HomeMy WebLinkAbout1996-12-02 Water Well RecordWELL LOCATION
MINNUMA _ ._ IwwwyrDi!!A LIMIKA r t eru tee r.
t G 1MLL AND BORING RECORD -
Qps
cp.+rNOM
m"Immm Sam" chmpw 1031
Tawlstrq Nom
Toj*%s No.Rarlp
NaC�
WELL DEPTH (Wmp )
Dsls V mk C MWW
_
Hou- ifto dW, Strait! Nom, Cry, IOM ZIP Cods of WON Loc~
or Rre Number
DRILLING METHOD
(c,, , ,
r all; , ltc,.-.:' I rte_, i :.:
i
n Cable Toa ❑ Duran n Duo
❑ Auger QiRIa-ty ❑ Jeri'
n -
Show esm toeelion d war in section grid w*h 'X'. Sketch map of wall auto,
Shot"prop" unes.
DRILLNG FLUID
oads am Wwv
N
-� -i- - -
I
USE n MwWorng n
Oamelic o Community PWS �
IQ
._� ewe
n trtlpahon (-I Noncommunay PWS ; I Ran""
w E -
n Test War n Oawwnrlp n
CASING Dnve Show n VM C) No
HOLE DAM.
L
. n S -el n ThreaOsd n WstdW
P -sac
L—�
CASING DIAMETER WEIGHT
_ m. a - - -� —I R. - - be -M.
�/,.�o' e.
PROPERTY OWNERS NAME_
7 rl1 w i i 1 ( t • ; :
_
— 'ML to d. = MA.
in. a - - fr. — — bsJ.
'- N.A"�DIE
— in. b — a•
Pt*W y omw s maft address d d0leta ten war Iocaton atldreas aldra-d above.
lit, iILi
SCREEN_ OPEN HOLE
5: 5(:4
Make .10 �.
TYW—tTr�Tri�=r=--r.4-:1� Drrtl. r
SIoUGmum
Set between FITTINGS:
STATIC WATER LEVEL
1 'L •. --ft. f]:bebw O abolw wt' wxtaos Dale
WELL OWNER'S NAME
PLWMNG LEVEL (below ISM surf
t L I. alter J ha. ptwgrg
Well onewes nlrI adbns r dP* m Inn prope ft omief s aderew ind Cana above.
WELL HEAD COMPLETION
t'.: 1 e;..! ! r'• �'
, _
El Pmm adapter alw%Aceaw Model
O C WWq Pro-ceon _ O 12 N. aloe WOM
❑ CIE 1atel- WW - eel godnIpm ONLY)
GAOLITwn wpORIMTION
wall groulap j7 yes ONO
nW O NOW uo n BsnloN- O Coneh t114409060wolbnb
Grout MMnw
GEOLOGICAL MATERIALS
COLOR
HARDNESS OF
FROM
TO
MATERIAL
from ft jt 1. _ ❑ yea. OAA
from b A. 13Vft ❑ beep
from b N ❑ yes. ❑ bap
NEARS BOUNCE OF CONTAMINATION
eel Sny % N
Was- upon canpleam ? ares ❑ No
.
P1IIp
- J-9•7
❑ No a-tsw DMI/ awtmm _
C.1E1�'
-: t. +
I
' 1 r:
Mos,bmwsmrm
Mo" fl., h r r HP 11-- VaMa 2 3
tlan Ieh d drop plea IL
water sand
r•r r r v:
i�'
t;
I vrewlae Taat caoae� L a►r . c
Type: 0 Subsarable ❑ L.S. Timbre ❑ A cip ling ❑ JM 0 -
-ABANDONED
ABANDONED WELLS
Don properly here any not M Iwo no not wale' wea(s)9 O Yn U Ib
VARIANCE
was a v&wm gran-' ham the MDH kx INs mp ❑ rte CI No
WELL CONTRACTOR CERTIFICATION
LAMB asclorl0 arraal a naeerr
This wellWes drwa under my supervam ane elo'do'r-s w1h Mlnr-aaa RWw Chapter 6725.
The irNontlallon oorlterra m On -ports that b to best d my' Op
REMARKS. ELEVATION. SOURCE OF DAl r►, alc.
11._..".:c; Cf-
Lr- or Reg ft
Chuck
t^:Lu,rcAWwi"'0 0a-
LOCA COPY
5 8 8 0 5 0
Nor- at Drs Olalr
IsaBNapbee• +Atte
POW