Well Information
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Identification
Type of Report: Water Well
Type of Work: ALTERATION
Well Report: JACK 64494 View Log
Well Label: 114220
Start Card: 1047672
Original Report: JACK 61775 View Original Log
Owner Well Nbr:
Company Job Nbr:
Primary Use: DOMESTIC
Complete Date: 06/19/2020
Land Owner
Name: ANDREA COOK
Company:
Address: PO BOX 5111

CENTRAL POINT, OR 97502
Location
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Latitude/Longitude
Latitude: 42.32350000
Longitude: -122.94328000
Horiz. Error: 99.00 ft.
Location
County: JACK
TRSQQ: WM37.00S2.00W28NWSE
Tax Map:
Tax Lot: 3800
Lot:
Block:
Subdivision:
Street of Well: 4425 W MAIN ST. MEDFORD OR 97501
WM District: 13
Surface Elev: 1440.93 FT
Well Report Mapping Tool
Tax Lots

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Well Construction
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Construction
Start Date: 06/18/2020
Completed Date: 06/19/2020
Drill Method: Rotary Air
Depth of Completed Well: 53.00
Est. Depth Drilled: 53.00
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: 14.00 ft to 25.00 ft
Filter Pack Material: PEA GVL
Filter Pack Size: pea gravel
Bore Hole
RowDiameter (in)From (ft)To (ft)
110.000.0014.00
26.0014.0053.00
Seal
RowMaterialFrom (ft)To (ft)AmountAmount Calc.
2Bentonite Chips0.0014.0010.006.39
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: 56 F
Lab Analysis:
Lab Analysis Done By:
Total Dissolved Solids: 370.00 ppm
Water Quality Concerns:
Well Test
Analysis
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Static Water Level
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Static Water Level
Depth First Water: 14.00
Pre-Static Water Level:
Pre-Static Water Level Date:
Post-Static Water Level: 8.00
Post-Static Water Level Date: 06/19/2020
Static Water Level
RowDateFrom(ft)To(ft)SWLEst. Flow RatePSI
16/19/202014.0025.008.008.0 
Lithology
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Materal
RowFromToMaterialStatic Water Level
10.0053.00OVERDRILLED SEAL- 0'-18' 
20.0053.00NEW BENTONITE SEAL- 0'-14' 
30.0053.00FILTER PACKED WITH PEA GRAVEL- 14'-25' 
40.0053.00PLUGGED BOTTOM OF WELL WITH CMNT 
50.0053.00PERFORATED CASING WITH AIR 14'-25' 
60.0053.00DEV WELL 2 HRS (SPECIAL STANDARD ALT) 
Well Constructor
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Bonded Driller Name: KEVIN GILL
Bonded Driller Company: CLOUSER DRILLING INC
Bonded Driller Number: 1835
Bonded Date Signed: 08/07/2020
Unbonded Name:
Unbonded Company:
Unbonded Number:
Unbonded Date Signed:
Other Name:
Other Affiliation:
Other License Nbr:
Geologist Engineer:
Geologist Date Signed:
Comments
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Documents
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TitleDocument TypeSourceDownload Image
JACK 64494EXEMPT USE MAPDRILLERImage
JACK 64494WELL REPORTDRILLERImage