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4 <br /> FIELD SERVICES REQUEST <br /> SITE INFORMATION FORM <br /> t <br /> Identification Prosect Type Check Appropriate Category <br /> Protect# 77BP 54932 o3 o335 Operation & Maintenance [E Budget Site Visit <br /> Station ID# ARCO 4932 El Sampling ❑ Out of Budget Site Visit <br /> Site Address 16 E Harding Way F1 1 st Time Visit <br /> Stockton, CA ❑ Quarterly Budget Hours <br /> Lab -Sequota _1st _2nd _3rd 4th Actual Hours <br /> County San Joaquin ❑ Monthly Mob/de Mob <br /> Protect Manager Rusty Benkosky nX Semi-Monthly <br /> Requester ClrntHarms Weekly Site Safety Concerns <br /> Client Atlantic Richfield(BP) -� ❑ One Time Event See Health and Safety Plan <br /> Client P O C Paul Supple - ❑ Other <br /> Date of Request CU2 Field Date / <br /> Field Tasks General Description <br /> Sample SVE system (bag samples) according to the following schedule <br /> s4 <br /> i ✓rsT 1 c a. 'Wg �� ent '' C <br /> � p3 <br /> TPHgBTF_X1MtBE-EPA 8260E M M <br /> FID M M M <br /> 2�Sample GWE system (water samples)according to the following schedule <br /> W4 7r <br /> BTEX/MtBE-EPA 8260B M M M M <br /> TPH-EPA 418 1 M M M M <br /> H EPA 1501 M M M M <br /> Total Cadmium,chromium,copper, <br /> lead,nickel,zinc EPA 200 Series -- --- --- A <br /> Total Toxic Or anics 40 CFR 413 --- --- --- A <br /> 3) M=Monthly <br /> Q=Quarterly,Quarterly samples=Jan,April, July, Nov <br /> A=annually,Annual=April _ <br /> 4)Call site engineer before leaving site <br /> Comments 1 Remarks from Field Staff <br /> �s JlEh r—/oC" 0 Sf�/'-/F /�FsA./rT <br /> Completed By Date SECOR <br /> K+FortnsWield Service Hequest xis Intemaflonal inco"rafed <br />