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Minnesota. Unique Well Number <br />768697 <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 10/09/2009 <br />Update Date 08/18/2014 <br />Received Date 09/08/2009 <br />Well Name Township Range Dir Section Subsection <br />OLSON, BRYAN 32 25 W 30 DAAABC <br />Elevation 867 ft. Elev. Method 7.5 minute topographic map (+/- 5 feet) <br />Well Depth Depth Completed Date Well Completed <br />185 ft. 185 ft. 07/10/2009 <br />Drill Method Non -specified Rotary Drill Fluid Bentonite <br />Use domestic Status Active <br />Address <br />C/W 14513 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 From <br />BLACK DIRT 0 <br />SANDY CLAY 6 <br />ROCKS/CLAY/GRAVEL 38 <br />CLAY/GRAVEL 128 <br />GRAVEL/SHALE 130 <br />SANDSTONE/SHALE 138 <br />To (ft.) <br />6 <br />38 <br />128 <br />130 <br />138 <br />185 <br />Color <br />BLACK <br />BROWN <br />GRAY <br />GRAY <br />BRN/GRY <br />TAN/GRY <br />Hardness <br />SOFT <br />SOFT <br />MEDIUM <br />MEDIUM <br />MEDIUM <br />HARD <br />Yes X No ❑ Above/Below <br />Casing Diameter Weight Hole Diameter <br />4 in. To 145 ft. 10.7 lbs./ft. 9 in. To 30 ft. <br />7 in. To 143 ft. <br />4 in. To 185 ft. <br />Open Hole From 143 ft. To 185 ft. <br />Screen? ❑ Type Make <br />Static Water Level <br />21 ft. top of casing Measure 07/14/2009 <br />Pumping Level (below land surface) <br />ft. 5 hrs. Pumping at 20 g.p.m. <br />Wellhead Completion <br />Pitless adapter <br />❑ Casing <br />❑ At -grade <br />manufacturer BAKER Model SNAPPY <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 />5 Sacks 0 ft. 50 ft. <br />Nearest Known <br />50 feet <br />Well disinfected <br />Source of Contamination <br />North 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 07/16/2009 <br />name GRUNDFOS <br />16S10-10 HP 1 Volt 23 <br />pipe 63 ft Capacity 16 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 <br />granted from the MDH for this well? ❑ Yes X No <br />Miscellaneous <br />First Bedrock St.Lawrence-Tunnel City Aquifer St.Lawrence- <br />Last Strat St.Lawrence-Tunnel City 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 <br />y461390 Y 5009037 <br />Unique Number Verification Address verification Input Date 01/04/2010 <br />Remarks <br />REPLACEMENT WELL. <br />NAMES OF DRILLER: LUCAS PRAUGHT AND ED RENNER <br />Angled Drill Hole <br />Well Contractor <br />EH Renner and Sons, Inc. 1431 SEE REMARKS <br />Licensee Business Lic. or Reg. No. Name of Driller <br />Minnesota We11 Index Report <br />768697 <br />Printed on 10/13/2020 <br />HE-01205-15 <br />