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12 What is the depth to groundwater? L <br /> /0 <br /> Describe the source of information <br /> A0.0ILI( ;"toe IIs /A2 <br /> 13_ Are there any water wells on this parcel or adjacent properties? YES [ ] NO [�'J <br /> TYPE OF WELLS DISTANCE TO TANK(S) <br /> Public Well ft. <br /> Private Wlell ft. <br /> Irrigation Well ft. <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 [ ] NO [.�] <br /> 15. Indicate the responsible party to be billed for additional PHS-EHD staff time expended beyond 3 hour minimum permit <br /> payment per tank. If the party designated below is different than the permit applicant, e.g.,property owner,the party <br /> must acknowledge this responsibility for the billing by signature and date below. <br /> Name Robert Miloslavich <br /> Mailing Address 1 029 W. Fremont St. Stockton, CA 95203 <br /> Day Phone Number ( 209 )466-6766 <br /> Signature IDate <br /> Page 6 <br />