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HomeMy WebLinkAbout066-370-043 EHWS21-0009 WELL COMPLETION REPORTState of California Well Completion Report Form DWR 188 Submitted 9/7/2023 WCR2023-009817 Owner's Well Number Date Work Began 280 06/26/2023 Date Work Ended 08/08/2023 Local Permit Agency Butte County Public Health Secondary Permit Agency Permit Number EHWS21-0009 Permit Date 01/20/2023 Well Location 13647 Nimshew Rd. Address Magalia City 95954Zip ButteCounty 39 Latitude 48 35.3987 Deg.Min.Sec. N -121Longitude 37 46.0163 Deg.Min.Sec. W Dec. Lat. 39.809833 Dec. Long. -121.629449 Vertical Datum Horizontal Datum WGS84 Location Accuracy 20 Ft Location Determination Method GPS 066-370-043APN 23 NTownship 03 ERange 34Section Mount DiabloBaseline Meridian 2148Ground Surface Elevation 30 FtElevation Accuracy GPSElevation Determination Method Destruction Details: Top of borehole excavated 5 feet dow, pulled out and removed all existing casing, filled with sand to 51 feet hello surface, remaining portion of top hole filled with 10 1/3 sack, cement grout meaning excavated portion backfilled with native soil Other Observations: Well Owner (must remain confidential pursuant to Water Code 13752) Troy Wilmes Name Mailing Address 13647 Nimshew Rd. Magalia City CAState 95954Zip Former Use Former Use Activity Water Supply Destroy Borehole Information Drilling Method Orientation Total Depth of Boring Vertical 142 Total Depth of Completed Well Drilling Fluid Feet Feet Specify Water Level and Yield of Completed Well Depth to first water Depth to Static Water Level Estimated 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 Certification Statement I, the undersigned, certify that this report is complete and accurate to the best of my knowledge and belief Name CHICO CONSTRUCTION INC Person, Firm or Corporation 35 JESSICA WAY COHASSET 95973CA Address City State Zip Signed electronic signature received C-57 Licensed Water Well Contractor 09/07/2023 Date Signed 780265 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) Page 2 of 2 Form DWR 188 rev. 12/19/2017