Well Information
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Identification
Type of Report: Water Well
Type of Work: NEW
Well Report: POLK 54325 View Log Groundwater Site
Well Label: 136027
Start Card: 1045083
Original Report:
Owner Well Nbr:
Company Job Nbr:
Primary Use: DOMESTIC
Complete Date: 10/08/2019
Land Owner
Name: LARRY A LYON
Company:
Address: 8455 BUENA VISTA ROAD

INDEPENDENCE, OR 97351
Location
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Latitude/Longitude
Latitude: 44.81150000
Longitude: -123.15958000
Horiz. Error: 99.00 ft.
Location
County: POLK
TRSQQ: WM9.00S4.00W3SWSE
Tax Map:
Tax Lot: 200
Lot:
Block:
Subdivision:
Street of Well: 8455 BUENA VISTA ROAD, INDEPENDENCE, OR 97351
WM District: 22
Surface Elev:
Well Report Mapping Tool
Tax Lots

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Well Construction
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Construction
Start Date: 10/04/2019
Completed Date: 10/08/2019
Drill Method: Rotary Air
Depth of Completed Well: 58.00
Est. Depth Drilled: 58.00
Special Standards:
Seal Placed Method: C , OTHER - BENTONITE DRY
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)
110.000.0020.00
26.0020.0058.00
Seal
RowMaterialFrom (ft)To (ft)AmountAmount Calc.
1Bentonite 0.000.500.500.23
2Cement with 5% Bentonite0.5020.0011.003.74
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: 53 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: 26.00
Pre-Static Water Level:
Pre-Static Water Level Date:
Post-Static Water Level: 21.00
Post-Static Water Level Date: 10/08/2019
Static Water Level
RowDateFrom(ft)To(ft)SWLEst. Flow RatePSI
110/8/201926.0054.0021.0050.0 
Lithology
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Material
RowFromToMaterialStatic Water Level
10.003.00TOP SOIL 
23.009.00SILTY BROWN CLAY 
39.0020.00SANDY BROWN CLAY 
420.0026.00COARSE BROWN SAND 
526.0028.00BROWN SAND AND VERY SMALL GRAVEL 
628.0031.00BROWN SAND AND LARGE GRAVEL 
731.0044.00BLUE GRAY SAND AND GRAVEL SEMI-CEMENTED 
844.0052.00GRAY SAND AND GRAVEL 
952.0054.00BLUE CLAY AND GRAVEL 
1054.0058.00BLUE CLAY 
Well Constructor
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Bonded Driller Name: FLOYD SIPPEL
Bonded Driller Company: SIPPEL WELL DRILLING INC
Bonded Driller Number: 1273
Bonded Date Signed: 10/14/2019
Unbonded Name: PILLSBURY,RYAN
Unbonded Company: OREGON WATER RESOURCES DEPARTMENT
Unbonded Number: 1903
Unbonded Date Signed: 10/09/2019
Other Name:
Other Affiliation:
Other License Nbr:
Geologist Engineer:
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Documents
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TitleDocument TypeSourceDownload Image
POLK 54325EXEMPT USE MAPDRILLERImage
POLK 54325WELL REPORTDRILLERImage