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10/11/2000 11:16 20946711?'- AGE STOCKTON PAGE 02/03 <br /> State of California <br /> Department of Water Resources <br /> Central District <br /> 3251 S Street <br /> Sacramento, CA 95816-7017 <br /> WELL DRILLER'S REPORTS <br /> INSPECTION REQUEST AND AGREEMENT <br /> Project i p p r + A <br /> Locatio 'O <br /> County:S&n 1o c� izu;n _— Contract Number: 17-0300 <br /> Request is made pursuant to Section 13751 of the California Water Code for permission to inspect or copy <br /> Water Well Driller's Reports v,,IL ch are on file in your office. <br /> bt accordance v ith the requirements of Section. 13752 of the Water Code, it is stipulated and agreed that such <br /> reports, or any copy or copies made thereof will not be made available for inspection by the public but will <br /> be used solely by this govemnental agency for making studies. If copies are made or taken, each copy will <br /> be stamped"CONFIDENTIAL" or"FOR OFFICE USE ONLY''ajtd will be kept in a restricted file; access <br /> to v,-J*h is limited to the staff of this govermnental agency or to its contracted agents. Any copies furnished <br /> to contracted agents must be returned to the Department of Water Resources. Central District upon completion <br /> of ivork by the contracted agent. <br /> No information contained in these reports can be disseminated or published Nvit]iout the written permission of <br /> the oitner of the well. <br /> AluA✓tcd GeoF—ny,t-on Me-nt1t_ — — /-f"!J <br /> Contracted.Agent Gm!cnimental Agency <br /> aoS Nord, <br /> W-'j9.AW 3 <br /> Address Address <br /> S+UCL+on _C A 7.'5.40Is- - � dc- g <br /> Cit),, State,&Zip Code City, State,Zip Code <br /> v v <br /> Officer Office <br /> Title 'title <br /> 7-- f(XJ. e-3V-C <br /> Telephone Telephone <br /> L0-a-p o (,v <br /> Date Date <br /> (for Dapartmertsa Womation: Copies sznl_ ) <br />