HomeMy WebLinkAbout029-151-008 EHWS18-0020 Well LogState of California
Well Completion Report
Form DWR 188 Complete 9/14/2018
WCR2018-007113
Owner's Well Number Date Work Began STATION #71 05/16/2018 Date Work Ended 05/18/2018
Local Permit Agency Butte County Public Health
Secondary Permit Agency Permit Number EHWS18-0020 Permit Date 04/23/2018
Well Location
1236 SCHOOL ST Address
RICHVALE City 95974Zip ButteCounty
39 Latitude 29 41.9999
Deg.Min.Sec.
N -121Longitude 44 50.2367
Deg.Min.Sec.
W
Dec. Lat. 39.4950000 Dec. Long. -121.7472880
Vertical Datum Horizontal Datum WGS84
Location Accuracy Location Determination Method
029-151-008APN
19 NTownship
02 ERange
16Section
Mount DiabloBaseline Meridian
120Ground Surface Elevation
UnknownElevation Accuracy
OtherElevation Determination Method
Geologic Log - Free Form
Depth from
Surface
Feet to Feet
Description
0 10 CLAY & FINE SAND
10 20 FINE GRAVEL & CLAY
20 40 HARD, SANDY CLAY
40 60 SANDY CLAY
60 70 HARD CLAY
70 90 HARD SANDY CLAY
90 110 FINE GRAVEL
110 120 HARD SANDY CLAY
120 130 FINE GRAVEL
130 140 FNE GRAVEL & SANDY CLAY
140 150 SANDY CLAY
150 180 FINE GRAVEL & SANDY CLAY
180 210 FINE SANDY GRAVEL & SOME CLAY
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 210
Reverse Circulation
Vertical
200 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
50Estimated 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
08/23/2018
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)
0 210 12
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 0 160 Blank PVC OD: 6.625 in. | SDR:
21 | Thickness: 0.316
in.
0.316 6.625
1 160 200 Screen PVC OD: 6.625 in. | SDR:
21 | Thickness: 0.316
in.
0.316 6.625 Milled
Slots
0.032
1 200 210 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 65 Cement 10.3 Sack Mix ANNULAR CEMENT SEAL
65 210 Filter Pack Other Gravel Pack 4 X 8 GRAVEL PACK
Page 2 of 2 Form DWR 188 rev. 12/19/2017