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10/10/2000 08:11 20984P'`98 WESTERN ASSET PAGE 02 <br /> C�*Pwt.MWA otWSW Resemigie <br /> CMtral t�4btd • •,� �, . <br /> 32214 etre t <br /> awroftMo,CA eagle_ 7 <br /> OWNER'S'REQUEST F`OR <br /> . .: WELL DRfLLER S REPORT(WELL L.OGf � <br /> Ple$se use the back of tuts ' <br /> pstge tc sthe the locazfon of your W41. Adoqume lefomialion <br /> must bs Provided before a aeart� for the w+dA to6 Cad _ � <br /> from cions stroett. Show tandm�eits such as schools, post offices,�aadshes, highways, <br /> county roads; rnsin streerts..etc. V diCate Nath on Ow sketch). <br /> Location of welt(City artd County): NgW U e f['k,►n�' <br /> Street Address 3 <br /> ' Township t Range J14..Seetion <br /> (CRY orcour Ptanii,riy 4 11.4 or 114 114 Section <br /> n' Q+De �r1t frwFir he aEle t4 lun�frs,this i {n} <br /> Assessor's Parcel Number(ort-tax statement) 76��t <br /> (Ir P"S'Ne.Pteese 4"*0 i cep}Of the A:.howsors Parol Msp, <br /> Subdivision or Tract Lot No_ <br /> Parent <br /> Owner whom well was drilled ' t���,r, 'r 7 � <br /> Other Previous Owners t ' , <br /> WOO Drilling Contractor or CompanY jj nb.y,o,a v-\ <br /> Year EMlted v •,ak,,, <br /> Depth of wall(if known) ... , (ZZL.,,.'_�.6C1.. .Qlamater a rr <br /> (This infoimatlon is eecesss If ��Of casino <br /> ry rocr havq more than ahe+aeEl.}.• <br /> SeCtton 13752 of the Carfpmim Waler Code permits role <br /> sae of v�ratsr well•drillers re <br /> upon the written request of the Ownfir of the well. The ownees certification must be comp tai <br /> 1 certify that I am the Owr+erof the ri.e?# Pieasa send a mpy o/the water <br /> dasCfbed share. well drillers report to: <br /> MUMS <br /> Name <br /> Edwards Rearl ' <br /> AddressAddmu <br /> 5 V. -797 ,1 <br /> Cay,5 a and Zip Cade CRY,$tate and ZIP code <br /> Telopharaa Narr+ber <br /> :Tote n6 umber <br /> 3�3 �� 3 o - <br /> . <br /> , „ V i <br /> 4 , DIll <br />