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I NSftCT1ON RECORD <br />DATE COMPLIANCE <br />9-y_8b " <br />J Q� <br />PUMPOUT RECORD <br />DATE GALLONS <br />f <br />LOCATION <br />SKETCH <br />O F <br />t' <br />op -956 moo. <br />19 '` " I <br />r <br />1 <br />1 <br />C' t= S Coo L--TA" I� <br />Include: 1) Well location <br />2) Distance from house to 1 <br />wmw teni.s, dirt. tiax, <br />and d:ainfield ) <br />C - CONFORMING S - SUBSTANDARD N - NONCONFORMING 3) North crow and rood <br />