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Home My WebLink Aboutwell info MINNESOTA UNIQUE WELL WELL}OR�B�G LOCATION MINNESOTA DEPARTMENT OF HEALTH AND BORING NO County Name WELL AND BORING RECORD 7 7 0 0� 4 Minnesota Statutes,Chapter 1037 in Township Name Township No. Range No. Section No. Fraction WELL/BORING DEPTH(completed) DATE WORK COMPLETED OS 2� S� NB �� 2Q3 " 2-2D-Q9 GPS DRILLING METHOD LOCATION: Latitude degrees minutes seconds Longitude degrees minutes seconds ��Cable Tool ��r!Driven ��!Dug �J Auger '�id'Rotary �J Jetted House Number,Street Name,City,and Zip Code of Well Location or Fire Number � T� DRILLING FLUID WELL HYDROFRACTURED? ��Yes �'�No �l.°T!t{!t!�t@ �. Show exact location of welUboring in section grid with"X:' Sketch map of well/boring I cati� . From ft.To R. Showing proper IiYies, N '" roads,buildings,and di ct�ipn. USE �omestic i]Monitoring ❑Heating/Cooling �M ;-. __ ___ __ __ _____ _ _ � �_,�Noncommunity PWS ��Environ.Bore Hole ❑Indushy/Commercial � I � ; � , , ; , ��Community PWS �J Irngation ��Remedial ��. --'--- —�----'--F----`-- � 1 Elevaror !�Dewatering �� w E CASING MATERIAL Drive Shoe? `,_'�,Yes �No HOLE DIAM. , , � . T � �\ �I Steel ��Threaded ❑Welded ; , ; ; 'h M�ie � iameter stic 1 , � Pla --.-----,----�-----:- 1 -�- I I ' ' �� CASING S �l,`_� D� We�ght Specifications �1 Mile—� �\\' �t _�,�__in.to�g�ft. �_Ibs./ft. �� _�_in.to�ft. J l PROPERTY OWNER'S NAME/COMPANY NAME in.to _ft. IbsJft. __._ _ �in.to�ft. in.to ft. Ibs./fl. in.to ft. Property owner's mailing address if different than well location address indicated above. SCREEq{�_. OPEN HOLE ��235�'65th Plece Make$F�� $ � From �b►To ft. � /+,�,,,,�,,� Type /� ._ Diam._� ��e VLLIYC� t�9 55311 SIoUGauze sVlo Length �- T �- /�� Set between�,��__ft.and ��t. FITTINGS ~ f STATIC WATER LEVEL Measured from _��__ ft�'6elow [ I Above land surface Date measured �� WELL OWNER'S NAME/COMPANY NAME PUM;ING LEVEL(below land surface) t �� l�A � ft.after L hrs.pumping _g.p.m. Well/boring owner's mailing address if different than property owner's address indicated above. WELLHEAD COMPLETION a F��Pitless/adaptermanufacturer �.:+�� -�� `�� Model ❑Casing Protection_ _ ��12 in.above grade []At-grade(Environmental Well and Boring ONLY) GROUTING INFORMATION Well grouted ,�;Yes ;J No Grout materials ! I Neat cement�Bentonite �_�Concrete [,'�Other _ From_�.To__��tt. �__,__ �_i Yds. �,+Bags GEOLOGICALMATERIALS COLOR HARDNESSOF FROM TO From�__To 1Q5 ft�g��,],_f��ds. UBags MATERIAL From To ft. j�Yda �]Bags NEAREST KNOWN SOURCE OF CONTAMINATION C�al ,v�� r� � �� feet __ direction - type C��y a�� PUIMPsinfected upon completion? Yes '�j No � J d rl� ��C�� 2�� [�Not installed Date installed -� � l l � Manufacturer's name � �te��iRRl g�$�T ��j lp� '��'� Model Number HP � 1 i.. Volts � C.T r Length of drop pipe /��/ �! ft. Capacity g.p.m. Type:`- Submersible iJ LS.Turbine ❑Reciprocating �]Jet ❑ ABAN ONED WELLS Does property have any not in use and not sealed well(s)? ��Yes '�, � o 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 hue to the best of my knowledge. Use a second sheet,if needed. REMARKS,ELEVATION,SOURCE OF DATA,etc. Don Stodola Weli Dri2lir►g Ct>., Ir�c. 1691 � Licensee Business Name Lic.or Reg.No. rfi ,R presen[a ive Sign�it�'� Certified Rep.No. Date Jilfl RA�11B , LOCAL COPY �7 o U l.l,`�. — — ——---- Name of Driller IC 140-0020 H601205-11(Rev.3/07) �► , � rw� c�-y w�-� c � � , l� 617 13th Ave S� • Hopkins, Minnesota 55343 • (612) 935 - 3556 02/25/2009 Stodola Well Drilling 3841 North Main St. Boni facius MN 55375 938-21 1 1 REPORT OF WATER ANALYSIS Lab #: 56BN . Our Laboratory reports these analytical results, determined on a sample taken by CLIENT on 02/23/2009 from the following location: 3225 Graham Hili Rd. Orono,MN WeIL 770004 Coliform Bacteria Absenr Nitrates Nitrogen <1.0 mg/1 Arsenic 2.48 ppb Twin C�� W�r Clinic, Inc. Bi/J'V.an:�rsdale Analyica]laboratory Consulting F�ngineer Water Analysis Reage�ts Boiler Water Chemica(s Lab CeRification#027-053-1 19