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Home My WebLink About2006 well & boring record MINNESOTA UNIQUE WELL WELUBORING LOCATION it MINNESOTA DEPARTMENT OF HEALTH AND BORING NO. County Name WELL AND BORING RECORD Th73 9139..oepin Minnesota S jtptes,Chapter 1037 Towriship Name Township No. Range No. Section No. Fraction WELUBORING DEPTH(completed) DATE WORK COMPLETED Orono 117 23 02 ,/, ,/, ,/, 245 ft. 5-10-06 GPS DRILLING METHOD LOCATION: Latitude degrees minutes seconds ❑Cable Tool ❑Driven ❑Dug Longitude degrees minutes seconds ❑Auger 1otary CI Jetted House Number,Street Name,City,and Zip Code of Well Location or Fire Number ❑ 1230 Woodhill Ave, Orono 55391 DFjILLI C�[FF8LII to ;& WELL HYDROFRACTURED? El Yes Xlo Show exact location of well/boring in section grid with"X." Sketch map of well location. D� From ft.To ft. Showing property lines, USE Domestic ❑Monitoring CI Heating/Cooling N roads,buildings, I and direction. ❑Noncommunity PWS ❑Environ.Bore Hole El Industry/Commercial ""T""' ❑Community PWS ❑Irrigation ❑Remedial 1 ICI MA'yElevator ❑Dewatering ❑ ------' I e� CASING ERIAL Drip Shoe?y�SYes ❑No HOLE DIAM. W 1 i E T Steel Threaded ❑Welded l ❑Plastic ❑ /:Mile CASING 1 Diameter Weight Specifications S � � \ 4 214 11 8 30 1 Mile I IJ+JL? C � in.to ft. lbs./ft. in.to-n-4 r"ft. in.to ft. lbs./ft. in.inpto qft. PROPERTY OWNER'S N]A�MEE/COMPANY NAME in.to ft. lbs./ft. 37 W,to 245 ft. Michael/Judy d SCREEN OPEN Hj4 245 Property owner's mailing address if different than well location address indicated above. Make From ft.To ft. same as above Type Diam. Slot/Gauze Length Set between ft.and ft. FITTINGS STATIC�IQIATER LEVEL �1 7 ftelow ❑Above land surface Date measured PUMPING LEVEL(below land surface) WELUBORING OWNER'S NAME/COMPANY NAME 180 ft.after 3 hrs.pumping 50 g.p.m. W LL HEAD COMPLETION Well/boring owner's mailing address if different than property owner's address indicated above. ,pitless Adapter Manufacturer o el ❑Casing Protection *2 in.above grade ❑At-grade(Environmental Well and Boring ONLY) GROUTING INFORMATION Well grouted? Xes ❑No Grout materials ❑Neat cementptentorwlar� l Concrete lther From cement To .71/ ft. jOtY4is. -Kegs From To Palma' f s. ❑Bags GEOLOGICAL MATERIALS COLOR HARDNESS OF FROM TO From To ft. ❑Yds. ❑Bags MATERIAL NEAREST KNOWN SOURCE OF CONTAMINATION /(TI clay yellow soft 0 12 feet ," direction -- - -- type Well disinfected upon completion? es ❑No sand brown soft 12 38 PUMP _ 60 CI Not installed Date installed '/ G clay gray soft 38 90 Manufacturer's name 90 Model Number / HP /Ka Volts `�? G gravel gray medium 110 Length of drop pipe /V I ft. Capacity g.p.m. Type: ubmersible ❑L.S.Turbine ❑Reciprocating ❑Jet ❑ clay/rocksgray medium 110 155 ABANDONED WELLS Does property have any not in use and not sealed well(s)? ❑Yes,t to - clay/sand gray medium 155 214 VARIANCE hard a variance granted from the MDH for this well? ❑Yes Jo TN# sandstone brown 214 245 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. Stodola ELEVATION,SOURCE OF DATA,etc. Don Inc.Well Drilling Co., 27172 Licensee Business Name Lic.or Reg.No. /tea-a(, ri epe native Signagr749 Date Chuck Moore LOCAL COPY 739139 Name of Driller : HE-01205-09(Rev.9/05) IC 140-0020 rw%vV City W a ori' CLIA4Lci, Inc/. 