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Minnesota Unique Well Number <br />242245 <br />County Hennepin <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 07/08/1996 <br />Update Date 04/01/2016 <br />Received Date <br />Well Name Township Range Dir Section Subsection Well Depth Depth Completed Date Well Completed <br />DAYTON - 120 22 W 9 ACBDDB 125 ft. 125 ft. 09/28/1987 <br />Elevation 903 ft. Elev. Method 7.5 minute topographic map (+/- 5 feet) Drill Method Drill Fluid <br />Address <br />Stratigraphy Information <br />Geological Material From To (ft.) Color Hardness <br />TOPSOIL 0 1 <br />SILTY CLAY RATHER 1 2 DK. BRN <br />LEAN CLAY W/ SAND 2 4 BROWN <br />SANDY LEAN CLAY 4 25 BROWN <br />SAND W/ SILT F MOIST 25 30 BROWN <br />SAND F MOIST DENSE 30 40 LT. BRN <br />SILTY CLAY / SAND 40 42 GRY/BRN SOFT <br />SAND W/ LI ITLE 42 47 LT. BRN <br />SAND F MOIST V 47 50 LT. BRN <br />SAND W/ SILT LITTLE 50 54 LT. BRN <br />FINE SAND DRY 54 55 LT. BRN <br />SAND W/ SILT & 55 58 BROWN <br />SAND W/ SILT & 58 60 BROWN <br />GRAVEL SILT & SAND 60 65 BROWN <br />SAND W/ SILT LITTLE 65 76 BROWN <br />CLAYEY SAND W/ 76 78 RED/BRN <br />SILTY SAND LII'ILE 78 81 BROWN <br />SILTY SAND F WB V 81 84 BROWN <br />SILTY SAND W/ 84 93 BROWN <br />SAND W/ SILT F-M WB 93 96 BROWN <br />SILTYSAND F WET 96 99 RED/BRN <br />SILTY GRAVEL W/ 99 103 BROWN <br />SANDSTONE 103 125 VARIED <br />Remarks <br />M.G.S. NO. 3587. SEE DETAILED SOIL BORING. <br />BORING BACKFILLED WITH NEAT CEMENT GROUT TO 3 FT. FROM LAND <br />SURFACE. <br />Use test well <br />Well Hydrofractured? <br />Casing Type <br />Drive Shoe? Yes ❑ <br />Open Hole <br />Screen? <br />From <br />Static Water Level <br />Yes ❑ <br />No <br />No ❑ <br />U From <br />Joint <br />Above/Below <br />ft. To <br />Type Make <br />Pumping Level (below land surface) <br />Status Active <br />ft. <br />To <br />Wellhead Completion <br />Pitless adapter manufacturer Model <br />❑ Casing Protection ❑ 12 in. above grade <br />❑ At -grade (Environmental Wells and Borings ONLY) <br />Grouting Information Well Grouted? 0 Yes ❑ No ❑ Not Specified <br />Material Amount From To <br />neat cement 3 ft. 125 ft. <br />cuttings ft. 3 ft. <br />Nearest Known Source of Contamination <br />feet Direction Type <br />Well disinfected upon completion? ❑ Yes ❑ No <br />Pump ❑ Not Installed Date Installed <br />Manufacturer's name <br />Model Number HP Volt <br />Length of drop pipe ft Capacity g.p. Typ <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 ❑ <br />No <br />Miscellaneous <br />First Bedrock Jordan Sandstone Aquifer <br />Last Strat Jordan Sandstone Depth to Bedrock 103 ft <br />Located by Minnesota Geological Survey <br />Locate Method Digitization (Screen) - Map (1:24,000) <br />System UTM - NAD83, Zone 15, Meters X 463036 Y 5007387 <br />Unique Number Verification Site Plan Input Date 12/23/2008 <br />Angled Drill Hole <br />Well Contractor <br />Twin City Testing M0112 <br />Licensee Business Lic. or Reg. No. Name of Driller <br />Minnesota Well Index Report <br />242245 <br />Printed on 09/22/2017 <br />HE-01205-15 <br />