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Home My WebLink AboutWell info MINNESOTA UNIQUE WELL WF�LL OR BORING LOCATION MINNESOTA D�PARTMENT OF HEALTH AND BORING NO. County Name � WELL AND BORING RECORD � 5 0�7 2 ��Pin Minnesota Statutes,Chapter 1031 Township Name Township No. Range No. Section No. Fraction WELUBORING DEPTH(completed) DATE WORK COMPLETED t)rono 117 23 08 ,, ,,, ,, 176 � 3-5-08 GPS DRILLING METHOD LOCATION: Latitude degrees _ minutes seconds Longitude degrees minutes seconds ❑Cable Tool ❑Driven ❑Dug -- ❑Auger ^�'Rotary ❑Jetted House Number,Street Name,City,and Zip Code of Well Location or Fire Number � / � I545 &yhns Point Rd, ��X1O 55391 DRILLING FLUID WELL HYDROFRACTURED? ❑Yes�No Show exact location of well/boring in section grid with"X" Sketch map of well/borin location. �ntQ�it� From ft.To ft. � Showing prop rry ines, : N roads,buildings,and di�\�\ ��n. USE �Domestic ❑Monitoring ❑Heating/Cooling ? j I I I I �^� , __,______,__. __�_.___,__ ( � ❑Noncommunity PWS ❑Environ.6ore Hole ❑IndustrylCommercial ` { + � _ [�Community PWS ❑Irrigation �Remedial �� ❑Elevator ❑Dewatering � ; w ; ' , `-- E T �� CASING MATERIAL Drive Shoe? ❑Yes ❑No HOLE DIAM. ' --�-----'--- ---�-- ---.-- ".r'� J � a I l �,� .) ❑Steel ❑Threaded ❑Welded � ; ; ; ; 'h Mile l�� PlastiC ❑ • X ', .� --�-----�--- '—�-- --•-- ..t �� i CASING � � S � � �'(� � Diameter Weight Specifications \ �1 Mile� � �m.to_�sn. _��_Ibs./ft. AetYn! ��n.to.��n. i � PROPERTY OWNER'S NAME/COMPANY NAME in.to ft. Ibs./fl. in.to ft. Ro'bert Craig No�es in.to ft. Ibs./flOPEN HOLE in.to ft. � Property owner's mailing address if different than well location address indicated above. SCREEN °FV� 2� St� Ste IOi Make J�j('�g��1 'From „ ff. To ft. � Type_�t��zni��n erl Diam. � ; Excelsior, NB�T 55331 SIoUGauze�nin _Length j Set between ft.and ft. FITTINGS ! STATIC WATER L te� Measured from 4J R.�Below I,]Above land surface Date measurec�+� � WELL OWNER'S NAME/COMPANY NAME PUMPING LEVEL(below land surface) � �.7� ft.after �S hrs.pumping �� g.p.m. Well/boring owner's mailing address if different than property owner's address indicated above. WELLHEAD COMPLETION -�.., �Pitless/adapter manufacturer �..? '�°'�-°��'�-�-�-+�.��'a-�-.�pAodel Casing Protection �12 in.above grade ❑At-grade(Environmental Well and Boring ONLY) GROUTING INFORMATION Well grouted ,�Yes ❑No Grout materials ❑Neat cement�Bentonite ❑Concrete ❑Other � From�To_�Q__ft. ?�_S ❑Yds. �]Bags HARDNESS OF From_�_To_I��j_fl.�.�,��(�s. ❑Bags GEOLOGICA�MATERIALS COLOR MATERIAL FROM TO - From 1 Sf To ds. Bags � NEAREST KNOWN SOURCE OF CONTAMINATION ��_�.., ��t�C� black �Qft � 16 < <"� feet '�-�� direction ..��.e .'J� -- — .�.�l��- tyPe Well disinfected upon completion? Yes ❑No �.�.,,. ��,..,��a.�- C�S CA .9OfC Z�j PUMP []Not installed Date installed +�-� � `J�-J sand fir� ra .91�f� � 1 $ Manufacturers name `'�-=-•�`�'" '�^� �" ) Model Number `�� HP �+: Volts <%"�� coarse sarxi r soft 1 8 j Length of drop pipe ``J � R. Capacity g.p.m. Type:?,�Submersible ❑LS.Turbine ❑Reciprocating ❑Jet ❑ � ABANDONED WELLS Does property have any not in use and not sealed well(s)? ❑Yes Q�No VARIANCE Was a variance granted from the MDH for this well? ❑Yes No 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,ifneeded. �,. �� ,�j'� �11 ]�iI1�L� ��• IT�• a division o REMARKS,ELEVATION,SOURCE OF DATA,etc. � ��Ola Weil Drilling Co,• 1�• I691 Licensee Business Name Lic.or Reg.No. ,- t.� c� �� , e rese ative Sig re Certified Rep.No. Date LOCALCOPY 7 5 0 6 7 2 Name of Driller � i�� IC 140-0020 HE-01205-10(Rev.6/O6) i rw� c�y w�� c � � � r�. 617 13th Ave So � Hopkins, Minnesota 55343 � (612) 935 - 3556 , 03/10/2008 Stodola Well Drillin� 3841 North Main St. Boni facius MN 55375 938-21 1 1 REPORT OF�JVATER ANALYSIS Lab #: 74BN Our Labaratory reports ihese analytical results, determined on a sample taken by CLIENT on 03/06/2008 from the following location: 1595 Bohns Point Rd. Orono,Mn Well 750672 Coli form Bacteria Absent 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 co!ifc�'m pl�� !