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STATE OF MINNES TA <br />DEPN(TF91T OF MEALTM <br />Is— re and Direeti <br />T <br />2. FORMATION I.OG <br />aw <br />MJ...Iesov umrod hwu NO. 127330 <br />VATER WELL RECORD for Yae.r sarz. <br />%ees.00t :;t.ltu 156A.01- 78 <br />tion Section Number oWnsnip % ber Ran Re Nu.ber 3. PRopmm WN31, NAIL ------ <br />a�K ge . a 117?) �►1. alas <br />Tres. .red Ct,y <br />.. cn ose:cn nap or veli _oe <br />V 1 _ <br />LOCAL COPY <br />Address a7 A Om ft=seet <br />Glow, hiss. <br />4. YLLL DEPTH coupleted D.0 of [a.ple tart <br />IL A <br />h. <br />5. t--1 <br />I���L <br />Cable tool Re— 7❑ Driven lOQ Dug <br />Sailor rod SQ Air R[Bored I lE] _ <br />19Aotary 60.letted 7❑Pouer Auger <br />IC7boae.tic L Public Supply 7U Industry <br />2E] Irrigation '.a Air Conditioning fa Conserrl.l <br />30 Tea Well 6❑ <br />— <br />VESS OF <br />-_MATI ON <br />—A <br />FROM <br />® <br />T. CASING DIAM. <br />Thre.d.4[]l Yelded❑ <br />Y <br />SLIGHT: ADove�� <br />Surface —ft. <br />Black Gel, <br />4 1n. to� aft. depth <br />Y.Icht W.0 lb../ft. <br />In. to_— —h. depth <br />1n. to tt. depth <br />Drtw Shoe? Ie.2 No <br />— <br />• SCRLBII <br />Or open hole --- <br />Make � <br />froa <br />Type Di.. <br />Slot/Gaup - Length_ <br />r1TTINGSt <br />Set between_ It. end ([. <br />ft. and ft. <br />_ —_ft. []&110e E] tbore Data Mtssured � <br />land surface <br />TISAFiL Ltd land surfaced---- <br />after_ _hn. DumD1.R <br />`•/ h. after_ hr.. pumping_ R.P•.• <br />11. 'JELL dXAD COMPLETION <br />1MP/t1... adapter Basement offset IQ At least 12" shove <br />12. Yell grouted? <br />MY.s []NO Ids.—. <br />i[71Neat caaent Bentlnit. INS_ 1 <br />-- — Dtpth: from ft, to ft. <br />from—ft. to _ —ft. <br />13. dsarest Source of possible contamination <br />feet di —tlon type <br />Well disinfected upon completion? To [a No <br />Data Installed W26101M <br />O Not Installed <br />Manufacturer'. Name_ _ <br />Madel Nuvblf hP�_Yolte_ <br />L..xth of drop Pipe.— __--ft. capacity to D•R. <br />Ilauri al of drop pipe 14,?___ <br />--------- Type: 3P SWamrsible I❑L.S. Turbine 50 Rsc iprocet in, <br />1n Jet 4❑Can trl fugal 6[] <br />— - --- 1n. WATER WILL CONTRACTON'S CEPTIFICATICN --- <br />This .ell was drill.•I under p Jurisdiction and this report 10 true to <br />----- ---.-- the ba.t or my "ovledre and baiter. <br />Address s�� . e 55%3 <br />31 at. <br />Auttiwlpd R.Proventative <br />----� --_ -ne. .,f Driller <br />