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12. What is the depth to groundwater? <br /> 75 feet <br /> Describe the source of Information: <br /> estimate <br /> 13. Are there any water wells on this parcel or adjacent properties? YES [ ] NO [X] <br /> TYPE OF WEIU S DISTANCE TO TANKS(S) <br /> Public Well ft. <br /> Private Well ft. <br /> Irrigation Well R. <br /> Monitoring Well ft. <br /> Other ft. <br /> 14. WIII the tank(s) pending closure be replaced with an aboveground or underground storage tank(s)? YES[ ] NOf] <br /> 15. Indicate the responsible party to be billed for additional PHS-EIID 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 owner, <br /> the party must acknowledge this responsibility for the hilling by signature and date below. <br /> Name Farmington Fire Dept Attn: Don Bri2us <br /> Mailing Address 25474E Hwy 4 Farmington CA 95230 <br /> Day Phone Number �� <br /> Signature Date <br /> Page 6 <br />