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HomeMy WebLinkAboutwell info • STATE OF MINMESOTA DEPARTMENT OF NEALTH � � � ABANDONED NELL RECORD 1. IOCATION Of MELL M(��E� blankNfaeoE known)N�• co��cy n.�. Henne in Tounshtp M�rr TownsMp Nwb�r R�ny� NwD�� S�ctton No. Frattlon �. WELI DEPTM (ewpl�t�d) Datt sul�d N E 4 # oi M Orono 117 5'' 2 3 w' 17 s�„�.s w N 13 � rc. � I ,..+ 1 c� � I Nuu�Nc�l Stnet Addnss and City of W�11 Lotttlon or Dtstant• frw� Ro�d 5. OIi1LLIN6 METNOD (tf known) Intersectton 1(]Cabl� tool 40 Revtrs� 7[]Dr1v�n 1�]Duy 3525 Lyric Avenue Wayzata, Mn. 55391 Zp�wi,o„ a,e ,�„�,. �gpred i�p �Roiary 60 Jttt�d �PovKr Augtr Show exact tocttlon of well 7� (1n s�ction yrid ritA '1`) Skttth wp of wil lotatton 6. OBSTRUCTIONS N IM11 obstruct�d Q Y s No _ � . _ ._ �_. � �'1 C- �V E ' oestructions n�ored Y�s ❑No It oDstructtons cannot De � � � re�ov�d. contut MOM � �1 � � � '�' �. _ C l �! 4 � uJf.'�� y _ . _. 19 7 tor su�inq. c , . � • 7. � ;. - • •- " I I a.'' �C�f 1 Do�estte �Monitortnq �N��t Loop ', y,:. ' � I 2[�Irrigatton 50 Pub11c �Industry ._�. . __�.. _.�.. ...- I ' S ' . 1 30 T�st Wll 60 Munitlpal 1[Q Cowirrciat �--1 .iL---� 7[]A1r Co�dittoninq 11(] 2. PfIOVERTY OMNER'S NAME Ma111ng Address if dlfferent than r� 8, S N6(5) property �ddr�ss indtc�ted abow �Black �Thn�dtd 70 T� 7'� Tim Logeais SANIE ���"• �]wi°'a 3[]vi,:cto �p sa���.:: sc�.t � HARDNESS OF � �p, �p �3 2 ft. 3. FORXIITION L06 COLOR FOtiM11TI0N FROM TO If not known, indtcate fonaatlon 1og fro� n�wr wll or n�arby wll. tn. to ft. Drift 0 136' 9. scRE�n 13 136 �StnenW wl l fro�_�, W_ ft. • (ff known) �Open Hole fra�_it, to_ ft. 10. STAiI�j WITEN LEYEL� " "l� ft.Y��{�Mlor �a0ow (� land suHac� Data Measund `� �� 11.�HEAD COIIPLETION , 1 Pitl�is Ad�pt�r �Found Buritd 2(]B�se�nt ofts�t '� 3(]W11 P1t 16. REMIIRKS, EIEVATION, SOURCE OF DATA - LASIN6S REMOVEO. CASINGS PERFORATEO. ETC. 12. GR UTIN6 INfORINTION Grout 4" Well 136' Deep ""` �"'"` �BinLon/i '� 12 BagS Ce171erit 6rout .�urial fro��3�to� ft. tu, yds 14 Lbs. Bentonite — — 2 N?en, I,r-�bor, Rig and Ceir�nt Grout Pump 17. NEAREST SOURCES OF CONTAM(NATION � fe�t dtnction ;ypQ IM11 disinf�etad p�ton sNllnyi [�r�t 1�. VUlli �RdovW Not Pnunt Typ�: 1[I SuO�rstblt x]L.S. Turbin� �R�clprocating 2Q J�t �C�ntNfuyal 6� 15. EXISTIN6 MELLS (it��s� slutch locatlons of abandoned �nd �tt1v� vNlls 1n nYrks i�c o or on Wck.) OtMr unu�d�11(s) on proptrtyt �T�s No � ` ADandon�d: �P�r�n�nt �T�a{wrary �N t s ted !� 11. WTER MELL CONTRlICT00.S CERTIFIGlT1pN This w�ll ws t�alW under q �uNsdtetton �nd thls nport ' , 1s tru� W tA� b�st of 4y knorl�dqe and beltef. ��N � � DON STODOLA WELL DRILLING CO., INC. ���;.�'�. , Lteense� 6uiin�ss MaM lic�ns� No.2 7�7 2 '•� Addnss nne o a, . 