HomeMy WebLinkAbout027-170-028 EHWS18-0126 WELL LOG FROM DWR SITEState of California
Well Completion Report
Form DWR 188 Complete 5/10/2020
WCR2020-003640
Owner's Well Number Date Work Began 1 01/02/2019 Date Work Ended 01/04/2019
Local Permit Agency Butte County Public Health
Secondary Permit Agency Permit Number EHWS18-0126 Permit Date 12/31/2018
Well Location
250 Candy Cane LN Address
Palermo City 95968Zip ButteCounty
39 Latitude 25 12.7235
Deg.Min.Sec.
N -121Longitude 28 20.965
Deg.Min.Sec.
W
Dec. Lat. 39.420201 Dec. Long. -121.4724903
Vertical Datum Horizontal Datum WGS84
Location Accuracy Location Determination Method
027-170-028APN
18 NTownship
04 ERange
13Section
Mount DiabloBaseline Meridian
Ground Surface Elevation
Elevation Accuracy
Elevation Determination Method
Geologic Log - Free Form
Depth from
Surface
Feet to Feet
Description
0 6 Brown dirt
6 185 Cemented gravel
185 280 Granitic rock
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 280
Downhole Rotary
Hammer
Vertical
280 Total Depth of Completed Well
Drilling Fluid Air
Feet
Feet
Specify
Water Level and Yield of Completed Well
35Depth to first water
Depth to Static
30Water Level
40Estimated Yield*
2Test Length
*May not be representative of a well's long term yield.
(Feet below surface)
(Feet)
(GPM)
(Hours)
Date Measured 01/04/2019
Air LiftTest Type
Total Drawdown 100 (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 WESTERVELT WELL DRILLING
Person, Firm or Corporation
26 BREEZE HOLLOW LANE OROVILLE 95966CA
Address City State Zip
Signed electronic signature received
C-57 Licensed Water Well Contractor
03/16/2020
Date Signed
570082
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 26 12.75
26 280 6.5
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 26 Blank PVC OD: 8.625 in. | SDR:
26 | Thickness: 0.332
in.
0.332 8.625 0 pvc
2 26 280 Screen PVC OD: 4.500 in. | SDR:
32.5 | Thickness:
0.138 in.
0.138 4.5 Saw
Cut
0.064 Pump Protector
Annular Material
Depth from
Surface
Feet to Feet
Fill Fill Type Details Filter Pack Size Description
0 26 Cement Portland Cement/Neat Cement na neat cement
26 280 Other Fill See description.0 none
Page 2 of 2 Form DWR 188 rev. 12/19/2017