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Home My WebLink AboutWell info , WELL LOCATION MINNESOTA DEPARTMENT OF HEALTH M/NNESOTA UNIQUE WELL NO. CountyName WELL AND BORING RECORD „ He n�e p i� Minnesota Statutes Chapter 1031 � � � � � � Township Name Township No. Range No. Section No. Fraction WELL DEPTH(completed) Date Work Completed Orona 127 23 t? ,, ,,, ,, 111 � � 12-9-�38 House Number,Street Name,City,and Zip Code of Well Location or Fire Number DRILLING METHOD I655 Nt7hriS PofTit Ro1d Orflno, M11. 5539 n CableTool ❑ Driven ❑ Dug ❑ Auger ,l�I Rotary ❑ Jetted � Show exact location of well in section grid with"X". Sketch map of well location. ❑ Showing property lines, roads and buil ings. DRILLING FLUID WELL HYDROFRACTURED? ❑YES O N i,+d"d�el� i i i � FROM ft.to ft. -i -i- -i- -i- ---- -- USE ❑ Monitoring ❑ Heating/Cooling i i i i � Domestic ❑ Communit PWS _i_ _�_ _�_ _i_ Y ❑ Industry/Commercial � � i i ❑ Irrigation ❑ Noncommunit PWS w E ❑ Test Well Y ❑ Remedial i i i i T ❑ Dewatering ❑ -r -7- -r- -r i i i � �/zIM1e � CASING Drive Shoe? ❑ Yes ❑ No HOLE DIAM. _i_ _ i_ _i_ _i_ � � ❑ Steel ❑ Threaded ❑ Welded i i i i � �Plastic ❑ �—,M,�e—� .Y N/�t�- a CASING DIAMETER WEIGHT PROPERTY OWNER'S NAME � in.to 1 d Z n. SDR—��. Ibs./n. 7/`�� 3�ft. ctoneli�n�e �.Q[ZFf�ruCt�.�Yl in.to h. ibs.in. ,n.co�_��n. Property owner's mailing address if different than well location address indicated above. in.to ft. Ibs./ft. � in.to ft. 33$? �ro�rniow �j�TQ♦ SCREEN OPENHOLE SL� LOt1�S Park, ?�SN. 5542�6 Make Jahnsen from n.�o n. TyPe a��$��e�s-S ��ee�. Diam.�w SIoVGauze t� 1 1 1 Length $� Set between Z V 2 ft.and .��_ft. FITTINGS: 3 t STATIC WATER LEVEL WELL OWNER'S NAME ___ r'J S • ft.�Q below ❑ above land surface Date measured �7..Q�.g PUMPING LEVEL(below land surtace) Well owner's mailing address if different than property owner's address indicated above. g Q ft. after �� hrs.pumping �_g.p.m. WELLHEADCOMPLETION t,,,�itewater C3�Pitless adapter manufacturer Model ❑ Casing Protection � 12 in.above grade ❑ At-grade(Environmental Wells and Borings ONLY) GROUTING INFORMATION �� Well grouted? �Yes ❑ No GEOLOGICAL MATERIALS COLOR HARDNESS OF FROM TO Grout Material ❑ Neat cement OXBentonite ❑ Concrete Q�High Solids eenronite MATERIAL from__�__to__�Q_R. _�:r�_ ❑ yds. C�bags C 1 a y yg�Z�pp� s (}� 2 Q• from to n. ❑ yds. ❑ bags from to_ ft. ❑ yds. ❑ bags NEAR SOURCE OF CO TAMINATION �~^ Clay Grey S 20'40' �' �'/s�;�T� �r-�Ed��ic feet directio rype Sa n d 'j`a�'1 S �Q� � 1� � Well disinfected upon completion? �1 Yes ❑ No PUMP ❑ Not installed Date installed ��.�� Manufacturer'snanme �� Jacket Model number v�'��OA� HP j 1 VolOts b�O Length of drop pipe v Y ft. Capacity_ �'Q�r� g.p.m. Type:� Submersible ❑ L.S.Turbine ❑ Reciprocating ❑ Jet ❑ ABANDONED WELLS Does property have any not in use and not sealed well(s)? ❑ Yes �1 No VARIANCE Was a variance granted from the MDH for this well? ❑ Yes ❑xlo -�- WELL CONTRACTOR CERTIFICATION Use a second sheet,ilneeded This well was drilled under my supervision and in accordance with Minnesota Rules,Chapter 4725. REMARKS,ELEVATION,SOURCE OF DATA,etc. The information contained in this report is true to the best of my knowledge. n�N STi}DOLA ��ELL DRILLrNG C(3. , IAiC. � � Li nsee Bu iness Name ,<� -�•� Lic.or Reg.No. - 27172 � � ��'' � - �� ..�e ":`f- .�� 6-8-9 9 � Authorized Representative Signature Date Fr�� i by 12-9-98 Name of Driller HE 01205-06(Rev.9/96) LOCAL COPY 5 g 7 Z � g , - - Jwin �it I/Vater ��inic, J�nc. � 617 13th Ave So • Hopkins, Minnesota 5534� • (612) 935 - 3556 12/14l1998 Stodola Well Drilling 3841 North Main St. Bonifacius MN 55375 938-2111 REPORT OF WATER ANALYSIS Lab#: 36318 Our Laboratory reports these analytical results, determined on a sample taken by CLIENT on 12/09/1998 from the following location: 1655 Bohns Point Rd. Orono,Mn Unique 1Mell#597228 Coliform Bacteria <1/100 ml Nitrates Nitrogen <1 . 