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' 'WELLHEAD iNISGEGT10H -HEGK,LI S i AND REPAIR ORDER <br /> inspection Date 7 <br /> Site Address_7n-s._0—l=aLcr_ _ fir__ Inspected By. Slay, — — <br /> 1 Lie nn bo/ = C assng sccrire^ 12 Watt -tanoma tr%v-loox^ 15 W11 cF-o 1unc[son2i <br /> 2 Lic r)rr KP-,-, 17 canna r it'evs 7 12a S 3-axg at•r v_the taF os Gasinc;% = G-)r cap be p,illeir l,asp? <br /> 5 Ltd bolts missing'' o Dae-,s n 112-7 Sand na halow the tep Cf Cestng'7 17 Can cep seal o at a*Ar" <br /> 4 Ltd b0't,.trit'ppri') `' `N Ilbcx t!- ,cut gradr- 12c —en with the t^o Cf Cesinq` to Padln& pms-nV <br /> E t Irl sea'mr;rl" CO t2't^at-)v„rar'�' Melt Cap grPseni 19 padlock h)nrtv,n31� <br /> �11 Wellbor r r rishecJr'amace,% I Id Well Cap foand sc Cure? <br /> CheCK boy I; no defer rendes wet founic' I late below deficiencies you wet e elle to correct <br /> Well I D D3rolanC.' Gcrrective Action i a'cen <br /> to <br /> I <br /> J,171,p l l d F 3 c t r lj n,-; l3'n C lrrect,d 4inrl �1i1' n l-nfl tri' be c-i-roct-d <br /> ^,F JF�4:4 all U{tl nC 2 that �J <br /> BTS Office, assign- r•r Da}- Date <br /> Well ! D Fersi Bina Def:cleriry __ defers Cori ection to assigned Corrected i <br />