HomeMy WebLinkAbout040-020-157 EHWS20-0125 Well LogState of California
Well Completion Report
Form DWR 188 Complete 10/12/2020
WCR2020-010875
Owner's Well Number Date Work Began SOUTHGATE 06/26/2020 Date Work Ended 06/29/2020
Local Permit Agency Butte County Public Health
Secondary Permit Agency Permit Number EHWS20-0125 Permit Date 06/24/2020
Well Location
0 SOUTHGATE AVE Address
CHICO City 95928Zip ButteCounty
39 Latitude 41 48.0839
Deg.Min.Sec.
N -121Longitude 47 19.788
Deg.Min.Sec.
W
Dec. Lat. 39.69669 Dec. Long. -121.78883
Vertical Datum Horizontal Datum WGS84
Location Accuracy Location Determination Method
040-020-157-000APN
21 NTownship
02 ERange
07Section
Mount DiabloBaseline Meridian
217Ground Surface Elevation
UnknownElevation Accuracy
Digital Aerial PhotoElevation Determination Method
Geologic Log - Free Form
Depth from
Surface
Feet to Feet
Description
0 10 TOP SOIL
10 30 GRAVEL
30 40 CLAY
40 200 GRAVEL
200 210 GRAVEL & CLAY
210 220 CLAY
220 230 COARSE BLACK SAND
230 240 CLAY & GRAVEL
240 250 FRACTURED CLAY
250 280 SANDY CLAY
280 310 SANDY CLAY W/ TRACE OF GRAVEL
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 310
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
150Estimated 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
08/18/2020
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)
0 310 14.5
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 0 190 Blank Low Carbon
Steel
Grade: ASTM A53 0.25 8.625
1 190 290 Screen Stainless
Steel
Grade: 304 Stainless
Steel
0.322 8.625 Wire
Wrap
0.06
1 290 300 Blank Stainless
Steel
Grade: 304 Stainless
Steel
0.322 8.625 W/ END CAP
1 300 310 No Casing
Installed
Other N/A NO CASING
Annular Material
Depth from
Surface
Feet to Feet
Fill Fill Type Details Filter Pack Size Description
0 80 Cement 10.3 Sack Mix ANNULAR CEMENT SEAL
80 310 Filter Pack Other Gravel Pack 4 X 8 GRAVEL PACK
Page 2 of 2 Form DWR 188 rev. 12/19/2017