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12. What is the depth to groundwater? \A, �i ULA N) <br />Describe the source of Information: <br />1& Are there any water wells on this parcel or adjacent properties? YES [I NO ( ] <br />.: I l the 1 .i pending closure :: 1 replaced w ! an aboveground 1 underground storage ! :/ YE•' I NO[ I M/1 <br />15. Indicate the responsible party f: be billed f additional why❑staff time expended beyond hourminimum permit !, 1101 <br />per i l party designated 1 : 1 '"' Is different i :• 1 the permit applicant, ' property owner,theparty ii ! ,/( 1 ' `. 1 <br />this responsibility .L 1 I 1 1' by : ygY11 and date below. <br />Mailing Address ?, LJP O SI � L4 `Z \_ 5 t 'a L\J 1, — 2=O(a A 2 5 42 <br />DayPhoneilli,::' <br />.. <br />r: - <br />Signature Titt Date <br />EH 23 046 (Revised 10/19/98) Page 6 <br />ll <br />I <br />.: I l the 1 .i pending closure :: 1 replaced w ! an aboveground 1 underground storage ! :/ YE•' I NO[ I M/1 <br />15. Indicate the responsible party f: be billed f additional why❑staff time expended beyond hourminimum permit !, 1101 <br />per i l party designated 1 : 1 '"' Is different i :• 1 the permit applicant, ' property owner,theparty ii ! ,/( 1 ' `. 1 <br />this responsibility .L 1 I 1 1' by : ygY11 and date below. <br />Mailing Address ?, LJP O SI � L4 `Z \_ 5 t 'a L\J 1, — 2=O(a A 2 5 42 <br />DayPhoneilli,::' <br />.. <br />r: - <br />Signature Titt Date <br />EH 23 046 (Revised 10/19/98) Page 6 <br />