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12. <br />13. <br />ld. <br />15. <br />v <br />What is the depth to groundwater? <br />50 fi-_ <br />Describe the source of information: <br />Lines of equal distance — San Joaquin County <br />Are there any water wells on this parcel or adjacent properties.? <br />TYPE OF WMIS <br />DISTANCE TO TANSS(S) <br />Public Well <br />ft. <br />Private Well <br />ft. <br />Irrigation Well <br />ft. <br />Monitoring Well <br />ft. <br />Other <br />ft. <br />YES [] NO [] <br />Will the tank(s) pending closure be replaced with an aboveground or underground storage tank(s)? YES[ ] NO[ ] <br />Indicate the responsible party to be billed for additional PHS-EHD staff time expended beyond 3 hour minimum <br />permit payment per tank. lithe 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 Gurpal Sidhu <br />Mailing Address 3032 E. Waterloo Rd., Stockton, CA 95205 <br />Day Phone Number ( 2 0 9 ) 466--9816 <br />Im <br />Signature Keith A:"T&111a-Agent <br />Page 6 <br />9/27/99 <br />Date <br />