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vL <br /> L <br /> LOCATION G. <br /> INSPECTION RECORD PUMPOUT RECORD SKETCH ` <br /> DATE COMPLIANCE DATE GALLONS <br /> S—/L{-8O /Vv SURF4C J( NOTED Z /2-/-f/ /ger 7 / <br /> a3 6-G,� ., .� 3-c10 =40 ,/ <br /> a-17-88 ,, PI <br /> % K <br /> ala-90 ,DF- bil-C /VA 'i II* <br /> A / • <br /> ts k , -/. a - rd 111' <br /> �. oP� \ t <br /> 1), �' <br /> #IA/ <br /> 1-1/4'10 pis 5,, e, A \ <br /> (j... ,)j---i` <br /> 44 <br /> Include: 1) Well location <br /> 2) Distance from house to <br /> septic tanks,dist.box, <br /> and drainfield <br /> C— CONFORMING S—SUBSTANDARD N —NONCONFORMING 3) North arrow and road <br /> yvIANi4oLE /N C,(><{LAG <br />