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Home My WebLink AboutWell info • MINNESOTA UNIQUE WELL WELUBORING LOCATION MINNESOTA DEPARTMENT OF HEALTH AND BORING NO. County Name WELL AND BORING RECORD 7 4 3 4 4 5 NIMEMMIBEINUMMI min Minnesota Statutes,Chapter 1031 Township Name Township No. Range No. Section No. Fraction WELL/BORING DEPTH(completed) DATE WORK COMPLETED Orono 117 23 07 - 335 ft. 1-5-07 GPS DRILLING METHOD LOCATION: Latitude degrees minutes seconds______ ❑Cable Tool I Driven Li Dug Longitude degrees minutes seconds ❑Auger X.Rotary ❑Jetted House Number,Street Name,City,ity,andanZip Code of Well Location or Fire Number ❑ • 1530 Orchard Beach Place, Ocean° 55364 DRILLING FLUID WELL HYDROFRACTURED? ❑Yes lewo Show exact location of well/boring in section grid with"X." Sketch map of well location. bentonite From ft.To ft. Showing property lines, N ,/ -7....A,,..„,,,41.. //i�ds,buildings, USE Domestic ❑Monitoring ❑Heating/Cooling I /(,/ ' `1.,.,�rxldirection. El Noncommunity PWS H Environ.Bore Hole ❑Industry/Commercial i ❑Community PWS E Irrigation ❑Remedial ❑Elevator Dewaterin ❑ - -i---'--'--- ---- - feel _Jve Shoe? _ Yes ❑No HOLE DIAM. W I E T ^Threaded ❑Welded-- I ❑Plastico V.Mil 1 1 J' CASING r • Diameter Weight Specifications S 4 306 8 I— 1 Mile —I in.to ft. 11 lbs./ft. __ in.to1. 30 ft. in.to ft. lbs./ft. in.inQto �j`^'ft. PROPERTY OWNER'S NAME/COMPANY NAME in.to ft. lbs./ft. ___ Via.,to 335 ft. LY11om SCREEN OPEN HQ335 Property owner's mailing address if different than well location address indicated above. Make From ft.To ft. 842 Ivy Lane Type Diam. MN 55123 Slot/Gauze Length Set between ft.and ft. FITTINGS STATIC VAER LEVEL elow Above land surface Date measured 1-5-47 PUMPVEL(below land surfaces WELUBORING OWNER'S NAME/COMPANY NAME70 ft.after hrs.pumping g.p.m. ;ILL HEAD COMPLETION Well/boring owner's mailing address if different than property owner's address indicated above. 'itless Adapter Manufacturer Model ❑Casing Protection X12 in.above grade ❑At-grade(Environmental Well and Boring ONLY) GROUTING INFORMATION Well grouted? 1'es ❑No ,,��(( Grout materials ❑Neat cemententonitekVoncrete ❑Other From To ft. �d'#, bags net From To ft. +tads+ ❑Bags GEOLOGICAL MATERIALS COLOR HARDNESS OF FROM TO From To ft. ❑Yds. ❑Bags MATERIAL NEAREST KNOWN SOURCE OF CONTAMINATION clay yellow medium 0 23 feet "� direction/ �` Well disinfected upon completion? 'YYes El No - PUMP fine sand/clay gray soft 23 194 _ ! .01 fine ry ❑Not installed Date installed fine sand gray soft 190 2.30 Manufacturer's name �~` 230 pModel Number yr�r1 y HP i�� Volts .2 3 fine sand/clay green/brown soft 298 Length of drop pipe r ft. Capacity g.p.m. 7,i`yr;Y Type '6ubmersible O L.S.Turbine ❑Reciprocating ❑Jet ❑ sandstone/shale 1 Ly yellow r , 306 WELLS Does property have any not in use and not sealed well(s)? 0 Yes 11\lo sanstone gray herd 306 335 VARIANCE y Was a variance granted from the MDH for this well? LI YesJOTJo TN# 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 the best of my knowledge. Use a second sheet,if needed. REMARKS,ELEVATION,SOURCE OF DATA,etc. Don Stodola Well Drilling Co., Inc. 1691V71 Licensee Business N e Lic.or Reg.No. //. , 71:ate- 41Ir ' ' th a Representative Slit ature Date 7 4 3 4 4 5 Jim Kohis __ Name of Driller LOCAL COPY HE-01205-09(Rev.9/05) IC 140-0020 . . . Tw&vti cry Wator C , I vtc'. 