"Petroleum Restoration Program Site Access Agreement" - Florida

Petroleum Restoration Program Site Access Agreement 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 27, 2020;
  • The latest edition currently provided by the Florida Department of Environmental Protection;
  • Ready to use and print;
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  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Florida Department of Environmental Protection.

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Download "Petroleum Restoration Program Site Access Agreement" - Florida

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Petroleum Restoration Program
SITE ACCESS AGREEMENT
1. The Parties. The undersigned real property owner, ______________________________________
[Insert name of each property owner(s) as listed on the deed]
("Owner"), hereby give(s) permission to the State of Florida, Department of Environmental Protection
(FDEP)
("Department") and all of it’s Contractors, subcontractors, and vendors (“Contractor”), to enter the Owner's
property
("the Property") __________________________________________________________________________
[Insert property address]
with FDEP Facility ID# _________________.
[Insert FDEP Facility ID#]
The Property. Owner owns the certain parcel(s) _______________________________________
[Insert parcel number(s) from Property Appraiser’s website]
of real property located at __________________________________________________________
[Insert physical mailing address]
________________ County, Florida (the “Property”), depicted on the attached legal description
[Insert Florida County]
as Exhibit “A.” [Attach a legal description of the Property –from the most current deed and or
a survey sketch/map of the property with GPS or other locational information]
2. Permissible Activities. This Site Access Agreement (“Agreement”) is limited to activities
which may be performed by the Department or its Contractors pursuant to Chapter 62-780,
Florida Administrative Code (F.A.C.), without cost to the Owner (unless required in a separate
agreement or is statutorily required for FPLRIP or ATRP programs) to locate contamination,
determine contamination levels and, when necessary, remove and remediate contamination which
may be performed by the Department and its Contractor. This access is provided only for the
contamination either eligible for a state-funded cleanup or is being investigated pursuant to a
consent order with the Department. If the contamination is eligible for state funding, nothing
herein is intended to modify the requirements and limitations of the eligibility program or order.
The following activities are included in this Agreement but are not limited to this list:
conduct soil, surface, subsurface, and groundwater investigations, including
but not limited to entry by a drill rig vehicle and/or support vehicles;
install and remove groundwater monitoring wells;
use geophysical equipment;
use an auger for collecting soil and sediment samples;
locate existing wells;
collect waste, soil, and water samples;
remove, treat and/or dispose of contaminated soils and water;
remove contaminated soil by digging with backhoes, large diameter augers
and similar equipment;
install, operate, and remove remedial equipment;
install and remove utility connections;
trenching for connection of remediation wells to equipment; and
conduct surveys, prepare site sketches, and take photographs.
PRPSiteAccessAgreement 04/27/2020
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Facility ID#:
Petroleum Restoration Program
SITE ACCESS AGREEMENT
1. The Parties. The undersigned real property owner, ______________________________________
[Insert name of each property owner(s) as listed on the deed]
("Owner"), hereby give(s) permission to the State of Florida, Department of Environmental Protection
(FDEP)
("Department") and all of it’s Contractors, subcontractors, and vendors (“Contractor”), to enter the Owner's
property
("the Property") __________________________________________________________________________
[Insert property address]
with FDEP Facility ID# _________________.
[Insert FDEP Facility ID#]
The Property. Owner owns the certain parcel(s) _______________________________________
[Insert parcel number(s) from Property Appraiser’s website]
of real property located at __________________________________________________________
[Insert physical mailing address]
________________ County, Florida (the “Property”), depicted on the attached legal description
[Insert Florida County]
as Exhibit “A.” [Attach a legal description of the Property –from the most current deed and or
a survey sketch/map of the property with GPS or other locational information]
2. Permissible Activities. This Site Access Agreement (“Agreement”) is limited to activities
which may be performed by the Department or its Contractors pursuant to Chapter 62-780,
Florida Administrative Code (F.A.C.), without cost to the Owner (unless required in a separate
agreement or is statutorily required for FPLRIP or ATRP programs) to locate contamination,
determine contamination levels and, when necessary, remove and remediate contamination which
may be performed by the Department and its Contractor. This access is provided only for the
contamination either eligible for a state-funded cleanup or is being investigated pursuant to a
consent order with the Department. If the contamination is eligible for state funding, nothing
herein is intended to modify the requirements and limitations of the eligibility program or order.
