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Minnesota Unique Well Number <br /> County Sherburne MINNESOTA DEPARTMENT OF HEALTH <br /> WELL AND BORING REPORT Entry Date 12/01/1990 <br /> 421447 Quad Lake Update Date 066/02/2014/2014 <br /> Quad ID 137A Minnesota Statutes Chapter 1031 <br /> Received Date <br /> Well Name Township Range Dir Section Subsection Well Depth Depth Completed Date Well Completed <br /> MANTHEI HOG 34 26 W 34 DADDBC 137 ft. 137 ft. 09/04/1987 <br /> Elevation 978 ft. Elev.Method 7.5 minute topographic map(+/-5 feet) Drill Method Non-specified Rotary Drill Fluid <br /> Address Use domestic Status Active <br /> C/W 23130 112TH STMN WellHydrofractured? Yes No From To <br /> Casing Type Single casing Joint Welded <br /> Stratigraphy Information Drive Shoe? Yes ❑ No ❑ Above/Below 1 ft. <br /> Geological Material From To(ft.) Color Hardness Casing Diameter Weight Hole Diameter <br /> GRAVEL 0 30 ORANGE SOFT 4 in.To 121 ft. 10.7 lbs./ft. 6.2 in.To 137 ft. <br /> FINE GRAVEL 30 50 ORANGE SOFT <br /> COARSE GRAVEL 50 59 ORANGE SOFT <br /> CLAY 59 67 BLUE MEDIUM <br /> GRAVEL 67 68 DARK MEDIUM <br /> CLAY 68 82 RED HARD Pen Hole From ft. To ft. <br /> BOULDER 82 84 HARD Screen? Type stainless Make JOHNSON <br /> Diameter Slot/Gauze Length Set <br /> GRAVEL 84 89 DK.RED HARD 4 in. 15 4 ft. 121 ft. 125 ft. <br /> CLAY 89 95 RED HARD <br /> COARSE GRAVEL 95 97 DARK HARD Static Water Level <br /> GRAVEL&QUARTZ 97 106 DK.ORN HARD 34 ft. land surface Measure 09/04/1987 <br /> SAND&LOTS OF 106 113 ORANGE SOFT <br /> SAND 113 126 YELLOW MEDIUM Pumping Level(below land surface) <br /> VERY FINE SAND 126 137 YELLOW SOFT 50 ft. 3 hrs. Pumping at 75 9- <br /> p.m-Wellhead Completion <br /> Pitless adapter manufacturer SNAPPY Model <br /> ❑ Casing Protection ❑ 12 in.above grade <br /> ❑ At-grade(Environmental Wells and Borings ONLY) <br /> Grouting Information Well Grouted? 0 Yes ❑ No ❑ Not Specified <br /> Material Amount From To <br /> bentonite 0 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 <br /> Manufacturer's name <br /> Model Number HP Volt <br /> Length of drop pipe ft Capacity g.p, Typ <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-yellow 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-Mad83,Zone 15,Meters X 456856 Y 5026410 <br /> Unique Number Verification Information from Inpute Date 04/12/1995 <br /> Angled Drill Hole <br /> Well Contractor <br /> Ingleside Engr. 27355 STEVENS,J. <br /> Licensee Business Lie.or Reg.No. Name of Driller <br /> Minnesota Well Index Report 421447 Printed on 08/16/2016 <br /> HE-01205-15 <br />