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m <br />Environmental Health Division <br />Drinking Water Protection Section <br />DEPARTMENT P.O. Box 64975 <br />nc DEPARTMENT <br />St. Paul. Minnesota 55164-0975 <br />INNER WELLHEAD MANAGEMENT ZONE (IWMZ) - <br />POTENTIAL CONTAMINANT SOURCE INVENTORY (PCSI) REPORT <br />PUBLIC WATER SYSTEM INFORMATION <br />PWS ID <br />NAME <br />ADDRESS <br />1020035 COMMUNITY <br />Ramsey <br />Ramsey Water Superintendent, 7550 Sunwood Drive, Ramsey, MN 55303 <br />FACILITY (WELL) INFORMATION <br />NAME <br />FACILITY ID <br />UNIQUE WELL NO. <br />COUNTY <br />Well #1 IS THERE A WELL LOG OR <br />ADDITIONAL CONSTRUCTION <br />SO1 INFORMATION AVAILABLE? <br />161441 0 YES (Please attach a copy) <br />Anoka 0 NO 0 UNDETERNIINED <br />PWS ID / FACILITY ID <br />1020035 S01 UNIQUE WELL NO. 161441 <br />PCSI <br />CODE <br />ACTUAL OR POTENTIAL <br />CONTAMINATION SOURCE <br />ISOLATION DISTANCES (FEET) <br />LOCATION <br />Minimum Distances <br />Sensitive <br />Well, <br />Within <br />200 Ft. <br />Y / N / U <br />Dist. <br />from <br />Well <br />Est. <br />(?) <br />Community <br />on- <br />community <br />Agricultural <br />Related <br />*AC1 <br />Agricultural chemical buried piping <br />50 <br />50 <br />N <br />*AC2 <br />Agricultural chemical multiple tanks or containers for residential retail sale <br />or use, no single tank or container exceeding, but aggregate volume <br />exceeding 56 gal. or 100 lbs. dry weight <br />50 <br />50 <br />N <br />ACP <br />Agricultural chemical tank or container with 25 gal. or more or 100 lbs. or <br />more dry weight, or equipment filling or cleaning area without safeguards <br />150 <br />150 <br />N <br />ADS <br />Agricultural chemical storage or equipment filling or cleaning area with <br />safeguards <br />100 <br />100 <br />N <br />ACR <br />Agricultural chemical storage or equipment filling or cleaning area with <br />safeguards and roofed <br />50 <br />50 <br />N <br />ADW <br />Agricultural drainage well' (Class V well - illegal') <br />50 <br />50 <br />N <br />AAT <br />Anhydrous ammonia tank (stationary tank) <br />50 <br />50 <br />N <br />AB1 <br />Animal building, feedlot, confinement area, or kennel, 0.1 to 1.0 animal unit <br />(stockyard) <br />50 <br />20 <br />100/40 <br />N <br />AB2 <br />Animal building or poultry building, including a horse riding area, more than <br />1.0 animal unit <br />50 <br />50 <br />100 <br />N <br />ABS <br />Animal burial area, more than 1.0 animal unit <br />50 <br />50 <br />N <br />FWP <br />Animal feeding or watering area within a pasture, more than 1.0 animal unit <br />50 <br />50 <br />100 <br />N <br />AF1 <br />Animal feedlot, unroofed, 300 or more animal units (stockyard) <br />100 <br />100 <br />200 <br />N <br />AF2 <br />Animal feedlot, more than 1.0, but less than 300 animal units (stockyard) <br />50 <br />50 <br />100 <br />N <br />AMA <br />Animal manure application <br />use discretion <br />use discretion <br />N <br />REN <br />Animal rendering plant <br />50 <br />50 <br />N <br />MS1 <br />Manure (liquid) storage basin or lagoon, unpermitted or noncertified <br />300 <br />300 <br />600 <br />N <br />MS2 <br />Manure (liquid) storage basin or lagoon, approved earthen liner <br />150 <br />150 <br />300 <br />N <br />MS3 <br />Manure (liquid) storage basin or lagoon, approved concrete or composite <br />liner <br />100 <br />100 <br />200 <br />N <br />MS4 <br />Manure (solid) storage area, not covered with a roof <br />100 <br />100 <br />200 <br />N <br />OSC <br />Open storage for crops <br />use discretion <br />use discretion <br />N <br />SSTS Related <br />AA1 <br />Absorption area of a soil dispersal system, average flow greater than <br />10,000 gal./day <br />300 <br />300 <br />600 <br />N <br />AA2 <br />Absorption area of a soil dispersal system serving a facility handling <br />infectious or pathological wastes, average flow 10,000 gal./day or less <br />150 <br />150 <br />300 <br />N <br />AA3 <br />Absorption area of a soil dispersal system, average flow 10,000 gal./day <br />or less <br />50 <br />50 <br />100 <br />N <br />AA4 <br />Absorption area of a soil dispersal system serving multiple family <br />residences or a non-residential facility and has the capacity to serve 20 or <br />more persons per day (Class V welly <br />50/300/1504 <br />50/300/1504 <br />100/600/300" <br />N <br />CSP <br />Cesspool <br />75 <br />75 <br />150 <br />N <br />AGG <br />Dry well, leaching pit, seepage pit <br />75 <br />75 <br />150 <br />N <br />*FD1 <br />Floor drain, grate, or trough connected to a buried sewer <br />50 <br />50 <br />N <br />*FD2 <br />Floor drain, grate, or trough if buried sewer is air -tested, approved <br />materials, serving one building, or two or less single-family residences <br />50 <br />20 <br />N <br />6/21/2019 <br />1 <br />