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PWS ID / FACILITY ID 1020035 S01 UNIQUE WELL NO.161441 <br />SETBACK DISTANCESAll potential contaminant sources must be noted on sketch. <br />Record the distance and approximate compass bearing of each potential contaminant source from the well, <br />and identify the source using the "Source Code". Unlabeled points on the map are unsealed wells. <br />0° <br />315° <br />45° <br />SBM <br />#* <br />SWD <br />PLM <br />#* <br />#* <br />GPR <br />#* <br />50'100'150'200' <br />270°90° <br />!(!( <br />SWD <br />FFH <br />#* <br />!( <br />SB2 <br />!( <br />SD1 <br />!( <br />135° <br />225° <br />180° <br />YNN/A <br />X <br />Were the isolation distances maintained for the new sources of contamination? <br />X <br />Is the system monitoring existing nonconforming sources of contamination? <br />Reminder Question: Were the wellhead protection measure(s) implemented? <br />INSPECTOR Freitag, John DATE 6 - 12 - 2019 <br />6/21/20194 <br /> <br />