HomeMy WebLinkAboutwell info �' , r .
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617 13th Ave So • Hopkins, Minnesota 55343 • (612) 935 - 3556
02/20/2009
Stodola Well Drilling
3841 North Main
St. Bonifacius MN 55375
938-21 1 1
RErORT GF WA'f'�R ANA�.YSIS
Lab #: 49BN
Our Laboratory reports these analytical results, determined on a sample taken
by CLIENT on 02/17/2009 from the following locarion:
3285 Graham Hill Rd.
Orono,MN
W elL 770003
Coliform eacreria Absent
Nitrates Nitrogen <1.0 mg/1
Arsenic <2.0 ppb
Twin Cit�%Y1/, Water Clinic, Inc.
.��-��i .;y
Bill V.a�fa Arsdale
Analyical laboratory Consulting Engineer
U�ater Malysis Reagents Boiler Water Chemicals
Lab Cert�cation#027-053-119
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MINNESOTA UN/QUE WELL
WELL OR BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH AND BOR/NG NO.
County Name WELL AND BORING RECORD
Minnesota StaWtes,Chapter f037 � �a o a �
Township Na e Township No. Range No. Section No. Fraction WELL/BORING DEPTH(completed) DATE WORK COMPLETED
,� h.
GPS DRILLING METHOD
LOCATION: Latitude degrees minutes seconds
Longitude degrees minutes seconds I�Cable Tool ❑Driven _ Dug
�.�Auger �otary ��Jetted
House Number,Street Name,City,and Zip Code of Well Location or Fire Number �
3285 Grah� �ti21s lid� (3raio 5535 DRILLING FLUID WELL HYDROFRACTURED? ❑Yes �o
Show exact location of well/boring in section grid with"X" Sketch map of well/boring I ation. From ft.To fl. -
Showing proper M-�s
N roads,buildings,and di elfdn. USE Domestic [�Monitoring [�Heating/Cooling
� � `�
__._____:__ ___�__ ___l_ r,, _J Noncommunity PWS ❑Erniron.Bore Hole ❑Industry/Commercial
�\ �� ' �;Community PWS [_]Irrigation [.J Remedial
--'-----;--- --`-----`-- ��' [��Dewater ',J
v
I I I I ..� t r.� —
-- Elevator ing
; ; ; ; � - �� CASING MATERIAL Drive Shoe? '�-J Yes �`No HOLE DIAM.
--�-----�-----�----.-- - y'
T L]Steel � I Threaded !Welded
, ; � , '/z Mile StiC � j
� , I -'�' Pla
--,--- --r----�-- ---:- 1 ;,
CASING
g � � " Diameter Weige�ht Specifications ?
�—i Miie—� f��`� � in.to '�^^�' ft. ` Ib�� �r��ih.to^�uft.
PROPERTY OWNER'S NAME/COMPANY NAME
in.to ft. Ibs./f�. "• in.to 4��ft.
��1� �(i �� in.to ft. Ibs./ft. in.to ft.
Property owner's mailing address if different than well location address indicated above.
SCREEN OPEN HOLE
15050 23rd Ae+e N Make From ft. To ft.
Plymauth, MN SS447 Type stainle�$_ stl Diam.
SIoUGauze_ �{}�� Length�� ♦ 4�
Set between ft.and it. FITTINGS � �
STATIC WATER LEVEL
I� Measured from _
ft.i� .Below f`i Above land surface Date measured s
WELL OWNER'S NAME/COMPANY NAME PUMPIftIG{{�VEL(bel w land surfaay q�
LtJ[� d J
ft.after hrs.pumping g.p.m.
Well/boring owner's mailing address if different than property owner's address indicated above. WELLHEAD COMPLETION
�
�Pitless/adapter manutacturer �. ���* �� Model
�Casing Protection �.12 in.above grade
[;At-grade(Environmental Well and Boring ONLY) -
GROUTING INFORMATION
Well grouted '_�_�,Yes ❑No
Grout materials ❑Neat cement�Bentonite �:��-'.Concrete ❑Other
From � To `� ft. ���� ��� �a gs
G E O L O G I C A L M A T E R I A L S C O L O R HARDNESS OF F R O M T O From
MATERIAL From To ft. ❑Yds. '�_J Bags .
♦ NEAREST KNOWN SOURCE OF CONTAMINATION
C18y �11� �r� (J t'�J ��� feet - � direction *�- • type
�1a� ��y lNird LD Z12 PUIMPsinfected upon completion? Yes ❑No �
�v�� ��� Lw� ��^ ��n ',_I Not installed Date installed `y �.l
�� ��'� � ti'� Manufacturer's name
fie�eea�i/clay �� �(j f� j�� �f/y\ Model Number ` " HP f � .�' Volts --,..�
GtN /
Length of drop pipe /�t/ ! ft. Capacity g.p.m.
��QY•�.�A �jC,av l•�rd �NV1 �f1'f Type:�' Submersible ❑LS.Turbine ❑Reciprocating ❑Jet []
ilU. , E l27 4llt! 6 L!
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? j �Yes No TN#
WELL CONTRACTOR CERTIFICATION
This well was drilled under my supervision and in accordance with Minnesota Rules,Chapter 4725.
The informalion contained in this report is Irue to the best of my knowledge.
Use a second sheet,if needed.
REMARKS,ELEVATION,SOURCE OF DATA,etc.
tbn Stodola W�I1 Dral2ing Co., Inc. 1691
Licensee Business Name Lic.or Reg.No.
� �� - l�
- _ , �
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� J
d epresentative Signatur�� Certified Rep.No. Date
(� Jita Roh2so
LOCAI C�JPY ��0 l.J O � Name of Driller
IC 140-0020 HE-01205-11(Rev.3/07)