Well Information
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Identification
Type of Report: Water Well
Type of Work: ALTERATION
Well Report: COOS 57486 View Log Groundwater Site
Well Label: 129838
Start Card: 1042519
Original Report: COOS 57360 View Original Log
Owner Well Nbr: 1793 (SR4A)
Company Job Nbr:
Primary Use: IRRIGATION
Complete Date: 05/03/2019
Land Owner
Name: MICHAEL KEISER
Company: BALLY BANDON LLC
Address: 875 NORTH MICHIGAN AVE #3920

CHICAGO, IL 60611
Location
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Latitude/Longitude
Latitude: 43.21784402
Longitude: -124.39205173
Horiz. Error: 99.00 ft.
Location
County: COOS
TRSQQ: WM27.00S14.00W20SWNW
Tax Map:
Tax Lot: 100
Lot:
Block:
Subdivision:
Street of Well: NO# VAC WHISKEY RUN ROAD, BANDON
WM District: 15
Surface Elev:
Well Report Mapping Tool
Tax Lots

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Well Construction
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Construction
Start Date: 04/23/2019
Completed Date: 05/03/2019
Drill Method: OTHER - PUMP HOIST
Depth of Completed Well: 92.25
Est. Depth Drilled: 92.25
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)
148.000.004.00
28.004.0092.25
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
1(Casing)Pre-Alteration8.00 ● 1.00 92.25 SDR 21 Plastic ●  
2Casing8.00 2.00 69.25 SDR 21 Plastic ●  
Temporary Casing
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Perforations
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Screens
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Well Test
Temperature:
Lab Analysis:
Lab Analysis Done By:
Total Dissolved Solids:
Water Quality Concerns:
Well Test
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Analysis
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Static Water Level
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Static Water Level
Depth First Water: 59.30
Pre-Static Water Level:
Pre-Static Water Level Date:
Post-Static Water Level: 59.30
Post-Static Water Level Date: 05/03/2019
Static Water Level
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Lithology
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Material
RowFromToMaterialStatic Water Level
10.0092.25ORIGINAL WELL L-129838 DRILLED11/20/2018 
20.0092.25REQUESTED A SPECIAL STANDARD FOR A BELOW 
30.0092.25GROUND COMPLETION BECAUSE WELL WAS IN 
40.0092.25THE MIDDLE OF A FAIRWAY ON A NEW GOLF 
50.0092.25COARSE. WELL WAS COMPLETED PER WRD 
60.0092.25PIT DESIGN (ATTACHED) W/2" DRAIN & CHECK 
70.0092.25VALVE TO COARSE DRAINAGE & A WATER TIGHT 
80.0092.25LID. APPROVED 3/25/2019 
Well Constructor
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Bonded Driller Name: JAMES MACK SR
Bonded Driller Company: BANDON WELL & PUMP COMPANY
Bonded Driller Number: 1493
Bonded Date Signed: 05/16/2019
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
COOS 57486EXEMPT USE MAPDRILLERImage5/16/2019
ARCHIVE DOCUMENTOTHERARCHIVEImage5/16/2019
COOS 57486WELL REPORTDRILLERImage5/16/2019