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PWS ID / FACILITY ID1020036 S01UNIQUE WELL NO.511091 <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 />50'100'150'200' <br />270°90° <br />!(!( <br />PR2 <br />!( <br />!( <br />135° <br />225° <br />!( <br />!( <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 />INSPECTORMcCormack, SimonDATE7 - 20 - 2017 <br />3/20/20204 <br /> <br />