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t <br /> • �.vu.v.rorrern�eec—,rXcretaULMIJV r s%J1VJr'UUIVU,ANUJI It INbtOtzUItUN FUKM Page_, of f <br /> INCIbFJdT# �� jr) ADDRESS 4) <br /> 4° <br /> J tit:xrr-, -f v 2d <br /> DATE: (5�tl'7-1 I-Zo)jJJ CITY&STATEfin- <br /> r O y ) <br /> 77 <br /> bbseryatJbn's Upon AMVaI:. �� <br /> Well{Q.. Well Labeled/ vueh Gap {Noll Pad): note Repairs fJlaHe.' t Photos Of Repalt batt' <br /> MaitWay Coynr,Type,Condlflan$`Siz9 "' Pallited (Gtippet)' Well LOCh:Corftiitioti, Su a •• betaged Fxplatidt on of ARatittenanpeRecotrlrnended ;Y,I :antl PIV(+.c <br /> :,, ; .t.. °,.^,ptr " Cgs:'"t: I ( ~��,� and performed 4 Cbnilltlon i ini4ai <br /> ,Size(loch) ' -- �Py'>J. --L ,.,•... _ _._—.t„"�. S <br /> Standpip Flu G f p) N G' R � R NL P Z YS�JG� f7J�✓�✓1Y <br /> t 1 V Slzo(Inch} <br /> Standpipe lus o t y N U R RNL O P <br /> Y60, <br /> Size(inch) r <br /> Standpipe Flu G �D { CY) N G R R NL G'• P r �+� <br /> !►ID ,✓ Y <br /> Size(inch) �^ i <br /> ;•tit t Standpipe •lu G P 0 N /tai f R G R NL C1 P y H) <br /> •• eta '7 <br /> `,./ <br /> Size(inch) <br /> StandpiFlus G' P Y1 N L R R NL P y <br /> v 7 (size(inch) `. <br /> Standpip Ffus'h Go P `Z & N R fR NL GG) P <br /> ( �.s Y <br /> �;� Size(inch) <br /> Standplp Ftusn (:ems P N 6f R R NL P- Y <br /> Size(IhCh) ., <br /> Standpip FI� P 4 1 N (G i R R NL /u; P Y <br /> Sae(inch) 4 Ar a✓ <br /> Standpipe, Flush G y P + N 6V R R NL 3� P Y <br /> Size(Inch) <br /> � T t Standpipe Flush P 101 N G R G R NL ((7; P y <br /> )� ! Siza(inch) `✓ �•.f <br /> Standpipe Flush P Y N G R G R NL G P y N <br /> TOTAL#CAPS REPLACED= �} .=TOTAL OF LOCKS REPLACED <br /> :<4ondittort ofBa{Bonng Pnfchax o !”' • <br /> �- G P N1A y _� if FOOft,Bonng9/WoU lDs or Locatfgn Dascrlpttarii <br /> A4agttonod Mgnitortng N/eltst �,,,! .I ;. ,,;: + ...;.': •->;, i:;. Y N <br /> Remed+atbnCompoundTypg '; " Goritlltionol'Afealn5)de.. Eme enc G'nt %In <br /> Cond(fion of Enclosure C.om ound Securi ,y. 0 ac fo F[totps of ;fta atrontes�d <br /> tC{tacli hoxrs Thai iipply( EhcCostrro P: tY U(slble <br /> rid",1 Repairs Recommended and,Gonduded <br /> •�. Coridldon ^:RI:tlnINais <br /> NA <br /> Building <br /> Building wl Fence Camp. G P NJAJ G P N A G P �a) Y N N1A~ Y <br /> Fenced Compound �a <br /> Trailer <br /> 77777. <br /> Numti'or-of Doos the LeboFR'eveal Uto Labelod!Cortoctty and �ontu}ri Dtutps. Du dca phd(as e", Arta 6rums';( <br /> ,'Dnlmsl?n-sites 'Source olalj4.Gontd)ts', .Wddn ,4e'ible ':Dmm.0°ndttlotY' ' 'Relatcdao '.etailed Ezptiination otAny issue$ aaalved '. :Drum <br /> ms,L ted to Min ' <br /> 9 9 Businesi lnterterenre ved <br /> Env)roniCtental fiR <br /> 0 <br /> Y N NIAY N NIA G P NIA Y (N Y N NIA <br /> G=Good(Acceptable) R=Replaced All environmental wells and the remediation compound were In good condition, <br /> P-Poor(needs attention) NL=No Lock Required locked,and secured upon my departure(unless otherwise noted above). <br /> Note:All ren-in other thnn Loci I sod 4it . reeuie Shell PM eoorovol prior to rooafr <br /> z <br /> --Grenitdwntar monitor'ng we:coven must be pointed and heeled in accordance with apc icable reyulahons. <br /> Version 2.4,Mach 2003 Print or typaAame df Field Personnel&Consultant Company <br />