�itYcatP onlv nnr,� G.Ines !?or i�r-lude analysis _n�'I_nqd and other contaminants. (Unless as speci fied by client). Twin City Vljater Clinic, Inc. .�, A' �'��'�.....,.: BI�� G#I'�AYSG�Q�� Lab Certification#027-053-119 MINNESOTA DEPARTMENT OF HEALTH Minnesota Well and Boring 2 6 4 3 2 WELL OR BORING LOCATION Sealing No. H ' Counry Name WELL AND BORING SEALING RECORD Minnesota Unique Well No. �� i� Minnesota Statutes,Cha/�ter 1031 or W-series No. ' Y (Leeve blank�it not known) Township Name Township No. Range No. Section No. Fraction(sm.-+IgJ Date Sealed Date Well or Boring Constructed g 4t�11O �� ! � � / f t� / GPS Latitude __ degrees minutes seconds Depth Before Sealing �/ ft. Original Depth ft. LOCATION: Longitude degrees minutes . seconds Q IFER(S) STATIC WATER LEVEL - Numericat Street Address or Fire Number and Ciry of Well or Boring Location Single Aquifer ❑Multiaquifer ��y!?�.. 1595 Bohr� P�int Rd, VCV[AJ �✓ELL/BORING �vleasured �_�Estimated Date Measured�1"�•-,- �� - Water-Supply Well ❑Monit.Well ....{�y/�� _ Show exact location of well or boring Sketch map of well or oring ;J Env.Bore Hole ❑Other J� ft. [�elow ` t in section grid with"X" location,showing pro rty i ;above land surface E N `` lines,roads,and buil 95� �CASINGTYPE(S) "� _''"' ___ ` _�_ �Y i ` � .,� `j,��. � J [_]Tile ❑Other � � � �., ��Steel . Plastic -- --- -- � WELLHEAD COMPLETION �`� W � � � ; E T � utside: f� ell House r]At Grade Inside: �;Basement Offset ^ --;-----�-- --�-- --�-- ` O ' W � �i+ �;. ; , ; ; nniie itless A pter/Unit � uned _ ell Pit ,� �P ; , , � da , g r]W --;--- --.-- --.-- -:-- l 0 � . ❑Buried � _ [;Well Pit ❑Other �1 Mile� � , �;Othef __ 7 , PROPERTY OWNER'S NAME/COMf,�PA,N�Y.,.N,,A.ME CASING(S) ' Robert Crai iAJ[t�Gi7 Diam te�� Depth � Set in oversize hole? Annular space initially grouted? , Property owner's mailing address if different than well location address indicated above �in.from � to�j,�ft. ❑Yes DQ NO ❑Yes ❑No ❑Unknown �1�4 Zti(� St� �@ ��. �� 8jOr' �* ��t in.from to ft. ❑Yes ❑No ❑Yes [�No ❑Unknown Z i7P 1 in.from to ft. �,�Yes ❑No ❑Yes ❑No ❑Unknown WELL OWNER'S NAME/COMPANY NAME SCREEN/OPEN HOLE / I ► Well owner's mailing address if diNerent than property owners address indicated above SCfeen ffOm_��_to�_�ft. Open Hole from to ft. OBSTRUCTIONS Rods/Drop Pipe J Check Valve(s) �]Debris ❑Fill ❑No Obstruction - - Type of Obstructions(Describe)1/t1/L/�+�� a �u !.7 GEOLOGICAL MATERIAL COLOH HARDNESS OR FROM TO Obstructions removed? es ❑No Describe FORMATION PUMP If not known,indicate estimated formation log from nearby well or boring. � . Type �L r'�.��1 M� <_� / t� ��/ � L�Fiemoved '�. �Not Pres nt Other )C ; METHOD USEDTO SEAL ANNULAR SPACE BETWEEN 2 CASINGS,OR CASING AND BORE HOLE: - � o Annular Space Exists I_J Annular Space Grouted with Tremie Pipe �]Casing Perforation/Removal in.from to__ ft. �]Perforated �]Removed in.from � to ft. ❑Perforated ❑Removed Type of Perforator �� ]Other �,�,��' GROUTING MATERIAL(S) (One bag of cement=94 Ibs.,one bag of bentonite=50 Ibs.) $, � r '�! Grouting Material �iQ%c`.�/�i�Yl/ from_�,� ro� ft. yards�_ bags - Y!. 1 from to ft. yards bags from to ft. yards bags - OTHER WELLS AND BORINGS �� REMARKS,SOURCE OP DATA,DIFFICULTIES IN SEALING �� Other unsealed and unused well or boring on property? ❑Yes o How many? ,�:i LICENSED OR REGISTEflED 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. `' !ES We11 & p�� In Ibn Stodo2a i�ie11 �i.�.ling G�o di�i c on 1�1 ��,j Licensee Business ame � License or Registration No. � I - i � � � /� G � �Y . � r d`epre ntative Sighat e ` Certified Rep.No. Date � "'� .ccti�c.o�v H '�'t-'t,Ev.. �� /�}- .✓'.,�,�Y�..� 2 6 4 3 2 5 Name ol Person Sealing Well or Boring ;' HE-01434-10 IC#140-0423 . . 5/a7a ��