Well Information
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Identification
Type of Report: Water Well
Type of Work: NEW
Well Report: JACK 61311 View Log Groundwater Site
Well Label: 109596
Start Card: 1017565
Original Report:
Owner Well Nbr:
Company Job Nbr:
Primary Use: DOMESTIC
Complete Date: 08/28/2012
Land Owner
Name: RICK BOTHWELL
Company:
Address: 11620 SUNSET RD

MONTAGUE, CA 96064
Location
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Latitude/Longitude
Latitude: 42.53649136
Longitude: -122.89320158
Horiz. Error: 9999.00 ft.
Location
County: JACK
TRSQQ: WM36.00S3.00W12NENW
Tax Map:
Tax Lot: 100
Lot:
Block:
Subdivision:
Street of Well: CORNER OF SHILO AND BEGAL RD, WHITE CITY OR 97523
WM District: 13
Surface Elev:
Well Report Mapping Tool
Tax Lots

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Well Construction
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Construction
Start Date: 08/28/2012
Completed Date: 08/28/2012
Drill Method: Rotary Air
Depth of Completed Well: 100.00
Est. Depth Drilled: 100.00
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
26.0019.00100.00
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
Screens
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Well Test
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Well Test
Temperature: 55 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: 50.00
Pre-Static Water Level:
Pre-Static Water Level Date:
Post-Static Water Level: 20.00
Post-Static Water Level Date: 08/28/2012
Static Water Level
RowDateFrom(ft)To(ft)SWLEst. Flow RatePSI
18/28/201250.0085.0020.0040.0 
Lithology
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Material
RowFromToMaterialStatic Water Level
10.007.00SOIL 
27.00100.00CLAYSTONE BLUE 
Well Constructor
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Bonded Driller Name: BRAD MILKOWSKI
Bonded Driller Company: GRIBBLE WELL DRILLING
Bonded Driller Number: 1661
Bonded Date Signed: 10/26/2012
Unbonded Name:
Unbonded Company:
Unbonded Number:
Unbonded Date Signed:
Other Name:
Other Affiliation:
Other License Nbr:
Geologist Engineer:
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Documents
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TitleDocument TypeSourceDownload ImageReceived Date
JACK 61311WELL REPORTDRILLERImage10/26/2012