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P6 ,a." State of California sww <br /> J Q f Department of Water Resources <br /> Co"tral District <br /> Street <br /> Sacra,-._--•.; 95916-701.7 <br /> .4f. <br /> WELL DRILLER'S REPORTS <br /> INSPECTION REQUEST AND AGREEMENT <br /> Project: foc.e-Il<3VkcrJ, L g <br /> Location_ tiZ.$Z <br /> County- cSp-1} -To A-0-,Lt 4 Contract Number. <br /> Request is made pursuant to Section 13751 of the California Water Code for permission to inspect <br /> 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 than such reports, or any copy of copies made thereof, will not be made available for <br /> inspor ion by the public but will be used solely by this government agency for malting studies. If <br /> copies are made or taken, each copy will be stamped "CONMENTI,AL" or "FOR OFFICIAL <br /> USE ONLY" and will be kept in a restricted file, access to which is limited to the staff of this <br /> governmental agency or to its contracted agents. Any copies furnished to contracted agents must <br /> be relurned to the Department of Water Resources, Central District upon completion of work by <br /> the contracted agent.. <br /> No ir..formation contained. in these reports can be disseminated or published with the written <br /> perms>;sion of the owner of the well. <br /> Uaradiot nvir Consultants S1 /6*b <br /> Contracted Agent Goversi na"Agency <br /> 33LI K nt�e� Zo4b 2-OD1 <br /> AddAddress <br /> jj c Sze I <br /> City, State&Zip Code City, State tit Zip Code <br /> Officer Officer <br /> . .rhe Title <br /> 7.DC1-777-36Z.D 0 <br /> � 2 <br /> Telephone Clep <br /> Dat Da <br /> (Far Dep rtts WKW 1"f0 060n: <br />