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FIELD SERVICES /O & M REQUEST <br /> SITE INFORMATION FORM <br /> }r.r <br /> Identification Protect Type Client <br /> Don Rodgers <br /> Project# 880-039 1A ❑ 1st Time Visit Client P Q C Don Rodgers <br /> 1 <br /> Task# 01030000 ❑ Quarterly Date of Request <br /> Site Address- 515 W_ Charter Way_ ❑ 1st ❑ 2nd ❑ 3rd ❑ 4th Ideal Field Date(s) <br /> Stocldon, CA ❑ Monthly Laboratory Sequoia Analytical <br /> Station I_D# N/A ❑ Semi-Monthly <br /> County- San Joaquin ® Weekly <br /> Project Manager Tom Allan ❑ One Time Event <br /> Requestor- Kathleen Waldo ❑ Other <br /> Field Tasks: For General Description _ <br /> ➢ Site requires weekly visits <br /> ➢ 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 sstem once a month and submit for GAS/BTEX analysis normal TAT , <br /> D Notify engineer of any problems <br /> 1 <br /> Comments remarks etc from Field Staff include problems encountered and out-of-scope work <br /> 'C�C <br /> Z+ r kr 41Z1S a� <br /> ;2r-6amples taken ❑ Samples not required oil vapor ❑ Groundwater ❑ Air Sparge <br /> Weekly ❑ SemrMonthly ❑ Monthly ❑ Quarterly ❑ Semi-Annual <br /> • 1 <br /> IT Corporation Completed by _ Date S f <br />