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12- What Is the depth to groundwater? <br /> Describe the 9! ''a 0 / 3 <br /> 13. Aro there any we=w ells on this parcel or aQlace�nt prvperdesT / Y I( NO(] <br /> TTFE OF WEU3 DISTANCE TO TA*IS.SP <br /> Public Woo R <br /> Private Well rt_ <br /> Irrigation Well R <br /> JHonftormg Weil -19— R <br /> Othet 'to'— R <br /> 14. wW the cangs)pending dosors be replaced with an abovegro®d or aadergronad storage tank(s)?YE*NO(-I /er <br /> 15. Indicate the reapoDsibie party to be billed for additional PHS-EMP staff time expended beyond 3 hoar mlnimnm permit payment <br /> per tank. If the party designated below Is different than the permit applicant e.g.property owner.the party must arlmewledge <br /> this rmpons1b131cy for the bmf by signature and date below. <br /> Name <br /> brAlling Address <br /> Day Phytie N ber — – --.-- <br /> slpatnre Ti Date <br /> Eli 23 046 (Revised 10/1919&) Page 6 <br /> uiTf tar hhi. �\:I BS : Ii iib �:61�.,'.T <br /> Td HdZ :ZT 366T Tc ''3Q •011 3140Hd 6J31S.'S XHd ='t'-'^S>=Jej : 1,10ai <br />