HomeMy WebLinkAbout2004-11-09 CC Meeting Packet EnclosureMeeting Date November 9th, 2004
Agenda Item Title VSSA Well Permit A
Resources
Time Required: 5 minutes
Agenda Placement: New Business
Oak Park Heights
Request for Council Action
lication to the Mn De t. of Natural
9 9
Originating Department/Res - .! or: E Johnson, City Administrator
Requester's Signature
Action Requested: onsider an
thorize comments to be sent to MnDNR,
authorize staff to discuss
.re.ire an a. •
ENCLOSURE 11
ro riate a eement on VSSA well.
Background/Justification (P ase indicate any previous action, financial
implications including budget information and recommendations).
1. VSSA (McKean's Square) has submitted an application to the MnDNR for permission
to draw from a well over 10,000 gallons per day/1 million gallons per year from the Jordan
Aquifer for irrigation purposes. The well (but not the pumping equipment) has been installed
and may draw water in amounts less than this wiout a DNR permit. This well is located within
the City's Wellhead Protection Area. The City Oak Park Heights may submit comments to
MnDNR by November 11 2004.
2 The October 1st letter (as attached) from the City Engineer states that the City has a
significant concern on the potential conflict of the City's capacity to provide a proper resource
to a new POTABLE WELL without negatively impacting the Applicant's IRRIGATION WELL
Effectively, If the Applicants irrigation well is to be located within the City's POTABLE
WELLHEAD PROTECTION AREA and based on an anticipated drawdown for a possible
POTABLE WATER well it could cause this IRRIGATION WELL to "draw air".
This City's ability to provide drinking water and fire protection to its residents cannot be
subject to a secondary need for lawn irrigation. MnDNR should require that the Applicants
well depth/plans be revised to specifically address this issue per the comments from the
City's Engineer.
Should this Permit be issued to the Applicant without requiring the corrective action as stated
by the City's Engineer then the MnDNR permit should be conditioned to state that if the City
does install a new well that that the Applicant must at that time retrofit their IRRIGATION
WELL to properly handle any anticipated and negative impacts as a result of the City's new
well and that the Applicant waives its rights to any and all damages from the City.
4. Regardless of the MnDNR permits, the entirety of the McKean Square Development is
permitted under a Planned Unit Development (PUD) and a subsequent Development
Agreement. While the Development Agreement between the City and VSSA does discuss
the installation a well the document does not grant unilateral discretion to VSSA on the
location, condition and capacities of such well. Such installation may only be accomplished
via a formal "Amendment" to the PUD Permit or other acceptable agreement. Accordingly,
the applicant is currently not in compliance with PUD permit as the well has been installed
and no PUD amendment or other agreement has preceded that event.
The City has yet to take any particular action on this matter. The City has had some generic
discussions with the Applicant that may ultimately lead to an agreement on the location /use
of such welly Staff recommends that the agreement must at feast include two specific points:
A. That the VSSA irrigation well be modified to the terms outlined in the City
Engineer's October 1 2004 memo.
S. Should the City decide to install a new well(s)within the City's Wellhead
Protection Area, such well(s) may have an impact on the VSSA irrigation
well /operations and vise- versa. VSSA and the City shall agree that City wells
shall maintain a priority and that VSSA shall curtail, alter or cease their well
operations, at their expense, so that the City's well operations may proceed
unencumbered by the VSSA irrigation well.
Action Needed:
Authorize staff to prepare and forward appropriate comments to MnDNR. Per item 2
above.
Authoize staff to prepare an acceptable agreement with VSSA that addresses City
concerns on the VSSA irrigation well. Such agreement would be brought back to the
Council for final approval. Per item 4 above
Bonestroo
Rosene
Anderlik &
Associates
Engineers &Architects
October 1, 2004
Mr. Eric Johnson
City Administrator
City of Oak Park Heights
14168 Oak Park Blvd., P.O. Box 2007
Oak Park Heights, MN 55082-2007
Re: McKean Square
Irrigation Well
BRA. File No. 55-03-129
Dear Eric:
Bonestroo, Rosene, Anderlik and Associates, Inc. is an Affirmative Action /Equal Opportunity Employer
and Employee Owned
Principals: Otto G. Bonestroo, PE. • Marvin L. Sorvala, RE. - ..,enn R. Cook, RE. • Robert G. Schunicht, P.E. •
Jerry A. Bourdon, RE. • Mark A. Hanson, RE.