0 mg/1 The results of these tests indicate that this w�ell 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 ciient). o � 'ty Water Clinic, Inc. �` Bill P,m�yica�labonwcy cuueultitg Eogineor Water Analyaic Resgante Boilar Water Chemicals Lab Ced�cation N 027-033-119 i� ; WELL OR BOFiNG LOCA710N ' «. IUINNESOTA DEPY�,RTMENT OF HFALTH Minnesota Well and Boring ��^�^ ■ � �o��Y Name WELL AND BORING SEALING RECORD Sealing No H � �4 Hennepin Mmnesota Unique No. .; Minnesota Statutes,Chapter 1031 or W-series No. �+ (Leave blank A not known) '/ � t� Township Name Township No. Range No. Sec6on No. Fraction(sm.�Ig.) Date Sealed Date Well or Boring Construded G�ronc, 1 17 2`s 17 , . � — � Nyumerical Street Adtlress or Fire Number and City of Well or Boring Location (�'{ � / �1 f'i�J Bohn' s ��. R�. Urano, Mn. �.�p��tKBAtore Sealing g / fl. Original Depth ��_ft. Show exact location of v.�ell or boring Sketch map of well bonng AO IFER�S) STATIC WATER LEVEL in section grid with"X". location, showing ropeny Single Aquifer � Multiaquifer Gnes,roads,and bw ings. N WELUBORING Measured ❑ Estimated � � � Water Supply Well ❑Monit.Well �. � � � � __r_ _r_ _'�" "�" } a./ �',./ �' ,- ❑ Ern.Bore Hole ❑Other _ � ft. �below ❑ above land surtace � •'�� . I ' I I �` � —�- -;-- -,— --,-- ,. W E , CASING TYPE�S) � � � � � � � � � � � 'i. —I-- -�-- -i-- —i-- � �, Steel ❑ Plastic ❑Tile ❑ Other - I I I I �i.m�le 4 '� —�- -i-- -�-- --�— � :.�.i f� �' CASING Diamet r �i Depth � Set in oversize hole? qnnualar space initially grouted? 1 S I �2 �r miie� �in.from� to S.LZ ft. ❑ Yes �No ❑ Yes ❑No ❑ Unknown PROPERTY OWNER'S NAME in.from to ft. ❑ Yes ❑ No ❑ Yes ❑No ❑ Unknown Si�onehen e Gcan�t�r. . , Properry owner's mailing address if different than well location address indicated above. in.from to ft. ❑ Yes ❑No ❑ Yes ❑No ❑ Unknown 1 U91(} Wayzata $��7C�, SCREEWOPENHOLE � � Mtka. Mn.�`_�:�CS Q`� � Screen from�to�-� L ft. Open Hole from to ri. OBSTRUCTIONS WELL OWNER'S NAME '�Rods/Dro Pi e p p ❑ Check Valve(s) ❑ Debris ❑ Fill ❑ No Obstruction Well owner's mailing address if diHerent than property owners address indirated above. TypB ot Obst�uclions(DesC�ibB) ��11�!�� l"r ¢ ��/'�/ Obstructions removed?�Yes ❑ No Describe PUMP TyPe �� U��. � HARDNESS OF Removed ❑ Not Present ❑ Other GEOLOGICAL MATERIAL COLOR FORMATION FROM TO It not known,indicate estimated formation log irom nearby well or bonng. METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS,OR CASING AND BORE HOLE: i , �j No Annular Space Exits t . B t ❑ Annular space grouted with tremie pipe (,� ❑ Casing Perforation/Removal in.from �o ri. ❑ Perforated ❑ Removed in.from to h, ❑ Perforated ❑ Removed n Type of perforator ❑ Other GROUTING MATERIAL(S) ��L � �? � //'� Grouting Matenal��7.r-�/ ��'�"��from � to�;.L ft. yards � bags from to fl. yards bags from to fl. yards bags from to__ ft. yards bags REMARKS,SOURCE OF DATA,DIFFICULTIES IN SEALING OTHER WELLS AND BORINGS Other unsealed and unused well or boring on property? ❑Yes No How many? LICENSED OR REGISTEREO 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. ._ DGN S`i'C�DGLI; WELL DRILLII�IG CC?. , INC. 2137:: Contractor Business Name License or Regisbation I'ro. . ..�' -- l„C" �' � ,� .� /'�.. . %t=%'/`' .,�=� _ �' ,��`.� .'. , ,, J / _< i��a . �"1-' !.. / / . y A h66riz Representative Signature Date .. �..' ..f' iL Y_x'v" ( l 3 7 fi 4 5 Neme o/Person!5ealing Well or Bonng LOCALCOPY H ' HE-01434•03 2/97 R