Form CalRecycle889 "Property Access Authorization and Non-responsibility Affidavit - Farm and Ranch Grant Program" - California

What Is Form CalRecycle889?

This is a legal form that was released by the California Department of Resources Recycling and Recovery - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on November 1, 2017;
  • The latest edition provided by the California Department of Resources Recycling and Recovery;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form CalRecycle889 by clicking the link below or browse more documents and templates provided by the California Department of Resources Recycling and Recovery.

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Download Form CalRecycle889 "Property Access Authorization and Non-responsibility Affidavit - Farm and Ranch Grant Program" - California

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State of California
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Department of Resources Recycling and Recovery (CalRecycle)
CalRecycle 889 (New 11/17)
Farm and Ranch Grant Program
Property Access Authorization and Non-Responsibility Affidavit
I,
certify that I am the
Property owner(s) (If Individual(s))
Authorized agent of the property owner(s) (If Entity(ies))
and I have the authority to grant access to the property that is proposed for cleanup at:
Site address or property description:
Size of parcel in acres:
Assessor’s Parcel Number (APN):
Neither I, nor any resident, invitee, licensee, lessee or person I purchased or inherited from, by
contract, agreement, or other arrangement, personally brought any of the subject solid waste
onto the property. Nor did I, or any of the above, direct, authorize, permit or otherwise provide
consent to another to bring the solid waste onto the property.
Specifically, to the best of my knowledge the circumstances of how the waste was brought onto
the property, and the manner in which I became aware that the waste was on the property, is as
follows: (Feel free to attach extra pages if you need more room to write)
I purchased the property on the following date:
I was aware of the subject waste on my property, or some portion thereof, at time of purchase.
YES
NO
Page 1 of 2
State of California
PRINT
CLEAR
Department of Resources Recycling and Recovery (CalRecycle)
CalRecycle 889 (New 11/17)
Farm and Ranch Grant Program
Property Access Authorization and Non-Responsibility Affidavit
I,
certify that I am the
Property owner(s) (If Individual(s))
Authorized agent of the property owner(s) (If Entity(ies))
and I have the authority to grant access to the property that is proposed for cleanup at:
Site address or property description:
Size of parcel in acres:
Assessor’s Parcel Number (APN):
Neither I, nor any resident, invitee, licensee, lessee or person I purchased or inherited from, by
contract, agreement, or other arrangement, personally brought any of the subject solid waste
onto the property. Nor did I, or any of the above, direct, authorize, permit or otherwise provide
consent to another to bring the solid waste onto the property.
Specifically, to the best of my knowledge the circumstances of how the waste was brought onto
the property, and the manner in which I became aware that the waste was on the property, is as
follows: (Feel free to attach extra pages if you need more room to write)
I purchased the property on the following date:
I was aware of the subject waste on my property, or some portion thereof, at time of purchase.
YES
NO
Page 1 of 2
If YES, please check one of the boxes below.
No, I did not pay a reduced price for the property due to the presence of the waste and/or
purchased the property “as is.”
Yes, I paid a reduced price for the property due to the presence of the waste and/or
purchased the property “as is.” Please provide explanation below, including amount purchase
price was reduced by:
I hereby authorize the following city, county, resource conservation district or Native
American tribe representatives applying for the grant:
their designated contractors and representatives, and other state and local agencies authorized to
access the property described above during the Grant Term as specified on the Grant Agreement
for the purpose of removing the solid waste and/or other activities as authorized under the Farm
and Ranch Solid Waste Cleanup and Abatement Grant Program, pursuant to the Public
Resources Code, sections 48100-48106 and attendant regulations.
I understand that by signing this authorization to access the property, I am not admitting
liability or responsibility for the cleanup of the property.
I understand that information and data provided to CalRecycle through the grant application and
during the performance of this grant may be subject to disclosure under the California Public
Records Act, Government Code Section 6250 et seq. I further understand that CalRecycle
agrees not to disclose such information or data furnished by the Grantee and/or property owner
and to maintain such information or data as confidential when so designated in writing by the
Grantee and/or me at the time it is furnished to CalRecycle, but only to the extent that such
information or data is exempt from disclosure under the California Public Records Act.
I declare, under penalty of perjury, that all the above information is true and accurate to
the best of my knowledge and belief.
If owner is an individual, complete this section. (Must be signed in the presence of a Notary
Public)
Print Name of Owner(s)
Telephone Number
Signature of Owner(s)
Date
If owner is an entity, complete this section. (Must be signed in the presence of a Notary Public)
Telephone Number
Print Name of Owner(s)
Name of Authorized Agent for Owner(s)
Title
Signature(s)
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