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doc10458 4430.pdf
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Page 1
73 item(s)
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1 · HEADER
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3 · FIGURE
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13 · LIST_ITEM
14 · FORM_FIELD
15 · TEXT
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65 · TEXT
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72 · FOOTER
73 · FOOTER
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"text": "This well will be submitted for cost share assistance payment under the Grants-to-Counties Well Program.\n□ Yes □ No",
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"text": "If yes, the reconstruction of this well was performed with the oversight and assistance of the designated county agent and conforms to the requirements stated in Iowa Administrative Code 567 Chapter 49.10."
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"text": "I have reconstructed this well in a manner defined by Iowa Administrative Code 567.49.10."
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"text": "<div style=\"text-align: center;\"><img src=\"imgs/img_in_image_box_1_2_461_66.jpg\" alt=\"Image\" width=\"97%\" /></div>"
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"text": "Complete one form for each well and submit within 30 days to the local county agent"
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