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CENTRRL DISTRICT ID : 91632271004 JUL 01 '94 9 :49 Na .003 P .02 <br /> Stale of California <br /> Department of Water Resources <br /> Central DlsWct <br /> 32518 Street <br /> Ucramento,CA 8581e-7017 <br /> WELL DRILLEWS REPORTS <br /> INSPECTION REQUEST AN13 AGREEMENT <br /> plroject, <br /> Location: 1766 Y'✓l C k jto c.t!e-t�v� CA - <br /> County: <br /> A - <br /> County. Contract Number: <br /> Request Is made pursuant to Section 13751 of the California Water Code for permission to <br /> inspect or copy Water Well Driller's Reports which are on file in your office. <br /> In accordance with the requirements of Section 13752 of the Water Code, it is stipulated and <br /> agreed that such reports, or any copy or copies made thereof, will not be made available for <br /> inspection by the public but will be used solely by this governmental agency for making- <br /> studies. If copies are made or taken, each copy will be stamped "CONFIDENTIAL" or "FOR <br /> OFFICIAL USE ONLY" and will be kept in a restricted file, access to which Is limited to the staff <br /> of this govermental agency or to its contracted agents. Any copies furnished to contracted <br /> agents must be returned to the Department of Water Resources, Central District upon <br /> completion of work by the contracted agent. <br /> No Information contained in these reports can be disseminated or published without the written <br /> permission of the owner of the well. <br /> �. Co. l�uG e r <br /> Contracted Agent overnme alAGQ <br /> D &ok 3b'3 <br /> Address Address <br /> --rr ,t-,- CA Sac► o <br /> City,State,&Zip Cade ©city,Staw•&Zip Code <br /> S <br /> Y mer <br /> Title Title <br /> Telephone Telephone <br /> Date Date <br /> (Far Deprrtltne"IvWnaiwn. COPcent——T—� <br />