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Home My WebLink Aboutwell info Field Engineering, Inc. WATER ANALYSIS 7608 119`h Lane North-Champlin,Minnesota 55316 3 0 S ept emb e r 2 0 0 0 Telephone: 763-427-0826 FED. ID#41 1443773 � Test # : 95455 Time : 2 : 00 PM From: Well To: T.L. STEVENS WELL Date drawn: 28 September 2000 6250 HWY 12 Date tested: 29 September 2000 MAPLE PLAIN, MN 55359 Unique # : 644868 Lic. # : 27194 RE: Water test at : 2375 Devin Ln; Orono, Mn Owner: Charles Carod�nuto Owners address : 1030 Cty Rd 83 Maple Plain, Mn Field Engineering personnel in conjunction with TCWC tested the water that was drawn by Joe Stevens at the above address and the results were as follows : Nitrate Nitrogen-per Electrode Method less than 1 . 0 mg/1) (Maximum allowable limits, less than 10 . 0 mg/1) Coliform Bacteria-per MF Method less than 1 . 0 per 100 ml (Maximum allowable limits, less than 1 per 100 ml) This water DOES meet FHA, VA, and U. S . P. H. S . specifications for the tests listed above . TCWC is authorized to perform these tests by the Minnesota Department of Health. Sincerely Yours, i/�,�z�,,�'�,,`' -'' ` ,,� �QQ ,f _ � �/ � � 3 'L ��M a�i�Y J.� W e e� C < 0 <G`\�`O �` WELL oR BORx1G�OCAT1pN MINNESOTA DEPAHTMENT OF HFALTH M�nnesota Well and eonng ' � ` �� ! O � CounryName WELL AND BORING SEALING RECORD SealingNo H L,�. L} _ M�nnesota Unique No. �Io.,.,e„� Minnesota StaNtes,Chapter 103/ or W-senes No. `y""�`"r ILeave Wank A nu�knownl Townshlp Name Township No- Range No- Sectbn No. Fraction(sm.i Ig.) Date Sealed Date Weii or Bonng Const.uctea Ororio 117 �i 03 FS'E '�NW � 10/Q3/00 Numencal SVeet AdOress o�Fue Numbe�aM Ciry o1 Well or Bonng Location 75 �• Depth Betore Seaiing �1 h. Orig�nal Depth N. � Show exad bcatan d Mell o/bonng Sketch map of well or bonng A�UIFER(S) STATIC WATER LEVEL in sectbn gnd wiM'X'_ bcation, showing property �Single Aquiter ❑ Multiaquiler lines,roads,and budd�ngs. ry ��v"\ 1 .,` WELL/BORING �] MeasureC ❑ EsGmated ��i �Water Supply Well ❑Monit.Well 3 ❑ Env Bore Hoie ❑other _ 1� n (1 beiow Q above�and sunace W -T- T- -T- -i-- E -J CASING TYPE�S) � � � -'r- -i-' -i-- -�-- � �`UvS� \ � ❑Steel � Plastic �Tile �Other Y nY1e --�- -+- -i-- -i-- � CASING Diameter Depth Set m overs¢e hde7 Mnualar space initially graited? �imis� V.�e.� 4 in.�rom� l0 267 tt. ❑ es ❑No ❑ ❑ s� 0 ` y Yes No U�known PROPERTY OWNER'S NAME in.from to R. ❑ Yes ❑No ❑Yes ❑No ❑ Unknown Charles CarodeoutA Pmpeny ownpef�s�maiq addre_s,_s,1 ddFe�an1 Uwi weY lo�ation address indicated above. in.from to ry. ❑ Yes ❑No ❑ Yes �No ❑Unknown � J.JIJC) Y VJ.i�ilmlt. � SCREEWOPEN HOLE - 1030 Co�mty Road 83 � -f Screen(rom to R. Open Hole from �/ to � R. Maple Plain PRd 55359 OBSTRUCTIONS �LL o�,iaErRles"�arodecuito ❑ Rods/Drop Pipe ❑ Check Valve(s) ❑ Debris ❑ Fill �No Obstructan wex owr�s m�iig�ddresa i1611ererw R�an propeny ownets aAaress indicateA above. rype ot obstructions(Describo) � Obstructions removed? ❑Yes ❑No Describe PUTAP ryPe G.}�r�ih1A GEOLO(i1CAL YATERIAL �,pq ��ESS OF FROM 70 p Removed ❑ Not Present ❑ Other FORMAT70N N�k��a�� METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS,OR CASING AND 80RE HOIE: � No Annular Space Exits ❑ Annular sqace grouted with tremie pipe ❑ Casing Pertoration/Removal in.from to ft. ❑ PeAorated ❑ Rertaved _ in.from to ry. ❑ PeAorated ❑ Removed Type of peAorator ❑ omer GROUTING MATERIAL(S) Grouting Material r��r fran � to�12L R. yerds � bsQs fran to ft. yards baqs from to ft. yards bags from ta__ k. yards beys R£YARKS,SOtNICE OF DATA,DIFRCULTIES NI SEALING OTHER WELLS AND BORINGS . Clther unsealed and unused well or boring on property7 ❑Yes �No How man� LICENSED OR HEGISTERED CONTRACTOR CEHTiFICATION This well w borirp was sealed in aocordance wRh Minnesota Rules.Chapter 4725. The information oontained in Vas report b true to the best ot my knowledge. T.L. Stevens We1l. C�ny 27194 Contredor Business Neme '//` L.icerrss w ReyistrsEion f+o. —t ,:�.