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HomeMy WebLinkAboutwell info illi . WELL LOCATION MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WELL NO. County Name WELL AND BORING RECORD Atrrtnrpi n Minnesota Statutes Chapter 103/ Township Name Township No. Range No. Section No. Fraction WELL DEPTH(completed) Date Work Completed n. Orono 117 23 09 108 7-15-02 House Number,Street Name,City,and Zip Code of Well Location or Fire Number DRILLING METHOD ❑ Cable Tool ❑ Driven ❑ Dug 9pn nt d Crystal Bay Rd So Orono 55391 El / Auger lotary ❑ Jetted Show exact location of we in section grid with" Sketch map of well location. ❑ . Showing property lines, roads and buildings. DRILLING FLUID WELL HYDROFRACTURED? ❑YES 4..1/0 N ' wa t e r .FROM ft.to ft. t USE ❑ Monitoring 0 Heating/Cooling Domestic J i _ J.l._. El Community PWS DIIndustry/Commercial i ❑ Irrigation ❑ Noncommunity PWS 0 Remedial w E El Environ.Bore Hole ❑ Dewatering ❑ r CASING Drive Shoe? ❑ Yes �1tJ❑oWelded HOLE DIAM. V2M,ie / I I ❑ Threaded1 ❑ PSteellastic ❑ S �� J I ,Mile I / if CASING DIAMETER WEIGHT PROPERTY OWNER'S �fNAME _ _in.to4AO—ft. 2.01 lbs./ft. $ in.to 30. Ken/Julie Riffr in.to ft. _lbs./ft. 61/4 in.to-108 Property owner's mailing address if different than well location address indicated above. in.to ft. .___ lbs./ft. V in.to ft. same as above SCREE OPEN HOLE Make from ft.to ft. Type stainise 4 4 etl Diam. E/y2M Slot/Gauze .010 Length ' ♦ 4 Set between 140 ft.and 108 ft. FITTINGS: 2.'730" w/kp STATIC WATER LEVEL WELL OWNER'S NAME 53 ft. 1.tfelow 0 above land surface Date measured 7-15-02 PUMPING LEVEL(below land surface) Well owner's mailing address if different than property owner's address indicated above. 85 ft. after 2 hrs.pumping 25 __g.p.m. WELL HEAD COMPLETION Whitewater Whitewater Model _ ❑ Casing Protection "(12 in.above grade ❑ At-grade(Environmental Wells and Borings ONLY) GROUTING INFORMATION Well grouted? Yes ❑ No GEOLOGICAL MATERIALS COLOR HARDNESS OF FROM TO Grout Material ❑ Neat cement 0 Bentonite 0 Concrete /High Solids Bentonite MATERIAL fom- to 30 ft. x.59 yds. a9 s from_ 0 to 104__ft.natural-fj4sl❑ bags topsoil black soft 0 3 from to ft. 0 yds. ❑ bags NEAREST KNOWN SOURCE OF CONTAMINATION clay gray soft 3 90 - ) feet direction - _ type Well disinfected upon completion? [ 'yes CI No watersand tan soft 90 108 PUMP / 0 Not installed Date installed _ _ 7-17-02 — Manufacturer's name Aermotor Model number HP 1 Volts_ 230 Length of drop pipe 63 ft. Capacity g.p.m. - Type: Crubmersible ❑ L.S.Turbine ❑ Reciprocating 0 Jet El • ABANDONED WELLS Does property have any not in use and not sealed well(s)? ❑ Yes *No VARIANCE Was a variance granted from the MDH for this well? 0 Yes '�No TN# 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. A BO - - s _ Y . c - 122 ice.•ee:usme Name ._ 'c.or-e..No. ,,,• "' �1 ► 9=25-e2 P ,'Au orized Re)rese.-title Signa ure Date Chuck Moore 7-15-02 Name of Driller Date LOCAL COPY 67 7871 HE-01205-07(Rev.2/99) IC#140-0020 Aw Tw&ry C Ct Wa "w' C ' i I vucr. y 617 13th Ave So • Hopkins, Minnesota 55343 • (612) 935 - 3556 07/17/2002 Stodola Well Drilling 3841 North Main St. Bonifacius MN 55375 938-2111 REPORT OF WATER ANALYSIS Lab #: 709 Our Laboratory reports these analytical results, determined on a sample taken by CLIENT on 07/15/2002 from the following location: Ken Riff 900 Old Crystal Bay Rd. Orono,Mn Unique Well #677871 Coliform Bacteria <1/100 ml Nitrates Nitrogen <1.0 mg/I 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). • y Water Clinic, Inc. Bill ' dale Lab Certification#027-053-119 MINNESOTA DEPARTMENT OF HEALTH Minnesota Well and Boring /� WELL OR BORING LOCATION WELL AND BORING SEALING RECORD Sealing No. 1 H l 6 County Name Minnesota Unique Well No. — _ Hennepin Minnesota Statutes. Chapter 1031 or W-series No. (Leave Sank 4 not known) Township Name Township No. Range No. Section No. Fraction(sm.