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TE INFORMATION FORM <br />Identification <br />Project # 077 43452 550 <br />Station ID # Chevron 95775 <br />Site Address 309 West Kettleman Lane <br />Lodi, CA <br />Lab) Kiff Analytical <br />County San Joaquin <br />Project Manager Ron Chinn <br />Requester David M Evans <br />Client Chevron Products Company <br />Client P O C Bob Cochran <br />Date of Request <br />20 -Feb -2009 <br />FIELD SERVICES REQUEST <br />Field Tasks General Description <br />Prosect Type <br />QX Operation & Maintenance <br />Sampling <br />1 st Time Visit <br />F1 Quarterly <br />1st —2nd —3rd —4th <br />Monthly <br />Semi -Monthly <br />�X Weekly <br />❑ One Time Event <br />❑ Other <br />Field Date Wednesdays at 90 am <br />Check Appropriate Category <br />Q Budget Site Visit <br />❑ Out of Budget Site Visit <br />Budget Hours 415 <br />Actual Hours /, U <br />Mob/de Mob <br />Site Safety Concerns <br />See Health and Safety Plan <br />1) Sample SVE system (bag samples) according to the following schedule — <br />0 <br />Take bag samples on even dated Wednesdays <br />2) Sample GWE system (water samples) according to the following schedule <br />€° �'ra F- <br />SVE Influent <br />SVE Effluent <br />TPHg/BTEX/MtBE <br />FID <br />2x per Month <br />2x per Month <br />2x per Month <br />2x per Month <br />Take bag samples on even dated Wednesdays <br />2) Sample GWE system (water samples) according to the following schedule <br />€° �'ra F- <br />GW Influent <br />Mid2l _ w ,Mid -2 <br />GWE Effluent' <br />TPHg/BTEX18260 <br />Weeks <br />Weekly Weeklv <br />Weeks <br />Analyze samples by 8260 for oxygenates TBA, MtBE, DIPS, TAME, EtBE ethanol, methanol, 1,2 -DCA, EDB <br />M = Monthly <br />Q = Quarterly Quarterly samples = Jan Apnl, July, Nov <br />3) Call site engineer before leaving site _ <br />Comments I Remarks from Field Staff <br />--- <br />Completed ByDate SECOR <br />in,ernauonar ler <br />K V-0" I-leW heN KLgUe51 X'S <br />