Laserfiche WebLink
State of;Caiifomhlb <br /> Department of Wster Rmur"s <br /> cent ibistrid <br /> 32516 street <br /> Sacramento,CA 95315.7017 <br /> WELL DRILLER'$REPORTS <br /> INSPECTION REQUEST AND AGREEMENT <br /> Project: F S <br /> Location: <br /> County: Saa,:I . ' Contract Number. <br /> Request is made pursuant to Section 13751 of 09 California Water Code for permission to <br /> inspect of copy Water Well Driller'§ Reports which are on Me in your office. <br /> In accnrdanca with the requirements of Section 13752 of the Water Code, it is stlpulsted and <br /> agreed that such reports, Or any copy or copies made thereof, will not to made available for <br /> inspection by to public but will be used solely by this governmental agency for making <br /> stuGles, if copias are made or taken, each copy will be stamped "CONFIDENTIAL" or"FOR <br /> OFFICIAL. USE ONLY anc YAH be kept in a restricted file, zc=ss to whic`t is limited to the staff <br /> of this govermental agency or to its contracted agents. Any =pies fumisheC to contracted <br /> agents must be returned to the Derartment of Water Resources, Central District upon <br /> ccmpletlon of work by ino contracted agent <br /> No information ccritained in these reports can be disseminated v:published without isle writts" <br /> permissier. of the owner of the well, <br /> Cot <br /> eAn <br /> Crrta.:,ed ApenHGove en <br /> . r s+tal Agency <br /> cy <br /> Z1tA M A lm z,a e 3- �b a r <br /> Aoar+« Address <br /> Ega�OAu, C;4 C6324 f)4VC�� <br /> Clty, State. &.ZIP Code City,Stale, &ZIp Code <br /> gy -Smk\_ llrue� ., By <br /> 0mcer '-ZT O'ticer <br /> t�C_�eo l,ae 1St, <br /> Title"' �'f�e <br /> 1 <br /> telapriono � Telephone <br /> z 17101 <br /> pbte Gate <br /> (Far otpvt„erc+i INarn+edon, caplet seat <br /> Ed Wd6b:b0 tiOOE Lti gad less ers 6oE 'ON dNOHd sTshlpud oaaz punoard WO�U <br />