Well Information
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Identification
Type of Report: Water Well
Type of Work: ALTERATION
Well Report: MARI 64323 View Log Groundwater Site
Well Label: 106360
Start Card: 1016794
Original Report: MARI 64141 View Original Log
Owner Well Nbr:
Company Job Nbr:
Primary Use: COMMUNITY
Complete Date: 06/28/2012
Land Owner
Name:
Company: CITY OF KEIZER
Address: 930 CHEMAWA ROAD NE

KEIZER, OR 97303
Location
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Latitude/Longitude
Latitude: 45.01168737
Longitude: -123.01002154
Horiz. Error: 50.00 ft.
Location
County: MARI
TRSQQ: WM6.00S3.00W35NENE
Tax Map:
Tax Lot: 6300
Lot:
Block:
Subdivision:
Street of Well: 6288 17TH AVENUE NE KEIZER, OR
WM District: 16
Surface Elev:
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Tax Lots

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Well Construction
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Construction
Start Date: 06/05/2012
Completed Date: 06/28/2012
Drill Method:
Depth of Completed Well:
Est. Depth Drilled:
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
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Seal
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Abandonment Log
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Casing/Liner
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Temporary Casing
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Perforations
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Screens
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Well Test
Temperature:
Lab Analysis:
Lab Analysis Done By:
Total Dissolved Solids:
Water Quality Concerns:
Well Test
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Analysis
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Static Water Level
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Static Water Level
Depth First Water:
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: FLOYD G SIPPEL
Bonded Driller Company: SIPPEL WELL DRILLING INC
Bonded Driller Number: 1273
Bonded Date Signed: 08/01/2012
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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TypeComments
CN Excavation around this well to appxox. 7ft. was done to accomidate installing a pittless unit. After cutting off 81.5 inches of casing and welding on the pittless unit the hole was backfilled. Bentonite was placed around casing as hole was filled. The soil was compacted as excavation was filled. 17 sacks of bentonite were used to reseal this well.
IS Groundwater determined MARI 64141 is the original report.