HomeMy WebLinkAbout1984-12-13 Water Well Recordi
Ex
STATE OF MI1fESnTA
DEPARTMEM W HEALTH
Cot�fjr%sr � lrarttcr� �� �er�lon 11 r 1lysn
stenos end M rection from Road intersections or Street Address and City
M
Q.
an of well in seetim frill with -X.
M
&Zia
E
T
l
J
------4
rGMT10 6%
:UX�tC►I1+C
5. PBMAP><11. EUITATIOs .
LOCM COPY
MATER wLL. RECORD
71mweata 'tat.tee 4,3".01 ,0I
nip Number Pemae Sumber 13.
7
map or well 1
ftlowsom UNIQUE kwu W.
for later :-wV1e 1110 0 3
2 Chem Avbrm
r
wa• _
• Caapls r Orte of G'aeplitiae
- 277' _ ft. j X1.2--€�4--€�4
j
ble tool Pevarse l(� ori ven IOQ Daftlle rod 5] Alr "Lor!coredLWr 60 Jetted �(_] t�u.er Auger
4h -
245 124:
Iliftmatic L P,*IiC Duppiy 7z:j Imdustry
'[]Irrigation SE]Atr Conditioning it]Ccsereial
1C] Test Well 60
:IiAR.
lhroaded welded Q Eutrlfaes ft.
Black [ Galr.
in. to__269 rt. depth woom 10-86 ris.m.
In. to` _ft. deptb
is. to __ft. depth Drive Shoe? Too so
Or open bole !
Mate ictmom fro. ft.2! to A it.
7y," stainless steel Dia. L—
SIt,Gaus. 10 LOMU 1 •
Set "two" 2,69 ft. end 277 rt.
ft. Ane It*
ft. and it.
. (abolat [] above Dass
32 ft. after—4 Ire. puiplas 20 t.p.m.
h , after hrs. pumping s.p•a•
I1:Y%tlesm adapter %L] Basement offset IQ At lost le sties
s.. .... as.......
[yes [:) so Cu. T4A, w
1(] Beat count 213 Bentonite q lb� iU
IMpth! from ft. to ft.
rrom ft. to ft.
13. nearest source of possible conteaimatlon
feet direction �____— type
Well disinfected upon Completion? Teo 11 so []
Data Iwtmll" 3w�• •
[]Not insUaled
•7i Manufacturer's Isms
itodel Number BP .•�%dw
Longed of Mop pipe ft. eap"Ity ���.p.a.
Material of drop pipe
typo; 1915dwersible 30 L.B. Turbine 50 Reciprocating
2c] Jet 6[] Cemtri rv4p1 60
This well was drilled under mV jurisdiction and this report is true to
t1w best of Mr kmowleAm and belief.
Di 6=010 hills MILLOde Me- --- _ 172.
--�yae�no..ZioAmr seta -
Address 15306 RV mirm, 55m
_-
12-13414
Jowl Dote
Authcrtted Aepretentative
F• Z3 • 1 m%:fix d1
n■r of Driller
,
-
-4-
i
&Zia
E
T
l
J
------4
rGMT10 6%
:UX�tC►I1+C
5. PBMAP><11. EUITATIOs .
LOCM COPY
MATER wLL. RECORD
71mweata 'tat.tee 4,3".01 ,0I
nip Number Pemae Sumber 13.
7
map or well 1
ftlowsom UNIQUE kwu W.
for later :-wV1e 1110 0 3
2 Chem Avbrm
r
wa• _
• Caapls r Orte of G'aeplitiae
- 277' _ ft. j X1.2--€�4--€�4
j
ble tool Pevarse l(� ori ven IOQ Daftlle rod 5] Alr "Lor!coredLWr 60 Jetted �(_] t�u.er Auger
4h -
245 124:
Iliftmatic L P,*IiC Duppiy 7z:j Imdustry
'[]Irrigation SE]Atr Conditioning it]Ccsereial
1C] Test Well 60
:IiAR.
lhroaded welded Q Eutrlfaes ft.
Black [ Galr.
in. to__269 rt. depth woom 10-86 ris.m.
In. to` _ft. deptb
is. to __ft. depth Drive Shoe? Too so
Or open bole !
Mate ictmom fro. ft.2! to A it.
7y," stainless steel Dia. L—
SIt,Gaus. 10 LOMU 1 •
Set "two" 2,69 ft. end 277 rt.
ft. Ane It*
ft. and it.
. (abolat [] above Dass
32 ft. after—4 Ire. puiplas 20 t.p.m.
h , after hrs. pumping s.p•a•
I1:Y%tlesm adapter %L] Basement offset IQ At lost le sties
s.. .... as.......
[yes [:) so Cu. T4A, w
1(] Beat count 213 Bentonite q lb� iU
IMpth! from ft. to ft.
rrom ft. to ft.
13. nearest source of possible conteaimatlon
feet direction �____— type
Well disinfected upon Completion? Teo 11 so []
Data Iwtmll" 3w�• •
[]Not insUaled
•7i Manufacturer's Isms
itodel Number BP .•�%dw
Longed of Mop pipe ft. eap"Ity ���.p.a.
Material of drop pipe
typo; 1915dwersible 30 L.B. Turbine 50 Reciprocating
2c] Jet 6[] Cemtri rv4p1 60
This well was drilled under mV jurisdiction and this report is true to
t1w best of Mr kmowleAm and belief.
Di 6=010 hills MILLOde Me- --- _ 172.
--�yae�no..ZioAmr seta -
Address 15306 RV mirm, 55m
_-
12-13414
Jowl Dote
Authcrtted Aepretentative
F• Z3 • 1 m%:fix d1
n■r of Driller