HomeMy WebLinkAbout063-040-065 EHWS23-0017 WELL LOGState of California
Well Completion Report
Form DWR 188 Submitted 4/24/2025
WCR2025-004261
Owner's Well Number Date Work Began 1 05/15/2023 Date Work Ended 05/15/2023
Local Permit Agency Butte County Public Health
Secondary Permit Agency Permit Number EHWS23-0017 Permit Date 04/13/2023
Well Location
15184 Siwini RD Address
Forest Ranch City 95954Zip ButteCounty
39 Latitude 51 42.1199
Deg.Min.Sec.
N -121Longitude 39 2.916
Deg.Min.Sec.
W
Dec. Lat. 39.8617 Dec. Long. -121.65081
Vertical Datum Horizontal Datum WGS84
Location Accuracy Location Determination
Method
063-040-065APN
23 NTownship
03 ERange
09Section
Mount DiabloBaseline Meridian
Ground Surface Elevation
Elevation Accuracy
Elevation Determination Method
Geologic Log - Lite
Depth from
Surface
Feet to Feet
Material Type Material Color Material Texture Material Description
0 2 Soil or Organic Brown
2 14 Clay Red
14 42 Rock Brown Hard
42 46 Rock Tan & Gray Gravely
46 105 Rock Gray Cemented
105 118 Sandstone Brown Dense
118 160 Rock Brown Hard
Well Owner (must remain confidential pursuant to Water Code 13752)
Roger Westman Name
Mailing Address 15184 Siwini Rd
Forest Ranch City CAState 95954Zip
Planned Use and Activity
Planned Use
Activity
Water Supply Domestic
New Well
Borehole Information
Drilling Method
Orientation
Total Depth of Boring 160
Downhole Rotary
Hammer
Vertical
160 Total Depth of Completed Well
Drilling Fluid Air
Feet
Feet
Specify
Water Level and Yield of Completed Well
0Depth to first water
Depth to Static
0Water Level
0Estimated Yield*
2Test Length
*May not be representative of a well's long term yield.
(Feet below surface)
(Feet)
(GPM)
(Hours)
Date Measured 05/15/2023
Air LiftTest Type
Total Drawdown 0 (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 BIG'N & SON DRILLING INC
Person, Firm or Corporation
PO BOX 902 PALERMO 95968CA
Address City State Zip
Signed electronic signature received
C-57 Licensed Water Well Contractor
04/24/2025
Date Signed
1100071
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 10.58
25 160 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 PVC OD: 6.625 in. | SDR:
32.5 | Thickness:
0.204 in.
0.204 6.625 F-480
1 25 160 Other: 0 Other N/A 0 0 None
Annular Material
Depth from
Surface
Feet to Feet
Fill Fill Type Details Filter Pack Size Description
0 25 Bentonite High Solids
0 160 Other Fill See description.NONE
Page 2 of 2 Form DWR 188 rev. 12/19/2017