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INVESTIGATION DETAILS <br /> N9ame of Investigator: ";c�,��-1'h�-,n C-oo1G— Date of Investigation: <br /> QF.Ialifications: CDOIOTOIREHS/Owner/Manager) C) <br /> SOURCE: Do the results indicate well is positive for bacteria. Y! COMMENTS <br /> If no,go to next section. If yes, inspect each source: Well ID Well ID Well ID Well 1D <br /> What is the bacteria count(MNP)for each well?(Is one well positive,which is activated <br /> at lower pressure events w/o your knowledge causing the TCR MCL) <br /> If Y- system maybe source I <br /> Is the wellhead check valve presAnt within three feet of the well head and does for well failing <br /> ll <br /> it leak water back into the we(l? N If stem f is a source ror <br /> system failing <br /> The well breathing from <br /> other locations, i.e.the <br /> Is\,vellhaad vent instailed properly (J-vent&screen, tightly screwed in, well seal, bolts, <br /> wGte 'fight, ^ leaks and a the well only breathing through the J vent, when it electrical conduits, <br /> turns off? " 6 cracks in the cement <br /> ad may be source. <br /> Is wellhead seal water tight, electrical box caulked at conduit into well, is the el Seal all openings to <br /> conduit without breaks/cracks, and bolts screwed in tightly &water ti ht? be air&water tight <br /> Is well head located in pit or is any piping from the wellhead submerged? Y <br /> Does the ground surface slope towards well head? Y <br /> Is`here evidence of standing water near the wellhead? Y <br /> Are there any connections to irrigation, fire, industrial piping that could be int r- <br /> connected? (backfiow devices removed, need repair, need to be installed) / <br /> Is the wellhead secured to prevent unauthorized access? Does well appear to <br /> be tampered with? 'ON —r_~,Vt,V16A � <br /> To what treatment plant (type)does this well pump? (GAC, nitrate, C12, Ar) <br /> is the surface pad properly installed &water tight 2-feet in all directions of <br /> casinq and well casing is at least one inch above surface pad?tel <br /> Are there trees located within 50 feet of well, surface roots near well? Y Tree roots grown into the <br /> well will cause TCR MCS. <br /> If no seal, TC enter into <br /> What is the depth and material of annular seal? the tio from rain or <br /> irri ation surface water. <br /> I <br /> Was work done on the well prior to the failures? (sounding the well, install or <br /> removal of the pump, chlorine added to the well, new check valve installed) Y <br /> Qil must be removed, <br /> 1`well has oil lubed turbine pump, is oil on top of water column inside the well I casing washed with <br /> casing? Is oil NSA 61 approved? Is oil stored and applied in a clean manner? detergent,flushed,then <br /> disinfected to eliminate <br /> YlN1N!` bacteria. <br /> Has well failed, after repairs and disinfection using AWWA methods to <br /> recalculate chlorinated water down the well casing to disinfect above the water <br /> table? YG <br /> Degradation of casing <br /> Has a down-hole camera been used to investigate the well? YPi may cause TCR MCL. <br />