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bit EUNC;WaI.II�.a'''TAL.LAT1ON RZPOUf <br /> CONtUCT[ON <br /> o1L IIF t l9D��o -n Toes Dept ! <br /> p�tise Ad3rers: Saet~.Length {From} (to) Z <br /> dH '/1/Il�fi a 0I ., <br /> Filter Pack C�'Oat)_ <br /> well No.. � BritroaiLe Cpm) <br /> l Croon CL-0m) (to) a <br /> ]�ettar. Deo D ! <br /> Dugs:Os7. LD <br /> Permit NQ: — Comuletion- Stovt pioe;/dtrisbe box Cis oat) <br /> 't a,, CoLagaszy: <br /> A <br /> # I�I T he;"c,Tz` T i <br /> -70 <br /> C-e-2Iogist C B'c-�'iC - ` �. `=&V_t=N <br /> Sp UAL P -PM--lIff . �tCYw <br /> sewer line <br /> Distanet to <br /> -P a • ' / i <br /> Domestic well aL: site - C y/ a) <br /> yes,tocatioa and distmcs -��--;L _ J 1' <br /> if <br /> i <br /> SAMPLING <br /> Holding T=Pdrzt=!` <br /> Screening Method T <br /> Tracking Sheat icy/ a) ! •• 7 _ t <br /> SPOMS <br /> 'ILA. <br /> ERIAL IDEVEL.O , <br /> ScamgeMe Qd��66.: - f ct.► mac. ✓� <br /> kh Con QQ 113 ell fi . r,•4 Lif Caraatgp <br /> Storaga LoatioBit Screen <br /> a <br /> Slot xiz= •D t 3 . <br /> � �G Burke be-n rate ' <br /> *.Bags =d/P—"dvel <br /> DeDLh to v=-- r . F1L _Pact e/= <br /> MET.P.aLsos I S=Wt Elocic- - <br /> insunadaLc Method Disrstssed with rnaoCp/ r ) <br /> Quantity LnstaYled tin jypt of raaLhod <br /> II <br />