Well Information
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Identification
Type of Report: Water Well
Type of Work: NEW
Well Report: JACK 63405 View Log Groundwater Site
Well Label: 128866
Start Card: 1038532
Original Report:
Owner Well Nbr:
Company Job Nbr:
Primary Use: DOMESTIC
Complete Date: 04/27/2018
Land Owner
Name: LOGAN CARR
Company:
Address: P.O. BOX 1695

JACKSONVILLE, OR 97530
Location
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Latitude/Longitude
Latitude: 42.17463000
Longitude: -122.97521000
Horiz. Error: 12.00 ft.
Location
County: JACK
TRSQQ: WM39.00S2.00W18SESE
Tax Map:
Tax Lot: 705
Lot:
Block:
Subdivision:
Street of Well: 9595 STERLING CR RD JACKSONVILLE OR 97530
WM District: 13
Surface Elev:
Well Report Mapping Tool
Tax Lots

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Well Construction
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Construction
Start Date: 04/27/2018
Completed Date: 04/27/2018
Drill Method: Rotary Air
Depth of Completed Well: 270.00
Est. Depth Drilled: 270.00
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)
110.000.0018.00
26.0018.00270.00
Seal
RowMaterialFrom (ft)To (ft)AmountAmount Calc.
1Bentonite Chips0.0018.009.50 
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 18.00 .250 Steel ● ● 18.00
2Liner4.00 0.00 270.00 SCH 40 Plastic  
Temporary Casing
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Perforations
Screens
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Well Test
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Well Test
Temperature: 51 F
Lab Analysis:
Lab Analysis Done By:
Total Dissolved Solids: 112.00 ppm
Water Quality Concerns:
Well Test
Analysis
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Static Water Level
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Static Water Level
Depth First Water: 250.00
Pre-Static Water Level:
Pre-Static Water Level Date:
Post-Static Water Level: 80.00
Post-Static Water Level Date: 04/27/2018
Static Water Level
RowDateFrom(ft)To(ft)SWLEst. Flow RatePSI
14/27/2018250.00260.0080.0050.0 
Lithology
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Material
RowFromToMaterialStatic Water Level
10.004.00BRN CLAY 
24.0020.00BRN SHALE MED HARD 
320.00270.00GRAY SHALE W/F 
Well Constructor
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Bonded Driller Name: BARRY PELKEY
Bonded Driller Company: APPLEGATE WELL DRILLING LLC
Bonded Driller Number: 1648
Bonded Date Signed: 05/02/2018
Unbonded Name:
Unbonded Company:
Unbonded Number:
Unbonded Date Signed:
Other Name:
Other Affiliation:
Other License Nbr:
Geologist Engineer:
Comments
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Documents
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TitleDocument TypeSourceDownload Image
JACK 63405EXEMPT USE MAPDRILLERImage
JACK 63405WELL REPORTDRILLERImage