Well Information
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Identification
Type of Report: Water Well
Type of Work: NEW
Well Report: POLK 54296 View Log Groundwater Site
Well Label: 131610
Start Card: 1043407
Original Report:
Owner Well Nbr: 6015
Company Job Nbr:
Primary Use: DOMESTIC
Complete Date: 07/11/2019
Land Owner
Name:
Company: CITY OF INDEPENDENCE
Address: 3841 FAIRVIEW INDUSTRIAL DR SE

SALEM, OR 97302
Location
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Latitude/Longitude
Latitude:
Longitude:
Horiz. Error: ft.
Location
County: POLK
TRSQQ: WM8.00S4.00W21NENE
Tax Map:
Tax Lot: 2009
Lot:
Block:
Subdivision:
Street of Well: DEANNE DR (END OF), INDEPENDENCE
WM District: 22
Surface Elev:
Well Report Mapping Tool
Tax Lots

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Well Construction
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Construction
Start Date: 06/24/2019
Completed Date: 07/11/2019
Drill Method: Rotary Air
Depth of Completed Well: 63.50
Est. Depth Drilled: 64.00
Special Standards:
Seal Placed Method: C , OTHER - POURED DRY
Abandonment Start Date:
Abandonment Completed Date:
Backfill
Backfill Placement: 25.00 ft to 27.00 ft
Backfill Material:
Explosives Used:
Explosive Type:
Explosive Amount:
Filter Pack
Filter Pack: 27.00 ft to 63.50 ft
Filter Pack Material: PEA GRAVEL
Filter Pack Size: wash round 3/8"
Bore Hole
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
1Casing12.00 3.00 32.00 .250 Steel  
2Casing12.00 52.00 63.50 .250 Steel  
Temporary Casing
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Perforations
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Screens
Well Test
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Well Test
Temperature: 62 F
Lab Analysis:
Lab Analysis Done By:
Total Dissolved Solids: 236.00 ppm
Water Quality Concerns:
Well Test
Analysis
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Static Water Level
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Static Water Level
Depth First Water: 25.00
Pre-Static Water Level:
Pre-Static Water Level Date:
Post-Static Water Level: 19.50
Post-Static Water Level Date: 07/11/2019
Static Water Level
RowDateFrom(ft)To(ft)SWLEst. Flow RatePSI
17/11/201925.0052.0019.50800.0 
Lithology
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Material
RowFromToMaterialStatic Water Level
10.002.00TOP SOIL 
22.005.00BROWN CLAY 
35.0020.00BROWN SILTY CLAY 
420.0052.00BROWN DIRTY GRAVEL 
552.0056.00BROWN CLAY 
656.0064.00BLUE CLAY 
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: 07/26/2019
Unbonded Name: MARTIN,KURT D
Unbonded Company: JONES DRILLING CO INC
Unbonded Number: 1411
Unbonded Date Signed: 07/26/2019
Other Name:
Other Affiliation:
Other License Nbr:
Geologist Engineer:
Comments
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Documents
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TitleDocument TypeSourceDownload Image
POLK 54296WELL REPORTDRILLERImage