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August 4, 1995 Chevron <br /> Chevron <br /> David M. &B. Guevara <br /> 615 N. Palm Circle <br /> Tracy, Ca 95376 Chevron Pipe Line Company <br /> 4000 Executive Parkway,Suite 400 <br /> Alden Park Area San Ramon,CA 94583 <br /> P.O.Box 5059 <br /> Owner/Occupant Consent Form San Haman,CA 94583-0959 <br /> Backyard Soil Sampling <br /> Subject Property: 615 N. Palm Circle, Tracy, CA <br /> Dear Owner/Occupant: <br /> Chevron is conducting a soil investieation 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 /> Sincerely, <br /> on O <br /> Culbertson <br /> Are you the owner of the subject property? Yes v No <br /> CONSENT: <br /> (Signature) <br /> (Name- Please Print) <br /> Date: / c 5 <br /> Home Phone: 2,O`/ a-'j 2- Z( 3 G Work Phone: 5-/0 A Z 3 050/ <br /> Al reverso hay una version en Espanol. <br />