Agenda - Council - 10/08/2019 - Laserfiche WebLink

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PWS ID / FACILITY ID 1020035 SO1 UNIQUE WELL NO. 161441 PCSI CODE ACTUAL OR POTENTIAL CONTAMINATION SOURCE ISOLATION DISTANCES (FEET) LOCATION Minimum Distances Sensitive Well' Within 200 Ft. Y / N / U Dist. from Well Est. (?) Community Non- community IWD Industrial waste disposal well (Class V welly illegal' illegal' N IWS Interceptor, including a flammable waste or sediment 50 50 N OH1 Ordinary high water level of a stream, river, pond, lake, reservoir, or drainage ditch (holds water six months or more) 50 35 N `PP1 Petroleum buried piping 50 50 N *PP2 Petroleum or crude oil pipeline to a refinery or distribution center 100 100 N PT1 Petroleum tank or container, 1100 gal. or more, without safeguards 150 150 N PT2 Petroleum tank or container, 1100 gal. or more, with safeguards 100 100 N PT3 Petroleum tank or container, buried, between 56 and 1100 gal. 50 50 N PT4 Petroleum tank or container, not buried, between 56 and 1100 gal. 505 20 N PU1 Pit or unfilled space more than four feet in depth 20 20 N PC1 Pollutant or contaminant that may drain into the soil 50 50 100 N SP1 Swimming pool, in -ground 20 20 N *VH1 Vertical heat exchanger, horizontal piping conforming to rule 50 10 N *VH2 Vertical heat exchanger (vertical) piping, conforming to rule 50 35 N *WR1 Wastewater rapid infiltration basin, municipal or industrial 300 300 600 N *WA1 Wastewater spray irrigation area, municipal or industrial 150 150 300 N `WS1 Wastewater stabilization pond, industrial 150 150 300 N *WS2 Wastewater stabilization pond, municipal, 500 or more gal./acre/day of leakage 300 300 600 N *WS3 Wastewater stabilization pond, municipal, less than 500 gal./acre/day of leakage 150 150 300 N *VVT1 Wastewater treatment unit tanks, vessels and components (Package plant) 100 100 N `WT2 Water treatment backwash disposal area 50 50 100 N Additional Sources (If there is more than one source listed above, please indicate here). Potential Contamination Sources and Codes Based on Previous Versions of this Form GPR Gravel pocket receiving clear water drainage 30 N/A Y 30 Y SBM Sewer, buried collector, municipal, pressurized, open jointed, or unapproved materials 50 50 Y 70 Y SWD Storm water drain pipe, 12 inches or greater 50 20 Y 65 Y SWD Storm water drain pipe, 12 inches or greater 50 20 Y 65 Y FFH Fire or flushing hydrant 10 N/A Y 30 N New potential contaminant source. A sensitive well has less than 50 feet of watertight casing, and which is not cased below a confining layer or confining materials of at least 10' in thickness. These sources, known as Class V underground injection wells, are regulated by the federal U.S. Environmental Protection Agency. These sources are classified as illegal by Minnesota Rules, Chapter 4725. 4 Isolation distance is determined by average flow per day or if a facility handles infectious or pathological wastes. A community public water -supply well must be a minimum of 50 feet from a petroleum tank or container, unless the tank or container is used for emergency pumping and is located in a room or building separate from the community well; and is of double -wall construction with leak detection between walls; or is protected with secondary containment. This form is based on the new isolation distances in Minnesota Rules, Chapter 4725, related to wells and borings adopted August 4, 2008, and Minnesota Rules, Chapter 4720, related to wellhead protection. 6/21/2019 3