HomeMy WebLinkAbout017-140-046 EHWS22-0060 WELL LOG DIS STATEMENTState of California
Well Completion Report
Form DWR 188 Submitted 5/12/2023
WCR2023-005560
Owner's Well Number Date Work Began 02/20/2023 Date Work Ended 03/21/2023
Local Permit Agency Butte County Public Health
Secondary Permit Agency Permit Number EHWS22-0060 Permit Date 08/08/2022
Well Location
12109 centerville road Address
Chico City 95928Zip ButteCounty
39 Latitude 44 35.8929
Deg.Min.Sec.
N -121Longitude 41 28.2166
Deg.Min.Sec.
W
Dec. Lat. 39.7433036 Dec. Long. -121.6911713
Vertical Datum Horizontal Datum WGS84
Location Accuracy Location Determination
Method
017-140-046APN
22 NTownship
03 ERange
19Section
Mount DiabloBaseline Meridian
Ground Surface Elevation
Elevation Accuracy
Elevation Determination Method
Geologic Log - Free Form
Depth from
Surface
Feet to Feet
Description
0 10 top soil cobble, boulders
10 65 lava rock and clay seams
65 120 volcanics sandstone layers black
120 130 Clay no water
130 145 clay rock gravel water
Well Owner (must remain confidential pursuant to Water Code 13752)
Julie Filice Name
Mailing Address 12109 Centerville road
Chico City CaState 95928Zip
Planned Use and Activity
Planned Use
Activity
Water Supply Domestic
New Well
Borehole Information
Drilling Method
Orientation
Total Depth of Boring 145
Downhole Hammer
Vertical
145 Total Depth of Completed Well
Drilling Fluid Air
Feet
Feet
Specify
Water Level and Yield of Completed Well
12Depth to first water
Depth to Static
15Water Level
40Estimated Yield*
1.5Test Length
*May not be representative of a well's long term yield.
(Feet below surface)
(Feet)
(GPM)
(Hours)
Date Measured 03/21/2023
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 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
05/12/2023
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)
0 35 10
35 145 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 0 130 Blank Low Carbon
Steel
Grade: ASTM A53 0.188 6.625
1 130 140 Other: mills
knife
Low Carbon
Steel
Grade: ASTM A53 0.188 6.625 Saw
Cut
0.25
1 140 145 Blank Low Carbon
Steel
Grade: ASTM A53 0.188 6.625
Annular Material
Depth from
Surface
Feet to Feet
Fill Fill Type Details Filter Pack Size Description
0 35 Cement 10.3 Sack Mix seal
35 145 Other Fill See description.none casing driven
Page 2 of 2 Form DWR 188 rev. 12/19/2017