## ![](media/image1.wmf)Chisago Soil & Water

####### **Conservation District**

# 38814 Third Avenue, North Branch, MN 55056

**Phone (651)674-2333, Fax (651)674-8828**

**www.chisagoswcd.org**

**UNUSED/ABANDONED WELL SEALING PROGRAM**

**FACT SHEET**

The Chisago Soil and Water Conservation District (SWCD) has been
delegated authority to administer the Chisago County Local Water Plan
Cost Share Program for sealing unused/abandoned private wells. Costs
eligible to be cost shared are limited to the permit, digging, sealing
materials, and backfill of the wellsite. The cost share can be up to 50%
of these costs, not to exceed \$500.00 per well. Any other related costs
shall be paid by the landowner. Just follow the instructions below.

1.  Obtain and fill out an application. Applications are available at
    the Chisago SWCD office, located at the AG Service Center, 38814
    Third Avenue, North Branch. The application can be printed off the
    district web site or one can be mailed to you. To request an
    application or to have any questions answered about the program,
    call 651/674-2333.

2.  Obtain at least two (2) bids from a licensed well driller/sealer (a
    list of some of the local contractors is included in the application
    packet). NOTE: the bids must be itemized to show
    windmill/pump/waterline changes in addition to actual sealing of the
    wellsite.

3.  Turn in the application with the bid attached to the SWCD office.
    The application is then reviewed on a quarterly basis by the SWCD
    Board of Supervisors who set the cost share amount. Guidelines that
    the Board will follow when approving a request for well sealing
    include; the total amount of cost share being received for the
    project from all local, state, and federal funds must not exceed 75%
    of the total cost, and only wells that penetrate a confining
    layer(s) is eligible for cost share. **[Work should not be started
    until AFTER this review is completed.]{.underline}** You will be
    notified by mail after the Board meets and your cost share as to the
    status of your request.

4.  After the well is sealed (which must be within 6 months of
    approval), the land owner is responsible for paying the entire bill
    and obtaining an itemized receipt and a MN Dept. of Health Well
    Sealing Record from the contractor. This paperwork must then be
    submitted (within 12 months of approval) to the SWCD office before
    the cost share amount can be disbursed to the landowner.

Contact the SWCD office at 651/674-2333 with any questions you may have.

**CHISAGO COUNTY UNUSED WELL SEALING**

**COST-SHARE APPLICATION AGREEMENT**

Applicant:

Phone Number: Home Work

Address: City/State/Zip:

Well Owner (if other than applicant):

Phone Number: Home Work

Address: City/State/Zip:

WELL LOCATION:

Township# Range#

Township Name

Section \#

Legal Description:

WELL INFORMATION:

Depth of Well: feet Diameter of Well:

How Determined: Date Drilled:

Condition of Well:

Well record Available: (attach if yes)

Type of Well: Drilled Tile Augured Sand Point Unknown

Type of Casing: Steel Tile Plastic Concrete Other

Well Head Status: Above Ground Basement Pit Buried Other

Is head of well subject to flooding? Is well within ½ mile of being
used?

Does the well pose a hazard for people and/or animals falling into it?
If yes, reason:

Nearest source of contamination (how many feet from the following) list
all those that apply to you unused well?

Septic Tank Chemicals-load/rinse area Feedlot

Drain field Chemical-storage area Pond/Lake/River

Sewage treatment Fuel storage tanks

Household and farm refuse disposal site

Other (please specify)

(ex. Cesspool, dry well, leaching pit, below ground manure storage area,
etc.)

Please check each category below if it applies to your unused well:

A threat of contamination from surface water runoff

In the floodplain

Downhill of a sewer system

Downhill of a livestock yard

Downhill of a manure storage area

Approximate year of abandonment?

Reason the well was abandoned?

Comments:

By signing, the applicant certifies that the above information is true
and accurate to the best of their knowledge; will allow access to the
Chisago SWCD and a licensed well contractor for estimating cost; and if
approved for cost share, will seal the well according to Minnesota
Statute Section 1031.331, and applicable state statutes and rules.
County and state employees or designees shall have the right to conduct
on-site inspections. This agreement is taken upon the express condition
that the Chisago SWCD, Chisago County Water Plan Policy Team, Cities of
Chisago County, and Townships in Chisago County be free from all
liabilities and claims for damages and/or suits for or by reason of
injury or injuries to any person or persons or property of any kind
whatsoever, whether the person or property of applicant, applicant's
agents or employees, or third persons from any cause or causes
whatsoever as a result of the application being accepted and the unused
well described in the application being sealed and the applicant hereby
covenants and agrees to indemnify and save harmless the above parties
from all liabilities, charges, expenses (including reasonable attorney's
fees) and costs on account of or by reason of any injuries, liabilities,
claims, suits or lawsuits however occurring or damages growing out of
sealing the well described in said agreement.

Signature Date

**BID SHEET**

(Make copies as needed)

**LISCENSED WELL SEALING CONTRACTOR**

Name of Company:

Contractor Name:

Phone Number:

Address:

City/State/Zip:

Cost Estimate (total cost to seal well):

(Including: permit, digging, materials, and backfill)

Cost Estimate for additional work incurred by well owner:

> (Including: remove a windmill, pump, existing water lines/connections
> or changes made to the lines, etc. are costs that will be incurred by
> the well owner)

Signature of Well Contractor Date

COMMENTS:

**LICENSED WELL DRILLERS LIST (07/03)**

SALVERDA WELL CO. #82006

19930 Harrow Avenue North

Forest Lake, MN 55025

651/464-2876

LAUREN MCCULLOUGH WELL

15597 Highway 61 #82443

Hugo, MN 55038

651/429-6332

SAMPSON WELL CO. #82673

6821 167^th^ Avenue

Forest Lake, MN 55025

651/464-6088

ROSGA WELL DRILLING, INC.

P.O. Box 586 #58069

Hinckley, MN 55037

320/384-6103

FRYE PUMP SERVICE #00241

ROUTE 2, Box 321A

Hinkley, MN 55037

320/384-6025

ZUERCHER WELL DRILLING

35569 Forest Blvd. #13490

North Branch, MN 55056

651/674-5939

A. RUPPERT WELL #30714

24877 Ulyssses Court NE

Isanti, MN 55040

763/444-3673

ANDERSON WELL DRILLING

P.O. Box 65 #13093

Shafer, MN 55047

651/257-2178

E.H. RENNER & SONS #02496

6295 144^th^ Avenue NW

Anoka, MN 55303

763/427-6100

LINDSAY WELL DRILLING

P.O. Box 243 #30385

Cambridge, MN 55008

612/689-2278

HUSNIK WELL DRILLING #13525

32920 Erie Circle

Stacy, MN 55079

651/462-1957

BARROT DRILLING SERVICES

681 Birch Street #02566

Lino Lakes, MN 55014

651/484-0198

MCCULLOUGH & SONS, INC.

20335 Forest Blvd. N. #82054

Forest Lake, MN 55025

651/464-3939

MORK WELL COMPANY #02658

7303 185^th^ Avenue NW

Anoka, MN 55303

763/753-2530

GEORGE JOHNSON WELL DRILLING

28125 Lamar Avenue #13539

Chisago City, MN 55013

651/257-2510

The above list does not constitute endorsement of any of the contractors
by the Chisago Soil and Water Conservation District. This list is based
on the latest available data provided to the SWCD office. There may be
other contractors. You may wish to consult the telephone directory,
Minnesota Department of Health, or other sources.