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08/14/2000 12:42 2044671 AGE STOCKTON PAGE 02/03 <br /> State of California <br /> Department of Water Resources <br /> Central District <br /> 3251 S Street <br /> Sacramento, CA 95816-7037 d <br /> WELL DRILLERS REPORTS <br /> INSPECTION REQUEST AND AGREEMENT <br /> Project- i V A u 5 eS <br /> Location: <br /> County; "n dontralt Number: <br /> Request is made pursuant to Section 13731 of,he California Nater Code for permission to inspect or copy <br /> NVzier Well Driller's Reports »•loch are on file m your office. <br /> In accordance»7th the requirement of Section 13752 of the Water Code.. it is sl ipulated and agreed that such <br /> reports, or any copy or copies made thereof, not be made available for inspection by the public but mill <br /> be used solely by this governmental agency for making studies. If copies are made or taken, each copy%Hill <br /> be stamped"CONFID]ENTLAI "or"FOR OFFICE USE 0\LY"and N01 be kept in a restricted file. access <br /> to%,Nch is limited to the staff of this governineirial agency or to its contracted agents. Any copies furnished <br /> to contracted agents must be returned to the DepaL�ent of Water Resources, Central District upon completion <br /> of work by the contracted agent. <br /> No infonnstion contained in these reports can be disseminated or published m ithout the%�Titten pennission of <br /> the o„-ner of the well. <br /> Contracted Agent Governmental Agency <br /> W CoQ kenr- <br /> Address <br /> A dress 54 <br /> vil 'R5 d4o-v, C-A %L <br /> Citi.. State. &2"p odei Sure,Zip Code <br /> RV _�-?r1 n �/lIG�✓Yikn �_ . <br /> Officer tar <br /> Title T_ Title <br /> /OD& r7 , � 6S - o33 <br /> Telephone Telephone <br /> AUG 14 LiJ <br /> Date Date <br /> (For DewinustAl W,.-=anon: Copia senor— -- - .. ) <br />