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HomeMy WebLinkAboutwell info STATE OF M[NNESOTA DEPART?ENT OF NEALTH ABANDONED MELL RECORD l. LOCATfON Of YELL M[NNESOTA UNIQUE MELL N0. (leave Dl�nk if not known) County Nanr Township NaoN Townsn D NuaDer Range Nwnber Sactlon No. Fraetton !. MELL DEPTN (cwpl�t�d) Date sealed N E 4 y of y Orono 118 Sr 23 Wr 36 JW 51'J 1Y1:+ /(�0 ft. �_r�P,.�� (J Nwne Ncat Str�et Address and Ctty of Mtll loution or OfsUnce froe lioad 5. DN(LU NG METH00 (11 known) Inun�cifon 1�Cable Coo1 IQ Rewrs� 7[�Drlven la]Dug 139 Chevy Chase Drive Wayzata, t�In. 55391 �"�„�� a�a 50 Atr �]Bond ��p 3�RoUry 6�J�tted �Powr Auger S�ow exact loutton of well (in s�ction qrtd rlth "X") Skett� map af w�ll lot+tton 6. OBSTRULTIONS N ��1�ph Mell ObStructt�Te � No _ � ._ .� �Q1��{-�-� Obstructtons r �d�Y�s �Na If oDstructtons cennot ba � • � � �—�"�. � � rl�aoved, COnt�ct MDH M - • - • - � - E Uht� bNore seiltng. . cr ;�h . � � � T � , �. �5E �- . '- - y�. � = �Doiaesttc �Monitoriny �lieat Loop ; , , � I � � � �-` 20 Irrig�tton 50 Publit � Industry V ,�� � l � 3�te:t wetl 60 Muntclpal 1CQ coswerct�l S 7[]A1r ConditloMnq 110 �-1 .i L----� 2. PROVERTY 04INER'S NAME Mailtng Address if different than 8. LASING(S) "..1 � property �ddress 1nd1 uted aCove t�Black q7p Thread�d 7[] !� i3ob Sinrnons 20 Galv. 5[]M�lded 3p vi.:c+� ep sc.��i.:: se..i HARONE55 OF �/ �� �o�ft. 3. fORMATION l06 COLOR FORMATION FROM TO If not known, fnEicate (orm�tion l09 from new rell or n�arby well. 1n. to ft. ���� 9. SC EEN Scr��n�d well tro�/�tt. to� ft. (if known) p ow� �oi. r�_ re. eo_ rc. 30. STATI 4AT€R LEYE� l ft.�b�low �abov� v D Lnd urf�c� Dat� Masured ��-�o 'Q `� � 11. YELLHEAO COMVLETION 1�Pttless Adapt�r �FounE lurl�d B�s�n�nt offs�t 'Sa Mell Pit 16. REMARKS, ELEVATION. SOURCE OF OATA - CASINGS REMOVED, CASINGS DERiOMTED, ETC. 12. G�TING INFORWITION Grout 3" Wel l Approx. 180' Deep Meat Cewent �p e��co�,�. � 8 �a�S �TIIEnt Grout wt�ri�l fron/�to Cr ft. cu. yds 1 Bag Fentonite — — 4 Hov.Ys L2bor, 2 Men & GYC�ut PL3mp +�. �EnaesT SOURL'ES OF COMTAM[NATtON �1�� feet dtr�ctlon ND/1�.1 type Mell dlslnf�tt�d bHon se�llnq7 �Yes 10. VUMP �Nerov�d �Not Prss�nt Typ�: ![1 Subrrslbl� �]L.S. Turbin� �Reciprocacinq �1 Jet �C�ntrifuqal 50 ��f 15. EXISTING WELLS (Pl�ai� sketc� locations of abandonea and �cNv� �wlls tn re�arks s�ctton or on Cuk.) Oth�r unused wll(s) on proptrtyt �Y�f �No Abandon�d: [�Ver�amnt �Tawporary (]Not seal�d 11. MATER WEIL CONTRACTORS CERTIFICATION TM s `+ell ws sealed und�r �y �urlsdiction and thts reDort is true to th� Dest of my knowledgt �nd Deltef. � Llcsns�� Susln�ft N�w Ltunse No. ��2 Addrtss . 345 Stqn -� D�t� Mark Ct�yjpl� au OFFICIAI ABAlIOONED YEIL RECORD (May De us�d for VroD��ty Tr�ntf�r) X��e of Or111�r L�P(1�TA/Tr Plld MITH DddD