Laserfiche WebLink
12. What is the depth to groundwater? U'n/AGNelz.2 <br /> Describe the source of information: <br /> 13. Are there any water wells on this parcel or adjacent properties? YESA NO[] <br /> TYPE OF WELLS DISTANCE TO TANKS(S) <br /> o24 <br /> Public Well / 7 ft <br /> 'NIG/I <br /> Private Well ft <br /> Irrigation Well It <br /> Monitoring Well ft <br /> Other ft <br /> 14. Will the tanks)pending closure be replaced with an aboveground or undergromid storage tank(s)?YES[I N4 <br /> 15. Indicate the responsible party to be billed for additional PHS EHD staff time expended beyond 3 hour minimum permit payment <br /> per tank. If 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 <br /> signaturree'yand date bbelow. <br /> Name_� L . <br /> Mailing Address // �/�y <br /> Day Phone Number( / 1�' 4e�j Q <br /> o6G, !Alae '7//g�o� <br /> Signature <T—Title Date <br /> EH 23 046(Revised 08/13199) Fage 6 <br /> i <br />