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1 <br /> FIELD SERVICES 10 & M REQUEST <br /> M>„ <br /> SITE INFORMATION FORM Rf tt.p tf..'or.v} r xrlrr`f..vraYhr`}f' t 3. }rfr^M1 Yrr rl yYv2` +:"cf+ ¢N J JlVf Jv <br /> J4 3 fyN <br /> rfv tc f <br /> Identification Protect Tyne Client Don Rodgers <br /> Protect# 880-039 1A ❑ 1st Time Visit Client P O C Don Rodgers <br /> Task# 01010000 ❑ Quarterly Date of Request <br /> Site Address: 515 W Charter Way [:list ❑ 2nd ❑ 3rd ❑ 4th Ideal Feld Date(s) <br /> Stockon,CA ❑ Monthly Laboratory Sierra Analytical <br /> Station 1-D# N/A ❑ Semi-Monthly <br /> county, San_fan Joaquin ® Weekly , <br /> Protect Manager David Herzog ❑ One Time Event <br /> Requestor � ❑ Other <br /> Field Tasks: For General DeSCrlption <br /> Site requires weekly visits _ <br /> ➢ Sample sstem Infl/Effl once a month and submit for GAS/BTEX analysis normal TAT <br /> Perform routine maintenance <br /> ➢ Complete attached data sheets <br /> O timize s stem performance based upon FID concentrations <br /> Sample sstem once a month and submit for GASBTE=X analysis normal TAT <br /> D <br /> Notify engineer of any problems ' <br /> Comments remarks etc from Field Staff finclude Problems encountered and out-of-scope work <br /> ❑ Samples taken Samples not required M-Soil vapor ❑ Groundwater ❑ Air Sparge ' <br /> F -4veekly ❑ Semi-Monthly ❑ Monthly ❑ Quarterly ❑ Semi-Annual <br /> Shaw E & I Inc. Completed by �r 1 �' Date 2 aY <br />