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03-06-1997 12 s 15 .� P.02 <br /> State of California � �~ <br /> Ova aa#rrrer:t of VVator iiesor UrCM 1 <br /> . . Oer"Dis#r3ct <br /> =19 Stmet <br /> Saacralamerate,CA 95514.7017 , <br /> WELL DFULLER'S REPORTS <br /> INSPECTION REQUEST ANIS AGREEMEN <br /> Prat}act: -Se-,e7m Afty &AAWGm-1 <br /> 11011 <br /> Lracatiax 7-oao <br /> Y�Y��.iYi1�Y <br /> copy; C ho ulAi Contraet Number: 33 7-z -0 0 <br /> Request is made pursuant to Section 13751 of the Ca ffor zia Water Code for pwrrdwjc)n to <br /> inspect or copy Water Weis Daar's Reports which are on iris in your oface. <br /> in a=rdance with the requirements of Sec don 13752 of the Water Code. It is.st ted and <br /> agreed that such reports, or any COpy.ar copies made ttaenW, will not be macle avaUbie for <br /> inspection by the public but %10 tae used 54" by this govemmentai agency for making <br /> studies. It copies are made or taken, each copy wM be stamped 4CONF1DENTEAL' or "FOR <br /> OFFICIAL USE ONLY"and wiD be!sept in as reaWded me,nems to which is !trued to the staff . <br /> of this govermentat agency or to its contracted agents, any copies fumis hed to raced <br /> agents must be ratumed to the DepaRment of Water Reascurces, Cantmi District upon " <br /> Completion of wafk by the t ontradad went <br /> No Infamation contained in these reports con be disseminated or pubilshed wfti ut the written <br /> per n %slon of the owner of the well. <br /> CM Agent PkFVG , CW Ageoeyl <br /> AMOW *.49 sures �4 <br /> Addws nadru 1 <br /> ass !91- <br /> Ctty, Stats.B.ZIp Code &Mp Coda <br /> $y Lt�� x�� �y <br /> OtlGosr <br /> Tilts ape <br /> rYYYi� <br /> Tetap!►4n4 Telephone <br /> 3 f � P <br /> Dara mets • <br /> {Fa 0 1 antemrNon: **pike 6en1 <br /> i <br /> i <br /> I� <br /> /c}1 <br /> .. 'i f' <br />