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Minnesota Unique Well Number <br />227345 <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 04/15/1991 <br />Update Date 02/14/2014 <br />Received Date <br />Well Name Township Range Dir Section Subsection <br />PEARSON, 32 25 W 30 AAABCA <br />Elevation 883 ft. Elev. Method 7.5 minute topographic map (+/- 5 feet) <br />Well Depth Depth Completed Date Well Completed <br />75 ft. 75 ft. 12/13/1972 <br />Drill Method Drill Fluid <br />Use domestic Status Active <br />Address <br />C/W 8846 10 HY NW RAMSEY MN 55303 <br />Well Hydrofractured? Yes No From To <br />Casing Type Single casing Joint Threaded <br />Drive Shoe? Yes ❑ No ❑ Above/Below 0 ft. <br />Stratigraphy Information <br />Geological Material From To (ft.) Color Hardness <br />SAND 0 10 BROWN <br />GRAVEL & SAND 10 15 YELLOW <br />CLAY & GRAVEL 15 60 BROWN <br />GRAVEL 60 75 BROWN <br />Casing Diameter Weight <br />4 in. To 71 ft. lbs./ft. <br />Open Hole From ft. To ft. <br />Screen? <br />x Type stainless Make JOHNSON <br />Diameter Slot/Gauze Length Set <br />4 in. 20 4 ft. ft. ft. <br />Static Water Level <br />30 ft. land surface Measure 12/13/1972 <br />Pumping Level (below land surface) <br />40 ft. hrs. Pumping at 17 g.p.m. <br />Wellhead Completion <br />Pitless adapter manufacturer BAKER Model <br />❑ Casing Protection ❑ 12 in. above grade <br />❑ At -grade (Environmental Wells and Borings ONLY) <br />Grouting Information <br />Well Grouted? ❑ Yes ❑ No 0 Not Specified <br />Nearest Known Source of Contamination <br />feet Direction Type <br />Well disinfected upon completion? ❑ Yes ❑ No <br />Pump <br />Manufacturer's <br />Model Number <br />Length of drop <br />❑ Not Installed Date Installed 12/00/1972 <br />name AERMOTOR <br />HP 0.75 Volt <br />pipe 50 ft Capacity 12 g.p. Typ Submersible <br />Abandoned <br />Does property have any not in use and not sealed well(s)? ❑ Yes ❑ 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 gravel (+larger) -brown Depth to Bedrock ft <br />Located by Minnesota Geological Survey <br />Locate Method Digitized - scale 1:24,000 or larger (Digitizing Table) <br />System UTM - Mad83, Zone 15, Meters X 461304 Y 5009799 <br />Unique Number Verification Address verification InputeDate 01/01/1990 <br />Remarks <br />WELL LOCATION: SOUTH SIDE OF HIGHWAY 10 & EAST OF PUMA <br />Angled Drill Hole <br />Well Contractor <br />Renner E.H. & Sons 27015 LEDBEI'IER, B. <br />Licensee Business Lic. or Reg. No. Name of Driller <br />Minnesota Well Index Report <br />227345 <br />Printed on 02/03/2017 <br />HE-01205-15 <br />