Well Information
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Identification
Type of Report: Water Well
Type of Work: NEW
Well Report: POLK 54272 View Log Groundwater Site
Well Label: 131606
Start Card: 1042219
Original Report:
Owner Well Nbr: 5981
Company Job Nbr:
Primary Use: DOMESTIC
Complete Date: 05/08/2019
Land Owner
Name:
Company: ACMPC OREGON 2 LLC
Address: PO BOX 717

JEFFERSON, OR 97352
Location
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Latitude/Longitude
Latitude: 44.89024810
Longitude: -123.15153032
Horiz. Error: 99.00 ft.
Location
County: POLK
TRSQQ: WM8.00S4.00W11SWNW
Tax Map:
Tax Lot: 103
Lot:
Block:
Subdivision:
Street of Well: 5605 HALLS FERRY RD, INDEPENDENCE
WM District: 22
Surface Elev:
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Tax Lots

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Well Construction
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Construction
Start Date: 05/06/2019
Completed Date: 05/08/2019
Drill Method: Rotary Air
Depth of Completed Well: 60.00
Est. Depth Drilled: 60.00
Special Standards:
Seal Placed Method:
Abandonment Start Date:
Abandonment Completed Date:
Backfill
Backfill Placement:
Backfill Material:
Explosives Used:
Explosive Type:
Explosive Amount:
Filter Pack
Filter Pack:
Filter Pack Material:
Filter Pack Size:
Bore Hole
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Seal
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Abandonment Log
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Casing/Liner
Temporary Casing
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Perforations
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Screens
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Well Test
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Well Test
Temperature: 58 F
Lab Analysis:
Lab Analysis Done By:
Total Dissolved Solids: 170.00
Water Quality Concerns:
Well Test
Analysis
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Static Water Level
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Static Water Level
Depth First Water: 22.00
Pre-Static Water Level:
Pre-Static Water Level Date:
Post-Static Water Level: 8.00
Post-Static Water Level Date: 05/08/2019
Static Water Level
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Material
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Well Constructor
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Bonded Driller Name: BRET JONES
Bonded Driller Company: JONES WELL DRILLING CO INC
Bonded Driller Number: 1684
Bonded Date Signed:
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 Image
POLK 54272EXEMPT USE MAPDRILLERImage
POLK 54272WELL REPORTDRILLERImage