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SHELL SITE INSPECTION CHECKLIST <br /> Client j�e i <br /> Date 30 �( b <br /> Site Address ��, <br /> Job Number (j�,�� ;_ `)t'D 1 Technician <br /> Site Status Branded Station Vacant Lot Other �- <br /> Inspected I Labeled I Cleaned - all wells on Scope Of Work �— <br /> Inspected / Cleaned Components - all other identifiable wells <br /> N/A <br /> Inspected site for site investigation & site remediation related trip hazards <br /> Completed all outstanding BLAINE Wellhead Repair Order(s) <br /> N/A <br /> Completed Shell Wellhead RepairForm(s) <br /> [� N/A <br /> Inspected treatment/ remediation system compound for security, <br /> cleanliness and appearance <br /> NIA <br /> Inspected vacant lot for signs of habitation, hazardous materials or <br /> terrain, overgrown vegetation and security <br /> �X N/A <br /> Visually inspected site drums for condition and proper labeling <br /> © N/A <br /> Unresolved deficiencies identified - "Notice ofDericient Condition" <br /> form(s) completed ❑ <br /> N/A <br /> Notes <br /> PROJECT MANAGER ONLY <br /> Checklist Reviewed Notes <br /> Initial/Date <br /> ELAINE TECH SERVICES,INC. SAN JOSE SACRAMENTO LOS ANGELES SAN DIEGO <br /> SEATTLE wxw.blainaletlican <br />