HomeMy WebLinkAbout071-530-005 EHWS19-0127 WELL LOGState of California
Well Completion Report
Form DWR 188 Auto-Completed 9/30/2019
WCR2019-010419
Owner's Well Number Date Work Began 19-2 07/22/2019 Date Work Ended 07/29/2019
Local Permit Agency Butte County Public Health
Secondary Permit Agency Permit Number EHWS19-0127 Permit Date 07/10/2019
Well Location
120 Swede Ranch RD Address
Berry Creek City 95916Zip ButteCounty
39 Latitude 37 7.464
Deg.Min.Sec.
N -121Longitude 22 57.5039
Deg.Min.Sec.
W
Dec. Lat. 39.61874 Dec. Long. -121.38264
Vertical Datum Horizontal Datum WGS84
Location Accuracy Location Determination Method
071-530-005APN
20 NTownship
05 ERange
02Section
Mount DiabloBaseline Meridian
Ground Surface Elevation
Elevation Accuracy
Elevation Determination Method
Geologic Log - Free Form
Depth from
Surface
Feet to Feet
Description
0 10 decomposed granite
10 262 granite
262 264 fracture
264 312 granite
312 313 fracture
313 750 granite
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 750
Other - Air
Vertical
750 Total Depth of Completed Well
Drilling Fluid None
Feet
Feet
Specify
Water Level and Yield of Completed Well
264Depth to first water
Depth to Static
80Water Level
0.01Estimated Yield*
4Test Length
*May not be representative of a well's long term yield.
(Feet below surface)
(Feet)
(GPM)
(Hours)
Date Measured 07/29/2019
Air LiftTest 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 PETERS DRILLING AND PUMP SERVICE
Person, Firm or Corporation
P O BOX 1546 GRASS VALLEY 95945CA
Address City State Zip
Signed electronic signature received
C-57 Licensed Water Well Contractor
07/29/2019
Date Signed
456136
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 25 10.63
25 30 8.63
30 750 6
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 30 Blank PVC OD: 6.625 in. |
Thickness: 0.432 in.
0.432 6.625 F-480 Cl 125
1 30 750 No Casing
Installed
Other N/A None
Annular Material
Depth from
Surface
Feet to Feet
Fill Fill Type Details Filter Pack Size Description
0 23 Bentonite High Solids
23 25 Cement 10.3 Sack Mix
25 750 Other Fill See description.none
Page 2 of 2 Form DWR 188 rev. 12/19/2017