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/� (gyp — <br /> 12 Unknown by contractor A What Is the depth to groundwater? ��a <br /> Describe the source of information:` <br /> Y /Q`i ..7 Gon 1&%A Mee 0 <br /> 13. Are there any water wells on this parcel or adjacent properties? YES <br /> TYPE OE WELLS DISTANCE TO TANBS(S) <br /> Public WellI It O b <br /> Private Well I rt <br /> Irrigation Well I it <br /> Monitoring Well I it <br /> Other I n <br /> 14. Will the tank(s)pending closure be replaced with an aboveground or underground storage tank(s)?YES()NO($ <br /> 15. Indicate the responsible party to be billed for additional PHMM staff time expended beyond 3 hour minim mpermittppaaymednt <br /> per tank If the party designated below is different than the permit applicant.e.g.property owner,the party <br /> ge <br /> this responsibility for the billing by signature and date below. <br /> Name The City of Stockton <br /> hfaillngAddress 445 N. E1 Dorado St . , Stockton, CA 95202-1997 <br /> Day Phone Number( 209 1 937-8358 <br /> Signature Tie Date <br /> EH 1-3 046 (Revised 08/13199) Page 6 <br />