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HomeMy WebLinkAbout056-020-124 EHWS19-0082 WELL LOGState of California Well Completion Report Form DWR 188 Auto-Completed 9/16/2019 WCR2019-009680 Owner's Well Number Date Work Began 19-1 06/19/2019 Date Work Ended 06/21/2019 Local Permit Agency Butte County Public Health Secondary Permit Agency Permit Number EHWS19-0082 Permit Date 05/13/2019 Well Location 0 Cohasset RD Address Chico City 95973Zip ButteCounty 39 Latitude 51 32.8319 Deg.Min.Sec. N -121Longitude 46 55.776 Deg.Min.Sec. W Dec. Lat. 39.85912 Dec. Long. -121.78216 Vertical Datum Horizontal Datum WGS84 Location Accuracy Location Determination Method 056-020-124APN 23 NTownship 02 ERange 08Section Mount DiabloBaseline Meridian Ground Surface Elevation Elevation Accuracy Elevation Determination Method Geologic Log - Free Form Depth from Surface Feet to Feet Description 0 1 top soil 1 3 boulder 3 35 clay & volcanics 35 135 volcanics with gravel lenses 135 140 sand & gravel 140 262 volcanics with gravel lenses 262 265 aluvials 265 640 volcanics with gravel lenses 640 690 hardsand 690 720 volcanics 720 765 soft sand 765 770 gravel aluvials 770 800 volcanics 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 Specify Exploratory Other New Well Borehole Information Drilling Method Orientation Total Depth of Boring 800 Other - Air Vertical 800 Total Depth of Completed Well Drilling Fluid None Feet Feet Specify Water Level and Yield of Completed Well 262Depth to first water Depth to Static 0Water Level 0Estimated Yield* 4Test Length *May not be representative of a well's long term yield. (Feet below surface) (Feet) (GPM) (Hours) Date Measured 06/21/2019 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 07/16/2019 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 23 10.63 23 190 8.63 190 800 6 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 0 170 Blank PVC OD: 6.625 in. | Thickness: 0.432 in. 0.432 6.625 F-480 Cl 125 1 170 190 Screen PVC OD: 6.625 in. | Thickness: 0.432 in. 0.432 6.625 Saw Cut 3 F-480 Cl 125 1 190 800 No Casing Installed Other N/A none Annular Material Depth from Surface Feet to Feet Fill Fill Type Details Filter Pack Size Description 0 22 Bentonite High Solids 22 25 Cement 10.3 Sack Mix 25 800 Other Fill See description.none Page 2 of 2 Form DWR 188 rev. 12/19/2017