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12. What is the depth to groundwater? <br /> Describe the source of information: <br /> !rater <br /> 13. Are there any water wells on this parcel or adjacent properties? YES [(j NO[] <br /> TYPE OF WELLS DISTANCE TO TANKS(S) <br /> Public Well ft. <br /> Private Well ft. <br /> Irrigation Well ft. <br /> Monitoring Well -2.o O ft. <br /> Other ft. <br /> 14. Will the tank(s)pending closure be replaced with an aboveground or underground storage tank(s)? YES[]NOW-- <br /> 15. Indicate the responsible party to be billed for additional EHD 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 <br /> owner,the party must acknowledge this responsibility for the billing by signature and date below. <br /> PrUS 4, t. ILL-t.'L% <br /> Name b (( � civ <br /> Mailing Address - l Hu <br /> Day Phone Number( ZO bl )q V1 - Z 9 1 <br /> �Qowg'�- SDC, <br /> afore ykm MTitle Date <br /> EH 23 046 (Revised 07/31/08) <br />