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14. <br />What is the depth to groundwater? lJrlknDLJn <br />Describe the source of information. <br />Are there any water wells on this parcel or adjacent properties? YES [I NO[ ] <br />N U4nown <br />TYPE OF WELLS <br />DISTANCE TO TANKS(S) <br />Public Well <br />Private Well <br />ft• <br />ft. <br />Irrigation Well <br />ft= <br />Monitoring Well <br />f#. <br />Other <br />ft. <br />Will the tank(s) pending closure be replaced with an aboveground or underground storage tank(s)? YES04 NO[ ] <br />lS. 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 <br />owner, the party must acknowledge this responsibility for the billing by signature and date below. <br />Name RHL Dem n C�,xc>3 Inc <br />Mailing Address &5o Haoe Avenv� # - <br />Day Phone Number�� <br />erg+ far A, 12rlj 4/1 & L'q f5 <br />S e Tiie Date <br />EH 23 046 (Revised 9111196) Page 6 <br />