HomeMy WebLinkAbout002-150-103 EHWS13-0217 Well LogState of California
Well Completion Report
Form DWR 188 Auto-Completed 8/30/2021
WCR2021-007765
Owner's Well Number Date Work Began Husa Lane 09/09/2013 Date Work Ended 09/12/2013
Local Permit Agency Butte County Public Health
Secondary Permit Agency Permit Number EHWS13-0217 Permit Date 09/09/2013
Well Location
884 Husa Ln Address
Chico City 95928Zip ButteCounty
39 Latitude 44 50.118
Deg.Min.Sec.
N -121Longitude 47 53.2283
Deg.Min.Sec.
W
Dec. Lat. 39.747255 Dec. Long. -121.798119
Vertical Datum Horizontal Datum WGS84
Location Accuracy Location Determination Method
002-150-103APN
22 NTownship
02 ERange
19Section
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
2 35 Cobble
35 90 Clay
90 160 Gravel
160 200 Clay
200 350 Sandy Lava
Well Owner (must remain confidential pursuant to Water Code 13752)
XXXXXXXXXXXXXXXXXXXX Name
Mailing Address XXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXX City XXState XXXXXZip
Planned Use and Activity
Planned Use
Activity
Water Supply Domestic
New Well
Borehole Information
Drilling Method
Orientation
Total Depth of Boring 350
Direct Rotary
Vertical
340 Total Depth of Completed Well
Drilling Fluid Bentonite
Feet
Feet
Specify
Water Level and Yield of Completed Well
150Depth to first water
Depth to Static
140Water Level
50Estimated Yield*
Test Length
*May not be representative of a well's long term yield.
(Feet below surface)
(Feet)
(GPM)
(Hours)
Date Measured
PumpTest 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 WELL INDUSTRIES INC
Person, Firm or Corporation
3282 HIGHWAY 32 CHICO 95973CA
Address City State Zip
Signed electronic signature received
C-57 Licensed Water Well Contractor
06/28/2021
Date Signed
812678
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)
0 350 10.75
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 0 200 Blank PVC OD: 5.563 in. | SDR:
17 | Thickness: 0.327
in.
0.327 5.563
1 200 340 Screen PVC OD: 5.563 in. | SDR:
17 | Thickness: 0.327
in.
0.327 5.563 Shutter 0.032
Annular Material
Depth from
Surface
Feet to Feet
Fill Fill Type Details Filter Pack Size Description
0 100 Cement 10.3 Sack Mix
100 350 Filter Pack 8 x 12
Page 2 of 2 Form DWR 188 rev. 12/19/2017