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0 • <br /> STATE OF CALIFORNIA-THE!RESOURCES AGENCY ARNOLD SCHWARZENEGGER,Governor <br /> DEPARTMENT OF WATER RESOURCES <br /> CENTRAL DISTRICT NORTHERN DISTRICT SAN JOAQUIN DISTRICT SOUTHERN DISTRICT <br /> 901 P Street 2440 Main Street 3374 E. Shields Ave Ste A7 770 Fairmont Avenue <br /> Sacramento, CA 95814 Red Bluff, CA 96080 Fresno, CA 93726 Glendale, CA 91203 <br /> (916)651-0753 (530)529-7300 (559)230-3300 (818)500-1645 ext.233 <br /> (916)651-0726(Fax) (530)529-7322(Fax) (559)230-3301 (Fax) (818)5434604(Fax) <br /> WELL COM LETION REPORT RELEASE AGREEMENT—AGENCY STUDY <br /> (Government Agencies and their Authorized Agents) <br /> Under California Water Code Section 13752, the agency named below requests permission from <br /> Department of Water R sources to inspect or copy, or for our authorized agent named below to <br /> inspect or copy, Well C mpletion Reports filed pursuant to Section 13751 to make a study. <br /> In accordance with Sec ion 13752, information obtained from these reports shall be kept <br /> confidential and shall n t be disseminated, published, or made available for inspection by the <br /> public. The information!shall be used only for the purpose of conducting the study. Copies <br /> obtained shall be stam ed CONFIDENTIAL and shall be kept in a restricted file accessible only to <br /> agency staff or the aut orized agent for this study. <br /> Project Name: Lopez ProDertv & Comfort Air County: San Joaquin <br /> lLo and !Go7 Tu{n�o;ke 'Rd. <br /> Street Address: 2-224 rvralTmcVRoad City: Stockton <br /> Township, Range, and Ic ection: T1 N RISE west of Section 10) Radius: 2000 feet <br /> (Include entire study area and a map that shows the area of interest.) <br /> Advanced GeoEnvironrnental, Inc. San Joaquin County Environmental Health Department <br /> Authorized Agent Company Name Government Agency Name <br /> 837 Shaw Road 60n East Main Street <br /> Address Address <br /> Stockton, CA, 95215 Stockton CA 95202 <br /> City, State, and Zip Code City, State, and Zip Code <br /> Ally Colavita Vicki McCartney <br /> Authorized Agent Name (please print) Agency Contact Name (please print) <br /> Signature: Si nature: <br /> Title: Project Scientist Title: Sen i o r Te-9 i S+ <br /> er CrtVi on rn.e-r&a,1 <br /> 444-&I'i-f` Sioe¢.ia.list <br /> Telephone: 209 467-1006 Telephone: (209 ) 4G 8 - 9 8 6 Z <br /> FAX: 209 467-111 FAX: ( 209') 468 - 3433 <br /> Date: 03/02/11 Date: 03 / 02 I// <br /> E-mail: acolavita ad eoenv.com E-mail: V M e c d r fn e v/d 5i s d co <br /> wcrrequest-agencystudy_2006 706.doc `06 July 2006 <br />