapter 1031 or W-series No. Hennepin (Leave blank it not known) Township Name Township No. Range No. Section No. Fraction Ism.-i Ig I Date Sealed Date Well or Boring Constructed Orono 127 23 04 ti ti Numerical Street Address or Fire Number and City of Well or Boring Location�t 405 S. Wi 12ov Drive Orono, M • Depth Before Sealing ft Original Depth _ ft Show exact location of well or boring Sketch map of well or boring AQUIFER(S) STATIC WATER LEVEL in section grid with"X". location, showing property ❑Single Aquifer ❑ Multiaquiter lines,roads,and b ildings. N { WELUBORING [I Measured El Estimated t� ❑-Water Supply Well ❑Mond Well --r- -,-- y © ❑ Env.Bore Hole ❑Other ft ❑ above land surface Lr ❑below W --�- -i-- - -- --i-- E CASING TYPE(S) --�- - - -i-- -- Steel ❑ Plastic ❑Tile ❑Other CASING 4— -i-- --1-- Diameter Depth Set m oversize hole'? Annualar space initially grouted? l S f mne f,., in.from to ft. ❑ Yes El, Yes E]No ❑ Unknown PROPERTY OWNER'S NAME 'r! in.from to ft. ❑ Yes ❑No ❑ Yes ❑No ❑ Unknown Lake Associates Property owner's mailing address if different than well location address indicated above. in.from to ft. ❑ Yes ❑ No ❑ Yes ❑No ❑ Unknown 2354 W. Wayzata Blvd. SCREEWOPENHOLE Ste. D Screen from to ft Open Hole from to tt Long Lake, Mn. 55356 OBSTRUCTIONS WELL OWNER'S NAMEXo ❑ Rods/Drop Pipe ❑ Check Valve(s) ❑ Debris dl ,f�oJ Obstruct ons. Well owner's mailing address if different than property owner's address indicated above. Type of Obstructions(Describe) Obstructions removed? ❑Yes ❑ No La�scri68 PUMP Type GEOLOGICAL MATERIAL COLOR HARDNESS OF FROM TO ❑ Removed ❑ Not Present ❑ Other FORMATION METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS,OR CASING AND BORE HOLE: It rot known,indicate estimated formation log from nearby well or boring, ❑ No Annular Space Exists ❑ Annular space grouted with tremie pipe ❑ Casing Perforation/Removal in.from to tt. ❑ Perforated ❑ Removed in.from to ft. ❑ Perforated ❑ Removed Type of perforator ❑ Other GROUTING MATERIAL(S) Grouting Material from to ft. yards bags from to ft yards bags from to ft. yards bags from to— ft. yards bags REMARKS,SOURCE OF DATA,DIFFICULTIES IN SEALING OTHER WELLS AND BORINGS Other unsealed and unused well or boring on property? ❑Yes ❑No How many? LICENSED OR REGISTERED CONTRACTOR CERTIFICATION This well or boring was sealed in accordance with Minnesota Rules,Chapter 4725. The information contained in this report is true to the best of my knowledge. DON STODOLA WELL DRILLING CO. , INC. 27172 Contractor Business NarM` License or Registration No. r Authorized Representative Signature Date LOCAL COPY H 156792 Name of Person Sealing Well or Boring HE•01434-04 8/98 R %YELL uOCATION MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WELL NO. County Namegennepin WELL AND BORING RECORD 624937 Minnesota Statutes Chapter 103/ Township Name Township No. I Range No. Section No. Fraction WELL DEPTH(completed) Date Work Completed Orono 1117 23 04 ./, 122' n. 7-12-99 House Number,Street Name,City,and Zip Code of Well Location or Fire Number DRILLING METHOD 405 S. Willow Drive Orono, m. 55356ElCable Tool Q�Driven ❑ Dug ❑ Auger f�iRotary ❑ Jetted Show exact location of well in section grid y✓ith�C. Sketch map of well location. ❑ X V3 G 6 Showing property lines, DRILLING FLUID WELL HYDROFRACTURED? ❑YES ❑NO N Natural FROM to ft. USE ❑ Monitoring ❑ Heating/Cooling I I I I IXDomestic -I- -�- -4- -�- ❑ Irrigation ❑ Community PWS ❑ Industry/Commercial I I I ❑ Noncommunity PWS ❑ Remedial W I E T ❑ Environ.Bore Hole ❑ Dewatering ❑ /2Ma� CASING Drive Shoe? ❑ Yes ❑ No HOLE DIAM. ❑ Steel ❑Threaded ❑Welded l IXPlastic ❑ s -1 Mila � CASING DIAMETER WEIGHT PROPERTY OWNER'S NAME 4 in.to 114 ft. 2.05 lb../ft. 8 in.to 30 ft. Lake .Associates in.to ft. lbs./ft. 6k-in.to122 Property owner's mailing address if different than well location address indicated above. in.to ft. lbs./ft. In.to_ft. --1212 E. Wayzata Blvd. SCREEN OPEN HOLE / >Wayzata, Mn. 55391 Make from to ft. f � Type Sta nless Steel Diam. Slot/Gauze -ill 0 Length Set between1 1 4 ft.and 127 FITTINGS:2 p X 1001 1t/k STATIC WATER LEVEL WELL OWNER'S NAME 54• —ft.16 below ❑ above land surface Date measured 7-1 2-99 PUMPING LEVEL(below land surface) Well owner's mailing address if different than property owners address indicated above. 108 ft. after 1.5 hrs.pumping 3 5 Sa i r g.p.m. WELL HEAD COMPLETION Critless adapter manufacturer Vel ❑ Casing Protection EA42 in.above grade ❑At-grade(Environmental Wells and Borings ONLY) GROUTING INFORMATION Well grouted? IXYes ❑ No HARDNESS OF Grout Material ❑ Neat cement ❑ Bentonite ❑ Concrete Hi h Solids Bentonite GEOLOGICAL MATERIALS COLOR MATERIAL FROM TO g from to 30_ft. 2. 13ydsX bags from to ft. Clay Yellow S 0 ❑ yds. ❑ bags 18' from to ft. ❑ yds. ❑ bags A NEA OWN,SOURCE OF CO MINATIONN Tf G 41 Clay Grey S 1 g# 98 0 feetOyT/l direction type Well disinfected upon completion? X Yes ❑ No Water Sand Grey S 98. 122• PUMP ❑ Not installed Date installed 8-30-99 Manufacturers name Red Jacket Model number 0148443 HP 3/4 vol, 230 Length of drop pipe 84 ft. Capacity 12 g.p.m. Type:X Submersible ❑ L.S.Turbine ❑ Reciprocating ❑Jet ❑ ABANDONED WELLS Does property have any not in use and not sealed well(s)? ❑Yes A No VARIANCE Was a variance granted from the MDH for this well? ❑ Yes :9 No TN# WELL CONTRACTOR CERTIFICATION Use a second sheet,i/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 WILL DRILLING CO. , INC. IL Busines Lic.or Reg.No. 27 9-28-99 Authorized R entative Signature Date Chuck Moore 7-12-99 Date LOCAL COPY 1624937 Name of Driller HE-01205-06(Rev.7/98)