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Home My WebLink Aboutwell info WELL LOCATION MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WELL NO. County Name WELL AND BORING RECORD 5 g 0 414 � I1i1E�>7.S` Minnesota Statutes Chapter 103/ Township Name Township No. Range No. Section No. Fraction WELL DEPTH(completed) Date Work Completed ft. Orono 117 2.3 (9 1 1. 11W f 7-9--96 House Number,Street Name,City,and Zip Code of Well Location or Fire Number DRILLING METHOD {'��, i- ❑ Cable Tool ❑ Driven IA Dug 870 Old Crystal Bay Road Orono, Mn. 5.1�-35 6 ❑ Auger XRotary ❑ Jetted Show exact location of well in section grid with"X". Sketch map of well location. ❑ Showing property lines, roads and buildings. DRILLING FLUID N 1's :t: ',.. USE ❑ Monitoring ❑ Heating/Cooling I L1Oomestic LI CommunityPWS -- ❑ Irrigation ❑ Industry/Commercial i 0 Noncommunity PWS ❑ Remedial w iI E T ❑ Test Well ❑ Dewatering p -ii --r---r- CASING Drive Shoe? 0 Yes 0 No HOLE DIAM. 1/2MileI 15 996 0 Steel 10Threaded ❑ 0 Welded 'OV El Plastic 1 aile CASING DIAMETER WEIGHT PROPERTY OWNER'S NAME 4- in.to 101 ft. SUR. 21 lbs./ft. l%t o 31st. Lake Associates in.to ft. lbs./ft. E, 1,141.40 1 1 eft. Property owner's mailing address if different than well location address indicated above. t in.to ft. lbs./ft. in.to ft. 1212 East Wayzata Blvd. SCREEN .iO+i]I'L..0%1 OPEN HOLE Wayzata, Mn. 55391 Make ; `a iY from _ft.to ft. Type Stainless nless Steel Diam. ra Slot/Gauze 16/1(; Length G 61 Set between 101 ft.and 1 14, ft. FITTINGS: 11-6 STATICCNfATER LEVEL WELL OWNER'S NAME '-J'j ft. [below ❑ above land surface Date measured I-9-96 PUMPING LEL(below land surface) Well owner's mailing address if different than property owner's address indicated above. { ft. after 1 hrs.pumping ..0 _g.p.m. WELL HEAD COMPLETION .Pitless adapter manufacturer White ter Model ❑ Casing Protection 1312 in.above grade ❑ At-grade(Environmental Wells and Borings ONLY) GROUTING INFORMATION Well grouted? C2�Yes 0 No GEOLOGICAL MATERIALS COLOR HARDNESS OF FROM TO Grout Material ❑ Neat cement LXBentonie 0 Concrete El High Solids Bentonite MATERIAL from U to ,a ) ft. L 0 yds. liC bags Clay �_, t,,, y from to ft. ❑ yds. 10 bags Clay yery llc�r from to ft. 0 yds. ❑ bags NEAREST KNOWN SOURCE OF CONTAMINATION Clay Grey _. 70 feet direction type Well disinfected upon completion? Ql'es CI No C ;-;_.:t:J 1. __. 9o' Iii:' PUMP O Not installed �flazeiostaYed 7-10-96 Manufacturer's name fl >b 0l.e tr Y - Model number 1`' ' �'` HP 1�' Volts �u f Length of drop pipe /-) ft. Capacity 18 g.p.m. PressureTankCapacity f .n X-TIYA Type: fS Submersible ❑ L.S.Turbine 0 Reciting ❑ J ❑ -- ABANDONED WELLS Does property have any not in use and not sealed well(s)? 0 Yes 4.No - --- - VARIANCE Was a variance granted from the MDH for this well? ❑ Yes L No WELL CONTRACTOR CERTIFICATION Use a second sheet,if needed This well was drilled under my supervision and in accordance with Minnesota Rules,Chapter 4725. REMARKS,ELEVATION,SOURCE OF DATA,etc. The information contained in this report is true to the best of my knowledge. DON S1iODOLP WELL DRILLING CO., INC. 27172 Licensee Business Name Lic.or Reg.No. r.