617 13th Ave So Hopkins, Minnesota 55343 • (612) 935 - 3556 05/16/2006 Stodola Well Drilling 3841 North Main St. Bonifacius MN 55375 938-2111 REPORT OF WATER ANALYSIS Lab #: 267BN Our Laboratory reports these analytical results, determined on a sample taken by CLIENT on 05/15/2006 from the following location: Michael Wood 1230 Woodhill Ave. Orono,Mn Well #739139 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 iSFArsdale Lab Certification#027-053-119 WELL OR BORIN(iLOCATION MINNESOTA DEPARTMENT OF HEALTH Minnesota Well and Boring I„I 247520 County Name WELL AND BORING SEALING RECORD sM a.lin ota Unique Well No. Pepin Minnesota Statutes,Chapter 1031 or W-series No. saws blank c not crawl Township Name Township No. Range No. Section No. Fraction(sm-)...Ig) Date Sealed Date Well or Boring Constructed Orono 117 23 42 ZI J iv U(.0 GPS Latitude degrees minutes seconds r LOCATION: Depth Before Sealing /9 7 ft. Original Depth ft. Longitude degrees minutes seconds AQUIFER(S) STATIC WATER LEVEL Numerical Street Address or Fire Number and City of Well or Boring Location (Single Aquifer 0 Multiaqulfer WELL/BORING ' XMeasured 0 Estimated 1230 Woodhill Ave, Orono 55391 Water Supply Well 0 Montt.Well Show exact location of well or boring Sketch map of well or boring �^ r in section grid with"X" location,showing property 0 Env.Bore Hole 0 Other 7._.C? ft. *low 0 above land surface N lines,roads,and buildings. CASING TYPE(S) l teel ❑Plastic 0 Tile 0 Other W---r---i----1------1---E WELLHEAD COMPLETION { Q' JJ T}I Outside: 0 Well House Inside: Basement Offset -f-`-1----1 l--' I 'r— I I { I *metal 0 Pitless Adapter/Unit 0 Well Pit 0 Well Pit 0 Buried S li.—r^".--ill" ❑Buried PROPERTY OWNER'S NAME/COMPANY NAME CASING(S) C.J.+( j ]/Jfusy Diam�e/ter r Depth Set in oversize hole? Annular space initially grouted? Property owners marl gad re if different than well location address indicated above / /! "+ in.from (� to / '7",)ft. ❑Yes �fJo 0 Yes 0 No 0 Unknown same as above in.from to ft. 7� ❑Yes ❑No 0 Yes 0 No 0 Unknown in.from to ft. ❑Yes 0 No 0 Yes 0 No 0 Unknown WELL OWNER'S NAME/COMPANY NAME SCREEN/OPEN HOLE /� ��7^ I Well owner's mailing address if different than property owner's address indicated above Screen from /`7 U to / �J ft. Open Hole from to ft. OBSTRUCTIONS ❑ Rods/Drop Pipe 0 Check Valve(s) 0 Debris 0 Fill ><No Obstruction Type of Obstructions(Describe) GEOLOGICAL MATERIAL COLOR HARDNESS OR FROM TO Obstructions removed? El Yes 0 No Describe FORMATION If not known,indicate estimated formation log from nearby well or boring PUMP Type y J / ❑ Removed C3.Not Present 0 Other METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS,OR CASING AND BORE HOLE: AVo Annular Space Exists 0 Annular space grouted with tremie pipe 0 Casing Perforation/Removal 51e in.from to ft. 0 Perforated 0 Removed in.from to ft. 0 Perforated 0 Removed Type of perforator ❑ Other GROUTING MATERIAL(S) (One bag of cement=94 lbs.,one bag of bentonite=50 lbs.) Grouting Material/(/4/9/ t" 91f.U/from to 7ti1 tX yards /ee, bags from to ft. yards bags from to ft. yards bags OTHER WELLS AND BORINGS { \ REMARKS,SOURCE OF DATA,DIFFICULTIES IN SEALING Other unsealed and unused well or boring on property? 0 Yes ! o 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 Busine Name License or Registration No. Aul senestive Srnaturi 247520 g " Date LOCAL COPY H !c' ` ,s Name of Person Sealing Well or Boring /