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WELLHEAD MAINTENANCE LOG <br /> Client 514CL _ Site &U W CHrp_Tc� Well N1L-D-4z, Date <br /> 7-�roc-r_'T a <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_ Securabletype Utility box with screw fasteners What brand? <br /> What kind of tool is needed to open it? 3 1,4 'k <br /> Were screws in place? _�4 Do Screws need to be replaced? <br /> Does the threaded receptacle need to be repaired? 'JJ threads?�weld`7 V � <br /> Is the well lockable? �.j Is there a lock? _ ��hat type of Lock? _4 Z % <br /> Was it locked?T Will it unlock easily? `�Q Does it need to be replaced? V14 V - <br /> Does the type of Iid or plug have the potential to keep surface runoff water from entering the <br /> well? Vj Does it appear that the plug or cap is tight enough to actually seal out water?_lAv— <br /> If sealed with an expanding plug, is the plug tight enough in the top of the well to resist being <br /> readily pulled out?_�4_ <br /> Did you decide that the plug should be reciaced? Did you replace it?__�_ <br /> Is there water present in the bottom of the box, below the to of the wellcase? t~l <br /> Is water standing at the level of the top of the well case? <br /> Is water standing ti.ell above the level of the top of the wllcase? <br /> Do you need to bail or suck out this standing eer?at3 <br /> Is the top of the Weil itself, cracked, belled or deformed so a plug will not seal tightly? t� <br /> Is any portion of the well itself, loose or aele 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? <br /> Does it prevent a watertight seal from being installed? -- <br /> Is <br /> Is there an installed pump or other recovery device insta led in the well? N What? <br /> Does it prevent a v�atertight seal from being installed? V' <br /> g g <br /> g <br /> Ares special instructions needed for gauging or sampling this well? <br /> P � � � P g <br /> NOTES <br /> file Wellhead sam <br />