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WELLHEAD MAINTENANCE LOG <br /> Client,5{-rj!�1_4 Site 141 N,574MRAPo Well W — 7— Date>i a� <br /> 5rack7ol-' <br /> Does the utility box have a lid?)L,1�5 <br /> Is the lid broken or damaged enough to warrant replacement? /1!D Did you replace rt? <br /> It is a Simple Utility box with lift type lid (non-locking) <br /> It is a X Securable type Utility box with screw fasteners What brand?tlr/i a E,6 J'W_✓E C a <br /> What kind of tool is needed to open it??/),*, s'ocxF_-r <br /> Were screws in place? � Do Screws need to be replaced? 90 <br /> Does the threaded receptacle need to be repaired? AIG threads?�/oweld? IVs' <br /> -A TNS flock WA-5 R�t�L +'�� WrrHv: 73s7 <br /> Is the well lockable?� Is there a lock? y4f What type of Lock?_j"A57?,e 34,z3r7 <br /> Was it locked? yo 5,_ Will it unlock easily? yr-::r Does it need to be replaced?yy5, /7- <br /> Does <br /> TDoes the type of lid or plug have the potential to keep surface runoff water from entering the <br /> well? Y Does it appear that the plug or cap is tight enough to actually seal out water? Ems` <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?)(F.> <br /> Did you decide that the plug should be replaced? U Did you replace it? <br /> Is there water present in the bottom of the box, below the top of the wellcase? 90 <br /> Is water standing at the level of the top of the well case? N D <br /> Is water standing well above the level of the top of the wellcase? Aj <br /> Do you need to bail or suck out this standing water? /+1 <br /> Is the top of the well itself, cracked, belled or deformed so a plug will not seal tightly? /o <br /> Is any portion of the well itself, loose or able to be readily unscrewed or pulled loose? c) <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? NO <br /> Does it prevent a watertight seal from being installed? <br /> Is there an installed pump or other recovery device installed in the well?L What? <br /> Does it prevent a watertight seal from being installed? <br /> Are special instructions needed for gauging or sampling this well? NO <br /> NOTES <br /> file Wellhead sam <br />