OKLAHOMA ENERGY RESOURCES BOARD
Tenant Right-of-Entry Consent and Release
Project Name:
Project Number: Date:
The undersigned tenant(s) (hereinafter "Tenants") of certain property, being all of owned by being
all that party's right, title and interest in Sec. , T , R , County, Oklahoma (the "Property") do hereby
grant to the Oklahoma Energy Resources Board ('"OERB") and its agents, employees, and contractors, the right to enter upon
said Pmperty h evaluate, study, photograph, explme, restore, reclaim, abate, contml mprevent the adverse effects of past oil
andlor gas exploration/production practices and to do all things deemed reasonable and necessary or expedient by OERB, in its
sole discretion, to protect the environment, public health, safety or general welfare. Tenants give this consent to enter upon the
Property for the length of time necessary to complete any environmental evaluation, studies, remediation andlor restoration
undertaken by OERB on the Property, subject to Tenants' continued use of the Property. If at anytime OERB determines in its
sole discretion that it is inappropriate to proceed, it shall have the right to cease further activity on the Property without liability
to Terlarlt. This corlserlt and release shall in no way be construed as an act of corldematiorl or of trespass by OERB.
Tenants hereby acknowledge, understand and agree that:
a) any and all OERB Activities are undertaken pursuant to specific statutory authority and neither the State of
Oklahoma nor OEM is liable for or accepts any liability for any past damages to, or pollution on, the Property irrespective of
the source of same;
b) Tenants are not entitled to any compensation from the OERB or its agents, employees and contractors or the
State of Oklahoma;
C) neither the State of Oklahoma nor OERB is under any obligation to perform any environmental evaluation,
studies, remediation andlor restoration or any other activities or work on the Property.
Tenants (check one) do Ido not have knowledge of the existence of any other person or persons, company or
entity with responsibility for restoring the sites submitted to the OERB
Tenants (check one) do Ido not own the mineral rights, working or other interest to the Property.
Tenants (check one) are /are not aware of any settlement, release or waiver of any claim for damages that have
been paid to Owner or to any prior owner with respect to the sites that have been submitted to the OERB.
Tenants (check one) are /are not aware of any claim of litigation, past, contemplated or threatened, against any
party involving the Property.
Is there an active oil and lease operator who is producing oil andlor gas from the property? Yes- No-
If yes, provide the lease producer or operator's name, address and telephone number:
RELEASE: The undersigned Tenants, in consideration of the selection of the Property for environmental evaluation, studies,
remediation andlor restoration, do hereby release OERB and its Board of Directors, its members, representatives, agents,
employees and contractors and the State of Oklahoma from any damages, claims, suits or other actions which might arise as a
result of any work whatsoever undertaken on the Property by, or on behalf of, OERB, including without limitation any
environmental evaluation, studies, remediation andJorrestoration. Tenants specifically acknowledge that OERB has no control
over, nor any duty to amend or remediate or modify, any native or naturally occurring site conditions on the Property, including,
but not limited to: (1) rock or stone exposed or surfacing during restoration actzvities, (2) inadequate or insufficient soil
profileslcharacteristics to support re-vegetation of the sites, (3) lack of readily available and easily accessible fill material or
topsoil on the Property; (4) existing erosion from any source whatsoever and specifically releases and holds OERB, itsBoard of
Directors, its members, representatives, employees, agents and contractors harmless from any and all claims related to said
native, naturally occurring or existing erosional site conditions.
Page 1 of 2
V 1.1. Revised 6-27-12
Witness the following signature(s) this day of ,20
(Tenant) (Witness)
(Tenant) (Witness)
(l'enant) (Witness)
e-mail address:
Mailing Address:
Telephone Number:
Page 2 of 2
V 1.1. Revised 6-27-12
EXHTBTT "A"
OERB TENANT lNFORMATTON SHEET
This Property has been selected as a possible Project for restoration of certain historic well sites. You are advised that the
following limitations and conditions apply to any and all activities and work of the OERB on the Property.
The OERB makes no representations as to the completion time for any Prqject selected. All activities are subject
to thc availability of budgctd funds and othcr rcsourccs, thc OERR is not rcsponsiblc for any cutbacks or lack of
funding to the OERB or any other agency.
Any activities undertaken by the OERE are limited to the scope of work approved by the OERB for the Project
and the available funds budgeted by the OERB for the Project. Additional funds cannot be expended without
OERB 's prior consent.
The OERB may erect a sign on the proper@ during and suhsequent to the restoration activities on the Pmperty.
The OERB's restoration activities are limited to the restoration of surface issues associated with exploration and
production activities.
The OERB does not perform groundwater remediation.
Hmardou~w astes. The OERR i~ under no ohligation to remove and d i ~ p o h~aez ardous w a ~ t oer~ m aterials
OERB determines, at any time to be present on the property. In the unlikely event hazardous wastes are identified
by OERB and the OERB elects to remove these wastes, the OERB will expect the tenant to fully cooperate in the
removal of these wastes. This mny include the tenant signing any manifests would Ix required to properly dispose
these wastes.
NORM. The OERB is under no obligation to remove and dispose naturally atcurring radioactive materials
(NORM). In the event Naturally Occurring Radioactive Material (NORM), which is a naturally occurring substance
that is sometimes associated with oil and gas production activities is encountered during the work on the Project, the
OERR will typically dispose NORM (including equipment, related scale or sludge) in accordance with those certain
NORM Management Guidelines developed in cooperation with the Oklahoma Corporation Commission. This may
include the onsite disposal of NORM.
The OERB under no obligation to provide topsoil or fill material from a source located off of tenant's property.
The OERB will utilize topsoil or fill material that is located on the property at no additional expense if the topsoil or fill
material is in proximity to the Project AND is easily accessible for use. If there are no such sources in proximity or that
are easily accessible, then the OERB will shape and mix the impacted area to blend with the existing terrain to the
extent possible as determind by the OERR
Rocks and naturally occurring terrain. The OERB has no control over certain naturally occurring issues such as 1)
rock or exposed stone or rocks, stones or outcroppings that may surface during restoration activities; 2) inadequate or
insufficient soil profileslcharacteristics to support site re-vegetation; 3) a lack of readily available and easily accessible
fill material or topsoil on the Property; 4) existing erosion from any source whatsoever. The OERB shall have no
responsibility for any of the foregoing.
Public recards. All OERB and/or outside funded activities are a matter of public record and could result in such
aclivilies being published in cerlain public dalabases (induding bul nol limild Lo EPA Brownfields).
V 1.1 Revised 6-27-12
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