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Home My WebLink Aboutwell info �(z WELL LOCATION MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WELL NO. Ccunty Name WELL AND BORING RECORD 6 9 2 � 3 3 ge��p� Minnesota Statutes Chapier 1031 Township Name Township No. Range No. Section No. Fraction WELL DEPTH(completed) Date Work Completed Orono I181� 23ii 31 ,� ,,. ,� 182 n 7-30-d3 GPS DRILLING METHOD Latitude degrees minutes seconds _ LOCATION: �- j_�Cable Tool (J Driven _J Dug Longitude degrees minutes seconds _J Auger �$otary ;_I Jetted House Number,Street Name,City,and Zip Code of Well Location or Fire Number �j 4385 Chippewa Ln, OLOI20 DRILLING FLUID WELL HYDROFRACTURED? j]Yes " No Shop exact location of well in section grid with"X". Sketch map of well location. �Iltonite FROM tt.TO tt. Showing property lines, N , roads and buildings USE f]Monitoring r��Heating/Cooling .: `-:-,_"""""'. �/� ' - ; , , � _.,__ ��^^^'� ,aiy7 r]Environ.Bore Hole [�Industry/Commercial L omestic _ ` ^r� �� I]Noncommunity PWS [��Irrigation �r J Remedial � �^4M""""`�� ❑Community PWS ❑Dewatering ❑__ - --'- i-- ---`---- ` . `, W � ; E� % t f; Drive Shoe? j=;Yes �No O�E DIAM. H �; _;_ �___ _.�___ , , /t't'` � ��._'',Steel �.Threaded• �,_I Welded �� ? CASIN . , , '/z Mile � : �_ � 18StiC ��' — - ---- - I va�i . . [� t',. � 1 �j CASING DIAMETER WEIGHT � � S � � � L O�f �`� ~ in.to a`� ft. tbsJft. � • in.to y�ft. f--1 Mile—� { .'+i.fYl��i � V � lOL in.to ft. Ibs./ft. � in.to_ ft. PROPERTY OWNER'S NAME/COMPANY NAME in.to ft. Ibs./ft. in.to ft. .1. �81C Fritzler � Despl L. Peteraoa SCREEN OPEN HOLE Property owner's mailing address if differert than well location address indicated above. Make J8�C0 FROM fL TO ft. 4385 Chippewa Ln TYPe --� De� --� — Maple Plain, � 55359 SIoUGauze gth _ Set between ft.and ft. FITTINGS_��er STATIC WATER LEVEL 183 tt. below ,l'above land surface Date measured__7-30-03 PUMPING LEVEL(below land surface) WELL OWNER'S NAME/COMPANY NAME J, I�arc Pritzler b Desyl L� PetersoA h.aher n�s.PUmP��9— SQ'f' g.p.m. LL HEAD COMPLETION p �� Well owner's mailing address if different than property owners address indicated above. i�itless adapter manufacturer_ �a8a Model � __ �� Casing Protection � �_�12 in.above grade �'��At-grade(Environmental Wells and Boring ONLY) GROUTING INFORMATIO� Well grouted Yes 'L.I No Grout material '�'',Neat cement�j Bentonite i�Concrete ��High Solids Bentonite from 6 to �� n. 3 �J yds ['bags from to _ft. ❑yds [i bags GEOLOGICAL MATERIALS COLOR HARDNESS OF FROM TO from to ft. [J yds. ��.bags MATERIAL NEAREST KNO�WN SOURCE OF CONTAMINATION _ Clay Yello�r 0 30 _ er 54 aaaq _ Q� feet direction type Weil disinfected upon completion ��Yes [�,No Ci1831 Gray 'jfl 9Q PUMP �j ��Not installed Date installed ` _�� i`Y8'Ve�. M�7CE� QQ i�rj IManufacturer's name '!�{�� --' Model number HP ` Volts Gravel & Clay �@d 135 170 Length of drop pipe /i;.