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FIELD SERVICES REQUEST <br /> SITE INFORMATION FORM <br /> ' Identification Protect Tyne Check Appropriate Cate o <br /> ry <br /> Project# 77BP$4932 03 0335 Operation & Maintenance <br /> ❑X Budget Site Visit <br /> Station ID # ARCO 4932 Sampling <br /> ' Site Address 16 E Hard9 WY <br /> 1 in a Out of Budget Site Visit <br /> st Time Visit <br /> Stockton, CA ElQuarterly Budget Hours <br /> Lab Sequoia _1st _2nd ^3rd �4th <br /> Actual Hours <br /> County San Joa ufn Monthly Mob/de Mob <br /> Project Manager Rusty Bonk)sky Semi-Monthly <br /> Requester Clint Harms Ej Weekly Site Safety, Concerns <br /> Client AfJan yc Richfield BP One Time Event <br /> See Health and Safety Plan <br /> Client P O C- Paul su ple Other _ <br /> Date of Request — zk�S cField Date '`[J� <br /> ' Field Tasks General Description <br /> i Sample SVP s tem ihaq samples according to the following schedule <br /> TPHgMTEX/MtBE-EPA 82606 M M <br /> FID M M <br /> ' 2 Sample GWE s tem(water samples)according to the following schedule <br /> BTEX/MtBE-EPA 82608 3 i <br /> ( preserved --- M am <br /> M W <br /> TPHg/BTEX(MtSE-EPA 6260B M M M <br /> M <br /> TPH-EPA 418 1(2 preserved ambers) — W 7M <br /> ' PH EPA 150 1(1-500 ml poly) M <br /> Total Cadmium,chromium,copper, <br /> lead,nickel,zinc EPA 200 Series -- A <br /> ' Total Toxic Organics 40 CFR 413 --- A ` <br /> ' 3 M=Monthly <br /> d=Quarterl ,Quarterly samples=Jan,April.July, Nov <br /> A=annually.Annual =Apni <br /> ' 4 Call site engineer before leaving site <br /> Comments 1 Remarks from Field Staff <br /> Completed By Date –[��- (f SEC©R <br /> '�0^%*.da menace arra r is Internal,ona!in<ppdrated <br />