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13, What is the depth to groundwater' <br /> Describe the source of information: <br /> � <br /> YES [ ] NO [ ] . <br /> 13. Are there any water wells on this parcel or adjacent properties. <br /> TYPE OF WII IS DLSTANCE TO TANKS(S) <br /> Public Well I ft. <br /> Private Well ft <br /> Irrigation Well ft. <br /> Monitoring Well fL <br /> Other I ft. <br /> 14. Will the tank(s) pending closure be replaced with an ataveground or underground storage tanks)". YES[ ] <br /> �, roe owner, <br /> 19. Indicate the responsible party to be billed for additional PIIS-EHD staff time expended beyond 3 hour minimum <br /> permit payment per tank. If the party designated below is different than the permit applicant. e., p p rt3' <br /> the parry must acknowledge this responsibility for the billing by signature and date below. <br /> Named - /7 <br /> Mailing Address 3 �3 I,' r i z <br /> Day Phone Number <br /> Date <br /> Signatur <br /> Page 6 <br />