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WELLHEAD MAINTENANCE LOG Client �(_Site LZO W 7E Z Well Date l l Z2 Does the utility box have a lid?� ` Is the lid broken or damaged enough to warrant replacement? Did you replace it? It is a 't - Simple Utility box with lift type lid (non-locking) It is a_\_N_Securable type Utility box with screw fasteners What brand?eMi What kind of tool is needed to n it? T Were screws in place? Do Screws need to be replaced? � Does the threaded receptacle need to be repaired? %Q threads?__IJ weld? Is the well Iockable7 _ Is there a lock? S_ What type of Lock?�.. 4 Z3- Was it locked? Will it unlock easily? --�a Does it need to be replaced? Does the type of Iid�lr plug have the potential to keep+ surface runoff water from entering the well? Does it appear that the plug or cap is tight enough to actually seal out water? If sealed with an expanding plug, is the plug tight enough in the top of the well to resist being readily pulled out?� Did you decide that the plug should be replaced? Did you replace it? -�l Is there water present in the bottom of the box, below the top of the wellcase?_,,h.._ Is water standinz at the level of the top of the well case? ,— Is water standing «ell above the level of the top of the wellcase? Do you need to i7ail or suck out this standing water? Is the top of the .,.e,l itself, cracked, belled or deformed so a plug will not seal tightly?-*.,,N Is any portion of the well itself, loose or able to be readily unscrewed or pulled loose? Are there cracks or other signs of damage to the well, the utility box or the concrete seal Is there a passive recovery device (skimmer) installed the well? t Does it prevent a watertight seal from being installed?� Is there an installed pump or other recovery device Inst led in the well9� What7�Di�. JUA ►"�� Does it prevent a watertight seal from being installed? V Are special instructions needed for gauging or sampling this well? NOTES • file Wellhead sam