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Minnesota Unique Well Number <br /> County Sherburne MINNESOTA DEPARTMENT OF HEALTH <br /> WELL AND BORING REPORT Entry Date 07/10/1998 <br /> Quad Lake Update Date <br /> 609084 <br /> Quad ID 137A Minnesota Statutes Chapter 1031 <br /> Received Date 02/14/2014 <br /> Well Name Township Range Dir Section Subsection Well Depth Depth Completed Date Well Completed <br /> DILLON,JIM 34 26 W 34 DBCAAC 171 ft. 171 ft. 03/26/1998 <br /> Elevation 1028 Elev.Method 7.5 minute topographic map(+/-5 feet) Drill Method Non-specified Rotary Drill Fluid Other <br /> Address Use domestic Status Active <br /> Well 23127 169 HY ELK RIVER MN Well Hydrofractured? Yes <br /> No From To <br /> Casing Type Single casing Joint Welded <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 68 BRNBLK SOFT 4 in.To 161 ft. lbs./ft. 6.5 in.To 161 ft. <br /> SAND,CLAY&ROCKS 68 159 BRNBLK MEDIUM <br /> SAND&GRAVEL 159 171 VARIED SOFT <br /> Open Hole From ft. To ft. <br /> Screen? X❑ Type plastic Make <br /> Diameter Slot/Gauze Length Set <br /> 4 in. 12 10 ft. 161 ft. 171 ft. <br /> Static Water Level <br /> 75 ft. Land surface Measure 03/26/1998 <br /> Pumping Level(below land surface) <br /> 120 ft. 3 hrs. Pumping at 30 9- <br /> p.m-Wellhead Completion <br /> Pitless adapter manufacturer MONITOR Model 4AO5.5 <br /> ❑ Casing Protection ❑X 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 /> High solids bentonite 3 Sacks 0 ft. 30 ft. <br /> Cuttings 30 ft. 161 ft. <br /> Nearest Known Source of Contamination <br /> 50 feet Southeas Direction Septic tank/drain field Type <br /> Well disinfected upon completion? Yes ❑ No <br /> Pump ❑ Not Installed Date Installed 04/10/1998 <br /> Manufacturer's name AERMOTOR <br /> Model Number A25B-150 HP 1_5 Volt 230 <br /> Length of drop pipe 120 ft Capacity 25 g-p- Typ Submersible <br /> Abandoned <br /> Does property 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 X❑ No <br /> Miscellaneous <br /> First Bedrock Aquifer Quat.buried <br /> Last Strat sand+larger Depth to Bedrock ft <br /> Located by Minnesota Geological Survey <br /> Remarks Locate Method GPS SA Off(averaged) <br /> System UTM-Mad83,Zone 15,Meters X 456299 Y 5026506 <br /> Unique Number Verification Address verification Inpute Date 11/12/2010 <br /> Angled Drill Hole <br /> Well Contractor <br /> McAlpine Well Drilling 27695 MCALPINE,S. <br /> Licensee Business Lie.or Reg.No. Name of Driller <br /> Minnesota Well Index Report 609084 Printed on 05/19/2016 <br /> HE-01205-15 <br />