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SITE NIUVIBER <br />12, What is the depth to groundwater? <br />ilN-1'N0TYl\I AT THIS TIME <br />Describe the source of information: <br />13. <br />Are there any water wells on this parcel or adjacent properties? <br />YES [] NO 11t' <br />r 14, Will the tank(s) pending closure be replaced with an aboveground or underground storage tank(s)? YES[ i NO[4 <br />15. Indicate the responsible party to be billed for additional PHS-EIID staff time expended beyond 3 hour minimum <br />designated below is different than the permit applicant, e.g. property <br />permit payment per tank. If the party <br />owner, the party must acknowledge this responsibility for the billing by signature and date below. <br />Name SIOCKTON PORT DISTRICT <br />Mailing Address PO 13OX 2089, S OCKTON, CA 95201-2089 <br />209 946-0246 <br />Day Phone Number <br />t <br />LMTROtriMFTUAL SPF, .IALIST r <br />iiVre a <br />Title Date <br />P <br />EH 23 046 (Revised 9/11196) age <br />