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HomeMy WebLinkAbout060-230-018 EHWS17-0143 Well LogState of California Well Completion Report Form DWR 188 Complete 9/11/2018 WCR2018-005855 Owner's Well Number Date Work Began e0366348 07/16/2018 Date Work Ended 07/17/2018 Local Permit Agency Butte County Public Health Secondary Permit Agency Permit Number EHWS17-0143 Permit Date 09/12/2017 Well Location 7845 White Channel LN Address Butte Meadows City 95942Zip ButteCounty Latitude Deg.Min.Sec. N Longitude Deg.Min.Sec. W Dec. Lat. Dec. Long. Vertical Datum Horizontal Datum WGS84 Location Accuracy Location Determination Method 060-230-018APN 26 NTownship 04 ERange 21Section Mount DiabloBaseline Meridian Ground Surface Elevation Elevation Accuracy Elevation Determination Method Geologic Log - Free Form Depth from Surface Feet to Feet Description 0 2 Top soil & boulders 2 15 Boulders, sand and gravel 15 28 Volcanic tuft 28 35 Volcanic & gravel 35 40 Volcanics 40 50 Gravel zone Well Owner (must remain confidential pursuant to Water Code 13752) Nels Leen Name Mailing Address 460 W. East Avenue, Suite 100 Chico City CAState 95926Zip Planned Use and Activity Planned Use Activity Water Supply Domestic New Well Borehole Information Drilling Method Orientation Total Depth of Boring 50 Other - Air Vertical 50 Total Depth of Completed Well Drilling Fluid None Feet Feet Specify Water Level and Yield of Completed Well 28Depth to first water Depth to Static 0Water Level 100Estimated Yield* 4Test Length *May not be representative of a well's long term yield. (Feet below surface) (Feet) (GPM) (Hours) Date Measured 07/17/2018 Air LiftTest Type Total Drawdown (feet) Page 1 of 2 Form DWR 188 rev. 12/19/2017 Other Observations: Certification Statement I, the undersigned, certify that this report is complete and accurate to the best of my knowledge and belief Name PETERS DRILLING AND PUMP SERVICE Person, Firm or Corporation P O BOX 1546 GRASS VALLEY 95945CA Address City State Zip Signed electronic signature received C-57 Licensed Water Well Contractor 07/24/2018 Date Signed 456136 C-57 License Number DWR Use Only CSG #State Well Number Site Code Local Well Number N Latitude Deg/Min/Sec Longitude Deg/Min/Sec TRS: APN: W Borehole Specifications Depth from Surface Feet to Feet Borehole Diameter (inches) 0 22 10.63 22 40 8.63 40 50 6 Attachments e0366348.pdf - Other Casings Casing # Depth from Surface Feet to Feet Casing Type Material Casings Specificatons Wall Thickness (inches) Outside Diameter (inches) Screen Type Slot Size if any (inches) Description 1 0 27 Blank Other N/A 0.188 6 steel 1 27 35 Screen Other N/A 0.188 6 Saw Cut 3 steel 1 35 40 Blank Other N/A 0.188 6 steel 1 40 50 No Casing Installed Other N/A none Annular Material Depth from Surface Feet to Feet Fill Fill Type Details Filter Pack Size Description 0 25 Cement Portland Cement/Neat Cement pumped seal 25 40 Other Fill See description.#8 Sand 40 50 Other Fill See description.none Page 2 of 2 Form DWR 188 rev. 12/19/2017