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Well Sealing Doc 'WELL OEt'84RING.LOCATION � 'A3 AA�t iIAE V7 p #1F.At tH tnnHSdYa Y1�i tl Bpr ng } 1'1 WELL SND DU11H G 7S i.t�1G Rl; OElf3 sealln ;Ng taJ cqunty ie ..,-.,.,-..-„,,,,:r.„„'-• AMri(tBsiv Uttlqu9 GY,i,,(4o _ i„ W ; y Anoka ° ^ =r a n� t .$taf�rress:chapr&?los, z F "v ;f Tav/,lship f tamA Township N0: Fame Nd Seatiort pia FtaatIonT{tttn-+•I ,pate;foaled flare Welt or Boring t g straoted ;Fridley 30. • 24 ` 13 ` SW SW,ItNi 1/13/12 Unknown '` "' _ c�«t /•dry t t3PS secbnrtS teptb I3gfora$eaAna' 9 f._ 7/ g t fade ea9 - r mi<i4tap L@CATIQNy' Longitude degrees minutae 7,,,,;..... ewto tF�F?{i5! STAT WA E LEVEL y tVuum§Tical$freer Address or Ffre,Nurnder and City wf 'o Sorl,ttt t ooaffon ]Singi'Aga for 1�Tuldaquilo �'"• 11•/}3/'12 _ RiNG as fired Q Estknated Date Mt#asured • . : 6581 Central Ave.Fridley,IVlN`65432 '' �ratersupp�y�+yelt�Mant:'�rerl - r `; • Slaw ekact an o€wall o--dorir ilt secNc>n grid tv °X la gorf&htlwl rtyt Q Env.i3ara n10 [J Etthgr tt tetow 0•above'and•euifaae '. N • • ` ASING T4'PE(S) f• + }$teei { 6#0.., Tile ©Oth6r wE1�LHEAR OOMPI�ETIQN E outage:q wan house [ At tdrle Inside mart c?ftset '� ( }.."77'Adapter/llnit lauded sp Pit , µ �,6uriGd l •'• sUP �. �� � �]weU Pit fisher Y • ..,_._.:_.:,,,...„..,...:,..,,,,,,,,,,:,.-,,,,:..•,.....-::,,,,.?''',..:..-'.',-.-;-:.:„:;;,,:. <.,•...•.:--,,r,.,:.' PR E .14--r'.444.. OWNER S @MPANY N�1M1 JN (8} D>v c a;ua t�1SQII fl tet Depth Set Cb;oversize lel Antlular space Ini6al!V grouteQ7 YPraperYp owner s matlMgaddress n•d-::. than wst r�a,1'-adress IrHf�eted above ' in from to 9 " ft �]Yes Q Yes {foknoam a lettlh',-::„:" 1 �, 13156AveN' • xr },' Fridley, 55432 in from t+ o ft p Yes 7 No p vet p wo -.-..p.-Unknown [•••:-:: C',."..,'1.' ''-':',.....'.''.'., F in.from fL Q Vea 3 Q No,d Q Yes Oro ©Unknown x l`�' YELL OWNER I+}4MEIQOMPM1yNAM SRF N/OPEN HOLE n fa Well ownefo mating address n different than Praper!ygwners•address indicated above Scieen from to ff. '9,1.7..r:,-,,-:7/,,..','',. ..4.'''-±''''' Open Hole-from to ft - _ a '� F - O r UCTIONA t 1� ,, ,, f. e ap Pipe Q Check Vaives}? r Qlpel�rt¢ FIJIObstruadah 1 Pipe&Jet ' : '►YPe4f4ans'�tYbsarib8}' s r .Fuled' WEOLOG iC`AL MAtERIAL ao�OIR a0wdait0w�, bafruatidna,i'ernbved7 res; Q Ns ;:bdsorlF>� , if not knftw ,trld cafe ssUmated toP+�latlnp tQ9 Vicom treark f we11.or orj PUMP De ';well•jet ! 3 f SanC Brown_ f• Q ,q' . ` " d Reino+ie4 ':.';,;.'...:,-,.1.71.. NotFieseut Q Other v ' Clay_ Gray '" 32 66 METHt�b'lig`D,TOSQA' A(INULARs�AcE$ETW�i`EN2OASINGS4OACASINGANDBOREHOLES Gravel $row . • _:::.,......':55,-;•,..t.'•:-..:.'..,...2 Q NR Annular Sporn EFarists 2'D Amwlai' paa4 C�rout4d widt;Trorrus Pipe; i G0&ing Pertoratlon/RerrlryveJ Glrayel , $'own • Ir from .:,-:-.1.2.:-.-..,:...: tt ©Perforated Q Removed .Y 12.7 1.36 � I ! jit from to ft ®perforated D Removed 1':•, F1 t fsA .x df Pe fpr ... -i + ©t.�ther f GROUTING MATERIAL�$} (One bag,o€consist a 94 Ibe.4 otne batt O begtonite;=80 Ibs3 0 � .' 6 ,i-1 r Neal�ir011t ' Y�--7 - ' iarQtrt rg•4atetir�l i'orlt, to a YaNa doge r from-' to :.,: ry ... : ti „ iL ands s • l'''',. u .1 ' ` � � r` from 4o ft Yards_,_,____. bay s R5MARKS SOURCE qF DAtA,Rt rfULT'IESJN SEAUMO t tfaar-unaaaled and r nuSe<€well'inporl tg on;properry?`rQ Yss,i$a1 ;Hpw,}iany7 i; LIQENSEO�7R REGIBtEREDt�`ON�AAGTOF(vE1(rIMCATION n '1Trie? I3 QK Pains.*Feledtn ecardapce Mmrtseata Rates�;Qgap(err47 .The illformatiorrceontakred Irlihls report " G From: 1315 66"Ave- , .",!-....h•-:.,.',,,,-,:-:... •.•.,,,,1:'',-,nor sag � G�eblogy Is rite bestof knawt e Water bevel'in Above V `elle 65 Date'W e� i 'amen k983 ` _ Ili, evd er d'i inc� 1431 ater_L a ,.r ', ; tfcerise arAegistratlpii No ; I Weil close by Unique 171830 a�►ti• x' il/26i12 • cerfit%d't?eprasent,;.,,i,4.04*..7 �ed Rep Na bad I: Keev�n 5'oleite.T�ei�nI : t •--::::::„,' 1 ar z arireofJjeraonSe UVBfrarHonr�, •> , '+IE-01 15 IC#14O-O4ta • z w kw qtr :ti