HomeMy WebLinkAbout061-080-122 EHWS18-0043 WELL LOG FROM DWRState of California
Well Completion Report
Form DWR 188 Complete 7/24/2018
WCR2018-004438
Owner's Well Number Date Work Began 18-1 05/24/2018 Date Work Ended 06/01/2018
Local Permit Agency Butte County Public Health
Secondary Permit Agency Permit Number EHWS18-0043 Permit Date 05/14/2018
Well Location
0 Bean Creek RD Address
Berry Creek City 95916Zip ButteCounty
Latitude
Deg.Min.Sec.
N Longitude
Deg.Min.Sec.
W
Dec. Lat. Dec. Long.
Vertical Datum Horizontal Datum WGS84
Location Accuracy Location Determination Method
061-080-122APN
21 NTownship
06 ERange
33Section
Mount DiabloBaseline Meridian
Ground Surface Elevation
Elevation Accuracy
Elevation Determination Method
Geologic Log - Free Form
Depth from
Surface
Feet to Feet
Description
0 460 unknown
460 510 granite
510 512 fracture
512 1000 granite
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
Deepen
Borehole Information
Drilling Method
Orientation
Total Depth of Boring 1000
Other - Air
Vertical
1000 Total Depth of Completed Well
Drilling Fluid None
Feet
Feet
Specify
Water Level and Yield of Completed Well
Depth to first water
Depth to Static
200Water Level
1Estimated Yield*
4Test Length
*May not be representative of a well's long term yield.
(Feet below surface)
(Feet)
(GPM)
(Hours)
Date Measured 06/01/2018
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
06/07/2018
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 1000 6
Attachments
e0366301.pdf - Other
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 0 460 No Casing
Installed
Other N/A unknown, specified on
original log
1 460 1000 No Casing
Installed
Other N/A no casing installed
Annular Material
Depth from
Surface
Feet to Feet
Fill Fill Type Details Filter Pack Size Description
Page 2 of 2 Form DWR 188 rev. 12/19/2017