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FIELD SERVICES REQUEST <br /> SITE INFORMATION FORM , hxs �xxw„rav�tx�in rary �,a� lxxa,x,�u�TM`,\ x� „1, ,ttxa,a l� xnrexuy„xl y xxr �t,t,-, , <br /> Identification Proiect Type Check Appropriate Category <br /> Project#: 211602384.500.9401 ❑ Operation & Maintenance ❑X Budget Site Visit <br /> Station ID#: Parcel 2A-Tidewater Stockton ❑ Sampling Out of Budget Site Visit <br /> Site Address: 666 West Weber Avenue ❑ 1s Time Visit <br /> Stockton, California ❑X Quarterly Budget Hours: <br /> Lab: NA _1st _2nd _3rd X 4m Actual Hours: <br /> County: San Joaquin Monthly Mob/de Mob: <br /> Project Manager: Dan Schreiner Semi-Monthly <br /> Requester: Alejandra Hernandez ® Weekly Site Safety Concerns <br /> Client: Chevron/ConocoPhillips F] One Time Event Please Read HASP and <br /> Client P.O.C: Rick Rittenberg/Eric Hetrick ❑ Other: conduct a tailgate meeting <br /> Date of Request: 101312012 Field Date: 1011112012 prior to beginning work. <br /> Field Tasks General Description <br /> 1 8:00 am-Stantec to meet Nieto and Sons for Belshire on site GATE COMBO: 0415 Tools for Stantec Staff: <br /> 2 Conduct a tailgate meeting : Check HASP and Nieto Sons/Belshire certifications 1) Interface probe <br /> 3 Stantec to perform pre extraction DTW and DTP gauging 2) Deionized water <br /> 4) Belshire extract SPH from monitoring wells: 3) Paper towels <br /> MW-19, 2A-MW-13, MW-17, MW-52, MW-46, MW-47, MW-48, MW-43, 4) 2-5 gallon buckets <br /> MW-49, MW-50. 5) Nitrile gloves <br /> 5 Belshire decontaminates extraction device between each extraction 6) Clipboard and pen <br /> 6 Stantec staff responsible for traffic control (delineators) 7) Delineators <br /> 7 Stantec staff fill data sheets 8) Trash bag <br /> 8 Once Belshire is finished, Stantec staff gauge and log wells 9) Ratchet Set <br /> 9 Belshire Vac Truck will slurp remaining product from system separator <br /> Comments / Remarks from Field Staff <br /> Alejandra Hernandez cell: (916)502-7886, Dan Schreiner: (916)861-0400 x227 cell: (916)475-7605 <br /> Belshire Contact: Erin Mahler(949)460-5200-Ask for Erin Mahler <br /> Belshire Driver: Lupe Flores(714)240-1298 <br /> Completed By: Date: (� <br />