HomeMy WebLinkAbout1993-01-18 Water Well RecordWELL L. CATION MINNESOTA DEPARTMENT OF HEALTH M!NNESOTA UNIOUE WELL Ali
County Name Henrwipi.n WELL RECORD 5 q
Minnesota Statutes Chapter 1031
v
Township Name Township No Range No Season No Fraction WELL DEPTH (completed) Dale Worts Cixripleted
h
Numerical Street Address and City or Well Location or Fire Number DRILLING METHOD
1 h `,1 CYO]; street O C a x1, mn . Cable Tod i Driven i ; Dug —
Auger jJ Rotary 1
Slow eaaa location of well in section grid with 'X' Sketch map of well locat
nuoulmmon
I t hilts
Showing property li -. _ - - __ - ----LAM
-
roads and buildlin s. DRILLING FLUID
Ben tnj
.USE !-I HeatnpR7ooyp
I
�. Domestic t 1 M Public:
g C7 ktdutrycorrime crM
/Irrigation] PuDkc ❑ Rentsdiel
tt { Test Well i : pewNMirq
AN
CASING Drive Threaded
[ Yes Ll No L,JI� HOLE
k 0 Steel I. Tbrsadad ❑
-'
w Plastic it \11j�-J
1,��• CASING DIAMETER WEIOHT
PROPERTY OWNER'S NAME
i a ri
J i-r, .. kmf e!l fiLx es
_— on to — h
1'' • 66
bJR
� '%
h. b A—
_— a .to _ h.
_--- -- in, to ._ h.
bJll
_ Itlrull.
= 1n. for IL
in. to —1
Maang address A d Wenl than property address indicated above
f' 1 r 1 !P rkwny
SCREEN —jh
� N HOLE
�linrx�`. cri'c�:, I�6T._ :�
Type Uteel
Dim
SbVGauze—� r
LWVMt
' `
Sat between ► 1 t _h. ands7-_h. F1nwas:
GEOLOGICAL MATERIALS
COLOR
HARDNESS OF
MATERIAL
FROM
TO
STATIC WATER LEVEI
S h. Ulbabw ❑ sbpteare•wtaoa Dan
C:Liy
t,
PUM L (below lard surface) A
2rt
1(-
h. stir
_ In. ptaltpatq nn�w.
WELL HEAD COMPLEriN .: <
.
�_.' onf'.Fji
CRP, a plsr msr.Aec�r
❑ Calling ProNctgn -- --
Modal
49 12 in. aboir. wmb
Wee grotAw ❑ Yee Q No
Grout Malarial ❑ Nets cow p 9erttarlits
from b IL ❑ yds. ❑ bop
from b It. -- ❑ yea. ❑ bare
from_ to K ❑ yft ❑ up
NEAREST KNOWN SOURCE OF CONTAMINATION
I" dYMOMon qp
Well dawillecilled upon complatlmT ❑ VM ❑ No
PUMP
❑ Na irtst.aw Dec. etM.rw
6-1c:—y:
Manufacturer's name X-•
Model number --- ►O ._e, _ Vo% f l
Length of drop tape __ r�i'iC1`141
PreawreTnkCa{Nuty Pregt+Idr(+ TPnk
Type: Cl Su.mwsible ❑ L.S. Turbine ❑ Rspgoea" ❑ JM ❑
ABANDONED WELLS
Does p•^.'- have any rid in use and not aeeled w1(s)9 ❑ Yw Q No
WEU 'OR CERTIFICATION
This w. ..under my supemwn and in aooadMtce war sUtrtaso4 Ruin. CMpNr 4725.
The im. --.. "lained in ees report is true to I* bets of my', dp.
Use s second sheer. A needed 0RJ1.UNU CV
REMARKS. ELEVATION, SOURCE OF DATA, etc. L.cerrsea Busrwsa sy"'s lle. or Oft No.
1-1ls-9?
-- Nit. a orwlw - --Dam -
LOCAL COPY 15204591 ME•01205-M(Retn. 5"