Well Information
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Identification
Type of Report: Water Well
Type of Work: NEW
Well Report: JACK 61215 View Log Groundwater Site
Well Label: 107195
Start Card: 1016446
Original Report:
Owner Well Nbr:
Company Job Nbr:
Primary Use: DOMESTIC
Complete Date: 05/03/2012
Land Owner
Name: JULIE MOORE
Company:
Address: 4152 WINNETKA

WHITE CITY, OR 97503
Location
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Latitude/Longitude
Latitude: 42.53190000
Longitude: -122.88305000
Horiz. Error: 50.00 ft.
Location
County: JACK
TRSQQ: WM35.00S2.00W13NWNE
Tax Map:
Tax Lot: 109
Lot:
Block:
Subdivision:
Street of Well: 4152 WINNETKA, WHITE CITY, OR 97503
WM District: 13
Surface Elev: 1381.43 FT
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Tax Lots

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Well Construction
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Construction
Start Date: 05/01/2012
Completed Date: 05/03/2012
Drill Method: Rotary Air
Depth of Completed Well: 345.00
Est. Depth Drilled: 345.00
Special Standards:
Seal Placed Method:
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)
110.000.0019.00
26.0019.00345.00
Seal
RowMaterialFrom (ft)To (ft)AmountAmount Calc.
1Bentonite Chips0.0019.00750.00 
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: 56 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: 130.00
Pre-Static Water Level:
Pre-Static Water Level Date:
Post-Static Water Level: 5.00
Post-Static Water Level Date: 05/01/2012
Static Water Level
RowDateFrom(ft)To(ft)SWLEst. Flow RatePSI
15/1/2012130.00140.00 15.05.000
25/1/2012145.00150.005.005.0 
35/1/2012320.00330.005.0010.0 
Lithology
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Material
RowFromToMaterialStatic Water Level
10.0012.00BROWN CLAYSTONE 
Well Constructor
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Bonded Driller Name: BRAD MILKOWSKI
Bonded Driller Company: GRIBBLE WELL DRILLING
Bonded Driller Number: 1661
Bonded Date Signed: 07/22/2012
Unbonded Name:
Unbonded Company:
Unbonded Number:
Unbonded Date Signed:
Other Name:
Other Affiliation:
Other License Nbr:
Geologist Engineer:
Comments
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Documents
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TitleDocument TypeSourceDownload ImageReceived Date
JACK 61215EXEMPT USE MAPDRILLERImage7/22/2012
JACK 61215WELL REPORTDRILLERImage7/22/2012