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JIJ.-20-2001 10:02 CAMRPIA INC. 1707 935 6649 P.02/02 <br /> State of COW011119 <br /> Deprtt of VVAerResawres <br /> cenrlral Dishicl <br /> saga�'. e-7o1� 01 JUL 20H 10: 49 <br /> WELL DRlLLER'S REPORTS d <br /> INSPECTION REQUEST AND AGREEMENT <br /> Project S�4At <br /> Location: _I2�~i 'buy, CIL JO <br /> County- —San .To�i M Ccntra�ct Number. <br /> Request is made pursuant to Section 13751 of the Califomia Water Code for permission to <br /> +fwPect or copy Water Well Drillers Reports which are on file in your office. <br /> In accordance with the requirements of Section 13752 of the Water Code, it is stipulated and <br /> agreed that such reports, or any copy or copies made thereof, will not be made available for <br /> inspection by the public but will be used solely by this governmerrtai agency for making <br /> 3Wdies. If copies are made or taken, each copy will be stamped "CONFOEN71AL" or "FOR <br /> OFFICL4L USE ONLY" and will be kept in a restricted file, accer to which is limited to the staff <br /> Of this govermental agency or to its contracted agents. Any =pies furnished to contracted <br /> agents must be returned to the Department of Water Rescces, Central District Loan <br /> completion of work by the contracted agent, <br /> No information contained in these reports can be disseminated cr published without the written <br /> permission of the owner of the well. <br /> `jay% 'Ta1�t�un Co�hj 'P�6lic, <br /> tan-t ZL. v t Yo y-1 m } a.�{ S�ry i Ct h, <br /> �^�. Atx.1-4h. iy. <br /> C n"c:ed Agent Gcvemmentai Age17 <br /> 'l? O . Box 2-59 E. 'Iti1dow Atm, kir or�r <br /> ,oddness <br /> SDS t CAt 954-711= S�m Ck-bM CA %U7-- <br /> Z-1%y,State, &Zip Coje - --C '.Z'I te, 9 Zip C*Qe <br /> By <br /> n O er <br /> rite "t '." <br /> ray <br /> 7a`7 33 - 23 Of <br /> Teiephane elephone <br /> — 2p _ ply <br /> (Dace 74 Date <br /> (Far 04owWwndl <br /> TOTAL P.02 <br />