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Minnesota Unique Well Number <br /> Count Anoka MINNESOTA DEPARTMENT OF HEALTH <br /> y WELL AND BORING REPORT Entry Date 04/15/1991 <br /> 450174 Quad Nowthen Update Date 02/14/2014 <br /> Quad ID 136C Minnesota Statutes Chapter 1031 <br /> �Q Received Date <br /> Well Name Township Range Dir Section Subsection Well Depth Depth Completed Date Well Completed <br /> KOEPP,GLENN 32 25 W 3 CDDDDB 58 ft. 58 ft. 09/10/1988 <br /> Elevation 885 ft. Elev.Method 7.5 minute topographic map(+/-5 feet) Drill Method Drill Fluid <br /> Address Use domestic Status Active <br /> Well 6841 173RD AV NW RAMSEY MN 55303 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 GRAVEL 0 11 BROWN HARD 4 in.To 50 ft. lbs./ft. 6.2 in.To 58 ft. <br /> CLAY&GRAVEL 11 28 BROWN MEDIUM <br /> SAND&GRAVEL 28 58 BROWN SOFT <br /> Open Hole From ft. To ft. <br /> Screen? X❑ Type stainless Make JOHNSON <br /> Diameter Slot/Gauze Length Set <br /> 2 in. 12 12.4 ft. 50 ft. 58 ft. <br /> Static Water Level <br /> 15 ft. land surface Measure 09/10/198 8 <br /> Pumping Level(below land surface) <br /> 45 ft. 1 hrs. Pumping at 30 g.p.m. <br /> Wellhead Completion <br /> Pitless adapter manufacturer MONITOR Model 8PL41UC1 <br /> ❑ Casing Protection ❑ 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 /> neat cement 3 Sacks ft. 30 ft. <br /> Nearest Known Source of Contamination <br /> feet Direction Type <br /> Well disinfected upon completion? Yes ❑ No <br /> Pump ❑ Not Installed Date Installed 09/26/1988 <br /> Manufacturer's name MYERS <br /> Model Number SJ724511P HP 0.75 Volt 230 <br /> Length of drop pipe 33 ft Capacity 15 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 Aquifer Quat.buried <br /> Last Strat sand+larger-brown Depth to Bedrock ft <br /> Located by Minnesota Geological Survey <br /> Remarks Locate Method Digitized-scale 1:24,000 or larger(Digitizing Table) <br /> System UTM-NAD83,Zone 15,Meters X 465461 Y 5014680 <br /> Unique Number Verification Address verification Input Date 01/01/1990 <br /> Angled Drill Hole <br /> Well Contractor <br /> Mork Well Co. 02133 LAWRENCE,R. <br /> Licensee Business Lic.or Reg.No. Name of Driller <br /> Minnesota Well Index Report 450174 Printed on 07/13/2021 <br /> HE-01205-15 <br />