Well Information
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Identification
Type of Report: Water Well
Type of Work: NEW
Well Report: CLAC 73228 View Log Groundwater Site
Well Label: 124973
Start Card: 1034928
Original Report:
Owner Well Nbr: 1
Company Job Nbr:
Primary Use: DOMESTIC
Complete Date: 06/20/2017
Land Owner
Name:
Company: HIDDEN CREEK POLO CLUB
Address: C/O SEAN TYLER KEYS LLC
7105 SW VARNS ST 220
TIGARD, OR 97223
Location
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Latitude/Longitude
Latitude: 45.32991000
Longitude: -122.70408000
Horiz. Error: 16.00 ft.
Location
County: CLAC
TRSQQ: WM3.00S1.00E8NENE
Tax Map:
Tax Lot: 101
Lot:
Block:
Subdivision:
Street of Well: 2882 SW HOMESTEADER RD, WEST LINN
WM District: 22
Surface Elev:
Well Report Mapping Tool
Tax Lots

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Well Construction
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Construction
Start Date: 06/16/2017
Completed Date: 06/20/2017
Drill Method: Rotary Air
Depth of Completed Well: 182.00
Est. Depth Drilled: 186.00
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 1.50 118.00 .250 Steel ●  
2Liner4.00 4.00 182.00 SCH 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: 59 F
Lab Analysis:
Lab Analysis Done By:
Total Dissolved Solids: 103.00 ppm
Water Quality Concerns:
Well Test
Analysis
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Static Water Level
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Static Water Level
Depth First Water: 14.00
Pre-Static Water Level:
Pre-Static Water Level Date:
Post-Static Water Level: 126.00
Post-Static Water Level Date: 06/20/2017
Static Water Level
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Material
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Well Constructor
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Bonded Driller Name: JONATHAN GROSSNICKLE
Bonded Driller Company: SKYLES DRILLING INC
Bonded Driller Number: 1998
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 73228WELL REPORTDRILLERImage7/3/2017