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TE.2 <br /> —02—IR-9 TIJR 15: I La:l.J r R INC <br /> STATEMENT OF PERMISSION TO CONDUCT <br /> SUBSURFACE INVESTIGATION ON <br /> PRIVATE PROPERTY <br /> To the San Joaquin Local Health District (S1LHD), the undersigned declares that he <br /> is the legal owner of the parcel of land located to the west of the intersection of Grant ,.. <br /> y, <br /> California, bounded on the south by Grant mine <br /> Line and Corral Hollow Roads in Trac - <br /> Road and on the east by the property that lies in the northwest corner of said intersectio <br /> and immediately adjacent to Carnal Hollow Road, and hereby <br /> ants to Western Geolog'C <br /> California, acting on behalf of Chevron Pipe Line <br /> Resources, Inc. (WGR), of San Rafael, <br /> Company, of Pittsburg, California, for a period of ninety (90) days from the date of this <br /> statement, permission to conduct a subsurface investigation, including a soil vapor 'survey <br /> and installation of monitoring wells on the said parcel. ,, <br /> This permission to conduct the subsurface investigation is revocable at any time ' <br /> after 90 days from the date of this statement, and is granted with the <br /> WGR tone nduc&the F' <br /> is required by the SJLHD in order to issue the necessary permits <br /> said work. <br /> , > <br /> Signed- Date <br /> (print name) <br /> Title <br /> Address.—,2� ._..--- �� – <br /> CIA <br /> kaa <br /> Phone <br /> � Q <br /> y <br />