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iZ. What is the depth to groundwater? I ' ' <br /> Describe the source of lnfarmati n: <br /> r C rrrT�►'�.v�- <br /> 13. Are there any water wells on this parcel or adjacent properties? M [1 NO <br /> TTPE OP WELLS DISTANCE TOT S) <br /> Public Well ft. <br /> Private Well ft. <br /> Irrigation Well <br /> It. <br /> Monitorini Well It. <br /> Other ft. <br /> 14, Will the s)pending closure be replaced with an aboveground or untlerground storagetank(s)? x011 <br /> 15. Indicate the responsible party to be baled for additional PlI&8HD Matt time expanded beyond 3 hour minimum permit payment <br /> per tank. it 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 /> Name <br /> Mailing Address ,(off til[..i L I fmT, v-,r t r=; zin c. ®w TC_ok <br /> Day Phone Number C( C1 Lk i �- <br /> S tore Tide <br /> EH 23 046(Revised 10/19/98) Page 6 <br />