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Proposed location for subsurface work: <br /> Property Address: Assessor's Parcel Number(APN): <br /> 3379 Tracy Boulevard 214-180-210-000 <br /> Tracy, CA 95376 <br /> I, So"n L,\ / n cy- owner of the property/properties listed above,give my permission to <br /> Stantec Consulting Services, Inc. (consulting company, contractor)to conduct the following work at the locations <br /> stated above. <br /> Install monitoring wells Destroy monitoring wells ❑ Drill 5 soil borings <br /> I understand that Patrick A. McConnell P.G. (registered professional)of Stantec Consulting Services Inc. <br /> (consulting company)and an authorized signer for Cascade Drilling Inc. have submitted a signed application to <br /> the Department of Environmental Health in which they have agreed to complete the above-stated work according the <br /> requirements of the State of California pertaining to well/boring construction and destruction. I have arranged <br /> with the Registered Professional, (the person who has requested borings be drilled on this property), and <br /> the drilling company, to ensure proper closure of the borings. 99 T <br /> Property Owner Signature: i �- Dater I S 12az� <br /> Sc f� <br /> Print Name: mo <br /> (� ,,T {{� Title: I - P(CSI ``�� <br /> Company: 0U l n4b /�f Lu— <br /> Mailing Address: 9505 Williamsburg Plaza 300, Lousiville, KY 40222-5090 <br />