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WELLHEAD MAINTENANCE LOG <br /> Client 'SAS U.Site LZO <br /> �i_— Well �NN Z Date <br /> 5-TCr_ TU <br /> Does the utility box have a lid?� <br /> Is the lid broken or damaged enough to warrant replacement? Did you replace it? <br /> It is a Simple Utility box with lift type lid (non-locking) <br /> It is a_:�__ �ecurable type Utility box with screw fasteners What brand? Luh� - <br /> What kind of tool is needed to open it? <br /> Were screws in place? �) Do Screws need to be replaced? <br /> Does the threaded receptacle need to be repaired? �j threads? j-J weld? <br /> Is the well lockable? Is there a lock? _ What type of Lock? <br /> Was it locked? Will it unlock easily? Does it need to be replaced? <br /> Does the type of li ug have the potential to I`eeli s dace runoff <br /> water from entering the <br /> well? �, Does it appear that the plug or cap is tight enough to actually seal out water? <br /> If sealed with an expands g plug, is the plug tight enough in the top of the well to resist being <br /> readily pulled out? � <br /> s� <br /> Did }ou decide that the plug should be replaced? � Did you replace it? <br /> rIs there vti ater present in the bottom of the box, below the top of the wellcase? <br /> Is water standing at the level of the top of the well case? � <br /> Is water standing a ell above the level of the top of the wellcase? <br /> Do you need to bail or suck out this standing eater? <br /> Is the top of the veil itself, cracked, bellea or deformed so a plug will not seal tightly? •a <br /> Is any portion of the well itself, loose or able to be readily unscrewed or pulled loose? '_ _ <br /> Are there cracks or other signs of damage to the well, the utility box or the concrete seal? <br /> Is there a passive recovery device (skimmer) installed in the well? yJ <br /> Does it prevent a watertight seal from being installed? -- <br /> ? <br /> Is there an installed pump or other recovery device installed in the well?�What� <br /> Does it prevent a watertight seal from being installed? <br /> Are special instructions needed for gauging or sampling this well? <br /> NOTES <br /> file- Wellhead sam <br />