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12. What Is the depth to groundwater? Unknown <br /> Describe the source of Information: <br /> 13. Are there any water wells on this parcel or adjacent properties? YES (J NO jJ <br /> MTYPEOFWELLS DISTANCE TO TANES(S) <br /> ft. <br /> ft. <br /> gft. <br /> Monitoring Well ft. <br /> Other ft. <br /> 14. Will the tank(s)pending closure be replaced with an aboveground or underground storage tank(s)?YES(I NO)q <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 responslbilfty for the billing by signature and date below. <br /> Name Oil Equipment Service <br /> Mailing Address P.O. Box 950, San Andreas, CA 95249 <br /> Day Phone Number(GGGj�_209 754-1808 - <br /> l Agent 1 /28/03 <br /> S1 a Title Date <br /> Keith A. Tallia <br /> Eli 23 046 (Revised 08/13/99) Pag-' 6 <br />