[] A public system such as a city water department, or private company?
[] An individual drilled well?
[] An individual dug well?
[] Some other source such as a spring, creek, river, cistern, etc.?

"If a well provides water for five or more houses, apartments, or mobile homes, mark A public system. If a well provides water for four or fewer houses, apartments, or mobile homes, fill one of the circles for Individual well. Drilled wells, or small diameter wells, are usually less than 1 1/2; feet in diameter. Dug wells are generally hand dug and are larger than 1 1/2; feet wide."