Laserfiche WebLink
uk <br />12. What is the depth to groundwater? <br />Describe the source of Information! <br />.., <br />IJ. Are there any water wells on this parcel or ndjncent properties? YES ( I NO <br />TYrr OF WELT S <br />DISTANCE. TO TANK," <br />rublle Well <br />R. <br />Private Well <br />n. <br />Irrigation Well <br />ft. <br />Monitoring Well <br />ft. <br />Other <br />ft. <br />IA. Will the lank(s) pending closure be replaced with an aboveground or undergrorad storage tank(s)? YES N0�7Q <br />15. Indicate the responsible party to be billed for additional PIIS -EAU staff time expended beyond 3 hour minimum <br />petmil pnyment per lank. If the party designated below Is different than the permit applicant, e.g. property <br />owner, the party must acknowledge this responsibility for the billing by signature and date below. <br />Name Henry Hansen c/o Right Way, Inc. <br />Mailing Address 2120 W. Lodi Ave., Lodi, CA <br />209 369-7335 <br />Pay Phone Nnmher () <br />Fit 23 046 (Revised 9/11/96) Page 6 <br />2- h JL <br />Date ; <br />