345 � Sign� �: �+ ; Oatt — — Mar . — — au FFICIAI ABANppNED YEII RECOftO (!4y b� us�d for Proptrty Tr�nsf�r) N�r of Drtll�� LrpQtT111R't PIId NZTS ARiD STATE OF MINNESOTA DEPARTMENT OF HEAL.TH , r;—., � ABANDONED NE11 RECORD i. �oc�tto� oF �e�� MINNESOTA UNIQUE WELL N0. (itav� Dlank 1f not known) co��cr h,�. Hennepin TownshiD N+n� Township Nunber Itange Nu�Ger Stctton No. Fractton �. 11ELL DEPTH (capl�t�d) O�tt s��l�d N E ti 4 ot y Or'oTlo 1 17 5� 23 M� 17 5�,� � N� � � tt. � � G+ °�� Numertcal Street Addnss and City of Y�11 Locatton or Dist�nc� trow Ro�d 5. I LIN6 METH00 (1f knawn) Intersection Cabl• tool 1�R�v�rs� 7�]Dr1v�n la]Dug 3525 Lyric Avenue Wayzata, Mn. 55391 zp ii,,, aoa 5[]A1r ep a��.a i�p 30 Rotary 60 J�tt�d �]Power Auytr Show exact location o1 wll (in section grtd rlth 'X') Sk�tch eap of wil lot�tlon 6. OBSTRUCTIONS N t wl l obstroct•a p��tw _ � . _ �_ _` l���� ' G ���+ Obstructlonf n�ov�d res �ho It oDstructloes cannot b� , • � , rnwwd, conUtt MOH ' �, � ' ' �— t-�„ �JeII �.s.,�,�9. ' -I- - E ' y _ . . , , , T �. S - . .- - y.:. ,�„�1e�I �oo..sc�� �MonitoNny e❑�..c �oop _ � , . , � 2[]Irrlg�tion 50 Pub)ic 9Q Industry ..�_ . ._�.. _.�-. _.. 3[]T�st Wil fi�Munlclpal 1CQ Coe�ercl�1 �_1 SL__� 7[]Air Gondlttonfny 13(] 2. PROVERTY OWNER'S NAME Matling Address 1f dliferent Yhaa S. CASIiiGiS) property addnss indicated abov� 1(]Bl�ck �Threaded JC1 `I'1IT1 �2ci1S S� �Wlv. 501N1d�d • ap vi.sc�o �sat�i�:: sce.� HARONESS OF � 1n, to 8� ft. 3. FONMIITION LOG COLOR FORMIITION fROM TO If not known. lndicate fonutlon log frow n�w wll or ntarhy wll. tn, to ft. Drift p 84� 9. SCREEN �Scr�enW w�ll f►o��ft. to��ft. (If known) �Open Iblt frwi_ft. to__ ft. 10. STATI YAiER LEYE� �_ft. Wlor �abo�� � land su ac� Datt 14�sured� 11. YEILHEAO CONVLET20N 1�P1tl�es Ad�pter �iaund Bur1�d 2(]B�s�nrnt ofls�t '�] �wit vtc 16. REMARKS, ELEYATTON. SOURCE Of DATA - LASIN6S RElqVEU. CASIM6S PERFORATED, ETC. 12. G�TING INFOIUNTION Grout 2" Well 84' Deep ""` `"'"` ��`"`°""' '� 2 �dgS CF1TlEnt 6rout iwt�Hal frw 1to U ft. cu. yds 4 Lbs. Bentonite — — 2 Men, L,abor, Rig and Celrtient Grout Puntp 13. NEAREST SOURCES Of COKTAMINATION _ teet dinctlon ___+, type IM11 disinf�ct�d b�fon su11�q7 �Yes 14. PUMP �RNovW �Noc Pns�nt Typ�: lQ Sub�nibt• �L.S. Turbin� �R�clproc+tiny 2[]d�t �Cantrlfugal E� r — 15. EXISTING MElLS (Vl�as� sk�tch toutlons of �bandonW �nd acttv� �wils in n�arkt i�c o o� on back.) � Otn�r unus 11(s) an prop�rtyt �Y�s No AWndon�d:�P�ryn�nt �T�porary �No��l�d 17. MATER 11ELL CONTRACTOIIS CERTIFICATION Thts rKil w�s seal�d und�r sy �urisdlction and thls nport is tru� to CM best of my tnowl�dge and belSef. ;;U'�; 1 r ' � DON STODOLA WELL DRILLING CO. , INC. Licen:�e Busin�ss Naw Licenst No.2']�72 �aa�.:(: �'• m?nne o a, . 345 S1yn�d` _i-'.�_�_ �' �Oat� — — Mark�G�Stodola au 6-4-92 FFICIAL ABANOONEO 1IELL RECORO (!4y b� u��0 for irop�rty Transt�r) N�� oi Dr111�r 71�GRTa/ir lIIB �IITH DEED