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r <br /> • WORK REQUEST FORM <br /> Date of Request: 052400 Requested Completion Date: 060500 <br /> Proj Name: SUSD Stagg, HS Proj No: 54.17292.0002 <br /> Site Address: 1621 Brookside Rd., Stkn Task: <br /> Project Manager: Tom Lutterman Field Tech: Alex Flores <br /> Client Contact: Butch Schmidt Phone No: 953-4069 <br /> Regulatory Contact: Jeff Wong _ Phone No: 468-0335 <br /> Approval:� - Com letion Date: � c CC � <br /> rr r �� <br /> Notify Client.and Regulator 48 hrs. prior to site work. <br /> Onsite contact Butch Schmidt. <br /> Monitor dtw/dtb in MW-1. <br /> Purge and sample MW-1. <br /> Sample for BTEX/TPHg and fuel ox enates by EPA 8260. <br /> Samples to Sequoia. <br /> Contain well purge water. Take one drum. <br /> Store well purged water inside fenced area. <br /> Well is 2" total depth is 24' doth to water is — 10'. <br /> Prepare purchase order re uisition for samples.-- AF <br /> AFLORESISUSDSHS.doc <br />