�,1 IO/03/00 Autho�ized Representa0've Signefure DeM ,� �t'acner�Q _ IMPORTANT-FILE WITH PROPERTY H 14 9 2 4 0 Name o!Person Sea irg ep a Boring P4PERS-WELL OWNER COPY HE-01r34-03 ��p WELL LOCATION MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WFLL NO. CountyName WELL AND BORING RECORD 6 4 4 8 6 8 t7e,,,,�,,,� Minnesota Statutes Chapter f03! i�i�ucY Township Name Township No. Ranqe No. Sedion No. Fraction WELL DEPTH(completed) Date Work Completed n. p� 117 23 �3 I�,(�.SE,�. NW ,�. 2l+2 10 02 00 House Number,Street Name,City,and Zip Code of Weil Location or Fire Number DRIIUNG METHOD �75 � � ❑ Cabie Tool ❑ Driven ❑ Dug ❑ Auger �Rotary ❑ Jetted Show exact bcation ot well in sec[ion grid with'X". Sketch map of well location. ❑ Showing property lines, roads and buildings. DRILLING FLUID WELL HYDROFRACTURED7 ❑YES �JO N ��V\\\ �C\\\� � i i i W3�T FF20M ft.to (1. -� -�- -�- -i- USE ❑ Monitoring O Heating/Cooling i � � � d L�Domestic ❑ Community PWS O Induslry/Commercial -i- -�- -i- -� b ❑ Irrigation ❑ Noncommunity PWS ❑ Remedial w E� N p v�Q� O Environ.Bore Hole ❑ pewaterin9 O i � � � Q�� -r -�- -r' -r � �e', i � � � ��ZM� CASING Drive Shce? ❑ Yes O No HOLE DIAM. _i_ _ i_ _L_ i I p Sleel ❑ Threaded ❑ Welded � � � � 1 �Piastic ❑ S �-1 1Ala--i CASING DIAMETER WEIGHT PROPERTY OWNER'S NAME _�__in.to��fl. Ibs.ttt. �in.to 2tF2fl. �� tQ in.to R. Ibs./ft. in.to_fl. Property ownefs mailing address if different than well location address indicated above. in.to ft. Ibs.Rt. _in.to_ft. � t�+�J►i VOIkP1�8L1C SCREEN � OPEN HOLE 1� (:,....h. � � Make .TBVCD from tt.to fl. wuaa�.� t�__� �^S_ � � Type ��ori(= Diam. rrdp c iau� SbVGauze �I�Vj ^,. Length S� �,.,.t�,„. Set between [...7/ R.and Lfi2 R. FITTINGS: R-s�:atici STATIC WATER LEVEL WELL OWNER'S NAME 1� ft. �below ❑ above land suAace Date measured 9/�/� Q]��PS CiSI�1tA PUMPING IEVEL(below land surface) Well ownefs mailing address if ditterent than property owner's address indicated above. ft. afler hrs.pumping � W/1�2' g.p.m. WELL HEAD COMPLETION �T� �Pitless adapter manufacturer `'d11� Model �71ft ❑ Casing Protection_ � 12 in.above grade ❑ At-grade(Environmenta�Wells and Borings ONLY) GROUTING INFORMATION Well grouted? L�Yes ❑ No GEOLOGICAL MATERIALS COLOR HARDNESS OF FROM TO Grout btaterial ❑ Neat cement ❑ eentonite ❑ Concrete L�High Solids Bento�de MATERIA� irom__.Q_to_�ft. _3�__ O yds. �bags trom to ' R. ❑ yds. ❑ bags � � Q 'L irom to fl. ❑ yds. ❑ bags NEAREST KNOWN SOUFiCE OF CONTAMINATION Y��+�W 2 17 � feet 5'(�t_f�7 direction � rype Well disinfected upon completion7 �Yes ❑ No 17 � PUMP ❑ Not installed Date installed 1�/vL�w .�lul o[ 7V � Manufadurers name �Y7'Y)� . Model number 2�.51514 HP_1�— vm�5 230 W� � � u5 Length ot drop Pipe � R. Capacity � g.p.m. � Type: (�Submersible ❑ L.S.Turbine O Reciprocating ❑ Jet ❑ w � � � ABANDONED WELLS Dces property have any not in use and not sealed well(s)? ❑ Yes l�No � � � � � �� VARIANCE � Was a vanance granted irom the MDH for this well? � Yes d1No TNN WELL CONTRACTOR CERTIFICATION Use.a second sheef,il needed This well was drilled under my supervision and in accordance with Minnesota Rules,Chapier 4725. REMARKS,ELEVATION,SOURCE OF DATA,etC. The information contained in this report is true to the best ot my knowledge Licensee Business Lic.or Reg.No. / 10/03/00 Authorized Representafive Signature Date Joe Stevens 10/Ol3/00 Name olOriller Date IMPORTANT-FIIE WITH PROPERTY PAPERS � 4 4 8 F 8 WELL OWNER COPY `� HE-01205-07(Rev.2/99)