HomeMy WebLinkAbout2000-11-03 Well And Boring Sealing RecordWELL OR BORING LOCATION MINNESOTA DEPARTMENT rDF Hf AL TH Minnesota Well and Boring
ty 1 Name
_ WELL AND BORING SEALING RECORD Sealing No H i
CounMinnesota Unique Well No -T00T5
--
9� f� bbnnesora Srarure, ,ravre •J 7 or W-senes No J
TownSh!p Ndme ,w. sr,q 1;. , ,,.p. N ,• No .g Date Sea*! ;tn+r lte,—!, Einnng
A :: onsn,a •m4
06
Numerical Street AyQre55 0• t .i Num[ra• ann !r '.Y " ,• Bc,nng Inc al,nn
\� eUn Be(.!en I n
7V2340-lax ftre �p Wall.
OUIFERISISnow exact rocal!on of "1' u, trnny STATIC WATER LEVEL
,n section Qnd wen -k' ,
w A! uae• r
,a , .f:,�t,au,..rn•
N WFLVBORING . • I,t,n•aren
-re
_� Aare, S.vpr We, Momt W,• �.
Env Brve Hobe ,' 0mr,' •+ tNtklw r-' abrrve nark w,racO
W E CASING TYPEISI
--7•- -- -i-- -i- 1 Steel [l Plash[ Sul T!te `. Other
Itrar
•-}- 4. .4. -4.
CASBI
Diameter, Deptl, /
jet in overs.te ride'
Annular space trlttially grouted?
. I-W ---- a
{
�,j/_
_ ' m .11 __a__ Ib _7.t 11
❑ Yes )&
❑ Yes j] No
❑ Unknown
_ ^ hrsm _ _ . _ _ lU _ it
Yes [] No
❑ Yes :I No
❑ Unknown
PROPERTY OWNER'S NAME
in from - to ._ If
[] Yes [] No
❑ Ye-s ❑ No
❑ Unknown
Property o.rren s mailing edo ,
SCNEENOMN HOLE
�
///x/� lr
�
$greed from � to + _ it Open
Hole from _ _— to
_ It
OBSTRUCTIONS
WELL OWNER'S NAME
❑ Rods/Drop Pipe ❑ Check VaNe(S) ❑ Debits
❑ F,II 910 obstruction
Wes own e, s maang add,ess ,• e,nerent man property owner s
Type of Obstrutt.onS (Describel
Obstructions removed! ❑ Yes ❑ No Describe
PUMP
Type ----- —
ATEAL
GEOLOGICAL MATERIAL
COLOR
_
NARONESS OF
FROM! TO
n Removal Not Present [] ^Iner
FORMATION
11 not known ,nAnts IsaarMlae formakbm log from nearby.Yea or bong _- --
METN^0 USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINOS, OR CASING AND BORE HOLE:
I �
i
REMARKS. SOURCE OF DATA DIFFICULTIES IN SEALMU
LOCAL (;Of , I H 170075
_— Annular Spate Exists
Annula, Space grouted with trenve prior
Catang P9,10,ation,Removal
_- rn From _ - to--. if ❑ PeAoattw ❑ Rantovad
-- in r.om _----- ra it ❑ PWWSted ❑ Ramoyed
TYPO of D61101ator .- - -- ----------- - ----
Other
GROUTING MATERIALS) (One bag of cement n 94 tbs.• one bag of bentonite . SD tbs.)
„wt,nQ MMena pI Q vx,os _ l bags
i
rams bays
words bags
CTHEP. WELLS AND BORINGS
LICENSED OR REGISTERED CONTRACTOR CERTIFICATION
.. 11 .,e, c,Jn„7 was ,e9�•-' .
.... , ., e".. - �'•e nlormatrcx coritane^ ,r tins •x><vt ,i
true to the DOS, n, mY Rr„!.y ..•
DON MDOU V=
MIZZIM CO. Inc. 27172
,.
• ., +
sense w Rotirm amv, ;.0
ese'rrahve S•V, r
„are
-
� \j
Name wParson eda Bonne
Wetly