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Site Address: 21268 AVENA RD Record ID WP0038194 <br /> Date: 5/24/2018 <br /> CASING: PVC OR TEEL <br /> LER — I ' <br /> - --- GAUGE <br /> SLOT SIZE —� f'� - --- • <br /> AT10N GRAVEL PACK-TYPE. <br /> �� L �11u1 SEAL DEPTH Er TYPE <br /> ROSS STREET PERFS <br /> ELL DIAML`Lit ;Is Ot_1.� WELL DESTROYED' YE_S UR AA <br /> ELL DEPTH - IF YES, FILL OUT JOBBER, PLEASE II <br /> —AW <br /> 33c_ = _tel ') s_a,� <br /> r. <br /> Naseem Ahmed, Environmental Health Specialist Page 1 of 2 <br />