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Minnesota Unique Well Number <br />541778 <br />County Anoka <br />Quad Anoka <br />Quad ID 120B <br />MINNESOTA DEPARTMENT OF HEALTH <br />WELL AND BORING REPORT <br />Minnesota Statutes Chapter 1031 <br />Entry Date 08/05/1997 <br />Update Date 02/14/2014 <br />Received Date <br />Well Name Township Range Dir Section Subsection <br />PEARSON, 32 25 W 30 AABACD <br />Elevation 883 ft. Elev. Method 7.5 minute topographic map (+/- 5 feet) <br />Well Depth Depth Completed Date Well Completed <br />66 ft. 66 ft. 08/24/1994 <br />Drill Method Non -specified Rotary Drill Fluid Bentonite <br />Use domestic Status Active <br />Address <br />Well 8846 10 SH W RAMSEY MN 55303 <br />Well Hydrofractured? Yes No From To <br />Casing Type Single casing Joint Threaded <br />Drive Shoe? Yes ❑ No X Above/Below <br />Stratigraphy Information <br />Geological Material <br />SAND <br />CLAY & ROCKS <br />SAND <br />CLAY FIRM <br />From <br />0 <br />23 <br />43 <br />66 <br />To (ft.) <br />23 <br />43 <br />66 <br />66 <br />Color <br />BROWN <br />BROWN <br />GRAY <br />GRAY <br />Hardness <br />SOFT <br />SOFT <br />SOFT <br />Casing Diameter Weight Hole Diameter <br />4 in. To 63 ft. 10.7 lbs./ft. 8.7 in. To 30 ft. <br />6.2 in. To 66 ft. <br />Open Hole From ft. To ft. <br />Screen? <br />x Type stainless Make JOHNSON 304 <br />Diameter Slot/Gauze Length Set <br />4.5 in. 18 4 ft. 62 ft. 66 ft. <br />Static Water Level <br />28 ft. land surface Measure 08/24/1994 <br />Pumping Level (below land surface) <br />48 ft. 3 hrs. Pumping at 40 g.p.m. <br />Wellhead Completion <br />Pitless adapter manufacturer BAKER Model SNAPPY <br />X Casing Protection X 12 in. above grade <br />❑ At -grade (Environmental Wells and Borings ONLY) <br />Grouting Information <br />Material <br />bentonite <br />Well Grouted? X Yes ❑ No ❑ Not Specified <br />Amount From To <br />0.8 Cubic yards ft. 60 ft. <br />Nearest Known <br />50 feet <br />Well disinfected <br />Source of Contamination <br />South Direction Septic tank/drain field Type <br />upon completion? X Yes ❑ No <br />Pump <br />Manufacturer's <br />Model Number <br />Length of drop <br />❑ Not Installed Date Installed 01/10/1994 <br />name RED JACKET <br />100CNS1- HP 1 Volt 230 <br />pipe 42 ft Capacity 18 g.p. Typ Submersible <br />Abandoned <br />Does property <br />have any not in use and not sealed well(s)? ❑ Yes X No <br />Variance <br />Was a variance granted from the MDH for this well? ❑ Yes ❑ No <br />Miscellaneous <br />First Bedrock Aquifer Quat. buried <br />Last Strat clay -gray Depth to Bedrock ft <br />Located by Minnesota Geological Survey <br />Locate Method Digitization (Screen) - Map (1:24,000) <br />System UTM - Mad83, Zone 15, Meters X 461347 Y 5009793 <br />Unique Number Verification Address verification lnpute Date 07/03/2008 <br />Remarks <br />Angled Drill Hole <br />Well Contractor <br />Renner E.H. Well 71015 SCHAFFER, R. <br />Licensee Business Lic. or Reg. No. Name of Driller <br />Minnesota Well Index Report <br />541778 <br />Printed on o2/03/2017 <br />HE-01205-15 <br />