Laserfiche WebLink
State of California <br /> Department of Water Resources <br /> Central District <br /> 3251 S Street <br /> Sacramento, CA 95816-7017 <br /> WELL DRILLER'S REPORTS <br /> INSPECTION REQUEST AND AGREEMENT <br /> Project l �J _ <br /> Location: V ] r <br /> County: Contract Number_ 20q $1,47 f2 ' <br /> Request is made pursuant to Section 13751 of the California Water Code for permission to inspect or copy <br /> Water Well Driller's 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 agreed that such <br /> reports, or any copy or copies made thereof, will not be made available for inspection by the public but will <br /> be used solely by this governmental agency for making studies. If copies are made,or taken, each copy will <br /> be stamped"COIN'FIDENTIAL"or "FOR OFFICE USE ONLY"and will be kept in a restricted file, access <br /> to c+hich is limited to the staff of this governmental agency or to its contracted agents. Any copies furnished <br /> to comtradcd agents must be returned to the Department of Vater Resources, Ce-nual District upon completion <br /> of work by the contracted agent. <br /> No inforniation contained in these reports can be disseminated or published without the written permission of <br /> the o%,%°ner of the well. <br /> t7 _ Erlvi onmen+al He- l� <br /> Contracted Agent Go-veno-ncntal Agency <br /> 304 E . Weber Avenue <br /> Address Address <br /> 6A 1,520Z-2708 <br /> City, State,� � <br /> &Zip Code City, tate,zip Code <br /> &� <br /> B, l & y <br /> p By L/64��/e� C;��— , - -- <br /> Officer Officer <br /> �ndironmg,rfal N,QP� <br /> isle Title <br /> Telephone Telephone <br /> 0 S 143 <br /> Date bate <br /> (Fflr Depanmcd�Information_. . Copica sept _ ) <br /> Z0 39dd NOiADD1S MV 8TTTL9b60Z 9b:80 600Z/S0/E0 <br />