Well Information
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Identification
Type of Report: Water Well
Type of Work: ALTERATION
Well Report: JACK 65817 View Log Groundwater Site
Well Label: 135928
Start Card: 1061250
Original Report: JACK 14479 View Original Log
Owner Well Nbr: WELL #5
Company Job Nbr:
Primary Use: COMMUNITY
Complete Date: 05/26/2023
Land Owner
Name:
Company: FERN VALLEY ESTATES IMPROVEMENT DISTRICT
Address: 2675 DAVID LN.

MEDFORD, OR 97504
Location
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Latitude/Longitude
Latitude: 42.29067000
Longitude: -122.77747000
Horiz. Error: 99.00 ft.
Location
County: JACK
TRSQQ: WM38.00S1.00W2SESE
Tax Map:
Tax Lot: 200
Lot:
Block:
Subdivision:
Street of Well: NEXT TO 3081 PAYNE RD. MEDFORD, OR 97504
WM District: 13
Surface Elev:
Well Report Mapping Tool
Tax Lots

Note: Tax lot overlay available only for a few counties.
Well Construction
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Construction
Start Date: 05/24/2023
Completed Date: 05/26/2023
Drill Method: Rotary Air
Depth of Completed Well: 362.00
Est. Depth Drilled: 362.00
Special Standards:
Seal Placed Method: OTHER - DRY POURED
Abandonment Start Date:
Abandonment Completed Date:
Backfill
Backfill Placement: ft to ft
Backfill Material:
Explosives Used:
Explosive Type:
Explosive Amount:
Filter Pack
Filter Pack:
Filter Pack Material:
Filter Pack Size:
Bore Hole
RowDiameter (in)From (ft)To (ft)
110.000.0038.00
26.0038.00362.00
Seal
RowMaterialFrom (ft)To (ft)AmountAmount Calc.
2Bentonite Chips0.0038.0021.0017.34
Abandonment Log
No data matches search criteria.
Casing/Liner
RowCasing/LinerDiameter (in)From (ft)To (ft)GaugeMaterialWeldGlueThreadShoe
Inside		Shoe
Outside		Shoe
Other		Shoe
Location
1P6.00-2.0034.00.250ST ● ● 38.00
2C6.00-2.0038.00.250ST ● ● 38.00
3L4.002.00362.00sch 40PL  
Temporary Casing
Temp CasingDiameter (in)From (ft)To (ft)
● 10.00-1.006.00
● 10.001.006.00
Perforations
RowMethodMaterialCasing/LinerDiameter (in)From (ft)To (ft)Perferation
Size		Screen/Slot
Size Width		Slot LengthNbr of SlotsTele/Pipe size
1LAZER CUT & SAW CUT L4.00200.00220.00 0.0321.0003116 
2LAZER CUT & SAW CUT L4.00303.00343.00 0.0321.0006232 
3LAZER CUT & SAW CUT L4.00343.00362.00 0.1884.00060 
Screens
No data matches search criteria.
Well Test
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Well Test
Temperature: 55 F
Lab Analysis:
Lab Analysis Done By:
Total Dissolved Solids: 190.00 ppm
Water Quality Concerns:
Well Test
Analysis
No data matches search criteria.
Static Water Level
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Static Water Level
Depth First Water: 285.00
Pre-Static Water Level: 5.00
Pre-Static Water Level Date: 05/24/2023
Post-Static Water Level: 5.00
Post-Static Water Level Date: 05/26/2023
Static Water Level
RowDateFrom(ft)To(ft)SWLEst. Flow RatePSI
15/24/2023285.00295.005.009.0 
25/24/2023315.00336.005.008.0 
Lithology
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Materal
RowFromToMaterialStatic Water Level
10.00362.00DEMO 2-1/2' THICK CMT SLAB 
20.00362.00PULL 4" PVC LINER THAT WAS IN WELL BORE 
30.00362.00CHECK SWL & TDS 
40.00362.00OVERDRILL 34' OF STEEL CASING & PULL 
50.00362.00DRILL 10" BORE TO 38' BGS-BLUE SANDSTONE 
60.00362.00INSTALL NEW 6" STEEL CASING- +2'-38' 
70.00362.00INSTALL NEW 10" SEAL W/BENTONITE 0'-38' 
80.00362.00CLEAN WELL BORE TO 362' BGS NATIVE ROCK 
90.00362.00AIR TEST AND DEVELOPED WELL AT 362' 
100.00362.00NEW 4" PVC LINER INSTALLED 
Well Constructor
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Bonded Driller Name: KEVIN GILL
Bonded Driller Company: CLOUSER DRILLING INC
Bonded Driller Number: 1835
Bonded Date Signed: 06/09/2023
Unbonded Name: SPLIETHOF,JUSTIN
Unbonded Company: CLOUSER DRILLING INC
Unbonded Number: 1945
Unbonded Date Signed: 06/09/2023
Other Name:
Other Affiliation:
Other License Nbr:
Geologist Engineer:
Comments
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Comments
This well #5 Jack 14479/30448 was repaired per requirements from OWRD and OHA. The well depth to native soil was 362' bgs and not 364' indicated on well report Jack 30448.
Documents
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TitleDocument TypeSourceDownload Image
JACK 65817GENERATED MAPDRILLERImage
JACK 65817GENERATED MAPDRILLERImage
JACK 65817WELL REPORTDRILLERImage