The following activities are included in this Agreement but are not limited to this list:
conduct soil, surface, subsurface, and groundwater investigations, including
but not limited to entry by a drill rig vehicle and/or support vehicles;
install and remove groundwater monitoring wells;
use geophysical equipment;
use an auger for collecting soil and sediment samples;
locate existing wells;
collect waste, soil, and water samples;
remove, treat and/or dispose of contaminated soils and water;
remove contaminated soil by digging with backhoes, large diameter augers
and similar equipment;
install, operate, and remove remedial equipment;
install and remove utility connections;
trenching for connection of remediation wells to equipment; and
conduct surveys, prepare site sketches, and take photographs.
PRPSiteAccessAgreement 04/27/2020
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Facility ID#:
Duration and Termination of Access. This Agreement is granted, without any fee or charge
3.
to the Department or Contractor, for so long as is necessary to assess, remove, monitor and
remediate the contamination on the Property. Access shall be allowed for the Department
(including its employees, contracted site managers with Teams 5 and 6 and local governments,
and contractors performing work for the Department under an environmental forensics site
investigation contract, if applicable) immediately upon the execution of this Agreement.
However, access for a Site Rehabilitation Contractor can be contingent upon the Owner timely
entering into an additional separate site access agreement with only the Site Rehabilitation
Contractor (if the Owner wants a separate agreement with the Site Rehabilitation Contractor
please check the appropriate box at the end of this document). Such agreement with a Site
Rehabiitation Contractor is not binding upon the Department. There is no option for an
additional site access agreement with any of the Department’s other Contractors. This
Agreement shall continue until the Department’s entry of a site rehabilitation completion order
pursuant to Rule 62-780.680, Florida Administrative Code, or low-scored site initiative no
further action order pursuant to Section 376.3071(12)(b), Florida Statutes (“Order”). At which
time the Owner shall be provided a copy of the Order and this Agreement shall be
automatically terminated
.
4. 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.
5. Environmental Infrastructure and Well Permits. The owner authorizes the Department and the
Contractor to act as its authorized representative in signing all required forms and documents
necessary for obtaining applicable permits related to environmental infrastructure improvements
including well construction, repair, maintenance, modification, and abandonment pursuant to
Chapter 373 F.S.
6. Activities Comply with Applicable Laws. The Department and Contractor agree that any and
all work performed on the Property and in association with this Agreement shall be done in a
good, safe, workmanlike manner, and in accordance with applicable federal and state statutes,
rules and regulations.
7. Proper Disposal of Contaminated Media. The Department and Contractor shall ensure that
soil cuttings, any work materials, and water generated shall be disposed of in accordance with
Environmental Laws. All soil cuttings, waste materials and development water generated shall
be promptly removed from the Property.
8. 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.
9. Owner’s Non-Interference. The Owner shall not interfere with the Department or Contractor
when performing the Permissible Activities. Owner shall not damage any equipment including
wells, piping, and remediation system that may be located on the Property. Owner shall notify the
Department 90 days prior to commencement of any construction, demolition or other work on the
Property that may damage or destroy any part of the equipment installed under this Agreement. If
the Department anticipates that the remediation equipment will not be used for over one calendar
year, the Owner can request removal of the remediation equipment if it is interfering with the
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Facility ID#:
operation of the business or with planned construction activities.
10. Non-revocable. If Property is the source of the discharge that is eligible for State funded
remediation pursuant to Chapter 376, Florida Statutes, access to the Property is required and
Owner may not revoke this Agreement with the Department until the appropriate site
rehabilitation completion order is issued under Chapter 62-780.680 or a low- scored site
initiative order issued pursuant to Section 376.3071(12)(b), Florida Statutes, is final.
