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ARNOLD SCNWARZENEGGER <br /> STATE OF CALIFORNIA-THE RESOURCES AGENCY <br /> Governor <br /> DEPARTMENT OF WATER RESOURCES <br /> CENTRAL DISTRICT NORTHERN DISTRICT SAN JOAQtJIN DISTRICT SOUTHERN DISTRICT <br /> 3251 S Street 2440 Main Street 3374 East Shields Avenue 770 Fairmont Avenue <br /> GlendaSacramento,CA 95816 Red Bluff,CA <br /> 96080 559)2300 3003726 818)5413 6 D <br /> (916)227-7600(Fax) ( ) 91203 <br /> (916)227-7632 (530 529-7322(Fax) (559)230-3301 (Fax) (818)543-4604(Fax) <br /> WELL COMPLETION REPORT RELEASE AGREEMENT--AGENCY <br /> (Government and Regulatory Agencies and their Authorized Agents) <br /> Project/Contract No. 006437 San Joa uin County <br /> Township, Range, and Section TIN R6E 2000' Radius <br /> (Must include entire study area and a map that shows the area of interest.) <br /> Under California Water Code Section 13752, the agency named below requests permission from <br /> Department of Water Resources to inspect or copy, or for our authorized agent named below to <br /> inspect or copy,Well Completion Reports filed pursuant to Section 13751 to (check one): <br /> Make a study, or, <br /> ❑ Perform an environmental cleanup study associated with an unauthorized release of a <br /> contaminant within a distance of 2 miles. <br /> In accordance with Section 13752, information obtained from these reports shall be kept <br /> confidential and shall not be disseminated, published, or made available for inspection by the public <br /> without written authorization from the owner(s) of the well(s). The information shall be used only for <br /> the purpose of conducting the study. Copies obtained shall be stamped CONFIDENTIAL and shall <br /> be kept in a restricted file accessible only to agency staff or the authorized agent. <br /> Brad Loewen, Geomatrix Consultants, Inc. Gt;x- * <br /> Authorized Agent Government-6r Regulatory Ag ncy <br /> 2444 Main Street, Suite 215 -� C• le <br /> � A, <br /> Address Address <br /> Fresno CA 93721 2, ��O 2— <br /> City, <br /> City, State, and Code City, State, 7iz <br /> Code <br /> Si natureAX5i nature <br /> Title Senior I Geologist Title <br /> Telephone 559 264-2535 Tele hone <br /> P p <br /> Fax 559 264-7431 Fax �o <br /> Date April 24 2006 _ Date <br /> E-mail BLoewen eomatrix.com E-mail �* gem <br /> 6 une 2001 <br />