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12. What is the depth to groundwater? �� 7"0 f2�. <br /> Describe the source of information_ <br /> 13. Are there any water wells on this parcel or adjacent properties? YES [} N0x <br /> TYPE OF WELLS DISTANCE TO TANHS(S) <br /> Public Well ft. <br /> Private Well ft. <br /> Irrigation Well ft. <br /> Monitoring Well ft. <br /> I� Other ft. <br /> f14. Will the tank(s)pending closure be replaced with an aboveground or underground storage tank(s)?YESWN/01 <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 /> Namer-I vv q� <br /> Mailing Address lY 2'y� ��I^�-C� `G� �(�•� O`er �52t 9 <br /> Day Phone Number( 209 <br /> i <br /> i <br /> 3 <br /> a <br /> EH 23 046(Revised 08/13/99) Page 6 <br />