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Minnesota Unique Well Number <br />416179 <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 08/24/1991 <br />Update Date 03/21/2017 <br />Received Date <br />Well Name Township Range Dir Section Subsection Well Depth Depth Completed Date Well Completed <br />GUIMONT, 120 22 W 9 BABCBD 295 ft. 295 ft. 12/05/1986 <br />Elevation 902 ft. Elev. Method 7.5 minute topographic map (+/- 5 feet) Drill Method Non -specified Rotary Drill Fluid <br />Address Use domestic Status Active <br />C/W 15501 DAYTON RIVER RD DAYTON MN 55327 Well Hydrofractured? Yes ❑ No ❑ From To <br />Casing Type Single casing Joint Threaded <br />Stratigraphy Information Drive Shoe? Yes ® No ❑ Above/Below 1 ft. <br />Geological Material From To (ft.) Color Hardness Casing Diameter Weight Hole Diameter <br />TOP SOIL 0 1 BLACK 4 in. To 260 ft. 10.7 lbs./ft. 4 in. To 295 ft. <br />CLAY & SAND 1 22 TAN <br />SANDY CLAY 22 24 TAN <br />GRAVEL 24 67 TAN <br />FINE SAND 67 73 BROWN <br />CLAY & GRAVEL 73 165 BROWN <br />CLAY 165 178 GRAY <br />CLAY & GRAVEL 178 206 BROWN <br />SHALE 206 244 WHT/YEL <br />SANDSTONE & SHALE 244 251 TAN/WHT SOFT <br />SANDSTONE SHALE 251 258 WHITE <br />SHALE & SANDSTONE 258 295 WHT/BLU <br />Remarks <br />Open Hole <br />Screen? <br />From 260 ft. <br />Type <br />To 295 ft. <br />Make <br />Static Water Level <br />65 ft. land surface Measure 12/05/1986 <br />Pumping Level (below land surface) <br />90 ft. 2 hrs. Pumping at 50 g.p.m. <br />Wellhead Completion <br />Pitless adapter manufacturer BAKER Model SNAPPY <br />❑ Casing Protection ❑ 12 in. above grade <br />❑ At -grade (Environmental Wells and Borings ONLY) <br />Grouting Information Well Grouted? X❑ Yes ❑ No ❑ Not Specified <br />Material Amount From To <br />bentonite 0 ft. 259 ft. <br />Nearest Known Source of Contamination <br />100 feet Southeas Direction <br />Well disinfected upon completion? <br />Septic tank/drain field Type <br />X❑ Yes ❑ No <br />Pump ❑ Not Installed Date Installed 12/09/1986 <br />Manufacturer's name GRUNDFOS <br />Model Number SP2-12 HP 0.5 Volt 115 <br />Length of drop pipe 90 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 St.Lawrence-Tunnel City Aquifer Tunnel City <br />Last Strat Tunnel City Group Depth to Bedrock 206 ft <br />Located by Minnesota Geological Survey <br />Locate Method Digitized - scale 1:24,000 or larger (Digitizing Table) <br />System UTM - NAD83, Zone 15, Meters X 462493 Y 5007815 <br />Unique Number Verification Information from Input Date 01/01/1990 <br />Angled Drill Hole <br />Well Contractor <br />Renner E.H. Well 71015 ROSGA, T. <br />Licensee Business Lic. or Reg. No. Name of Driller <br />Minnesota Well Index Report <br />416179 <br />Printed on 09/20/2017 <br />HE-01205-15 <br />