HomeMy WebLinkAbout028-080-043 EHWL17-0013 Well LogState of California
Well Completion Report
Form DWR 188 Complete 11/29/2017
WCR2017-005562
Owner's Well Number Date Work Began SITE 1 08/15/2017 Date Work Ended 08/17/2017
Local Permit Agency Butte County Public Health
Secondary Permit Agency Permit Number EHWL17-0013 Permit Date 08/02/2017
Well Location
0 LOMA RICA RD Address
HONCUT City 95965Zip ButteCounty
Latitude
Deg.Min.Sec.
N Longitude
Deg.Min.Sec.
W
Dec. Lat. 39.3274730 Dec. Long. -121.4818340
Vertical Datum Horizontal Datum WGS84
Location Accuracy Location Determination Method
028-080-043APN
17 NTownship
04 ERange
13Section
Mount DiabloBaseline Meridian
Ground Surface Elevation
Elevation Accuracy
Elevation Determination Method
Geologic Log - Free Form
Depth from
Surface
Feet to Feet
Description
0 10 SAND
10 15 1/8 GRAVEL
15 27 COBBLE & 3/4 GRAVEL
27 30 CLAY
30 42 HARD ROCK
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
Destruction
Drill and Destroy
Borehole Information
Drilling Method
Orientation
Total Depth of Boring 42
Reverse Circulation
Vertical
Total Depth of Completed Well
Drilling Fluid Bentonite
Feet
Feet
Specify
Water Level and Yield of Completed Well
Depth to first water
Depth to Static
Water Level
Estimated Yield*
Test Length
*May not be representative of a well's long term yield.
(Feet below surface)
(Feet)
(GPM)
(Hours)
Date Measured
Test Type
Total Drawdown (feet)
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 42 No Casing
Installed
Other N/A
Annular Material
Depth from
Surface
Feet to Feet
Fill Fill Type Details Filter Pack Size Description
0 42 Bentonite High Solids HOLE PLUG
Page 1 of 2 Form DWR 188 rev. 09/29/2017
Destruction Details:
FILLED BOREHOLE WITH BENTONITE HOLE PLUG AND COVERED THE SITE WITH NATIVE MATERIAL.
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
11/28/2017
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 42 7.875
Attachments
/WellReport_20171129_163709.pdf - WCR Final
Page 2 of 2 Form DWR 188 rev. 09/29/2017