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FLDOP rr+u .bra <br /> is 2I72 <br /> F 20 03 t2' 30p <br /> +:r zon i~nv In.. <br /> $tee ofCAfomta <br /> Cepaejncnt of WItef PX50U sC <br /> CentrW oijjid <br /> 3255 S Street <br /> Saemmento CA 956167917 i Z1 J; S$.ov, <br /> WELL ORSLL.ER'S REPORTS <br /> INSPECTION REQUEST AND AGREEMP_NT <br /> Protect <br /> &agaw r <br /> Locabon Z��7 5 JAJr <br /> Courtly- ,� _� Contract Number <br /> Request is made pursuant to Section 13751 of the California Water Code for pemtcss�cn to <br /> inspect or copy Water Well Drlier's Reports which are on file in your ot;rce <br /> In accordance with the requirements of Section 13752 cf the Water Ccde, it:s s�;cJated and <br /> agreed that 5jch repers, cr any Copy or copies made the•eof Mild not bs rude aea,iable rqr <br /> mspec+tion by the pubtic but will be used ScWy by U';ts govemmerttal ase"cy fC' rnaKng <br /> stl.dres 1t cco,es Pre made cr taken, each copy wtfl be stamped "CONFiDEtNTIAI " cr 'FOR <br /> OFr=iCIAL USE ONLY'anC will be kept in a restricted fire, access to which la llrtt,'e4 tc to sta- <br /> cf th,3 gcverre^t'at agency or to its cc ntractsd agents Any ccoies fvrrlslied .o =ntrac•ed <br /> agents must be returned to the Depararent of Water ResoL;rcas, Ceara' t.Ocn <br /> ccmpleuCn -fiwcrl'ct y tare c retracted agent <br /> No infarrha ;r --j- ed-in theca repvrs can be d+s5a1n1r1a.ec eF p�.cstsr,ed Wlt- c­e <br /> per—J5sion cf the cwner cf the well <br /> czn:aced Ase.1t Ga�emrrsenta���yez�� I n <br /> f .,6 to y 6u�Jebe*r r f it tri tiG <br /> Adcress Aad,ass <br /> 5ZOL-Z-4d <br /> city $taov a z p r^ a CiS'zatt R_7, via <br /> By <br /> �} Otis•r Of rer <br /> Tire U +iZle <br /> 1 — <br /> o�y <br /> Tese�hone Tete?rcne <br /> ?.o o <br /> Zoo <br /> ate tale <br /> (For Daparat&,U In%m aAen toples aertt______) <br />