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2900 - Site Mitigation Program
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PR0505768
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
11/25/2020 9:40:24 AM
Creation date
5/13/2020 2:04:42 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0505768
PE
2960
FACILITY_ID
FA0006988
FACILITY_NAME
ALDEN PARK CHEVRON
STREET_NUMBER
500
Direction
N
STREET_NAME
SEQUOIA
STREET_TYPE
AVE
City
TRACY
Zip
95376
APN
23416001
CURRENT_STATUS
01
SITE_LOCATION
500 N SEQUOIA AVE
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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• z3�/-ido -3`/ <br /> /7 <br /> Chevron <br /> Chevron <br /> August 17, 1995 <br /> Chevron Pipe Line Company <br /> 4000 Executive Parkway,Suite 400 <br /> San Ramon,CA 94583 <br /> Alden Park Area P.O.Box 5059 <br /> Owner/Resident Consent Form San Ramon,CA 94583-0959 <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 permission 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 /> J <br /> Property Address: <br /> Are you the owner of the subject property? Yes \ No <br /> CONSENT: <br /> ,,—gnature) <br /> 7Lggy � �ANF7 Mr�cK <br /> (Name -Please Print) <br /> Date: <br /> Home Phone: 7 'L ZW // ( k-6 FF <br /> Work Phone: ��_ <br /> Al reverso hay una version en Espanol. — <br />
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