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Report (102) FDq 15 SI,3 \ -1r. NI-e.- . STATE OF OREGON . 0/'Z/7`e)e/57 -__-- WELL ID#L None WATER SUPPLY WELL REPORT (as required by ORS 537.765) KYLe$ DRILLING INCA m .: START CARD# W1038.496 Instructions for completing this report are on the last page of this or ' `503456-2483 (1)OWNER: Well Number: 09 (9)LOCATION OF WELL by legal description: Name County -Washington__ Latitude Longitude tilutes�ExcaxatorS,_Inc LEoiygon Township 28OUTH N or S. Range 1 WEST E or W.of WM. Address 430411W Bethany_Blyd,Ste 1-2_P_MB_361_ City Portland State Section _080c W__ 1/4 SE 1/4OB_.Zip 9722 rax lot 00104_.___Lot Block subdivision (2)TYPE OF WORK: Street Address of Well(or nearest address) 15915 SW 150th Ave, New Well Deepening Alteration(repair/recondition) ITC Abandonment Tigar_d,OR __ (3) DRILL METHOD: (10)STATIC WATER LEVEL: X Rotary Air RotaryMud 187 ft.below land surface. Date 4/25/2018 ❑Cable Auger Artesian pressure lb.per square inch. Date Other (11)WATER BEARING ZONES: (4)PROPOSED USE: Depth at which water was first found NA �X Domestic Community Industrial Ti Irrigation Thermal Injection Livestock TI Other From To Estimated Flow Rate S ' (5) BORE HOLE CONSTRUCTION: DEC 1 8 2018 ...._.__....-......... . Special Construction approval L.,--J Yes `Xi No Depth of Completed Well 0 ft. —• __ CITY CITY OF TIG I°w 1 Explosives used Yes X No Type Amount HOLE SEAL Amount BUILDING DIVISION Diameter From To Material From To sacks or pounds (12)WELL LOG: 6 Cement w/5% i 298 Ground elevation _ _bentonite 14 36 Sacks Material _Front To SWL Bentonite 14 0:5 Sacks Abandonment Only. Calculated 141 Sacks 'Unable to perforate casing below T How was seal placed: Method A B C U D Li E X Other P_umped_atbstttflm;Pouredlzentonite Backfill placed from ft.to ft. Material Gravel placed from ft.to ft. Size of gravel (6)CASING/LINER: —_ Diameter From To Gauge Steel Plastic Welded Threaded Casing:_. 6 0 ?? .250 :lc ?( . Li 1 - KYLES DA LING, INC. C �; � U �I 503-656-2683 Liner: Removed r 77 Drive Shoe used 7Inside -Outside ;_._!None Final location of shoe(s) _N/A________ _____. (7)PERFORATIONS/SCREENS: X Perforations Method Air Perforator Screens Type Material Slot Tele/pipe From To size Number Diameter size Casing Liner 0 7 1/8x1 95 '-x, i Date started4/25/2018____ Completed 4/26/2018 -- —__ (unbonded)Water Well Constructor Certification: I certify that the work I performed on the construction,alteration,or abandon- ment of this well is in compliance with Oregon water supply well construction (8)WELL TESTS: Minimum testing time is 1 hour standards.Materials used and information reported above are true to the best of my Pump Bailer Air Ti Flowing Artesian knowledge and belief. WWC Number 1115 Yield gal/min Drawdown Drill stem at Time Signed. ------------7 Date 4/27/201.8_ N/A _ _ ___ yles Drilling,Inc. (bonded)Water Well Constructor Certification: -- — I accept responsibility for the construction, alteration, or abandonment work _ performed on this well during the construction dates reported above. All work Temperature of Water Depth Artesian