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FIELD SERVICES REQUEST <br /> TE INFORMATION FORM t Y r` "V 4 "~ <br /> Identification Protect T,r e Check Appropriate_Category <br /> Project# 07741928 190 Ox Operation & Maintenance Budget Site Visit <br /> Station ID # ARCO 2093 ❑ Sampling E] Out of Budget Site Visit <br /> Site Address 3435 Tracy Blvd F1 1 st Time Visit <br /> Tracy, CA El Quarterly Budget Hours <br /> Lab Sequoia _tst _2nd —3rd —4th Actual Hours <br /> County San Joaquin QX Monthly Mob/de Mob <br /> Project Manager Rusty Benkosky ❑ Semi-Monthly <br /> Requester Demian Wincele ❑ Weekly Site Satety Concerns <br /> Client Atlantic Richfield Company One Time Event See Health and Safety Plan <br /> Client P O C Paul Supple [] Other <br /> Date of Request Field Date f "% ,� <br /> f <br /> Field Tasks General Description <br /> 1 Sample SVE system(bag samples) according to the following schedule <br /> t2 R-M �VIT� - If <br /> UMMff uent <br /> TPHg/BTEX/MtBE M <br /> FID M M M <br /> M=MonthlY Q=Quarterly,samples=Jan,April,July,Nov <br /> 2 Complete the data sheet <br /> 3)Call site engineer before leaving the site <br /> Comments / Remarks from Field Staff <br /> Avo 77. <br /> �r <br /> ter. r�Ci �S <br /> leted By. Date SECOR <br /> + tom k=rpomted <br /> oms�rww aewce naquw)m <br />