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6 ,* • • <br /> [�evron <br /> Chevron <br /> August 14, 1996 <br /> Chevron Pipe Line Company <br /> 4000 Executive Parkway,Suite 400 <br /> San Ramon,CA 94583 <br /> P0.Box 5059 <br /> Alden Park Area San Ramon,CA 94583-0959 <br /> Owner/Resident Consent Form <br /> Backyard Soil Sampling <br /> Dear Owner/Occupant: <br /> Chevron is conducting a soil investigation in the vicinity of your residence. AS part of this study, <br /> Chevron would like your pennission to obtain a soil sample from your property. <br /> Chevron has selected an independent contractor, Geomatrix Consultants, Inc., to perform the soil <br /> sampling. In the unexpected event that your yard or other property is damaged by the contractor, <br /> Chevron will assume responsibility for correcting the damage. <br /> If you consent to Chevron entering your property to perform this work,please sign and date this <br /> letter on the line below. Please include your phone numbers so that Chevron can contact you to <br /> schedule a date and time to perform the work. We greatly appreciate your cooperation in this <br /> matter. <br /> Property Address: 810 Palm Circle, Tracy <br /> Are you the owner of the subject property? Yes �_ No <br /> CONSENT: <br /> ( i ature) <br /> TaS ,P 'I c-4aid <br /> (Name - Please Print) <br /> Date: SL—/$-- 'j6 <br /> Home Phone: 5/4 — Work Phone: <br />