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Minnesota Unique Well Number <br />MINNESOTA DEPARTMENT OF HEALTH <br />Anoka <br />County <br />Entry Date <br />01/11/2005 <br />WELL AND BORING REPORT <br />Anoka <br />Quad <br />Update Date07/29/2008 <br />711529 <br />Minnesota Statutes Chapter 1031 <br />120B <br />Quad ID <br />Received Date08/13/2004 <br />Well NameTownshipRangeDirSectionSubsectionWell DepthDepth CompletedDate Well Completed <br />MORAVETZ,3225W30ADCAAC155 ft.153 ft.07/12/2004 <br />7.5 minute topographic map (+/- 5 feet) <br />Drill Method <br />863 ft. <br />Elev. MethodNon-specified Rotary Drill Fluid <br />Elevation <br />Bentonite <br />AddressUseStatusActive <br />domestic <br />Well Hydrofractured? <br />Well14593 BOWERS DR NW RAMSEY MN 55303 <br />Yes <br />From <br />No <br />To <br />Casing TypeSingle casingJoint <br />Glued <br />No <br />Drive Shoe?Yes <br />Stratigraphy InformationAbove/Below <br />Geological MaterialFromTo (ft.)ColorHardness <br />Casing DiameterWeightHole Diameter <br />SAND & GRAVEL032BROWNSOFT <br />4142in. Toft.lbs./ft.8.5in. To30ft. <br />CLAY & GRAVEL3235BROWNSOFT <br />6.5155in. Toft. <br />SAND3548BROWNSOFT <br />CLAY & GRAVEL4892BROWNHARD <br />SAND & SILT92102BROWNSOFT <br />Open Hole <br />Fromft.Toft. <br />SAND & CLAY102134BROWNSOFT <br />TypestainlessMakeJOHNSON <br />Screen? <br />CLAY & GRAVEL134140BROWNSOFT <br />DiameterSlot/GauzeLengthSet <br />SAND140155BROWNSOFT <br />2in.108ft.142ft.153ft. <br />Static Water Level <br />30ft.land surfaceMeasure07/12/2004 <br />Pumping Level (below land surface) <br />ft.3hrs.Pumping at25g.p.m. <br />Wellhead Completion <br />Pitless adapter manufacturer <br />Model <br />MONITORSNAPPY <br />Casing Protection12 in. above grade <br />At-grade (Environmental Wells and Borings ONLY) <br />Well Grouted? <br />Grouting InformationYesNoNot Specified <br />MaterialAmountFromTo <br />high solids bentonite5Sacks0ft.30ft. <br />cuttings30ft.142ft. <br />Nearest Known Source of Contamination <br />Direction <br />51South <br />feetOtherType <br />Well disinfected upon completion?YesNo <br />Pump <br />Not InstalledDate Installed07/19/2004 <br />Manufacturer's name <br />RED JACKET <br />HP <br />Model Number <br />0.75Volt230 <br />75F211 <br />Length of drop pipeCapacity <br />ftg.p.Typ <br />6015Submersible <br />Abandoned <br />Does property have any not in use and not sealed well(s)? <br />YesNo <br />Variance <br />Was a variance granted from the MDH for this well?Yes <br />No <br />Miscellaneous <br />First Bedrock <br />Aquifer <br />Quat. buried <br />Last StratDepth to Bedrock <br />ft <br />sand-brown <br />Located by <br />Minnesota Geological Survey <br />Remarks <br />Locate Method <br />Digitization (Screen) - Map (1:24,000) (15 meters or <br />SECTION MAP. <br />UTM - NAD83, Zone 15, Meters <br />SystemXY <br />4612515009233 <br />Unique Number VerificationInput Date <br />Address verification07/03/2008 <br />Angled Drill Hole <br />Well Contractor <br />Mork Well Co., Inc.02730BECKWORTH, D. <br />Licensee BusinessLic. or Reg. No.Name of Driller <br />711529 <br />Printed on 10/13/2020 <br />Minnesota Well Index Report <br />HE-01205-15 <br /> <br />