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071/01/94 10:45 $916 456 0110 SEACOR-SACRAMENT lih 0[12 <br /> CENTRAL DISTRICT 1:9163227184 JUL '94 9 :47 No -002 ia.02 <br /> State of Caitlftmia <br /> Department of Water Rmu=s <br /> Cen"i plstridt <br /> 32518 Street <br /> Sacramento,CA 96a18.7017 <br /> WELL ORILLER'S REPORTS <br /> INSPECTION REQUEST AND AGREEMENT <br /> Location: I (`l a ,eL b P <br /> colum: ,•n _ — Contract Number. <br /> Raquest Is made pursuant to Section 13751 of the Caiifomia Water Code for permissfon to <br /> inspect or copy Water Well Driller's Reports which are on stile in your office_ <br /> In accordance with the requirements of Section 13752 of the Water Code, ft is stipulated and <br /> agreed that such reports, or any copy or copies made thereal', will not be made available for <br /> inspeCd+on by the pubic but will be used solely by this governmental agency for malting, <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 tv contracted <br /> agents must be re-tumed to the department of Water Resources, Central District upon <br /> completion of work by the contracted agent. <br /> No informa*w contained in mese reports can be dlsseminated or published without the written <br /> permission of the owner of the well. <br /> S E C-o R., <br /> Contracted Agent Gwwwnmental Agency <br /> 1-�3cl 3q- �{— <br /> AddtBss Addrw <br /> City.State, Zip Code City, Sate, &Vp Coda <br /> BY pt By <br /> �C++rfic ottker <br /> Tide Titin <br /> Telephone Telephone <br /> �- l <br /> '7- <br /> Date Data <br /> (far Nim"W"lnbmmftx 0*"Wt ) <br />