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I <br /> WELL DATA SHEET(Page 3 of 3 <br /> Complete as much information as possible. Leave blank if information is not available, use N.A. if not applicable. <br /> "Indicates items required for Source WaterAssessment <br /> Indicates additional items required for assessments and Ground Water Rule - <br /> NOTES <br /> 1. Neighborhood/Surrounding Area (list all that apply);A=Agricultural, Ru= <br /> Rural, Re=Residential, Co=Commercial, <br /> =Industrial, Mu =Municipal, P=Pristine, O=Other <br /> 2. Conductor Casing-Oversized casing used to stabilize bore hole during well <br /> construction. Should be removed during installation of annular seal. <br /> 3.Annular Seal-Seal of grout in the space between the well casing and the <br /> wall of the drilled hole. Sometimes called"sanitary seal". <br /> 5 <br /> Rec' 11-18-99 <br /> Well Data Sheet Final2JWetl Data Sheet <br />