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Home My WebLink AboutWell Construction 12-15-24 • MINNESOTA UNIQUE WELL ' WELL OR BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH AND BORING NO. County Name - WELL AND BORING CONSTRUCTION RECORD 5 1 Minnesota Statutes,chapter 1031 Uennepin Township Name Township No. Range No. Section No. Fraction(sm.—.lg.) WELL/BORING DEPTH(completed) DATE WORK COMPLETED Drono 117 23 3 3t; SUET, SW,, 185 t. 12/15/24 GPS LOCATION—decimal degrees(to four decimal places). t DRILLING METHOD Latitude Longitude ❑Cable Tool DI Driven ❑Dual Rotary ❑Auger Rotary ❑Rotasonic House Number,Street Name,City,and ZIP Code of Well Location ❑Other 2285 Webber Hills Rd, -Orono MN 55391 DRILLING FLUID WELLHYDROFRACTURED? ❑Yes +- No Show exact location of well/boring in section grid with"X." Sketch map of well/boring location. Bon t o n i t e ' From ' ft.To ft. Showing property lines, N roads,buildings,and direction. USE ®Domestic ❑Monitoring ❑Heating/Cooling --^ i 1 i l ❑Noncommunity PWS ❑Irrigation ❑Industry/Commercial ❑Community PWS ❑Dewatering ❑Remedial \A Elevator ❑ w , ET CASING MATERIAL Drive Shoe? ❑Yes No HOLE DIAM. ---4---r Ni 5� ❑Steel ❑Threaded ❑Welded '/Mile L_ ©Plastic ❑ I ' s S Diameter Weight Specifications 5 0 I �--1 Mile I in.TO 175 ft. lbs./tt. V in.To R in.To ft. lbs./ft. 6. q•� 1" PROPERTY OWNER'S NAME/COMPANY NAME coin.Td 5 ft. Dennis P?d rSon in.To ft. Ibs./ft. in.To ft. Property owner's mailing address if different than well location address indicated above. SCREEN ,y D s OPEN HOLE Make Jot1n$an From ft. To ft. stainless 4" Type 1 rtrt Diam. . Slot/Gauze "•_°10 Length 8 It Set between 1 /5 ft.and 1 8) ft. FITTINGS i lead STATIC WATER LEVEL 47 ft. Below ❑Above land surface Date measured 12/15/24 Dry hole ❑Yes 1 No . WELL OWNER'S NAME/COMPANY NAME PUMPING LEVEL(below land surface)1 70 ft.after 4 hrs.pumping 30 q.p.m. Well/boring owner's mailing address if different than property owner's address indicated above. WELLHEAD COMPLETION K Pitless/adapter manufacturer monitor Model ❑Casing protection L]12 in.above grade ❑At-grade ❑Well House ❑Hand Pump GROUT INFORMATION(specify bentonite,cement-sand,neat-cement,concrete,cuttings,or other) Material cut t i ng from 175 To 50 ft. ElYds. ❑Bags Material Dent o n i Fropm 50 To ° ft. 3 ❑Yds. Bags , HARDNESS OF Material From To ft. ❑Yds. ElBags GEOLOGICAL MATERIALS COLOR FROM TO MATERIAL Driven casing seal From To Bags One bag=94 lbs.cement or 50 lbs.bentonite - NEAREST KNOWN SOURCE OF CONTAMINATION (/11-L\_ Cla/Sand Brown. �f 1,1 w �' m 0 2 4 Well is `"� feet direction from : l..}" type I ^!f Well disinfected upon completion? ❑Yes El No Clay/Sand Gray S 24 2 PUMP 12.20.24 y 7 t ❑Not installed Date installed - Brown S 7 2 100 Manufacturer's name Shafer . Sand 1 7 y B ro$r. S 100 13-(} Model Number 105 HP 3/4 Volts 230 Sandy Ci 1 a y/G r V 1 0 Length of drop pipe ft. Capacity g.p.m. Red S 1 59 Type: Submersible ❑L.S.Turbine ❑Reciprocating Ill Jet ❑ Clay/Gravel 130 JABANDONED WELLS C f� Does property have any not in use and not sealed well(s)? ❑Yes g No Clay rab M 159 172 VARIANCE Yellow St 172 185 Was a variance granted from the MDH for this well? ❑Yes No TN# Sand - 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. Don Stodola Well Drilling Co Inc 1691 Licensee Business Name Lic.or Reg.No. ` t �-%- 558 12/20/24 GC&rtified Representative Signature Certified Rep.No. Date LOCAL COPY 8 7 3 5 6 Rob staC�01a 9Name of Driller ID#52603 HE-01205-18(Rev.3/19) 61713th Ave S. TCW Hopkins,MN 55343 (952)935-3556 'r�.•fn City water Clinic ...._.--._.---...,...-... info@twincitywaterclinic.com Drinking Water Laboratory Test Report Report#: Report Issue Date: 25-02100 2/14/2025 CLIENT INFORMATION CLIENT/CLIENT ADDRESS: OWNER/OWNER ADDRESS: Don Stodola Well Drilling Dennis Peterson 3841 North Main Street St.Bonifacius,MN 55375 WELL It: WELL ADDRESS: 873596 2285 Webber Hills Rd,Orono,MN SAMPLE INFORMATION DATE/TIME COLLECTION OF SAMPLE: DATE/TIME OF SAMPLE RECEIPT: 2/13/2025 at 8:30 2/13/2025 at 11:20 SAMPLE RECEIVED ON ICE: TEMP.OF SAMPLE UPON RECEIPT: el YES El NO » °C SAMPLE COLLECTION POINT: COLLECTED BY: Well 0 TCWC ® CLIENT ❑ OTHER SAMPLE RESULTS LABORATORY SAMPLE ID: CLIENT ID: 25-02100 ANALYTE PASS/FAIL. RESULT MCL ANALYSIS DATE ANALYSIS TIME METHOD SM 9223 B(Colisure- Total Coliform PASS ./ ABSENT <1 cfu/1o0mL 2/13/2025 12:26 Presence/Absence)-2016(23rd Ed) Nitrate as N PASS r/ <1.00 mg/L 10 mg/L 2/13/2025 13:59 EPA353.2 Rev.2.0 Arsenic PASS ./ <2.00 41g/L 10 pg/L 2/14/2025 12:34 SM3113 B-93 ,The analyte(s)reported,for the above listed sample(s)pass if the result is below the MCL(maximum contaminant level)and fail if the result is above the MCL.The MCL is set by the U.S.EPA and followed by the Minnesota Department of Health for safe drinking water. NOTES APPROVED BY: __ ++ 2t Frances Turner-Laboratory Director '`1Minnesota Laboratopry ID#'027 053-119 '�" r + 4 . r .. y"tt�'� "� Sy # 'r• _ � l fir Sreport apply onlyto the above listed sam'les All routineuali assuranceprocedures The'result(s)listed in this pquality' were followed unless otherwise noted• .7he analytical report �-��f must be reported in its entirety.All methods are certified by the Minnesota Department of Health`unless otherwise noted' - ,-4 f . . ,�...}.r* �. ..�,..-•�. ,r,.o,!.m..,.0,...,.�.,,..-.'...t z , .a-.�. a,....i.6_��t C - fq4 v~1jLRev:1 41,fj_ Pagel of . ;�..