Flow found performed during this time is in compliance with Oregon water supply well Was a water analysis done? iTI Yes By whom r-- construction standards. This report is true to the best of my knowledge and belief. Did any strata contain water not suitable for intended use? IToo little 9 WWC Number 2096 Salty Muddy 7 Odor Colored Other Signed ��- - ---- Date 4/27/2018_ Depth of strata: Skyles Drillln , ----4—nc. ORIGINAL-WATER RESOURCES DEPARTMENT FIRST COPY-CONSTRUCTOR SECOND COPY-CUSTOMER P.O. BOX 1050 '���%/' � .'-" i.;.: :: dry' I - ► ;iat - �lot GASTON, OR 97119 -iv^‘a.�1. INVOICE# ii,,,, i 503-522-2727 OFFICE r.r 503-687-2381 FAX DATE / /i I ORIGINATION gZt,5�_/�/�' TECHNICIAN -q-iiS4',`(.,1 # I&2 CUSTOMER Lw, fec 2 XoLuc f-S ADDRESS 15-9/5 5110 4b ✓`4- -- ., � CITY p 1,,,,L. STATE 6 at ZIP 97o�a 522-2727 . .'- : BEST PHONE# ($ ) ?//r/- 7/(t (Axel)CONTACT# ( ) CCB#202772 FAX# ( ) TIME IN / ? I6 S AM/ ' DEQ#38783 PLUMBING# PB1466 ❑ YES DAYS GUARANTEE X❑ NO TIME OUT c)-:4V AM6) DRAIN SNEED FLAT/ URV. HOURLY $ AUTH. jtjc R K PERFORMED DRAIN CLEANING ADD.DRAINS MAIN LINE HOURLY i y CM- .y/-'C 4-m.4u ,< /7 00 0 C9ci//opJ5 SEPTIC PUMP 5-5-19 '- KITCHEN KITCHEN SINK FLAT i 0i . /yK 7:3-C_ CA-e C 01'11 SS )0N' GREASE PUMP LAUNDRY LINE FLAT VIDEO INSPECTION BATH SINK FLAT PIPE LOCATE BATH TUB FLAT WATER JETTING VIDEO HOURLY EXCAVATION TOILET FLAT PRODUCTS FLOOR DRAIN FLAT PARTS AREA DRAIN HOURLY LABOR RAIN DRAIN HOURLY 1 DIAGNOSIS FEE CO ar SEPTIC/GREASE GAL. , ST SERVICE CALL C C) = VIDEO HOURLY ROOF/2ND FLOOR d c:73 rri SECOND MAN Z Q c-) C) APPROVAL CODE# CHECK# PLUMBING c�3 oo PARTS RECOMMENDATIONS QTY. PART# DESCRIPTION PRICE ❑ ENZYME TREATMENT ❑VIDEO INSPECTION to 'r ❑ ROOT KILLER ❑ PIPE REPAIR/REPLACEMENT 5%CC FEE CIANNUAL MAINTENANCE ElCLEANOUT/INSTALLATION S-572 El JETTING CI RECEIVED BALANCE DUE s'-5-0" ADDITIONAL TERMS AND CONDITIONS CONTAINED ON THE REVERSE SIDE OF THIS SHEET f'� �Q r WEBSITE:WESTSIDEDRAIN.COM X �-� C7�/ `ter l <+ U EMAIL:WESTSIDEDRAIN©ICLOUD.COM ACCEPTANCE OF ESTIMATE AND TERMS AND CONDITIONS ACKNOWLED MENT OF COMPLETION CITY OF TIGARD SITE COPY BUILDING PERMIT COMMUNITY DEVELOPMENT Permit#: BUP2017-00157 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07!13(2017 Parcel: 2S108DC01404 Site address: 15915 SW 150TH AVE Jurisdiction: Tigard Project: River Terrace Crossing Subdivision: None Project Description: Demo(1)1,019 sf dwelling on septic and(4)accessory buildings. UPON FINAL INSPECTION,SDC CREDITS Lot: None MAY APPLY. Contractor: NORTHWEST EARTHMOVERS INC Owner: NEIDERS,REGINE I&GUNARS K PO BOX 1609 14517 SE 178TH PL SHERWOOD,OR 97140 RENTON,WA 98058 PHONE: 503-625-3100 PHONE: FAX: 503-625-3108 Specifics: FEES Type of Use: SF Description Date Amount Permit Fee-COM-New Construction 07/13/2017 $379.22 Class of Work: DEM Type of Const: Info Process/Archiving-Sm$0.50(up to 07/13/2017 50.50 Occupancy Grp: Occupancy Load: Dwelling Units: 1 11x17) Stories: Height: Erosion Control w/Development 07/13/2017 5107.60 ft Bedrooms: Bathrooms: Value: $29,550 Floor Areas: Total Area: Accessory Struct: Basement: Carport: Covered Porch: Deck: