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FIELD SERVICES REQUEST <br /> SITE IN FORM <br /> Identification Pro ect T e <br /> Project# 77BP 54932 03 0335 Check A ro rials Cate o <br /> ❑X Operation & Maintenance 0 Budget Site Visit <br /> station ID # ARCD 4932 El Sampling Site Address t6 E Hardin ElOut of Budget Site Visit <br /> 9 Wa ❑ 1 st Time Visit <br /> Stockton, CA ❑ Quarterly Budget Hours <br /> !mob ty cola _tst `2nd _3rd `4th Actual Hours <br /> County San Joaquin <br /> Monthly y Mab/de Mob <br /> Project Manager Rus Benkosk ❑X Semi-Monthly <br /> Requester Clint Harms � ❑ Weekly <br /> talent. Atlantic R1cht7eld BP Site Safety Concerns <br /> Client P.O.0 Pau! <br /> ❑ One Time Event See Health and Saregy plan <br /> _Supple „` � Other ' <br /> Date of Request: I JU Field Date• - W J <br /> ' FleldTasks General Descri tion <br /> t Sample SVE system(bag samples)1100ording to the foaowing schedule <br /> HEM Ems= <br /> rTZM9ffiW7TEYWJMtBE-EPA 82608 r' f- <br /> M M M c`fi=- s,z,x-f` <br /> M M M M <br /> x Sam a GWE System water samplosl sampless000rdl2a to the following schedule <br /> BTEXWS-EPA 82606{3 Preservedvoas -- M <br /> ' TPHABTEXlM11E-EPA 82608 M M M , <br /> TPH-EPA 478.1 es preseryambers M r <br /> PH EPA 1150.1 i-500 rw <br /> -- M <br /> — M <br /> Total Cadmium,chromium,Dopper, <br /> lead,nickel,zinc EPA 200 A==:�Series <br /> Total To)dc O anics 40 CFR �W �- ♦ S <br /> 3 M=Monthly 10 . i0 it- c <br /> Q=Quarterly.Quarterly sam les=.fan. rll,July,Nov <br /> A=annually,Annual=Apdl <br /> 4 Cell site engineer before leaving site <br /> Comments / Remarks from Field Staff <br /> Completed By Date SE�On <br /> �IN <br /> IF/Ntl`3erN[e HlQuesl Illt InWyl&kOM1 WWPO(Sl`ed <br />