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x <br />' FIELD SERVICES 10 & M REQUEST <br /> • v>1 �tiV L�. k J'+rrv'S F1.v. yS1JiA{ M1{[ti : .{9 s�9 v }r{'gj`N 77-7YL`~ ~ "SITE INFORMATION FORM <br /> .iStt^ 5v\ ' r�r ..Ay`vp]ry} v\tel F�r <br /> Identification Project Type Client <br /> DonRodgers <br /> Prosect# 880-0391A ❑ 1st Time Visit Client P O C Don Rodgers <br /> Task# 01010000 ❑ Quarterly Date of Request <br /> Site Address 515 W Charter Way ❑ 1st ❑ 2nd ❑ 3rd ❑ 4th Ideal Field Date(s) <br /> Stockton, CA ❑ Monthly Laboratory Sierra Analytical _ <br /> Station I b# NIA ❑ Semi-Monthly ^ <br /> County San Joaquin - ® Weekly <br />' Protect Manager David Herzog ❑ One Time Event <br /> Requestor ❑ Other <br /> Field Tasks: <br /> For General Description <br /> ➢ Site requires weekly visits <br /> ➢ Sample sstem Infl/Effl once a month and submit for GASBTEX analysis normal TAT <br /> ➢ Perform routine maintenance <br /> ➢ Complete attached data sheets <br /> ➢ Optimize system performance based u on FID concentrations <br /> ➢ Samples rem once a month and submit„for GAS/BTEX analysis normal TAT <br /> ➢ Notify engineer of any problems _ _. <br /> i <br /> Camments. remarks,etc from Field Staff(include problems encountered and out-of-scope work) <br /> 1 <br /> ❑ Samples taken t�_ftmples not required toil vapor ❑ Groundwater ❑ Air Sparge <br /> ❑ Weekly ❑ Semi-Monthly ❑ Monthly ❑ Quarterly ❑ Semi-Annual <br /> Shaw E & I Inc. Completed by Date <br />