Home Methane Study Waiver

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I, ... (Write your first and last name below.) *

am the owner / occupant (Check all that apply. For example if you are an owner and you live in the home you own, check both owner and occupant.)
*

Owner

Occupant

Required

of the residence located at ... (Please write the complete address: street, town/city, state and zip code below.)
*

As the owner or occupant of this property, I give Gas Safety, Inc. (“GSI”) permission to enter the residence and test the concentration of methane (CH4) and carbon dioxide (CO2) in the air (the “Testing”). I acknowledge that GSI is not responsible for any repairs or remediation based on the results of the Testing. I acknowledge that GSI is not responsible for notifying any individuals or entities based on the results of the Testing, including but not limited to the owner or occupant of this property, utility companies, service providers, or contractors.

Release. By signing below, I, on my own behalf, and on behalf of my successors and assigns, heirs, next of kin, executors, administrators, and agents, hereby release and forever discharge GSI, including its officers, directors, agents and employees of and from all claims, both in LAW and EQUITY, whether known or unknown, anticipated or unanticipated, on account of, by reason of, or resulting from or arising out of the Testing.

Full name *

Email address *

Date *

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