Laserfiche WebLink
El <br />12.*, What is the depth to groundwater? 55 <br />Describe the source of Information: ICI i sr r i <br />13.E Are there any water wells on this parcel or adjacent properties? YES [ ] NO [ <br />4 <br />TYPE OF WMJLS <br />I DISTANCE TOT (S) <br />Public Well <br />It. <br />Private Well <br />ft. <br />Irrigation Well <br />it. <br />Monitoring Well <br />ft. <br />Other <br />ft. <br />14. Will the tank(s) pending closure be replaced with an aboveground or underground storage tank(s)? NO [ <br />15. Indicate the responsible party to be billed for additional PHS-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 owner, <br />the party must acknowledge this responsibility for the billing by signature and date below. <br />Name <br />01.1.ay Phone Number <br />Signature <br />Page 6 <br />Date <br />