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HomeMy WebLinkAbout027-140-010 EHWS23-0025 WELL LOG FROM DWR SITEState of California Well Completion Report Form DWR 188 Complete 5/31/2023 WCR2023-004518 Owner's Well Number Date Work Began 23-1 04/04/2023 Date Work Ended 04/11/2023 Local Permit Agency Butte County Public Health Secondary Permit Agency Permit Number EHWS23-0025 Permit Date 03/17/2023 Well Location 161 Butte Vista RD Address Palermo City 95968Zip ButteCounty 39 Latitude 25 50.6315 Deg.Min.Sec. N -121Longitude 28 59.8008 Deg.Min.Sec. W Dec. Lat. 39.430731 Dec. Long. -121.483278 Vertical Datum Horizontal Datum WGS84 Location Accuracy Location Determination Method 027-140-010APN 18 NTownship 04 ERange 11Section Mount DiabloBaseline Meridian Ground Surface Elevation Elevation Accuracy Elevation Determination Method Geologic Log - Free Form Depth from Surface Feet to Feet Description 0 30 clay 30 70 decomposed granite 70 75 boulder 75 80 decomposed granite 80 155 weathered greenstone 155 720 greenstone with fractures 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 720 Other - Air Vertical 720 Total Depth of Completed Well Drilling Fluid None Feet Feet Specify Water Level and Yield of Completed Well 196Depth to first water Depth to Static 50Water Level 5.0Estimated Yield* 4Test Length *May not be representative of a well's long term yield. (Feet below surface) (Feet) (GPM) (Hours) Date Measured 04/11/2023 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 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 04/14/2023 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 25 10.63 25 220 8.63 220 720 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 80 Blank PVC OD: 6.625 in. | Thickness: 0.432 in. 0.432 6.625 F-480 Cl125 1 80 100 Screen PVC OD: 6.625 in. | Thickness: 0.432 in. 0.432 6.625 Saw Cut 3 F-480 Cl125 1 100 200 Blank PVC OD: 6.625 in. | Thickness: 0.432 in. 0.432 6.625 F-480 Cl125 1 200 220 Screen PVC OD: 6.625 in. | Thickness: 0.432 in. 0.432 6.625 Saw Cut 3 F-480 Cl160 1 220 720 No Casing Installed Other N/A none Annular Material Depth from Surface Feet to Feet Fill Fill Type Details Filter Pack Size Description 0 23 Bentonite High Solids 23 25 Cement 10.3 Sack Mix 25 720 Other Fill See description.none Page 2 of 2 Form DWR 188 rev. 12/19/2017