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12. What is the dept ft to groundwater? <br />Aze0j, AoLer.L, <br />Describe the source of <br />13. Are there any water wells on this parcel or adjacent properties? <br />J TYPE OF WELIS <br />DISTANCE TO TANKS(S) <br />Public Well <br />ft. <br />Private Well <br />M <br />Irrigation Well <br />ft. <br />Monitoring Well <br />M <br />Other <br />ft. <br />YES X NO <br />I <br />14. Will the tank(s) pending closure he replaced with an aboveground0 torage tank(s).' YES <br />61� KrqO[ I <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 d U=nlaf: :J-- Ac— - <br />Mailing Address <br />Day Phone Number ( <br />Ohl <br />Page 6 <br />ig <br />ce <br />Date <br />