HomeMy WebLinkAboutwell info WELL LOCATION MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WELL NO.
CountyName WELL RECORD � ,� � � � 3
H�nnepin Minnesota Statutes Chapter 1031 `- �-
Township Name Township No. � Range No. Section No. Fraction WELL DEPTH(completed) Date Work Completed
Orono 117N 23W 4 SW SW NW lZg n 7/13/93
Numerical Sireet Address and City of Well Location or Fire Number DRILLING METHOD
1 10 LE?cl� S�. ❑ CableTool ❑ Driven ❑ 0�9
C Auger p..Rotary ❑ Jetted
Show exact location of well in section grid with"X". Sk@}�h pf well location. ❑
_---�-"` 5'��g property lines,
N t � "'r Of ,fclatls and buildings. DRILLING FLUID
� � , � ,^{o _;' Baroi� quik c�el
--r--7- -1 -1- 4'; . _. —_.`_'
i � i i t` _ ,USE ❑ Heating/Cooling
a_ _�_ �_ �_ �omestic ❑ Moniroring ❑ Industry/Commercial
yy �i � i E ❑ Irrigation ❑ Public
�-••�- _1_ _�_ __ __ T ❑ Test Well ❑ Dewatering O Remedial
� � � fl mi.
� CASING Drive Shoe? ❑ Yes L�No HOLE DIAM.
� --�- i- � -r- � ❑ Steel ❑ Threaded ❑ Welded
1 C.�s�Plastic ❑
�-1 milr O�� 2 � �.993
CASING DIAMETER WEIGHT
PROPERTY OWNER'S NAME � in.to �14 ft. 1 •g Ibs./ft. � in.to 3� ft
Mark Gronberg �� to n. �bs.�h. 1 ��.to119�.
Mailing address if ditterent than property address indicated above. in.to ft. Ibs./ft. in.to ft.
SCREEN OPEN HOLE
Make j ayco from fl.to fl.
� Type Z��$t j,C Diam. �
SIOUGauze ��.___�_��L Length_� C��
Set between ft.and ft. FITTINGS: ,,,�-
STATIC WATER LEVEL
GEOLOGICALMATERIALS COLOR HARDNESSOF FROM TO 80 7�13
MATERIAL h�� below ❑ above land surface Date measured
PUMPING LEVEL(below land surface)
yellaw C.'�.c3� brO�dT1 SOft � ig .�? ft aft� hrs.pumping z0 g.p.m.
WELL HEAD COMPLETION
clay �ray $Q�t Z9 63 1�7 Pitlessadaptermanufacturer 1��'l�t�l1$t@rModel SU �'rJ�
❑ Casing Protection ❑ 12 in.above grade
''ga2�� �rL�� '�'Of t v� 77 GROUTING INFORMATION
Well grouted? l�Yes ❑ No
C�.a�7 y r a y .r"a O f'fi 7�] 1�� Grout Material q[Neat cement ❑ Bentonite
from 3� to � ft. � ❑ yds.L3iI bags
sar�c3 bZ'owtl soft I03 119 '�°`"—�--�-`°��`� ❑ vds. ❑ bags
from to R. ❑ yds. ❑ bags
NEAREST KNOWN SOUFiCE OF CONTAMINATION
3� feet P_c'lSt direction hALCe rype
Well disinfected upon completion? p�s ❑ No
PUMP ry f�C/n�
!/ V �
❑ Not installed Date installed
Manufacturer'sname Aermotor
Modelnumber HP 3 4 vons 220
Length of drop pipe 1 Q� ft. Capacity 10 g.p.m.
Pressure Tank Capacity
Type: C7`i$ubmersible ❑ L.S.Turbine ❑ Reciprocating ❑ Jet ❑
ABANDONED WELLS
j Does property have any not in use and not sealed well(s)? [] Yes QQJo
7
� WELL CONTRACTOR CERTIFICATION
i
This well was drilled under my supervision and in accordance with Minnesota Rules,Chapter 4725.
The information contained in this report is true to ihe best of my knowledge.
Leut��n�r idell Inc. Z0125
Use a second sheet,if needed
REMARKS,ELEVATION,SOURCE OF DATA,eta Licensee Business Name Lic.or Reg.No.
�f � / /
�'��e�.-����v---�A '�-�L..—�/� '/�'���
A thor¢ed Representah ignature �Dat�
� Ken Schmieg 9/21j93
Name ol Driller Date
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LOCAL COPY � 2 6 6-� � HE-01205-04(Rev.5/92)