Senior Consultants: Robert W. Rosene, P.E. • Joseph C. Anderlik, P.E. • Richard E. Turner, P.E. • Susan M. Eberlin, C.P.A.
Associate Principals: Keith A. Gordon, RE. • Robert R. Pfefferie, RE. • Richard W. Foster, P.E. • David O. Loskota, P.E. •
Michael T. Rautmann, P.E. • Ted K. Field, RE. • Kenneth P. Anderson, PE. • Mark R. Rolls, P.E. • David A. Bonestroo. M.B.A. •
Sidney P. Williamson, TAE„ L.S. • Agnes M. Ring, M.B.A. • Allan Rick Schmidt, RE, • Thomas W. Peterson. PE. •
James R. Maland, P.E. • Miles B. Jensen. P.E. • L. Phillip Gravel !I!, P.E. • Daniel J. Edgerton, P.E. • Ismael Martinez, PE. •
Thomas A. Syfko,.PE. • Sheldon J. Johnson • Dale A. Grove, P.E. • Thomas A. Roushar, P.E. • Robert J. Devery, P.E.
Offices: St. Paul, St. Cloud, Rochester and Willmar, MN • Milwaukee, WI • Chicago, IL
Website: www.bonestroo.com
We have reviewed the permit application submitted for water appropriations for the McKean
Square irrigation well. Based on our preliminary analysis of the information, we have the
following comments: .
1. The location and proposed pumping rate of the irrigation well does not appear to pose a
threat to the existing Oak Park Heights municipal wells. The distance from the current
municipal wells is likely great enough that drawdown interference from the irrigation
well on the municipal wells would be negligible.
2. The irrigation well would not likely preclude the City from installing a new municipal
well in the same general area of the City, assuming the new municipal well were located
at least 500 -1 000 feet from the irrigation well. While the irrigation well would be
expected to have some interference on a municipal well in this area, the amount of
interference is likely to be small enough as to not significantly degrade the performance
of a municipal well.
3. A new municipal well located near the irrigation well, however, may have some adverse
impacts on the irrigation well. Specifically, drawdown interference from a high capacity
municipal well may lower the water level in the irrigation well enough to affect the
performance of that well. In the Well and Boring Record for the McKean Square
irrigation well (unique number 712467), the static water level is noted to be 75 feet, with
a pumping level of 175 feet at 300gpm (gallons per minute). The drop pipe length of the
pump was left at 175 feet, with the pump capacity of 300gpm.
The irrigation well is initially planned to pump at 25 0gpm, which would result in a
predicted pumping level of 158 feet, leaving only 17 feet of available head between the
pumping level and the end of the drop pipe. A nearby municipal well pumping at 1000-
1500 gpm could easily have an influence that results in 10 -20 feet of additional
drawdown at the irrigation well, depending on the distance between the wells and the
2335 West Highway 36 . St. Paul, MN 55113 ri 651 - 636 - 4600 u Fax: 651 - 636 -1311
local transmissivity of the aquifer. This could cause the irrigation well to pull air while
both wells are pumping simultaneously. Additionally, further municipal wells (i.e. a
fourth City well) would compound the amount the drawdown at the irrigation well.
Based on our preliminary analysis, we highly recommend that the operators of the McKean
Square irrigation well consider lowering the drop pipe to their pump to gain additional available
head. Since the irrigation well is cased down to 245 feet, there is sufficient room available to
lower the pump in the irrigation well.
Additional analysis of the potential well interference issues can be completed when sites for
future municipal wells are selected.
If you have any questions or require additional information, please contact me at (651) 604 -4815
or Mark Janovec at (651) 604 -4831.
Sincerely,
BONESTROO, ROSENE, ANDERLIK & ASSOCIATES INC
Dennis M. Postler, P.E.
cc: Tom Ozzello, Public Works Director
Jim Butler, Building Official
Scott Richards, City Planner
Mark Vierling, City Attorney
Kathy Widin, din, City Arb orist
Todd A. Erickson Folz, Freeman, Erickson, Inc.
DMP, DDH, File - Bonestroo & Associates
K:\ 55155031291 Word \Work_In_Progressllrrigation Well comments_10- 1- 04.doc
Department cif
Natural 14613ouroee
MINNESOTA DNR PERMIT APPLICATION NUMBER:
b —I
(Note: Comments on this application are Due 30 days from the date of thi jrequ -R� urn Comments to: DNR Waters,
Central Region, 1200 Warner Road, St. Paul, MN 55106.)
