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V } <br /> 05/02/2000 14:011 209-57" ?225 MODESTO ATC �^ PAGE 02 <br /> r flWR SJD FRESNO : 209-445-.53A�7. . "'' RPR rw�O 15 :31 N0 .013 P:01 # <br /> E VA'M OF CA►MC1+n�..n18 w�6i OIJriCia wu+CY ' <br /> DEPARTMENT OF WATER RESOURCES -" <br /> Sw-noun V*TPNcr !� <br /> 3374 Eml Sh ww Ar* <br /> FMWA c,ltlf "s <br /> (569)44&ula%ol <br /> WEiLL INFORMATION RELEASE AGREEMENT <br /> (for Use by Govemmental Agencies and their GontWed Consul;erits) <br /> Project l�_ _►o+l �._ ., .._ ContrsCt Number <br /> County <br /> Township, Range. and Section Z 5 'Z'9 KIA6, tt+ zb zz <br /> r 15 tLS EI VAI 33. a-A <br /> ` In order to conduct a study in the above area, we request permission from the <br /> Department of Water Resources to Inspect or copy Well Completion Reports made <br /> pursuant toy Section 13751 of the Catlfomla Water Code and Well Data Reports <br /> pertinent to out study which are on file In your office. <br /> In accordance with ttte tequirements of Section 13752 of the Water Code, we agree <br /> that Information obtained directly from such reports will be kept confidential and i <br /> will not bol�dieeeminatsd or published without written permission of the well . <br /> owner. Additlonaily, we agree that any copies obtained will not be made available for <br /> inspection by the public but will be used solely by this governmental agency for <br /> c mducting'this study, Copies obtained wilt be stamped'CONFIDENTIAL" or"FOR <br /> OFFICIAL USE ONLY* and will be kept In a restricted file, access to which is IlmHad to <br /> the staff of this governmental agency or our Contracted consultant$. Upon completion <br /> Of this wont-� all Copies furnished to our consultants will be retumed to this <br /> governmental agency, <br /> 2 <br /> r Ccrnwitent overnmentat AcoAcy <br /> Address AddMm <br /> <-* q s� s l ��OZ- . <br /> city,State,and lap Code City. State, nd ode <br /> By <br /> iTitle TI <br /> Teiopl,one Telephone <br /> Flax Fax <br /> Date Date <br /> t <br />