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Minnesota Unique Well Number MINNESOTA DEPARTMENT OF HEALTH <br />WELL AND BORING REPORT <br />Minnesota Statutes Chapter 1031233887 <br />County Hennepin Entry Date 08/24/1991 <br />Quad New Update Date 12/17/2015 <br />Quad ID 119C Received Date <br />Well Name Township Range Dir Section Subsection Well Depth Depth Completed Date Well Completed <br />29 23 W 7 BBDDCD 58 ft.58 ft. <br />Elevation 925 ft.Elev. Method 7.5 minute topographic map (+/- 5 feet)Drill Method Drill Fluid <br />Address Use domestic Status Active <br />Well Hydrofractured?Yes <br />No <br />From To <br />Casing Type <br />No <br />Above/BelowYesDrive Shoe? <br />Joint <br />C/W 2613 27TH AV NE MINNEAPOLIS MN <br />Geological Material From To (ft.) Color Hardness <br />DRIFT 0 58 <br />LIMESTONE 58 58 <br />Stratigraphy Information <br />Screen?MakeType <br />Open Hole From ft. To ft. <br />Static Water Level <br />Pumping Level (below land surface) <br />Wellhead Completion <br />Pump <br />Nearest Known Source of Contamination <br />Abandoned <br />Variance <br />Well Contractor <br />Minnesota Well Index Report 233887 <br />HE-01205-15 <br />Printed on 09/29/2016 <br />Pitless adapter manufacturer Model <br />At-grade (Environmental Wells and Borings ONLY) <br />Casing Protection 12 in. above grade <br />Does property have any not in use and not sealed well(s)? <br />Grouting Information Well Grouted?Yes No Not Specified <br />No <br />feet Direction Type <br />Well disinfected upon completion?Yes <br />Not Installed Date Installed <br />Manufacturer's name <br />Model Number HP Volt <br />Length of drop pipe Capacity Typftg.p. <br />Yes No <br />Was a variance granted from the MDH for this well?Yes No <br />Licensee Business Lic. or Reg. No. Name of Driller <br />Minnesota Geological Survey MGS HOGE <br />Remarks <br />Platteville Formation <br />Miscellaneous <br />Last Strat <br />Aquifer <br />Depth to Bedrock <br />Located by <br />Locate Method <br />First Bedrock <br />Platteville Formation <br />Minnesota Geological Survey <br />58 <br />Digitization (Screen) - Map (1:24,000) <br />System X Y482465 4984869 <br />ft <br />UTM - Mad83, Zone 15, Meters <br />Unique Number Verification Inpute Date 06/02/2000Address verification <br />Angled Drill Hole <br />89