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SENT BY;EMCON 5-18-55 8:06AM E1lCON SACRXMENT0- ;# 2/ 2 <br /> _ 1. 1'� Nd .UU2 P ,02 <br /> $tate of CAtifomle <br /> Department of Water Ftosowaee <br /> central Dloct <br /> 32618 Murat <br /> Sacramento.CA-115818-1017• <br /> WELL DRILLER'$ REPORTS <br /> INSPECTION RECUESTAND AGREEMENT <br /> project C.a <br /> Location: 3212 t J . <br /> County. ,-, Contract Number. <br /> Request is made pursuant to Section 13751 of the CailforMla Water-Code for permission to <br /> Inspect or copy Water Well DdIler's Reports which are on filo in your office. <br /> In ac cordanca with the requirements of Sec:jon 13752 of the Water Code, it is stipulated and <br /> agreed that such rsgorts. or any copy or copies made thereof, will nqt be macre availahIp for <br /> i11apvct1san by me OU011c but will be used solely by this governmental agency. for making <br /> studies, if copies aro made or taken, each copy will be stamped "CONFIDENTIAL" or "FOR <br /> OFFICIAL USE ONLY" and will be kept in a restricted file, v=ss to which Is limited to the staff <br /> of this govementai agency or to its contracted agents. Any Copies furnished to contracted <br /> agents must be returned to the Ospartment of Water Resources, Ggntrai Giatrlct upon <br /> 001ti41iwdan of warn Dy me CoMtracted agant. <br /> No information Contained in these reports Can be disseminated or published without the written <br /> Permission of the owner of the well. <br /> r 1`r1 L Ol� ,SZr1 �c3c�i.► �r, �ov� ��11iP'�rnY7u b� <br /> CW%tracted Agentt3ovarnmen[al Aderioy <br /> P.O . 3 <br /> Address ` Address <br /> '�G C G rnix� CArJ i3 3 'u G�r-_ov - L A 1 l -a 1 3 <br /> es <br /> dry, State, UIP code Qty,.Mats. 6 ZIp.Cads <br /> 9y Sy <br /> OfiEcer Olrlesr ~ <br /> Titif Title <br /> all3(00 _ 1- - 345; <br /> Tif�pharre Ts1e0t1ano <br /> oats unto <br /> `ref OGPvlm d*IM*.,, son: w� mm <br />