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12. What is the depth to groundwater? 75-0 F2.2r b SA:,: <br /> Describe the source of Information; <br /> PreyL&A Slrte work /' lJCJ"J'* WATeti SFwle- . <br /> 13. Are there any water wells on this parcel or adjacent properties? YES [I NO[J <br /> TYPE OF WELLS DISTANCE TO TANKS(S) <br /> Public Well ft <br /> Private Well ft. Z064/ <br /> Irrigation Well rL <br /> Monitoring Well rL <br /> Other ft. <br /> 14. Will the tank(s)pending closure be replaced with an aboveground or underground storage tank(s)?YES[j NOV <br /> 15. Indicate the responsible party to be billed for additional PH&EHD 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 for the billing b/y,,signature and date below. <br /> Name <br /> Mailing Address ��J1� _ f f 6Yr okll) J <br /> Day Phone Number(9 t �( 1�(off --737 7 <br /> `) 7 07 <br /> Signature / Title Date <br /> EH 23 046 (Revised 10/19/98) Page 6 <br />