The URL can be used to link to this page

Home My WebLink AboutWell info WELL LOCATION MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UN/QUE WELL NO. F County Name WELL AND BORING RECORD , , , Hennep3n Minnesota Statutes, Chapter 1037 � � �� ¢ �� ; ,Township Name Township No. Range No. Section Nq. Fraction WELL DEPTH(completed) Date Work Completed �; ' Orono i1T 23 1�i ,� ,� �, n _ + -' GPS ` DRILLING METHOD � LOCATION: Latitude degrees minutes _ seconds Longitude degrees minutes seconds ❑Cable Tool r Driven Dug ❑Auger �'Flotary Jetted House Number,Street Name,City,and Zip Code of Well Location or Fire Number � �-� 1 b�0 Bohns L"ZI�LIC �,d� Or000 5391 DRILLING F�UID WELL HYDROFRACTURED? ,_]Yes No S exact location of well in section grid with"X". Sketch map of well location. b�n t on i t e FROM ft.TO ft. Showing property lines, N roads and buildings USE ��Monitoring �Heating/Cooling ' � � � � �Domestic [_J Environ.Bore Hole �L�Industry/Commercial ' --'--- --'--- --`-----'-- . �Noncommunity PWS �.._'Irrigation ,_ �Remedial �Community PWS ��Dewatering ] ' --'----'-----`-----`-- � CASING HOLE DIAM. ' .� w ; ; ; � E T Drive Shoe? f..�Yes �No � - � . � _Steel ��Threaded [�Welded '/Mile ' Plastic ` ] 1 `�� CASING DIAMETER WEIGHT s �� 11 � 1 Mile� -�� L -� �——in.to�_�ft. 4 Ibs./k. __�in.to 9 f1ft. i �Q _ in.to ___, ft. _ Ibs./ft �in.to��t. � PROPERTY OWNER'S NAME/COMPANY NAME in.to_____ ft. Ibs./ft. in.to ft. - ' �n j v --�-- .__.._ .. Robert �rC�i� 1'!OR}EB SCREEN OPENHOLE � f ., Property owner's mailing address it different than well location address indicated above. Make JO�TISOII FROM fL TO ft. � 565 Big Waoda �� Type fdtg�tf1�R14 �tI, Diam - ` Chanha�sen, t�fAi 55327 SIoUGauze ____*�'1� Length __��_ �_ ___._ Set between ft.and ft. FITTINGS 1� � STATIC WATER LEVEL ' �3 ft.'�below �above land surface Date measure��3�Q6 PUMPING LEVEL(below land surface) WELL OWNER'S NAME/COMPANY NAME I g� �� hrs.pumping �O ' ft.after 9.p.m. WELL HEAD COMPLETION �{� �. Well owner's mailing address if different than property owners address indicated above. �pitless adapter manufacturer �..J-�T�a,.7�.s-�.�s7�el _'Casing Protection �12 in.above grade . At-grade(Environmental Wells and Boring ONLY) � GROUTING INFORMATION - Well grouted �Yes _.]No Grout material ❑Neat cement I,__j Bentonite ❑Concrete�High Solids Bentonite _ from � to____! ��ft. 3 _yds. �bags from 3� to l��ft. �a't$ra��y�si��ags HARDNESS OF GEOLOGICAL MATERIALS COLOR MATERIAL FROM TO from to ft �yds. �,J bags NEAREST KNOWN SOURCE OF CONTAMINATION . C�I�y b ro�n .g(�f� ll �V `1.-r feet /`✓ direction . ��-fi��_�+�:^}ype Well disinfected upon completion Yes ��-No ��-.. "'+Jc..c��---� ��... G18� �r8y soft '�� PUMP [ Not installed Date installed �' •:.J'`� �--�� L ,�:-�.�,s�.� sand g�$� .�(�f t �,v I�iQ Manufacturer's name �^.�.,, -._ � Modelnumber � HP�Volts =�� Length of drop pipe �� ft. Capacity_ g.p.m. Type:[�Submersible ❑LS.Turbine ❑Reciprocating ;_i Jet ❑ ABANDONED WELLS Does property have any not in use and not sealed well(s) ❑Yes No VARIANCE Was a variance granted from the MDH for this well? �]Yes No TNN 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. vV n S r odo i a �e Z 1 D r i 1 I in�; Cd� • 18�• G 1 7 Z�:,�. Licensee Business Name Lic.or Reg.No. � - �..