02/23/2020 - well and boring construction record

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• MINNESOTA UNIQUE WELL WELL OR BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH AND BORING NO. County Name WELT AND BORING CONSTRUCTION RECORD ` 8 4 4 81 3 Hennepin Minnesota Statutes,chapter 1031 Township Name Township No. Range No. Section No. Fraction(sm.—+Ig.) WELUBORING DEPTH(completed) DATE WORK COMPLETED Orono 117 23 10 SE SE Ste 197 n. 2-23-2020 GPS LOCATION—decimal degrees(to four decimal places). DRILLING METHOD Latitude Longitude - ❑Cable Tool ❑Driven ❑Dual Rotary ❑Auger SRotary ❑Rotasonic House Number,Street Name,City,and ZIP Code of Well Location ❑Other - _ - 1525 Bay Ridge Rd, orono 55391 DRILLING FLUID WELL HYDROFRACTURED? ❑Yes [VC Show exact location of well/boring in section grid with"X" Sketch map of well/boring location. water From ft.To ft. Showing property lines, _ N roads,buildipQs, direction. USEomestic ❑Monitoring ❑Heating/Cooling U K ❑Noncommunity PWS ❑Irrigation ❑Industry/Commercial , s_ • .. ❑Community PWS ❑Dewatering ❑Remedial •--____ -----`______`___ Li Elevator ❑ w ET I CASING MATERIAL Drive Shae? ❑Yes �No HOLE DIAM. I. ID Steel ❑Threaded ❑Welded 'h Mile ----1 lastic CI --- ---__I__-- 1 CASING s Diameter Weight Specifications ) - 1 Mile ( 4 in.To 189 ft. lbs./ft. _8_in.To 50ft. in.To ft. lbs./ft. �Y" in.To 197ft. PROPERTY OWNER'S NAME/COMPANY NAME 2 Stonewood LLC in.To ft. lbs./ft. in.To ft. Stonewood fade SCREEN3� OPEN HOLE Property owner's mailing address if different than well location address indicated above. m 153 E Lake St Type st'Sinliss steel inson akeFroDiam. 2" ft. To ft. Wayaata, MN 55391 Slot/Gauze +15 Length 4' + 4 8 Set between 1R9 ft.and 197 ft. FITTINGS,a3 8 loader STATIC WATER LEVEL �f/1 45 ft. .Below ❑Above land surface Date measured 2-23-2020 Dry hole ❑Yes NriNo WELL OWNER'S NAME/COMPANY NAME PUMPING LEVEL(below land surface) , 190 ft.after 7 hrs.pumping 50 g.p.m. Well/boring owner's mailing address if different than property owner's address indicated above. W LLHEAD COMPLETION • ;Pitless/adapter manufacturer ❑Casing protection -c:?62 in.above grade ❑At-grade ❑Well House ❑Hand Pump GROUT INFORMATION(specify bentonite,cement-sand,neat-cement,concrete,cuttings,or other) Material bentoniteFrom 0 To 50 ft. 3 ❑Yds. 14r Bags Material_eut t41,18;s_From 50 To 1 s, ft. ❑Yds. ❑Bags HARDNESS OF Material From To !t7l ft. ❑Yds. ❑Bags GEOLOGICAL MATERIALS COLOR MATERIAL FROM TO Driven casing seal From To Bags = One bag94 lbs.cement or 50 lbs.bentonite p 0 NEAREST KNOWN SOURCE OF CONTAMINATION clay/sand brown soft 16 Well is /—'O feet NiC direction from 1 type silty clay/ Well disinfected upon completion? . Yes ❑No fine sand gray soft 16 75 PUMP ❑Not installed Date installed S— I 1 — ad sandy clay gray soft 1 75 142 Manufacturer's name l caly/sand cjy/ �r8 /bl�kk soft 142 163 Model Number HP I /� Volts a 3a Y is Length of drop pipe 6 3 ft. Capacity g.p.m son Cla ra` soft 163 1R9 Type: Submersible ElL.S.Turbine El Reciprocating ❑Jet ❑ y JL ABANDONED WELLS Does property have any not in use and not sealed well(s)? ❑Yeslo gravel mix bard 189 197 VARIANCE Was a variance granted from the MDH for this well? Li Yes ,Frio TN# WELL CONTRACTOR CERTIFICATION 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. 1691 Licensee Business Name Lic.or Reg.No. " 3-9-2020 rfed wase lati -Signature Certified Rep.No. Date Rob Stodola LOCAL COPY 8 4 4 813 Name of Driller ID#52603 HE-01205-1e(Rev.3/19)