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Minnesota Unique Well Number <br />MINNESOTA DEPARTMENT OF HEALTH <br />Anoka <br />County <br />Entry Date <br />10/09/2009 <br />WELL AND BORING REPORT <br />Anoka <br />Quad <br />Update Date08/18/2014 <br />768697 <br />Minnesota Statutes Chapter 1031 <br />120B <br />Quad ID <br />Received Date09/08/2009 <br />Well NameTownshipRangeDirSectionSubsectionWell DepthDepth CompletedDate Well Completed <br />OLSON, BRYAN3225W30DAAABC185 ft.185 ft.07/10/2009 <br />7.5 minute topographic map (+/- 5 feet) <br />Drill Method <br />867 ft. <br />Elev. MethodNon-specified Rotary Drill Fluid <br />Elevation <br />Bentonite <br />AddressUseStatusActive <br />domestic <br />Well Hydrofractured? <br />C/W14513 BOWERS DR NW RAMSEY MN 55303 <br />Yes <br />From <br />No <br />To <br />Casing TypeSingle casingJoint <br />Threaded <br />No <br />Drive Shoe?Yes <br />Stratigraphy InformationAbove/Below <br />Geological MaterialFromTo (ft.)ColorHardness <br />Casing DiameterWeightHole Diameter <br />BLACK DIRT06BLACKSOFT <br />414510.7in. Toft.lbs./ft.9in. To30ft. <br />SANDY CLAY638BROWNSOFT <br />7143in. Toft. <br />ROCKS/CLAY/GRAVEL38128GRAYMEDIUM4185in. Toft. <br />CLAY/GRAVEL128130GRAYMEDIUM <br />GRAVEL/SHALE130138BRN/GRYMEDIUM <br />Open Hole <br />Fromft.To185ft. <br />143 <br />SANDSTONE/SHALE138185TAN/GRYHARD <br />TypeMake <br />Screen? <br />Static Water Level <br />21ft.top of casingMeasure07/14/2009 <br />Pumping Level (below land surface) <br />ft.5hrs.Pumping at20g.p.m. <br />Wellhead Completion <br />Pitless adapter manufacturer <br />Model <br />BAKERSNAPPY <br />Casing Protection12 in. above grade <br />At-grade (Environmental Wells and Borings ONLY) <br />Well Grouted? <br />Grouting InformationYesNoNot Specified <br />MaterialAmountFromTo <br />bentonite5Sacks0ft.50ft. <br />Nearest Known Source of Contamination <br />Direction <br />50North <br />feetSeptic tank/drain fieldType <br />Well disinfected upon completion?YesNo <br />Pump <br />Not InstalledDate Installed07/16/2009 <br />Manufacturer's name <br />GRUNDFOS <br />HP <br />Model Number <br />1Volt23 <br />16S10-10 <br />Length of drop pipeCapacity <br />ftg.p.Typ <br />6316Submersible <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 />St.Lawrence-Tunnel CitySt.Lawrence- <br />Last StratDepth to Bedrock <br />ft <br />St.Lawrence-Tunnel City130 <br />Located by <br />Minnesota Geological Survey <br />Remarks <br />Locate Method <br />Digitization (Screen) - Map (1:24,000) (15 meters or <br />REPLACEMENT WELL. <br />UTM - NAD83, Zone 15, Meters <br />SystemXY <br />4613905009037 <br />NAMES OF DRILLER: LUCAS PRAUGHT AND ED RENNER <br />Unique Number VerificationInput Date <br />Address verification01/04/2010 <br />Angled Drill Hole <br />Well Contractor <br />EH Renner and Sons, Inc. 1431SEE REMARKS <br />Licensee BusinessLic. or Reg. No.Name of Driller <br />768697 <br />Printed on 10/13/2020 <br />Minnesota Well Index Report <br />HE-01205-15 <br /> <br />