HomeMy WebLinkAboutwell info �I'zvin City �Vater CCinic, Inc. �
617 13th Ave So • Hopkins,Minnesota 55343 • (612)935-3556
08/12/1995
Stodola Well Drilling
1 5306 Hwy 7
Minnetonka MN 55345
938-21 1 1
REP(JRT OF WATER ANA,L,7IS�.S
Lab�: 26922
Our Laboratory reports these analytical results, determined on a sample taken
by CLIENT on 08/10/1995 from the following location:
Tony Eiden
265b Countryside Dr W
Orono,M�
UMque 1Me11�b61372 ,
Coliform Bacteria <1/100 ml
Nitrates Nitrogen <1.0 mg/I
The results of these tests indicate that thls weli fs producing water that meets the
standards for F.H.A., V.A., or conventional loans. This report is an analysis for coliform
and nitrate only and does not include analysis of Lead and other contaminants. (Untess
as speciiie� €�y clientj.
�\, � ��\
T � ater Clinic, inc.
Bill V I
Aualyiwl labontory C��q�g�
Wator Aoaly+u ReageNe Bailer Wator Chemica4
I.ab Cmt�icatiou Y Q27-033-119
� WELL LOCATION MINNESOTA DEPARTMENT OF HEALTH M/NNESOTA UNIQUE WELL NO.
CountyName . WELL RECORD 5 613 7 2
�"-�''�`"� -' Minnesofa Sfatutes Chapter f031
Township Name Township No. Range No. Section.No. Fraction WELL DEPTH(completed) Date Work Completed
� ':t:;�c ; 1 t . . '� f, , _ " _
�a v. �i.
Numerical Street Address and City of Well Location or Fire Number DRILLING METHOD
• , , , :_ ❑ Cable Tool ❑ Driven ❑ Dug
,,.,.. ;.:_LC � L'1"��t_'.
`" � ' -- i �`-^'` ' - ❑ Auger ❑ Rotary ❑ Jetted
Show exact location of well in section grid with"X". Sketch map of well location. ❑
ShoW property lines,
N � �)'� ads and buildings. DRILLING FLUID
I i � �
__r__y_ _1 _1' � Jrt,.
U•
� � � i ,USE ❑ Heating/Cooling
,_a_ _:_ �_ �_ 4,Domestic ❑ Monitoring
W ' i � E ���ti O lrrigation ❑ Public ❑ Industry/Commercial
' T � I .�;�i.� ❑ Test Well ❑ Dewatering O Remedial
_1_ _i_ _'_ _' I
I , i �
+ �'�'"'� �� � CASING Drive Shoe? ❑ Yes ❑ No HOLE DIAM.
� '
'-�- �' - -�' 1 � O Steel ❑ Threaded ❑ Welded
- -� Plastic ❑
~—1 milr—� - .
CASING DIAMETER WEIGHT
PROPERTYOWNER'SNAME �� in.to i`-�ih �?'�.-_ r �bs� iri.to `tt.
"_ 'i r.. , .,-• —
� -: in.to R. Ibs./ft. �_�ytp��ry.
Mailing address if diRerent than property address indicated above. in.to ft. Ibs./ft. j�,to tt,
,t:, 1 i-;r SCREEN OPEN HOLE
,, , ..
� -
� Make ��....=..1.1 1�- ;..?=.'i from ft.to ft.
.. .i.' �. ..�� . . . .. � ... TYPe •.�.,_,P� `�; ���, Diam.
SIOUGauze���1-},:�'h�_����� Length �
Set between !::� 1 � ft.and I".�'�:� ft. FITTINGS:
STATIC WATER IEVEL
GEOLOGICAL MATERIALS COLOR HARDNESS OF FROM TO R. [3;below ❑ above�and suriace Date measured t
MATERIAL '
PUMPING LEVEL(below land surface)
�.lc:a j . � f � ft. after hrs.pumping g.p.m.
WELL HEAD COMPLETION
;,�;;,-�.21(j , �-��i-' ���-;�. C3�,.,Pitless adapter manutacturer s�'.;��-;* ����- Model
❑ Casing Protection p 12 in.above grade
��.�-���'Y� . �_;'_ S E:.�..� GROUTING INFORMATION
Well grouted? C3,Yes ❑ No
r.,t� �� : s ��,: Grout Material ❑ Neat cement Q Bentonite
from �to _ ' ft. _ :-: ❑ yds. 0��,bags
from to ft. ❑ yds. � bags
from to ft. ❑ yds. ❑ bags
NEAREST KNOWN SOURCE OF CONTAMINATION
^- <<,��-
��//,.�_feet "�F�� direction '" t ' � type
Well disinfected upon completion? ❑Yes ❑ No
PUMP
❑ Not installed Date installed (`^ -'���`";�� �
Manufacturer's name �� � �"k
Model number $°�c�;'�_� HP 1; Volts , ,
Length of drop pipe �,��� fl. Capacity _1{' m.
9P
Pressure Tank Capaciry {.",�'='�..i�'� - '"'r,-t
Type: O Submersible ❑ L.S.Turbine ❑ Reciprocating ❑ Jet O
ABANDONED WELLS
Does property have any not in use and not sealed well(s)? ❑ Yes ❑'No
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,ilneeded ?A +t ��f��f,;' t i:.,�: i t��.y.�i.�.,r.!l.j '''� � t i �
REMARKS,ELEVATION,SOURCE OF DATA,etc. Licensee eusiness Name Lic.or Reg.No.
� ���._._. " :
.- .
�-/i��Cir� ti c..�...c...... ._
� J Authorized Represenfative Signature � ' Date r
_ ._ . , Cl.. . .:i'_ < -�'` Z.
Name of Dri/ler Date
LOCAL COPY 5 613 7 2 HE-01205-04(Rev.5/92)