617 13th Ave So • Hopkins, Minnesota 55343 • (612) 935 - 3556 01/10/2007 Stodola Well Drilling 3841 North Main St. Bonifacius MN 55375 938-2111 REPORT OF WATER ANALYSIS Lab #: 16BN Our Laboratory reports these analytical results, determined on a sample taken by CLIENT on 01/08/2007 from the following location: 1530 ORCHARD BEACH PL ORONO,MN WELL 743445 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). Twin City ater Clinic, Inc. Bill n Arsdale Lab Certification N 027-053-119 MINN:SOTA DEPARTMENT OF HEALTH Sealin Minnesota Well and Boring L� e WING LOCATION IVO. f7 WELL AND BORING SEALING RECORD Minne9ota Unique Well No. r— `/'1f' ii Minnesota Statutes.Chapter 1031 or W-series No. 5 riapain (Leave dank H not known) Township Name Township No. Range No Section No. Fraction Ism - Ig) Date Sealed Date Well or Boring Constructed Orono 117 23 07 43-0003 r. 7e 7--k-T-t z, . Numerical Street Address or Fire Number and City of Well or Boring Location r r 153(? Orchard Beach Place, t 0fl epthBetoreSealing ft. Original Depth h Show exact location of well or boring Sketch map of well or boring A�OyUIFER(S) STATIC WATER LEVEL in section grid with"X". location, showing property SA Single Aquifer ❑ Multiaquifer ; SlOads,and buildings. •,g{GJ N A i WELUBORING : Measured ❑ Estimated.1 Water Supply Well ❑Monit.Well '-`- ❑ Env Bore Hole ❑Other _. ft. (below ❑ above land surface i CASING TYPE(S) --- 41 � '�,Vi)) f�/.�teel 5 Plastic ❑The ❑ Other __ f I Yzmb 'j 1 CASING(S) i 1 i ) ' , I Diameter Depth Set in oversize hole? Annular space initially grouted? ll 4/S1 I It�r mile 41'j in.from tot ft. ❑ Yes ((No ❑ Yes 5 No ❑ Unknown PROPERTY OWNER'S NAME in.from to ft. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown Ace Properties ) 763-694-8800 ' Property owner's mailing address if different than well location address indicated abovein.from to ft. 5 Yes ❑ No 5 Yes 5 No ❑ Unknown 5500 Aderson Estate Rd SCREEN/OPENHOLE r Maple Plain, MN 55359 ,� —, h ,t^ 7 Screen from to . Open Hole from to ft. At t n:Larry Palm OBSTRUCTIONS WELL OWNER'S NAME .liFlods/Drop Pipe ❑ Check Valve(s) ❑ Debris ❑ Fill ❑ No Obstruction Well owner's mailingaddress if different than roe owner's address Indicated above. 7� /Fire_ Ci fry-) properly rty Type of Obstructions(Describe) /�./�r>�i �` Obstructions removed? (1'es ❑ No Describe PUMP Type /,/2 PC/M/2 GEOLOGICAL MATERIAL COLOR HARDNESS OF FROM TO �' RemovedV I=1Not 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: XAnnular Space Exists '-..f - = ❑Annular space grouted with tremie pipe ,j ❑Casing Perforation/Removal I in.from to ft. 5 Perforated ❑ Removed in.from to ft. 0 Perforated ❑ Removed Type of perforator ❑ Other GROUTING MATERIAL(S) (One bag of;cement=94 lbs.,one bag of bentonite=50 lbs.) ( Grouting Material 1J /of r elft':�fiern' n to sq ft. yards FS'-' _ be from to ft. yards from to ft. yards ' from to_ ft. yards REMARKS,SOURCE OF DATA,DIFFICULTIES IN SEALING OTHER WELLS AND BORINGS ,{,� Other unsealed and unused well or boring on property? 