FROM: rr\ � l� Sk0 ‹A'C' -tvi
TO:
❑ City /County
❑ Watershed Authority
❑ Cons. District (SWCD)
❑ Corps of Engineers
❑ DNR Wildlife
❑ DNR Fisheries
❑ DNR Eca Services
C DNR Fisheries; APM
PROPOSAL INFORMATION
Applicant:
Protected Water:
Project Description:
sS
Recommendation of Reviewer:
Name of Reviewer:
E-)r kryylv,
REQLJST FOR REVIEW ANL OMMENTS
. ) \ 00s -
DATE OF REQUEST:
FO
S'
PHONE: (651) 772 -7910
Title:
COMMENTS ON PROPOSAL
Comments on Project by Reviewer (attach separate sheet if needed):
Date:
Folz, Freemai, Erickson, Inc.
September 24, 2004
Molly Shodeen
MN DNR Metro Waters
1200 warner Road
St. Paul, MN 55106
RE: Permit Application for Appropriation of Waters of the State
Dear Molly,
Bruce A. Folz, LS
1939.2001
LAND PLANNING + SURVEYING f ENGINEERING
1
Timothy J. Freeman, LS
President
•
Enclosed is the permit application for irrigation purposes for the Presbyterian Homes Facility
located in the City of Oak Park Heights at the Boutwell and McKean Senior Housing Campus.
The Boutwell and McKean Square Campus is currently irrigated with city water. To reduce the
overall cost of irrigation with treated water from the city and to reduce the amount of water drawn
from the ground water resource we have proposed a well and an irrigation pump, which will
operate utilizing an existing pond as a reservoir to allow for a reduction in the rate of pumping
from the well.
The pond level will be maintained with the use of a float system, which will allow for a drop in the
water level. The lag time for the well pump to fill the pond will allow for some potential use of
rainfall that will be collected in the pond, again reducing the need for pumping from the well. The
well will shut off at the existing normal water level in the pond, which is controlled and will
continue to be controlled by the storm outlet structure.
The pump outlet from the well has been designed with an outlet which exits into a rubber lined
rock bed to control erosion. The well water then travels over a constructed waterfall into the
pond/reservoir where the irrigation pump is situated. I have attached a sketch of the delivery
system for clarification.
The total area to be irrigated is approximately 32 acres as identified on the enclosed map. The
period of irrigation as presently determined would be from May through October depending upon
conditions. The amount of water delivered to the area would be approximately one -inch per week.
Subtracting the average rain days for any given year the total estimated water usage for irrigation
is estimated from 12.7 to 18.5 million gallons per year (See the enclosed calculation summary).
This complex and costly system that has been designed will reduce the overall cost of irrigation for
the owners and ultimately conserve the amount of water being pumped from the aquifer.
5620 Memorial Avenue North, Stillwater, MN 55082 4 Phone: (651) 439 -8833 + Fax: (651) 430 -9331 • Website: www ffe -inc. corn
Todd A. Erickson, PE
Vice President
We contacted the Washington Conservation Office and requested the help with a conservation plan
for irrigation and received a statement of opinion rather than any type of technical assistance with
a conservation plan for the site. I have attached their letter dated September 24, 2004 for your
information.
Please contact me if you have any questions or require any additional information in processing
this permit application.
Sincerely,
Folz, Freeman, Erickson, Inc.
Todd A. Erickson, PE
2
5620 Memorial Avenue North, Stillwater, MN 55082 4 Phone: (651) 439 -8833 + Fax: (651) 430 -9331 4 Website: www.ffe- inc.com
Todd A. Erickson, PE
19 President Vice President
Bruce A Folz LS Timothy j Freeman, LS
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▪ C\I 00
A- 02621 -06
(Rev.1/03)
Minnesota
DNR Waters
NOTICE OF WARNING: All information provided on this form is considered to be public informatioj j _
in accordance with the Minnesota Data Privacies Act M.S. 15.1611 to 15.1698 "; ;_ � f' °`;;; .
