01-12-2005 Council Agenda - Laserfiche WebLink

Home Browse Search

WELL DISCLOSURE STATEMENT 54. Page 2 ()LA__ Pages 55. INSTRUCTIONS FOR COMPLETING THE WELL DISCLOSURE STATEMENT 56. DEFINITION 57. A "well" means an excavation that is drilled, cored, bored, washed, driven, dug, jetted, or otherwise 58. constructed if the excavation is intended for the location, diversion, artificial recharge, or acquisition of 59. groundwater. 60. MINNESOTA UNIQUE WELL NUMBER 61. All new wells constructed AFTER January 1, 1975 should have been assigned a Minnesota unique well 62. number by the person constructing the well. If the well was constructed after this date you should have the 63. unique well number in your property records. If you are unable to locate your unique well number and the well 64. was constructed AFTER January 1, 1975, contact your well contractor. If no unique well number is available, 65. please indicate the depth and year of construction for each well. 66. WELL TYPE 67. Use one of the following terms to describe the well type. 68. WATER WELL: A water well is any type of well used to extract groundwater for private or public use. 69. Examples of water wells are: domestic wells, drive -point wells, dug wells, remedial wells, and municipal 70. wells. 71. IRRIGATION WELL: An irrigation well is a well used to irrigate agricultural lands. These are typically large 72. diameter wells connected to a large pressure distribution system. 73. MONITORING WELL: A monitoring well is a well used to monitor groundwater contamination. The well is 74. typically used to access groundwater for the extraction of samples. 75. DEWATERING WELL: A dewatering well is a well used to lower groundwater levels to allow for construction 76. or use of underground spaces. 77. INDUSTRIAUCOMMERCIAL WELL: An industrial /commercial well is a nonpotable well used to extract 78. groundwater for any nonpotable use including groundwater thermal exchange wells (heat pumps and heat 79. loops). 80. WELL USE STATUS 81. Indicate the use status of each well. CHECK ONLY 1 BOX PER WELL. 82. IN USE: A well is "in use" if the well is operated on a daily, regular, or seasonal basis. A well in 83. use includes a well that operates for the purpose of irrigation, fire protection, or emergency pumping. 84. NOT IN USE: A well is "not in use" if the well does not meet the definition of "in use" above and has not 85. been sealed by a licensed well contractor. 86. SEALED: A well is "sealed" if a licensed contractor has completely filled a well 87. by pumping grout material throughout the entire bore hole after removal of any obstructions from 88. the well. A well is "capped" if it has a metal or plastic cap or cover which is threaded, bolted, or welded into the 89. top of the well to prevent entry into the well. A "capped" well is not a "sealed" well. 90. If the well has been sealed by someone other than a licensed well contractor or a licensed well sealing contractor, 91. check the well status as not in use. If you have any questions, please contact the Minnesota Department of health, Well Management Section at (651) 215 -0819 (metropolitan Minneapolis -St. Paul) or 1 -800- 383 -9808 (greater Minnesota). MN-WDS-2 (9 /00) -32-