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12. What Is the depth to groundwater? <br /> Describe the source of Information: <br /> 13. Are there any water wells on this parcel or adjacent properties? r,, YFS [ J NO (I <br /> TYPE. OF WFLLS DISTANCE.TO TANRS(S) <br /> Public Well ft. <br /> Private Well ft. <br /> Irrigntlon Well ft. <br /> Monitoring Well ft. <br /> Other ft. <br /> 14. Will the tank(s) pending closure be replaced with an aboveground or underground storage tank(s)? YFS[ J NO`J <br /> 15. Indicate the responsible party to be billed for additional PIIS-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 Imust acknowledge this responsibility for the billing by signature and date below. <br /> Name IlP/ST S4ac CML L�01)/J'lC',ea( <br /> Mailing Address Xo( <br /> /I <br /> ,17 <br /> Day Phone Number ( 9 p) 672 9—'SSS — <br /> 31 re Date <br /> Page 6 <br />