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What is the depth to groundwater? <br /> 12 4 5 feet <br /> Describe the source of information: g1Qod information <br /> can Joaquin County <br /> Are there any water wells on this parcel or adjacent properties? <br /> yES i 1 NO <br /> } 1 <br /> 13. - <br /> TYPE OF M ELLS DISTANCE TO TAN S(5) <br /> Public Well <br /> 750 ft. <br /> Private Well NA <br /> ft. <br /> NA <br /> Irrigation Well <br /> ft. <br /> Monitoring Well 2r500 ft. <br /> NA <br /> Other <br /> hnd or underground storage tank(s)'. YES j tiO3XIX <br /> l l N 'ill the tank(s)'pending closure be replaced with an abovegroa <br /> o property <br /> res onsible part,' to be billed for additional PHS-EHDts than the permit <br /> eapplicant e•�hour minimum <br /> Indicate p <br /> permit payment Per tank. If the part} designated below is dif eren <br /> owner, the part}' must acl:nawledge this responsibility for the billing by signature and date below• <br /> Name , Bob Eustis 95207 <br /> 5457. Covey Creek iCircie , Stockt <br /> Nlailing Address <br /> on Car <br /> 473 0501 <br /> Day Phone Number <br /> 2� o� — <br /> Date <br /> Title <br /> Signatu <br /> k <br /> Page 6 <br /> EH 23 046 (Revised 9111196) <br /> 9f n <br />