Well Information
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Identification
Type of Report: Water Well
Type of Work: NEW
Well Report: POLK 54266 View Log
Well Label: 131349
Start Card: 1042304
Original Report:
Owner Well Nbr: 3197
Company Job Nbr:
Primary Use: DOMESTIC
Complete Date: 04/15/2019
Land Owner
Name: JANET JACKSON
Company:
Address: 16869 SW 65TH AVE, #175

LAKE OSWEGO, OR 97035
Location
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Latitude/Longitude
Latitude: 45.07197928
Longitude: -123.09360220
Horiz. Error: 99.00 ft.
Location
County: POLK
TRSQQ: WM6.00S3.00W6SESE
Tax Map:
Tax Lot: 102
Lot:
Block:
Subdivision:
Street of Well: NEXT TO 9675 LONESTAR RD.NW, SALEM
WM District: 22
Surface Elev:
Well Report Mapping Tool
Tax Lots

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Well Construction
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Construction
Start Date: 04/09/2019
Completed Date: 04/15/2019
Drill Method: Rotary Air
Depth of Completed Well: 278.00
Est. Depth Drilled: 278.00
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)
110.000.0040.00
28.0040.00178.00
36.00178.00278.00
Seal
RowMaterialFrom (ft)To (ft)AmountAmount Calc.
1Bentonite Chips0.0031.0024.0016.00
2Cement31.00178.0031.0030.00
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 2.00 178.00 .250 Steel  
2Liner4.00 18.00 238.00 SCH 40 Plastic  
Temporary Casing
Perforations
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Screens
Well Test
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Well Test
Temperature: 54 F
Lab Analysis:
Lab Analysis Done By:
Total Dissolved Solids: 63.00 ppm
Water Quality Concerns:
Well Test
Analysis
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Static Water Level
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Static Water Level
Depth First Water: 222.00
Pre-Static Water Level:
Pre-Static Water Level Date:
Post-Static Water Level: 35.00
Post-Static Water Level Date: 04/15/2019
Static Water Level
RowDateFrom(ft)To(ft)SWLEst. Flow RatePSI
14/15/2019222.00269.0035.0024.0 
Lithology
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Material
RowFromToMaterialStatic Water Level
10.005.00TOP SOIL 
25.0051.00CLAY, BROWN 
351.00164.00BASALT, DECAYED LAYERS W/SOME CLAY 
4164.00212.00BASALT, MED. GRAY W/OCC BROWN 
5212.00269.00BASALT, DECAYED W/OCC GRAY 
6269.00278.00BASALT, MED GRAY 
Well Constructor
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Bonded Driller Name: DAVID PAYSINGER
Bonded Driller Company: BLUE WATER DRILLING CO INC
Bonded Driller Number: 1438
Bonded Date Signed: 04/15/2019
Unbonded Name: ESTRADA,JOSE
Unbonded Company: BLUE WATER DRILLING COMPANY
Unbonded Number: 1977
Unbonded Date Signed: 04/15/2019
Other Name:
Other Affiliation:
Other License Nbr:
Geologist Engineer:
Comments
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Documents
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TitleDocument TypeSourceDownload Image
POLK 54266EXEMPT USE MAPDRILLERImage
POLK 54266WELL REPORTDRILLERImage