WS-31_30022_G_ACCAGMT_unsigned

NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF WASTE MANAGEMENT MICHAEL F. EASLEY, GOVERNOR William G. Ross Jr., SECRETARY Dexter R. Matthews, DIRECTOR UNDERGROUND STORAGE TANK SECTION
DIVISION OF WASTE MANAGEMENT/UST SECTION 1637 MAIL SERVICE CENTER, RALEIGH, NORTH CAROLINA 27699-1637
PHONE: [phone] \ FAX: [phone]
INTERNET: http://www.wastenot.enr.state.nc.us
AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER - 50% RECYCLED/10% POST-CONSUMER PAPER

Herb Berger
Hydrogeologist DWM UST Section 1637 Mail Service Ctr Raleigh, NC 27699-1637 RE: Access Agreement Eden Traffic Circle Intersection of Boone & Meadows Roads Eden, Rockingham County, NC
DWM Incident #30023 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 and Natural Resources (Department) or its contractor to enter
upon said property for the purpose of conducting an investigation of the groundwaters 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 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 in 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
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Phone Number
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