SECTION CORNER REFERENCE SECTION__________, TOWNSHIP__________, RANGE__________
(Description of Corner Location)____________________________________________________ _____________________________TWP., ___________________________COUNTY, INDIANA COORDINATES N NAD '83 IN E. ZONE NAD '83 IN W.ZONE LOCAL GRID Units:_______________ Pt.#:________________ N:__________________ E:__________________
TYPE OF MON.:__________________ DEPTH:_________________________ UNCERTAINTY:__________________ BY:_____________________________ DATE:__________________________ DES.NO.:________________________
STATE FORM 40180 (R2 / 2-04)