HomeMy WebLinkAbout1997-10-15 Water Well RecordWELL LOCATION MINdNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WELL NO.
County Name WELL AND BORING RECORD 596669
Hennepin Minnesota Statutes Chapter 1031
Township Name Townshi No Ran No Secton No Fraction WELL DEPTH (comvlete4) Date Work Completed
Orono 11� �? )6 2001 a 10-15-97
HITm r. Street Ndmo, City, and Zip Code of Well Location or Fire Number DRILLING METHOD
t 'ernda le Road North oro n, Mn. Cable Tool Driven ❑ Dug
Auger I :Aolary n Jetted
Show exact location of well rn section god with'%' Sketch map of well location
rt lines.
roads an s DRILLING FLUID WELL HYDROFRACTJRED'r YES J440
N Benronj.
FROM n. to ft
USE Domestic Mondnrmg •, HeetklpK,boWlp
_ _ _ _ _ V ❑ hrlpaaon ; Community PWS IndustrylIC4nitnerCW
w ❑ Test Well watering y PWS : Remedial
` CASING Drrvd Shoe? Yes Xo HOLE DIAM.
_ _ - - _ _ L - ❑Steel ; ; Threaded Welded
1 Y
5LL [7 Plastic ❑ __-_-----
CASING,DIAMETER 1 C, 2 WGT 1 • 9 a 3
PROPERTY OWNER'S NAME 4 �, b 7_ M. _ Ibsfi. p lb
Lauer Hones ----fn.b_ —ff. _ bsA1. —r�4-_-26
Property owners mailing address it different than well'ocaton address indicated above. in. to _ fl. ... IDs.AL m. to __. _. ft
'%UJ rerndale Road N. SCREEN _— en OPEN HOLE
Wayzata, MN.55391 Make from_. _ _ Ilb__ ft
Type 9� Steel own.
SWIRu=e -__- I U // �I Lwgth IS
Selbetween _„__192 M.alw 200-hTTI . FINGs.2____"- 3"
STATIC WATER LEVEL
WELL OWNER'S NAME �) t'
ft Qi below U abbVa Wad e1M1aCe Date measured 7 �-��.= 1
PUMPING ALEVEL (below land surface)
Well owner's mailing address if dalerenl than property, owner's address indicated above _ - �.'l�h. after �_._ _ - his pumping y, +. _ _ g p m
WELL HEAD COMPLETION
A Nmessadapisrmanufactwer-Whi_tewater _ Model _
❑ Casing Protection i4 12 in above grade
r) At -grade (Environmental Wells and Borings ONLY)
GROUTING INFORMATION
Well grouted? X'. Yes No
HARDNESS OF Grout Material Neat cem t Benl . Concrete Solids Bentonee
GEOLOGICAL MATERIALS COLOR MATERIAL FROM TO °oV - X
Iron _._b R _ ❑ yds bags
Irom _ to IL ._ ❑ - be
Topsoil Brown S :) 1 21 from _ b fL — ❑ yds hags
NEAR t��SOURCE OF CO AMIN T N —
Clay S.,nd Brown S 2' 25 i� feet dirMlon`Sf T�
Walldlwlected upon completion? A Yet ❑ No
Clay brown S 25 6b pump 1-2-98
17 Nol installed Date installed
Clay Rocx!, Grey S 60 130 Manufacturers nartJe6�Goulds
Model number -_--_ HP L J V
Send Grev M 13(} tUu 1'75 - --- --
- Length d drop p" n Cap" y.p.m.
Type: 9 Subw4r$W ❑ L S Turbine Reciprocahrg ❑ Jet ❑
— -- ABANDONED WELLS Does property have any not m use and not sealed welds)? ElYes Aft.
VARIANCE
Was a variance grar ;ed from the MOH for this wain Yes i ' 4.
WELL CONTRACTOR CERTIFICATION
Use a eeodrd slaw. it needed This well was drilled under my supervision and in accordance with Minnesota Rules Chapter 4725
The information contained in Ihis report is true to the best of my knowledge
REMARKS, ELEVATION, SOURCE OF DATA, etc. (jUN STODC)T-A.. WLLI, MILLING CO. INC .
,
Lbansaw AraMwaa Name LAc. a Ap. No L 7 l .'
APR 1 .3 1997 tChuck mocre
sp.iafun,
Name rN.Mller ..____. faa _. .
LOCAL COPY F59 6 6 6 9 1 NE-M 28546(Nw. Win)
KP