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Minnesota. Unique Well Number <br />494213 <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 12/23/1991 <br />Update Date 08/18/2014 <br />Received Date <br />Well Name Township Range Dir Section Subsection <br />GORHAM, GARY 32 25 W 30 ABADCB <br />Elevation 878 ft. Elev. Method 7.5 minute topographic map (+/- 5 feet) <br />Well Depth Depth Completed Date Well Completed <br />211 ft. 211 ft. 08/07/1991 <br />Drill Method Non -specified Rotary Drill Fluid Bentonite <br />Use domestic Status Active <br />Address <br />C/W 14801 BOWERS DR NW RAMSEY MN 55303 <br />Well Hydrofractured? Yes ❑ No ❑ From To <br />Casing Type <br />Drive Shoe? <br />Single casing Joint Threaded <br />Stratigraphy Information <br />Geological Material <br />SAND & GRAVEL <br />GRAVEL <br />CLAY <br />CLAY & GRAVEL <br />SHALE & SANDSTONE <br />SANDSTONE & SHALE <br />From <br />0 <br />14 <br />40 <br />45 <br />130 <br />150 <br />To (ft.) <br />14 <br />40 <br />45 <br />130 <br />150 <br />211 <br />Color <br />TAN <br />TAN <br />BROWN <br />BROWN <br />TAN <br />TAN/BRN <br />Hardness <br />SOFT <br />MEDIUM <br />HARD <br />HARD <br />MEDIUM <br />HARD <br />Yes X No ❑ Above/Below 1 ft. <br />Casing Diameter Weight Hole Diameter <br />4 in. To 151 ft. 11 lbs./ft. 4 in. To 211 ft. <br />Open Hole From 151 ft. To 211 ft. <br />Screen? ❑ Type Make <br />Static Water Level <br />33 ft. land surface Measure 08/05/1991 <br />Pumping Level (below land surface) <br />43 ft. 3 hrs. Pumping at 49 g.p.m. <br />Wellhead Completion <br />Pitless adapter <br />❑ Casing <br />❑ At -grade <br />manufacturer MONITOR Model 5PS45BS4C1 <br />Protection X 12 in. above grade <br />(Environmental Wells and Borings ONLY) <br />Grouting Information <br />Material <br />bentonite <br />Well Grouted? X Yes ❑ No ❑ Not Specified <br />Amount From To <br />ft. ft. <br />Nearest Known <br />57 feet <br />Well disinfected <br />Source of Contamination <br />West Direction Septic tank/drain field Type <br />upon completion? X Yes ❑ No <br />Pump <br />Manufacturer's <br />Model Number <br />Length of drop <br />❑ Not Installed Date Installed 08/07/1991 <br />name AERMOTOR <br />SD 20-75 HP 0.75 Volt 230 <br />pipe 60 ft Capacity 18 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 St.Lawrence-Tunnel City Aquifer Tunnel City <br />Last Strat Tunnel City Group Depth to Bedrock 130 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 461244 Y 5009740 <br />Unique Number Verification Information from Input Date 05/17/2006 <br />Remarks <br />Angled Drill Hole <br />Well Contractor <br />Hadden Well Co. 02164 HADDEN, M. <br />Licensee Business Lic. or Reg. No. Name of Driller <br />Minnesota Well Index Report <br />494213 <br />Printed on 10/13/2020 <br />HE-01205-15 <br />