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4 11., 14/2000 18: 45 2094671318 AGE STOCKTON <br /> PAGE 02 <br /> State'af Callromia <br /> Depertrrterlt of Water Resources <br /> Central olstrlct <br /> 3251 $Street <br /> Sacramento, CA 95818-7017 <br /> WELL DRILLERS REPORTS <br /> INSPECTION REQUEST AND AGREEMENT <br /> Project SG e S <br /> Location_ % I Nor � <br /> County: an <br /> Contract Number. <br /> Request.is made pursuant to Section 13751 of the Califamia Water Code for permissiQrt to <br /> inspect or copy Water Well 0P ller's Reports which are on rile In your office_ <br /> In accordance with the requirements of Section 13752 of the Water Code, it is stipulated and <br /> agreed that such reports, or any copy or copies ade thereof, will not be made available for <br /> inspection by the public but will be used solei <br /> aking <br /> studies. If copies are made or taken, each copy will belstamped 'CONFIDENTAL"roh. <br /> r�"FOR <br /> OFFICIAL USE ONLY"and will be kept in a restricted file, access to which is f <br /> ta <br /> st <br /> limited to the f <br /> Of this govermentai agency or to its contracted agents. Any copies furnished to cothe staff <br /> agents must be returned to the Department of Water Resources, Central District upon <br /> completion of worm by the contracted agent. <br /> No information contained in these reports can be disseminated or published without the written <br /> permission of the owner of the well. <br /> INVant es— GeQ Co u,rd v%$c� 5� (-fs l,N <br /> (/ Cantraaed Agent Governmental Agencf <br /> Address <br /> Address <br /> s�eGk � C S�oS k-�'� CA <br /> city, State. &.Zip Code Citi, state. &Ztp C(octe '} <br /> By By n (it/ <br /> Officer <br /> C r <br /> Title <br /> i t:e <br /> 100(, ., m�, 4 —1 �S 1+ ( ' <br /> Telepnane Telephone . <br /> Dace l <br /> • Oats <br /> Post-it®Fax Note 7671 15 200 pages <br /> To s From 3 <br /> Co./Dept. �-� Co. ej- 'i"Hs•/C 11 <br /> Phone# Phone# l ��oC��� <br /> Fax# t� <br />