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4 <br /> FIELD SERVICES REQUEST <br /> FSITE INFORMATION FORM <br /> Identification Pro ect <br /> Type Check Appropriate Cateslory <br /> Project# 77BP 54932 03 0335 0 Operation & Maintenance nX Budget Site Visit <br /> Station ID# ARCO 4932 Sampling Out of Budget Site Visit <br /> Site Address 16 E Harding Way _ F� 1 st Time Visit <br /> Stockton, CA ❑ Quarterly Budget Hours <br /> Lab Sequoia _1st _2nd 3rd 4th Actual Hours <br /> County San Joaquin ❑ Monthly Mob/de Mob <br /> Project Manager Rusty Senkosky Ox Semi-Monthly <br /> Requester Clint Harms Weekly Site Safety Concerns <br /> Client AHanac Rrchtr"eld(BP One Time Event See Health and Safety Plan <br /> Client P O C Paul Sup le Other <br /> Date of Request (,� Field Date2- F003 <br /> i_ir i nnn ,.wr. rrwr^� <br /> Field Tasks General Description <br /> 1 Sample SVE system(bag samples)accordin2 to the following schedule <br /> TPHg/BTEX/MtBE- ERA 4698- M M M <br /> • FID J @,azU M M M M <br /> .S /;Z/e <br /> 2 Sample GW E system water samples)according to the following schedule <br /> BTEXUBE-EPA 826413(3 preserved voas) --- --- M --- <br /> TPHgBTEX/MtBE-EPA 82608 M M M -- M <br /> TPH-EPA 418 1(2 preserved ambers) -- --- --- M <br /> pH EPA 150111-500 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 /> 6 U rmc 1010- / r rte' Z (yU-e' c ,asf <br /> 3) M=Monthly ;GJ /.z SS <br /> QQr U,Quarterly samples=Jan,April,July,Nov <br /> A=a^ nnuall ,Annual=April <br /> 4) Call site engineer before leaving site <br /> Comments 1 Remarksfrom Field Staff <br /> `'J�._. - S��1ti�� V ASN.p� --t �� d <br /> Ti - leuE^_ ?'CAA0VE0 <br /> -lam\ �Ir °F �� <br /> s , <br /> Completed By: Date: S , <br /> �} x <br /> r,'+a r*WjNd UGMCe H aqueataea i K unernau,„ai rp�ated�_. <br />