11 4. 2. Business Name t SEE INSTRUCTIONS,..TYPE OR PRINT CLEARLY ter ; ' r .
t Z.'t
- C T 7 . j wr i VVVFFF
Pt: •`�Tif
� i
(di
1. Applicant Name (landowner or renter)
`S5 r
3. Authorized Agent (if applicable)
1C 1Th 6 Sod 17
5. Mailing Address
2-
Perm
7, Source of Water ( "X" one and complete
a.; 1 One well
b.❑ manifoided wells
c.❑ Stream, ditch, or river (name)
d. Wetland, lake, or impoundment (name) VS `'`''- `0
e.❑ Other
10, Method of Measurement
a Flow Meter
bin Timing Device
c.❑ Electric Power Consumption
d.❑ Other
13. Irrigation of: ( "X" those that apply)
a. ❑ Upland Crops: ❑ Com ❑ Potatoes
❑ Alfalfa ❑ Soybeans
❑ Other
b. ❑ Golf Course: ❑ 9 Hole ❑ 18 Hole ❑Other
c. ❑ Wild Rice
d. ther $Q - r 0 S
16. Total Acres Irrigated
(No. of Acres)
17. Total Annual Use
(Inches /Acre/Year)
18. SOI L AND WATER CONSERVATION PLAN
❑ YES ❑ NO
pplication for Appropriation
of Waters of the State
IRRIGATION
I' Additional information MUST be
supplied for each source.
Refer to instructions (7 & 8) for
requirements.
* Rental Agreement MUST Be Submitted
20. Si
APPLICANT: KEEP A COPY FOR YOUR RECORDS
This information is available in an alternative format upon request.
4. Phone Numbers (with area codes)
65 ,g5 1 -- 0
6. City, State, Zip "7
B. Point of Taking/Pumping Site
a. 5 114 of 114 of SIC 1/4
b. Section No.
c. Township No. 141'
d. Range No. 2.-°
e. CountyN 0 '
It Legal Description -Land Owned /Rented
Township No. Range No. Section Fractional Section /Gov't Lot
14. Irrigation System To Be Used
a. ❑ Center Pivot
b. ❑ Traveling Gun
c. ❑ Linear System
diAi Fixed Sprinkler
e. ❑ Other Lin/
19. Additional Requirements:
re of Land • net; or Authorized Agent
r r+. y
5 "Z:, may ,g f�5 f ey„ e
,57? Lam. r, 5:5 0 6'
‘c bit serving Submit this application and all suppo ng data to the DNR Office ng y ou ( see back for addresses).
9. Means of Taking and Rate
a. Stationary Pump(s) at.' gpm
b. ❑ Portable Pump at gpm
c. ❑ Gravity Flow at gpm /cfs
di ❑ Other gpm/cfs
(circle one)
12. Schedule of Irrigation
DJAN
❑ FEB
❑ MAR
❑ APR
15. Major Soils and Percentage of Each:
SOIL TYPE PERCENTAGE
;Cr £fit
5 Ga
Kw) SEP
,JUN OCT a
f&IJUL ❑ NOV
NAUG ❑ DEC
Map or Air Photo which shows: 1) Point of Taking or Pumping Site 2) Test Hole Location
a.�
3) Boundaries of Property Owned /Rented 4) Property To Be Irrigated
$75.00 Minimum. FILING FEE payable to: "DEPARTMENT OF NATURAL RESOURCES"
..Statement of Justification/Altemative Sources
d. ❑ Additional Documents Required
I hereby make application pursuant to Minnesota Statutes Chapter 103a261 and all supporting rules for a permit to appropriate water in
accordance with all supporting maps, plans, and other information submitted with this application. The information submitted and statements
made concerning this application are true and correct to the best of my knowledge.
21. Date
d e. v/p
o �o
°lo
P.A. No. �
iFFICE USE
ONLY
Date(s) Served
❑ SWC D
❑WSD
❑ CITY
A- 02621 -06
(Rev.1/03)
Minnesota
DNR Waters
NOTICE OF WARNING: All information provided on this form is considered to be public informatioj j _
in accordance with the Minnesota Data Privacies Act M.S. 15.1611 to 15.1698 "; ;_ � f' °`;;; .
11 4. 2. Business Name t SEE INSTRUCTIONS,..TYPE OR PRINT CLEARLY ter ; ' r .
