HomeMy WebLinkAbout06-05-2020 well & boring construction record MINNESOTA UNIQUE WELL
WELL OR BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH AND BORING NO.
County Name WELL AND BORING CONSTRUCTION RECORD 84 4 816
HennepinMinnesota Statutes,chapter 1031
Township Name Township No. Range No. Section No. Fraction(sm.—.Ig.) WELL/BORING DEPTH(completed) DATE WORK COMPLETED
Orono 117 23 07 NW nwsE ' 165 ft.
6-5-20
GPS LOCATION—decimal degrees(to four decimal places). DRILLING METHOD
Latitude Longitude ❑Cable Tool ❑Driven ❑Dual Rotary
❑Auger XRotary ❑Rotasonic
House Number,Street Name,City,and ZIP Code of Well Location ❑Other
1405 Park Dr, Orono 553 L DRILLING FLUID WELL HYDROFRACTURED? ❑Yes o
Show exact location of well/boring in section grid with"X" + Sketch map of well/boring location. bentonite From ft.To ft.
Showing property lines,
-i .1 I E._ it
N { roads,buildings,and direction. USE s'Domestic ❑Monitoring ❑Heating/Cooling
_______?__ _----_ .J❑o Noncommunity PWS ❑Irrigation ❑Industry/Commercial
❑Community PWS ❑Dewatering ❑Remedial
---'---- -----f--------- ❑Elevator ❑
w E CASING MATERIAL Drive Shoe? ❑Yes �Tlo HOLE DIAM.
❑Steel ❑Threaded ❑Welded
S Mile „Ntlastic ❑
— CASING
9 Diameter4 Weight Specifications �/�
{--1 Mile I 10.To 155 ft. lbs./ft. 8 in.To 50 ft.
PROPERTY OWNER'S NAME/COMPANY NAME in.To ft. lbs./ft. in.T 65 ft.
in.To ft. lbs./ft. in.To ft.
Norton Homes OPEN HOLE
Property owner's mailing address if different than well location address indicated above. SCREEJo. S
onM
18215 45th A'V? N, Ste �} � stainless st From ft. To ft.
N
Plt outh, MN 55446 SIoVGauze ,15 Length 4 9 + 4 5
' Set between 1 55 J ft.and 165,_ t.FITTINGS'? Y le
STATIC WATER LEVEL 6ft.,KBelow ❑Above land surface
' Date measured 6-5-20 Dry hole ❑Yes rielo
WELL OWNER'S NAME/COMPANY NAME PUMPING LEVEL(below land surface)
1 0ft.after hrs.pumping 35 q.p.m.
Well/boring owner's mailing address if different than property owner's address indicated above. WELLHEAD COMPLETION
gPitless/adapter manufacturerttet Model
❑Casing protection ,.12 in.above grade
❑At-grade ❑Well House ❑Hand Pump
GROUT INFORMATION(specifybentonite,cement-sand,neat-cement,concrete,cuttings,or other)
. material bentonite,. 0 To 50 ft. 3 ❑Yds. ,�}bags
Material cuttings From 50 To 155 ft. ❑Yds. ❑Bags
HARDNESS OF i Material From To ft. ❑Yds. ❑Bags
GEOLOGICAL MATERIALS COLOR MATERIAL FROM TO Driven casing seal From To Bags
One bag94 lbs.cement
or 50 lbs.bentonite
NEAREST KNOWN SOURCE OF CONTAMINATION
clay brown Idinm - (IL 27 Well is J feet N...% direction from ~t) 'Ttype-
Well disinfected upon completion? 'Yes ❑No �"
clay/sand gray aoft 77 52 PUMP
❑Not installed Date installed 620
.
sand (fits) hrnwn soft 52 115 Manufacturer's name Schaefer .
/ Model Number HP 1 Volts
210
end!c'1 1y ay medium 115 138 Length of drop pipe 105 ft. Capacity g.p.m
Type:gSubmersible ❑L.S.Turbine ❑Reciprocating ❑Jet ❑
sandy ei ay`grRVP1 r pddi qh ABANDONED WELLS
brown media 138 153 Does property have any not in use and not sealed well(s)? ❑Yes X'No
Sand PIX 'riita 153 165 VARIANCE
Was a variance granted from the MDH for this well? ❑Yes A•Mo TN#
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.
REMARKS,ELEVATION,SOURCE OF DATA,etc.
Ion Stodola Well Drilling Cos. Inc. 1691
Licensee Business Name Lic.or Reg.No.
Grp 8-3-20
di led Representative Signature Certified Rep.No. Date
Rob Stodola
LOCAL COPY 8 4 4 816
Name of Driller
; ,, ID#52603 HE-01205-18(Rev.3/19) ,_