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INVESTIGATION DETAILS <br />Name of Investigator: _- dr)nc!ii InGC'O Cj:�Dy--Date of Investigation; <br />Qtaalificatlons: CDO/CTO/RENS/Owner/Manager) C�C��+ UTc <br />�a etre re►sti`t+�:� � ',>. <br />� <br />- _ -Al - <br />-114&. <br />What Is the bacteria count (MNP) for each well? (Is one welt positive, which is activated <br />at lower Xqssure vents w/o your knowied a causing the TCR MCL) <br />Is the wellhead check valve present within three feet of the well head and does <br />If Y- system may+bg sowoe <br />Ibr well fairing <br />it leak water back into the well? YIN <br />yG `J <br />If rt- wa R is a source for <br />s stent fail <br />The well breathing from <br />Is wellhead vent installed properly (J -vent & screen, tightly screwed in, <br />other locations, I.e, the <br />watertight, no leaks and is the well only breathing through the J vent, when it <br />J <br />well seal• bolts <br />turns off? YIN <br />7 <br />well conduits, <br />cracks in the cement <br />ad may be source. <br />Is wellhead seal water tight, electrical box caulked at conduit into well is the el <br />i <br />o <br />Seai all openinMh—'t--� <br />conduit without breaks/cracks, and bolts screwed in ht! & water tilht? YIN <br />ti <br />�� <br />be air & water <br />Is well head located in pit or is any piping from the wellhead submerged? YIN <br />D <br />Does the ground surface slope towards well tread? YIN <br />—; <br />Is there evidence of standing water near the wellhead? YIN <br />Are there any connections to irrigation, fire, industrial piping that could be inter- <br />connected? (backflow devices removed, need re air, need to be installed) YIN <br />N D <br />Is the wellhead secured to prevent unauthorized access? does well appear to <br />be tampered with? YIN <br />To what treatment plant (type) does this well pump? (GAC, nitrate, CIS., Ar) <br />Is the surface pad properly Installed & water tight 2- feet in all directions of <br />casing and well casing is at least one inch above surface ad? YIN <br />Are there trees located within 50 feet of welJ, surface roots near wed!? YIN <br />O <br />Tree roots gro m Into th- <br />wgil will cause TCR MO <br />If no seal, TC enter into <br />What is the depth and material of annular seal? <br />the well from rain or <br />irrigation. sufface water, <br />Was work done on the well prior to the failures? (sounding the well, install or <br />removal of the purnp, chlorine added to the well, new check valve installed) YIN <br />N D <br />If well has oil tubed turbine pump, Is oil on top of water column inside the wall <br />Oil must be removed, <br />ming washad with <br />casing? Is oil NSF 61 approved? Is oil stored and applied in a clean manner? <br />, t D <br />detergent, Hushed, then J <br />Y"NA <br />N <br />dlslrfected to eliminate <br />bacteria. <br />has well failed, after repairs and disinfection cuing AWWA methods to <br />recalculate chlorinated water down the well casing to disinfect above the water <br />N i) <br />table? YIN <br />Has a dawn -hole carnera been used to investigate the well? YIN <br />N <br />Degradation of casing <br />may cause TCR MCL. <br />