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HomeMy WebLinkAbout061-080-122 EHWS20-0062 WELL LOGState of California Well Completion Report Form DWR 188 Complete 6/28/2020 WCR2020-005381 Owner's Well Number Date Work Began 20-1 04/22/2020 Date Work Ended 04/27/2020 Local Permit Agency Butte County Public Health Secondary Permit Agency Permit Number EHWS20-0062 Permit Date 04/08/2020 Well Location 0 Bean Creek Address Berry Creek City 95916Zip ButteCounty 39 Latitude 38 29.328 Deg.Min.Sec. N -121Longitude 18 43.5599 Deg.Min.Sec. W Dec. Lat. 39.64148 Dec. Long. -121.3121 Vertical Datum Horizontal Datum WGS84 Location Accuracy Location Determination Method 061-080-122APN 21 NTownship 06 ERange 33Section 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 28 clay & decomposed granite 28 55 decomposed granite 55 75 weathered granite 75 155 salt & pepper granite 155 157 fracture 157 290 salt & pepper granite 290 293 fracture 293 362 salt & pepper granite 362 364 fracture 364 590 salt & pepper granite 590 592 fracture 592 650 salt & pepper granite 650 653 fracture 653 820 salt & pepper granite 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 820 Other - Air Vertical 820 Total Depth of Completed Well Drilling Fluid None Feet Feet Specify Water Level and Yield of Completed Well 55Depth to first water Depth to Static 200Water Level 1Estimated Yield* 4Test Length *May not be representative of a well's long term yield. (Feet below surface) (Feet) (GPM) (Hours) Date Measured 04/27/2020 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 04/28/2020 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 90 8.63 90 820 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 70 Blank PVC OD: 6.625 in. | Thickness: 0.432 in. 0.432 6.625 F-480 Cl 125 1 70 90 Screen PVC OD: 6.625 in. | Thickness: 0.432 in. 0.432 6.625 Saw Cut 3 F-480 Cl 125 1 90 820 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 25 820 Other Fill See description.none Page 2 of 2 Form DWR 188 rev. 12/19/2017