� 7 - G>• 'f�7- 8-28-96 Authorized Representative Signature Date erect Leiby 8-28-96 5 8 0 414 Name of Driller Date LOCAL COPYHE-01205-05(Rev.1/95) Jwin City 1/Vater C/ njc, inc. 617 13th Ave So • Hopkins, Minnesota 55343 • (612) 935 - 3556 07/12/1996 Stodola Well Drilling 15306 Hwy 7 Minnetonka MN 55345 938-2111 REPORT OF WATER ANALYSIS Lab#: 30171 Our Laboratory reports these analytical results, determined on a sample taken by CLIENT on 07/09/1996 from the following location: Lake Associates 870 Old Crystal Bay Rd Orono,Mn Unique Well#580414 Coliform Bacteria <1/100 ml Nitrates Nitrogen <1.0 mg/I Iron as Fe 0.2 mg/I Total Hardness 235.0 mgA 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. This report is an analysis for coliform and nitrate only and does not include analysis of Lead and other contaminants. (Unless as specified by client). ' \Water Clinic, Inc. Bill • .I Mishima laboratory Coma**Engineer Wale(Analysis Rea®eotr Boiler Water Chemicals Lab Certification I 027-053419 WELL LOCATION MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WELL NO. County Name WELL AND BORING RECORD Minnesota Statutes Chapter 1031 580411 Township Name Township No. Range No. Section No. Fraction WELL DEPTH(completed) Date Work Completed Orono 117 23 09 101 n. 4-11-96 House Number,StreetoName.City,and Zip Code of Well Locationyor Fire Number DRILLING METHOD J U N QCSL' tw1een 870 & 89(; Old ryEtc,'�l Ba Rd. 0 Auger Tool U Dmevn�V 0 Dug Y ❑Auger Notary 0 Jetted Show exact location of well in section grid with X. Sketch map of well location. 0 •••' Showing property lines, N Ori], (4 p roads and buildings. DRILLING FLUID �i�S' Eer:tt'.;1.`.e.. USE 0 Heating/Cooling __�__�_-_L_--`- G 0 Jlomestic 0 CommunityPWSg W Q 0 Irrigation 0 Industry/Commercial w r W E 0� vt ❑ Test Well ❑ Noncommunity PWS ❑ Remedial W - ❑ Dewatering ❑ iI - Yiaw CASING Drive Shoe? ❑ Yes ❑ No HOLE DIAM. 1 LI ) ❑ Steel ❑ Threaded ❑Welded S 1 �Plastc 0 —'Ude— I CASING DIAMETER WEIGHT PROPERTY OWNER'S NAME 4 93 7/6 3(1 Lake Associates in.to ft. lbs./ft. in.to_ft. in.to ft. IbsJft. _6_it r K1 Property owner's mailing address if different than well location address indicated above. in.to ft. lbs./ft. in.n.to to ft. 1 212 E Wayzata Blvd. SCREEN OPEN HOLE Wayzatar Mn. `55 9'1 Make Johnson from ft.to ft. Type Sta 7 nles= Steel Diam. '.w Slot/Gauze 1 /10 Length 6' Set between 93 ft.and 1 L 1 ft. FITTINGS: STATIC WATER LEVEL WELL OWNER'S NAME 38 ft. ❑Nielow 0 above land surface Date measmed'4-11-96 PUMPING LEVEL(below land surface) Well owner's mailing address if different than propertyowner's address indicated above. ft. after hrs.pumping g.p.m. WELL HEAD COMPLETION N/A ❑ Pitless adapter manufacturer Model ❑ Casing Protection 0 12 in.above grade ❑ At-grade(Environmental Wells and Borings ONLY) GROUTING INFORMATION Well grouted? pi Yes 0 No GEOLOGICAL MATERIALS COLOR HARDNESS RIALOF FROM TO Grout Material 0 Neat cement ❑h3.Bentonite 0 Concrete 0 High Solids Bentonite MATE1 ,,�� from 3 0 to 30 ft. 3 0 yds. IjCbags Top Soil Black S 0+ 10 l from to ft. 0 yds. 0 bags from to ft. 0 yds. 0 bags • NEARE u Mpl SOURCE OF CON IINATION Clay Dark Grey M 10' 30' /.� feet J d ti �f direction S&6T/‹. tYlm /rte,,, Well disinfected upon completion? ❑res 0 No Gravel Black/Tan A 30' 40 PUMP _ 0 Not installed Date installed 4-16-96 Clay-mixed w/Gravel Grey S 401 80 l Manufacturer's name Red jacket Model number N12GC HP 2 vats 230 Sand—fine Grey S 80 O{i, Length of drop pipe 63 N/A ft. Capacity G s g.p.m. Pressure Tank Capacity Type:ury] Submersible 0 L.S.Turbine 0Reciprocating 0Jet ❑ Water Sand Colored S 90 11;1 ABANDONED WELLS X Does property have any not in use and not sealed well(s)? 0 Yes U No VARIANCE • Was a variance granted from the MDH for this well? 0 Yes CIWNo WELL CONTRACTOR CERTIFICATION . Use a second sheet,if needed This well was drilled under my supervision and in accordance with Minnesota Rules,C REMARKS,ELEVATION,SOURCE OF DATA,etc. The information contained in this report is true to the best of m y knowledge ►Wepfer 4725. . DON STODOLA WELL DRILLING CO., INC. 27172 Licensee Business Name Lic.or Reg.No. 4-11-96 Authorized Representative Signature Date Mark Sto&ola 4-11-96 LOCAL COPY 580411 Name o/Odller Date HE-01205-05(Rev.1/95)