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�a !I x I k KLEINFELDFR l I!I' APPENDIX F I� APPLICATION FOR AUTHORIZATION TO USE REPORT MONITORING WELL INSTALLATION !I AND GROUNDWATER SAMPLING AND ANALYSES ! DSS GRAVEL PIT(QX-96-1) KOSTER ROAD FACILITY TRACY,CALIFORNIA File Number: 20-2245-36.EO I Report Date: March 14, 2001 TO: Kleinfelder, Inc. I 2825 East Myrtle Street i Stockton, California 95205-4794 I� Telephone: (209)948-1345 Fax: (209)948-0621 To Whom It May Concern: Applicant understands and agrees that the above referenced report for the subject site is a copyrighted document, that Kleinfelder, Inc., is the copyright owner and that unauthorized use or copying of the report is strictly prohibited without the express written permission of Kleinfelder, Inc. Applicant understands that Kleinfelder, Inc., may withhold such permission at its sole discretion, or grant such permission upon such terms and conditions as it deems acceptable. Applicant agrees to accept the contractual terms and conditions between KIeinfelder, Inc. and DSS Company, originally negotiated for preparation of this report. Use of this document without permission releases Kleinfelder, Inc. its owners, employees and subcontractors from any liability that may arise from use of this report. 1 I, I To be Completed by Applicant A �� (Company Name) (Print Name) " (Address) (Signature) h le (City, State, Zip) (title) i (Tele hone) (Fax) (date) 11 Approval of Original Client By: _ (Client Signature) (date) iI (Client Name and Title For Kleinfelder, Inc.'s use only Approved for re-use with additional fee of$ Approvedfor re-use with applicant's agreement to following conditions: Applicant agrees to above terms and understands that findings discussed in report were based on available information and site conditions as noted at time of the report I� Disapproved,report needs to be updated By: Date: (Kleinfelder,Inc. Manager) U 20-2245-36.1r01/2011R279 Page F-1 Copyright 2001,KIeinfelder, Inc. March 14,2001