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Hs A (9S�.n. smrar� <br /> Chevron <br /> August 4, 1995 , Chevron <br /> John &Maria Santos <br /> 525 N. Palm Circle <br /> Tracy, CA 95376 Chevron Pipe Line Company <br /> 4000 Executive Parkway,Suite 400 <br /> San Ramon,CA 94583 <br /> Alden Park Area Ro.Box 5059 <br /> Owner/Occupant Consent Form San Ramon,CA 94583-0959 <br /> Backyard Soil Sampling <br /> Subject Property: 525 N.Palm Circle,Tracy, CA <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 /> Sincerely, <br /> Don O. Culbertson <br /> Are you the owner of the subject property? Yes _ No <br /> CONSENT: <br /> (Si ature) <br /> (Name -Please Print) <br /> Date:- ?/) ) / 95 <br /> Home Phone: FSS` S ,j Work Phone: 35 (-p—] Q _ <br /> Al reverso hay una version en Espanol. <br />