Laserfiche WebLink
FROM Geo-Phase Ervironment.a' -1c. FAX NO. : 2095690295 Ji-in. 05 2001 06:49PM P2 <br /> State of California <br /> Department of Water Resources <br /> Central pistrict <br /> 3251 S Street <br /> SSCramento, CA 95816.7017 <br /> WELL DRIL.L.ER'$ REPORTS <br /> INSPECTION REQUEST AND AGREEMENT <br /> Project rK -%�1 y� 1`;ta,•�I` +�� <br /> C,uOoD U�1-4 <br /> County- Contract Number- <br /> Request 15 made ptarsuarit to Sectiort 13751 of the California Water Code for permission to <br /> inspect or copy Water Well Drlller's Reports which are on file in your office, <br /> In accordance with the raquirements of Section 13752 of the Water Coda, it is stipulated and <br /> agreed that such reports, or any copy or copies made thereof, will not be made available for <br /> inspection by the public but will be used solely by this governmental agency for making <br /> Studies_ if copias are made or taken, each copy will be stamped "CONFIDENTIAL" or"FOR <br /> OFFiClAt-USR ONLY" and will be kept in a restricted file, access to which is limited to the staff <br /> Qf this govermentat agency or to its contracted agents. Any copies fumi5hOd to contracted <br /> agents must be returned to the Department of Water Rasources, Central District upon <br /> completion of work 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 /> t�;c? •- F''tt�ls� >�...��i�2.o,1>-f,�e��� j "� �?I"`.� ( � I-I <br /> Contracted Agent Governme--wai Agency <br /> Address ( Address Ln <br /> City,State, B.Zip Code city, state, 8 zip Code <br /> By �� �— S �) �' �c i �, <br /> Officer Y L CSYL <br /> Otrca (\ <br /> Title Titlo l <br /> Telophone Telephone <br /> Dates L78ie '"^ <br /> ;.Fa DspariN:.nt�l�rrformatlon ap�a sent_��� <br />