11. No Admission. The granting of this Agreement 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.
12. Owner’s Use of Property. The Owner retains the right to use the Property, and the
Department and its Contractors will work with the Owner regarding minimizing activities that
may interfere with the Owner’s management and use of the Property. However, neither the
Department nor the Contractor are responsible for any inconvenience, economic injury, or
business damage that Owner may suffer due to the performance of any Permissible Activity. This
agreement does not modify any legal right the parties may have regarding negligent acts.
13. Owner’s Release of Claim. If Owner selected a qualified contractor (not an agency term
contractor), the Owner hereby releases the Department from any and all claims against the
Department performed by the Owner’s selected contractor arising from or by virtue of, the
Permissible Activities.
14. 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.
15.
Indemnification. The Department does not indemnify the Owner, see paragraph 16. The
Contractor has indemnified the Department. However, if the Owner chooses to enter into a
separate access agreement with the Contractor, the Contractor is not prohibited from
indemnifying Owner as long as such indemnification does not conflict with the Contractor’s
indemnification of the Department. Where no conflicts exist, any subsequent indemnification by
the Contractor to any party associated with the Permissible Activities is subservient and
subordinate to the Contractor’s indemnification of the Department.
16. 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.
17. 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 number reference above.
http://depedms.dep.state.fl.us/Oculus/servlet/login?action=login
18. Entire Agreement. This Agreement shall constitute the entire agreement between the
Department and the Owner regarding this grant of access to the Department as stated herein. No
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Facility ID#:
modification, amendment or waiver of the terms and conditions of this Agreement shall be
binding upon Department unless approved in writing by an authorized representative of Owner
and Department.
19. Governing Law and Venue. This Agreement shall be governed by and construed in
accordance with the laws of the State of Florida. Venue for any action or proceeding arising
from or relating to this Agreement shall be in the appropriate Florida court having jurisdiction
located in Leon County, Florida.
20. Severability. Any provision of this Agreement that is prohibited or unenforceable shall be
ineffective to the extent of such prohibition or unenforceability without invalidating the
remaining provisions hereof.
21. No Third Party Beneficiaries. This Agreement is solely for the benefit of the parties hereto
and their respective successors and assigns and shall not be deemed to confer upon third parties
any remedy, claim, liability, or reimbursement, claim of action or other right.
A.
Are additional requirements attached to this agreement? If neither are checked, the
Department will assume “NO.”
Note: Additional requirements must be on a separate page titled
Exhibit B and include the facility ID#, owner signature and date on the page. If an Exhibit B is not
submitted to the Department with the signed Site Access Agreement, the Department will consider that
you have changed your selection from “YES “to “NO”.
YES
NO
B.
Do you wish to participate or provide input with respect to rehabilitation of this
facility? If neither are checked, the Department will assume “NO.”
YES
NO
C.
If you wish to exercise the option to reject one Contractor prior to assignment of
work, please enter an email address. ____________________________________.
If you do not have an email address, you can enter a telephone number or street
address instead.
D.
Do you want the site rehabilitation Contractor to contact you to obtain a separate
site access agreement? Note: Optional site access agreements between the owner
and site rehabilitation Contractor must be completed within (90) calendar days.
Since such an agreement is neither necessary nor required, state-funded site
rehabilitation activities will begin whether or not you and the site rehabilitation
Contractor have executed this optional agreement. Entities listed in paragraph 3
which this agreement provides immediate access for are excluded from this option
of obtaining an additional site access agreement.
YES
NO
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Facility ID#:
__________________________________
_____________________________________
Signature of each Property Owner
Signature of Witness
______________________ ___________
________________________ ____________
Print Name
Date
Print Name
Date
_________________________________________________________________________
Property Owner Mailing Address
__________________________________________
Property Owner Telephone or Cell Phone Number
__________________________________________
Property Owner E-mail Address
Accepted by the State of Florida Department of Environmental Protection:
______________________________________
_____________________________________
Natasha Lampkin
Signature of Witness
Program Administrator
Petroleum Restoration Program
______________
_________________________ ___________
Date
Print Name
Date
Attachments: Exhibit A- Legal description of the Property. FDEP
Coordinates (Degrees Minutes Seconds) for Facility ID#: _____________
Latitude ________________________
Longitude ________________________
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