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r <br /> WELLHEAD MAINTENANCE LOG <br /> Client• Site 7�� N /, �� Well N c,� Date: l5 <br /> Does the utility box have a Iid?Y ,r� <br /> Is the lid broken or damaged enough to warrant replacement? //Did you replace it? <br /> It is a S�Ie Utility box with lift type lid (non-locking) 1 <br /> It is a Securable type Utility box with screw fas hers Wh brand?Ui�• � <br /> What kind of tool is needed to open it? /rf - S � <br /> Were screws in place?�_ Do crews need to be replaced? /V <br /> Does the threaded receptacle need to be repaired?-/V—threads? weld? <br /> a-%_- <br /> Is the well lockable? Is there a lock? C What type of Lock?/,l1� -- # Z35-`7 <br /> Was it locked? 4/*� Will it unlock easily5 �-Does it need to be replaced <br /> Doesth t e of lid or plug have the potential to keep surface runoff water from entering the <br /> well?= Does it appear that the plug or cap is tight enough to actually seal out water?—I--f <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?_z <br /> Did you decide that the plug should be replaced?-k Did you replace it? �- <br /> Is there water present in the bottom of the box, below the top of the wellcase? <br /> Is water standing at the level of the top of the well case? <br /> Is water standing well above the level of the top of the wellcase? <br /> Do you need to bail or suck out this standing water? <br /> Is the top of the well itself, cracked, belled or deformed so a plug will not seal tightly? /t/ <br /> Is any portion of the well itself, loose or able to be readily unscrewed or pulled loose?eal/v ` � <br /> Are there cracks or other signs of damage to the well, the utility box or the concrete s ? X- <br /> Is there a passive recovery device(skimmer) installed in the well?z_�_/ <br /> Does it prevent a watertight seal from being installed? - - <br /> Is there an installed pump or other recovery device installed in the well?What? -r <br /> Does it prevent a watertight seal from being installed? ­Z— <br /> I <br /> Are special instructions needed for gauging or sampling this well? <br /> NOTES <br /> 4+ <br /> file: Wellhead sam <br />