1998_0209_packet - Laserfiche WebLink

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INSTRUCTION'S FOR COMPLETiNG THE WELL DISCLOSURE STATEMENT DEFINITION A"well"means an excavalion that is drilled,cored.bored,washed,driven,dug,jetted.or otherwise constructed if the excavation is intended for the location,diversion,artificial recharge,of acquisition of groundwater. MINNESOTA UNIQUE WELL NUMBER All new wells constructed AFTER January 1. 1975 should have been assigned a Minnesota unique well number by the person constructing the well. 11 the well was constructed aflef this date you should have the unique well number in your property records.ii you are unable to locate your unique well number the well was constructed AFTER January 1, 1 975,contact your well contractor.If no unique well number is available.please indicate the depth and year of construction For each weld. WELLTYPE Use one of the following terms to describe the well type WATER WELL A water well is any type of well used to extract groundwater for private or public use,Examples of water wells are'domestic walls,drive-point wells,dug wells.remedial swells.and municipal wells, IRRIGATION WELL An irrigation well is a well used to irrigate agricultural lands. These of e t yptcaI ly large diameter walls connected to a large pressure distribution system. MONITORING WELL A monitoring well is a well used to monitor groundwater con tarni nation Pip well is typically used to access groundwater for the extraction of samples_ DEWATERING WELL A dewwatering well is a well used to lower groundwater levels to allow for construction or use of underground spaces. INDUSTRIAL/COMMERCIAL WELL An lndustriallcommerciat well is a nonpotable wets used t� extract groundwater for any nonpotable use including groundwater thermal exchange wells(heat pumps and heat loops). WELL USE STATUS Indicate the use status of each well,CHECK ONLY 1 BOX PER WELL. IN USE A well is"in use"it the well is producing sufficient water to meet its intended use and is being operated on a regular basis. NOT IN USE A well is"not in use"if the well is inoperable and not in use or the well is disconnected from a power supply and is not sealed. SEALED A well is"sealed"it the well has been sealed by a licensed contractor and there is a Sealed Well Report on file at the Minnesota Department of Health, A properly sealed well has been sealed by a licensed contractor by pumping grout throughout the entire borehole from the bottom of the well. NOTE It a well is inoperable and not in use or disconnected from a power source,it must be sealed by a licensed well contractor or a well owner must obtain a maintenance permit from the Minnesota Department of Health and pair an annual maintenance fee.tf a well is operable and properly maintained a maintenance permit is not required.