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L ' a� WELLHEAD MAINTENANCE LOG is _ Client;�1 jl Site• �O � �- �•�c __Well:_ Gy — Date: �//2 C111Does the utility box have a lid? I Is the lid broken or damaged enough to warrant replacement? IV Did you replace it? — It is a � Simple Utility box with lift type lid (non-locking) � It is a V Securable type Utility box with screw fasteners. W _�� What brand? C�i�, �� What kind of tool is needed to open it? � Id Were screws in place? J_ Do Screws need to be replacea?� Does the threaded receptacle need to be repaired? /k/ threads? �U weld?� Is the well lockable? � Is there a Tock?� What type of Lock?/��as��r 4-21—E-2 Was it locked?`Will it unlock easily? �/ Does the type of lid or plug have the potential to keep surface es it need to r runoffwa erfromlentering the well?�_ Does it appear that the plug or cap is tight enough to actually seat out water?_' / If seated with an expan ng plug, is the plug tight enough in the top of the well to resist being readily pulled out? Did you decide that the plug should be replaced?_ZZ Did you replace it? Is there water present in the bottom of the box, below the to' of the ? Is water standing at the level of the top of the well case? p Weltcase Is water standing well above the Ievel of the top of the wellcase? Do you need to bail or suck out this standing water9 e<- Is the top of the well itself, cracked, belled or deformed so a plug will not sea] tightly? �� Is any portion of the well itself, loose or able to be readily unscrewed or pulled loose?: V Are there cracks or other signs of damage to the well, the utility box or the concrete seat?--A/,,,' Is there a passive recovery device (skimmer) installed in the well? Does it prevent a watertight seal from being installed? Is there an installed pump or other recovery device installed in the well? What? Does it prevent a watertight seal from being installed?r' Are special instructions needed for gauging or sampling this well? NOTES: file. Wellhead.sam