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Minnesota Unique Well Number <br />745313 <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 07/19/2007 <br />Update Date 12/02/2014 <br />Received Date 12/28/2006 <br />Well Name Township Range Dir Section Subsection Well Depth Depth Completed Date Well Completed <br />FAUSTAD 120 22 W 9 ACDDCC 182 ft. 182 ft. 10/30/2006 <br />Elevation 924 ft. Elev. Method LiDAR lm DEM (MNDNR) Drill Method Non -specified Rotary Drill Fluid Qwik gel <br />Address Use domestic Status Active <br />Well 14771 DAYTON RIVER RD DAYTON MN 55327 Well Hydrofractured? Yes ❑ No ❑ From To <br />Casing Type Single casing Joint Welded <br />Stratigraphy Information Drive Shoe? Yes ❑ No ❑ Above/Below <br />Geological Material From To (ft.) Color Hardness Casing Diameter Weight Hole Diameter <br />CLAY 0 37 BRN/YEL MED-HRD 4 in. To 174 ft. lbs./ft. 6.5 in. To 174 ft. <br />CLAY & SAND 37 43 BROWN SOFT <br />SAND 43 70 BROWN SOFT <br />CLAY, GRAVEL, SAND 70 142 BRN/BLK SFT-HRD <br />CLAY & SAND 142 150 BROWN SFT-HRD <br />SAND 150 160 BRN/YEL MED-HRD Open Hole From ft. To ft. <br />CLAY 160 165 YELLOW MED-HRD Screen? Type stainless Make JOHNSON <br />Diameter Slot/Gauze Length Set <br />SAND 165 182 BRN/WHT MEDIUM 2 in. 10 8 ft. 174 ft. 182 ft. <br />Remarks <br />Static Water Level <br />77 ft. land surface Measure 11/22/2006 <br />Pumping Level (below land surface) <br />120 ft. 4 hrs. Pumping at 40 g.p.m. <br />Wellhead Completion <br />Pitless adapter manufacturer MERRILL Model MCK6 <br />0 Casing Protection 0 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 />cuttings 30 ft. 174 ft. <br />bentonite 3 Sacks ft. 30 ft. <br />Nearest Known Source of Contamination <br />50 feet South Direction Septic tank/drain field Type <br />Well disinfected upon completion? X❑ Yes ❑ No <br />Pump ❑ Not Installed Date Installed 11/22/2006 <br />Manufacturer's name AERMOTER <br />Model Number S20-150 HP 1_5 Volt 230 <br />Length of drop pipe <br />Abandoned <br />Does property have any not in use and not sealed well(s)? <br />120 ft Capacity 20 <br />g.p. Typ Submersible <br />❑ Yes ❑X No <br />Variance <br />Was a variance granted from the MDH for this well? ❑ Yes <br />Miscellaneous <br />First Bedrock <br />Last Strat <br />Located by <br />Locate Method <br />X❑ No <br />Jordan Sandstone Aquifer Jordan <br />Jordan Sandstone Depth to Bedrock 165 ft <br />Minnesota Geological Survey <br />GPS SA Off (averaged) <br />System UTM - NAD83, Zone 15, Meters <br />Unique Number Verification <br />Angled Drill Hole <br />X 463218 <br />Address verification Input Date <br />Y 5007170 <br />10/21/2014 <br />Well Contractor <br />McAlpines Well Drilling of 1477 MCALPINE, T. <br />Licensee Business Lic. or Reg. No. Name of Driller <br />Minnesota Well Index Report <br />745313 <br />Printed on 09/20/2017 <br />HE-01205-15 <br />