Well Information
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Identification
Type of Report: Water Well
Type of Work: ALTERATION
Well Report: JACK 66190 View Log Groundwater Site
Well Label: 125241
Start Card: 1073778
Original Report: JACK 62965 View Original Log
Owner Well Nbr:
Company Job Nbr:
Primary Use: DOMESTIC
Complete Date: 05/17/2024
Land Owner
Name: THOULFEKAR AIRAHEM
Company:
Address: 7117 GRIFFIN LANE

MEDFORD, OR 97501
Location
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Latitude/Longitude
Latitude: 42.23903000
Longitude: -122.92149000
Horiz. Error: 99.00 ft.
Location
County: JACK
TRSQQ: WM38.00S2.00W27SWNE
Tax Map:
Tax Lot: 211
Lot:
Block:
Subdivision:
Street of Well: 7117 GRIFFIN LANE MEDFORD OR 97501
WM District: 13
Surface Elev: 3085.00 FT
Well Report Mapping Tool
Tax Lots

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Well Construction
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Construction
Start Date: 05/17/2024
Completed Date: 05/17/2024
Drill Method: Rotary Air
Depth of Completed Well: 340.00
Est. Depth Drilled: 340.00
Special Standards:
Seal Placed Method: OTHER - NOT DISTURBED
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)
110.000.0039.00
26.0039.00340.00
Seal
RowMaterialFrom (ft)To (ft)AmountAmount Calc.
2Bentonite Chips0.0039.0023.0017.80
Abandonment Log
No data matches search criteria.
Casing/Liner
RowCasing/LinerDiameter (in)Above Land SurfaceFrom DepthTo (ft)GaugeMaterialWeldGlueThreadShoe
Inside		Shoe
Outside		Shoe
Other		Shoe
Location
1(Casing)Pre-Alteration6.00 ● 2.00 98.00.250ST ● ● 98.00
2Casing6.00 ● 2.00 98.00.250ST ● ● 98.00
Temporary Casing
No data matches search criteria.
Perforations
Screens
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Well Test
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Well Test
Temperature: 55 F
Lab Analysis:
Lab Analysis Done By:
Total Dissolved Solids: 215.00 ppm
Water Quality Concerns:
Well Test
Analysis
No data matches search criteria.
Static Water Level
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Static Water Level
Depth First Water: 50.00
Pre-Static Water Level: 26.00
Pre-Static Water Level Date: 05/17/2024
Post-Static Water Level: 26.00
Post-Static Water Level Date: 05/17/2024
Static Water Level
RowDateFrom(ft)To(ft)SWLEst. Flow RatePSI
15/17/202450.0070.0026.0014.0 
25/17/2024218.00220.0026.002.0 
Lithology
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Material
RowFromToMaterialStatic Water Level
10.00340.00MEASURE WELL DEPTH, TDS & SWL 
20.00340.00REMOVE 4" PVC LINER FROM WELL 
Well Constructor
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Bonded Driller Name: KEVIN GILL
Bonded Driller Company: CLOUSER DRILLING INC
Bonded Driller Number: 1835
Bonded Date Signed: 05/20/2024
Unbonded Name: KLIPFEL,JASON
Unbonded Company: CLOUSER DRILLING
Unbonded Number: 2009
Unbonded Date Signed: 05/17/2024
Other Name:
Other Affiliation:
Other License Nbr:
Geologist Engineer:
Comments
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Comments
Remove 4" PVC pipe liner from well.
Documents
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TitleDocument TypeSourceDownload Image
JACK 66190EXEMPT USE MAPDRILLERImage
JACK 66190WELL REPORTDRILLERImage