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SHAW Environmental&Infrastructure, Inc <br /> GROUNfWATER SAMPLING AND ANALYSIS REQUEST FORM <br /> PROJECT NAME Parkiison's Arco <br /> ADDRESS 32,50 West Hammer Lane,Stockton,Ca(1-5 &Hammer Lane) <br /> SCHEDULED DATE April 2,2003 <br /> SPECIAL INSTRUCTIONS,/CONSIDERATIONS �rz <br /> Project Manager David Herzog <br /> 2nd Quarter 2003 Ground Water Monitoring Dir Ph in Sacto 916-565-4377 <br /> Project No 8800401A <br /> Standard 3-casing volume purge Cost Code 01060000 <br /> Bang purgewater back to the office tank Document amount <br /> Copies to David Herzog <br /> cc <br /> Blaine Tech (408-573-05551 x221, Cindy)is no longer sampling adjacent site <br /> Well Lock <br />' O Number(s) <br /> 0464 <br /> Contact Vicki McCartney @ San Joaquin County to notify her of <br /> the sampling event 209-468-3456 <br />' Site Contact Jiro Parkinson(owner)or Mike Doughtery(Mngr) <br /> We]I Number Casing Casing Depth to <br /> or Source Diameter Length Water ANALYSES REQUESTED <br /> (inches) (feet) (feet) <br /> Sample Order Last Event 1/2/03 <br /> IMW-3 20 250 13 36 TPHG/BTEX(8015/8020) <br /> MTBE/DIPE/ETBE/TAME/TBA J82 <br /> MW-2 20 210 1411 .�= <br /> MW4 20 250 13 56 <br /> Field Meas tments <br />' MW-1 20 250 13 98 pH, EC, mp IIIYYY�y, <br /> MW-5 2025 25 0 13 87 <br /> V <br /> Laboratory(address, phone,contact and QC instructions) <br /> CLS Labs P O For 2003' 206765 <br /> 3249 Fitzgerald Road <br /> Rancho Cordova, Calif 95742 <br /> 916-638-7301 /Fx 638-4510 <br /> Contact Ray Oslowski <br /> Page 1 of I <br />