Well Information
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Identification
Type of Report: Water Well
Type of Work: NEW
Well Report: POLK 50048 View Log Groundwater Site
Well Label: 10461
Start Card: 86246
Original Report:
Owner Well Nbr: 1
Company Job Nbr:
Primary Use: DOMESTIC
Complete Date: 03/02/1996
Land Owner
Name: RANDY ROTH
Company:
Address: 742 SE BIACH

DALLAS, OR 97338
Location
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Latitude/Longitude
Latitude: 44.96758526
Longitude: -123.31794304
Horiz. Error: 10.00 ft.
Location
County: POLK
TRSQQ: WM7.00S5.00W17NENE
Tax Map:
Tax Lot: 101
Lot:
Block:
Subdivision:
Street of Well: REIMER RD
WM District: 22
Surface Elev:
Well Report Mapping Tool
Tax Lots

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Well Construction
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Construction
Start Date: 02/27/1996
Completed Date: 03/02/1996
Drill Method: Rotary Air
Depth of Completed Well: 76.00
Est. Depth Drilled: 76.00
Special Standards:
Seal Placed Method:
Abandonment Start Date:
Abandonment Completed Date:
Backfill
Backfill Placement:
Backfill Material:
Explosives Used:
Explosive Type:
Explosive Amount:
Filter Pack
Filter Pack:
Filter Pack Material:
Filter Pack Size:
Bore Hole
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Seal
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Abandonment Log
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Casing/Liner
Temporary Casing
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Perforations
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Screens
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Well Test
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Well Test
Temperature: 52 F
Lab Analysis:
Lab Analysis Done By:
Total Dissolved Solids:
Water Quality Concerns:
Well Test
Analysis
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Static Water Level
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Static Water Level
Depth First Water: 4.00
Pre-Static Water Level:
Pre-Static Water Level Date:
Post-Static Water Level:
Post-Static Water Level Date:
Static Water Level
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Materal
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Well Constructor
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Bonded Driller Name: WILLIAM A. BLAIR
Bonded Driller Company: DICKERSON WELL DRILLING
Bonded Driller Number: 1571
Bonded Date Signed:
Unbonded Name:
Unbonded Company:
Unbonded Number:
Unbonded Date Signed:
Other Name:
Other Affiliation:
Other License Nbr:
Geologist Engineer:
Geologist Date Signed:
Comments
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Documents
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TitleDocument TypeSourceDownload Image
POLK 50048WELL REPORTDRILLERImage