5 Yes L>CNo How many? LICENSED OR REGISTERED CONTRACTOR CERTIFICATION This well or boring was sealed in accordance with Minnesota Rules,Chapter 4725. The information contained in true to the best of my knowledge. soon stodola Well Drilling Co, - inc- 2717' Contractor Business Name - License or Registration . ////,, I ° is /�� •T,,../77: ithpnfed resentative Signature.- Date 1 H �� Name of Person Sealing Well or Boring LOCAL COPY 9 ,il► WELltR BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH Minnesota Well and Boring H 202121 2121 County Name WELL AND BORING SEALING RECORD So. ealing Minnesotanique Well No. V Hennepin Minnesota Statutes,Chapter 1031 or W-series No. (Leave blank If nd kn wn) Township Name Township No. Range No. Section No Fraction(sm-.Ig) Date Sealed Date Well or Boring Constructed Orono 117 23 07 43-0 Q3 2cj OCT C)2 GPS Latitude degrees minutes seconds h I LOCATION: Depth Before Sealing 7d ft. Original Depth �� ft. Longitude degrees minutes seconds AQUIFER(S) STATIC WATER LEVEL Numerical Street Address or Fire Number and City of Well or Boring LocationSingle Aquifer ❑Multiaquifer 1530 Orchard Beach Place, Orono ELUBORING Measured El Estimated ater Supply Well ❑Monit.Well Show exact location of well or boring Sketch map of well or boring in section grid with"X" location,showing property Env.Bore Hole Ill Other ft. PI below PI above land surface N ( lines,roads,and buildings. CASING TYPE(S) r---,----,----- _- 0 ( Steel ❑ Plastic ❑Tile ❑Other W E WELLHEAD COMPLETION - i----.--- , , vN 1�1 Outside: ❑Well House Inside: ❑Basement Offset 9 r f 1 i thmr� 0�3N,�D ❑Pitess Adapter/Unit Nell Pit ---1-H----i t ' I c, ❑Well Pit ❑Buried S 1 LI 11,. I mge- 4 1. _ ❑Buried PROPERTY OWNER'S NAME/COMPANY NAME n p /� CASING(S) Ace Properties 763-694-8800 Diameter„ Depth , Set in oversize hole? Annular space initially grouted? Properly owner's mailing address if different than well location address indicated above In.from b to_41,41:ft. ❑Yes 1)I(lo ❑Yes ❑No ❑Unknown 5500 Adderson Estate Rd Maple Plain, MN 55359 in.from to ft. ❑Yes ❑No ❑Yes ❑No El Unknown At t n:Larry Palm in.from to ft. ❑Yes ❑No ❑Yes ❑No El Unknown WELL OWNER'S NAME/COMPANY NAME r. SCREEN/OPEN HOLE i // ,, ...... 1 Well owner's mailing address if different than property owner's addred dicated above Screen from C.e�COto 7C./ft. Open Hole from to ft. OBSTRUCTIONS ❑ Rods/Drop Pipe El Check Valve(s) El Debris El Fill ),,No Obstruction Type of Obstructions(Describe) GEOLOGICAL MATERIAL COLOR HARDNESS OR FROM TO Obstructions removed? ❑Yes ❑ No Describe FORMATION - . — If not known,indicate estimated formation log from nearby well or boring PUMP Type drift 0 . 70 ❑ Removed p(Not Present ❑Other METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS,OR CASING AND BORE HOLE: Llo Annular Space Exists ❑ Annular space grouted with tremie pipe El Casing Perforation/Removal in.from to ft. ❑ Perforated ❑ Removed in.from to ft. ❑ Perforated El Removed Type of perforator • El Other _ GROUTING MATERIAL(S) (One bag of cement w 94 lbs.,one bag of bentonite w 50 lbs.) Grouting Material 40.&-47(”_2)T from O to_ Z ft. yards 3 bags from to ft. yards bags from to ft. yards bags OTHER WELLS AND BORINGS REMARKS,SOURCE OF DATA,DIFFICULTIES IN SEALING Other unsealed and unused well or boring on property? ❑ Yeso How many? 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. CPRidr B ir12S5 5l a Well Drilling Co. L Jnecr 4eg2r7 72 �— /-//�! 