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4 F <br /> • SITE INSPECTION CHECKLIST <br /> Client S Date <br /> Site Address 6zv w G� -,kr L✓ S „ !, _ —_ <br /> Job Number 0Y0317-,0,V--6 Technician moo. �. <br /> Site Status S�1616( Branded Station Vacant Lot Other <br /> Inspected 1 Labeled 1 Cleaned -All Wells on Scope Of Work []� <br /> Inspected 1 Cleaned Components -All Other Identifiable Wells NIA <br /> Inspected Site for Investigation Related Trip Hazards [✓]� <br /> Addressed All Outstanding Wellhead Repair Order(s) N/A <br /> Completed Repair Data Sheets(s) [✓� NIA <br /> cspected Treatment 1 Remediation System Compound For Security, [ NIA <br /> leanliness and Appearance <br /> Inspected Vacant Lot for Signs of Habitation, Hazardous Materials or [] N/A <br /> Terrain, Overgrown Vegetation and Security <br /> PLEASE BE ADVISED THAT,UNLESS OTHERWISE INSTRUCTED,NO REPAIRS ARE PLANNED FOR THE ISSUES DESCRIBED EELOVI <br /> Outstanding Problems 1 Comments (Inaddition to other Issues,note all SOW wellboxes that by design,are not securable) <br /> 3 �ra�cr. �S ,�' ,w�,,, �ro.s �a/� diad„ a��j� .4% Gfn•.Sk <br /> 2k/'' a ;f ee.. /a! is �� r✓r./ SEGurt, <br /> .+w--7 = Jwr *0 Ae-i.Adsk <br /> PROJECT COORDINATOR ONLY <br /> Checklist Reviewedcrk- 18--jw Notes <br /> 1nllialloate <br /> OLAIME TECI I SERVICES RIC SAI I JOSE SACRALIE14TO LOS ANGELES SAN DIEGO v nr blametech c:m <br />