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Oct 01 03 08: 13a Ho~ Ton Env. Inc 916 -19 2172 p• 2 <br /> `s01 <br /> State of California <br /> Department of Water Resources <br /> CentmI District <br /> 3251 S Street <br /> Sacramento, CA-g5a16-7017 <br /> WELL DRILLER'S REPORTS <br /> ,(� INSPECTION REQUEST AND AGREEMENT <br /> Project: ZX w� <br /> Location: fp�,� Sptc, <br /> Gauntly; Contract Number, <br /> Request is made pursuant to section 13751 of the California Water Code for permission to <br /> inspect or coPY Water Well Drilier'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 <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 governmental agency for making <br /> Studies. If copies are made or taken, each cagy will be stamped "CONFIDEN71AZ" or <br /> OFFICIAL. USE ONLY'' and will be kept in a restricted file, "FOR to which is iirnited to the start <br /> of this govermentai agency or to its contracted agents. Any copies furnished to ccrtrcted <br /> agents must be returned to the Department of Water Resources, Cen <br /> completion of work by the contracted agent. tral District upon <br /> No informations contained in these reports can be disseminated or FErbiished without the written <br /> permission of the owner of the well. <br /> €Lt Vi rite �"IG <br /> Contrac:ed Aden: <br /> avernmertal Agency <br /> Uf ok �oa "I �r U) � r <br /> Address <br /> Address <br /> & or A�pCity, S . . <br /> By <br /> ity.State. ,t lir C,no..� <br /> 44 <br /> 4�— <br /> Officer By <br /> Officer <br /> Tate <br /> 3 —2-11-0 <br /> Telephone �� � 3 <br /> Ap� Telephone <br /> Date • <br /> (For QePwaneltr rnfarrrsatlan: oopaea sent��y <br />