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WELL lJ w+r 3 2 2_i O S 5 A M1K '1320259059433 MINNESOTA DEPARTMENT of HEALTH N O. 1 )2 4;OrA 13,.._1/1 <br /> verLL NO. <br /> Coy*Mow WELL AND BORING RECORD • — <br /> Sherburne Awrrr..ota Statute,Ch piw?031 664852 <br /> TarrNb Nano Tewn.lNp N. : Ns.• Becdat ND.' Faelbn Will DEPTH(rrorRoei.d) Data Walt Cpep_ - <br /> % x r _. • <br /> w Numbs.11Mnet Nona alb.end DO Cod.of Wed Location • • a RN/Nolte, aaLUNO&. n oo - r <br /> o Cabin Tod • .0 OtWen : . 0 Ou, <br /> Show erect l o o*S O n d well bl a dll00 orb 1M i l d s'� $NNdt m d s,�ll 1 1 0 0 Ate'•''' 4.�!4I • O Jatbd <br /> �r t_ <br /> . A 'I i <br /> r oalulNO.iLllo •�w61k1+MVnoF!AeTUStE01 OYES 0 N <br /> USE <br /> 11111111/ • O Dedie stlo _ D 40 MYt6• A O ettkiewygoteeerdtei <br /> ,O unseen M O Mon.olpmrnijKW; 7 NamoM O ertOn.eon NON.��� ry ' CASING Or t O Yr •.,Q No NGLip1AM,r • • • •��� N0 i # <br /> O Pigott o'Me aded O watd.d <br /> O <br /> • <br /> 1. ^"'n-� . . <br /> . . <br /> CASING DIA NITIR WEIGHT <br /> PROPERTY OWNER'S NAME N;le N. • .Es" fin.to_ e.• <br /> . in a A ea/}I. Lt I. t <br /> Properly ova***mailing adorns It afferent am well Wagon addri,es Indicated Mow. •IL W • - ..A _ • IbIML • —h.ro_R. <br /> 8OneeN (VON MOLE <br /> • Make - from Rte S. <br /> TYOe—_ Diem. <br /> IdotpW[e_._ Leneth <br /> Set eerwsen_ R.and & FITTING <br /> STATIC WATCn Level <br /> W U. oNNRL`.J.K Ever e.0 oaow 0 eon land sudaa Dabmwaed <br /> PUMPING ISM(below w+d wra.csl <br /> WO Ownst s mNinp whim*N dreamt man Moen),ownds address Indicated.cow. IL altar reds.pu <br /> mpUp_ —p:p.Rl . <br /> w <br /> weLL HEAD COMPLETION <br /> o Now Waffler manufacturer ,.maul ... <br /> O Cesrnp Probc*on 0 12 in.above rids <br /> O et•p soe Iew+ronrnmrrral Wes and oorin sONLYI <br /> OpOVYINOINrOAr ATIQN <br /> Wdl yrwedt O Teo L1 No <br /> 1. <br /> GEOLOGICAL MATERIALS COLOR HARDNESS OF FROM 1 TO MOON O NdataTwr1 0 8.nlonle .0 Conasb 0 flier ScM,emwnlb <br /> l YOm b R. _ _ D yd. D baps <br /> Tan Irvin to n. O vas.r ales <br /> Sandstone & Shale +-�G►reen- S-M 200 230 hem 10 A. —.. 0 yde.0 bete <br /> G gat NEAREST KNOWN SOURCE OF OONTAMINATION <br /> Sandstone & Shale Green S-14 230 285 —-.- Nat direction tWa <br /> Woo dwM.ded upon completion? O Yes 0 No • - • <br /> Sandstone Yellow S 285 290 "tom' <br /> Yellow 0 Netinalelod Ws molaUSd <br /> 5andstone Tan S 290 295 menetedoehnanw . <br /> Meom number No VWr. <br /> Sandstone Tan S 295 335 Longaadro.tNp. R. Comity. 9.P" <br /> Yellow <br /> Sandstone . Tan.. . . • S •S . 335 340 • Type: o Qubnienwe 01..S.Tioln. 0 R•aonCb aw D Jet p <br /> ABANDONED WQ1A . • •.. . <br /> wands tone Salmon H 340 341 Dams. p haw my not h Ilp and not staled w.il(sIl o Yee O No <br /> VARIANCE • • .. . <br /> • Wu■uedntc•wonted Mom iha 1.404 ex thIs well . O You O No . •TNI <br /> • / ' MU-CONTRACTOR CERTIFICATION . <br /> Um•a•oond#flat,dswe d.: �y• I. Thaws*Wa OrWid ands my supervision and a acooreame win Wane ota Ruhr.Cnapl.r 472S. <br /> REMARKS.ELEVATION.SOURCE OF DATA. JAN TM Mlonnadon oorRatned h MIh rayon Y Cue lo Ow tent d my lero,.ladye- <br /> �`[/?0p2 <br /> .- R�`•-C1 v/ LbMMM Eluelm.d Nam. Lk or AO&N•0. <br /> 'A WEI/ E� <br /> 4r- MGT . <br /> �9!Sl 6l LSt�\\� A 0m d A prs..n.Ww$ efure ow. <br /> Name d Drew oar <br /> MINN. DEPT. OF HEALTH COPY <br /> 545412054Y ••v.WI, <br /> IC%140-0020 <br />