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FIELD SERVICES ! O & M REQUEST <br /> TION FORM <br /> SITE 1NFORMA <br /> Identification Pro ect T e Client Don Rodgers <br /> Project# 880-039 1A ❑ 1 st Time Visit Client P O C Don Rodgers <br /> Task# 03030000 ❑ Quarterly Date of Request <br /> Site Address 515 W. Charter <br /> Wa ❑ 1st ❑ 2nd ❑ 3rd ❑ 4th Ideal Field Date(s) <br /> Stockton, CA ❑ Monthly Laboratory Sequoia Analytical <br /> Station 1.13# N/A ❑ Semi-Monthly Mileage <br /> County San Joaquin ® Weekly Budget Hours <br /> Project Manager Tom Allan ❑ One Time Event Actual Hours i <br /> Requestor Kathleen Waldo y - ❑ Other Mob/Demob <br /> Field Tasks, For General Description ' <br /> A Site requires weekly visits <br /> ➢ Sam les stem Infl/Effl once a month and submit for GAS/BTEX analysis normal TAT <br /> A Perform routine maintenance <br /> ➢ <br /> Complete attached data sheets <br /> ➢ <br /> Optimize system performance based upon FID concentrations t <br /> ➢ <br /> Sample sstem once a month and submit for GAS/BTEX analysis normal TAT <br /> A Notify engineer of any problems <br /> 1 <br /> Comments remarks etc fram Feld Staff include Problems encountered and out-of-scope work <br /> e a mm2i <br /> r <br /> C � <br /> ❑ Samples taken ❑ Samples not required ❑ Soil vapor ❑ Groundwater ❑ Air Sparge <br /> ❑ Weekly ❑ Semi-Monthly ❑ Monthly ❑ Quarterly ❑ Semi-Annual ' <br /> IT Corporation Completed b Date <br /> P Y <br />