Water Supply Well Log Form
The Oregon Water Resources Department is pleased to announce online filing of well logs on the web with the new Well Log Entry Application.
Electronic submittal of logs directly from the Adobe form will be phased out and will be retired June 1st, 2012.
If you choose not to enter well logs online, you can still fill out the form, print it, sign and date it, and send it into the department to be processed as a normal well log. This report must be filed with the department within 30 days from the date of completion of well construction, deepening, alteration, abandonment, or conversion.
|Working with the forms|
|Template well logs |
If you have several wells constructed on one location, you can fill out one log and save it. Then you can copy that file to a new name, open it up, and change just those items that need to be changed.
Saving the form locally
Unlike previous versions of the well log PDF, this version can be saved on your local machine with the free version of Adobe Acrobat. The department has purchased a license from Adobe which allows it to “reader extend” this form and make it so you can save the form as you fill it out.
|Filling out the form|
|Owner (section 1) |
Enter owner’s name and address as completely as possible. Owner is the landowner where the well is located.
Type of work (section 2)
Check appropriate box(es): new, abandon, deepening, conversion, alteration. Describe alteration or abandonment procedures under Section (11). For deepening indicate beginning and ending static water level under Section (10). Indicate Well ID number if the well already has one.
Drill Methods (Section 3)
Check appropriate box: rotary air, rotary mud, cable, cable mud, or other.
Proposed Use (Section 4)
Check all boxes that apply. A community well serves more than three households.
Borehole Construction (Section 5)
Indicate depth of completed well. Indicate if special construction standards were approved and attach copy of approval. Describe each change in borehole diameter. Indicate placement (from/to) of seal material, type of material and amount (lbs/sacks) used. For full descriptions of seal methods see Chapter 690, Division 210, Appendix 3 of Rules and Regulations Prescribing General Standards for the Construction and Maintenance of Water Supply Wells in Oregon.
Backfill: Show type of backfill used, location where backfill was placed and size of backfill.
Gravel Packed: Show location(s) where gravel was placed and the size of the gravel used.
Casing/Liner (Section 6)
Describe type of casing and liner including wall thickness (gauge) and location(s). If drive shoe was used, show type and final location. Indicate if temporary casing was used.
Perforations/Screens (Section 7)
Indicate if perforations are in the casing and or liner Describe method of perforations and the location(s). Method(s) may include use of drill, mills knife, torch, or other. Describe the type of screens installed. If inner casing is telescoping indicate its diameter.
Well Tests (Section 8)
Indicate the type of test that was done to determine the quantity of water available from the well. Indicate water temperature, and the depth(s) if artesian flow(s)were found. If a chemical or biological water analysis was done, show who did the test. If any strata contained water not suitable for use, indicate why.
Location of Well (Section 9)
Indicate the location of the well by County, Township, Range, Section, and Tax Lot number, ¼ ¼ or latitude and longitude, and street address of the well or nearest address. Latitude and longitude may be substituted for ¼ ¼ ONLY. If LORAN equipment is available, please report latitude and longitude in degrees, minutes, and seconds or decimals.
Static Water Level (Section 10)
Show the static water level (SWL)of the completed well in feet below land surface. Be sure to check the box to the left of the SWL if it is above land surface. Indicate the artesian pressure, if appropriate. For deepening indicate beginning SWL and the date it was measured ;and ending SWL and the date it was measured.
Water Bearing Zones (Section 10)
Indicate the depth at which water was first found. Show all water bearing zones and you may include the depth of static water level(s) (SWL) for each water bearing zone. Estimate flow rate, if possible. Check the box to the left if the SWL is above land surface.
Well Log (Section 11)
Describe the color, texture, grain size, and structure of materials and show the thickness (from/to) of each formation found with at least one entry for each change of formation.
Overflow and Comments page (Page 2)
Provide additional information regarding the well construction on this page. Complete as appropriate. If you cannot fit everything on the overflow page, you will not be able to submit electronically. You will need to print the form and complete it manually.
Map pages (Pages 3 & 4)
The map pages allow you to insert a graphic file showing a mapped location of the well. Click on the blank map and you will be presented with a File browser to locate a file you have created for insertion. Graphic files in the .jpg format seem to work best for this feature.