Laserfiche WebLink
12. What is the de pW to groundwater! <br />•nnnnv 11(1 nr <br />Describe the source or informations <br />GEOLOGIST <br />13. Are there any water welts on this parcel or adjacent properties? <br />NONE AWARE OF <br />TYPIK OF WE S <br />DISTANCE TO TANKS(� <br />Public Well <br />ft. <br />Private Wen <br />it. <br />Irrigstiat Well <br />R. <br />Monitoring Well <br />R. <br />Other <br />R <br />YES 11 NOXI <br />14. Will the tank(s) pending closure be replaced with an sboregrvuod or ouderrmund storage tank(s)? YES[ I NO 1X <br />15, indicate the responsible party to be billed for aldlHonal PHS•EHD staff time expended beyond 3 hoar minimum <br />permit payment per tank If the party designated below is different than the permit applicant, a g. property owner, <br />the party must acknowledge this responsibility for the billing by signature and date below. <br />Name THERESA M. rURLER <br />Mailing Address 540 N. SANTA CRUZ SUITE 123. LOS GATOS, CA 95030 <br />Day Phone Number ( 408 �— 395 3991 <br />Signature JAMES J. HOBLITZ , ,IGEN FOR OWNER <br />SEE ATTACHED AGENT—XUTFIORIZATION <br />Page C 0 <br />12 AUGUST, 1994 <br />Date <br />