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12. <br />13. <br />• <br />i <br />What Is the depth to groundwater? ESTIMATED FEET TO FEET <br />Describe the source of information: LINES OF EQUAL DEPTH SdK �pQ fir/ <br />Are there any water wells on this parcel or adjacent properties? <br />NONE KNOWN <br />E OF WELLS <br />DISTANCE TO TANES(S) <br />lic Well <br />r <br />tt <br />ate Well <br />ftrgation <br />Well <br />fL <br />Monitoring Well <br />It. <br />Otherft. <br />YES [) NO[ 9 �i <br />14. Will the tank(s) pending closure be replaced with an aboveground or underground storage tank(s)? YES( j NOjj <br />15. Indicate the responsible party to be billed for additional PHS -EH) staff time expended beyond 3 hour minimum permit payment <br />per tank. If the party designated below is different than the permit applicant, e.g. property owner, the party must acknowledge <br />this responsibility for the billing by signature and date below. <br />Name JAGENDER SINGH <br />Malflugpddreaq 650 E. MINER AVENUE, STOCKTON, CALIFORNIA 95202 <br />Day Phone Number(2 0 9 ) 466 9082 <br />G <br />OWZ,:73 Z: lO <br />Signa tie <br />U� <br />EH 23 046 (Revised 10/19/98) Page 6 <br />