Garage: Mezzanine: Total 5487.32 Required: Required Items and Reports(Conditions) Fire Sprinkler: Parapet: Fire Alarm: Protected Corridors: Smoke Detectors: Manual Pull Stations: Accessible Parking: This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 9522-00.10090.You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332 2344. Issued By: ✓J/{1 // Permittee Signature: • r.GrJl 14e,,,, e7 Call 503.639.4176 by 7:00 a.m.for the next available inspection date. This permit card shall he kept in a conspicuous place on the job site until completion of the project Approved plans are required on the job site at the time of each inspection. r t4 { r Inspections Required for I .nit No.: (,'/, 2/7 s7 IVR Code Type Permit Description IVR Code Type Permit Description 01 BUP Building—structural 07 SIT Site Work 02 ELC Electrical 08 SWR Sewer Connection 03 ELR Restricted Energy 09 FPS Fire Protection 04 MEC Mechanical 10 RER Re-Roof 05 MST Master—residential combination 11 CMS Commercial Manufact.Structure 06 PLM Plumbing 12 SFM Single-Family Manufact.Structure J Req'd I Code Inspection Description J Req'd Code Inspection Description Building(structural)Inspections Electrical Inspections 205 Footing 105 Underground/slab cover 210 Foundation walls 110 Temporary electrical service 215 Footing drain 115 Electrical service 220 Slab 120 Electrical rough-in 225 Post/beam structural 125 Wall cover 230 Underfloor insulation 130 Ceiling cover 240 Exterior shearwall 135 Low voltage rough-in 242 Interior shearwall 140 Sign installation 245 Firewall 145 A/C or heating unit circuit 250 Roof nailing 150 Hot tub/spa/pool 255 Wtr proofing basement walls 195 Misc.inspection 260 Tilt-up panel 198 Low voltage final 265 Masonry 199 Electrical fmal 270 Reinforcing steel(rebar) 275 Framing Mechanical Inspections 280 Insulation 605 Post/beam mechanical 285 Drywall nailing 610 Gas line 287 Suspended ceiling 615 Mechanical rough-in 289 Approach/sidewalk 620 Hydronic piping 295 Misc.inspection 625 Duct work 299 Final inspection 630 Fire damper 635 Smoke detector shutdown Fire Protection System Inspections 640 Exhaust hood 901 Sprinkler supply lines 645 Grease duct test 905 Sprinkler underfloor/slab 695 Misc.inspection 906 Flush test 699 Mechanical final 907 Sprinlder hydro test 910 Sprinlder rough-in/test Plumbing Inspections 915 Fire alarm rough-in 305 Plumbing underslab 920 Suppression trip test 310 Crawl drain 995 Misc.inspection 312 Backwater valve 998 Alarm final 315 Post/beam plumbing 999 Sprinlder final 320 Plumbing rough-in 322 Shower pan Site Work Inspections 330 Water service 405 Excavation 335 Rain drain 410 Fill 340 Storm sewer 415 Grading 345 Culvert/catch basin 495 Misc Inspection 350 Septic tank 499 Final Inspection 395 Misc.inspection 399 Plumbing final Sanitary Sewer Inspections 505 Sanitary sewer Erosion Control Inspections 585 Misc.inspection 750 Initial erosion control 599 Final inspection 752 LIDA on-site facility inspection 755 Regular erosion control Manufactured Structure Inspections 797 Final LIDA inspection 810 MFG-Structure set-up 798 Final erosion control 899 MFG-Structure final I:\Building\Forms\Inspection Cards\AOP Insp Card By Case\InspCard_All_031816.doca • . r r,_,/ !