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S.O.# <br /> MONITOR WELLS <br /> Nnmbe 1 2 s 4 5 6 7 8 9 10 11 12 <br /> Depth <br /> Water <br /> Prod.Detecte <br /> NOT Det <br /> Location Diagram <br /> f .3 <br /> N z 3 3 . <br /> 0o s> <br /> Parts and Labor used <br /> General Comments <br /> AUG i !990 <br /> LINVIHONMENTALHEALTI; <br /> HE R M IT/SER'V,C'r_S <br /> When local regulations require immediate reporting of a system leak-Complete the following: <br /> Reported to: <br /> Name Date Time <br /> Phone Number Regulatory Agency File Number <br /> Print' Corti d Testers Name Vacutect(tm) Certification Number <br /> ��� 7/iz�S0 <br /> C ied 3 rs Signature Date Testing Completed Form:TestData 189 <br />