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Minnesota Unique Well Number <br />MINNESOTA DEPARTMENT OF HEALTH <br />Anoka <br />County <br />Entry Date <br />04/15/1991 <br />WELL AND BORING REPORT <br />Anoka <br />Quad <br />Update Date02/14/2014 <br />169236 <br />Minnesota Statutes Chapter 1031 <br />120B <br />Quad ID <br />Received Date <br />Well NameTownshipRangeDirSectionSubsectionWell DepthDepth CompletedDate Well Completed <br />PETERSON,3225W19DCDDDC82 ft.82 ft.12/29/1980 <br />7.5 minute topographic map (+/- 5 feet) <br />Drill Method <br />870 ft. <br />Elev. MethodNon-specified Rotary Drill Fluid <br />Elevation <br />AddressUseStatusActive <br />domestic <br />Well Hydrofractured? <br />C/W9002 10 HY W RAMSEY MN 55303 <br />Yes <br />From <br />No <br />To <br />Casing TypeSingle casingJoint <br />Threaded <br />No <br />Drive Shoe?Yes1 ft. <br />Stratigraphy InformationAbove/Below <br />Geological MaterialFromTo (ft.)ColorHardness <br />Casing DiameterWeightHole Diameter <br />SAND082BROWNSOFT <br />47811in. Toft.lbs./ft.6.2in. To78ft. <br />4in. To82ft. <br />Open Hole <br />Fromft.Toft. <br />TypestainlessMakeJOHNSON <br />Screen? <br />DiameterSlot/GauzeLengthSet <br />4in.154ft.78ft.82ft. <br />Static Water Level <br />40ft.land surfaceMeasure12/29/1980 <br />Pumping Level (below land surface) <br />47ft.3hrs.Pumping at30g.p.m. <br />Wellhead Completion <br />Pitless adapter manufacturer <br />Model <br />Casing Protection12 in. above grade <br />At-grade (Environmental Wells and Borings ONLY) <br />Well Grouted? <br />Grouting InformationYesNoNot Specified <br />MaterialAmountFromTo <br />cuttingsft.ft. <br />bentoniteft.78ft. <br />Nearest Known Source of Contamination <br />Direction <br />50East <br />feetSeptic tank/drain fieldType <br />Well disinfected upon completion?YesNo <br />Pump <br />Not InstalledDate Installed01/02/1981 <br />Manufacturer's name <br />RED JACKET <br />HP <br />Model Number <br />0.75Volt230 <br />75V19BC <br />Length of drop pipeCapacity <br />ftg.p.Typ <br />5414Submersible <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. Water <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 />UTM - NAD83, Zone 15, Meters <br />SystemXY <br />4610235009874 <br />Unique Number VerificationInput Date <br />Information from08/19/2008 <br />Angled Drill Hole <br />Well Contractor <br />Ruppert & Son27086RUPPERT, G. <br />Licensee BusinessLic. or Reg. No.Name of Driller <br />169236 <br />Printed on 10/13/2020 <br />Minnesota Well Index Report <br />HE-01205-15 <br /> <br />