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FIELD SERVICES REQUEST <br /> E INFORMATION FORM <br /> Identification Protect Type Check Appropriate Category <br /> Project # 07741928 190 rX Operation & Maintenance ❑X Budget Site Visit <br /> Station ID # ARCO 2093 r] Sampling ❑ Out of Budget Site Visit <br /> Site Address 3435 Tracy Blvd 1 st Time Visit <br /> Tracy, CA Quarterly Budget Hours <br /> Lab Sequoia _1st _2nd _3rd —4th Actual Hours I, <br /> County San Joaquin Monthly Mob/de Mob <br /> Project Manager Rusty Benkosky Semi-Monthly <br /> Requester Demian Wincele ❑ Weekly Site Safety 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 q11 7 )U1 <br /> Field Tasks General Description <br /> 1) Sample SVE system (bag samples)according to the following schedule <br /> - 11 1 Wells SVE Influent SVE Effluent <br /> TPHg/BTEX/MtBE M <br /> FID Cf V G-_45, 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 /> I <br /> zi <br /> le <br /> pleted By ��_2 � �� Date SECOR <br /> Imemational knoarporaled <br /> K ir0MISU-eta 5emce Hewom ids <br />