HomeMy WebLinkAbout028-390-023 EHWS19-0074 WELL LOGState of California
Well Completion Report
Form DWR 188 Auto-Completed 9/16/2019
WCR2019-009630
Owner's Well Number Date Work Began 1 06/11/2019 Date Work Ended 06/13/2019
Local Permit Agency Butte County Public Health
Secondary Permit Agency Permit Number EHWS19-0074 Permit Date 05/03/2019
Well Location
218 PRIDES WAY Address
BANGOR City 95914Zip ButteCounty
39 Latitude 22 39.5299
Deg.Min.Sec.
N -121Longitude 25 29.4326
Deg.Min.Sec.
W
Dec. Lat. 39.3776472 Dec. Long. -121.4248424
Vertical Datum Horizontal Datum WGS84
Location Accuracy Location Determination Method
028-390-023APN
18 NTownship
05 ERange
33Section
Mount DiabloBaseline Meridian
595Ground Surface Elevation
10 FtElevation Accuracy
GPSElevation Determination Method
Geologic Log - Lite
Depth from
Surface
Feet to Feet
Material Type Material Color Material Texture Material Description
0 26 Soil or Organic Red W/Boulders TOP SOIL W/ GRANITE
26 85 Rock Gray & White Hard GRANITE HARD
85 250 Granite Gray & White Water Bearing GRANITE W/ QUARTZ W/ WATER BERING
STRINGERS
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 250
Downhole Rotary
Hammer
Vertical
250 Total Depth of Completed Well
Drilling Fluid Air
Feet
Feet
Specify
Water Level and Yield of Completed Well
85Depth to first water
Depth to Static
28Water Level
3Estimated Yield*
4Test Length
*May not be representative of a well's long term yield.
(Feet below surface)
(Feet)
(GPM)
(Hours)
Date Measured 06/13/2019
Air LiftTest Type
Total Drawdown 0 (feet)
Page 1 of 3 Form DWR 188 rev. 12/19/2017
Other Observations:
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 80 Blank PVC OD: 4.500 in. | SDR:
21 | Thickness: 0.214
in.
0.214 4.5
1 80 120 Screen PVC OD: 4.500 in. | SDR:
21 | Thickness: 0.214
in.
0.214 4.5 Milled
Slots
32
1 120 140 Blank PVC OD: 4.500 in. | SDR:
21 | Thickness: 0.214
in.
0.214 4.5
1 140 160 Screen PVC OD: 4.500 in. | SDR:
21 | Thickness: 0.214
in.
0.214 4.5 Milled
Slots
32
1 160 180 Blank PVC OD: 4.500 in. | SDR:
21 | Thickness: 0.214
in.
0.214 4.5
1 180 200 Screen PVC OD: 4.500 in. | SDR:
21 | Thickness: 0.214
in.
0.214 4.5 Milled
Slots
32
1 200 220 Blank PVC OD: 4.500 in. | SDR:
21 | Thickness: 0.214
in.
0.214 4.5
1 220 240 Screen PVC OD: 4.500 in. | SDR:
21 | Thickness: 0.214
in.
0.214 4.5 Milled
Slots
32
1 240 250 Blank PVC OD: 4.500 in. | SDR:
21 | Thickness: 0.214
in.
0.214 4.5 W/ CAP INSTALLED
Annular Material
Depth from
Surface
Feet to Feet
Fill Fill Type Details Filter Pack Size Description
0 250 Filter Pack Other Gravel Pack #6 SILICA GRAVEL 1.5 YARDS
Page 2 of 3 Form DWR 188 rev. 12/19/2017
Certification Statement
I, the undersigned, certify that this report is complete and accurate to the best of my knowledge and belief
Name VICS WELL DRILLING INC
Person, Firm or Corporation
3807 SIERRA HWY UNIT #6 ACTON 93510CA
Address City State Zip
Signed electronic signature received
C-57 Licensed Water Well Contractor
07/15/2019
Date Signed
886439
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 21 10.63
21 250 6
Attachments
NENG HANG PLOT PLAN #1.jpg - Location Map
NENG HANG DRILLERS REPORT.docx - Other
NENG HANG APPROVED PERMIT.pdf - Permit
NENG HANG ACRE VALUE.pdf - Location Map
Page 3 of 3 Form DWR 188 rev. 12/19/2017