HomeMy WebLinkAboutWell Construction Record 1-10-25 ,, MINNESOTA UNIQUE WELL
tAIELL OR BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH AND BORING NO.
County Name - WELL AND BORING CONSTRUCTION RECORD � .9 •
Minnesota Statutes,chapter 1031
Hennepin .
Township Name Township No. Range No. Section No. Fraction(sm. Ig.) WELL/BORING DEPTH(completed) DATE WORK COMPLETED
Orono 118 23 27 SW STD: SE/, 170 1/1O/25
GPS LOCATION—decimal degrees(to four decimal places). DRILLING METHOD
Latitude Longitude .❑Cable Tool i❑Driven III Dual Rotary
❑Auger ❑Rotary ❑Rotasonic
House Number,Street Name,City,and ZIP Code of Well Locationi ❑Other
900 Brown Rd No, Long Lake, MN 55356 DRILLING FLUID WELL HYDROFRACTURED? ❑Yes DI.No
Show exact location of well/boring in section grid with"X" Sketch map of well/boring location. Ben t o n i t e Fram ft.To ft.
Showing property lines,
N -7 roads,buildings,and direction. USE •®Domestic ❑Monitoring ❑Heating/Cooling
I i I 1
_ - _ ❑Noncommunity PWS El Irrigation ❑Industry/Commercial
• 9. r
/ Community PWS ❑Dewatering ❑Remedial
/ ❑y___i_ ___,__ Z l ❑Elevator
W - ET r CASING MATERIAL Drive Shoe? ❑Yes g No HOLE DIAM.
r
* ❑Steel ❑Threaded ❑Welded
'h Mile . ..n Plastic ❑
I k.- CASING
' s Diameter Weight Specifications 8
4 /� 50
1 1 Mile I in.TO � 0- ft. lbs./ft. in.To 7
eft.
PROPERTY OWNER'S NAME COMPANY NAME in.To ft. lbs./ft. in.To ft. ,
Mike Geelaa in.To ft. lbs./ft. in.To ft.
J .-4.., OPEN HOLE
Property owner's mailing address if different than well location.address indicated above.'
SCREEN • -a k` 6-
Make J.0 • .i From ft. To ft.
ci 6t, •l lsvu.r
t:
Type n i .,1 Diam. L, n ,
•a,,:i R. Li
Slot/Gauze Length
Set between 1 6 0 /ft.and 1 U ft, nFJ�TTINGS t 1, a tL
STATIC WATER LEVEL ` "' ft.-fn Below ❑Above land surface
1/10/25 �
Date measured Dry hole ❑Yes"u No `
WELL OWNER'S NAME/COMPANY NAME PUMPING LEVEL(below land surface)
155
ft.after 2 hrs.pumping q.p.m.
Well/boring owner's mailing address if different than property owner's address indicated above. WELLHEAD COMPLETION monitor
Tn Pitless/adapter manufacturer Model
❑Casing protection ' N 12 in.above grade '
❑At-grade ❑Well House ❑Hand Pump
GROUT INFORMATION(specify bentonite,cement-sand,neat-cement,concrete,cuttings,or other)
1 cuttings 160 50
Material., • From r n To t.., ft. ❑Yds. ❑Bags
Material o e n t U u l e F om )u u To v ft. ❑Yds. N Bags
HARDNESS OF Material From To ft. ❑Yds. ❑Bags
GEOLOGICAL MATERIALS COLOR MATERIAL FROM TO Driven casing seal From To Bags One bag=94 lbs.cement
or 50 lbs.bentonite
NEAREST/KNOWN'SOURCE OF CONTAMINATION,lillk F
Clay Brown 23 Well is !�a� feet S4 directionfromL � type
PU Well No isinfected upon completion? ❑
Clay Gray S 23 66 Yes ❑
Not installed Date installed 1/1 /25
❑
Clay/Sand Gray S f66 117 Shafer
Manufacturer's name
I 2O
Sand/Gravel Mix S 11 r 170 Model Number 2 HP Volts
t3 1Length of droppipe 1 L 6 ft. Capacity 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 3 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,if needed.
REMARKS,ELEVATION,SOURCE OF DATA,etc.
' \ " --- Don Stodola Well Drilling Co Inc 1691.
f Licensee Business Name Lic.or Reg.No.
i > l 1/16/2 5
[certified Representative ignature Certified Rep.No. Date
. Rob S,todola
LOCAL COPY 8 7 3 5 9 9
Name of Driller
ID#52603 HE-01205-18(Rev.3/19)
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on13th Ave S.
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&PIAAWL
Frances Turner'Laboratory Director `
The res6l in this r600&apply onlito theabove listed,samples;All'routine',�luality assurance,procedures�ver4 follov�4�d unless otherwise noted.The ana lytical report
muslebe=in it's erltirety'All?nethoasare certified by the Minnesota Department of,�iealth'uniess'oth6rv�is4�rted.