HomeMy WebLinkAbout02-15-1994 Water Well RecordWELL LOCATION
Cooijty Narr Hennepin
MINNESOTA DEPARTMENT OP HEALTH
WELL RECORD
Minnesota Statutes Chapter 1031
MINNESOTA UNIQUE WEU NO.
536243 ’’
Township Name
Orono
Township No Range No S«lK)n No.Fraction WELL DEPTH (complelw))Dale Work Completed
117 23 C3 7. 7. 7.K.1'2-1 [1-94
Numerical Street Aridress and City of Well Location
2240 Abingdon Way Qruno, Nn.
or Fire Number
Show exact location of well in section grid with *X*
N
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1
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1••-I-•.•
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t Sketch map of wen location
Showing property lines,
roads and buildings
DRILLING METHOD
□ Cable Tool
□ Auger□ _____
□ Driven
a Rotary
□ Dug
□ Jetted
DRILLINGFI
c
T
'<• m
1
.USE
X! Domestic
□ irrigation
n Tost Well
□ Monitoring
□ Public
□ Dewatering
D Heating/Cooling
□ Industry/Commercial
□ Remedial
□ _________
CASING
^ Steel
n Plastic
Drive Shoe? ^ Yes
□ Threaded
□ ___
n No
n
PROPERTY OWNER'S NAME
Tony Eic^ CXjrpsny
Mailing address if different than property address indicated above
4100 Berkshire Lano
Plymc4it_h, fto.S5446
CASING DIAMETER
__4__„
___________m to „
___________m to _
WEIGHT
L.ft
— ft
_.»t . t)S /Tt.
SCREEN
Make “Jonnscji
Stalhli^^rSteel
HOLE DIAM
y//m.toi_.fl.
3n tol
__in. to _
OPEN HOLE
__ft.to_
Type _________D«m.
SloVGauze_________li)____________________Length______
Set between ‘ti:j_ft and_li4.__ft FITTINGS:.
GEOLOGICAL MATERIALS COLOR HARDNESS OF
MATERIAL FROM
STATIC LEVEL
. ft. . IQielow n above land surface Date measured.
2-15-91
Clay S Sonri (;•PUMPING LEVEL (below land 8u.-face)
__________________ft after______, hrs pumping __gpm.
Sand WELL HEAD COMPLETION
^ j Pitless adapter manufacturer „
’ Casing Protection__________
Wtiitewuter Model
„X] 12m above grade
GROUTING INFORMATION
Woligrouted? X ves □ No
Grout Material r: Neat cement rXBentonite
from___to_________ft.
from._________to ______ _ ft.
from ___ to ft
_ □ yds. CX^
□ yds. □ bags
__n yds. n bags
w '1^ ^
NEAREST KNOWN SOURCE OF C .^TAMINATION^
/QO^_____feet_____________________^direction
Well dismlocted upon completion? R Yes j No
Date installed
PUMP
; 1 Not installed
Manufacturers name
Model number __
Length of drop pipe
Pressure Tank Capacity
Type X: Submersible i ] L.S Turbme 11 Reciprocating i j Jet □
j-2y-yA ‘
■TTLii^i. S Wblling
HP 230
Ti30l »g'cT _gp.m.
■ —
-1.
ABANDONED WELLS
Does properly have any not in use and not sealed well(s)'» ! ) Yes
Use a second sheet, it needed
WELL CONTRACTOR CERTIFICATION
This well was drilled under my supennsion and m accordance with Minnesota Rules. Chapter 4725.
The information contained m this report is true to the best of my knowledge
DON S'lYJDCa./^ WELL ERILTilNG 00., INC. 27172
REMARKS. ELEVATION. SOURCE OF DATA, elc Licensee Business Name
Name ol DnUet
LOCAL COPY 536243
°r-i3-94
HE-01205-04 (Rev. S/92)