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1 <br /> WELLHEAD MAINTENANCE LOG <br /> Srock rOAf <br /> Client S'N rk l Site L41 /V R)>,nexpo _Well M W S Date xi A!3 <br /> Does the utility box have a lid?)Lr-5 <br /> Is the lid broken or damaged enough to warrant replacement?,hLc7 _Did you replace it? <br /> It is a Simple Utility box with lift type lid (non-locking) <br /> It is a_ 5c Securable type Utility box with screw fasteners What brand? 0,17 C o <br /> What kind of tool is needed to open it? 14/i, <br /> Were screws in place? S Do Screws need to be replaced? AIV <br /> Does the threaded receptacle need to be repaired?_ //0 threads? Al weld?74lt, <br /> w rr+f #Z 3 S 7 <br /> Is the well lockable? Is there a lock? y65 What type of Lock?MA5T_,A�# Z3 <br /> Was it locked?yrs Will it unlock easily?XE,_Does it need to be replaced? YE <br /> Does the type of lid or plug have the potential to keep surface runoff water from entering the <br /> well?_)5E.f_ 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?y� S <br />• Did you decide that the plug should be replaced?_C-�; Did you replace it? <br /> Is there water present in the bottom of the box, below the top of the wellcase? M D <br /> Is water standing at the level of the top of the well case? dO <br /> Is water standing well above the level of the top of the wellcase? NO <br /> Do you need to bail or suck out this standing water? jVa <br /> Is the top of the well itself, cracked, belled or deformed so a plug will not seal tightly? tlp <br /> Is any portion of the well itself, loose or able to be readily unscrewed or pulled loose? N U <br /> Are there cracks or other signs of damage to the well, the utility box or the concrete seal? /,!V <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?jQ What? <br /> Does it prevent a watertight seal from being installed? <br /> Are special instructions needed for gauging or sampling this well?_L40 <br /> NOTES <br /> file Wellhead sam <br />