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12. What is the depth to groundwater? 7-10 feet <br /> Describe the source of information: I <br /> �pfe hni a ( i UU_ q� cL �6 -) onsl /e btr tTa �I?ilbec.l _ � ftSSDG.� <br /> A ®l I I Q 19.E JJ <br /> 13. Are there any water wells on this parcel or adjacent properties? YES [ [ NO [ <br /> TYPE OF WELLS DISTANCE TO TANKS(S) <br /> Public Well ft. <br /> Private Well It. <br /> Irrigation Well ft. <br /> Monitoring Well ft. <br /> Other ft. <br /> 14. Will the tank(s) pending closure be replaced with an aboveground or underground storage tank(s)? YES[ J Nk <br /> 15. Indicate the responsible party to be billed for additional PHS-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.g. property <br /> owner, the party must acknowledge this responsibility for the billing by signature and date below. <br /> Name /,E'/ hIOA1 s <br /> Mailing Address P6 ,E3 A 166-6 ALAAZ) da9 94 567 <br /> Day Phone Number :5139- /119 10 <br /> S store Title Date <br /> EH 23 046 (Revised 9/11/96) Page 6 <br />