-w Ig) Date Sealed Date Well or Boring Constructed Orono 117 23 09 1L2-000#3,. !0 1 02- . Numerical Street Address or Fire Number and City of Well or Boring Location i x /" / 900 Old Crystal Bay yy Rd, S, O ror.�pth Before Sealing �1 6,) tt. Original Depth , r' � ft Show exact location of well or boring i "J J-etch map of well or botifig /{OyIFER(S) STATIC WATER LEVEL in section grid with"X" location, showing pfpperty Single Aquifer ❑ Multiaquifer lines,roads,and buildings. ��// N _ --- WELUBORING L�9.Measured ❑ Estimated { ' 1 r — -1 -1- --, -' ._ l - rVater Supply Well ❑MoniL Well 14F1 1 ❑ Env.Bore Hole ❑Other �,- ft. below El above land surface W- r -1 ---- 1 "E 3 y CASING TYPE(S) ( 1-- -------i----r— 4 y Reel ❑ Plastic ❑Tile ❑ Other I - $milei -I .......�_.__,._..- I f CASING(S) 1 Diameter,,,, Depth f Set in oversize hole? Annular space initially grouted? r node _ in.from ItO to TX'',ft. ❑ Yes [ 40 ❑ Yes ❑No ❑ Unknown 1 PROPERTY OWNER'S NAME infrom to ft. ❑ Yes ❑No ❑ Yes ❑No ❑ Unknown Ken/Julie Riff 952-249-7217 Property owner's mailing address if different than well location address indicated above . in.from to ft. ❑ Yes ❑No ❑ Yes ❑ No ❑ Unknown SCREEN/OPEN HOLE 1 Screen from .jt' F , i to UD ft. Open Hole from to _ ft. OBSTRUCTIONS WELL OWNER'S NAME Rods/DropPipe �y�� ❑ p ❑ Check Valve(s) ❑ Debris ❑ Fill I�lvO Obstruction Well owner's mailing address if different than property owner's address indicated above Type of Obstructions(Describe) ��\\ Obstructions removed? ❑Yes ❑ No Describe PUMP Type GEOLOGICAL MATERIAL COLOR HARDNESS OF FROM TO ❑ Removed Not Present ❑ Other FORMATION If not known,indicate estimated formation log from nearby well or boring. METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS,OR CASING AND BORE HOLE: 'No Annular Space Exists i ) ❑Annular space grouted with tremie pipe ❑Casing Perforation/Removal in.from to ft. ❑ Perforated ❑ Removed in.from to ft. ❑ Perforated Cl Removed Type of perforator • t - ❑ Other GROUTING MATERIAL(S) (One bag of cement=94 lbs.,one bag of bentonite=50 lbs.) Grouting Material AJ�44JT(7--":-/./'at-/ ✓ to ea ft. yards .`f bags from to ft. yards bags from to ft. yards bags from to— ft. yards bags REMARKS,SOURCE OF DATA,DIFFICULTIES IN SEALING OTHER WELLS AND BORINGS Other unsealed and unused well or boring on property? ❑Yeslo How many? 1 LICENSED OR REGISTERED CONTRACTOR CERTIFICATION This well or boring was sealed in accordance with Minnesota Rules.Chapter 4725. The information contained in this report is true to the best of my knowledge. Don Stodola Well Drilling Co,inc. 27172 Contractor Business e License or Registration Pio. ,e .'1-;''''''' `'f E' , a/ A on�� ied Re resentative 9nature Date C LOCAL COPY H Name of Person Sealing Well or Boring WELL LOCATION MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WELL NO. County Name WELL AND BORING RECORD 6 7 3 8 6 2 Henne p i n Minnesota Statutes Chapter 103! Township Name Township No. Range No. Section No. Fraction WELL DEPTH(completed) Date Work Completed Orono 117 23 4 155 n 1-10-02 House Number,Street Name,City,and Zip Code of Well Location or Fire Number DRILLING METHOD 525 Sussex CrI Orono 55356 0 CableeTool ❑ Driven 0 Dug ❑ Augr Rotary ❑Jetted Show exact location of well in section grid with"X". Sketch map of well location. 