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FIELD SERVICES REQUEST <br /> M. <br /> ITE INFORMATION FORM � � � <br /> Identification Proiect Type Check Appropriate Category <br /> Project #: 077.41997.034 Operation & Maintenance ❑X Budget Site Visit <br /> Station ID#: Chevron 9-4275 ❑ Sampling ❑ Out of Budget Site Visit <br /> Site Address: 2905 Benjamin Holt Drive n 1 st Time Visit <br /> Stockton, CA 0 Quarterly Budget Hours: <br /> Lab: NA _tst _2nd —3rd —4th Actual Hours: <br /> County: San Joaquin [X Monthly Mob/de Mob: <br /> Project Manager: Scott Gable ❑ Semi-Monthly <br /> Requester: Greg McIver E] Weekly Site Safety Concerns <br /> Client: Chevron Products Co ❑ One Time Event See Health and Safety Plan <br /> Client P.O.C: Bob Cochran [—] Other: <br /> Date of Request: Field Date: <br /> Field Tasks General Description <br /> 1)Sample system to following schedule. SVE system is currently off due to flooded well screens. <br /> k # , ru= Wells SIZE Influent ..;3 SllifBfituent .'..'" <br /> TPHg/BTEX/MtBE M M <br /> FID M <br /> M =Monthly Q=Quarterly,Quarterly samples=Jan, April,July, Nov. <br /> 2)Complete the data sheet <br /> 3)Call site engineer before leaving the site. <br /> Comments 1 Remarks from Field Staff <br /> �mpleted By: ;► �� Date: SECOR <br /> KAFormS%FUWd 5oMO8 HegUeSIAS Internatio��incorporated <br />