HomeMy WebLinkAbout028-380-016 EHWS19-0180 Well LogState of California
Well Completion Report
Form DWR 188 Complete 1/21/2020
WCR2019-017419
Owner's Well Number Date Work Began 19-1 12/10/2019 Date Work Ended 12/11/2019
Local Permit Agency Butte County Public Health
Secondary Permit Agency Permit Number EHWS19-0180 Permit Date 09/27/2019
Well Location
6141 Oro Bangor HWY Address
Bangor City 95966Zip ButteCounty
39 Latitude 26 15.756
Deg.Min.Sec.
N -121Longitude 25 48.1799
Deg.Min.Sec.
W
Dec. Lat. 39.43771 Dec. Long. -121.43005
Vertical Datum Horizontal Datum WGS84
Location Accuracy Location Determination Method
028-380-016APN
18 NTownship
05 ERange
08Section
Mount DiabloBaseline Meridian
Ground Surface Elevation
Elevation Accuracy
Elevation Determination Method
Geologic Log - Free Form
Depth from
Surface
Feet to Feet
Description
0 12 clay loam
12 60 weathered
60 75 fractured
75 95 greenstone
95 97 fractured
97 119 greenstone
119 140 fracture
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 140
Other - Air
Vertical
140 Total Depth of Completed Well
Drilling Fluid None
Feet
Feet
Specify
Water Level and Yield of Completed Well
75Depth to first water
Depth to Static
40Water Level
60Estimated Yield*
4Test Length
*May not be representative of a well's long term yield.
(Feet below surface)
(Feet)
(GPM)
(Hours)
Date Measured 12/11/2019
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
12/11/2019
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
25 100 8.63
100 140 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 80 Blank PVC OD: 6.625 in. |
Thickness: 0.432 in.
0.432 6.625 F-480 Cl 125
1 80 100 Screen PVC OD: 6.625 in. |
Thickness: 0.432 in.
0.432 6.625 Saw
Cut
3 F-480 Cl 125
1 100 140 No Casing
Installed
Other N/A none
2 0 80 Blank PVC OD: 4.500 in. |
Thickness: 0.337 in.
0.337 4.5 F-480 Cl 160
2 80 100 Screen PVC OD: 4.500 in. |
Thickness: 0.337 in.
0.337 4.5 Saw
Cut
3 F-480, Cl 160
2 100 120 Blank PVC OD: 4.500 in. |
Thickness: 0.337 in.
0.337 4.5 F-480 Cl 160
2 120 140 Screen PVC OD: 4.500 in. |
Thickness: 0.337 in.
0.337 4.5 Saw
Cut
3 F-480 Cl 160
Annular Material
Depth from
Surface
Feet to Feet
Fill Fill Type Details Filter Pack Size Description
0 25 Bentonite High Solids
25 27 Cement 10.3 Sack Mix
27 140 Other Fill See description.none
Page 2 of 2 Form DWR 188 rev. 12/19/2017