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WELLHEAD MAINTENANCE LOG <br /> S7_ocr. TCr/ <br /> Chent-5-HFLG Site 141 Al 1 leAb0 Well 1Zw'Z Date �7 zL �3 <br /> Does the utility box have a lid?_)�g�; <br /> Is the lid broken or damaged enough to warrant replacement? X0 Did you replace it? <br /> It is a Simple Utility box with lift type lid (non-locking) s 4%1nter <br /> It is a LK --Securable type Utility box with screw fasteners What brand? -5P1�4- <br /> What kind of tool is needed to open it? /iLyEW KF K <br /> Were screws in place73/¢ Do Screws need to be replaced?NF6-b5' ! �aLr <br /> Does the threaded receptacle need to be repaired? No threads?aa weld? &C <br /> Is the well lockable?Ap Is there a lock? NO What type of Lock? P/fl- <br /> Was it locked? NA Will it unlock easily? N-A Does it need to be replaced? AAA <br /> Does the type of lid or plug have the potential to keep surface runoff water from entenng the <br /> well? NA Does it appear that the plug or cap is tight enough to actually seal out water?� <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? ./fit <br /> Did you decide that the plug should be replaced? )q A Did you replace it? <br /> Is there waterP resent in the bottom of the box, below the top of the wellcase? ALO <br /> Is water standing at the level of the top of thew ell case? nN0 <br /> Is water standing well above the level of the top of the wellcase? 00 <br /> Do you need to bail or suck out this standing water? TND <br /> Is the top of the well itself, cracked, belled or deformed so a plug will not seal tightly? /Y o <br /> Is any portion of the well itself, loose or able to be readily unscrewed or pulled loose? 1VO <br /> Are there cracks or other signs of damage to the well, the utility box or the concrete seal? /,.Z y <br /> Is there a passive recovery device (skimmer) installed in the well? No <br /> Does it prevent a watertight seal from being installed? <br /> Is there an installed pump or other recovery device installed in the wellepF�What?E7 7)2/� T/O5?S. <br /> Does it prevent a watertight seal from being installed? N D <br /> Are special instructions needed for gauging or sampling this well? X4.S <br /> NOTES <br /> 5 ��oQ r?Et ;L � lf}r3El.F-1� div' Tt�� C�.vr,QoL rt/�L <br /> R W –Z 1 S ^L o T -Z A ;tJF �a <br /> )Z\(J–Z 15 F'_ J A 'FtfE r�2T <br /> file Wellhead sam <br />