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OCT 24 '96 07=53AM SMITH ENVIRONMENTAL TECH CORP , 2 <br /> CENTRAL_ DISTRICT CCT I�f�1, 96 8:11 No . v� P .03 <br /> state 01 callfamis <br /> Department of Water Res+ouraw <br /> Control Distdict <br /> 1251 S street <br /> Sacmmerdb,CA 0581&7017 <br /> WELL. DRILLEFU6 LgEPORTS <br /> INSPECTION REQUEST AND AGREEMENT <br /> Pfa6�j t:.' �!ywe r.. q � `'at�t �7�tc►^rk � 'GLS f" <br /> r� A //,& .vel <br /> County; 1^ • Off, �. Clantrod Numbor: e 2233 <br /> Re <br /> quest is made pursuant to Section 13751 of the California Water Cade for pormissicn to <br /> inopcot or 9*py Wni*r Well Drli7cf o RdpOft Which,81`6 an filo In YOUP cfficO. <br /> !n a=rdance vAth the requirements,of Section 13M of the Water Code, it is stipulated and <br /> agghnd that ouch roparts, of any copy or.toptas made nereof, will not bo made availaabis for <br /> Inbscatlon by tho public but YAQ bo ueod B01sly by thia3 govetnmcntcI .agency for making <br /> btudlon. if coplen cre me-da or talion, each dopy will be stamped 'WNFIDIENTIAL:' or "FOR <br /> OGp1t' O.L.U66 ONLY"and will be kept in a restricted 00, 2=09s to Which Is Ilmited to the Otaff <br /> of Mir, govermentAl agency Ct to its contraetod agents. Any copies furnished to contracted <br /> egents must be returned to the Department of Water Resources, Central. District upon <br /> completion of fork by the contreeM agent. <br /> Nrp Information contained in those rapdris can bo-disseminated or published without the wrltion <br /> Oormisdon of the cwncr of tho wall,' <br /> iHJ .rlr� n a �G' d f!` '! Stw Soayo#+� Coo&cr`( rxac, �TN <br /> Contra c qg t I +Go+rernrrtentel A9asney E►JJ• tka_►u_* S. <br /> 2-69 6 � 62 304 t-tJEe*_--Tz <br /> .•�~~.� Atldre�a Addraoa <br /> • - ,�- Ci� �CN''�O,q,ck�`'�"� Sroc.,can,� C►� qs zo�.. <br /> .1 /Y. Iy 1■ I�^.I��^ 1 �� <br /> Sty,stcto, &.zip Coda City,State, a Zip Code <br /> �y k4z w .' ao }-ll�? BY <br /> ffcer <br /> TRW Title <br /> 7-2:2- <br /> Telephone� Telephone <br /> Dota Data <br /> (Fer B r_rrm&i latemctm; G�vc71co'c:rs <br /> Post-it"Fax Note 7671 Date� � pages' <br /> ToJiIAA, <br /> RM _. 1 From n 1�_- ' <br /> Co./D _L i7c Co. t,)vvs - <br /> oaa <br /> Phone#S�`1 2ZZ I Phone# �� O <br /> Fax# C ' .ZZZ�j Fax# q3'5 <br />