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CENTRAL DISTRICT ID :9163227184 JUL 01 ' 94 9 :49 No .003 P .02 <br /> State of California <br /> Department of Water Resources <br /> Central District <br /> 32-518 Street <br /> Sacramento, CA 95816-7017 <br /> WELL DRILLER'S REPORTS <br /> INSPECTtON REQUEST AND AGREEMENT <br /> project: l/ <br /> Location: <br /> County: Contract Number. <br /> Request is made pursuant to Section 13751 of the Califomia Water Code for permission to <br /> inspect or copy Water Well Drilles s Reports which are on rile in your office. <br /> in accordance with, the requirements of Section 13752 of the Water Cade, 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 inforrnation contained in these reports can be disseminated or published without the written <br /> permission of the owner of tt•.e weii. <br /> Cc, mul e <br /> overnrne ai Aqe <br /> Contracted Agert �� <br /> D, r3ox <br /> Address Address <br /> CA 1�5- Z1 -038`? <br /> city,State, &-TAP Code city,State. S Z1p Code <br /> By By A16� <br /> Officer Officer <br /> sine rale <br /> Telephone Telephcns <br /> Date <br /> Post-ItT'brand fax transmittal memo 7671 #of pages ► <br /> From <br /> P.Co. S(�o �' )St-ItT'brand fax transmittal memo 7671 #of pages <br /> Co.CDLt�2 , <br /> C c ,,.,��6 . �� From <br /> �k <br /> Depttt.�� Phone# .. y <br /> Co. <br /> Far# h(L_ S b 'p�G�Ct'✓�. ��N� Fl�^ <br /> fs O / rb <br /> �7/ y Phone,#` <br /> raxiq,C� -0�� <br /> Fax <br />