•-` //-- // /.// /-// ✓ I/!' F///�`//�I�/� \ EXISTING GRAVEL DRIVE .. _• - _ / /J // /// ^ ! N.J /..,.. ! F / \ TO REMAIN y ^-Ns-. /. ‘...1 !/ ! - / COSTING GRAVEL DRIVEWAY ! `t .. / TAXLOT:1b2,-„ TO BE MOVED \ / ,..../ � TREE PROTECTION FENCE REMOVED '$ \ r �� / ,i .. --6 .-_. 1•� SI_I ' p ♦ I•moi ♦ L __ TA/0.017 t9o3 / •••• --7'�IXISTING FENCES'�' 1 /'. ]•� _ ms's 1 =- w-•//.`/ .. �/" 'EXISTING 76 SF \TO BE REMOV[D _, _—_._ / ram ✓ '/ ( -\ I.. R`. / STRUCTURE TO RE IT ! + EXISTING 1,919 SF STRUCTURE \ I, / /' -,/f. t REMOVED AND WELL TO t / n //( _' TO BE REMOVED ! //� 1-;Lt TAXLOT:ibS`-."�- .� !—X TAXLOT:1b6 J/ 1 ! DE REMOVED PER DEQ I // ( / \ 1 1� `I ,,._ / T A/,-rite' -- .- / / 'GUIDELINES ONCE T7T �� I A" AD/ACENi PROPERTY IS / / .1__ / / //' ' I y\, 1 Ara..---......... _ ftf 1A' x / 1`,< / '1..1/" G PROVIDED PUBLIC WATER " ^- /_:.. 1 r \ 1 I \ / I•��! / / „ / SERV.‹... NECTION y / � I wax /�/ /// // li• L ..�` J 1 O,} EASTMG RO Si STRUCTURE/ / ` EXISTING FENCES ll I \ / \\„ / / :r/%/d. T- - - `•TpI'' / `�. I ^ ( .41 1�'. TO BE REMOVED TO BE REMOVED Xii• \\ 1 x� ��,�J/. \ f( //- //w I //'�) \\ ____----+-- AlE%ISTING FENCES.- / ;/ I 'I EXITOBE STWGEMFEVED,OCES 1 x \\ \\'-�/ •vin� //// -\ \ �s�i \^' TO BE REMOVED / ; II \ A‘T ( X 1 ' EXISTING 6.961 SF STR 44// / •�\\ •IS-Y/�EXISTING DRIPLINE ‘s. \X rX/. .I Y / " - TO BE PEMOVEO - �� \ ( // `\ -s. w .� m_ "-"'/ r "\ /\ w / / I TAXLOT:1909 FASTING STREAM \\\ „-„ w-" /--n6" /-•-+• _/ TO REMAIN \\ 1 x \ EXISTING 1,019 SF STRUCTURE �,�yy _ / �' � 5 \ \\ TO BE REMO D—.!'..�O^--•' XX - _ SO'STEAM BUFFER ��/ 1• ! / _ X—X X TREE PROTECTION FENCE / � � \ `�� _ /-_J10•//"`~\\ w^_ _X—' FASTING 1695E STRUCTURE A�M>~•x „ / \\ w - ........... �.- \ -- \ TO BE REMOVED""'' 'V � Y---"/ /II,� \ I .-\ /1- \\ _ `k .L IXISTING FENCES / / ('aaalll„rrr,. \\ ���``` " %,/ "-\ oIS11NBE RGOtV1[EEDS.�,'/INSTALL SEDIIAEM FENCE " X./ -yI TO RE REMOVED""/// " *1°1:0',4;tri,......x r' EXISTING 6� //"/" \w1 ( �%_*� / TO BE REMOVY�O "/ ..•". . \�\ // —z—X—X--`�z —x—z—x—�R-�fA- X//..X—x— X—% z— \ �\./ .� / % —X x1 — —..--��-- —.0N-�.al- _e.,,, /^ _ - .......... - / / 1 ( --\ 777-7 --/ r...," '\ -- w\T/// ^/.. —* ,_ ...-/�/ '/J i–Tq0 ;\ • \, .\` /� !.---- ......,.......,,-..,......4....\.., S\\ LEGEND 1 PAVEMENT n9- �� �// I SIDEWALK STORM DRAIN LINE J GUY VIRE 0 TELEPHONE RISER -4—7Tv— WATERLINE 0 SANITARY SEWERMANHOLE aDITCH INLET —IV ELECTRIC LINE 0 STORM DRAIN MANHOLE Q VERIEOII ELECTRICAL BOX ` ( I BUILDING —07— TELEPHONE LINE q FIRE HYDRANT Q IRRIGATION CONTROL VALVE —IG— GAS LINE -r SIGN 0 UTIUTY RISER Ed WETLANDS © STEAM —0— TREE PROTECTION FENCE I WATER METER N GAS VALVE FENCE -E}' UTILITY POLE • WATER VALVE 94 FLOW DIRECTION —X—X— `, ROI--OVERHEAD WIRES 0 LIGHT POLE ER CURB INLET X TREE TO BE REMOVED n _XSs—SANITARY SEWER LINE 0 ELECTRICAL RISER ® MAILBOX N t m1¢767741 .Mahn.. 4 g . .VIEW _e^_,!„ xa1 NOTES: `� M !/ 111 D CD /\ � l mmxana rust V• ,777,,,7,, PROFILE x,77.7. 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