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INVESTIGATIuN DETAILS Name of Investigator: <'ThvNc�-*�i ( -I-) v__ Date of Investigation: & - 73 - /q Qualifications: CDO/CTO/RENS/Owner/Manager) SOURCE: Do the results indicate well is positive for bacteria. Y/No If no, go to'next section. If yes, inspect each source: COMMENTS Wet! ID Wel! ID Well ID Well ID What is the bacteria count(MNP) for each well?(Is one well positive,which is activated at lower pressure events w/o Vour knowledge,causing the TCR MCL Is the wellhead check valve pres within three feet of the well head and does If Y- system maybe source it leak water back into the well? for well failing If N-well is a source for system failing Is wellhead vent installed properly w/J-vent& screened, ti htl screwed in The well breathing from g y other locations, i.e. the watertight, Q leaks and is the well only breathing through the J vent, when it well seal, bolts, turns off? OC1fd electrical conduits, cracks in the cement Is wellhead seal water tight, electrical box caulked at conduit into well, is tqpel pad may be source. conduit without breaks/cracks, and bolts screwed in tightly &water tight? Seal all openings to Is well head located in it or an be air&water tight p y piping from the wellhead submerged. Y Does the ground surface slope towards well head? Y Is there evidence of standing water near the wellhead? Y Are there any connections to irrigation, fire, industrial piping that could be inte - connected? (backflow devices removed, need repair, need to be installed) YR) Is the wellhead sec ed ? D to prevent unauthorized accessoes well appear to be tampered with To what treatment plant(type) does this well pump? (GAC, nitrate, C12, Ar) Is the surface pad properly installed &water tight 2-feet in all directions of casinq and well casing is at least one inch above surface pad?(/N Are there trees located within 50 feet of well, surface roots near well? Tree roots grown into the well will cause TCR MCL.. What is the depth and material of annular seal? If no sea!, TC enter into the well from rain or Was work done on the well prior to the failures?(sounding the well, install or irrigation surface water. removal of the pump, chlorine added to the well, new check valve installed If well has oil lubed turbine pump, is oil on top of water column inside the well Oil must be removed, casing? Is oil NSF 61 approved? Is oil stored and applied in a clean manner? casing washed with YIN/NAW detesdthen L disinfected to eiminate Has well failed, after repairs and disinfection using AWWA methods to bacteria, rtable?ecalculat hlorinated water down the well casing to disinfect above the water Has a down-hole camera been used to investigate the well? Y6�1 Degradation of casing mav cause TCR MCL.