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12. What is the depth to groundwater? '>-02� / <br />Describe the source of information: Chevron <br />13. Ary there any water wells on this parcel or adjacent properties? <br />14. <br />..v� <br />TYPE OF:l <br />WELLS <br />DISTANCE TO <br />TANKS(S) <br />Public Well <br />ft. <br />Private Well <br />ft. <br />Irrigation Well <br />ft. <br />Monitoring Well <br />ft. <br />Other <br />ft. <br />YES [I NO[] <br />Will the tank(s) pending closure be replaced with an aboveground or underground storage <br />tapk(s)? YES[ ] NOK <br />15. Indicate the responsible party to be billed for additional 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 <br />Ont>(rrs7' Gor�ir,r(oil <br />Mailing Address <br />Day Phone Number <br />4 L <br />Signature <br />1). <br />61,0 <br />Title <br />EH 23 046 (Revised 3115102) Page 6 <br />---L4.1 <br />a <br />te <br />