10-29-02 oozed Representative Sig -ur- Date LOCAL COPY H 202121Jim Antonson Name of Person Sealing Well or Boring • WEc R BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH Minnesota Well and Boring H 202122 County Name WELL AND BORING SEALING RECORD Minnesota Unique Well No. Minnesota Statutes,Chapter 1031 or W-series No. Hennepin (Leave blank if not known) Township Name Township No. Range No. Section No. Fraction(sm-).Ig) Date Sealed Date Well or Boring Constructed Orono 117 23 07 43-0003 24 OCT UZ • GPS Latitude degrees minutes seconds / LOCATION: Depth Before Sealing '73 ft. Original Depth ft. Longitude degrees minutes seconds AQUIFER(S) STATIC WATER LEVEL Numerical Street Address or Fire Number and City of Well or Boring Locationingle Aquifer 9 Multiaquifer 1530 Orchard Beach Place, Orono., Measured ❑ Estimated Water Supply Well 9 Monit.Well yf Show exact location of well or boring Sketch map of well or boring in section grid with"X" location,showing property 0 Env.Bore Hole 9 Other D ft. below 0 above land surface N lines,roads,and buildings. ED xCASING1� TYPE(S) ---r---,----,-----,--- Steei 0 Plastic 0 Tile 0 Other W--r---,----r----, E WELLHEAD COMPLETION '::S. t.3,,,.14 Outside: ❑Well House Inside: 9 Basement Offset 10 4 4 4 f hmrie Ns 30- . ❑ PitessAdapter/Unit Well Pit 0 Well Pit ❑Buried I I mAe i ..r { pl00 I , 0 Buried PROPERTY OWNER'S NAME/COMPANYNAtCASING(S) Ace Properties !63-694-88 Diameter Depth Set in oversize hole? Annular space initially grouted? Property owner's mailing address if different than well location address indicated above 2 r 1 � v in.from 0 to 6 ft. 9 Yes XNo 0 Yes 0 No 0 Unknown 5500 Anderson Estate Rd Maple Plaine,MN 55359 in.from to ft. ❑Yes ❑No ❑Yes ❑No ❑Unknown Attn: Larry Palm in.from to ft. ❑Yes 0 No ❑Yes 9 No ❑Unknown WELL OWNER'S NAME/COMPANY NAME 3 of SCREEN/OPEN HOLE /� / / Well owner's mailing address if different than property owner's address indicated above Screen from YJ( to .2,,� ft. Open Hole from to ft. OBSTRUCTIONS Rods/Drop Pipe 0 Check Valve(s) 0 Debris 0 Fill 0 No Obstruction Type of Obstructions(Describe) ..../1//t. ' /9 ,f ‘14.-r. GEOLOGICAL MATERIAL COLOR HARDNESS OR FROM TO Obstructions removed? ,%Yes ❑ No Describe FORMATION If not known,indicate estimated formation log from nearby well or boring PUMP Type JP t rump drift 0 73yRemoved 0 Not Present ❑Other METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS,OR CASING AND BORE HOLE: XNo Annular Space Exists 0 Annular space grouted with tremie pipe 0 Casing Perforation/Removal IIIIII"'''' in.from to ft. 0 Perforated 0 Removed in.from to ft. 0 Perforated 0 Removed Type of perforator 0 Other GROUTING MATERIAL(S) (One bag of cement=94 lbs.,one bag of bentonite=50 lbs.) Grouting Material NFA/ /4from (l to �3 ft. yards ...3 bags from to ft. yards bags from to ft. yards bags OTHER WELLS AND BORINGS REMARKS,SOURCE OF DATA,DIFFICULTIES IN SEALING Other unsealed and unused well or boring on property'? 0 Yes CXVo How many'? 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. COf1t9ctortluu Ines s: -ea Well .Drilling Co, , c277LicenserRegrr1 10-29-02 __ •/or•c-. 'et nt r e ignakke Date Jim Antonson LOCAL COPY H 202122 Name of Person Sealing Well or Boring