HomeMy WebLinkAbout040-020-039 EHWS20-0153 Well LogState of California
Well Completion Report
Form DWR 188 Submitted 10/5/2020
WCR2020-014171
Owner's Well Number Date Work Began DOMESTIC WELL 08/26/2020 Date Work Ended 09/02/2020
Local Permit Agency Butte County Public Health
Secondary Permit Agency Permit Number EHWS20-0153 Permit Date 08/13/2020
Well Location
114 MARYBILL RANCH RD Address
CHICO City 95928Zip ButteCounty
39 Latitude 41 27.0887
Deg.Min.Sec.
N -121Longitude 47 36.5711
Deg.Min.Sec.
W
Dec. Lat. 39.690858 Dec. Long. -121.793492
Vertical Datum Horizontal Datum WGS84
Location Accuracy Location Determination Method
040-020-039APN
21 NTownship
02 ERange
07Section
Mount DiabloBaseline Meridian
205Ground Surface Elevation
UnknownElevation Accuracy
Digital Aerial PhotoElevation Determination Method
Geologic Log - Free Form
Depth from
Surface
Feet to Feet
Description
0 5 TOP SOIL
5 17 COBBLES
17 21 CLAY
21 60 CLAY & GRAVEL
60 160 HARD FORMATIONS / LAVA CAP
160 210 LOOSE ROCK FORMATIONS
210 220 CLAY
220 230 GRAY ROCK
230 260 CLAY
260 270 GRAY ROCK
270 285 CLAY
285 305 GRAY ROCK
Well Owner (must remain confidential pursuant to Water Code 13752)
TOM DIXON Name
Mailing Address 114 MARYBILL RANCH RD
CHICO City CAState 95928Zip
Planned Use and Activity
Planned Use
Activity
Water Supply Domestic
New Well
Borehole Information
Drilling Method
Orientation
Total Depth of Boring 305
Direct Rotary
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
100Estimated 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
10/05/2020
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)
0 305 12.25
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 0 240 Blank PVC OD: 6.625 in. | SDR:
17 | Thickness: 0.390
in.
0.39 6.625
1 240 300 Screen PVC OD: 6.625 in. | SDR:
17 | Thickness: 0.390
in.
0.39 6.625 Milled
Slots
0.032 W/ END CAP
Annular Material
Depth from
Surface
Feet to Feet
Fill Fill Type Details Filter Pack Size Description
0 26 Bentonite High Solids CHIP SEAL
26 305 Filter Pack Other Gravel Pack 1/4 PEA GRAVEL GRAVEL PACK
Page 2 of 2 Form DWR 188 rev. 12/19/2017