"Permission to Enter Property - Non-source" - Florida

Permission to Enter Property - Non-source is a legal document that was released by the Florida Department of Environmental Protection - a government authority operating within Florida.

Form Details:

  • Released on April 4, 2016;
  • The latest edition currently provided by the Florida Department of Environmental Protection;
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PERMISSION TO ENTER PROPERTY- NON-SOURCE
1. The Parties. The undersigned real property owner, __________________________________________
("Owner"), hereby give(s) permission to the State of Florida, Department of Environmental Protection
("Department") and it’s Contractor, subcontractors, and vendors (“Contractor”), to enter the Owner's property
("the Property") (see next paragraph).
2. The Property. Owner owns the certain parcel(s) ________________________________________________
of real property located at ____________________________________________, _______________, Florida
3. The Source: The suspected source of the contamination is located at ______________________________,
parcel number #_______________________________ and FDEP Facility/Project # is___________________.
4. Permissible Activities. This Permission to Enter Property (“Permission”) is limited to activities which may
be performed by the Department or its Contractors pursuant to Chapter 62-780 or 62-730, Florida
Administrative Code, without cost to the Owner to locate contamination, determine contamination levels and,
when necessary, remove and remediate contamination which may be performed by the Department and its
Contractor. Specifically, to collect soil, groundwater (including the installation of wells), surface water and
sediment samples; removal and treatment of contamination on the Property; installation of a treatment system
(as necessary); and monitoring of contamination until completion of remediation.
5. Work Performed during Business Hours. The Department and Contractor may enter the Property during
normal business hours and may also make arrangements to enter the Property at other times after agreement
from the Owner.
6. No Admission. The granting of this Permission by the Owner is not intended, nor should it be construed, as
an admission of liability on the part of the Owner for any contamination discovered on the Property.
7. Activities Comply with Applicable Laws. The Department and Contractor agree that any and all work
performed on the Property and in association with this Permission shall be done in a good, safe, workmanlike
manner, and in accordance with applicable federal and state statutes, rules and regulations.
8. Well Permits. The Owner authorizes the Department and its Contractor to act as its agent in signing all
required forms and documents necessary for obtaining applicable permits related to well construction, repair,
maintenance, modification, and abandonment pursuant to Chapter 373, Florida Statutes.
9. Equipment Ownership. The monitoring wells and remedial equipment installed pursuant to this agreement
are the property of the Department. The Owner is responsible for replacing any Department property that may
be damaged or lost due to any actions by the owner.
10. Property Restoration. The Department shall pay the reasonable costs of restoring the Property as nearly as
practicable to the conditions which existed before activities associated with contamination assessment or
remedial action were taken.
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PRPOffSiteAccessAgreement 04042016
PERMISSION TO ENTER PROPERTY- NON-SOURCE
1. The Parties. The undersigned real property owner, __________________________________________
("Owner"), hereby give(s) permission to the State of Florida, Department of Environmental Protection
("Department") and it’s Contractor, subcontractors, and vendors (“Contractor”), to enter the Owner's property
("the Property") (see next paragraph).
2. The Property. Owner owns the certain parcel(s) ________________________________________________
of real property located at ____________________________________________, _______________, Florida
3. The Source: The suspected source of the contamination is located at ______________________________,
parcel number #_______________________________ and FDEP Facility/Project # is___________________.
4. Permissible Activities. This Permission to Enter Property (“Permission”) is limited to activities which may
be performed by the Department or its Contractors pursuant to Chapter 62-780 or 62-730, Florida
Administrative Code, without cost to the Owner to locate contamination, determine contamination levels and,
when necessary, remove and remediate contamination which may be performed by the Department and its
Contractor. Specifically, to collect soil, groundwater (including the installation of wells), surface water and
sediment samples; removal and treatment of contamination on the Property; installation of a treatment system
(as necessary); and monitoring of contamination until completion of remediation.
5. Work Performed during Business Hours. The Department and Contractor may enter the Property during
normal business hours and may also make arrangements to enter the Property at other times after agreement
from the Owner.
6. No Admission. The granting of this Permission by the Owner is not intended, nor should it be construed, as
an admission of liability on the part of the Owner for any contamination discovered on the Property.
7. Activities Comply with Applicable Laws. The Department and Contractor agree that any and all work
performed on the Property and in association with this Permission shall be done in a good, safe, workmanlike
manner, and in accordance with applicable federal and state statutes, rules and regulations.
8. Well Permits. The Owner authorizes the Department and its Contractor to act as its agent in signing all
required forms and documents necessary for obtaining applicable permits related to well construction, repair,
maintenance, modification, and abandonment pursuant to Chapter 373, Florida Statutes.
9. Equipment Ownership. The monitoring wells and remedial equipment installed pursuant to this agreement
are the property of the Department. The Owner is responsible for replacing any Department property that may
be damaged or lost due to any actions by the owner.
10. Property Restoration. The Department shall pay the reasonable costs of restoring the Property as nearly as
practicable to the conditions which existed before activities associated with contamination assessment or
remedial action were taken.
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PRPOffSiteAccessAgreement 04042016
11. Injury to Department. The Owner shall not be liable for any injury, damage or loss on the Property suffered
by the Department, Department employees or Contractors not caused by the negligence or intentional acts of the
Owner's agents or employees.
12. Sovereign Immunity. The Department acknowledges and accepts its responsibility under applicable law
(Section 768.28, Florida Statutes) for damages caused by the acts of its employees while on the Property.
13. Public Records. All documents created or received associated with the Permissible activities are a public
record pursuant to Chapter 119, Florida Statutes. The Owner may retrieve any documents or other information
related to the Permissible Activities online using the facility or project number referenced above in paragraph 4.
http://depedms.dep.state.fl.us/Oculus/servlet/login?action=login
____________________________________
___________________________________
Signature of each Property Owner
Signature of Witness
____________________________________
____________________________________
Print Name
Date
Print Name
Date
____________________________________
Mailing Address
____________________________________
_____________________________________
Telephone or Cell Phone Number
E-mail Address
Accepted by Contractor on behalf of the State of Florida Department of Environmental Protection:
____________________________________
___________________________________
Signature of Contractor
Signature of Witness
___________________________________
___________________________________
Print Name of Contractor
Date
Print Name
Date
___________________________________
__________________________________
Contractor’s Contact name
Contractor Company name
___________________________________
__________________________________
Contractor Mailing Address
Contractor Contact email address
___________________________________
____________________________________
Contractor Contact’s phone number
Contractor Company City and zip code
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PRPOffSiteAccessAgreement 04042016
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