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Minnesota Unique Well Number <br /> Count Anoka MINNESOTA DEPARTMENT OF HEALTH <br /> y WELL AND BORING REPORT Entry Date 08/05/1997 <br /> 562382 Quad Anoka Update Date 08/18/2014 <br /> Quad ID 120B Minnesota Statutes Chapter 1031 <br /> Q Received Date <br /> Well Name Township Range Dir Section Subsection Well Depth Depth Completed Date Well Completed <br /> 32 25 W 9 ABBCDD 142 ft. 142 ft. 06/20/1995 <br /> Elevation 904 ft. Elev.Method 7.5 minute topographic map(+/-5 feet) Drill Method Non-specified Rotary Drill Fluid Bentonite <br /> Address Use domestic Status Active <br /> Well 17289 VARIOLITE ST NW RAMSEY MN Well Hydrofractured? Yes ❑ No ❑ From To <br /> Casing Type Single casing Joint <br /> Stratigraphy Information Drive Shoe? Yes ❑ No ❑ Above/Below <br /> Geological Material From To(ft.) Color Hardness Casing Diameter Weight Hole Diameter <br /> SAND 0 46 4 in.To 126 ft. 2 lbs./ft. 8 in.To 126 ft. <br /> SAND&CLAY 46 117 4.7 in.To 142 ft. <br /> SANDROCK 117 126 SOFT <br /> SANDROCK 126 142 HARD <br /> Open Hole From 126 ft. To 142 ft. <br /> Screen? ❑ Type Make <br /> Static Water Level <br /> 25 ft. land surface Measure 06/20/1995 <br /> Pumping Level(below land surface) <br /> 50 ft. 1 hrs. Pumping at 25 9- <br /> p.m-Wellhead Completion <br /> Pitless adapter manufacturer MONITOR Model 8PL410 <br /> ❑ Casing Protection 0 12 in.above grade <br /> ❑ At-grade(Environmental Wells and Borings ONLY) <br /> Grouting Information Well Grouted? X❑ Yes ❑ No ❑ Not Specified <br /> Material Amount From To <br /> bentonite 2 Sacks 6 ft. 36 ft. <br /> Nearest Known Source of Contamination <br /> 75 feet Southeas Direction Septic tank/drain field Type <br /> Well disinfected upon completion? Yes ❑ No <br /> Pump ❑ Not Installed Date Installed 07/25/1995 <br /> Manufacturer's name RED JACKET <br /> Model Number 75UI-12BC HP 0.75 Volt 230 <br /> Length of drop pipe 60 ft Capacity g.p. Typ Submersible <br /> Abandoned <br /> Does property have any not in use and not sealed well(s)? ❑ Yes No <br /> Variance <br /> Was a variance granted from the MDH for this well? ❑ Yes ❑ No <br /> Miscellaneous <br /> First Bedrock Tunnel City Group Aquifer Tunnel City <br /> Last Strat Tunnel City Group Depth to Bedrock 117 ft <br /> Located by Minnesota Geological Survey <br /> Remarks Locate Method GPS SA Off(averaged)(15 meters) <br /> System UTM-NAD83,Zone 15,Meters X 464004 Y 5014500 <br /> Unique Number Verification Address verification Input Date 01/04/2010 <br /> Angled Drill Hole <br /> Well Contractor <br /> Lauren McCullough Well 82443 OTTEN,D. <br /> Licensee Business Lic.or Reg.No. Name of Driller <br /> Minnesota Well Index Report 562382 Printed on 07/13/2021 <br /> HE-01205-15 <br />