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FIELD SERVICES REQUEST <br /> SITE INFORMATION FORM <br /> Identification Proiect Type Check Appropriate Cate o <br /> Project# 77BP 54932 03 0335 Operation & Maintenance Budget Site Visit <br /> Station ID # ARCO 4,932 Sampling Out of Budget Site Visit <br /> Site Address 16 E Harding Way ❑ 1 st Time Visit <br /> Stockton, CA Quarterly Budget Hours <br /> Lab Sequoia _1 St _2nd _3rd 4th Actual Hours <br /> County San Joag'u1n Monthly Mob/de Mob <br /> Project Manager Rush Benkosky n Semi-Monthly <br /> Requester Clint Harms ❑ Weekly Site Safety_Concerns <br /> Client Atlantic Rrchrleld(BP) F-1 One Time Event See Health and Safety Plan <br /> Client P O C Paul Supple ❑ Other <br /> Date of Request o3 Field Date <br /> Field Tasks Genera! Description <br /> 1 Sam le SVE system (bag samples)according to the following schedule <br /> e <br /> TPHg/BTEX/MtBE-EPA-8264B M M M <br /> • FII] j ti Z CJ M M M M <br /> Z `-rJ Z3u ZB � <br /> 2 Sample GWE system (water sam les)according to the following schedule <br /> BTEXIMtBE-EPA 8260B(3 preserved voas) --- --- --- M <br /> TPHg1BTEX/MtBE-EPA 8260B M M M --- M <br /> TPN--EPA 418 1(2 preserved ambers) — --- -- M <br /> pH EPA 1501(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 /> Q=Quarterly,Quarterly samples=Jan,April, July, Nov . <br /> A=annually,Annual=Apn1 <br /> 4) Call site engineer before leaving site <br /> Comments / Remarks from Field Staff <br /> Completed B Date SECOR <br /> K%F0rrt1$WWd Senne Kequest xis Intemational Incorporated <br />