HomeMy WebLinkAbout1986-12-04 Water Well Record11i v
or Stem Adirer and City
STATE OF MIIHNZSOTA DUARTMENT OF HEALTH
WATEN WELL RECORD MINNESOTA UNIQUE WELL NO
Mr.autak Srhao 1564 01 OR f Wak, Seaq+e
SWIM No Frartron a WELL DEPT11(o iso"adl ir
Y
AM,tw Name
-r-
1
, ,
ute,lrr
IS
,
La Flamm
2. POMETY OWNER'S NAMt
in
3 f C' Fbmj� t Arn 1,ina
F
J
3 FORMATION LOG
COLOR
He �u.rrr
JV
Ir.—
F:IEVATNtN ?I11'RLI. (B DATA rti
race/ a ,s.W i
LOCAL CONY
map
FROM I T(
)awNG METHOD
10 Calk told 413 Re --
20 1"10. roll (' j2AAlr
A&Xotwy I ff,
426520
1--•:-e.0
orin," Ins Dq
1 l0 —
7 US& t,,.. Utt 1 y 1
..-
IODomestnc 40Mmtlonrtg IDRIopump
20krtlplron 5CIPuMr 901Muory
30Test Well `LJ 60Muntol"M ,- 1g1Cmtuueo'i
70 Air Condnnrlwr 110
6 CASING r_.-..--- ..'—.. -
HOLE DIAM.
HWIfT: Abooe/hrbw
IrO+ack pThIN%!d
Sudwr It
20 Gal. 50 weMld f
Dr., til,or! YesQ_ No—
l0 ram. 60
lu II Weight 1.L•�Lla>L_. Ih, rll.
Jn. lo_1I1.
Wrobt the r11,
ten- to�Jl.
Weight The
_in toJJI.
9
Or ,pins Ink
altiCItEE glkjoi"�
Me -
'S.
Inar, 1t m
_ It.
TyR .lt sr f el1 A %t.1 _—
SlouCrauae_ III 1�r,Rlh
ae
L
Net leween —>� tl II and _.1Lti. f1TT
INGS'
It Mow 0 abaye Date Messand--
lard strtare
11 PIMPING LEVEL Itolo- land .urfaal
r tr
11 alley hra pwnpuy ._. _. Rpm.
filer hrs pumping __ ____ _- Rpm.
12 HEAD WELL COMPLETION
m P,Iless adapler manulaourer - j*j i L - W;I-- madrl'--_----
20 Halmenl dfan )p At least 12" abure gn,und
40 Plato. caarng poenum.___-- _
I., WELL GROUTED'
J19 Yrs ❑ Nn
ID Neat Cement 20 llrntrn,Ir ckf�u
In,m --_-.-_lu _ (I m Inks _-_---.
14 NEAREST S(HIRCES OF POSSMLE CONTAMINATION
--_ _.._Het dtreettm type
Nrll dninfn led up,m iumplM.w,' (Wes ❑ No
�
1-m oAled _ um.a.. Aafi______ _ ____-- _. ❑ Nut installed
M(drl number HP
p—.
I� *1 h ,e drug pp —. It spawn, 1L Spin
Mai".. d dmp ppr 1" GRIM pipe - - - - - -
Type )I Submerrlk :O L.S Tarlttte 50 Rmpn.l,ng
MJet 40 Lentrdutpl 60 - -
16 EXIS1INt. WT.LLs
Unuaed .ell m poprty' O Yes Oh.,
Abandoned 0 14rmanent ❑ lemporan D Nut ,r.M
In WATER WELL CONTRALIORNCERTIFICATION
1'h,s well was drtlM urder m,I tunsd.t.rn and this rrprt ,% troy to ttnr best d my
krn.lrillp and belief
1[
Ix..rr Ar.rwess . ar••77 Luets
Add. _15314 111,17�f ----
Sltnel_- _ _-_ '' 1_ ILtr
�u,h.—M Rrpearnutn,
tir/ri'�S.T-44
T' a�i r . rJ4r
S r 7a pM
r, n arf
HE U121C, 1Q ,pies Iu-d5r !/n yRR1
426520