WS-3748_12330_G_ACCAGMT_unsigned Kodell's Grocery Access Agreement

Herb Berger Hydrogeologist
DWM UST Section 1646 Mail Service Ctr Raleigh, NC 27699-1643 RE: Former Kodell’s Grocery
7150 North Carolina Highway 89 W Westfield, Stokes County, NC DWM Incident #12330 Dear Mr. Berger:
I am/We are the owner(s) of a parcel of property, located at or near the incident in question, and hereby permit the Department of Environment Quality (Department) or its contractor to enter upon said
property for the purpose of installing a water supply line under the authority of G.S. 143-215.3(a)2. I am/We are granting permission with the understanding that: 1. The investigation shall be conducted by the UST Section of the Department’s Division of Waste Management or its contractor. 2. The costs of construction and maintenance of the site and access shall be borne by the Department or its
contractor. The Department or its contractor shall protect and prevent damage to the surrounding lands. 3. Unless otherwise agreed, the Department or its contractor shall have access to the site by the shortest
feasible route to the nearest public road. The Department or its contractor may enter upon the land at reasonable times and have full right of access during the period of the investigation.
4. Any claims which may arise against the Department or its contractor shall be governed by Article 31 of Chapter 143 of the North Carolina General Statutes, Tort Claims Against State Departments and Agencies, and as otherwise provided by law.
5. The information derived from the investigation shall be made available to the owner upon request and is a public record, in accordance with North Carolina G.S. 132-1.
6. The activities to be carried out by the Department or its contractor are for the primary benefit of the Department and of the State of North Carolina. Any benefits accruing to the owner are incidental. The Department or its contractor is not and shall not be construed to be an agent, employee, or contractor of the landowner.

I/We agree not to interfere with, remove, or any way damage the Department’s well(s) or its contractor’s well(s) and equipment during the investigation.
Sincerely,
_________________________________ Signature

_________________________________ Type/Print Name of Owner or Agent
__________________________________ Phone Number
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Address
_________________________________ City/State/Zip Code

_________________________________ Date Prepared By: Herb Berger Hydrogeologist DWM UST Section 1646 Mail Service Ctr
Raleigh, NC 27699-1643