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NOV 07 '95 10:17RM 209 838 3509 . p,2 <br /> WELL DRILLER$ REPORTS <br /> INSPECTION REQUEST AND AGREEMENT <br /> Project: 1�` C N-cll aecrcE+ <br /> Location: �:: ,.viatr i �5;•<�is��)J; ...t Las <br /> County: SaN l ,.l,;,n Contract Number: <br /> Date: tdi <br /> State of California <br /> Department of Water Resources <br /> Cethtral District <br /> 3251. 5 Street <br /> Sacramento, CA 95816-7017 <br /> Request is made for permission to inspect or copy Water Well <br /> ]drillers Reports made pursuant to Section 13751 of the Cali- <br /> fornia Water Code, copies of which are on file in your office. <br /> In consideration of such permission, it is stipulated and <br /> agreed that such reports, -or any copy or copies made thereof, <br /> will not be made available for inspection by the public but <br /> will be used solely by this governmental agency for making <br /> studies, in accordance with the requirements of Section 13752 <br /> of the Water Code. If copies are made or taken, each copy <br /> will be stamped "CONFIDENTIAL" or "FOR OFFICIAL USE ONLY" and <br /> will be kept in a restricted file, access to which is limited <br /> to the staff of this agency or to its professional consultants. <br /> Any copies furnished to consultants will be returned to this <br /> agency upon completion of work by the consultant. <br /> No information contained in these reports can be published <br /> without the iaritten permission of the owner o��f�� the well. 1 � ((����� ,, <br /> `arniF+,7 Eil1 Yi�uva�at /tck C�v,S. SaA S �Y\ lA Q�tb�(L f-�o14 �� Vic2z� <br /> Consultant Gov rnmental Agency <br /> y Address Address <br /> /' ( <br /> City, State, & Zip Code City, State, & Zip Code <br /> HY Me\ sY TLkrU + � <br /> Officer n Officer <br /> Title Title <br /> Telephone Telephone <br /> (For Departmental Information: copies sent - ) <br />