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HomeMy WebLinkAboutwell info 1 � • TWIN CITY WATER CLINIC, INC. 617 13th Ave. So. Hopkins, Minnesota 55343 (612) 935-3556 03/14/93 Stodola Well Drillin� 15306 Hwy 7 Minnetonka, MN 55345 938-2111 Lab # : 18970 RHPORT OF WATEft ANALYSIS Our laboratory reports these analytical results, determined on a sample taken by YOU on 03/OS/93 from the followin� location: , � • Tony Eiden Company Unique # 515576 2550 Fox St Orono, Mn Coliform Bacteria <1/100 ml Nitrates Nitrogen 3_ 15 mg/1 The results of these tests indicate that this well is producing water that meets the standards for F.H.A. , V.A. , or conventional loans. . � , . \�\�`i�y Water Clinic , Inc . ` � ��\, Bill , Arsdale Brian Blair � - _ WELL LOCATION MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WELL NO. CounryName WELL RECORD � � � � � � ���)j,� Minnesota Statutes Chapter f031 Township Name Township No. - Range No. Section No. Fraction WELL DEPTH(completed) Date ork Completed � L�TY?l'ft�+ � � f d� {�� y. v. v. �a� � i-'n-'�`� Numerical Street Address and City of Well Lxation or Fire Number DRILLING METHOD � Cable Tool ❑ Driven ❑ Dug `'���'� � P' i�`"' �f���� ❑ Auger �,Rotary ❑ Jetted Show exact location of well in section grid with"X'. Sketch map of well location. ❑ Showing property lines, N �y�'' roa�,apd buildings. DRIILING FLUID I � _1 _1_ ./7' �' .�.'.[��.i�'r'1#'.k^a --r- ti- � i J��Y i � i Yw ,USE ❑ Heating/Cooling _�_ ___ �_ �_ � �� �, �1 Domestic ❑ Monitoring yy i ; i E ❑ Irrigation ❑ Public ❑ Industry/Commercial _1_ _1_ __ __ T ❑ Test Well ❑ Dewatering O Remedial 1 ' � ' ' h mi. CASING Drive Shoe? jt�Yes ❑ No HOLE DIAM. --�- �- ; -r- I r[7 Steel ❑ Threaded � ❑ Welded � ' 1 � ❑ Plastic ❑ F—I mile—� CASING DIAMETER WEIGHT PROPERTY OWNER'S NAME e.". ���"+ Z i'.FE� "/ � in.to ft. Ibs./R. /.� - �in.to��ft. �.�.`CsY't�r �.`l�@.� E.�:�1if�L�.%'":y in.to ft. Ibs✓ft. in.to! � ft. Mailing address if different than property address indicated above. in.to ft. Ibs./ft. _in.to_ft. SCREEN OPEN HOLE � Make .7f3�'tY!�':CiYd from ft.to ft. t TYPe4'�+-�, . .�Y���,�3 —Diam. n - .�cc-�..t����'1'��.'�l`r7 4�liti ���..4ILZ.Y� �.�1?��. SIoVGauze ,�. Length LJ,�_ D������ �� cjr�Li;�ti Setbetween ft.and it. FITTINGS: STATIC WATER LEVEL HARDNESS OF _,� � �;, GEOLOGICAL MATERIALS COLOR MATERIAL FROM TO � ft.}�] below ❑ above�and surface Date measured .�-�-._ PUMPING LEVEL(below land surface) ��,, �� 'q; } ft. atter hrs.pumping g.p.m. WELI HEAD COMP�ETION i� li;e �r;i, r� pitlessadaptermanufacWrer ���t���s���� Model 4.:1� - & .;:�It� ❑ Casing Protection 7�] 12 in.above grade �-ti A:�,, & (i3-�-�%Yn� ,,i'� ��;� � GROUTING INFORMATION Well grouted? ❑ Yes Gj,�No Grout Material ❑ Neat cement ❑ Bentonite from to R. ❑ yds. ❑ bags from from to ft. ❑ yds. ❑ bags NEAREST KNOWN SOURCE OF CONTAMINATION feet direction type �� Well disinfected upon completion? �Yes ❑ No PUMP ❑ Not installed Date installed �^G�'i �'�!�' Manufacturer's name 1'�VE'�'S Model number HP � Volts "�''�j� Length of drop pipe � lft�. Capacity t��z �r g.p.m. Pressure Tank Capacity V ti� �uC:37 �.i-1�.E'.�& � Type: �Submersible ❑ LS.Turbine ❑ Reciprocating ❑ Jet ❑ ABANDONED WELLS Does property have any not in use and not sealed well(s)? ❑ Yes f�No _ "� � WELL CONTRACTOR CERTIFICATION y A �„ �� This well was drilled under my supervision and in accordance with Minnesota Rules,Chapter 4725. � L The information contained in ihis report is true to the best of my knowledge. Use a second sheet,i/needed � �C�.i�'��j�{:y �r��T� ���p.� �}�� �.��� G���� REMARKS,ELEVATION,SOURCE OF DATA,etc. Licensee eusiness Name Lic.or Reg.No. �"%�� '. - , �-�.-�13 �- 7�thonzed RepresenhaBve S�gnature Date 0�+�'_ _ Bi1I Ii..i<j<� �-�`-�� � f yi � L=�'�'i � � Name ol Driller Date ! LOCAL COPY � ��5 �6 HE-01205-04(Rev.S/92)