HomeMy WebLinkAbout022-180-105 EHWS19-0167 WELL LOG FROM DWR SITEState of California
Well Completion Report
Form DWR 188 Complete 11/25/2019
WCR2019-014202
Owner's Well Number Date Work Began 212 Dakota 09/18/2019 Date Work Ended 09/20/2019
Local Permit Agency Butte County Public Health
Secondary Permit Agency Permit Number EHWS19-0167 Permit Date 09/18/2019
Well Location
212 Dakota AVE Address
Biggs City 95948Zip ButteCounty
39 Latitude 24 31.1382
Deg.Min.Sec.
N -121Longitude 41 51.7488
Deg.Min.Sec.
W
Dec. Lat. 39.4086495 Dec. Long. -121.697708
Vertical Datum NAVD88 Horizontal Datum WGS84
Location Accuracy Location Determination Method
022-180-105APN
18 NTownship
02 ERange
13Section
Mount DiabloBaseline Meridian
97Ground Surface Elevation
10 FtElevation Accuracy
OtherElevation Determination Method
Geologic Log - Free Form
Depth from
Surface
Feet to Feet
Description
0 4 Topsoil
4 26 Brown Clay
26 30 Brown Clay / Sand & Gravel
30 70 Soft Brown Clay
70 78 Sandy Brown Clay
78 85 Reddish Brown Clay
85 100 Sand
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 100
Cable Tool
Vertical
80 Total Depth of Completed Well
Drilling Fluid Water
Feet
Feet
Specify
Water Level and Yield of Completed Well
10Depth to first water
Depth to Static
10Water Level
50Estimated Yield*
Test Length
*May not be representative of a well's long term yield.
(Feet below surface)
(Feet)
(GPM)
(Hours)
Date Measured 09/20/2019
Test 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 DAVIS MACHINE SHOP INC
Person, Firm or Corporation
P O BOX 37 MERIDIAN 95957CA
Address City State Zip
Signed electronic signature received
C-57 Licensed Water Well Contractor
10/09/2019
Date Signed
776953
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)
0 100 8.625
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 80 Blank Low Carbon
Steel
Grade: ASTM A53 0.25 8.625
Annular Material
Depth from
Surface
Feet to Feet
Fill Fill Type Details Filter Pack Size Description
0 20 Cement Other Cement
20 100 Other Fill See description.Native
Page 2 of 2 Form DWR 188 rev. 12/19/2017