HomeMy WebLinkAbout040-280-042 EHWS13-0063 Well LogState of California
Well Completion Report
Form DWR 188 Complete 9/21/2016
WCR2016-006629
Owner's Well Number Date Work Began 040-280-042 05/01/2013 Date Work Ended 05/06/2013
Local Permit Agency Butte County Public Health
Secondary Permit Agency Permit Number EHWS13-0063 Permit Date 04/13/2013
Well Location
9143 Stanford LN Address
Durham City 95938Zip ButteCounty
Latitude
Deg.Min.Sec.
N Longitude
Deg.Min.Sec.
W
Dec. Lat. 39.6340788 Dec. Long. -121.7844701
Vertical Datum Horizontal Datum WGS84
Location Accuracy Location Determination Method
040-280-042APN
21 NTownship
02 ERange
32Section
Mount DiabloBaseline Meridian
Ground Surface Elevation
Elevation Accuracy
Elevation Determination Method
Geologic Log - Free Form
Depth from
Surface
Feet to Feet
Description
0 20 Top Soil
20 100 Clay
100 200 Clay & Gravel
200 320 Gravel & Clay
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 Irrigation -
Agriculture
New Well
Borehole Information
Drilling Method
Orientation
Total Depth of Boring 320
Reverse Circulation
Vertical
300 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)
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
09/21/2016
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 50 20
50 320 20
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 0 100 Blank PVC OD: 8.625 in. | SDR:
21 | Thickness: 0.410
in.
0.41 8.625 CLS 200 SDR21
1 100 300 Screen PVC OD: 8.625 in. | SDR:
21 | Thickness: 0.410
in.
0.41 8.625 Milled
Slots
0.032 CLS 200 SDR21
Annular Material
Depth from
Surface
Feet to Feet
Fill Fill Type Details Filter Pack Size Description
0 50 Bentonite High Solids
50 320 Filter Pack Other Gravel Pack 0.250 X 8 Birdseye Gravel
Page 2 of 2 Form DWR 188 rev. 12/19/2017