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12. What is the depth to groundwater? Unkown by contractor UIQ/ 42.(� <br /> Describe the source of Information: <br /> � _Ay 0�.i.,g 2 ��Y96��t �@ivr 74�G ;gjfi-��a l e o <br /> 13. Are there any water wells on this parcel or adjacent properties? YES [] NOT] <br /> TYPE OF WELLS DISTANCE TO TANKS(S) <br /> Public Well ft. <br /> Private Well R. <br /> Irrigation Well h. <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)?YES[)NOpq <br /> 15. Indicate the responsible party to be billed for additional PHS-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 by signature and date below. <br /> Name The City of Stockton <br /> MaflingAddress 305 N. E1 Dorado St . , Suite 200 , Stockton , CA 95202 <br /> Day Phone Number( 209 ) 937-88320 <br /> Signature Title Date <br /> EH 23 046 (Revised 08/13/99) Page 6 <br />