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f s� WELLHEAD MAINTENANCE LOG Client•S-_ kt/Site XCQ tv,v— Well: _ _Az2y 2— Date- 2_ c �Y Does the utility box have a lid? Is the lid broken or damaged enough to warrant replacement?ADid you replace it? It is a Simple Utility box with lift type lid (non-Iocking) It is a7�Securable type Utility box with screw fastener . What brand? &'P-1 � What kind of tool is needed to open it? Were screws in place? Do Scre s need to be replaced? Does the threaded receptacle need to be repaired?/threads7L/ weld?/(/ Is the well Iockable? Is there a Icck? What type of Lock?/�1" rar �S Was it locked? _ WilI it unlock easily? —Does it need to be replacea?� Does the type of lid or plug have the potential to keep surface runoffwater from entering the well? ' Does it appear that the plug or cap is tight enough to actually seal out water? If sealed with an a>.panding 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 replacea?k Did you replace it? Is there water present in the bottom of the box, below the top of the wellcase? Is water standing at the Ievel of the top of the well case? Is water standing well above the level of the top of the wellcase? -- Do you need to bail or suck out this standing water? 11 Is the top of the well itself, cracked, belled or deformed so a plug will not seal tightly? l" Is any portion of the well itself, loose or able to be readily unscrewed or pulled loose?- ,—t/ there cracks or other signs of damage to the well, the utility box or the concrete seal? /V Is there a passive recovery device(skimmer) installed in the well? !y 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? — Are special instructions needed for gauging or sampling this well? NOTES: r file: WeIlhead.sam