Laserfiche WebLink
12. What Is the depth to groundwater? v"V k G YJ <br /> Describe the source of Information: °'�• "T C'� � — <br /> �7 <br /> 13. Are there any water wells an this parcel or adjacent properties? YES (j N0' <br /> TYPE OF WELLS DISTANCE TO TANKS(S) <br /> Public Weft ft <br /> Private Well <br /> Irrigation Well fL <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 NO[) <br /> 15. Indicate the responsible party to be billed for additional MEHD 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 forthe billing <br /> by signature and date <br /> bellow. <br /> Name �t�n/W-2 <br /> Mailing Address 1(, 19K krW - <br /> Day Phone Number a DJ 9 Y3 - 7/3 5` <br /> giQaature Title Da e <br /> EH 23 046 (Revised 10/19/98) Page 6 <br />