Well Information
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Identification
Type of Report: Water Well
Type of Work: NEW
Well Report: JACK 63222 View Log Groundwater Site
Well Label: 127481
Start Card: 1036381
Original Report:
Owner Well Nbr:
Company Job Nbr:
Primary Use: DOMESTIC
Complete Date: 09/22/2017
Land Owner
Name: MICHAEL FORNEY
Company:
Address: 8835 WAGNER CREEK RD.

TALENT, OR 97540
Location
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Latitude/Longitude
Latitude: 42.50771000
Longitude: -123.16837000
Horiz. Error: 99.00 ft.
Location
County: JACK
TRSQQ: WM35.00S4.00W22SWSW
Tax Map:
Tax Lot: 2000
Lot:
Block:
Subdivision:
Street of Well: EAST EVANS CREEK RD. TL 2000
WM District: 13
Surface Elev:
Well Report Mapping Tool
Tax Lots

Note: Tax lot overlay available only for a few counties.
Well Construction
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Construction
Start Date: 09/21/2017
Completed Date: 09/22/2017
Drill Method: Rotary Air
Depth of Completed Well: 240.00
Est. Depth Drilled: 240.00
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)
110.000.0036.00
26.0036.00240.00
Seal
RowMaterialFrom (ft)To (ft)AmountAmount Calc.
1Bentonite Chips0.0036.0091.0016.43
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 ● 2.00 58.00 .250 Steel ● ● 58.00
2Liner4.00 2.00 240.00 SCH 40 Plastic ● 58.00
Temporary Casing
No data matches search criteria.
Perforations
RowMethodMaterialCasing/LinerDiameter (in)From (ft)To (ft)Perforation
Size		Screen/Slot
Size Width		Slot LengthNbr of Slots
1AIR AND SAW CUT Casing6.0047.0056.00 0.1881.000216
2AIR AND SAW CUT Liner4.00220.00240.00 0.1884.00060
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: 170.00 ppm
Water Quality Concerns:
Well Test
Analysis
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Static Water Level
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Static Water Level
Depth First Water: 47.00
Pre-Static Water Level:
Pre-Static Water Level Date:
Post-Static Water Level: 12.00
Post-Static Water Level Date: 09/22/2017
Static Water Level
RowDateFrom(ft)To(ft)SWLEst. Flow RatePSI
19/22/201747.0056.0012.0011.0 
29/22/2017162.00164.0012.005.0 
Lithology
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Material
RowFromToMaterialStatic Water Level
10.005.00BROWN/RED CLAY 
25.0046.00BROWN DECOMP GRANITE & GRAVEL 
346.0056.00BROWN & WHITE GRANITE MEDIUM 
456.00240.00BLACK/WHITE GRANITE MEDIUM 
Well Constructor
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Bonded Driller Name: KEVIN D GILL
Bonded Driller Company: CLOUSER DRILLING INC
Bonded Driller Number: 1835
Bonded Date Signed: 10/03/2017
Unbonded Name: PETERSON,SHAWN
Unbonded Company:
Unbonded Number: 1994
Unbonded Date Signed: 10/02/2017
Other Name:
Other Affiliation:
Other License Nbr:
Geologist Engineer:
No data matches search criteria.
Documents
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TitleDocument TypeSourceDownload ImageReceived Date
JACK 63222EXEMPT USE MAPDRILLERImage10/3/2017
JACK 63222WELL REPORTDRILLERImage10/3/2017