*^•�,e _ft. Capaciry ( � g.p.m. Type: � �Submersible ❑LS.Turbine ❑Reciprocating ��Jet ❑ Gr84E�. M�Xed 170 1�2 ABANDO ED WELLS Does property have any not in use and not sealed well(s) ❑Yes � No � VARIANCE Was a variance granted from the MDH for this well? '�Yes �,-� No TN# WELL CONTRACTOR CERTIFICATION This well was drilled under my supervision and in accordance with Minnesota Rules,Chapter 4725. The information contained in this report is true to the best of my knowledge. Use a second sheet,il needed REMARKS,ELEVATION,SOURCE OF DATA,eta sti@V@fl8 Drilling � Enviro�ental Svc 86654 ,. —._. _—_ . __— —�--- ---- ---- � - Licensee Business Name Lic.or Reg.No. - ��\ � \` x ��f V J 1 � � 7 Authorized Representative Signature Date aanay Joh�Bo� _ ::��:l �, � _ - --- -- --- ---- - LOCAL COPY 6 9 2 8 3 3 Name of Driller oate HE-01205-08(Rav.5/02) IC 140-0020 ; wELL OR BORING LOCA7lON MINNESOTA DEPARTMENT OF HEALTH Minnesota Well and Boring H 2 018 3 8 ;County Name WELL AND BORING SEALING RECORD Mennle9oNa Unique Well No. Hennepin Minnesota Statutes,Chapter f031 or W-series No. (Leave blank I�not known) Township Name Township No. Range No. Section No. Fraction(sm->Ig) Date Sealed Date Well or Boring Constructed -` 8rono 118N 23W 31 ,. �. �. `�\ ��?�' , =� . f ._�- 1 C� �..� GPS Latitude degrees minutes seconds - LOCATION: Depth Before Sealing ft. Original Depth ft. Longitude degrees minutes seconds qpUIFER(S) STATIC WATER LEVEL Numericai Street Address or Fire Number and City of Well or Boring Location Single Aquifer ❑Multiaquifer 4385 Ct►ipge�ra Ln, OlOAO WELUBORING Q'Measured ❑Estimated i� ❑Water Supply Well ❑Monit.Weil � Show exact location of well or boring Sketch map of well or boring // ,I�� in section grid with"X" location,showing property ❑ Env.Bore Hole ❑Other �ft. [�below ❑above land surface n N lines,roads,and buildings. CASING TYPE(S) �� Steel ❑Plastic ❑Tile ❑Other W -� - -- - -- --�-- E , WELLHEAD COMPLETION � � � , , � ��` ` Outside: ❑Well House Inside: ❑ Basement Offset �-- �-- -;-- --1-- � . ,4 CITY OF ORONO �m�� i7 Pitess AdaptedUnit ❑Well Pit ---- -i-- -i-- --�— I 7C� 1 ❑Well Pit ❑Buried �l� S �" im/re��.f il..'�C� ❑Buried PROPERTY OWNER'S NAME/COMPANY NAME CASING(S) .7. Marc Fritzler � D68 1 1.. Peterson oiameter oeptn _ set in oversize no�e? Annular space initially grouted7 Property owner's mailing address if different than well location address indicated above � � in.frOm� to� —, ✓ft. ❑Yes [�`�No ❑Yes ❑No �Unknown 4385 Chippewa Ln Maple Plain, AII�i 55359 in.ffOm to ft. ❑Yes ❑No ❑Yes ❑No ❑Unknown in.ffom to ft. ❑Yes ❑No ❑Yes ❑No ❑Unknown WELL OWNER'S NAME/COMPANY NAME SCREEN/OPEN HOLE J. Marc Fritzler & Des 1 L. PeCerson ` ,t. �_.� � . � Well owner's mailing address if ditterent than property owner's address indicated above Screen from .�' �� to ft. Open Hole from t0 ft. OBSTRUCTIONS ❑ Rods/Drop Pipe ❑Check Valve(s) ❑ Debris ❑ Fill �No Obstruction Type of Obstructions(Describe) GEOLOGICAL MATERIAL COLOR HARDNESS OR FROM TO Obstructions removed? ❑Y2S ❑ NO Describe FORMATION If not known,indicate estimated formation Iog from nearby weil or boring PUMP Type ,�.� �`�}r1 Removed ❑ Not Present ❑Other METHOD USED TO SEAL dNNULAR SPACE BETWEEN 2 CASINGS,OR CASING AND BORE HOLE: [�No Annular Space Exists ❑ Annular space grouted with Uemie pipe ❑ Casing Perforetion/Removal /\ in:from to ft. ❑ Perforated ❑ Removed • in.from to ft. ❑ Perforated ❑ Removed ` Type of perforator ❑ Other GROUTING MATERIAL(S) (One bag of cement=94 Ibs.,one bag of b��entonite=50 Ibs.) �{ t +!i ( � Grouting Material 'v"��' �� `� ��}�� om�to�k' yards bags from to ft. yards bags from to ft. yards bags OTHER WELLS AND BORINGS REMARKS,SOURCE OF DATA,DIFFICULTIES IN SEALING Other unsealed and unused well or boring on property? ❑ Yes No How many? 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