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Home My WebLink Aboutwell info WELL LOCATION MINNESOTA DEPARTMENT OF HEALTH M/NNESOTA UNIQUE WELL NO. CounryName WELL AND BORING RECORD 6 2 3 5 8 3 Minnesota Statutes Chapter 103/ Township Name Township No. Range No. Section No. Fraction WELL DEPTH(completed) Date Work Completed fl. 4< 4� /. House Number,Street Name,City,and Zip Code of Well Location or Fire Number DRILLING METHOD 47t�Q Creekwooc� Trl, arono 5369 ❑ CableTool ❑ Driven ❑ Dug ❑ Auger �otary ❑ Jetted Show exact location of well in section grid with"X". Sketch map of well location. ❑ _ Showing property lines, roads and buildings. DRILLING FLUID WELL HYDROFRACTURED? ❑YES �QO N , , , , �¢'L1r bentonite FROM_ n.to n. ,- -,- -,-- -, M USE ❑ Monitoring ❑ Heating/Cooling i i i i A �omestic ❑ Communit PWS _i_ _�_ _i_ _i_ ❑ Irrigation Y ❑ Industry/Commercial i i i i ❑ Noncommunity PWS ❑ Remedial w E� ❑ Environ.Bore Hole i i i i ❑ Dewatering ❑ i -, i -r +/zM1e CASING Drive Shoe? ❑ Yes �lo HOLE DIAM. _i _i_ _i_ _i_ � O Steel ❑ Threaded ❑ Welded i i i i �lastic ❑ S �-1 Mile-� �:. CASIfNG DIAMETER WEIGHT k PROPERTY OWNER'S NAME /` ( ��j�� j �t in.to �-Q� ft. ��g Ibs./ft. 8 ��.to , Q RPC Ho�te� C.r�G��"'� in.to ft. Ibs./f[. �in.to�ty 6 > Property owner's mailing address if different than well location address indicated above. in.to ft. Ibs.ttt. in.to ft. 64�5 REgency Lane SCREEN + OPENHOLE S�}en Prair3e, l'iP1 �5�•i�3 Make_ �f��`��— from ft.to ft. Type $ta n �Ss steel Diam. Slot/Gauze �(�1� Length 4� ♦ �i f Setbetween ��_ft.andT1� ft. FITTINGS:�„$'!�1_�_��k STAT{L'*N/ATERLEVEL �� WELL OWNER'S NAME �� ft.�elow ❑ above land surface Date measured PUMPING LEVEL(below land surface) Well owners mailing address if difterent than property owner's address indicated above. ��,f,� ft. after ? hrs.pumping_��g.p.m. WELL HEAD COMPLETION p�itless adapter manufacturer �hi t ec�a t er Model ❑ Casing Protection_ J5C12 in.above grade - ❑ At-grade(Environmental Wells and Borings ONLY) GROUTING�NFORMA—T`ION Well grouted? le'�res ❑ No GEOLOGICAL MATERIALS COLOR HARDNESS OF FROM TO Grout Material ❑ Neat cement ❑ Bentonite ❑ Concrete ,�'Fiigh Solids Bentonite _ MATERIAL from__�_ro_�_ft. �_T_5❑ yds.�bags 1 from�to 1 A Q ft. ��❑ yds. ❑ bags � C+�y �Z��p Q�t Q �5 irom to =�°r ft. ❑ yds. ❑ bags 4; NEAR KNOWN SOURCE OF CON I TION L Ciay -ray �1� ys g� feet ��—��! direction��"` �� fype Well disinfected upon completion? C�Yes ❑ No Claqlrocks ra�n ard 65 95 PUMP ❑ Notinstalled Dateinstalled 3"`3�77 �'�8{T��►S'8flt� olared �dium 9� �.iF1 Manufacturer'sname ��C�. �8.'L'�CQt Model number I S�ensl-CNSIICF 1.S �o„S 234 Length of drop pipe Qli�� ft. Capaciry _�� g.p.m. Type: �ubmersible ❑ L.S.Turbine ❑ Reciprocating ❑ Jet ❑ t ABANDONED WELLS Does property have any not in use and not sealed well(s)? ❑ Yes �Ao VARIANCE Was a variance granted from the MDH for this well? ❑ Yes ,�RIo TN# - WELL CONTRACTOR CERTIFICATION Use a second sheet,if needed This well was drilled under my supervision and in accordance with Minnesota Rules,Chapter 4725. - REMARKS,ELEVATION,SOURCE OF DATA,etc. The information contained in this report is true to the best of my knowledge. en us�ness N .o g.IVS. • j• � `� �� J' ��:. �.� _1£i- Authorized RepreseAtative Signature Date Chuck I�aore 1-21-99 . Name ol Driller , Date LOCAL COPY 6��5 8 3 HE-01205-06(Rev.7/98) � Juiir� �itc� I/Vater (��inic, J`n.c. 617 13th Ave So • Hopkins, Minnesota 55343 • (612) 935 - 3556 01/26/1999 Stodola Well Drilling 3841 North Main St. Bonifacius MN 55375 938-2111 REPORT OF WATER ANALYSIS Lab#: 36504 Our Laboratory reports these analytical results, determined on a sample taken by CLIENT on 01/25l1999 from the following location: RVC Homes 4700 Creekwood Trail Orono,Mn Unique Well #623583 Coliform Bacteria <1/100 ml Nitrates Nitrogen <1 . 0 mg/1 The results of these tests indicate that this w�ell is producing water that meets the standards for F.H.A., V.A., or conventional loans. This report is an analysis for coliform and nitrate on�y and d�es not inc�ude analysis of LeUd and other contaminants. (Unless as specified by client). T� `� ' Water Clinic, Inc. � \ \ Bill Van rsd�le Analyical Isbontory Coreulting Eugu�eer Wa[er Analyais Reagenta Boiler Water Chemicals Lab Cert�cation!I 027-053-119