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Minnesota. Unique Well Number <br />486181 <br />County Anoka <br />Quad Anoka <br />Quad ID 120B <br />MINNESOTA DEPARTMENT OF HEALTH <br />WELL AND BORING REPORT <br />Minnesota Statutes Chapter 1031 <br />Entry Date 12/12/1991 <br />Update Date 02/14/2014 <br />Received Date 09/13/1991 <br />Well Name Township Range Dir Section Subsection <br />32 25 W 30 ADBCAD <br />Elevation 858 ft. Elev. Method 7.5 minute topographic map (+/- 5 feet) <br />Well Depth Depth Completed Date Well Completed <br />145 ft. 145 ft. 06/14/1991 <br />Drill Method Non -specified Rotary Drill Fluid Bentonite <br />Use domestic Status Active <br />Address <br />Well 14623 BOWERS DR NW RAMSEY MN 55303 <br />Well Hydrofractured? Yes ❑ No ❑ From To <br />Casing Type <br />Drive Shoe? <br />Single casing Joint <br />Stratigraphy Information <br />Geological Material From <br />CLAY & GRAVEL 0 <br />GRAVEL 135 <br />To (ft.) <br />135 <br />145 <br />Color <br />BROWN <br />Hardness <br />MEDIUM <br />SOFT <br />Yes ❑ No X Above/Below 1 ft. <br />Casing Diameter Weight Hole Diameter <br />4 in. To 135 ft. lbs./ft. 6 in. To 145 ft. <br />Open Hole From ft. To ft. <br />Screen? <br />x Type stainless Make JOHNSON <br />Diameter Slot/Gauze Length Set <br />2 in. 15 12.3 ft. 135 ft. 145 ft. <br />Static Water Level <br />13 ft. land surface Measure 06/14/1991 <br />Pumping Level (below land surface) <br />130 ft. 1 hrs. Pumping at 50 g.p.m. <br />Wellhead Completion <br />Pitless adapter <br />❑ Casing <br />❑ At -grade <br />manufacturer MONITOR Model 8PL41UC1 <br />Protection X 12 in. above grade <br />(Environmental Wells and Borings ONLY) <br />Grouting Information <br />Material <br />neat cement <br />Well Grouted? X Yes ❑ No ❑ Not Specified <br />Amount From To <br />0 0 ft. 30 ft. <br />Nearest Known <br />feet <br />Well disinfected <br />Source of Contamination <br />Direction Type <br />upon completion? X Yes ❑ No <br />Pump <br />Manufacturer's <br />Model Number <br />Length of drop <br />❑ Not Installed Date Installed 07/01/1991 <br />name MYERS <br />23242D700 HP 0.5 Volt 230 <br />pipe 50 ft Capacity 10 g.p. Typ Submersible <br />Abandoned <br />Does property <br />have any not in use and not sealed well(s)? ❑ Yes X No <br />Variance <br />Was a variance granted from the MDH for this well? ❑ Yes ❑ No <br />Miscellaneous <br />First Bedrock Aquifer Quat. buried <br />Last Strat gravel (+larger) Depth to Bedrock ft <br />Located by Minnesota Geological Survey <br />Locate Method Digitization (Screen) - Map (1:24,000) (15 meters or <br />System UTM - NAD83, Zone 15, Meters X <br />y461177 Y 5009324 <br />Unique Number Verification Address verification Input Date 07/03/2008 <br />Remarks <br />SECTION MAP. <br />Angled Drill Hole <br />Well Contractor <br />Mork Well Co. 02133 AESHLIMAN, S. <br />Licensee Business Lic. or Reg. No. Name of Driller <br />Minnesota We11 Index Report <br />486181 <br />Printed on 10/13/2020 <br />HE-01205-15 <br />