HomeMy WebLinkAbout063-250-027 EHWS20-0167 Well LogState of California
Well Completion Report
Form DWR 188 Complete 4/1/2022
WCR2022-001882
Owner's Well Number Date Work Began 264 04/20/2021 Date Work Ended 05/21/2021
Local Permit Agency Butte County Public Health
Secondary Permit Agency Permit Number EHWS20-0167 Permit Date 09/25/2020
Well Location
12341 Doe Mill RD Address
Forest Ranch City 95942Zip ButteCounty
39 Latitude 50 36.2147
Deg.Min.Sec.
N -121Longitude 40 8.4108
Deg.Min.Sec.
W
Dec. Lat. 39.843393 Dec. Long. -121.669003
Vertical Datum Horizontal Datum WGS84
Location Accuracy 50 Ft Location Determination
Method
GPS
063-250-027-000APN
23 NTownship
03 ERange
20Section
Mount DiabloBaseline Meridian
Ground Surface Elevation
Elevation Accuracy
Elevation Determination Method
Geologic Log - Free Form
Depth from
Surface
Feet to Feet
Description
0 50 Red dirt
50 210 Gray volcanic rock
210 212 Gray sand
212 250 Gray volcanic rock
250 252 gray volcanic cobble
252 260 Hard gray volcanic rock
260 370 Gray volcanic rock
370 510 Gray sandstone
510 512 Hard green rock
512 725 Consolidated mixed gravel red gray and green
725 730 Hard dark gray rock
730 740 Red clay
740 750 Multi-colored gravel gray, green, red and white
750 765 Hard green 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
Water Supply Domestic
New Well
Borehole Information
Drilling Method
Orientation
Total Depth of Boring 883
Downhole Hammer
Vertical
880 Total Depth of Completed Well
Drilling Fluid Air
Feet
Feet
Specify
Water Level and Yield of Completed Well
58Depth to first water
Depth to Static
530Water Level
12Estimated Yield*
5Test Length
*May not be representative of a well's long term yield.
(Feet below surface)
(Feet)
(GPM)
(Hours)
Date Measured 05/13/2021
Air LiftTest Type
Total Drawdown 350 (feet)
Page 1 of 2 Form DWR 188 rev. 12/19/2017
765 770 Red Clay
770 785 Green and white gravel
785 883 Green gray sandstone
Other Observations:
Certification Statement
I, the undersigned, certify that this report is complete and accurate to the best of my knowledge and belief
Name CHICO CONSTRUCTION INC
Person, Firm or Corporation
35 JESSICA WAY COHASSET 95973CA
Address City State Zip
Signed electronic signature received
C-57 Licensed Water Well Contractor
02/08/2022
Date Signed
780265
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)
0 883 9
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 0 660 Blank PVC OD: 4.950 in. | SDR:
20 | Thickness: 0.248
in.
0.248 4.95
1 660 880 Screen PVC OD: 4.950 in. | SDR:
20 | Thickness: 0.248
in.
0.248 4.95 Milled
Slots
0.032
Annular Material
Depth from
Surface
Feet to Feet
Fill Fill Type Details Filter Pack Size Description
0 50 Cement 10.3 Sack Mix
50 882 Filter Pack 8 x 12
Page 2 of 2 Form DWR 188 rev. 12/19/2017