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FIELD SERVICES REQUEST <br /> SITE INFORMATION FORM <br /> Identification Protect Type Check Appropriate Catenor <br /> Project # TTBP 54932 03 0335 Q Operation & Maintenance X❑ Budget Site Visit <br /> Station ID # ARCO 4,932 0 Sampling E] Out of Budget Site Visit <br /> Site Address 16 E Harding Wat ❑ 1 st Time Visit <br /> Stockton, CA F] Quarterly Budget Hours <br /> Lab Sequoia _1s( _2nd 3rd 4th Actual Hours <br /> County Sari Joaquin � Monthly — Moblde Mob <br /> Project Manager Rusty Benkdsky Semi-Monthly <br /> Requester Clint Harms Weekly Site Safety Concern <br />' Client. Atlantic Richfield BP E] One Time Event See Health and Safety Plan <br /> Client P.O.C: Pau!Su le E] Other <br /> Date of Request. Z--Z-w Field Date <br /> Field Tasks General Descd tion <br /> 11 Sample SVE system(bag samples)according to the following schedule <br /> e u <br /> 1PHgf13TEX/MtBE-EPA 6260B M M M <br /> RID M M M M l <br /> 11 Sample GWE system(water sampiao according to the followim schedule <br /> STEMOE-EPA 821606(3 pmMryed upas — M <br /> TPHglBTPWtBE-EPA aM8 M M M --- M <br /> TPH-EPA 418 1(2 p2Mmod ambers) M <br /> pH EPA 15010-WO ffd } — -- -- M <br /> Total Cadmium,chromium,copper, V — W — <br /> lead,nickel,zinc EPA 200 Series A <br /> Total Toidc Organics 40 CFR 413 --- --- --- A --- <br /> 3 M=montlll Z-`r^ <br /> Q Quarterly.Quar"samples_Jon_April,July,Nov <br /> A=annually,Annual= nl <br /> 4) Call site englneer before leaving site <br /> ' Comments 1 Remarks from Field Staff <br /> SECOR <br /> Completed By Date <br /> i <br /> —- — MIMrlalitlryl MC.OrpOfafC� <br /> errrMV K7tl,ern[e rMu� it -_ �_ -- <br />