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WELLHEAD MAINTENANCE LOG Client Hal— LZo W C.- �E—_, -2 Well M w)_ 10 Date �.Z Does the utility box have a lid?%I-- Is the lid roken or damaged enough to warrant replacement? Did you replace it? It is a Simple Utility box with lift type lid (non-locking) F 1 It is a Securable type Utility box with screw fasteners What brand?0,jtVeeSAL What kind of tool is needed to open it? etbt," Were screws in place? �V _ Do Screws need to be replaced Does the threaded receptacle need to be repaired? 0 threads? v.J weld?_ tJ_ Is the well Iockable? 1 Is there a lock? LA What type of Lock? M6 #__= Was it locked? 4 Will it unlock eas:ly? �4 Does it need to be replaced? E) Does the type of lidorplug 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 e-%pajiding plug, is the plug tight enough in the top of the well to resist being readily pulled out?-1V Did you decide that the plug should be replaced? Did you replace it? Is there water present in the bottom of the box, below the top of the wellcase? ►� c�J Is water standing at the level of the top of the well case? 1J Is water standing well above the level of the top of the we case? r) Do you need to bail or suck out this standing water? Is the top of the well itself, cracked, belled or deformed so a plug will not seal tightly? t ) Is any portion of the well itself, loose or able to be readily unscrewed or pulled Ioose? l�T Are there cracks or other signs of damage to the well, the utility box or the concrete seal? N� Is there a passive recovery device (skimmer) installed ina well? I.) Does it prevent a watertight seal from being installed? t� Is there an installed pump or other recovery device insta ed in the well? tJ What? Does it prevent a watertight seal from being installed? Are special instructions needed for gauging or sampling this well? NOTES. file: Wellhead sam