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HomeMy WebLinkAbout052-011-113 EHWS24-0028 WELL LOG ABANDONTMENTState of California Well Completion Report Form DWR 188 Submitted 6/21/2024 WCR2024-005382 Owner's Well Number Date Work Began 06/14/2024 Date Work Ended 06/20/2024 Local Permit Agency Butte County Public Health Secondary Permit Agency Permit Number EHWS24-0028 Permit Date 06/06/2024 Well Location 686 Bille RD Address Paradise City 95969Zip ButteCounty 39 Latitude 46 12.113 Deg.Min.Sec. N -121Longitude 37 29.8696 Deg.Min.Sec. W Dec. Lat. 39.7700314 Dec. Long. -121.6249638 Vertical Datum Horizontal Datum WGS84 Location Accuracy Location Determination Method 052-011-113APN 22 NTownship 03 ERange 15Section Mount DiabloBaseline Meridian Ground Surface Elevation Elevation Accuracy Elevation Determination Method Destruction Details: Well was Approx 3-4' in diameter. Keller drilling and pump filled from bottom up with chlorinated pea gravel to 25' below grade, then filled with bentonite slurry to 5' below grade, then capped with concreate and backfilled. to natural grade. Other Observations: Well Owner (must remain confidential pursuant to Water Code 13752) MARROW FAMILY TRUST, Angela Marrow Name Mailing Address 1380 East Ave #314 Chico City CAState 65928Zip Former Use Former Use Activity Water Supply Destroy Borehole Information Drilling Method Orientation Total Depth of Boring Vertical 40 Total Depth of Completed Well Drilling Fluid Feet Feet Specify Water Level and Yield of Completed Well Depth to first water Depth to Static 38Water Level Estimated Yield* Test Length *May not be representative of a well's long term yield. (Feet below surface) (Feet) (GPM) (Hours) Date Measured 06/14/2024 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 KELLER DRILLING AND PUMP Person, Firm or Corporation 2767 HEGAN LANE CHICO 95928CA Address City State Zip Signed electronic signature received C-57 Licensed Water Well Contractor 06/21/2024 Date Signed 1038857 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