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1 M1 <br /> FIELD SERVICES REQUEST <br /> E INFORMATION FORM <br /> Yr <br /> � <br /> �� �- ; <br /> ti r', T rk�Ir� nrN9FFr <br /> Identification Proiect Tyee Check Appropriate Cate o <br /> Project# 07741928 190 ❑X Operation & Maintenance Budget Site Visit <br /> Station ID# ARCO2093 Sampling Out of Budget Site Visit <br /> Site Address 3435 Tracy Blvd 1 st Time Visit <br /> Tracy, CA El Quarterly Budget Hours <br /> Lab Sequoia —1st —2nd 3rd —4th Actual Hours <br /> County San Joaquin FX Monthly Mob/de Mob <br /> Project Manager Rusty Benkosky ❑ Semi-Monthly <br /> Requester Demian Wincele F] Weekly Site Safety Concerns <br /> Client Atlantic Richfield Company One Time Event See Health and Safety Plan <br /> Client P O C Pa_ut Supple Other <br /> Date of Request Meld Date y O <br /> Field Tasks General Description <br /> 1) Sample SVE system(bag samples) according to the following schedule <br /> �g V -,,r-Wells, SVInfluent '_SVE Eftluentr 4 <br /> TPHg/BTEX/MtBE M <br /> FID M M M <br /> M=Monthl Q=Quarterly,samples=Jan, April,July, Nov <br /> 2)Complete the data sheet <br /> 3)Call site engineer before leaving the site i <br /> Comments / Remarks from Field Staff <br /> J9 <br /> Wpleted By: �'�� � Date !/ o/ SECOR <br /> Intemationw Incorpomted <br />&-WomisWwW bermo H9gueZ ins <br />