Laserfiche WebLink
12. <br />13. <br />14. <br />15. <br />.w <br />What Is the depth to groundwater? <br />Describe URsource of information: <br />77LO -ro 8�-0" DSP <br />_ -- - — Ai- 'ThwIL <br />Are there any water wells on this parcel or adjacent properties? <br />M <br />TYPE OF WELLS <br />DISTANCE TO TANKS(S) <br />Public Well <br />-- ft. -- <br />Private Well <br />ft. <br />Irrigation Well <br />ft. <br />Monitoring Well <br />, o) ft. t N <br />Other <br />ft. <br />YES�W <br />� motD ToAINEt W&J'--) <br />w <br />Sbe:- Arnccmp M t P — <br />(syLu x le) Raom () Mmut+ <br />Will the tank(s) pending closure be replaced with an aboveground or underground storage tank(s)? YES[ j NO[ J N iIpxfjMWTk <br />'TW1 CA!MdJU9 P INf WILL � P�PLACL,P <br />Indicate the responsible party to be billed for additional PHS-EHD staff time expended beyond 3 hour minlmum 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 by signature and date below. <br />Name <br />Mailing Address <br />May Phone Numb <br />CIEV)MAL MAn&CX. O <br />Title Date <br />EH 23 046 (Revised 08/13/99) Page 6 <br />_F' <br />596 <br />