HomeMy WebLinkAbout022-210-107 EHWS23-0031 WELL LOGState of California
Well Completion Report
Form DWR 188 Complete 9/17/2023
WCR2023-007927
Owner's Well Number Date Work Began 06/13/2023 Date Work Ended 07/11/2023
Local Permit Agency Butte County Public Health
Secondary Permit Agency Permit Number EHWS23-0031 Permit Date 05/04/2023
Well Location
1044 AD LN Address
gridley City 95948Zip ButteCounty
39 Latitude 22 54.3665
Deg.Min.Sec.
N -121Longitude 44 17.3994
Deg.Min.Sec.
W
Dec. Lat. 39.3817685 Dec. Long. -121.7381665
Vertical Datum Horizontal Datum WGS84
Location Accuracy Location Determination
Method
022210107APN
18 NTownship
02 ERange
27Section
Mount DiabloBaseline Meridian
Ground Surface Elevation
Elevation Accuracy
Elevation Determination Method
Geologic Log - Free Form
Depth from
Surface
Feet to Feet
Description
0 15 Brown sand
15 25 Bown sandy clay
25 40 Coarse sandy clay
40 60 Soft tan clay
60 70 Coarse sand
70 95 Clay
95 105 Sandy clay
105 110 Coarse sand
110 118 Fine brown sand
118 120 Sandy brown clay
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 120
Cable Tool
Vertical
120 Total Depth of Completed Well
Drilling Fluid Water
Feet
Feet
Specify
Water Level and Yield of Completed Well
7Depth to first water
Depth to Static
5Water Level
75Estimated Yield*
4Test Length
*May not be representative of a well's long term yield.
(Feet below surface)
(Feet)
(GPM)
(Hours)
Date Measured 06/27/2023
PumpTest Type
Total Drawdown 15 (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
07/16/2023
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 25 14
25 120 8
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 25 No Casing
Installed
Low Carbon
Steel
Grade: ASTM A53 14
2 25 90 Blank Low Carbon
Steel
Grade: ASTM A53 0.188 8
3 90 110 Screen Low Carbon
Steel
Grade: ASTM A53 0.188 8 Bridge
Slot
0.06
4 110 120 Blank Low Carbon
Steel
Grade: ASTM A53 0.188 8
Annular Material
Depth from
Surface
Feet to Feet
Fill Fill Type Details Filter Pack Size Description
0 25 Cement 10.3 Sack Mix
25 120 Other Fill See description.No fill
Page 2 of 2 Form DWR 188 rev. 12/19/2017