0 Spewing property lines, • i_,,to4s and buildings. DRILLING FLUID WELL HYDAOFRACTURED? 0 YES 10 N �. ...,, �! .^`4 water FROM tit() ft. USE ,/ ❑ Monitoring ❑ Heating/Cooling I ---7,---..,.. ` er Domestic ❑ CommunityPWS 0 Irrigation ❑ Industry/Commercial t_ `-� 0 Noncommunity PWS 0 Remedial w r - ET .\ 0 Environ.Bore Hole ❑ Dewatering ❑ r / ,y{ ^ CASING Drive Shoe? 0 Yes ifNoHOLE DIAM. I - �/ZMile i Y t 1 ' .ti ! 0 Steel 0 Threaded 0 Welded S ) `? Plastic ❑ — 1_1 mile—I CASING DIAMETER WEIGHT PROPERTY OWNER'S NAME 4 in.to 147 ft. _ _ 2X0.1— lbs./ft. 8 in.to X01. Tony Eiden Company in.to _ft. _lbs./ft. 6,ii_in.tol__5_5ft. Property owner's mailing address if different than well location address indicated above. _ in.to ft. _lbs./ft. in.to ft. 4100 Berkshire Lane SCREE3Ghnson OPEN HOLE Plymouth, MN 55446 M Dam. k at1 11.10 ft. ype Slot/Gauze .010 _Length 4Z + 4° Set between 147 ft.and 155 ft. FITTINGS2"x30" w/kp _ STATIC WATER LEVEL WELL OWNERS NAME 90 ft./below 0 above land surface Date measured 1-10-02 PUMPING LEVEL(below land surface) Well owners mailing address if different than property owner's address indicated above. 143 ft. after 2 hrs.pumping 25 g.p.m. `�W(E LL HEAD COMPLETION �E PPitless adapter manufacturer whit lira t e r Model 0 Casing Protection Lc12 in.above grade ❑ At-grade(Environmental Wells and Borings ONLY) • GROUTING INFORMATION Well grouted? iK Yes 0 No HARDNESS OF Grout Material 0 Neat cement 0 Bentonite 0 Concrete 4'High Solids Bentonite GEOLOGICAL MATERIALS COLOR MATERIAL FROM TO /� ,/ from 0 to 30 ft. 2•5 0 yds. IG.bags clay brown soft 0 18 from 30 tol#-7_ft.natural_b114 ❑ bags from to ft. D yds. ❑ bags sand brown soft 18 90 NEARGST�C� SOURCE OF C9NTr AT directio }��-,+� � T r feetr �^' r /C-type Well disinfected upon completion? "(Yes 0 No clay gray soft 90 140 PUMP 0 Not installed Date i talled -1—©2 sand gray soft 140 155 Manufacturer's name installed 1.5 230 Model number HP Volts Length of drop pipe 126 ft. Capacity g.p.m. Type: iSubmersible 0 L.S.Turbine ❑ Reciprocating 0 Jet 0 ABANDONED WELLS ►../ Does property have any not in use and not sealed well(s)? CI Yes tem, VARIANCE Was a variance granted from the MDH for this well? 0 Yes 1No TN# 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 Sto ola Well Drillin co., Inc. 27172 . ensee Bu ess Name— ic.or Reg.No. Yom" 7-16-02 Authorized Re motive Signature Date Chuck Moore 1-10-02 Name of Driller Date LOCAL COPY 6 7 3 8 6 2 HE-01205-07(Rev.2/99) IC#140-0020 ( . _ Tw('vv C£ y W c tex C LI4'U'ci, I vtc'. 617 13th Ave So • Hopkins, Minnesota 55343 • (612) 935 - 3556 01/16/2002 Stodola Well Drilling 3841 North Main St. Bonifacius MN 55375 938-2111 REPORT OF WATER ANALYSIS Lab #: 43 Our Laboratory reports these analytical results, determined on a sample taken by CLIENT on 01/14/2002 from the following location: 525 Sussex Circle Orono,Mn Unique Well#673862 Coliform Bacteria <1/100 ml Nitrates Nitrogen <1.0 mg/I 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). ty Water Clinic, Inc. Bill • , Lab Certification#027-053-119