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FIELD SERVICES REQUEST <br /> ,.,.<n . a.raw.q� ?�,' 4 t}t"` F <br /> SITE INFORMATION FORM v �x; ".� `2= Y x �'' �w mn}``xx hµ '; r h <br /> x. ry ix•k x x>� >, rryr <br /> `x~r4`}. .shs w yr.Z{tet,-'v,Y2` ' ,. <br /> Identification Project Type Check A ro nate Ca n <br /> to <br /> 1 YP p ` <br /> p q p Q r1( <br /> Project # 70007-032-01 task 1 ® Operation & Maintenance ® Budget Site Visit <br /> Station ID # Chevron 9-4275 Cl Sampling ❑ Out of Budget Site Visit <br /> Site Address 2905 Benjamin Holt Drive ❑ 1 st time visit <br /> Stockton CA ❑ Quarterly Budget Hours 4 <br /> Lab Sequoia, SO# 9030619 ❑ 1st ❑ 2nd ❑ 3rd ❑ 4th Actual Hours <br /> County San Joaquin ❑ Monthly Mob de Mob 2 <br /> Project Manager Rusty E Benkosky ® Semi-Monthly <br /> Requester Rusty Eenkosky ❑ Weekly Site Safety Concerns <br /> Client Chevron Products Company ❑ Onetime event <br /> Client P O C Brett Hunter ❑ Other <br /> Date of Request �) Ideal field date <br /> Field Tasks General Description <br /> 1) Sample system to following schedule <br /> Wells Infl Eff <br /> I <br /> TPH-g/BTEX/MtBE M M <br /> FID M M M <br /> 2 Complete data sheet <br /> 3) Gather well field data (FID, flow rate, vacuum) <br /> 4) Call site engineer before leaving site <br /> Q = Quarterly M = Monthly " = When dilution valve is open <br /> Comments, remarks from field staff <br /> 11ar o 064 /< o ,edcw7 "e-"e- ,,J �EA�irr61 <br /> r %/ Er d4/dc Sc7- tM(zA- SLA 1�rL Pk W EI l aT� <br /> Completed B Date - `` ~�` SECOR International Incorporated <br />