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FROM Ground Zero Analysis PHONE NO. : 209 838 9883 May. 17 2000 08:20AM P2 <br /> State of Celfomta j <br /> 4 Department of Wider Rmurm <br /> Geminal irlWl t I <br /> 3251 a street <br /> Sacramento,CA 45MO.7017 <br /> WELL Di IUAR'S REPORTS <br /> INSPECTION REQUEST AND AGREEMENT <br /> i <br /> 5Il..t4lAl.a <br /> tvcaeiieon: Dw�oMANTCA <br /> Co�rnty: W contract Number: <br /> Request is made pursuant to Secdcn 13731 of ths California Water Code far permissicn to <br /> 1 inspedt or caps Water Well D 06es Reports which are an me in your office, <br /> 1 Irll accordance with, the requirements of Sectton 13752 of Ithe Water Code, it is stpulated and <br /> agreed that Such raperts, or any copy or copies made thire0f, will nct be made availatle for t <br /> Inspeden by the pt:blic but wHI ba used Sotaly by thls gcv4nmantal agency for rnaMig <br /> studies, If copies are made or taken, each ropy will be stimpei =NFtDENTIAL" or"FOR <br /> OPr{CfA1. U$7-ONLY"and wits be kept In a restricted file access to which Js lirrita:to the staff' <br /> sof this govarmantal agancy of to its =ntraCsd agents, ''Any e�ples f,rmishertl to contracted <br /> agents must ho returned to the Department of Water Rezcu=s, Contmi Cis:rjgt Upon <br /> eernplotlom of wetk by the contracted agent <br /> No information containse in these repors can be disseminlated ar pubNahed witricut the wrl tan <br /> permission of tha owner of the wail. <br /> 1llli Contra=ad{agent �a Gm-emrriental A f enc% <br /> or <br /> Ar�cra:s Address <br /> A-W Pt dw3AO S " <br /> City, 5 ea, &ZIP Cade Clty,�State, &zlp Code <br /> i <br /> By, 46La., <br /> By <br /> Omer p'>5oar <br /> lip <br /> SSI R F{ r <br /> TWO TltlipI <br /> LL-o <br /> Telephone YvlephcRa <br /> os-A-7/00 <br /> cite L Oct <br /> (Far Qtpaltamft In(wm0m CLQIbs sent <br /> I� 'E <br />