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' APPENDIX H kn KLEINFELDER <br /> APPLICATION FOR AUTHORIZATION TO USE FORM <br /> REPORT <br /> ADDITIONAL SUBSURFACE ASSESSMENT, <br /> LIMITED SENSITIVE RECEPTOR SURVEY <br /> AND 1ST SEMI-ANNUAL 2000 GROUNDWATER SAMPLING <br />' FORMER UNDERGROUND S'T'ORAGE TANK SITE <br /> H&H ENGINEERING CONSTRUCTION,INC <br /> 212 INDUSTRIAL DRIVE <br />' STOCKTON,CA 95206 <br /> File Number 20-4439-01 Report Date October 16,2000 <br />' TO Klemfelder,Inc <br /> 2825 E Myrtle Street <br /> Stockton,CA 95205 <br /> (209)948-1345 <br />' (209)948-0621 (Fax) <br /> To Whom It May Concern <br />' Applicant understands and agrees that the Additional Subsurface Assessment, Limited Sensitive Receptor Survey and 151 Semi-Annual <br /> 2000 Groundwater Sampling Report for the subject site is a copyrighted document That Klemfelder, Inc, is the copyright owner and <br /> that unauthorized use or copying of the document is strictly prohibited without the express written permission of Klemfelder, Inc <br /> Applicant understands that Klemfelder, Inc, may withhold such permission at its sole discretion, or grant such permission upon such <br /> terms and conditions as it deems acceptable <br /> Applicant agrees to accept the contractual terms and conditions between Klemfelder,Inc and Ms Jan Thompson,Agent for Wilbur-Ellis <br /> Company,originally negotiated for preparation of this document Use of this work product without permission releases Klemfelder,Inc <br /> ' its owners,employees and subcontractors from any liability that may arse from use of this report <br /> To be Completed by Applicant <br /> (Company Name) (Print Name) <br /> (Address) (Signature) <br /> ' (City,State,Zip) (title) <br /> (Telephone) (Fax) (date) <br /> ' Approval of Original Client <br /> By <br /> (Client Signature) (date) <br /> (Client Name and Title) <br /> For Klemfelder,Inc's use only <br /> ' Approved for re-use with additional fee of$ <br /> Approved for re-use with applicant's agreement to following conditions <br /> Applicant agrees to above terms and understands that findings discussed in report were based on available <br /> ' information and site conditions as noted at time of document preparation <br /> Disapproved,report needs to be updated <br /> By Date <br /> ' (Klemfelder,Inc Manager) <br /> 20-4439-01 E01/2000R726 Page 14-1 <br /> Copynght 2000 Klemfelder Inc October 16,2000 <br /> i <br />