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Minnesota Unique Well Number <br />1 521655 <br />A County Anoka <br />Quad Nowthen <br />Quad ID 136C <br />MINNESOTA DEPARTMENT OF HEALTH <br />WELL AND BORING REPORT <br />Minnesota Statutes Chapter 1031 <br />Entry Date 03/04/1993 <br />Update Date 02/14/2014 <br />Received Date 01/23/1993 <br />Well Name Township Range Dir Section Subsection <br />32 25 W 9 ABDBDB <br />Elevation 898 ft. Elev. Method 7.5 minute topographic map (+/- 5 feet) <br />Well Depth Depth Completed Date Well Completed <br />75 ft. 75 ft. 12/18/1992 <br />Drill Method Non -specified Rotary Drill Fluid Bentonite <br />Use domestic Status Active <br />Address <br />C/W 17151 VARIOLITE ST NW RAMSEY MN <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 />SAND 0 <br />CLAY 35 <br />GRAVEL 45 <br />WATER SAND 60 <br />To (ft.) <br />35 <br />45 <br />60 <br />75 <br />Color <br />Hardness <br />Yes ❑ No X Above/Below <br />Casing Diameter Weight Hole Diameter <br />4 in. To 66 ft. lbs./ft. 8.5 in. To 35 ft. <br />6.5 in. To 75 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. 12 8 ft. 66 ft. 75 ft. <br />Static Water Level <br />15 ft. land surface Measure 12/18/1992 <br />Pumping Level (below land surface) <br />ft. hrs. Pumping at 35 g.p.m. <br />Wellhead Completion <br />Pitless adapter manufacturer WHITEWATER Model <br />❑ Casing Protection ❑ 12 in. above grade <br />❑ At -grade (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 />ft. 35 ft. <br />Nearest Known <br />30 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 01/04/1993 <br />name FLINT AND WALLING <br />HP 0.5 Volt <br />pipe 40 ft Capacity g.p. Typ <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 sand Depth to Bedrock ft <br />Located by Minnesota Geological Survey <br />Locate Method GPS SA Off (averaged) (15 meters) <br />System UTM - NAD83, Zone 15, Meters X 464184 Y 5014413 <br />Unique Number Verification Address verification Input Date 01/04/2010 <br />Remarks <br />Angled Drill Hole <br />Well Contractor <br />Torgerson Well Co. 27056 TORGERSON, S <br />Licensee Business Lic. or Reg. No. Name of Driller <br />Minnesota Well Index Report <br />521655 <br />Printed on 07/13/2021 <br />HE-01205-15 <br />