�,�� J� uy _ed Repre entative Si t Date Chuck pivare �OCAL COPY �� l�ameof�riuer HE01205-OB(Rev.5/02) - C 140-0020 T'tiu%w C%t� yVa,t�� C - , y , r�,� 617 13th Ave So � Hopkins, Minnesota 55343 � (612) 935 3556 01/OS/2006 Stodola Well Drrlling 3841 North Main St. Boni facius MN 55375 938-21 1 1 REPORT OF WATER ANALYSIS Lab #: 2BN Our Laborarory reporrs rhese analytical resulrs, determined on a sample taken by CLfENT on 0 J/03/2006 from the following locatron: C Robert 4raig Homes 1640 Bohns Point Rd Orono,Mn Well #726443 Coli form Bacteria <1/100 ml Nitrates Nitrogen <1.0 mg/1 The results of these tests indicate thar this wel! is producing water that meers rhe standards for F.H.A., V.A., or convenrional loans. This report is an analysis for coJiform and nitrare or,ly and does not inclu�e a,Malysrs of Lea� and oti�er contaminanis. (Unless as specified by client). ,C win Ciry Warer Clinic, Inc. ,, ,, �. Bi� �sdale � �' Lnb Certificntion N 027-053-1 I� . � . -.�, � _ :� , .. . . � ;� =�.=, '�" wE�L OR BORING LOCA'nON MINNESOTA DEPARTMENT OF HEALTH Minnesota Well and Boring '„I �` WELLAND BORING SEALING RECORD Mnn'esotaUniqueWeltNo. �� 8 County Name F��LtEtta��t1 Minnesota Statutes,Chapter 1031 or W-series No. . t�u�a�a a�� Township Name Township No. Range No. Section No. Fraction(sm->Ig) Date Sealed Date Well or Boring Constructed rar�, i t� 2 3 l h 22-C?�Q2 .,. ZZ- .;�,�(' t� GPS Latitude degrees minules seconds f� � LOCATION: Depth Before Sealing /� ft. Original Depth ft. " Longitude degrees minutes seconds qpUIFER(S) STA71C WATER LEVEL �� Numerical St�eetAddress or Fire Number and City of Well or Bonng Location Single Aquifer ❑Multiaquifer �e: f� �Measured ❑Estimated 1�7�4� �Q�� PQ��t �t�� r�II(,� 55391 WELUBORING ! �Water Supply Well ❑Monit.Well �.-� Show exaC[IocaGon of well or bonng ��Sketch map of well or bonng t�� ,,( �•_ Env.Bore Hole ❑Other ft. below above land surface in sechon grid with"X" location,showing property ❑ A�l ❑ �;;;;�, . N lines,roads,and buildings. � CASING TYPE(S) � .�-.�','_'.'�- . � - - - - - -- ' -- ''� � �Steel ❑Plastic ❑Tile ❑Other '�e. . � �: - -- � . . W —�- --i— E WELLHEAD COMPLETION �. , ' � � �{ Outside: ❑Well House Inside: ❑Basement Offset '�—.. � � I - '= � --r- �-i'- -i— --�-- .. �` ��'i; 1��e ❑Pitless Adapter/Unit ❑Well Pft ;�.r.. - - -�-- -i-- --�-- I �. - �:.�.-�� 1 ❑Well Pit �uried �:• S �J"" �;':.... 4'—i""i°—+�. �Buried I I �' PROtP,,E,�RTY OWNE,R.,'Si NAME/COMPANY NAME CASING(S) �y' �LJC�� CCa1 � �L�e$ Diameter � Depth � Set in oversize hole? Annular space inRially grouted? '� - Property owner's mailing address if diiterent than well location address indicated above �� .�.��_ � � in.f�Om d t0�ft. ❑Yes ID+fJo ❑Yes ❑No ❑Unknown �; Sb5 �3ig t�ods Blvcl •, �' In.from t0 ft. ❑Yes ❑No ❑Yes ❑No ❑Unknown �" aen, MN 55317 in.f�om to ft. ❑Yes ❑No ❑Yes ❑No ❑Unknown WELL OWNER'S NAME/COMPANY NAME SCREEWOPEN HOLE ! � Well owner's mailing address it dilferent ttian property owners address indicated above Screen from "'`�� t0�ft. Open Hole from t0 ft. OBSTRUCTIONS ❑ Rods/Drop Pipe ❑Check Valve(s) ❑ Debris ❑ Fill �No Obstruction �, Type of Obstructions(Describe) GEOLOGICAL MATERIAL COLOR HARDNESS OR FROM TO ObstrUctions removed? ❑YeS ❑ NO DeSCribe FORMATION tl not known,indicate estimated tormalion log from nearby well or boring PUMP Cfft Q � Type ❑ Removed ot Present ❑Other METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS,OR CASING AND BORE HOLE: �No Annular Space Exists ❑ Annular space grouted wfth tremie pipe ❑ Casing PerforatioNRemoval 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.) ^��{-y / Grouting Material �� ('=/��T from Q to �/ ft. yards � bags { f 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 wetl 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 oi my knowledge_ � Contractor Business Name License or egistration No. , Au e e resentative gnatu Date �� LOCALCOPY H �a�o��o J� �t�� Name of Person Sealing Well or Boring