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FIELD SERVICES REQUEST <br /> SITE INFORMATION FORM <br /> Identification Prosect Type Check Appropriate Cater <br /> qVq..,�, <br /> Project # 77BP 54932 03 0335 Operation & Maintenance QX Budget Site Vint <br /> Station ID # ARCO 4932 Sampling ❑ Out of Budget Site Visit <br /> Site Address 16 E Harding Way 1st Time Visit <br /> Stockton, CA Quarterly Budget Hours <br /> Lab Sequoia _est _2nd _3rd 4th Actual Hours <br /> County San Joaquin [:] Monthly Mob/de Mob <br /> Project Manager Rusty Benkosky X] Semi-Monthly <br /> Requester Clint Harms [:] Weekly Site Safet Concerns <br /> Client Atlantic Richfield(BP) ❑ One Time Event See Health and Safety Plan <br /> Client P O C Paul Su le n Other <br /> Date of Request Field Date <br /> Field Tasks General Description <br /> 1E Sample SVE system (bag samples)according to the following schedule <br /> TPHg/BTEX/MtBE-EPA 8260B M M M <br /> FID M M M M <br /> 3 • <br /> 2 Sample GW E system water samples according to the following schedule <br /> BTEwMME-EPA 826oB(3 preserved vows) --- 7- 7- <br /> 7m7 <br /> — <br /> TPHgl13TEX/MtBE-EPA 8260B M M <br /> TPH-EPA 418 1(2 preserved ambers) --- <br /> H EPA 150 1(1-500 ml — — �. M <br /> Total Cadmium,chromium,copper, <br /> lead,nickel,zinc EPA 200 Series – --- — A — <br /> Total To)dc Organics 40 CFR 413 -- — -_ A — <br /> 3 M= Months <br /> Q=Quarterly.Quarterly samples=Jan,April,July, Nov <br /> A=annually,Annual= nl <br /> 4 Call site engineer before leaving site <br /> Comments f Remarks from Field Staff <br /> I <br /> Completed By Date SECOR <br /> K trorrrat�iLya Service Hequest xis International Incorporated <br />