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FIELD SERVICES !O & M REQUEST <br /> SITE INFORMATION FORM <br /> t <br /> Identification Project Type Client Don Rodgers 1 <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 Wa ❑ 1st ❑ 2nd ❑ 3rd ❑ 4th Ideal Field Date(s) <br /> Stockton CA ❑ Monthly Laboratory Sequoia Analytical <br /> Station 1_0# N/A ❑ Semi-Monthly Mileage <br /> Countyt San Joaquin ® Weekly Budget Hours <br /> Project Manager Tom Allan ❑ One Time Event Actual Hours <br /> Requestor Kathleen Waldo ❑ Other Mob/Demob <br /> Field Tasks, For General Description <br /> Site requires weekly visits <br /> ➢ Sam les stem Infl/Effl once a month and submit for GAS/BTEX analysis normal TAT <br /> ➢ Perform routine maintenance <br /> ➢ Complete attached data sheets <br /> optimize system performance based upon FID concentrations , <br /> ➢ Sam les stem once a month and submit for GASIBTEX analysis normal TAT <br /> D Noti en flneer of any problems <br /> Comments remarks etc from Field Staff include problems encountered and out-of-scope work <br /> ❑ Samples taken ❑ Samples not required 'Soil vapor ❑ Groundwater ❑ Air Sparge <br /> ❑ Weekly ❑ Semi-Monthly ❑ Monthly ❑ Quarterly ❑ Semi-Annual <br /> !7 Cor oration Completed by V z A— Date <br />