HomeMy WebLinkAbout2016-02-01 Bells Email - Well & Boring Sealing Record & Demoliton Material Julie Hultman
From: Eric Johnson
Sent: Monday, February 1, 2016 10:55 AM
To: Julie Hultman
Subject: Emailing: Well closure and Demolition Materials - Final Reports from Bell's
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Well closure and Demolition Materials- Final Reports from Bell's
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1
LIGHTNING DISPOSAL, INC. Page 1 of 1
1725 MEADOW VIEW ROAD EAGAN, MN 55121 INVOICE/STATEMENT: 383570
Phone: (651)457-4434 Fax: (5511905-7762 DATE:
RECEIVED ACCOUNT:
STATEMENT TOTAL:
DUE DATE:
FEB - 1 2016
City of Oak Pari Heghts
Bill To: __AM_ PftA Service Location:
BELL'S TRUCKING BELL'S TRUCKING
PO BOX 775 6180 OSGOOD AVE N
STILLWATER, MN 55082 STILLWATER, MN 55082
Service Dates: 6180 Osgood Ave N
DATE REFERENCE/PO DESCRIPTION QUANTITY 1 AMOUNT TOTAL
Previous Balance
CHARGES THIS INVOICE
12/09/15 79761 30 YD DEMO SWITCH 1.00
12/09/15 79761 FSC ROLLOFF 1.00
12/09/15 79761 30 YD DEMO SWITCH 1.00
12/09/15 79761 FSC ROLLOFF 1.00
12/09/15 79761 30 YD DEMO SWITCH 1.00
12/09/15 79761 FSC ROLLOFF 1.00
12/09/15 79761 30 YD DEMO SWITCH 1.00
12/09/15 79761 FSC ROLLOFF 1.00
12/09/15 79762 30 YD DEMO SWITCH 1.00
12/09/15 79762 FSC ROLLOFF 1.00
12/09/15 79762 30 YD DEMO SWITCH 1.00
12/09/15 79762 FSC ROLLOFF 1.00
12/09/15 79762 30 YD DEMO SWITCH 1.00
12/09/15 79762 FSC ROLLOFF 1.00
12/10/15 79791 30 YD DEMO DONE 1.00
12/10/15 79791 FSC ROLLOFF 1.00
We accept Visa, MasterCard payments.
Any invoice not paid by original due date may be subject to a finance charge
Account# 1525-040 of 1.5%per month.
LIGHTNING DISPOSAL, INC. 1725 MEADOW VIEW ROAD EAGAN, MN 55121
MINNESOTA DEPARTMENT OF HEALTH Minnesota Well and Boring
WELL OR BORING LOCATION Sealing No. H
County Name WELL AND BORING SEALING RECORD Minnesota Unique Well No.
Minnesota Statutes.Chapter 1031 or,sseries No.
u n pilerivNo. Fr ownshlp No. !Range Nov.
.Section ction(sm.-.Ig.) Date Sealey Date Wet or Boring Constructed
GPS LOBATION-decimal degrees(to four decimal places) ,R Li kJ;;
Latitude ---- LongitudeDepth Before Sealing I I `l7 ft. Original Depth_ ‘ Q ..—.it.
( STATIC WATER LEVEL
Numerical Street Address or Fire Number and City of Well or Boring Location ("UIFERSingle Aqu
S) ler 0 Muttiaquifer 1242.Z-i1,5
- l}(� r }. �^��� I e � j� WELLIBORING f Measured J Estimated Date Measured
b[} � s Awe 0,44• V k 1' •, ` Water-Supply Well j Monit.Well
Show axed locatio well or boring Sketch map of well r ring
Iln section grid with" bcation,showir�p Env Bore Hole Other _-- -.. ---ft. Iekry above land surface
N tines,roads.and butldings. CASINGa��/ TYPE(S) - —
11111111111111111 (*tee! ❑Plastic _ Tile . Other _-. --.-------•.---
w--L111111111-1-- • WELLHEAD COMPLETION
unimi E
T Outside: ❑Well House At Oracle Inside: ❑Basement Offset
1M11e I I§ r4 Pities Adapter/Urdt L1 Buried 2.1Vell Pit
i Buried
sgj 7j Well Plt Other
I--I Mile.. -) r I Otte!.
P.1*-E%it{OWN_:' NAME.sM(ANYNAME CASING(S)
VII r It , rt• Diameter Depth Set In oversize hole? Annular space Initially grouted?
Property owner's mailing address it different .4,g location address Picketed above yift In.from__CI___ to_,,5 f('__ tt. ;Yes [it No ❑Yes 0 No LI Unknown
P o s. 11S
In.from to 1 Yes 0 No (_:Yes D No []Unknown
SNi �,,i F�5 �y
\\ ({•tr +}. i ly W O . - In from_---_-_ to._. .- . .ft. []Yes . •No i_.]Yes O No 0 Unknown
WELL OWNER'S NAMECOMIrANY NAME SCREEWOPEN HOLE L�
Well owner's maihrg address it different than property owners address indicated above Screen from to _..__----_ft. Open Hole from to /lib b ft-
differentOBSTRUCTIONS
❑Rods/Drop Frye ❑Check Valve(s) L I Debris (_i Fill 15L/No Obstruction
Type of Obstructions(Describe)
GEOLOGICAL MATERIAL COLOR HARDNESS CR FROM TO Obstructions removed? 0 Yes L_1 No Describe _
FORMATION
If not known.hxf;cyte estimated formation b9 from nearby well or boring. PUMP
�I^fn,�`_� ..�� lei\ l /in `Type.5�b1MerSI e -----__ ___...__...--.
+. L1+ *exsitt -4 IV lei\ VG!Lt`d V gi I Removed LE Not Present 0 Other
t„L rikeY`V i` \fat\ stay.I,et( 61 141 �M,/E�THOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS,OR CASING AND BORE HOLE:
YY No Annular Space Exists J Annular Space Grouted with Tram a Pipe Casing Perforation/Removal
: :Perforated '_'Removed
in.from—.._.�._ . to - it. Perforated 7 Removed
Type of Perforator _ .. •
VARIANCE
Was a variance granted from the MDH for this well? Yes ](No The __--_
GROUTING MATERIAL(S)
yy /� (One bag of cement
s.94 lbs.,one fbeg of bentonite.60 lbs.) �
Grouting Materia s 1 n front L"..r�to 1'i tti h____._ yyardsjj_.f% bags
Pe' . _from____to ft.__,*____yards_`__ bags
from --_... t0 -- — t- — — —_____bags
OTHER WELLS AND DORSiGS
REMARKS,SOURCE OF DATA,DIFFICULTIES IN SEALING Other unseated and unused well or boring on property? Li Yes No How many?_- — --
LICENSED OR REGISTERED CONTRACTOR CERTIFICATION
This well or boring was sealed in accordance with Minnesota Rules,Chapter 4725.The information contained in Vita report
Is true to the best of my knowledge.
.-2 S. . a
� L 4
Licensee ,l''..,. ane — License or Registretlnn Mo.
-.t
111111"
-m - ),. , .) -
C' R
red -•es:. .Signature Certified p.No. Date
wroN iAn 'S. Vie it,PROFSSIv H s,d i,d a1 Y I' .:
' PAS RS-wA,S OW.*r':COP' 3(. "} Name of Person -'rg elf or Boring — --- _ — —
I
ME-o14:4-14 ICS 140-0423 5/ISR