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SITE INSPECTION CHECKLIST <br /> Client SNEtt. • <br /> Date <br /> Site Address as" couvrFY cl-aAr STacA oAl <br /> Job Number OSox03 --ri,.i Technician <br /> M�tL c.e <br /> Site Status Branded Station Vacant Lot Other <br /> Inspected I Labeled I Cleaned - All Wells on Scope Of Work <br /> Inspected 1 Cleaned Components -All Other Identifiable Wells �' <br /> NIA <br /> Inspected Site for Investigation,Relate d Trip Hazards Rr <br /> Addressed All Outstanding Wellhead Repair Order(s) [2t' ,NIA <br /> Completed Repair Data Sheets(s) EJ r'LNIA <br /> Inspected Treatment/ Remediation System Compound For Security, Ea <br /> NIA .Cleanliness and Appearance <br /> Inspected Vacant Lot for Signs of Habitation, Hazardous Materials or <br /> NIA <br /> Terrain, Overgrown Vegetation and Security <br /> PLEASE BE ADVISED THAT.UNLESS OTHERWISE INSTRUCTED,NO REPA RS ARE PLANNED FOR THE ISSUES DESCRIBED BELOW <br /> Outstanding Problems I Comments (In addtiontoother issues note all SOW wellboxes that.bydesign.are not securable) <br /> �llli-'it X0665 of r--4A& &FAjlr IN LIP D60SNor FlT wStor— R!M rRIP r(AZALq <br /> N11�N� Tate KAZAAVS IREo T��IkS � -W Izl ou�in. <br /> NAsSE ol4 V l-T ISStN e0- <br /> Z -1tIAMS 10 Ci ATfr d Gong6tAPo Ojo w incl Nor 'fkroiC =(XNP <br /> of# Tq?.O%g q 0 k&T Suri <br /> V%%* oto- t�-Y E tN� St Y[o <br /> PROJECT COORDINATOR ONLY <br /> Checklist Reviewed �. Notes <br /> 1 GaI10a e <br /> BLAINE TECH SERVICES INC SAN JOSE SACRAMENTO <br /> LOS ANGELES SAN QtEGO www 61a1ndech.com <br />