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MINNESOTA DEPARTMENT OF HEALTH Update Date 2003/10/10 <br />Unique No. 00127221 WELL AND BORING RECORD <br />Entry Date 1988I04/17 <br />County Name Sherburne Minnesota Statutes Chapter 1031 <br />Well Depth Depth Completed Date Well Completed <br />Township Name Township Range Dir Section Subsection 1 90 ft 1 ft 1 g77/10/27 <br />33 26 W 28 ADDDDA <br />90 <br />Well Name BAUFIELD, MARY Drilling Method Non -specified Rotary <br />Drilling Fluid Well Hydrofractured? ❑ Yes []No <br />Contact's Name BAUFIELD, MARY ft <br />From ft. to <br />11948192ND NW AV <br />GEOLOGICAL MATERIAL COLOR HARDNESS FROM TO <br />SAND BROW 0 50 <br />CLAY BLUE 50 150 <br />WATER SAND BROW 150 190 <br />USGS Quad: Elk River <br />Aquifer: QBAA <br />Re <br />Elevation: 965 <br />Aft Id: <br />Copy <br />Use Domestic <br />Casing Drive Shoe? ❑ Yes ❑ N Hole Diameter <br />Casing Diameter Weight(lbs/ft) <br />4 in. to 185 ft <br />Screen Y Open Hole From ft. to ft <br />Make JOHNSON Type L <br />Diameter Slot Length Set Fitting <br />2 ft. to ft <br />Static Water Level 70 It. from Land surface <br />Date 1977/10/27 <br />PUMPING LEVEL (below land surface) <br />80 ft. after 3 hrs. pumping 30 9•P-m- <br />Well Head Completion <br />Pitless adapter mfr Model <br />Casing Protection ❑ 12 in. above grade <br />❑ At-grade(Environmental Wells and Borings ONLY) <br />Grouting Information Well grouted? 0 Yes <br />No <br />Material From To (ft.) Amount(Vdslba. <br />Y <br />Nearest Known Source of Contamination <br />ft. direction. type <br />Well disinfected upon completion? © Yes ❑ No <br />Pump ❑ Not Installed Date Installed Y <br />Mfr name AERMOTOR <br />Model HP 0.75 Volts <br />Drop Pipe Length 72 ft. Capacity 9-p-m <br />Type S <br />Any not in use and not sealed well(s) on property?❑yes <br />No <br />Was a variance granted from the MDH for this Well? ❑ Yes ❑ No <br />Well CONTRACTOR CERTIFICATION Lic. Or Reg. No. 27056 <br />License Business Name <br />Name of Driller <br />