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r rtts � 1 yb 1i=1y F'HKK ENV1MUNMENIHL UUM . <br /> SUM ofCAgkwtft � 3 <br /> i t,��it1ilQRt S'lf I�rso{rr�►S ! <br /> i al Dftu <br /> 557& t <br /> SaGI M S CA-1816-7017• <br /> LL DRILLER'S REIORTS <br /> INS-P1; C5N REQUEST AND AGREEMENT <br /> Local'art: :[. L _0 b i Lo�i A <br /> Cordract Nwvber, <br /> i' <br /> ReqIJ st Is inWe r 13751 of the Cardorrtia water Coda <br /> ! Ins or espy W ter Well{Will Reports which am an Se h your,offim, �p�rmrss+on fa <br /> In a man7ce v= the requir r arts of Smart 13762 of the VYater Code, 4 is S#Uliftld and <br /> 89 that Ist#CI1 Pods, or co of eapi�s rr,ede rdcf, v�nll not be rude +alrrail�[e far <br /> ' insp ort by the public but wt-11 !be used solely by tt�s gover'rtti rdw ager, for rnaldno <br /> sturrii If cotes re made or talon, each copy vAl lay stamped =NFIDE. 1�' ac"'FOR <br /> OF1FI IAL USE L' r and will be kept in a noiewd lila,mss to which is a tb to staff <br /> of gmerme agency or to He cottb'acted agents. Arty cppi fMishid 4w&ac*d <br /> SQW r, Must Ise reed° to the. MpadrWt of Water Rescurdes, Ceriral trfic# upon <br /> COM; letkm of w0d by the Stasi WrvL ! <br /> i <br /> No in orrnatlen car,' In these eepcM tart be dlswrd't d or pt*Uh" !ha v9Men <br /> pe cion offfi� er of Me well: <br /> av, Taaq c- i-�, C <br /> P+ t s <br /> dad AqwdGati+a�airier l Ajehry <br /> i <br /> d 0 <br /> morass 15 <br /> Jdty. ta►ta. <br /> By '(Yldn <br /> BY <br /> 1 V1l�iVf <br /> pe Sen P-e) r C,-- G:7 <br /> Ct <br /> Toe TM <br /> 27 69.4" g 3 <br /> eraptaoae _10 <br /> Tde�ohp � i <br /> sxaoa l>� <br /> i <br /> , <br /> r Post-W Fax Note 7671 DateX1`1 (� p of I,. <br /> To jai+�„6 � From u � <br /> Co. c�L S L f{�� TOTAL P.02 <br /> Phone# 4� Phone#2_ q w <br /> Eft, <br /> Fax#qL ��-�_ � C Fax# f �D <br />