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• WORK REQUEST FORM <br /> Date of Request: 111400 Requested Completion Date: 120800 <br /> Proj Name: SUSD_Stagg HS _ . _ Proj No: 54.17292.0002 <br /> Site Address: 1621 Brookside Rd., Stkn Task: <br /> Project Manager: Tom Lutterman Field Tech: Alex Flores <br /> Client Contact: Butch Schmidt Phone No: 953-4069 <br /> Regulatory Contact: Jeff Wong Phone No: 468-0335 <br /> Approval: ti �a- -- _ Completion Date: <br /> Notify Client and Regulator 48 hrs. prior to site work. <br /> Onsite contact Butch Schmidt. <br /> Monitor dtw/dtb in MW-1. <br /> Purge and sample MW-1. '�3 <br /> Sample for BTEX/TPHg and fuel ox enates by EPA 8260. <br /> Samples to Sequoia. <br /> Contain well purge water. Take one drum. <br /> Store well purged water inside fenced area. <br /> Well is 2" total depth is 24', depth to water is --- 12'. _. <br /> Prepare purchase order requisition for samples. A-f <br /> ak CL <br /> • <br /> AFLORES%SUSBSHS.doc <br />