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STATE OF CALIFORNIA-THE RESOURCES AGENCY <br /> DEPARTMENT OF WATER RESOURCES ARNOLD SCHWARZENEGGER Governor <br /> CENTRAL DISTRICT NORTHERN DISTRICT SAN JOAQUIN DISTRICT SOUTHERN DISTRICT <br /> 901 P Street 2440 Main Street <br /> Sacramento, CA 95814 E. Shields Ave Ste A7 770 Fairmont Avenue <br /> (916)651-0753 Red Bluff, CA 96080 Fresno, CA 93726 <br /> (530)529-7300 (559)230-3300 Glendale, CA 91203 <br /> (916)651-0726(Fax) (530)529-7322(Fax) (818)500-1645(559)230-3301 (Fax) (ext.233 <br /> Fax)(818)543-4604(Faz) <br /> WELL COMPLETION 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 Resources to inspect or copy, or for our authorized agent named below to <br /> inspect or copy, Well Completion Reports filed pursuant to Section 13751 to make a study. <br /> In accordance with Section 13752, information obtained from these reports shall be kept <br /> confidential and shall not 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 stamped CONFIDENTIAL and shall be kept in a restricted file accessible only to <br /> agency staff or the authorized agent for this study. <br /> Project Name: Former Ocampo Property(A.K.A.Former Electro Delta) <br /> County: San Joaquin <br /> Street Address: 821 South Wilson Way City:Stockton <br /> Township, Range and Section: Township 1 North,Range 6,Section 32 Radius: 2.000 square feet <br /> (Include entire study area and a map that shows the area of interest.) <br /> Advanced GeoEnvironmental Inc. San Joaquin County Environmental Health Department <br /> Authorized Agent Company Name Government Agency Name <br /> 837 Shaw Road 1868 East Hazelton Avenue <br /> Address Address <br /> Stockton,California,95215 Stockton,California,95205 <br /> City, State, and Zip Code City, State, and Zip Code <br /> Daniel Villanueva Angelica Sandoval Marin <br /> Authorized Agent Name (please print) Agency Contact Name ( s rint) <br /> Signature: Si nat <br /> Title: Project Geologist Title: Senior Environmental Health Specialist <br /> Telephone: ( 209 ) 467-1006 Telephone: ( 209 ) 468-2807 <br /> FAX: ( 209 ) 467-1118 FAX: ( ) N/A <br /> Date: Date: -:y251/j <br /> E-mail: dvillanueva@advgeoenv.com E-mail: amadn@sjoehd.com <br /> wcr request-agencystudy_20060706.doc 06 July 2006 <br />