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Welliwater supply (continued) <br />Is there a treatment system? <br />yes ❑ no <br />Type of treatment <br />,Is the water sampling point prior <br />treatment? 0 yes Ej no <br />Sampling Information <br />May the we# be unsealed to measure <br />depth to and of water? ❑ yes ❑ no <br />Depth of water. 2.2 C� fL <br />Grwnd level to weter.—a.Y—ft <br />May the weAbe pumped to measure <br />recharge charsctehsNcs ?�O yes ❑ no <br />Recharge rate_ gPm <br />Date measured <br />Date sampled <br />I WI sample no: <br />8eptichwmge treatment system <br />❑ pubNc service system <br />❑ aeration system <br />❑ package plant <br />® septic tank <br />® concrete <br />❑ plastic <br />❑ metal <br />❑ other (explaln)---- <br />drainfiekt <br />other (explain) <br />Attach lab analysis of the pre-treatment water and any avaftle written well <br />documentetion. Provide source of documentation. <br />.7 " /f. <br />kEo 1309TLM <br />