Well Information
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Identification
Type of Report: Water Well
Type of Work: NEW
Well Report: CLAC 71235 View Log Groundwater Site
Well Label: 116751
Start Card: 211281
Original Report:
Owner Well Nbr:
Company Job Nbr:
Primary Use: DOMESTIC
Complete Date: 04/03/2015
Land Owner
Name: RON RAINES
Company: RAINES, BARB
Address: PO BOX 936

CANBY, OR 97013
Location
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Latitude/Longitude
Latitude: 45.19272000
Longitude: -122.67092000
Horiz. Error: 11.00 ft.
Location
County: CLAC
TRSQQ: WM4.00S1.00E27NWSE
Tax Map:
Tax Lot: 602
Lot:
Block:
Subdivision:
Street of Well: 9479 S HEINZ RD
WM District: 20
Surface Elev:
Well Report Mapping Tool
Tax Lots

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Well Construction
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Construction
Start Date: 03/30/2015
Completed Date: 04/03/2015
Drill Method: Rotary Air
Depth of Completed Well: 257.00
Est. Depth Drilled: 257.00
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
RowCasing/LinerDiameter (in)Above Land SurfaceFrom DepthTo (ft)GaugeMaterialWeldGlueThreadShoe
Inside		Shoe
Outside		Shoe
Other		Shoe
Location
1Casing6.00 1.50 242.00 .250 Steel ● 242.00
2Liner4.00 200.00 241.00 40 Plastic ●  
3Liner4.00 256.00 257.00 40 Plastic ●  
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: 20.00
Pre-Static Water Level:
Pre-Static Water Level Date:
Post-Static Water Level: 25.10
Post-Static Water Level Date: 03/03/2015
Static Water Level
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Material
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Well Constructor
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Bonded Driller Name: STEVEN N STADELI
Bonded Driller Company: WESTERBERG DRILLING
Bonded Driller Number: 688
Bonded Date Signed:
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
CLAC 71235WELL REPORTDRILLERImage4/10/2015