WM0401520_WM0401320 Application attachment 1_20240311

RHGC Investments, LLC ECS Southeast, LLC
.• ;.
PROPERTY OWNER ACCESS AUTHORIZATION FORM
ECS Southeast, LLC
Proposal No.: 49:42708P
Project Name: Optical Place Property
Location: 2633 Randleman Road,
Greensboro, Guilford County, North Carolina 27406
Parcel Identification Number:7862-39-0907
ECS Southeast, LLP (ECS) has been requested to conduct an environmental assessment at the site.
The groundwater sampling at the site requires that ECS procure a permit from the North Carolina
Department of Environmental Quality(NCDEQ).
ECS respectfully requests that the owner of the property grant permission to ECS to access the
property to conduct the environmental assessment. By signing below, property owner authorizes ECS
to conduct the aforementioned groundwater sampling at the site and to obtain the above-referenced
permit on behalf of the owner.
Property Owner(Please Print) y f - 0­0rll�/1-
Property Owner Address(please print):,; 633 /lwx_m,� Q� 6 8aAD /V
Property Owner Telephone(please print): R73 3'?�-6 O
Property Owner Signature Date: 3-6-2�-
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