HomeMy WebLinkAboutAbandoned WellSTATE OF MINNESOTA DEPARTMENT OF HEALTH
ARANDONED WELL R`_:ORD
I. LOCATION aF WIE_LI MINNESOTA UNIQUE WELL NO.
(leave blank +f not known)
Cdue"Name (fOtt
To+nz"ip Maine
Spring Lake
Townshlp "umber
114 "
Range Number
22
Section No.
10
Frac[Inn
NE "S4�
a, WEll BEDTN (cpmpleteU)
108
Na [e sesled
5 -14 -91
Y
Numerical Street Address and City oI Well Location or Distance trom Rnad
Interse.tl.N
`.. DI LLING METHOD (if known)
ID Cable tool 40 Reverse 70 Driven IC{] Dug
111J Sunset Trail SW., Prior Lake, Mn.
20 xa1 tow Rod So Air Bored! IID
30 Rotary 60 Jetted 50 Power Auger
Snow ev location o f well
(lo ecti an grid with '3")
section
N (�
fie a0S1 RUCTI DXs
Yell abs lucted ® Yes 0 No
Obstructions removed ■ Yes 0 No If obstructions cannot be
r e m o v ed . cants.[ Max
b e seating.
7. USE
1E Domestic 40 Monitoring BD Meat LOOP
201«19ation So Public golo,ustry
]o Test Well 60 Municipal 1L0 Commercial
70 Air Conditioning LID
n -pf`jL
—i S,
4 p �'
2. PROPERTY OuHER'S NAME
W111ng Address 1/ different than
Property adonis ins icated above
0. CASING(S)
ID Black 1W Threaded 70
Margie Harley
20 Gals. Sp Welded
30 Plastic 60 Stainless Steel
2 in to 104 ft.
In. to ft.
HARDNESS OF
3. FORMATION LOG COLOR FORMATION FROM TO
If not known, indicate formation tag from new well or nearby well.
Clay
0
30
9. SCREEN
■ Screened wen free .LQ4 ft. to rte
(It knovn)
❑Open Hod free_ ft. to rt.
Sand
30
52
C l a y & sand l a v e
s
52
158
10. STATIC WATER LEVEL
SO ft. 0below []above 5 -14 -91
land face Data Measured
a
Limesto
158
195
11. WE L LHEAO COMPLETION
ID Pltless Adapter 4[] Found Buried
a Basement offset so
30 Yell Pit
16. REMARKS. ELEVATION. SOURCE OF DATA - CASINGS REMOVED. CASINGS PERFORATED. ETC.
Geology taken from a well we drilled in 1977.
(SW of NW of SW, Section 10, Township 114N,
12. GROUTING INFORM ATION
ir Neat cm Cement nt 20 G ntan ,le p
GroutNt.ole, Neat free8 ta (—
Range 22W)
cement
No well or wells at this above address.
13. X LEAIREST SOYRC F CONTAMINATION
N g REST direction sewer l i n e type
This house has a municipal water supply.
'
Well disinfected before snlingi YII
14. PUMP * Rmvad 0 Met Present
Coldwell Banker - Richard Lannon (612)445 -511
T ITT Subme rsible 30 L.S. Turbine VRedprom.tiog
22 Jet Centrifugal
Obstructions removed: 70 feet of 194 inch dro
15. EXISTING YELLS (Please sketch locations of abandoned and
active wits to reearks auction or on batk.l
pipe and jet nozz
Other unused wall(%) an property? Is Yes 0 No
Rakishness: 0 pensioners 0 in T ,-., 0 Not ...led
N�
I 1 II
r,. Ir �V
❑. WATER WELL CONTRACTORS CERTIFICATION
` ///]
i F\
This e sealed under jurisdiction Ind this report
n q
VV
D
is town Be the Gat of q YnowledN and belief.
Hartmann Well Co. 40174
308` "'1�iaLn "thew
Pra ue,`EMI "Sb071
BY
A",
.
Signed GBe -
Roge ar mann GG
FFICIAI. IMPRISONED XCLL M ON (ft, G uW fee property TesnafeA
Nw s1 prtl tai
mwaR * ►wars 02 tR®