t Z.'t
- C T 7 . j wr i VVVFFF
Pt: •`�Tif
� i
(di
1. Applicant Name (landowner or renter)
`S5 r
3. Authorized Agent (if applicable)
1C 1Th 6 Sod 17
5. Mailing Address
2-
Perm
7, Source of Water ( "X" one and complete
a.; 1 One well
b.❑ manifoided wells
c.❑ Stream, ditch, or river (name)
d. Wetland, lake, or impoundment (name) VS `'`''- `0
e.❑ Other
10, Method of Measurement
a Flow Meter
bin Timing Device
c.❑ Electric Power Consumption
d.❑ Other
13. Irrigation of: ( "X" those that apply)
a. ❑ Upland Crops: ❑ Com ❑ Potatoes
❑ Alfalfa ❑ Soybeans
❑ Other
b. ❑ Golf Course: ❑ 9 Hole ❑ 18 Hole ❑Other
c. ❑ Wild Rice
d. ther $Q - r 0 S
16. Total Acres Irrigated
(No. of Acres)
17. Total Annual Use
(Inches /Acre/Year)
18. SOI L AND WATER CONSERVATION PLAN
❑ YES ❑ NO
pplication for Appropriation
of Waters of the State
IRRIGATION
I' Additional information MUST be
supplied for each source.
Refer to instructions (7 & 8) for
requirements.
* Rental Agreement MUST Be Submitted
20. Si
APPLICANT: KEEP A COPY FOR YOUR RECORDS
This information is available in an alternative format upon request.
4. Phone Numbers (with area codes)
65 ,g5 1 -- 0
6. City, State, Zip "7
B. Point of Taking/Pumping Site
a. 5 114 of 114 of SIC 1/4
b. Section No.
c. Township No. 141'
d. Range No. 2.-°
e. CountyN 0 '
It Legal Description -Land Owned /Rented
Township No. Range No. Section Fractional Section /Gov't Lot
14. Irrigation System To Be Used
a. ❑ Center Pivot
b. ❑ Traveling Gun
c. ❑ Linear System
diAi Fixed Sprinkler
e. ❑ Other Lin/
19. Additional Requirements:
re of Land • net; or Authorized Agent
r r+. y
5 "Z:, may ,g f�5 f ey„ e
,57? Lam. r, 5:5 0 6'
‘c bit serving Submit this application and all suppo ng data to the DNR Office ng y ou ( see back for addresses).
9. Means of Taking and Rate
a. Stationary Pump(s) at.' gpm
b. ❑ Portable Pump at gpm
c. ❑ Gravity Flow at gpm /cfs
di ❑ Other gpm/cfs
(circle one)
12. Schedule of Irrigation
DJAN
❑ FEB
❑ MAR
❑ APR
15. Major Soils and Percentage of Each:
SOIL TYPE PERCENTAGE
;Cr £fit
5 Ga
Kw) SEP
,JUN OCT a
f&IJUL ❑ NOV
NAUG ❑ DEC
Map or Air Photo which shows: 1) Point of Taking or Pumping Site 2) Test Hole Location
a.�
3) Boundaries of Property Owned /Rented 4) Property To Be Irrigated
$75.00 Minimum. FILING FEE payable to: "DEPARTMENT OF NATURAL RESOURCES"
..Statement of Justification/Altemative Sources
d. ❑ Additional Documents Required
I hereby make application pursuant to Minnesota Statutes Chapter 103a261 and all supporting rules for a permit to appropriate water in
accordance with all supporting maps, plans, and other information submitted with this application. The information submitted and statements
made concerning this application are true and correct to the best of my knowledge.
21. Date
d e. v/p
o �o
°lo
Oct 04 04 1O :47
FFE, Inc.
Office Phone (651) 454 -3939 • (715) 386 -3992 • (715) 483 -3939
. Fax (651) 464 -8849
Contractor: Presbyterian Homes
5540 Nolan Avenue North
Oak Park Heights, MN 55082
Contact: Ed Reid
Phone No,: 651-889-7912
2nd Contact: Brett LMS
Phone No.: 651 -- 755.2852
'WELL DRILLING ANO PUMP REPAIRING
20335 FOREST BOULEVARD NORTH (HIGHWAY 61)
FOREST LAKE, MINNESOTA 55025 .
Well Drilled on August 4th, 2004
Well Unique No.: 712467
Depth of Well: 306 feet
Job Location: Norwich Parkway & Nolan Ave.
Legal Description:
Washington County, Baytown Township
Section No. 5, Township No. 29N, Range No. 20W
SE' /4,SW' /4,SE1
Pump Information:
Berkely Model No. 7T20 -350
B77542
20 HP 200 Volt
3 -- Phase
6" Franklin Motor
bbl -4 U-8 "4Zi1
z
U c t U U''
WELL LOCATION
County Name
ashington
Township Name
ytown
GPS Latitude _ degrees
LOCATION:
Longitude degrees
House Number, Street Name, City, and Zip Code of Well Location
Nolan Avenue North
Show exact location of well in section grid with "7C ".
