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08/14/2000 11 55 2094683433 FIFTH FLOOR PAGE 03 <br /> 08/14/2008 12."42 2094671118 AGE STOCKTON PAGE 03/03 <br /> State of Caufornia <br /> DePsnwtnt of Water?Lesour= <br /> Cenval District <br /> I D <br /> .3231 S Strect nD <br /> Sacramento, CA 95316-7017 <br /> WELL DRILLER'S REPORTS <br /> INSPECTION REQUEST AND AIGIMEMENT <br /> (fop W <br /> Locatcn: 0 . <br /> C <br /> countv Sr, rn -,M!3!A t,I'A ofttract Numbcr, <br /> V <br /> ReVeSt JS M2dC PUTS=10 StdM 13751 OfUV Cabfornm Wairr Code fiar pemiss7on to inespea or copy <br /> wa;tr WCE DnIjar's pwpons%N on file ul't our offim <br /> In ac=darca NmTh 71erequirmwnLc of Section 1�7-52 of ihe Waiex Code, 21 as filipulated and agrftd That such <br /> TePUMIL or any copy or coples made thereof,%,.III not be made avallable for mspection by the public but-%ill <br /> be wed Solely Dy tWs P-01,e=mentW agency for]p2L-jMg smdies If popies axe m3de or taken, each o0py w9l <br /> bes1=ped"C0J\T1Z)ENTLkL or"rOR OFFICE USE ONLY-and-Aill be kept in a resuicud file;. ac=s <br /> luniied Toibe staff ofaus SoNe=jemw aaency Qrjo its ccmtra-ted agents Anycopicsfarmsbed <br /> To c=Ln=0d agzm rrmst be rammed ic%he Depament of Waw Resources, Central Dist=upon c=pIctm <br /> of-v%vrk by the ron-rxPcrcd ag= <br /> NO 4-rojw"Q4i LaTm3md I)i ihast reporLs can be f-'issm=ated oi-publisbed viithovi The v\-nv.en permimm,of <br /> ihe ov.-ner of-Lhe v�a <br /> GM CI-117r;1!Btal AgtnO� <br /> Addrm <br /> c1tv Stile- &Z;F codt Cirv,Swt 2�p Cod,; <br /> Yin-Coll. -- 2Ll j I t* (,I C E"-1-13 <br /> v If (9. 5m=r <br /> Th3e TWo <br /> ^�g 7 � 9� - C) <br /> 'felqhonc, Telephone <br /> V —00 AUG 14 20OU <br /> D:ue <br />