New Hampshire Code of Administrative Rules
We - Water Well Board
Chapter We 600 - STANDARDS FOR THE CONSTRUCTION, MAINTENANCE AND ABANDONMENT OF WELLS
Part We 602 - NEW WELL CONSTRUCTION
Section We 602.17 - Setback Reductions: Setback Reduction Form
Current through Register No. 40, October 3, 2024
A "Setback Reduction Form" shall contain the following:
(a) Name of property owner;
(b) Location of property, including, as applicable; and
(c) Reason for alternate location;
(d) If applicable, methods of construction used for construction of wells with reduced setbacks, as specified in We 602.14;
(e) A sketch map of the on lot well location indicating exact distances to at least 3 permanent reference points;
(f) The actual setback distances from the alternate location to potential observed sources of contamination, including but not limited to:
(g) The property owner's signature and date; and
(h) The water well contractor's name and license number.