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12. What V the depth to gronhdwater? , <br />Desbrlbe the Source of lalormallon: <br />13. Are there any water wells on this parcel orad)aeeutproperties? YES )) <br />TYPE OF WELLS <br />D19TANCE TO TMS(S) <br />Pabhe Well <br />K <br />Private Well <br />K <br />Irrl etion Well <br />K <br />Monitoring Wel <br />K <br />Other <br />K <br />Ii Will the tuMs) pending closers be replaced with an shoreground or tmderrmilstorage tuXs)?YESUN0() <br />15. <br />Indicate the responsible parry to be bWed for additional PDS EED staff time expended beyond S hour mi➢Imttm permatpayment <br />par teak It the party designated below to m?1crant than the permlt apDllcant, e.g. property owner, the party must admowledge <br />,M. Ier the billing by Slgnetuce and date below. <br />�a o r �{✓ �Dz— <br />EH <br />23 046 (Revised 09/13/99) Page 6 <br />qsz -3- / <br />