HomeMy WebLinkAbout030-300-034 EHWS23-0023 WELL LOG FROM DWR SITEState of California
Well Completion Report
Form DWR 188 Complete 8/11/2023
WCR2023-006563
Owner's Well Number Date Work Began 05/16/2023 Date Work Ended 05/19/2023
Local Permit Agency Butte County Public Health
Secondary Permit Agency Permit Number EHWS23-0023 Permit Date 03/17/2023
Well Location
Address
City Zip ButteCounty
39 Latitude 28 14.8799
Deg.Min.Sec.
N -121Longitude 37 45.1199
Deg.Min.Sec.
W
Dec. Lat. 39.4708 Dec. Long. -121.6292
Vertical Datum Horizontal Datum WGS84
Location Accuracy Location Determination
Method
030-300-034APN
19 NTownship
03 ERange
27Section
Mount DiabloBaseline Meridian
Ground Surface Elevation
Elevation Accuracy
Elevation Determination Method
Geologic Log - Free Form
Depth from
Surface
Feet to Feet
Description
0 10 clay
10 55 gravel
55 78 clay
78 88 gravel
88 102 clay
102 115 volcanics
115 125 clay
125 147 volcanics
147 151 clay
151 164 volcanics
164 175 clay
175 205 volcanics
205 250 clay fractured
250 275 volcanics
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 275
Direct Rotary
Vertical
275 Total Depth of Completed Well
Drilling Fluid Bentonite
Feet
Feet
Specify
Water Level and Yield of Completed Well
Depth to first water
Depth to Static
41Water Level
Estimated Yield*
Test Length
*May not be representative of a well's long term yield.
(Feet below surface)
(Feet)
(GPM)
(Hours)
Date Measured 05/19/2023
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 SULLIVAN DRILLING INC
Person, Firm or Corporation
P O BOX 1227 ORLAND 95963CA
Address City State Zip
Signed electronic signature received
C-57 Licensed Water Well Contractor
06/09/2023
Date Signed
656504
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)
0 275 12
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 0 255 Blank PVC OD: 6.625 in. | SDR:
17 | Thickness: 0.390
in.
0.39 6.625
1 255 275 Screen PVC OD: 6.625 in. | SDR:
17 | Thickness: 0.390
in.
0.39 6.625 Milled
Slots
0.05
Annular Material
Depth from
Surface
Feet to Feet
Fill Fill Type Details Filter Pack Size Description
0 50 Cement Portland Cement/Neat Cement
50 275 Filter Pack 6 x 16
Page 2 of 2 Form DWR 188 rev. 12/19/2017