HomeMy WebLinkAbout061-480-052 EHWS21-0059 WELL LOG UPLOADED FROM DWR SITEState of California
Well Completion Report
Form DWR 188 Auto-Completed 8/16/2021
WCR2021-006880
Owner's Well Number Date Work Began Date Work Ended 06/09/2021
Local Permit Agency Butte County Public Health
Secondary Permit Agency Permit Number EHWS21-0059 Permit Date 04/27/2021
Well Location
327 encina Grande RD Address
Berry Creek City 95916Zip ButteCounty
39 Latitude 37 30.2329
Deg.Min.Sec.
N -121Longitude 26 11.6599
Deg.Min.Sec.
W
Dec. Lat. 39.6250647 Dec. Long. -121.4365722
Vertical Datum Horizontal Datum WGS84
Location Accuracy Location Determination Method
061-480-052APN
20 NTownship
05 ERange
05Section
Mount DiabloBaseline Meridian
Ground Surface Elevation
Elevation Accuracy
Elevation Determination Method
Geologic Log - Free Form
Depth from
Surface
Feet to Feet
Description
0 10 Sand Clay Brown
10 60 Blue Grey rock (soft)
60 250 Grey Blue Rock (hard)
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 250
Downhole Hammer
Vertical
250 Total Depth of Completed Well
Drilling Fluid Air
Feet
Feet
Specify
Water Level and Yield of Completed Well
80Depth to first water
Depth to Static
75Water Level
10Estimated Yield*
2Test Length
*May not be representative of a well's long term yield.
(Feet below surface)
(Feet)
(GPM)
(Hours)
Date Measured 06/09/2021
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
06/14/2021
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 25 10.5
25 250 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 25 Blank Low Carbon
Steel
Grade: ASTM A53 0.25 6.625
2 0 150 Blank PVC OD: 4.500 in. |
Thickness: 0.337 in.
0.237 4.5
2 150 250 Screen PVC OD: 4.500 in. | SDR:
SCH 40 | Thickness:
0.237 in.
0.237 4.5 Saw
Cut
0.38
Annular Material
Depth from
Surface
Feet to Feet
Fill Fill Type Details Filter Pack Size Description
0 25 Bentonite Non Hydrated Bentonite 3/8 chips sanitary seal
25 250 Other Fill See description.natural none
Page 2 of 2 Form DWR 188 rev. 12/19/2017