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Well Data Sheet Instructions(Rev. 11/99) Page 4 circular, enter both the length and width as the diameter of,the slab. Within 100 year flood plain or DHS staff should base their answer to this question on information subject to flooding? in system files. If it is]mown that the source is subject to flooding (i.e., it is near a surface water source or is in a low area),answer "Yes"and don't worry about trying to determine if it is within the 100 year flood plain. If it is not obviously subject to flooding,and it is not readily known whether the source is within the flood plain, ask the water system. If the system does not know, you may call the county planning department,the local flood control agency, or FEMA to find the answer. If"Unknown"is entered it will be assumed in the PBE evaluation that the source is subject to flooding. However,this represents only a small factor in the PBE analysis and should not significantly affect the results. The information can then be collected later. Drainage away from well? Is the ground surface around the well sloped so that water does not pond around the well? If the well is located in a pit or vault is it drained to keep water from standing around the top of the well? } ENCLOSURE/HOUSING Enclosure type: Briefly describe what type of enclosure, if any, is there around the well. This may include a building, a vault; or another kind of structure. If there is no enclosure, i.e. the well is out in the open, enter `none'. Floor Material: Enter the floor material of the enclosure, such as concrete, wood, dirt, etc. Located in pit? Is the top of the well casing located in a pit or vault underground? (This is done infrequently to provide frost.protection for pipes,but is generally discouraged.) Pit depth (if applicable):. If the top of the well casing is located in a pit or vault (see above), enter the depth of the pit in feet below ground surface. If the pump is not located in a pit enter N.A. WELL CONSTRUCTION Date drilled Enter date as month/year Drilling method Enter the drilling method if known. Typical methods include: cable tool, mud rotary, air rotary,reverse circulation, dual tube,and air- percussion rotary. Other less common methods include:jetting, hollow-rod,auger bucket, and driven wells. Depth of bore hole: Enter the depth, in feet below ground surface, of the maximum depth to which the borehole of the well was drilled. Casing Beginning Depth/Ending A well may be constructed with a casing that changes size with Depth: depth,or one casing may be installed within another. The upper or outer casing should be entered first,with the beginning and ending depths separated by a slash(/).•'If there are more casings,the succeeding Iower or inner casing should be entered next, separated with a semicolon from the previous casing. Casing Diameter: The diameter of the upper or outer casing should be entered first(in inches),followed by the succeeding lower or inner casings, separated with a semicolon from the previous casing. Casing Material: The material of the upper or outer casing should be entered first, followed by the material for the succeeding lower or inner casings, separated with a semicolon from the previous casing. Typical