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s <br /> FIELD SERVICES 10 & M REQUEST <br /> ..,.fa .. . f:C 4 c .J.frc .x ,. +tG c<. ,n•ur, .�`�N r �t$4�'-r. 4 yVv {.. <br /> [ <br /> SITE INFORMATION FORM <br /> Identification Protect Type Client <br /> Don Rodgers <br /> Project# 880-039 1A ❑ 1st Time Visit Client P O C Don Rodgers <br /> Task# 03030000 ❑ Quarterly Date of Request <br /> Site Address: 515 W. Charter Wa ❑ 1st ❑ 2nd ❑ 3rd ❑ 4th Ideal Field Date(s) <br /> Stockton, CA ❑ Monthly Laboratory Sequoia Analytical <br /> Station 1.13# NIA ❑ Semi-Monthly Mileage <br /> County, San Joaquin _ ® Weekly Budget Hours ' <br /> Project Manager Tim Anenson ❑ One Time Event Actual Hours <br /> Requestor Kathleen Waldo ❑ Other Mob/Demob <br /> Field Tasks: For General Description <br /> Site requires weekly visits <br /> D Sample system (infl/Effl) once a month and submit for GAS/BTEX analysis normal TAT <br /> Perform routine maintenance <br /> ➢ Complete attached data sheets <br /> ➢ Optimize system performance based upon FID concentrations <br /> ➢ Sample system once a month and submit for GAS/BTEX analysis normal TAT <br /> Notify engineer of any problems <br /> Comments, remarks, etc from Field Staff(include problems encountered and out-of-scope work) <br /> tri <br /> ❑ Samples taken �amples not required 'Soil vapor ❑ Groundwater ❑ Air Sparge <br /> ❑ Weekly ❑ Semi-Monthly ❑ Monthly ❑ Quarterly ❑ Semi-Annual ' <br /> IT Corporation Completed by W4AJ Date <br /> 3� <br />