HomeMy WebLinkAboutAbandoned Well- STATE OF MINNESOTA DEPARTMENT OF HEALTH
ABANDONED WELL RECORD
1. La[Anr of SELL MINNESOTA k it WELL ELL N0.
(lea" bl 1I nt W ELL
�(OUnty No. CrMY 1
To.nsnlo Haw
V ship Nunwr, Range Mwner
Section As. Practlen
a. YELL BE PTx I<con,. )
rte *�y
Pr ior Lake
133 or 057 ;r
25 NE`S�
n.
aI I cl el
S Y
O
Numerical Street Address And City of Well Location or Distance frme RG&d
S. DRILLING METHOD (If A.)
Intersection
10 Cable to01 40 4nrw 70 Driven 1tQDeg
2922 Spring Lake Road Prior Lake, MN. 55372
Ip doll kit Call Bernd lip
)Efilotery 6p Jetted gp Power Sugar
Show a a act lot."..
or well
(in Section grid
with 'X') Sketch SAP of well I0cati0m
6. OBSTRUCTIONS
E
/Y
wll ob1tlwc4E�Y.A p ft
/ /
ratructiona roved ves p w ION oestructlons C.Ant ON
_
r ` ..ad, cont 11 "N'
M - - -
. -I • - E nee
rfOn s«11nB.
1
lDOwsI is Q ratdrie9 10 rat L «B
a✓G'II
Irrlgot i on ID Public 901MUts"
1
3p iert NOT 60 Ibn1c1 «I IlQ CdeenrcLl
gp A il it1 «I« 110
c,
2. PROPERTY OWNER'S MANE
lin: Address if different than
Pro address Indicated above
B. CAS NG(5)
I&Bl.tk A TMMMI 1p
20 Gal V. 5 0 Wham!
Mark Wright
SAME
3 0 Plastic 6p stainless steal
4 to 276 n
MAROx6s5 OF
L. FORMATIW LOG COLOR FORMATION TOM TO
If not known, indicate forptl On log from new wall or nearby w11.
In. t0 ft.
Drift
0
P80'
9. SCREEN o� ��
® Screened wit /fen 4 ca+v tt.
(If wool)
p G a la even _ n. 4 � n.
10. STATIC TER LE YE IV
r t. 41« p awe -
�.
land W ace rte refund T
11.' EELL ,`AO COMPLETION
X Pill«t Arr4r Q Found mild
2 13 rs«ent offset
1[] wll Pit
16. REMARKS, ELEVATION, SOURCE OF RATA • CASINGS REMOVED, CASINGS PERFORATED. ETC.
12 W ING IXFWMTION
)Q Wt Cent fret «14
Grout 4" Well Approx. 280' Deep
Mont «4rial ft. n. ym
24 Bags Cement
26 lbs. Bentonite
]. NW EST s a EONTAN
2 Men, Tabor, Rig and Cement Grout PLmp
fas dl.«t1« tyre
Nell d1s4 / actual berm. emit"? 0 Yes
14. PIDN eel 0 Not Fm .t
Type. Sob«ntble 3[3 L.S. Ton /M 'CI R iN itlo{
CI At . q 4m41fna1 10
15. EXISTING WELLS (Pl«n ,hmtab i«{tla« of GUN W
actin Hal{ 1m rem, NO «en Wt.)
at", ."W wIf(,) r Pnrrty7 0 4{ ® IY
RrnN : 0 ft en t 0 Town 0 t lr
12. LATER WELL CAIMCTW CWtFiOTTON
This sell a, Wt" «For OR Oorlsdlctlen sod this report
Is tree 4 tr Nwt of 4 reniNp MN bollef.
DO sDODDIA WELL DRILLING Coe INCe
Liw Sair« For L" "22122
ANn«
s1 - rte,
Fo r
N,en OF MIST
FICIAL AW g WILL UE (Foy In USN for Regent Tnosfo)
yBgP , rzw REE stiall,
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