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. SITE INSPECTION CHECKLIST <br /> Client SkIEI.L Date o S" <br /> Site Address �p W, to s r,Ktk,fr.u4 <br /> JOEL Number b S a S L T'-- rw.3 Technician T �/L u Lsra Y <br /> Site Status Branded Station Vacant Lot Otller o t� <br /> Inspected I Labeled 1 Cleaned -All Wells on Scope Of Work <br /> Inspected I Cleaned Components -All Other Identifiable Wells NIA <br /> Inspected Site for InvestlgationyRelated Trip Hazards <br /> Addressed All Outstanding Wellhead Repair Order(s) El EQ <br /> Completed Repair Data Sheets(s) ❑ NI <br /> Inspected Treatment I Remediation System Compound For Security, ❑ Iq <br /> *Cleanliness and Appearance <br /> Inspected Vacant Lot for Signs of Habitation, Hazardous Materials or ❑ NIA <br /> Terrain, Overgrown Vegetation and Security <br /> PLEASE BE ADVISED THAT,UNLESS OTHERWISE INSTRtJCTED,NO REPAIRS ARE PLANNED FOR THE ISSUES DESCRIBED BELOW <br /> Outstanding Problems I Comments (In addition to other Issues,note all SOW wellboxes that,by design,are not securable) <br /> ASK Ilr.ouwa 1T <br /> PROJECT COORDINATOR ONLY <br /> hocklist Reviewed ahil Notes <br /> Inl I/Date <br /> BLAINE TECH SERVICES INC SAN JOSE SACRAMENTO LOS ANGELES SAN DIEGO _w _blajnelech can <br />