Well Information
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Identification
Type of Report: Water Well
Type of Work: NEW
Well Report: JACK 63757 View Log
Well Label: 133117
Start Card: 1042217
Original Report:
Owner Well Nbr:
Company Job Nbr:
Primary Use: COMMUNITY
Complete Date: 03/21/2019
Land Owner
Name:
Company: ROYAL ORDER OF THE MOOSE #178
Address: 9713 OLD STAGE RD.

GOLD HILL, OR 97525
Location
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Latitude/Longitude
Latitude: 42.42458200
Longitude: -123.04465400
Horiz. Error: 99.00 ft.
Location
County: JACK
TRSQQ: WM36.00S3.00W22NESW
Tax Map:
Tax Lot: 400
Lot:
Block:
Subdivision:
Street of Well: 9713 OLD STAGE RD. GOLD HILL, OR 97525
WM District: 13
Surface Elev:
Well Report Mapping Tool
Tax Lots

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Well Construction
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Construction
Start Date: 03/21/2019
Completed Date: 03/21/2019
Drill Method: Rotary Air
Depth of Completed Well: 200.00
Est. Depth Drilled: 200.00
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)
110.000.0021.00
26.0021.00200.00
Seal
RowMaterialFrom (ft)To (ft)AmountAmount Calc.
1Bentonite Chips0.0021.0016.009.58
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: 176.00 ppm
Water Quality Concerns:
Well Test
Analysis
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Static Water Level
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Static Water Level
Depth First Water: 63.00
Pre-Static Water Level:
Pre-Static Water Level Date:
Post-Static Water Level: 23.00
Post-Static Water Level Date: 03/21/2019
Static Water Level
RowDateFrom(ft)To(ft)SWLEst. Flow RatePSI
13/21/201963.00132.0023.0015.0 
Lithology
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Material
RowFromToMaterialStatic Water Level
10.0022.00TAN TIGHT CLAY 
222.0056.00BRN CLAY MXD GRAVL COBBLE CRS SAND 
356.00132.00GREY BASALT BROKEN 
4132.00200.00GREY BASALT HARD 
Well Constructor
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Bonded Driller Name: KEVIN GILL
Bonded Driller Company: CLOUSER DRILLING INC
Bonded Driller Number: 1835
Bonded Date Signed: 04/08/2019
Unbonded Name: SPLIETHOF,JUSTIN
Unbonded Company: CLOUSER DRILLING INC
Unbonded Number: 1945
Unbonded Date Signed: 03/28/2019
Other Name:
Other Affiliation:
Other License Nbr:
Geologist Engineer:
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Documents
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TitleDocument TypeSourceDownload Image
JACK 63757EXEMPT USE MAPDRILLERImage
JACK 63757WELL REPORTDRILLERImage