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12. What is the depth to groundwater? <br /> Unknown <br /> Describe the source of information: <br /> N/A <br /> 13. Are there any water wells on this parcel or adjacent properties? Unknown YES [ ] NO [ ] <br /> TYPE OF WELLS DISTANCE TO TANK.S(S) <br /> Public Well a, <br /> Private Well 1L <br /> Irrigation Well 2 <br /> Monitoring Well R <br /> Other ft. ii <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 parry 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 owner, <br /> the party must acknowledge this responsibility for the billing by signature and date below. <br /> Name DECON Environmental Services, Inc. <br /> Mailing Address 23490 Connecticut Street Hayward, CA 94545 <br /> Day Phone Number ( 510 ) 732-6444 <br /> J <br /> 1 ..� <br /> Signature Date <br /> Page 6 <br />