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Well Construction 12-15-24
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Well Construction 12-15-24
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• <br /> MINNESOTA UNIQUE WELL <br />' WELL OR BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH AND BORING NO. <br /> County Name - WELL AND BORING CONSTRUCTION RECORD 5 <br /> 1 Minnesota Statutes,chapter 1031 <br /> Uennepin <br /> Township Name Township No. Range No. Section No. Fraction(sm.—.lg.) WELL/BORING DEPTH(completed) DATE WORK COMPLETED <br /> Drono 117 23 3 3t; SUET, SW,, 185 t. 12/15/24 <br /> GPS LOCATION—decimal degrees(to four decimal places). t DRILLING METHOD <br /> Latitude Longitude ❑Cable Tool DI Driven ❑Dual Rotary <br /> ❑Auger Rotary ❑Rotasonic <br /> House Number,Street Name,City,and ZIP Code of Well Location ❑Other <br /> 2285 Webber Hills Rd, -Orono MN 55391 DRILLING FLUID WELLHYDROFRACTURED? ❑Yes +- No <br /> Show exact location of well/boring in section grid with"X." Sketch map of well/boring location. Bon t o n i t e ' From ' ft.To ft. <br /> Showing property lines, <br /> N roads,buildings,and direction. USE ®Domestic ❑Monitoring ❑Heating/Cooling <br /> --^ <br /> i 1 i l ❑Noncommunity PWS ❑Irrigation ❑Industry/Commercial <br /> ❑Community PWS ❑Dewatering ❑Remedial <br /> \A Elevator ❑ <br /> w , ET CASING MATERIAL Drive Shoe? ❑Yes No HOLE DIAM. <br /> ---4---r Ni 5� ❑Steel ❑Threaded ❑Welded <br /> '/Mile L_ ©Plastic ❑ <br /> I <br /> ' s S Diameter Weight Specifications 5 0 I <br /> �--1 Mile I in.TO 175 ft. lbs./tt. V <br /> in.To R <br /> in.To ft. lbs./ft. 6. <br /> q•� <br /> 1" PROPERTY OWNER'S NAME/COMPANY NAME coin.Td 5 ft. <br /> Dennis P?d rSon in.To ft. Ibs./ft. in.To ft. <br /> Property owner's mailing address if different than well location address indicated above. SCREEN ,y D s OPEN HOLE <br /> Make Jot1n$an From ft. To ft. <br /> stainless 4" <br /> Type 1 rtrt Diam. . <br /> Slot/Gauze "•_°10 Length 8 It <br /> Set between 1 /5 ft.and 1 8) ft. FITTINGS i lead <br /> STATIC WATER LEVEL 47 ft. Below ❑Above land surface <br /> Date measured 12/15/24 Dry hole ❑Yes 1 No . <br /> WELL OWNER'S NAME/COMPANY NAME PUMPING LEVEL(below land surface)1 70 ft.after 4 hrs.pumping 30 q.p.m. <br /> Well/boring owner's mailing address if different than property owner's address indicated above. WELLHEAD COMPLETION <br /> K Pitless/adapter manufacturer monitor Model <br /> ❑Casing protection L]12 in.above grade <br /> ❑At-grade ❑Well House ❑Hand Pump <br /> GROUT INFORMATION(specify bentonite,cement-sand,neat-cement,concrete,cuttings,or other) <br /> Material cut t i ng from 175 To 50 ft. ElYds. ❑Bags <br /> Material Dent o n i Fropm 50 To ° ft. 3 ❑Yds. Bags , <br /> HARDNESS OF Material From To ft. ❑Yds. ElBags <br /> GEOLOGICAL MATERIALS COLOR FROM TO MATERIAL Driven casing seal From To Bags One bag=94 lbs.cement <br /> or 50 lbs.bentonite - <br /> NEAREST KNOWN SOURCE OF CONTAMINATION (/11-L\_ <br /> Cla/Sand Brown. �f 1,1 <br /> w <br /> �' m 0 2 4 Well is `"� feet direction from : l..}" type <br /> I ^!f Well disinfected upon completion? ❑Yes El No <br /> Clay/Sand Gray S 24 2 PUMP <br /> 12.20.24 <br /> y 7 t ❑Not installed Date installed - <br /> Brown S 7 2 100 Manufacturer's name Shafer . <br /> Sand <br /> 1 7 y B ro$r. S 100 13-(} Model Number 105 HP 3/4 Volts 230 <br /> Sandy Ci 1 a y/G r V 1 0 Length of drop pipe ft. Capacity g.p.m. <br /> Red S 1 59 Type: Submersible ❑L.S.Turbine ❑Reciprocating Ill Jet ❑ <br /> Clay/Gravel 130 JABANDONED WELLS <br /> C <br /> f� Does property have any not in use and not sealed well(s)? ❑Yes g No <br /> Clay rab M 159 172 VARIANCE <br /> Yellow St 172 185 Was a variance granted from the MDH for this well? ❑Yes No TN# <br /> Sand - WELL CONTRACTOR CERTIFICATION <br /> . This well was drilled under my supervision and in accordance with Minnesota Rules,chapter 4725. <br /> The information contained in this report is true to the best of my knowledge. <br /> Use a second sheet,if needed. <br />... REMARKS,ELEVATION,SOURCE OF DATA,etc. <br /> Don Stodola Well Drilling Co Inc 1691 <br /> Licensee Business Name Lic.or Reg.No. <br /> ` t �-%- 558 12/20/24 <br /> GC&rtified Representative Signature Certified Rep.No. Date <br /> LOCAL COPY 8 7 3 5 6 Rob staC�01a <br /> 9Name of Driller <br /> ID#52603 HE-01205-18(Rev.3/19) <br />
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