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SITE INSPECTION CHECKLIST <br /> Client Date <br /> Site Address __,2310 ;V. ,O'/1Jv <br /> - - <br /> Job Number 04A9Ifz6 -AW/ Technician <br /> Site Status 54 e14( Branded Station , Vacant Lot Other <br /> Inspected 1 Labeled 1 Cleaned -All Wells on Scope Of Work <br /> Inspected 1 Cleaned Cornponente - All Other Identifiable Wells N/A <br /> Inspected Site for Investigation Related Trip Hazards 0� <br /> Addressed All Outstanding Wellhead Repair Order(s) N1A <br /> Q <br /> f <br /> Completed Repair Data Sheets(s) ❑ N1A <br /> Inspected Treatment 1 Remediation System Compound For Security, NIA <br /> Cleanliness and Appearance <br /> Inspected Vacant Lot for Signs of Habitation, Hazardous Materials or N1A <br /> Terrain, Overgrown Vegetation and,Security <br /> PLEASE BE ADVISED THAT.UNLESS OTHERWISE JNSTRUCTED, NO REPAIRS ARE PLANNED FOR THE ISSUES DESCRIBED BELOW <br /> r <br /> Outstanding Problems 1 Comments (In addition to other Issues,note all Sow weilboxes that by design,are not securable) <br /> / �� ,'� wcu #.2 0., � ,rte sccKrt. /1�•rl.,:l�.s..� �cr�.•-d>^ �,� -- ���- <br /> SvaC c.rt o., c.. Gid box- -40 5-"V-r /urs, L•cf d G#ts,va!r•� .�' <br /> A <br /> L ast`L I � oinks Sar, a.,d .'d %S 07 alp 5*eu4.."4e 1�dAo OW <br /> r�c.1 ,�/c.-, � �vrr, /�Cens?c„c/ �e " cc/G x w� �s /uc�c./ o.. � •erL , <br /> PROJECT COORDINATOR ONLY <br /> Checklist Reviewed -TiNates <br /> Initial/Date <br /> WsUE TECH SERVICES itlC SAN JOSE SACRAMENTO LOS ANGELES SAW DIEGO <br /> *hwr hlane Zech m"� <br />