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Jul -07-99 05 : 06P Mason-MCDuffie - Team Pro 209-477-3239 1 .03 <br /> 11. Whet N the depth to groundwater? <br /> Describe At source of information: <br /> IJ. Are there any water wells on this parcel or adlaceM properties? YES NO I I <br /> TY?E OF WELLS DISTANCE TO TAMCNS) <br /> Public Well fl. <br /> Private Well It <br /> Iâ–ºrlpllon Well rl. <br /> Monitoring Well fl <br /> Other <br /> 11. Will The lank(s) pending closure be tipleced *lth in ebov"vad or widergmed storeee lenk(s)? YES( ( h1 <br /> M Indicate the retpanslble party to he billed ror additional PIIS,EHD staff time expended beyond ) hour mfnlar <br /> permit payment per tank_ If the party detisoaied below Is different than the permit applicant a{- Property <br /> owner, the parry muff ecknowttdge that retponsibillty roe the billing by signature and dale below_ <br /> Mailing Address <br /> Der Phone Number <br /> / n Title DIN <br /> V <br /> EH 23 046 (Roe ter:d 9/11/96) Page 6 <br />