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HomeMy WebLinkAboutWell info ___'., _" """'•���."' �.�..�....�... �n ..r�.r��� ABANDONED WELL RECORD 1. IOCATION OF �[ll• M(le�w b1�nkNt�E W�E��NO. —_ County Na�e Hennepin Tovnship Map TownsAip NwD�r Rang� NwMr S�ction No. Fractton ♦. MEIL DEPTH (co�pt�t�d) D�tt s��1�A E Qr0110 1 l7 or 23 a'' 2� � SE'o�y � � � ft. � ,�, I /v ' � � S M Numerlcal Stre�t Address �nd City of M�11 Loe�tton or Distance frow Road 5. NILIlN6 IffTNOD (if knmrn) Int�rs�ctton �Cabl� tool �R�v�rs� 7[]Driv�n Iq]Dug 2618 Casco Point Road Wayzata, Mn. 55391 zp�w�,,,, eoa 50 A1r ep a��.a ��p , / 30 Rotary 6�J�tttd �Pawr Aug�r SAow exact location of wll N (in sectton yrid rlth `x") Sk�tch �p of wil loc�tlon N 6. OBSTRUCTIONS Yeli obstruct�d Yts � No - � - - - -- -� � Obstructions ��Rf�es (]No if obstructtons cannot b� . . • � � J.��` M _ : � � � _ � n�owd. ConNtt MDH .. .�_ � E c�.t � b�fon :..ltey. . _ ' ._ ;. T '"c � �. use '� y.w. W°y �- �Do�estic �Nonttorinq �il��t loop ._;_ , _;. ' ' I � 2Q Irrigatlon 5[�Publlc �industry . _.,.. .., ' S ' . 1 � 3�T�st Wll 6�Municlpal 1�Cos�rcial �---1 .iL-� � 7(�Air Condltioninq 1](] 2. PROPERTY OWNEN'S NAME Ma111ng Addnss if dlfferont CAan A.��CAS11iM6I51 11�� property addnss Tndtuted �boq �Btatk �Thnaded 7(] Joyce `I�aedt SAME zp w,., sp w,a., 3p vi,:e�e �sai��.:s ss..i HARDNESS OF � ��, � �Q 1t. 3. FORMATION L06 COLOR FORIYITION FROM TO If not known, indiute torw�tion log fro� nw we11 or n�arby w�ll, ��. Lp ft. Drift 9. sca�� (�s�...�.e .i.�t r►o.7� rc. w 74 rc. - (If linown) �Op�n 1b1� fro�_ft. to_ tt. 10. STATI WATEq LENE ��% ft�b�law �abov� land su ue Dau 14�sund �-� 11. YELLHEAO COIiLETION 10 Pitl�st Adapt�r �Faund BuriW 2[]Bas�nt offstt 50 �H�11 V1t 16. REtMRKS, ELEVATION, SOURCE OF DATA - CASIN6S RElqYED, CASIN6S PERFORATED, ETC. 12. GROUTIN6 INFORIN7ION Grout 3" Well Approx. 74' deep �"'+` `"'"s ��`"`°"'�' '� 4 Bags Cement sro�t ..a�,., rro. �� w� ft. w. ,,as 6 Lbs. Bentonite _ _ 2 Men, Labor, Big and Cement Grout Pump 13. NEAREST SOURCES OF CONTAMINATIOM _ r..e atr.ccton �rv iNll difinf�et,�d !»fone sssl!ng7 Q Ye: 14. VUMP RaovW �Not inunt Typ�: 1 Su0�rs1b1• �]I..S. TurEtn� �R�Nproc�ting ._ �J�t �Gntrltuyal 6� 7� � I5. EXISTIN6 NEllS (Pl��s� skatcb lxattons of �bandon�d �nd �ettvt�wlls in rwtrks s�c on or on batk.) Otb�r ueu�t(�) pe proptrtyT �]Y�s No , Abandontd• P�nianent �Twpor�ry �] t �led 17. WTER MELI CONTRACTORS CERTIFICATION This r�lt ws s�al�d undtr qy �urisdictton and thTs report is tru� to tM b�st of qy knowledy� •nd Mltef. �- � !� _ �' DON STODOLA WELL DRILLING CA. , INC. Ltcensn Busln�ss Nur Llcense No.27}��:Z Address 15306 . 7 M'nne 5345 s,9�.,,e-�'.��.� ,� o.a 1 -6-91 Mark G. Sto o a o.0 1`L-6-91 FFICIAL ABAMOpNEO WELL itEC01tD (!4y p� us�d for irop�rty Tr�ntftr) Na� of pr111�� �4'A�?: IILd NSTE DEdD