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HomeMy WebLinkAbout038-080-007 EHWS19-0147 WELL LOGState of California Well Completion Report Form DWR 188 Complete 12/10/2019 WCR2019-014487 Owner's Well Number Date Work Began 09/23/2019 Date Work Ended 09/30/2019 Local Permit Agency Butte County Public Health Secondary Permit Agency Permit Number EHWS19-0147 Permit Date 09/23/2019 Well Location 2856 house Address Durham City 95938Zip ButteCounty 39 Latitude 37 30.5994 Deg.Min.Sec. N -121Longitude 49 18.9523 Deg.Min.Sec. W Dec. Lat. 39.6251665 Dec. Long. -121.8219312 Vertical Datum Horizontal Datum WGS84 Location Accuracy Location Determination Method 038-080-007APN 21 NTownship 01 ERange 36Section Mount DiabloBaseline Meridian Ground Surface Elevation Elevation Accuracy Elevation Determination Method Geologic Log - Free Form Depth from Surface Feet to Feet Description 0 145 all ready drilled 145 183 brown clay 183 190 course black sand 190 208 brown clay 208 230 fine sand and small gravel 230 284 brown clay 284 313 medium sand and gravel 313 347 brown clay 347 353 sand and gravel 353 377 brown clay with 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 Deepen Borehole Information Drilling Method Orientation Total Depth of Boring 377 Cable Tool Vertical 377 Total Depth of Completed Well Drilling Fluid Water Feet Feet Specify Water Level and Yield of Completed Well Depth to first water Depth to Static 40Water Level 700Estimated Yield* Test Length *May not be representative of a well's long term yield. (Feet below surface) (Feet) (GPM) (Hours) Date Measured 09/30/2019 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 BLAINE'S WELL DRILLING, Blaine Willliams Person, Firm or Corporation 5205 La Porte Rd Marysville 95901CA Address City State Zip Signed electronic signature received C-57 Licensed Water Well Contractor 10/14/2019 Date Signed 1018188 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) 0 145 12 145 377 10 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 0 170 Blank Low Carbon Steel Grade: ASTM A53 0.188 10.375 1 170 377 No Casing Installed Other N/A open hole Annular Material Depth from Surface Feet to Feet Fill Fill Type Details Filter Pack Size Description 0 377 Other Fill See description.no fill. existing well Page 2 of 2 Form DWR 188 rev. 12/19/2017