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WELLHEAD MAINTENANCE LOG Client f1FU Site 141 N El ), PW&P _ Well _ _ Date /i z-m- a+3 Does the utility box have a lid?_Ys Is the lid broken or damaged enough to warrant replacement? AfO Did you replace it9 It is a Simple Utility box with lift type lid (non-locking} It is a__�<�Securable type Utility box with screw fasteners What brand? S7-0-fEL Amr� What kind of tool is needed to open it? A«E.J A-FK Were screws in plac02 �4 Do Screws need to be replaced? ff 2 Does the threaded receptacle need to be repaired? lgO threads? // weld?AtO p er - 1 H fls Hiv5 F-5 r-p-om F xrp_Ac rro q 5 K3 ./ 4nl D / v G A P Is the well lockable?&Q Is there a lock? NO What type of Lock? &(A # Was it locked? A(O Will it unlock easily? /Y A- Does it need to be replaced? Does the type of lid or plug have the potential to keep surface runoff water from entering the well? 14A Does it appear that the plug or cap is tight enough to actually seal out water? A1.4 If sealed with an expanding plug, is the plug tight enough in the top of the well to resist being readily pulled outs 6LA Did you decide that the plug should be replaced? Hp Did you replace it? Is there water present in the bottom of the box, below the top of the wellcase? "Q Is water standing at the level of the top of the well case? P 0 Is water standing well above the level of the top of the wellcase? tJ 0 Do you need to bail or suck out this standing water?� ,A/ 0 Is the top of the well itself, cracked, belled or deformed so a plug will not seal tightly? iV b Is any portion of the well itself, loose or able to be readily unscrewed or pulled loose? At o Are there cracks or other signs of damage to the well, the utility box or the concrete seal?No Is there a passive recovery device (skimmer) installed in the well? '40 Does it prevent a watertight seal from being installed? Is there an installed pump or other recovery device installed in the well'A5'What XTi A6-1IVA( S Y�, Does it prevent a watertight seal from being installed? N 0 Are special instructions needed for gauging or sampling this well?ff S NOTES �,j i5 tnc0rrec`�`�y Lr�.ac�r'�4f on [on4vI 'arn e rz w - r t s fi a-� P- 1 A fi- -fhe PopT- j 5 P- Z AT she 1>02-r (ffjr-TwE9�i✓ S'AMp111-rnl?— S/z17/IT 3 — /'F fzz/I3 ; mow- 1 file Wellhead sam At%jb vv- -2 oW rtif co,,,j WF�iE' SpvlTctiF-6)