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u ..i <br /> 12. What is the depth to groundwater? <br /> Unknown by contractor <br /> Describe the source of information: <br /> 13. Are there any water wells on this parcel or adjacent properties? YES [] N0i] <br /> TYPE OF WELLS I DISTANCE TO TAN%S(S) <br /> Public Well ri• <br /> Private Well n• <br /> Irrigation Well n <br /> Monitoring Well ft. <br /> Other tL <br /> 14. Will the tank(s)pending closure be replaced with an aboveground or underground storage tank(s)?YES[]NO[]x <br /> D staff <br /> e expended beyond 3 hour <br /> um <br /> at <br /> ment <br /> 15. Indicate rtank. It responsible party to the party designatedbbelow s diffed for rent than the ponal ermit appiimcanL e.g. roperty owner,the party must acknowlledge <br /> this responsibility for the billing by signature and date below. <br /> Name Jim Thorpe Oil , Inc. <br /> MailingAddress P.O. Box 357, Lodi, CA-95241-0357 <br /> Day Phone Number 2( 09 1 368-6175 <br /> Vice Pres. 10/19/01 <br /> Sl, a <br /> Title Date <br /> EH 23 046 (Revised 08/1:/99) Page 6 <br />