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f r <br /> 1 <br /> FIELD SERVICES REQUEST <br /> ITE INFORMATION FORM <br /> Identification Project Type Check Appropriate Category <br /> Project #: 077.41991.034 Operation & Maintenance QX Budget Site Visit <br /> Station ID #: Chevron 9-0275 E] Sampling ❑ Out of Budget Site Visit <br /> Site Address: 2905 Benjamin Holt Drive F] t st Time Visit <br /> Stockton, CA r] Quarterly Budget Hours: <br /> Lab: NA _i st —2nd _3rd —4th Actual Hours: <br /> County: San Joaquin _ _ ❑X Monthly Mob/de Mob: <br /> Project Manager: Scott Gable Semi-Monthly <br /> Requester: Greg McIver Weekly Site Safety Concerns <br /> Client: Chevron Products Co One Time Event See Health and Safety Plan <br /> Client P.O.C: Bob Cochran Other: !� <br /> Date of Request: Field Date: / a <br /> Field Tasks General Description <br /> 1) Sample system to following schedule. SVE system is currently off due to flooded well screens. <br /> � t w <br /> `; 11Ve11s .SVErNntliaeri#+,a '51+1J~Eiffuent+: <br /> TPHg1BTEX/Mtl3E M M <br /> 0 FID M <br /> M=Monthly Q=Quarterly,Quarterly samples=Jan,Aril,July, Nov. <br /> 2)Complete the data sheet <br /> 3)Call site engineer before leaving the site. <br /> Comments / Remarks from Field Staff <br /> mpleted By: Date: of SECOR <br /> Intemetignal Incorporated <br /> K;-4- v-mod Serra*Hequest.fds <br />