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FIELD SERVICES 10 & M REQUEST <br /> SITE INFORMATION FORM I <br /> Identification Protect Type Client Don Rodgers <br /> Project# a80-039 1A ❑ 1st Time Visit Client P O C Don Rodgers <br /> Task# 03030000 ❑ Quarterly Date of Request - I <br /> Site Address 515 W Charter Way ❑ 1 st ❑ 2nd ❑ 3rd ❑ 4th Ideal Field Date(s) <br /> Stockton, CA ❑ Monthly Laboratory Sequoia Anal ical I <br /> Station I.D# NIA ❑ Semi-Monthly Mileage <br /> County San Joaquin ® Weekly Budget Hours ' <br /> Protect Manager Chet Zaven ❑ One Time Event Actual Hours <br /> Requestor Chet Zaven <br /> Other S Si` �T`Wr Mob/Demob <br /> I <br /> Field Tasks- For General Description ' <br /> Site re uires weekly visits <br /> Sample sstem Infl/Effl once a month and submit for GAS/BTEX analysis normal TAT I <br /> Perform routine maintenance <br /> Complete attached data sheets <br /> optimize system performance based upon FID concentrations <br /> Sample sstem once a month and submit for GASIBTEX analysis normal TAT <br /> > Notify engineer of any problems' <br /> 4 <br /> Comments remarks etc. from Field Staff include problems encountered and out-of-scope work <br /> - — , XI <br /> Samples taken ❑ Samples not required Soil vapor ❑ Groundwater ❑ Air Sparge <br /> ❑ Weekly ❑ Semi-Monthly ❑ Monthly ❑ Quarterly ❑ Semi-Annual <br /> IT Corporation Completed by Date 3 <br /> F <br />