•
PPOPER1T W$t B`S NAME/COMPANY NAME
Y .: Presbyterian Homes
Property vvvner'a mailing address if different than welt location address indicated above.
Ian Ave. North
•k Ra i* Rei ghts , MN 55082
• :r =.
ELL OWNER'S NAME/COMPANY NAME
Well owner's mailing address i1 different than property owners address Indicated above.
•
GEOLOGICAL MATERIALS
Clay & Gravel
Lime
Sandrock .. .
REMARKS, ELEVATION, SOURCE OF DATA, etc,
IC 144-024
Township No. '
29N
w
Range No,
20W
COLOR
Use a second sheet, if needed
r'rC,
Section No.
5
minutes seconds
minutes seconds
HARDNESS OF
MATERIAL
Brown Hard
Yellow Hard
Brown r Me d
IMPORTANT - FILE WITH PROPERTY PAPERS
• WELL OWNER COPY j
MINNESOTA' DEPARTMENT OF•HEALTH
; WELL AND BORING RECORD
Minnesota Statutes, Chapter 1031
Fraction
5;, SW, SE,
or Fire Number
Sketch map of well location.
Showing property fines,
roads and buildings
'TO
5 , z
26
06
'712467
WELL DEPTH (completed)
USE
3 06
Steel
9
f �•' . � Plastic
CASING DIAMETER
.3.
tr
i n. La 05
8 ' in. to C^5
in. to
ft.
tt:
SCREEN
Make
'Type
Slot/Gauze
Set between
STATIC WATER LEVEL
712467
Date Work Completed
❑ Monitoring
❑ Domcstrc ❑ Environ. Bore Hole
❑ Noncommunify PWS Irrigation
❑ Community PWS Dewaterhng •
CASING
Drive Shoe? %J Yes ❑ No
❑ Threaded -j Welded
WEIGHT
54 lbsJlL
ibs.ftt
IbsJtL'
MINNESOTA UNIQUE WELL Na
DRILLING METHOD
❑ Cable Too! .0 Driven 0 Dug
❑ Auger 3R1Ralary • :: ` ❑ Jetted
❑
DRILLING FLUID f4 y WELL:•HYDROFRACTURED? Yes No
r
nTc, s i -1 < Aq t FROM ft. TO 11.
• ❑ Haating/Coaling
❑ Industry/Commercial
❑ Remedial
d
OPEN HOLE
FROM ,f ft. TO '306 tt.
Diam.
Length
It. and ft FITTINGS
toiD below ❑ above and surface Gate measured
PUMPING LEVEL (below and surface)
ft. after 7
WELL HEAD COMPLETION
❑ Pitless adapter manufacturer Model
❑ Casing Protection ] in. above grade
❑ Atgrade (Environmental Wells and Boring ONLY),
GROUTING INFORMATION
Well grouted Yes ❑ No
Grout material Neat cement ❑ Bentonite 0 Concrete ❑ High Solids Bentonite
from_ k/ OS ft. ❑ yds. 0 bags
it. a.r2 yds. ❑ bags
from_ to it ❑ yds. ❑ bags
NEAREST KNOWN SOURCE OF CONTAMIN TION
feet ,,, direction
Well Olsiriledect upon completion 0 Yes :❑ No 4..i i A
PUMP
--c4Not installed Date installed
Manufacturer's name
Model number Tr . 9 4/ O- • HP.?b Volts 2O —
Length al drop~ pipe ) ft. Capacity. g.p,m.
Type: ( Submersible ❑ L.S. Turbine ❑ Reciprocating ❑ Jet ❑
ABANDONED WELLS
Does property have any not in use and not sealed well(s) 0 Yes
VARIANCE
WELL CONTRACTOR CERTIFICATION
This well was drille . . • • r my s
The information • • ntaine • rrt th
me
usiness N
Authorized Re • i sentatmve Signature
h rs. pumpin
0
HOLE DIAM. •
in._ ft.
in. tioVV5It.
Was a variance granted from the MDH ior•this'well? ❑ Yes to `TN4
n and In accordance with Minnesota Rules, Chapter 4725.
True to the hest of my knowledge.
Sons, ..iL. o 2054
r Reg. Na
Date
type
UrEae ikek_ "` 08
Name of Driller .
HE-012054e IR./. 5/02)
:19g41
gslil
vggied
f,
4
- � .
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ROSEVILLE, MN 557t3
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